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Associations between pediatric intensive care procedures and urinary free-BPA levels

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Abstract

Background

Bisphenol A (BPA) is found in many medical materials used in the paediatric intensive care unit (PICU). Our aim was to evaluate how the urinary free-BPA(fBPA) and total-BPA(tBPA) levels were associated with the use of medical devices in the PICU in a prospective study.

Methods

The procedures applied to the patient were recorded during the follow-up period. Three urine samples were taken on the first day of hospitalization; the seventh day, and after 30 days or when the patients were discharged. Urinary tBPA and fBPA levels were determined using high-pressure liquid chromatography. Generalized estimating equations with repetitive measures were used to determine the associations between PICU procedures and BPA levels.

Results

A total of 115 urine samples of 40 children were studied. Mean urinary levels were 189.2 μg/g-creatinine for tBPA and 27.8 μg/g-creatinine for fBPA, and the fBPA/tBPA ratio was 27.9%. Endotracheal intubation, catheter, and haemodialysis procedures caused higher urinary fBPA levels. External drains, inhaler treatment, and the use of four or more medical devices were associated with considerably higher values of fBPA%. The increase in tBPA was positively correlated with fBPA.

Conclusions

fBPA levels and the fBPA/tBPA ratio varied according to the procedure and level of BPA exposure in children.

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Data availability

For access to the files, please send an e-mail request to siyalcin@hacettepe.edu.tr.

Code availability

Not applicable.

References

  • Abraham A, Chakraborty P (2020) A review on sources and health impacts of bisphenol A. Rev Environ Health 35(2):201–210. https://doi.org/10.1515/reveh-2019-0034

    Article  CAS  Google Scholar 

  • Aguilar F, Autrup H, Barlow S, Castle L, Crebelli R, Dekant W et al (2008) Toxicokinetics of bisphenol A scientific opinion of the panel on food additives, flavourings, processing aids and materials in contact with food (AFC). EFSA J 759:1–10

    Google Scholar 

  • Authority E (2015) Scientific opinion on the risks to public health related to the presence of bisphenol A (BPA) in foodstuffs. EFSA J 13(1)

  • Ayar G, Yalçın SS, Emeksiz S, Yırün A, Balcı A, Kocer-Gumusel B, Erkekoğlu P (2021) The Association Between Urinary BPA Levels and Medical Equipment Among Pediatric Intensive Care Patients. Environ Toxicol Pharmacol 103585:103585. https://doi.org/10.1016/j.etap.2021.103585

    Article  CAS  Google Scholar 

  • Badding MA, Vargas JR, Fortney J, Cheng QJ, & Ho, C.-H. (2020). Toxicological risk assessment of bisphenol a released from dialyzers under simulated-use and exaggerated extraction conditions. Regul Toxicol Pharmacol 118: 104787. https://doi.org/10.1016/j.yrtph.2020.104787.

  • Bernard L, Bailleau M, Eljezi T, Chennell P, Souweine B, Lautrette A, Sautou V (2020) How does continuous venovenous hemofiltration theoretically expose (ex-vivo models) inpatients to diethylhexyladipate, a plasticizer of PVC medical devices? Chemosphere Jul 250:126241. https://doi.org/10.1016/j.chemosphere.2020.126241

    Article  CAS  Google Scholar 

  • Bernard L, Bouattour Y, Masse M, Boeuf B, Decaudin B, Genay S, Lambert C, Moreau E, Pereira B, Pinguet J, Richard D, Sautou V, for the ARMED Study Group (2021) Association between Urinary Metabolites and the Exposure of Intensive Care Newborns to Plasticizers of Medical Devices Used for Their Care Management. Metabolites 11(4):252. https://doi.org/10.3390/metabo11040252

    Article  CAS  Google Scholar 

  • Bosch-Panadero E, Mas S, Sanchez-Ospina D, Camarero V, Perez-Gomez MV, Saez-Calero I et al (2016) The Choice of Hemodialysis Membrane Affects Bisphenol A Levels in Blood. J Am Soc Nephrol 27(5):1566–1574. https://doi.org/10.1681/ASN.2015030312

    Article  CAS  Google Scholar 

  • Boucher JG, Boudreau A, Ahmed S, Atlas E (2015) In Vitro Effects of Bisphenol A beta-D-Glucuronide(BPA-G) on Adipogenesis in Human and Murine Preadipocytes. Environ Health Perspect 123(12):1287–1293. https://doi.org/10.1289/ehp.1409143

    Article  CAS  Google Scholar 

  • Calafat AM, Weuve J, Ye X, Jia LT, Hu H, Ringer S, Huttner K, Hauser R (2009) Exposure to bisphenol A and other phenols in neonatal intensive care unit premature infants. Environ Health Perspect 117(4):639–644. https://doi.org/10.1289/ehp.0800265

    Article  CAS  Google Scholar 

  • Duty SM, Mendonca K, Hauser R, Calafat AM, Ye X, Meeker JD, Ackerman R, Cullinane J, Faller J, Ringer S (2013) Potential sources of bisphenol A in the neonatal intensive care unit. Pediatrics 131(3):483–489. https://doi.org/10.1542/peds.2012-1380

    Article  Google Scholar 

  • Eckert E, Müller J, Höllerer C, Purbojo A, Cesnjevar R, Göen T, Münch F (2020) Plasticizer exposure of infants during cardiac surgery. Toxicol Lett 330:7–13. https://doi.org/10.1016/j.toxlet.2020.04.004

    Article  CAS  Google Scholar 

  • Gaynor JW, Ittenbach RF, Calafat AM, Burnham NB, Bradman A, Bellinger DC, Henretig FM, Wehrung EE, Ward JL, Russell WW, Spray TL (2019) Perioperative exposure to suspect neurotoxicants from medical devices in newborns with congenital heart defects. Ann Thorac Surg 107(2):567–572. https://doi.org/10.1016/j.athoracsur.2018.06.035

    Article  Google Scholar 

  • Genuis SJ, Beesoon S, Birkholz D, Lobo RA (2012) Human excretion of bisphenol A: blood, urine, and sweat (BUS) study. J Environ Public Health 2012:185731–185710. https://doi.org/10.1155/2012/185731

    Article  CAS  Google Scholar 

  • Ginsberg G, Rice DC (2009) Does rapid metabolism ensure negligible risk from bisphenol A? Environ Health Perspect 117(11):1639–1643

    Article  CAS  Google Scholar 

  • Ho K-L, Yuen K-K, Yau M-S, Murphy MB, Wan Y, Fong BM-W, Tam S, Giesy JP, Leung KSY, Lam MHW (2017) Glucuronide and sulfate conjugates of bisphenol A: Chemical synthesis and correlation between their urinary levels and plasma bisphenol A content in voluntary human donors. Arch Environ Contam Toxicol 73(3):410–420

    Article  CAS  Google Scholar 

  • Kaestner F, Seiler F, Rapp D, Eckert E, Müller J, Metz C, Bals R, Drexler H, Lepper PM, Göen T (2020) Exposure of patients to di (2-ethylhexy) phthalate (DEHP) and its metabolite MEHP during extracorporeal membrane oxygenation (ECMO) therapy. PLoS One 15(1):e02249. https://doi.org/10.1371/journal.pone.0224931

    Article  CAS  Google Scholar 

  • Lušin TT, Roškar R, Mrhar A (2012) Evaluation of bisphenol A glucuronidation according to UGT1A1* 28 polymorphism by a new LC–MS/MS assay. Toxicology 292(1):33–41

    Article  Google Scholar 

  • Mas S, Bosch-Panadero E, Abaigar P, Camarero V, Mahillo I, Civantos E, Sanchez-Ospina D, Ruiz-Priego A, Egido J, Ortiz A, González-Parra E (2018) Influence of dialysis membrane composition on plasma bisphenol A levels during online hemodiafiltration. PLoS One 13(3):e0193288. https://doi.org/10.1371/journal.pone.0193288

    Article  CAS  Google Scholar 

  • Nachman RM, Fox SD, Golden WC, Sibinga E, Veenstra TD, Groopman JD, Lees PSJ (2013) Urinary free bisphenol A and bisphenol A-glucuronide concentrations in newborns. J Pediatr 162(4):870–872. https://doi.org/10.1016/j.jpeds.2012.11.083

    Article  CAS  Google Scholar 

  • Panagiotopoulou EC, Fouzas S, Douros K, Triantaphyllidou IE, Malavaki C, Priftis KN, Karamanos NK, Anthracopoulos MB (2015) Increased beta-glucuronidase activity in bronchoalveolar lavage fluid of children with bacterial lung infection: A case-control study. Respirology 20(8):1248–1254. https://doi.org/10.1111/resp.12596

    Article  Google Scholar 

  • Snyder RW, Maness SC, Gaido KW, Welsch F, Sumner SC, Fennell TR (2000) Metabolism and disposition of bisphenol A in female rats. Toxicol Appl Pharmacol 168(3):225–234. https://doi.org/10.1006/taap.2000.9051

    Article  CAS  Google Scholar 

  • Testai E (2016) The safety of the use of bisphenol A in medical devices. Regul Toxicol Pharmacol 79:106–107

    Article  CAS  Google Scholar 

  • Thayer KA, Doerge DR, Hunt D, Schurman SH, Twaddle NC, Churchwell MI, Garantziotis S, Kissling GE, Easterling MR, Bucher JR, Birnbaum LS (2015) Pharmacokinetics of bisphenol A in humans following a single oral administration. Environ Int 83:107–115. https://doi.org/10.1016/j.envint.2015.06.008

    Article  CAS  Google Scholar 

  • Vandenberg LN, Chahoud I, Heindel JJ, Padmanabhan V, Paumgartten FJ, Schoenfelder G (2012) Urinary, circulating, and tissue biomonitoring studies indicate widespread exposure to bisphenol A. Cien Saude Colet 17(2):407–434. https://doi.org/10.1590/s1413-81232012000200015

    Article  Google Scholar 

  • Völkel W, Colnot T, Csanády GA, Filser JG, Dekant W (2002) Metabolism and kinetics of bisphenol A in humans at low doses following oral administration. Chem Res Toxicol 15(10):1281–1287

    Article  Google Scholar 

  • Völkel W, Kiranoglu M, Fromme H (2008) Determination of free and total bisphenol A in human urine to assess daily uptake as a basis for a valid risk assessment. Toxicol Lett 179(3):155–162

    Article  Google Scholar 

  • Völkel W, Kiranoglu M, Fromme H (2011) Determination of free and total bisphenol A in urine of infants. Environ Res 111(1):143–148. https://doi.org/10.1016/j.envres.2010.10.001

  • Willhite CC, Ball GL, McLellan CJ (2008) Derivation of a bisphenol A oral reference dose (RfD) and drinking-water equivalent concentration. J Toxicol Environ Health B Crit Rev 11(2):69–146. https://doi.org/10.1080/10937400701724303

    Article  CAS  Google Scholar 

  • Yanagisawa R, Koike E, Win-Shwe TT, Takano H (2019) Oral exposure to low dose bisphenol A aggravates allergic airway inflammation in mice. Toxicol Rep 6:1253–1262. https://doi.org/10.1016/j.toxrep.2019.11.012

    Article  CAS  Google Scholar 

  • Ye X, Kuklenyik Z, Needham LL, Calafat AM (2005) Quantification of urinary conjugates of bisphenol A, 2,5-dichlorophenol, and 2-hydroxy-4-methoxybenzophenone in humans by online solid phase extraction-high performance liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 383(4):638–644. https://doi.org/10.1007/s00216-005-0019-4

    Article  CAS  Google Scholar 

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Acknowledgements

The authors are grateful to all volunteers for participating in this study.

Funding

Hacettepe University Scientific Research Projects Coordination Unit; TDK-2018-17392

Author information

Authors and Affiliations

  1. Ministry of Health, Ankara City Hospital, Children’s Hospital, Bilkent, Ankara, Turkey

    Ganime Ayar & Serhat Emeksiz

  2. Faculty of Medicine, Department of Pediatrics, Hacettepe University, Sıhhiye, Ankara, Turkey

    Sıddıka Songül Yalçın

  3. Faculty of Pharmacy, Department of Toxicology, Hacettepe University, Sihhiye, Ankara, Turkey

    Anıl Yırün, Aylin Balcı & Pınar Erkekoğlu

Authors
  1. Ganime Ayar
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  2. Sıddıka Songül Yalçın
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  3. Anıl Yırün
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  4. Serhat Emeksiz
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  5. Aylin Balcı
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  6. Pınar Erkekoğlu
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Contributions

SSY and GA contributed to the conception or design of the work. GA and SE contributed to the acquisition of data. AY, AB, and PE performed laboratory analysis. SSY contributed to the statistical analysis and interpretation of data for the work. GA prepared the draft of the manuscript. SSY and GA gave the final manuscript. All of the authors gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

Corresponding author

Correspondence to Sıddıka Songül Yalçın.

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Ethics approval

Ethical Committee of Ankara Children’s Hematology Oncology Education and Research Hospital (Number: GO 18/570) approved the protocol.

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Not applicable.

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All parents gave written consent for participation.

Conflict of interest

The authors declare no competing interests.

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Responsible Editor: Lotfi Aleya

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Ayar, G., Yalçın, S.S., Yırün, A. et al. Associations between pediatric intensive care procedures and urinary free-BPA levels. Environ Sci Pollut Res 29, 13555–13563 (2022). https://doi.org/10.1007/s11356-021-16677-2

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  • DOI: https://doi.org/10.1007/s11356-021-16677-2

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