Toxicology of di-2-ethylhexyl phthalate and other phthalic acid ester plasticizers.

The first poly(vinyl chloride) blood bag containing di-2-ethylhexyl phthalate (DEHP) as a plasticizer was introduced in medicine in 1950. Since then, millions of liters of blood collected in plastic have been transfused. Aside from the obvious advantages of plastic over glass containers for the collection, storage and transfusion of blood, plastic containers have made blood component therapy possible; at least six different blood fractions can now be separated aseptically from whole blood and administered individually to the patient as needed. Poly(vinyl chloride) plastics containing DEHP also have been employed in a variety of other biomedical devices, including transfusion and infusion assemblies, administration sets, artificial kidney connecting tubing, bubble-type oxygenators, catheters, enema and urinary drainage bags, etc. Plasticized poly(vinyl chloride) plastics were selected for these medical applications principally because of their unique physical properties, ease of fabrication, low cost, and apparent safety. To provide the necessary flexibility, relatively high levels of plasticizer (up to 40%) must be blended into the plastic formulation. Recent reports have identified milligram-% quantities of DEHP in blood or plasma