Editing Apheresis (section)

===== Plasticizer exposure =====

Apheresis uses plastics and tubing, which come into contact with the blood. The plastics are made of [[PVC]] in addition to additives such as a [[plasticizer]], often [[DEHP]]. DEHP leaches from the plastic into the blood, and people have begun to study the possible effects of this leached DEHP on donors as well as transfusion recipients.<ref>{{cite journal |vauthors=Larsson L, Sandgren P, Ohlsson S, Derving J, Friis-Christensen T, Daggert F, Frizi N, Reichenberg S, Chatellier S, Diedrich B, Antovic J, Larsson S, Uhlin M |title=Non-phthalate plasticizer DEHT preserves adequate blood component quality during storage in PVC blood bags |journal=Vox Sang |volume=116 |issue=1 |pages=60–70 |date=January 2021 |pmid=32918773 |doi=10.1111/vox.12982 |doi-access=free }}</ref>
* "current risk or preventive limit values for DEHP such as the RfD of the US EPA (20 μg/kg/day) and the TDI of the European Union (20–48 μg/kg/day) can be exceeded on the day of the plateletpheresis. ... Especially women in their reproductive age need to be protected from DEHP exposures exceeding the above mentioned preventive limit values."<ref>{{cite journal |doi=10.1007/s00204-005-0004-x |title=Intravenous exposure to di(2-ethylhexyl)phthalate (DEHP): Metabolites of DEHP in urine after a voluntary platelet donation |year=2005 |last1=Koch |first1=Holger M. |last2=Bolt |first2=Hermann M. |last3=Preuss |first3=Ralf |last4=Eckstein |first4=Reinhold |last5=Weisbach |first5=Volker |last6=Angerer |first6=Jürgen |journal=Archives of Toxicology |volume=79 |issue=12 |pages=689–93 |pmid=16059725|s2cid=743051 }}</ref>
* "Commercial plateletpheresis disposables release considerable amounts of DEHP during the apheresis procedure, but the total dose of DEHP retained by the donor is within the normal range of DEHP exposure of the general population."<ref>{{cite journal |doi=10.1046/j.1537-2995.2003.00479.x |title=Donor exposure to the plasticizer di(2-ethylhexyl)phthalate during plateletpheresis |year=2003 |last1=Buchta |first1=Christoph |last2=Bittner |first2=Claudia |last3=Höcker |first3=Paul |last4=Macher |first4=Maria |last5=Schmid |first5=Rainer |last6=Seger |first6=Christoph |last7=Dettke |first7=Markus |s2cid=34539126 |journal=Transfusion |volume=43 |issue=8 |pages=1115–20 |pmid=12869118}}</ref>
* The Baxter company manufactured blood bags without [[DEHP]], but there was little demand for the product in the marketplace
<!-- * Some apheresis products are now manufactured in China. <ref>http://nigale.en.alibaba.com/offerdetail/203354126/Sell_Single_use_Apheresis_Plasma_Separating_Kit.html {{Bare URL inline|date=May 2022}}</ref> -->
* "Mean DEHP doses for both plateletpheresis techniques (18.1 and 32.3 μg/kg/day) were close to or exceeded the reference dose (RfD) of the US EPA and tolerable daily intake (TDI) value of the EU on the day of the apheresis. Therefore, margins of safety might be insufficient to protect especially young men and women in their reproductive age from effects on reproductivity. At present, discontinuous-flow devices should be preferred to avert conceivable health risks from plateletpheresis donors. Strategies to avoid DEHP exposure of donors during apheresis need to be developed."<ref>{{cite journal |doi=10.1016/j.ijheh.2005.07.001 |title=Di(2-ethylhexyl)phthalate (DEHP) exposure of voluntary plasma and platelet donors |year=2005 |last1=Koch |first1=Holger M. |last2=Angerer |first2=Jürgen |last3=Drexler |first3=Hans |last4=Eckstein |first4=Reinhold |last5=Weisbach |first5=Volker |journal=International Journal of Hygiene and Environmental Health |volume=208 |issue=6 |pages=489–98 |pmid=16325559}}</ref>