Plasticizers, antioxidants, and other contaminants found in air delivered by PVC tubing used in respiratory therapy.

Of the many compounds that leach from respiratory therapy tubing into air passing through it, we selected five compounds to analyze. The five compounds are known to be potentially carcinogenic, toxic or known to induce estrogenic activity. Parts-per-million and parts-per-billion concentrations of these species were found in the air passing through the tubing: the plasticizers di-(2-ethylhexyl) phthalate (DEHP) and di-ethyl phthalate (DEP), the antioxidants butylated hydroxy toluene (BHT) and p-nonylphenol (p-NP), and the contaminant (from commercial preparation of DEHP) 2-ethylhexanol (2-EH). These levels are high enough to cause some concern about exposure for patients who use oxygen on a long-term basis, those sensitive or allergic to these species, or those with asthma. A method was developed for analysis of solid tubing samples, showing great variability in concentrations of small, volatile molecules from sample to sample. A method was also developed for pre-concentration of small molecules onto Tenax adsorbants from air passing through the tubing. Both solid samples and adsorbant loaded with analyte were analyzed by direct dynamic thermal desorption gas chromatography mass spectrometry (GCMS). This study does not imply that adverse reactions by patients to chemical compounds leaching from respiratory medical tubing will occur but that further investigation is warranted. Copyright 2003 John Wiley & Sons, Ltd.