Understanding the Concerns with DEHP & Urinary Health
- By Lisa Wells
- May 08, 2018
On March 1, 1987, after a popular voter initiative was approved, the state of California created a comprehensive list of “Chemicals Known to Cause Cancer or Reproductive Toxicity.”
Because of this legislative action, Proposition 65 labeling came into effect. You’ll see the Prop 65 label today on many home medical equipment products manufactured with chemicals that fall under this category.
Unfortunately, some products on the market today may not be labelled with a Prop 65 warning, even if they are made with chemicals on that California list.
Health Risks Associated with DEHP
DEHP (Di[2-ethylhexyl]phthalate) is a chemical commonly used in traditional catheter manufacturing. DEHP is a plastic softener that is often used in the manufacturing process to make PVC more flexible, and it is listed on the Proposition 65 registry as a chemical that can cause cancer and reproductive toxicity in males.
The health risk from DEHP is severe enough that the federal government has banned it from being used in children’s toys due to the chemical’s ability to be absorbed through the mouth and skin.
Several kinds of medical devices, including some catheters, still contain DEHP — and this is currently legal. However, if you can avoid these chemicals altogether in the products that you offer to your complex rehab clients, there are compelling health reasons to do so.
Reducing exposure to known carcinogens is a legitimate concern for people at a higher risk for cancer due to hereditary issues or other health issues. For example, the incidence rate of bladder cancer in people who have spinal cord injury (SCI) is 16 to 28 times higher than that of the general non-injured population, according to a research study published by model SCI center Craig Rehabilitation Hospital in Englewood, Colo.
Options Exist to Avoid DEHP in Urinary Catheters
The good news is that a large selection of quality-made, user-friendly intermittent catheters exist today that are not made with DEHP.
Cure Medical CEO John Anderson explains, “The use of DEHP in catheters creates a number of health risks, including patient exposure to hazardous chemicals which leach from vinyl medical devices.
“When there are options available to create intermittent catheters that work just as well as those made with standard chemicals, there’s really just no reason to use these chemicals anymore if you can avoid it. Cure Medical believes it’s the right thing to do, so we made the decision to go without DEHP in our products,” Anderson adds.
Medical Professionals Understand the Health Risks of DEHP
Expert urologist Dr. Gerard Henry sees patients from all over the world at his practice, Ark-La-Tex Urology, because of his skill and reputation in treating male urinary incontinence, erectile dysfunction and urinary difficulties. He received his medical degree from University of North Carolina at Chapel Hill School of Medicine, and completed a six-year urology residency at Duke University in Durham, N.C., including a one-year basic science research fellowship. Henry has been in practice for more than 20 years.
“Catheter users should care about DEHP and BPA, because they are known carcinogens and known to cause reproductive harm,” Henry says.
“As a medical professional, my first rule is Do No Harm,” he continues. “If I was discussing with my medical colleagues what they were prescribing, if they were still prescribing catheters that are made with DEHP, I would refer them to that landmark study from Craig Hospital. Anything you can do to avoid known carcinogens is a good idea.”
Cure Medical founder Bob Yant also agrees on the importance of DEHP awareness and avoiding it if at all possible. Yant is a C5 quadriplegic and an intermittent catheter user himself.
“I was the first person with spinal cord injury to start a retail company in this industry, and I was the first person with SCI to start a manufacturing company for intermittent catheters. I devote much of my time to raising money for spinal cord injury and urinary retention medical research, so I am well versed in the health risks associated with DEHP,” Yant explains. “That’s one of the many reasons why Cure Medical catheters are not made with DEHP, BPA or natural rubber latex.”
What You Can Do to Avoid DEHP
While complex rehab technology providers don’t have to take the Hippocratic Oath, most who are genuinely concerned about serving their community will help their customers avoid the health risks listed above. Ask your manufacturing partners to identify which of their products are made with Prop 65 chemicals so that you and your team are fully aware.
Offer alternative products, such as intermittent catheters that are not made with chemicals like DEHP, for customers who have concerns or are at a higher risk of developing cancer. When you do, be sure to educate your clinical referral sources that you have these options available for their patients, too.
Learn More About DEHP and Proposition 65
Prop 65 News: News and details about California’s Safe Drinking Water and Toxic Enforcement Act, better known by its original name, Proposition 65 – www.prop65news.com
“Bladder cancer in patients with spinal cord injury”: https://www.ncbi.nlm.nih.gov/pubmed/14992333
Dr. Henry Video on the Risks of DEHP in Catheters: https://www.youtube.com/embed/09LcP0mXis0