{"id":31212,"date":"2020-03-28T10:18:38","date_gmt":"2020-03-28T10:18:38","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=31212"},"modified":"2020-04-22T12:30:16","modified_gmt":"2020-04-22T12:30:16","slug":"evaluation-of-phthalate-in-breast-milk-and-urine-of-lactating-women-in-egypt","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol13no1\/evaluation-of-phthalate-in-breast-milk-and-urine-of-lactating-women-in-egypt\/","title":{"rendered":"Evaluation of Phthalate in Breast Milk and Urine of Lactating Women in Egypt"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

Phthalates,1<\/sup> or phthalate esters are added to plastics making them more flexible, durable, transparent and long lived; therefore they are used in softening polyvinyl chloride (PVC). Due to low cost, di(2-ethylhexyl) phthalate (DEHP) was the main plasticizer and benzyl butyl phthalate (BBP) is used in the manufacture of flooring material. In the US, Canada and European Union, they are replaced by many products due to health concerns where non phthalate plasticizers are used instead 2<\/sup><\/p>\n

They are also found in modern electronics, catheters, enteric coatings of pharmaceutical pills, blood transfusion devices as well as nutritional supplements and personal-care products (perfumes, eye shadows, moisturizers, nail polish, liquid soap, hair spray).3<\/sup> This leads to high non-occupational human exposure (ingestion, dermal contact and,4<\/sup> parenteral exposure).5<\/sup><\/p>\n

They are rapidly metabolized and excreted in urine and feces.4<\/sup> Monoesters (mono butyl phthalate) are excreted unchanged in urine and feces or may undergo biotransformation to produce more water soluble glucuronide conjugates increasing urinary excretion.4,6<\/sup> Monoesters can be measured in urine, breast milk, serum, saliva, seminal plasma and amniotic fluid using High Performance Liquid Chromatography (HPLC).7,8,9<\/sup><\/p>\n

During gestation, phthalates may cause male infertility where semen quality and volume are decreased and sperms show increased damaged DNA and decreased motility.10,11,12,13,14 <\/sup>Exposure may be also associated with diabetes,15,16<\/sup> breast cancer, obesity, metabolic disorders, and immune function.17<\/sup> It may also develop ADHD, autistic behaviors in children.18,19<\/sup><\/p>\n

So in our study, detection of\u00a0 Monoesters (mono butyl phthalate) by HPLC is very important to be detected in breast milk and urine of lactating women is important\u00a0 to avoid potential risk of phthalate toxicity to mother as well as her newborn infant.<\/p>\n

Aim of the Study<\/strong><\/p>\n

Since phthalates are proven harmful to the health of human beings and newborn infants (especially neurodevelopment), so our study is concerned about assessing and detecting phthalates in milk of lactating women in different stages of lactation as milk is the main nutritional source for newborns and infants compared to urinary detection of exposure level of mothers.<\/p>\n

\u00a0Methodology<\/strong><\/p>\n

Mono-n-Butyl phthalate (MnBp), a metabolite of di-n-butyl phthalate was detected in the breast milk and urine of 20, randomly selected, lactating females house wife\u2019s (to exclude occupational exposures) \u00a0from Helwan Primary Health Center \u2013 Cairo \u2013 Egypt.<\/p>\n

Written informed consents from all participant in the study with no disclosure for names or any data of patients as we use serial number in all our samples and the consent include acceptance for publication of the data\u00a0 as well as the approval of Human Research Ethical Committee were done. Sample analysis was conducted in The Micro Analytical Center \u2013 Faculty of Science \u2013 Cairo University.<\/p>\n

History<\/strong><\/p>\n

Personal history \u00e0 name, age, marital status, special habits of medical importance.<\/p>\n

Medical history \u00e0 hypertension, diabetes, kidney or liver disease, any neurological symptoms as well as history of blood transfusion or intravenous drug intake.<\/p>\n

Exposure history \u00e0 smoking (active or passive) and duration of exposure, cosmetic use, drinking in plastic bottles and eating in plastic containers.<\/p>\n

Surgical history.<\/p>\n

Questionnaire<\/strong><\/p>\n

Table 1: English <\/strong>translated questionnaire:<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Name:<\/strong><\/td>\n<\/td>\n<\/tr>\n
Age:<\/strong><\/td>\n<\/td>\n<\/tr>\n
Occupation:<\/strong><\/td>\n<\/td>\n<\/tr>\n
Present history:<\/strong><\/td>\nComplaint<\/td>\n<\/tr>\n
<\/td>\nSystem related to complaint<\/td>\n<\/tr>\n
Past history<\/strong><\/td>\nSimilar problems:<\/td>\n<\/tr>\n
previous illness (DM, HTN, bronchial asthma, others)<\/td>\n<\/tr>\n
operations<\/td>\n<\/tr>\n
blood transfusion<\/td>\n<\/tr>\n
hospital admissions<\/td>\n<\/tr>\n
Drug history<\/strong><\/td>\nMedications or over the counter drugs \u00e0 regular or irregular intake and duration of intake.<\/td>\n<\/tr>\n
Illicit drug use.<\/td>\n<\/tr>\n
Family history<\/strong><\/td>\nSimilar problems.<\/td>\n<\/tr>\n
DM, HTN, bronchial asthma.<\/td>\n<\/tr>\n
Social history<\/strong><\/td>\nDaily activity.<\/td>\n<\/tr>\n
Smoking, alcohol.<\/td>\n<\/tr>\n
Family.<\/td>\n<\/tr>\n
Potential\u00a0 Sources of Exposure to Phthalates<\/strong><\/td>\n<\/tr>\n
Occupational Exposure<\/strong><\/td>\n<\/tr>\n
<\/td>\nPVC plastic factories<\/td>\n<\/tr>\n
<\/td>\nPerfume industry<\/td>\n<\/tr>\n
<\/td>\nCosmetic industry<\/td>\n<\/tr>\n
Dietary Exposure<\/strong><\/td>\n<\/tr>\n
<\/td>\nContainer type<\/td>\nFrequency\/week<\/td>\n<\/tr>\n
\u00a0Consumer\u00a0Products<\/td>\n<\/tr>\n
<\/td>\nHousehold cleaners 2hours\/ week<\/strong><\/td>\n<\/tr>\n
<\/td>\nPerfumes<\/td>\n<\/tr>\n
<\/td>\nSoaps , shampoos<\/td>\n<\/tr>\n
Material Used in Building<\/strong><\/td>\n<\/tr>\n
<\/td>\nHome built time period<\/td>\n<\/tr>\n
<\/td>\n1969 or earlier<\/td>\n<\/tr>\n
<\/td>\n1970-1979<\/td>\n<\/tr>\n
<\/td>\n1980-1989<\/td>\n<\/tr>\n
<\/td>\n1990-1999<\/td>\n<\/tr>\n
<\/td>\n2000-2010<\/td>\n<\/tr>\n
<\/td>\nIn last year<\/td>\n<\/tr>\n
<\/td>\nFlooring material<\/td>\n<\/tr>\n
<\/td>\nPoly vinyl flooring<\/td>\n<\/tr>\n
<\/td>\nWood<\/td>\n<\/tr>\n
<\/td>\nWall materials<\/td>\n<\/tr>\n
<\/td>\nWall paper<\/td>\n<\/tr>\n
<\/td>\nVinyl<\/td>\n<\/tr>\n
<\/td>\nWood<\/td>\n<\/tr>\n
<\/td>\nTextile<\/td>\n<\/tr>\n
<\/td>\nVentilation system<\/td>\n<\/tr>\n
<\/td>\nNatural<\/td>\n<\/tr>\n
<\/td>\nMechanical exhaust<\/td>\n<\/tr>\n
<\/td>\nMechanical exhaust and supply<\/td>\n<\/tr>\n
Medical Exposure<\/strong><\/td>\n<\/tr>\n
<\/td>\nChronic need for blood transfusion<\/td>\n<\/tr>\n
<\/td>\nChronic use of any IV preparations<\/td>\n<\/tr>\n
Do you agree to share in research about phthalate exposure<\/strong><\/td>\nNO<\/strong><\/td>\nYES<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Laboratory Investigations<\/strong><\/p>\n

Comparative assessment of MnBP in breast milk and urine obtained from 20 lactating females.<\/p>\n

MnBp (>99.9%) \u00e0 from FLUKA, Inc.<\/p>\n

Methanol, acetonitrile, ethyl acetate and dichloromethane \u00e0 from Carlo Erba group, Inc. All solvents are HPLC grade.<\/p>\n

\u03b2-glucuronidase (Escherichia coli<\/em>-K12<\/sub>) \u00e0 from Roche Biomedical.<\/p>\n

Water was purified using a direct-Q gradient 8 UV system (Millipore).<\/p>\n

Sample collection<\/strong><\/p>\n

Urine Specimens<\/strong><\/p>\n

Urine specimens were labeled with the subject identification number.<\/p>\n

Turbid samples or those containing blood were excluded.<\/p>\n

They were then analyzed by HPLC in the laboratory of Faculty of Science \u2013 Cairo University.<\/p>\n

Collected urine samples (pooled from individuals) were stored at -40 \u00b0C.<\/p>\n

In this study, plastic equipment\u2019s were not used to avoid contamination; all glass apparatuses were washed with chromic acid solution and rinsed with deionized water and methanol before drying.<\/p>\n

Breast Milk Specimens<\/strong><\/p>\n

A single sample was collected from each lactating female.<\/p>\n

To assess average exposure, samples consisted of many small aliquots collected over successive infant feeds up to a volume of 50ml.<\/p>\n

Samples were collected and stored in 250-mL Pyrex glass bottles with Teflon-coated caps.<\/p>\n

Oral and written instructions were given to mothers to feed their baby first before milk aliquot collection (hind milk).<\/p>\n

This collection method was chosen to ensure that breastfeeding had been well established beforehand.<\/p>\n