HCWH's co-founder Gary Cohen is a recipient of the prestigious Skoll Award. This video, chronicling the evolution of HCWH's work, premiered at the 2009 Skoll World Forum. enlarge video
Tools and Resources
- Reducing Your Use of PVC
- About Exposure to and Hazards of DEHP
- Wikipedia Articles
- Examples of Seminal DEHP Studies
- Phthalates and Infant Reproductive Health
- High DEHP Exposure of Neonates in Hospital
Reducing Your Use of PVC
HCWH Europe Factsheets
HCWHE has published several factsheets to help hospitals understand the basic steps they need to go through, and demonstrate that they aren't the first (and won't be the last!) to do so.
- Healthy & Sustainable Flooring, choosing resilient flooring for the European healthcare sector
- How to survey PVC use in your hospital and begin a successful PVC phase-out programme (pdf)
- PVC/DEHP phase-out is possible anywhere in Europe: Model hospitals show how to succeed (pdf)
- Alternatives to PVC and DEHP Medical Devices on the European Market (pdf)
Karolinska University Hospital Report
Karolinska UH was responding to Stockholm County Council's goal, originally put forward in 1997, to phase out PVC. With HCWH, they inventoried their use of soft PVC plastics, prioritising for elimination those used for extended periods with vulnerable patients.
A secondary goal of the project was to better understand staff needs, which influence PVC use, and look at ways of encouraging adoption of alternatives.
Download the Report: PVC in Medical Devices: An Inventory of PVC and Phthalates Containing Devices Used in Health Care (pdf)About Exposure to and Hazards of DEHP
Download the HCHW factsheet: Neonatal Exposure to DEHP and Opportunities for Prevention, 3rd Edition
Wikipedia Articles
Examples of Seminal DEHP Studies
Gray, TJ et al. (1984). Effect of some phthalate esters and other testicular toxins on primary cultures of testicular cells
Since 1984, studies have consistently found that MEHP, one of the metabolytes of DEHP, consistently produces developmental, reproductive and hepatic toxicity in animals. Read the article.
Swan et al. (2005). Decrease in anogenital distance among male infants with prenatal phthalate exposure
The study is known for its novel use of anogenital distance as an indicator of potentially abnormal sexual development in baby boys, finding that exposure to DEHP reduces that distance, which suggests feminisation. Read the article.
Also see a recent study by same author "Environmental phthalate exposure in relation to reproductive outcomes and other health endpoints in humans", which linked DEHP exposure to a wide range of indicators of abnormal sexual development. Read the article.
Calafat et al. (2004) Exposure to di-(2-ethylhexyl) phthalate among premature neonates in a neonatal intensive care unit
The researchers provided the first quantitative evidence confirming that newborns who undergo intensive therapeutic medical interventions are exposed to higher concentrations of DEHP than the general population. Read the article.
A second study from 2005, "Use of Di(2-ethylhexyl) Phthalate-Containing Medical Products and Urinary Levels of Mono(2-ethylhexyl) Phthalate in Neonatal Intensive Care Unit Infants" found an association between treatment types and DEHP exposure, and confirmed that neonates can be exposed to levels of DEHP exceeding the no-observed-effect level. Read the article.
Possible Impacts of Phthalates on Infant Reproductive Health
Lottrup et al. (2006) reviewed two recent research papers. One (Swan et al. 2005) study found a link between prenatal exposure and alterations in reproductive organs in boys; another (Main et al. 2005) found that higher concentrations of phthalates in breast milk are linked to a decrease in sex-hormone concentrations in baby boys.
(1) Lottrup et al. 2006 (2) Swan et al. 2005 (3) Main et al. (2005)
High DEHP Exposure of Neonates Undergoing Intensive Hospital Treatment
Calafat et al. found that concentrations of DEHP metabolites, the agents of DEHP toxicity, were seven times higher in 6 premature infants who underwent intensive therapeutic interventions than in the US general population; Green et al. found a five-fold difference increase of exposure in children treated with DEHP-containing medical devices. Koch et al., calculated that in extreme cases, premature babies could suffer extreme DEHP exposure, 100 times the dietary exposure advisories for the US and EU.
(1) Calafat et al. 2004 (2) Green et al. 2005 (3) Koch et al. 2006
