Vinyl IV Bags: Media lose message

By Steven J. Milloy
March 27, 2000, Chicago Sun-Times

Deerfield-based Baxter Healthcare has been vindicated on a major health scare. But don’t expect to read about it in the media. It’s more fun to scare readers about vinyl IV bags causing cancer than it is to set the record straight.

“Environmentalists allege cancer risks associated with plastic IV bags” was the headline in Mealey’s Litigation Report on March 5, 1998. The scare has continued with more widely read headlines, including “Vinyl IV bags may leach liver-damaging toxins” and “Blood bags deemed dangerous.”

The alleged cancer risk was from a chemical called di-ethylhexyl phthalate (DEHP), and the “environmentalists” in question included Greenpeace and an offshoot, Health Care Without Harm. They claimed DEHP leached from IV bags into patients.

As a major manufacturer of vinyl IV bags, Baxter is a primary target. Healthcare Without Harm even became a Baxter shareholder to apply pressure as an “owner.” The group should think about reinvesting.

A science panel from the World Health Organization’s International Agency for Research on Cancer (IARC) reviewed the science on DEHP and downgraded DEHP’s classification of “possibly carcinogenic to humans” to “not classifiable as to carcinogenicity to humans.”

IARC concluded that while larger doses of DEHP–much higher than humans would ever be exposed to through IV bags–were associated with increased liver tumors in rats and mice, the biological mechanism by which DEHP produced those tumors doesn’t exist in humans.

Without other evidence of carcinogenicity, IARC decided the rat and mouse data weren’t relevant to humans.

The downgrading is unusual. The only other time IARC reclassified a chemical was in late 1998, when the artificial sweetener saccharin was downgraded.

Though there is no evidence DEHP caused any harm in more than 40 years of use, the IARC decision should be reassuring. You might expect the major media that so eagerly sounded the alarm earlier–including the Chicago Tribune, Time magazine, National Public Radio and CBS News–would reassure, or at least update their audiences.

But other than a lone report in a trade publication, Plastics Week, nary a word about the IARC decision has been read by the public.

Unlike the media, Health Care Without Harm noticed the IARC action. It can’t change its tune fast enough. Until the IARC decision, Health Care Without Harm always spotlighted the alleged cancer threat from DEHP. Now Health Care Without Harm says, “Our concern has always been more focused on reproductive and developmental effects as well as the potential for kidney damage.”

No one disputes that high doses of DEHP produce noncancerous effects in some lab animals. But there are two major problems with extending these results to humans.

A fundamental tenet of toxicology is, “It is the dose that makes the poison.” Even water, sugar and table salt can be “toxic” if ingested in sufficient amounts. The lowest levels at which rats and mice exhibit toxic effects from DEHP are still tens and hundreds of times higher than the highest human exposures from vinyl IV bags.

High doses of DEHP may cause reproductive problems in rats and mice. But hamsters are more resistant, and monkeys are unaffected. Decreased kidney function was reported in rats exposed to DEHP. But not in dogs or humans.

This probably explains why no studies link DEHP from medical devices with harm to humans.

With the facts against it, why won’t Health Care Without Harm give up the IV-bag scare? Because “safer” medical products aren’t the goal. Fund-raising for Greenpeace is.

Blandly described by Health Care Without Harm as a “member,” Greenpeace boasts a $20 million annual budget. Scaring the public about plastic products made with polyvinyl chloride (PVC), including IV bags, feeds the Greenpeace coffers.

Last March, when the vinyl IV-bag scare peaked, the Medical Post astutely reported, “The underlying problem is that PVC . . . is a chlorine-based product. Chlorine has been on Greenpeace’s global hit list for years, and the organization has, of late, made a successful fund-raising gambit out of it. In doing so, it seems to be indulging in hyperbole, its possibly sensible warnings sensationalized to the brink of extremism.”

The IARC decision should put an end to even the “possibly sensible warnings” about vinyl IV bags. Now if only the media would tell someone.

Steven J. Milloy is a lawyer, biostatistician, publisher of Junkscience.com and adjunct scholar at the Cato Institute.