# Impact of phthalate and phenol exposures on congenital heart surgery outcomes.

> **NIH NIH R21** · GEORGE WASHINGTON UNIVERSITY · 2023 · $213,595

## Abstract

Abstract
Industrial contaminants in healthcare settings are a largely overlooked source of chemical exposures.
Neonates, particularly those in an intensive care unit, are a highly vulnerable population and may have a
heightened risk for greater chemical exposures as well as adverse outcomes. Bisphenol and phthalate
exposures have been shown to increase following cardiac surgery involving cardiopulmonary bypass (CPB) in
neonates and children and have been detected in common medical devices used in neonatal intensive care
units. Gestational exposures to these chemicals have been shown to negatively impact neurodevelopment,
which remains the most frequent and significant consequence of congenital heart disease and its treatment.
Despite the known presence of these chemicals in healthcare settings and in CPB equipment, no studies have
assessed the influence of exposures during surgery on postoperative outcomes and neurodevelopment. Using
a longitudinal analysis of a randomized controlled trial completed in a neonate population undergoing cardiac
operation with CPB, we propose to characterize trajectories of bisphenol and phthalate exposures in relation to
cardiac surgery by measuring biomarkers in serial urine samples collected pre-operation and 4- and 24-hours
post-operation. We will assess associations of exposures with early clinical outcomes (a previously validated
morbidity-mortality composite outcome, acute kidney injury, hepatic injury, and low cardiac output syndrome)
as well as neurodevelopment at 12-months of age. If our hypotheses are confirmed, reducing bisphenol and
phthalate exposures during neonatal cardiac surgery may be a new avenue for improving postoperative and
neurodevelopmental outcomes in this highly vulnerable neonatal population.

## Key facts

- **NIH application ID:** 10852165
- **Project number:** 7R21ES033384-02
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Jordan Richard Kuiper
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $213,595
- **Award type:** 7
- **Project period:** 2022-05-18 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10852165

## Citation

> US National Institutes of Health, RePORTER application 10852165, Impact of phthalate and phenol exposures on congenital heart surgery outcomes. (7R21ES033384-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10852165. Licensed CC0.

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