The substance, di(2-ethylhexyl)phthalate, or DEHP, is used to make plastic medical devices more flexible. But it also easily leaches into bodily fluids and tissues it comes into contact with.

Researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore found that premature babies can be exposed to levels of the chemical that are 4,000 to 160,000 times higher than desired to avoid toxic effects.

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DEHP has been linked to disruptions in normal hormone function, as well as increased inflammation, liver injury, and the disrupted development of the lungs, brain and eyes in animals. The risks are believed to be particularly high for newborn boys, because the compound has been found to affect the development of the testicles and the production of normal sperm in animals, according to the Food and Drug Administration.

"It's remarkable that the care of sick and developmentally vulnerable preterm infants depends on an environment composed almost entirely of plastic," said neonatologist Eric Mallow, who is the study's author and a senior research program coordinator at the Bloomberg School of Public Health. "The role of these synthetic materials in the clinical course of our patients remains almost completely unexplored."

Most medical devices are made of a plastic called polyvinyl chloride (PVC). The devices often provide life support to premature infants whose vital organs may be underdeveloped.

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But the tradeoff can be significant.

The study found that a four-pound preemie can be exposed daily to toxic levels of DEHP that are 4,000 times the level desired to prevent toxicity that affects the male reproductive organs, and 160,000 times higher than desired to prevent liver damage.

In some cases, high exposure to the DEHP occurs though breathing tubes used to deliver support with a ventilator. But the exposure to toxic chemicals could be one of the reasons why preemies whose breathing is managed without a ventilator have better lung outcomes, researchers said.

"We were floored by how high the exposures are when you look at all of the devices together," said Mary Fox, an assistant professor in the school's Department of Health Policy and Management and co-author of the study. "It's a population that we know is vulnerable to begin with. They're struggling to survive. And the concern now is whether this phthalate exposure is actually contributing to their problems when these medical products are supposed to be helping them get better."

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The results were published online in the Journal of Perinatology on Thursday.

DEHP is one of many compounds called phthalates that are added to plastics to improve their flexibility, transparency or durability. It is the only phthalate approved for use in medical settings -- but it isn't regulated.

Researchers say that immediate steps can be taken to evaluate where exposure to DEHP is happening in a medical setting and to reduce it where possible. Using alternate non-DEHP products should also be explored.

The European Union announced in 2011 that it would begin phasing out the chemical by 2015. In France, DEHP will be prohibited altogether in tubing for the care of neonatal and maternal patients by 2015.

"We do have to make tradeoffs and we want to save these babies," Fox says. "But can we save them by using alternative products that reduce their exposures to substances that may be harming them? It seems like we could."