[2922.325] Alcohol Exposure from Hand Hygiene Products in Preterm Infants in Neonatal Giraffe Isolette
Shiv S. Kapoor, Shizuka Hsieh, Rebecca Wood, Cynthia Bearer, Amir Sapkota. Pediatrics, Neonatal Division, University of Maryland School of Medicine, Baltimore, MD; Chemistry, Smith College, Northampton, MA; Maryland Institute for Applied Environmental Health, College Park, MD.
BACKGROUND: Alcohol based hygiene products are increasingly used in intensive care units to prevent infections. Preterm babies spend up to 12 weeks in neonatal isolettes, which is an enclosed space with minimal exchange of air. Alcohol vapors from hand sanitizers may build up in isolette following insertion of hands cleaned with ethanol based hand sanitizers (EBHS). Ethanol is a known developmental neurotoxicant and may have long term consequences on the neurodevelopment of these babies.
OBJECTIVE: To determine the alcohol concentration levels in Giraffe isolette air after introduction of hands cleaned with hand EBHS.
DESIGN/METHODS: Neonatal Giraffe isolette was placed at 36.5C as maintained for cares of preterm babies. Hands were cleaned with two squirts (1.5±0.1ml) of EBHS (Ecolab Quickcare 62% w/w Ethyl alcohol) and rubbed continuously for 10 or 20 seconds before placing the hands in the isolette for 5 minute and this process was repeated every 30 minutes. Alcohol concentration was measured in isolette air with Photoionization detector (PID) and alcohol breathalyzer (Drager alcotest 6510) simultaneously. PID was used to measure volatile organic compounds in isolette air continuously over the period of 8hrs. Breathalyzer was modified to measure ethanol in isolette air every 2 minutes for first 10 minutes and every 4 minutes for next 20 minutes in thirty minutes cycles. Multiple readings were taken over different days. Both instruments were calibrated before testing. The results were converted to ethanol concentration and were reported as parts per million (ppm).
RESULTS: The ethanol concentration in isolette air peaked at 384±193ppm (140-902) after 10 seconds hand rub and 93±23ppm (45-133) after 20 seconds rub of EBHS. Both instruments showed similar results. Alcohol concentration peaked within 1 min of insertion of hands and quickly decreased to base line by 10 min.
CONCLUSIONS: Our results suggest that use of EBHS within NICU may result in elevated level of unintended ethanol exposure among preterm babies. The permissible short term exposure limit for ethanol is 1000 ppm as set by safety and health administration (OSHA) for healthy adults. The acceptable exposure limit to developing preterm babies is unknown and repeated exposure to ethanol may have long-term consequences for the developing brain. Potential ethanol exposure could be significantly reduced if hands are rubbed for a longer duration before placing them in isolette.
Session: Poster Session: Neonatology - General (4:15 PM - 7:30 PM)
Date/Time: Sunday, May 5, 2013 - 4:15 PM
Room: Hall D/E - Walter E. Washington Convention Center
Course Code: 2922