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Neonatal ethanol exposure from ethanol-based hand sanitisers in isolettes
  1. Shizuka Hsieh1,
  2. Amir Sapkota2,
  3. Rebecca Wood2,
  4. Cynthia Bearer3,
  5. Shiv Kapoor3
  1. 1 Chemistry Department, Trinity Washington University, Washington, DC, USA
  2. 2 School of Public Health, University of Maryland, College Park, Maryland, USA
  3. 3 Division of Neonatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Shiv Kapoor, Division of Neonatology, University of Maryland School of Medicine, Baltimore, MD 21201, USA; skapoor{at}mdmercy.com

Abstract

Objective The aims of this study is to measure the ethanol vapours in the isolette after use of hands cleaned with ethanol-based hand sanitiser (EBHS).

Methods Two squirts (1.5 mL) of hand sanitiser were rubbed on hands for 10 or 20 s before inserting the hands in the isolette for 5 min. Ethanol vapours were measured in the isolette with photoionisation detector and alcohol breathalyser for 30 min.

Results Peak ethanol concentration in the isolette was considerably higher with a 10 s hand rub (381±192 ppm) compared with a 20 s hand rub (99±50 ppm), and dissipated to ≤5 ppm within 30 min. Under routine care, EBHS use by care providers exposes neonates in isolettes to 3.7–7.3 or 1.4–2.8 mg/kg ethanol per day with 10 or 20 s hand rubs, respectively. The expected blood level from average single exposure is 0.036 mg/dL with 10 s hand rub and may increase further with multiple exposures in a short period.

Conclusion Preterm neonates in the isolette are at risk of inadvertent exposure to ethanol. The expected blood alcohol level from this exposure is small and below 1 mg/dL level recommended by European Medicines Agency to limit the ethanol exposure in children. The unintended ethanol exposure can be avoided by rubbing hands for at least 20 s after applying EBHS.

  • Alcohol exposure
  • Neonatal isolette
  • Neonatal intensive care unit
  • Preterm infant
  • Ethanol based hand sanitizers

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Footnotes

  • Contributors SK and CB conceived of the idea and health implications of this study. SH and AS developed methods. SH collected and analysed data. RW contributed to data analysis.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are included in the study.

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