Neonatal ethanol exposure from sanitizers in isolettes: a bench study.

Background: Ethanol-based hand sanitizer (EBHS) is used repeatedly in neonatology. Inadequately dried hands can increase ambient ethanol concentrations in air, especially in a small, enclosed space as isolette. We sought to better document the potential exposure to alcohol vapors on a newborn placed in an isolette, by mimicking common neonatal situations.

Methods: EBHS were rubbed on hands for 10 or 30 seconds, before inserting hands in the isolette of 1 or 2 experimenters for 6 minutes. Ethanol concentrations were measured every 30 seconds with photoionization detector.

Results: Twenty-six trials were made, with 286 measurements. With four hands, the concentration peak was in mean about 700 (±900) ppm and with two hands about 300 ppm. With 10-second rubbing time, the concentrations peak was in mean about 850 ppm, and with 30-second rubbing time, mean concentrations were about 100 pm. When respecting normal use (rubbing time 30 seconds), observed ethanol concentrations were low, always below 200 ppm with 2 or 4 hands.

Conclusions: Concentrations of ethanol are very high when drying of EHBS is incomplete. The exposure is of short duration, but ethanol inhalation may be negatively experienced by the child during procedures, especially since they may be frequent and repeated. To minimize the child's exposure to ethanol, we suggest the hands should be completely dried before being inserted into the isolette.