Epidemic Neonatal Hyperbilirubinemia and Use of a Phenolic Disinfectant Detergent

Abstract

Between March 28 and April 12, 1972, nine neonates in a New Jersey hospital received exchange transfusions for idiopathic hyperbilirubinemia. Five infants who had peak bilirubin concentrations from 23.9 to 42 mg/100 ml were treated within a 36-hour period. Affected infants had no other illnesses, and they and their mothers did not differ significantly from unaffected infants and their mothers regarding factors which could explain the epidemic. The increase in exchange transfusions began in January, which coincided with the time that the nursing staff increased the concentrations of a phenolic disinfectant detergent used for cleaning bassinets and mattresses. Preceding the cluster of cases in April they had vigorously cleaned the nursery with the disinfectant detergent. After use of the phenolic compound was discontinued, the epidemic of hyperbilirubinemia ceased.

These findings are similar to those of a subsequent outbreak in 1975 in a Wyoming hospital in which idiopathic hyperbilirubinemia developed in ten (18.5%) of 54 newborn infants; two received exchange transfusions. The same phenolic compound was used in excessive concentrations to clean incubators and bassinets. In addition, nursery ventilation was inadequate. When use of the cleaning compound was discontinued and the ventilation defects were corrected, the epidemic of hyperbilirubinemia ceased. These two episodes suggest a causal association between use of excessive concentrations of this phenolic disinfectant detergent and neonatal hyperbilirubinemia.