Epidemic neonatal hyperbilirubinemia and use of a phenolic disinfectant detergent.

2 epidemic iatrogenic outbreaks of neonatal hyperbilirubinemia 1 in Wyoming and 1 in New Jersey both followed cleaning of nursery and bassinets with a phenolic disinfectant detergent. From March-April 1972 9 neonates in a New Jersey hospital received exchange transfusions for idiopathic hyperbilirubinemia. 5 infants who had peak bilirubin concentrations from 23.9-42 mg/100 ml were treated within a 36-hour period. The increase in exchange transfusions coincided with the time that the nursing staff increased the concentrations of phenolic disinfectant detergent used for cleaning the nursery and mattresses. Preceding the cluster of cases in April they had vigorously cleaned the nursery with the detergent. After use of the compound was discontinued the epidemic of hyperbilirubinemia discontinued. These findings are similar to those reported by a Wyoming hospital in 1975 in which idiopathic hyperbilirubinemia developed in 10 (18.5%) of 54 newborn infants; 2 received exchange transfusions. The same phenolic compound had been used in excessive concentrations to clean incubators and bassinets. In addition nursery ventilation was inadequate. When use of the detergent was discontinued and ventilation improved the epidemic ceased. These 2 reports suggest a causal association between use of excessive concentrations of this phenolic detergent and neonatal hyperbilirubinemia.