Alcohol-based disinfectants (ABDs) are commonly used to prevent infections in neonatal ICUs, but the level of alcohol exposure in infants in incubators hasn't been studied. A quality improvement study was undertaken to determine whether evaporated alcohol from ABDs inside incubators is systemically absorbed by premature infants and whether a simple new practice could reduce alcohol exposure in this population.

Infants were included in the study if they were born before 34 weeks of gestational age and cared for in neonatal incubators. A total of 28 infants were enrolled in the study, which consisted of three periods: (1) prospective observation to measure baseline alcohol concentrations in the air of the incubators and in the infants' blood; (2) introduction of a new practice designed to reduce the evaporation of alcohol from ABDs inside the incubators (ABD-PRAC) to medical staff and parents; and (3) prospective observation to evaluate changes in alcohol concentrations in incubators and infants' blood after the introduction of ABD-PRAC.

Alcohol was detected in all blood samples. Before introduction of ABD-PRAC, the median blood alcohol concentration of infants in incubators was 7 mg/dL. The median alcohol concentration in incubators was 23.6 ppm during the day and 13.2 ppm during the night. After introduction of ABD-PRAC, the median blood alcohol concentration in premature infants decreased to 4.2 mg/dL, and the median alcohol concentration in incubators was 9.4 ppm during the day and 5.7 ppm during the night.

The authors acknowledge certain limitations of the study, including that it was performed in a single institution. Additionally, the authors note, they couldn't measure maternal blood alcohol concentrations.