Reducing hazardous chemical exposures in the neonatal intensive care unit: a new role for nurses

A wide range of toxic chemicals have been found in the umbilical cord blood of newborns, indicating the potential for health risks from chemical exposure that begin in utero. The neonatal intensive care unit (NICU) setting may also have potential chemical exposures that create health risks. Given the extreme vulnerability of this patient population, it is critical to minimize unnecessary hazardous chemicals. Neonatal intensive care unit nurses have an important role to play in making the NICU as safe as possible for their patients and themselves. This article will focus on the human health effects of several chemical exposures commonly found in the NICU for which nurses can help to eliminate or select safer alternatives: (1) diethylhexyl phthalates (a plasticizer commonly found in intravenous tubing/bags and other products); (2) bisphenol A (commonly found in the lining of baby formula cans); (3) personal care products used in the NICU; (4) cleaning, sterilants, and disinfectants; and (5) mercury. A tool for assessing environmental health risks will be presented and associated intervention options including purchasing policies; hospital-wide chemical policies; and development of institutional infrastructures, such as Green Teams, to address NICU and hospital-wide environmental health concerns. Nursing's evolving role in environmental health will be reviewed.