Comment: Hazard of ultraviolet radiation from fluorescent lamps to infant during phototherapy

Elder, Robert L.

doi:10.1016/s0022-3476(74)80577-9

Cited by 7 publications

(9 citation statements)

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“…Phototherapy is useful for the acute management of neonatal hyperbilirubinemia, although some studies reported possible adverse effects. [32][33][34][35][36][37][38][39] The suggestion that photometabolic products might interfere with albumin binding of bilirubin raised the possibility that phototherapy might contribute to the neurotoxicity of bilirubin. 52 There was the possibility of delayed effects of phototherapy concerning neurodevelopment, [32][33][34][35][36] vision, 37 and skin abnormalities.…”

Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

“…52 There was the possibility of delayed effects of phototherapy concerning neurodevelopment, [32][33][34][35][36] vision, 37 and skin abnormalities. 38,39 However, recent studies, 40,52 including a multicenter randomized controlled study, 40 concluded that phototherapy effectively controlled neonatal hyperbilirubinemia without adverse outcome at 6 years and was at least as effective as exchange transfusion alone.…”

Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

“…[29][30][31] Serial brainstem auditory evoked potentials were performed at different ages: 15 to 80 months, 28 2 to 6 years, 30,31 and 8 to 13 years. 29 The possibility of delayed effects on growth and development, [32][33][34][35][36] vision, 37 and skin abnormalities 38,39 had been reported for phototherapy. However, a recent multicenter randomized controlled study concluded that phototherapy can effectively control neonatal hyperbilirubinemia without adverse outcome at 6 years.…”

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confidence: 99%

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Short- and Long-Term Outcome of Severe Neonatal Nonhemolytic Hyperbilirubinemia

2006

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We studied the effects of hyperbilirubinemia on brainstem auditory pathways and neurodevelopmental status in 99 full-term neonates with severe nonhemolytic hyperbilirubinemia (total serum bilirubin level = 301 to 500 micromol/L) born between 1995 and 2000. These were divided into three groups: group 1, moderate hyperbilirubinemia (n = 30; mean maximum total serum bilirubin = 320.7 micromol/L or 18.9 mg%); group 2, severe hyperbilirubinemia (n = 63; mean maximum total serum bilirubin = 369.0 micromol/L or 21.7 mg%); and group 3, super hyperbilirubinemia (n = 6; mean maximum total serum bilirubin = 457.2 micromol/L or 26.9 mg%). All received phototherapy, and three neonates also had exchange transfusion. Initial brainstem auditory evoked potentials were recorded in all at the mean age of 3.1 months (range 1-9 months). At initial assessment, only nine neonates (9.1%) had abnormal brainstem auditory evoked potentials. All except two returned to normal at 2 years. These two children had a hearing threshold at 50 nHL. We then compared serial brainstem auditory evoked potentials until 2 years for these nine cases with initial abnormal brainstem auditory evoked potentials, and nine cases with initial normal brainstem auditory evoked potentials were recruited for comparison. All 99 children had regular physical, neurologic, visual, and auditory assessments every 3 to 6 months until the age of 3 years. There was no significant correlation between demographic factors (gender, gestational age, or birthweight), maximum total serum bilirubin, and total serum bilirubin at discharge with an abnormal brainstem auditory evoked potential. There was no significant difference in the rate of brainstem auditory evoked potential abnormalities between the three groups: moderate (10%), severe (7.9%), and super (16.7%). All had normal neurodevelopmental status at 3 years. Only two children had transient mild motor delay and hypotonia, and both had normal brainstem auditory evoked potentials. There was no relationship between the abnormalities of the brainstem auditory evoked potentials and neurodevelopmental status. None of the three children receiving exchange transfusion had abnormal brainstem auditory evoked potentials or neurodevelopmental outcome. With the neurophysiologic and clinical outcomes in our cohort with severe nonhemolytic hyperbilirubinemia, we propose that the toxic effect of hyperbilirubinemia on auditory brainstem pathways might be transient provided that prompt treatment is initiated.

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Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

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confidence: 99%

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Short- and Long-Term Outcome of Severe Neonatal Nonhemolytic Hyperbilirubinemia

2006

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“…[28][29][30][31]48 The suggestion that photometabolic products might interfere with albumin binding of bilirubin raised the possibility that phototherapy might contribute to the neurotoxicity of bilirubin. [28][29][30][31]48 The suggestion that photometabolic products might interfere with albumin binding of bilirubin raised the possibility that phototherapy might contribute to the neurotoxicity of bilirubin.…”

Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

“…[28][29][30][31]48 The suggestion that photometabolic products might interfere with albumin binding of bilirubin raised the possibility that phototherapy might contribute to the neurotoxicity of bilirubin. 30,31 However, recent studies, 32, 49 including a multicenter, randomized, controlled study, 32 concluded that phototherapy effectively controlled neonatal hyperbilirubinemia without evidence of an adverse outcome at 6 years and was at least as effective as exchange transfusion alone. 30,31 However, recent studies, 32, 49 including a multicenter, randomized, controlled study, 32 concluded that phototherapy effectively controlled neonatal hyperbilirubinemia without evidence of an adverse outcome at 6 years and was at least as effective as exchange transfusion alone.…”

Section: Phototherapy In Neonatal Hyperbilirubinemiamentioning

confidence: 99%

Visual Evoked Potentials in Neonatal Hyperbilirubinemia

Chen

Wong

2006

J Child Neurol

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The management of neonatal hyperbilirubinemia is very standardized. However, there is a lack of an objective method to evaluate the cerebral effects of bilirubin apart from brainstem auditory evoked potentials. There were few studies evaluating the effects of hyperbilirubinemia or phototherapy on the visual pathway in infants with hyperbilirubinemia. Serial visual evoked potentials of two groups of term neonates (N = 24)--group 1 with moderate hyperbilirubinemia (n = 16) and group 2 with severe hyperbilirubinemia (n = 8)--were evaluated prospectively. All infants had regular physical, neurologic, visual, and auditory evaluations until 3 years. Four (16%) had abnormal visual evoked potentials before 1 year, and the abnormalities returned to normal thereafter. There was no significant difference in visual evoked potentials between the two groups. All had normal neurodevelopmental status by 3 years, with the exception of one child from the severe group with ABO incompatibility with transient mild motor delay, hypotonia, and abnormal visual evoked potential. There were no abnormal effects of phototherapy on visual evoked potentials in infants with neonatal hyperbilirubinemia after 1 year of age. Although our sample size was small, the results suggest that the effects of hyperbilirubinemia on visual evoked potentials might be transient. (J Child Neurol 2006;21:58-62).

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Nonionizing Radiation

Wilkening¹

2001

Patty's Industrial Hygiene

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The development and proliferation of electronic devices that either intentionally or inadvertently emit nonionizing radiation have brought about immense interest in the subject. The promise of an increase in the number and use of such devices has concerned many persons who believe that the radiation hazards have not been sufficiently studied. Those who express concern about an inadequate understanding of the biological effects of nonionizing radiations point out that many electronic devices have already found their way into common use (e.g., microwave ovens, radar for pleasure boats, scanning lasers in supermarket checkout counters, near‐ultraviolet radiation in fluorescent lighting fixtures, and a variety of high‐intensity light sources). Other concerns include the many infrared, ultraviolet, microwave, and laser devices that might produce excessive occupational exposures. Because of the heightened public interest in electromagnetic radiation hazards, Congress enacted the Radiation Control for Health and Safety Act. The declared purpose of the act is to establish a national electronic product radiation control program, including the development and administration of performance standards to control the emission of electronic product radiation. The act covers both ionizing and nonionizing electromagnetic radiations emitted from any electronic product. This includes X‐rays and gamma rays and particulate, ultraviolet, visible, infrared, millimeter wave, microwave, radio‐frequency, and, interestingly enough, sonic, infrasonic, and ultrasonic radiation. Since the inception of the act, the federal government has conducted or funded research into the biological effects of radiation, with special emphasis on low‐level effects. Standards have been developed and promulgated for television set receivers, medical X‐rays (amendments to existing standard), cathode ray tubes, microwave ovens, and lasers. Calibration, measurement, and product testing laboratories have been established to ensure proper evaluation of accessible radiation from electronic products, and a compliance program has been developed to obtain manufacturers' adherence to established standards. During the course of standards development efforts, the Food and Drug Administration (FDA) has been required to consult with the Technical Electronic Product Radiation Safety Standards Committee (TEPRSSC), an advisory body established under the Act. Unlike some federal advisory committees, TEPRSSC has the authority to develop and recommend its own standards directly to the Secretary of Health and Human Services. Other federal agencies that are actively concerned with nonionizing radiation hazards include the Occupational Safety and Health Administration (OSHA), the Environmental Protection Agency (EPA), the National Institute for Occupational Safety and Health (NIOSH), and the National Institute of Environmental Health Sciences (NIEHS).

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Comment: Hazard of ultraviolet radiation from fluorescent lamps to infant during phototherapy

Cited by 7 publications

References 0 publications

Short- and Long-Term Outcome of Severe Neonatal Nonhemolytic Hyperbilirubinemia

Short- and Long-Term Outcome of Severe Neonatal Nonhemolytic Hyperbilirubinemia

Visual Evoked Potentials in Neonatal Hyperbilirubinemia

Nonionizing Radiation

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