Pinto Iole, Bogi Andrea, Picciolo Francesco, Stacchini Nicola, Buonocore Giuseppe, Bellieni Carlo V
a Regional Public Health Laboratory - Physical Agents Sector , Siena , Italy.
J Occup Environ Hyg. 2015;12(9):603-10. doi: 10.1080/15459624.2015.1029611.
Phototherapy is the use of light for reducing the concentration of bilirubin in the body of infants. Although it has become a mainstay since its introduction in 1958, a better understanding of the efficacy and safety of phototherapy applications seems to be necessary for improved clinical practices and outcomes. This study was initiated to evaluate workers' exposure to Optical Radiation from different types of phototherapy devices in clinical use in Italy. During infant phototherapy the staff monitors babies periodically for around 10 min every hour, and fixation of the phototherapy beam light frequently occurs: almost all operators work within 30 cm of the phototherapy source during monitoring procedures, with most of them commonly working at ≤25 cm from the direct or reflected radiation beam. The results of this study suggest that there is a great variability in the spectral emission of equipments investigated, depending on the types of lamps used and some phototherapy equipment exposes operators to blue light photochemical retinal hazard. Some of the equipment investigated presents relevant spectral emission also in the UVA region. Taking into account that the exposure to UV in childhood has been established as an important contributing factor for melanoma risk in adults and considering the high susceptibility to UV-induced skin damage of the newborn, related to his pigmentary traits, the UV exposure of the infant during phototherapy should be "as low as reasonably achievable," considering that it is unnecessary to the therapy. It is recommended that special safety training be provided for the affected employees: in particular, protective eyewear can be necessary during newborn assistance activities carried out in proximity of some sources. The engineering design of phototherapy equipment can be optimized. Specific requirements for photobiological safety of lamps used in the phototherapy equipment should be defined in the safety product standard for such equipment.
光疗是利用光线降低婴儿体内胆红素浓度的方法。自1958年引入以来，它已成为一种主要治疗手段，但为了改善临床实践和治疗效果，似乎有必要更好地了解光疗应用的疗效和安全性。本研究旨在评估意大利临床使用的不同类型光疗设备使工作人员暴露于光辐射的情况。在婴儿光疗期间，工作人员每小时定期监测婴儿约10分钟，并且光疗光束经常固定照射：几乎所有操作人员在监测过程中都在光疗源30厘米范围内工作，其中大多数人通常在距直接或反射辐射光束≤25厘米处工作。本研究结果表明，根据所使用灯的类型，所调查设备的光谱发射存在很大差异，并且一些光疗设备会使操作人员暴露于蓝光对视网膜的光化学危害中。一些所调查的设备在UVA区域也有相关的光谱发射。考虑到儿童时期暴露于紫外线已被确定为成人患黑色素瘤风险的一个重要促成因素，并且考虑到新生儿因其色素特征对紫外线引起的皮肤损伤高度敏感，在光疗期间婴儿的紫外线暴露应“尽可能合理地低”，因为这对治疗并非必需。建议为受影响的员工提供特殊的安全培训：特别是在靠近某些光源进行新生儿护理活动期间可能需要佩戴防护眼镜。光疗设备的工程设计可以优化。光疗设备所使用灯的光生物安全的具体要求应在该设备的安全产品标准中予以明确。
