Exploring the olfactory environment of premature newborns: a French survey of health care and cleaning products used in neonatal units.

AIM: To assess the main determinants of the newborn's nosocomial olfactory environment. METHODS: An electronic questionnaire was sent to 99 neonatal units in France. Senior nurses and/or physicians described the nature and use of skin care products (e.g. umbilical cord and skin disinfectants, adhesive removers), lubrications used for tubes positioning, disinfectants used to clean materials, hand hygiene products (e.g. alcohol-based hand rubs, soaps) and newborns' bath. RESULTS: Nine groups of products and 76 distinct commercial preparations were identified. Depending on their level of respiratory support, preterm newborns were estimated to be exposed to nosocomial odours (NO) an average of 1320-1800 times during their first month of life. During their whole hospital stay, newborns of 28 and 32 weeks of gestational age could be exposed to NOs products an average of 3448 and 2024 times, respectively. The use of these products varied among medical centres. Newborns were most frequently exposed to the odour of aqueous alcoholic solutions. CONCLUSIONS: Vulnerable preterm infants are daily exposed to multiple NOs most of them be considered as irritant for the nose. Minimizing infants' exposure to them would be beneficial. Future studies should describe the exact olfactory properties of the products considered essential for infant care and should assess their effects on the infant's well-being and development.