Infant blood hexachlorophene concentrations and central nervous system changes in hexachlorophene intoxication

Abstract

The use of a 3% hexachlorophene emulsion in infant antiseptic skin care for controlling staphylococcal cross-infection was reported in a study concerning 26,114 infants born in Geelong during the years 1960-1972 During 1972, blood hexachlorophene analysis of samples taken from the femoral vein of 150 new-born babies on the afternoon prior to discharge home ranged from 0.015 to 0.092 μg/ml. The maximum blood hexachlorophene concentration was shown to reach a plateau at the 4th or 5th day of life of infants undergoing antiseptic skin care. The concentration reached did not vary with birth weight and on no occasion in a new-born infant reached one tenth the minimum concentration reported as producing neurotoxic changes in animals. In comparing the histological changes produced in the central nervous system of rats and monkeys by larger than therapeutic doses of hexachlorophene, retrospective review of the microscopic findings in 234 neonatal and postneonatal deaths occurring in Geelong since 1960 did not reveal evidence of such neurotoxic changes in any infant. The author stated that the histological simplicity of the 'cystic spaces' produced by hexachlorophene 'neurotoxicity' with a lack of any cellular reaction, a frequent widespread distribution with no apparent concordance with any neurological deficit, and the reversibility, were an anachronism to him as an anatomical pathologist. He concluded that these features also were not inconsistent with artefacts occurring in tissues subsequent to death or during histological preparation.