Irradiance of Phototherapy Devices in General Hospitals in the Northern Netherlands

Background Sufficient irradiance levels of phototherapy (PT) devices are essential for the efficacy of PT. Yet, irradiance levels are infrequently measured, are sometimes lower than recommended, and little is known about whether improvement over time occurs. Aim To investigate the irradiance levels of PT devices in pediatric departments of all general hospitals in the Northern Netherlands in two different time epochs. Methods Irradiance levels of all available PT devices were measured in eight pediatric departments in 2023, and median levels were compared with levels measured in 2017. The PT devices were positioned as they were routinely used. Two calibrated radiometers were used: the Dale 40 Phototherapy Radiometer (Fluke Biomedical, Everett, WA) and the Ohmeda Medical BiliBlanket Meter II (BBII, GE Healthcare, Chicago, IL). Results Irradiance levels of overhead devices increased from 20 µW/cm²/nm in 2017 to 24 µW/cm²/nm in 2023 ( P = .021). The mean distance between the PT device and the silhouette decreased by 19 cm in 2023 ( P < .001). Irradiance of the devices underneath was similar in 2017 and 2023, that is, 25 (18-28) and 24 (11-34) µW/cm²/nm, respectively. There were no differences in median irradiance between hospitals. High-intensity irradiance levels >30 µW/cm²/nm were not possible for all devices, but more (66% in 2017; 97% in 2023) PT devices met the recommended minimum irradiance. Irradiance measurements of the BBII were significantly higher than those of the Dale 40 for underneath PT devices. Conclusions Irradiance levels of PT devices in general hospitals increased over time, but high-intensity PT was not always possible. The observed improvement may be explained by the shorter distance between the PT device and the silhouette and the use of newer PT devices. Finally, the radiometer-specific irradiance measurements underline the importance of measuring irradiance with an appropriate radiometer.