Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 33
Filter
1.
Front Public Health ; 9: 705225, 2021.
Article in English | MEDLINE | ID: covidwho-1775819

ABSTRACT

Coffee production is a global industry with roasteries throughout the world. Workers in this industry are exposed to complex mixtures of gases, dusts, and vapors including carbon monoxide, carbon dioxide, coffee dust, allergens, alpha-diketones, and other volatile organic compounds (VOCs). Adverse respiratory health outcomes such as respiratory symptoms, reduced pulmonary function, asthma, and obliterative bronchiolitis can occur among exposed workers. In response to health hazard evaluations requests received from 17 small- to medium-sized coffee facilities across the United States, the National Institute for Occupational Safety and Health conducted investigations during 2016-2017 to understand the burden of respiratory abnormalities, exposure characteristics, relationships between exposures and respiratory effects, and opportunities for exposure mitigation. Full-shift, task-based, and instantaneous personal and area air samples for diacetyl, 2,3-pentanedione and other VOCs were collected, and engineering controls were evaluated. Medical evaluations included questionnaire, spirometry, impulse oscillometry, and fractional exhaled nitric oxide. Exposure and health assessments were conducted using standardized tools and approaches, which enabled pooling data for aggregate analysis. The pooled data provided a larger population to better address the requestors' concern of the effect of exposure to alpha-diketones on the respiratory heath of coffee workers. This paper describes the rationale for the exposure and health assessment strategy, the approach used to achieve the study objectives, and its advantages and limitations.


Subject(s)
Bronchiolitis Obliterans , Occupational Exposure , Bronchiolitis Obliterans/etiology , Coffee/adverse effects , Diacetyl/adverse effects , Diacetyl/analysis , Food Industry , Humans , Occupational Exposure/adverse effects , Occupational Exposure/analysis , United States
2.
Viruses ; 14(1)2022 01 07.
Article in English | MEDLINE | ID: covidwho-1614006

ABSTRACT

In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country's weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a "herd" immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.


Subject(s)
COVID-19/epidemiology , Health Personnel , Occupational Exposure/analysis , Adult , Antibodies, Viral/blood , COVID-19/blood , COVID-19/diagnosis , Female , Hospitals , Humans , Immunoglobulin G/blood , Male , Mali/epidemiology , Odds Ratio , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Seroepidemiologic Studies
3.
Toxins (Basel) ; 13(10)2021 09 28.
Article in English | MEDLINE | ID: covidwho-1481004

ABSTRACT

Despite the awareness that work in the sewage treatment plant is associated with biological hazards, they have not been fully recognised so far. The research aims to comprehensively evaluate microbiological and toxicological hazards in the air and settled dust in workstations in a sewage treatment plant. The number of microorganisms in the air and settled dust was determined using the culture method and the diversity was evaluated using high-throughput sequencing. Endotoxin concentration was assessed with GC-MS (gas chromatography-mass spectrometry) while secondary metabolites with LC-MS/MS (liquid chromatography coupled to tandem mass spectrometry). Moreover, cytotoxicity of settled dust against a human lung epithelial lung cell line was determined with the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay and UHPLC-Q-ToF-UHRMS (ultra-high-performance liquid chromatography-quadrupole time-of-flight ultrahigh-resolution mass spectrometry) analysis was performed to determine the source of cytotoxicity. The total dust concentration in the sewage treatment plant was low and ranged from 0.030 mg m-3 to 0.044 mg m-3. The highest microbiological contamination was observed in sludge thickening building and screenings storage. Three secondary metabolites were detected in the air and sixteen in the settled dust. They were dominated by compounds typical of lichen and plants and Aspergillus, Penicillium and Fusarium genera mould. The settled dust from the sludge thickening building revealed high cytotoxicity to human lung epithelial cells A-549 (IC50 = 6.98 after 72 h). This effect can be attributed to a biocidal compound-didecyldimethylammonium chloride (DDAC-C10) and seven toxic compounds: 4-hydroxynonenal, carbofuran, cerulenin, diethylphosphate, fenpropimorph, naphthalene and onchidal. The presence of DDAC-C10 and other biocidal substances in the sewage treatment plant environment may bring negative results for biological sewage treatment and the natural environment in the future and contribute to microorganisms' increasing antibiotics resistance. Therefore, the concentration of antibiotics, pesticides and disinfectants in sewage treatment plant workstations should be monitored.


Subject(s)
Aerosols/analysis , Dust/analysis , Occupational Exposure/analysis , Waste Disposal, Fluid , Aerosols/toxicity , Air Microbiology , Cell Line , Disinfectants/analysis , Endotoxins/analysis , Environmental Monitoring , Humans , Sewage/chemistry , Sewage/microbiology , Water Purification
4.
Int J Environ Res Public Health ; 18(19)2021 09 27.
Article in English | MEDLINE | ID: covidwho-1463639

ABSTRACT

This study aimed to detect airborne Mycobacterium tuberculosis (MTB) at nine public health facilities in three provinces of South Africa and determine possible risk factors that may contribute to airborne transmission. Personal samples (n = 264) and stationary samples (n = 327) were collected from perceived high-risk areas in district, primary health clinics (PHCs) and TB facilities. Quantitative real-time (RT) polymerase chain reaction (PCR) was used for TB analysis. Walkabout observations and work practices through the infection prevention and control (IPC) questionnaire were documented. Statistical analysis was carried out using Stata version 15.2 software. Airborne MTB was detected in 2.2% of samples (13/572), and 97.8% were negative. District hospitals and Western Cape province had the most TB-positive samples and identified risk areas included medical wards, casualty, and TB wards. MTB-positive samples were not detected in PHCs and during the summer season. All facilities reported training healthcare workers (HCWs) on TB IPC. The risk factors for airborne MTB included province, type of facility, area or section, season, lack of UVGI, and ineffective ventilation. Environmental monitoring, PCR, IPC questionnaire, and walkabout observations can estimate the risk of TB transmission in various settings. These findings can be used to inform management and staff to improve the TB IPC programmes.


Subject(s)
Mycobacterium tuberculosis , Occupational Exposure , Tuberculosis , Delivery of Health Care , Health Personnel , Humans , Infection Control , Mycobacterium tuberculosis/genetics , Occupational Exposure/analysis , South Africa/epidemiology , Tuberculosis/epidemiology
5.
PLoS One ; 16(9): e0258134, 2021.
Article in English | MEDLINE | ID: covidwho-1448581

ABSTRACT

Pesticides use in Southeast Asia has increased steadily, driven by the growth of large-scale commercial farming, as well as a desire to maximise food production in rural subsistence economies. Given that use of chemical pesticides, such as organophosphates and carbamates, has known potential health impacts, there are concerns about the safety of agricultural workers, and a need for a better evidence base to underpin regulation and worker education. This study, undertaken in 9 districts in Lao PDR, Thailand and Vietnam, will interview agricultural workers to investigate how they use pesticides, their knowledge of risks and self-protective practices, and their self-reported illness symptoms. In each district researchers will recruit and interview 120 participants engaged in vegetable farming, who have recently used pesticides, making a total of 1080 subjects divided equally between the three study countries. Workers' degree of pesticides exposure will be determined from acetyl cholinesterase concentrations in capillary blood samples collected using field test kits, and these data will be analysed together with the interview findings. Country findings will be compared and contrasted, and general patterns noted. Knowledge gained about risky behaviours, self-protective practices and degree of association with serious pesticides exposure will assist policy makers and inform health improvement programmes.


Subject(s)
Acetylcholinesterase/blood , Agricultural Workers' Diseases/blood , Farmers , Health Knowledge, Attitudes, Practice , Occupational Exposure/analysis , Pesticides/analysis , Research Design , Health Status , Humans , Laos , Thailand , Vietnam
6.
PLoS One ; 16(9): e0258070, 2021.
Article in English | MEDLINE | ID: covidwho-1448578

ABSTRACT

BACKGROUND: Air pollution is the largest environmental health risk in the United Kingdom, and an issue of concern amongst outdoor workers. Road transport is a major source producing the largest amount of nitrogen dioxide (NO2) and ozone (O3) (as a secondary pollutant). Hundreds of vehicles enter and exit the Tidworth Camp's main gate daily, potentially producing these pollutants. However, the air pollution exposure experienced by personnel on guard duty is unknown. This study aimed to determine and compare background NO2 and O3 levels experienced by personnel on guard duty. METHODS: Cross-sectional data was collected using a static sampling technic on randomly selected days of the week. Data analysis was done using IBM-SPSS-26 and a p-value of <0.05 was considered statistically significant. RESULTS: The background concentration of NO2 and O3 pollutants were within recommended limits. There was no significant difference between mean morning and afternoon exposure levels for both pollutants. However, NO2 and O3 levels were significantly higher during weekdays compared to weekends (M = -0.022, SD = 0.007, t(6) = -8.672, p <0.0001 and M = -0.016, SD = 0.008, t(6) = -5.040, p = 0.002 respectively). Both pollutants showed no significant differences in exposure levels when only weekdays were compared. NO2 levels showed a weak positive correlation during weekdays (r = 0.04) and a strong positive correlation during weekends (r = 0.96). O3 levels had a positive correlation on both weekdays and weekends; however, levels on Monday showed a negative correlation (r = -0.55). Linear regression analysis showed that outside temperature was a significant predictor of O3 levels (p = 0.026). CONCLUSION: Personnel on guard duty experienced higher pollution levels during weekdays compared to weekends; however, air pollution levels for both pollutants were within recommended limits. Further studies are recommended over hotter months using a personal sampling technic to measure personal air pollution exposure levels in order to minimise any health and safety risks.


Subject(s)
Air Pollutants/analysis , Air Pollution/analysis , Nitrogen Dioxide/analysis , Occupational Exposure/analysis , Ozone/analysis , Cross-Sectional Studies , Environmental Exposure/analysis , Environmental Monitoring , Humans , Military Personnel , United Kingdom
7.
BMJ Open ; 11(9): e047328, 2021 09 29.
Article in English | MEDLINE | ID: covidwho-1443591

ABSTRACT

OBJECTIVES: Globally, there are increasing cases of chronic kidney disease of unknown origin among heat-exposed workers. We aimed to see the kidney damages of indoor heat-exposed workers and whether urine specific gravity can predict any kidney damages. DESIGN: A cross-sectional study. SETTING: A shoe-making factory in West Java, Indonesia. PARTICIPANTS: 119 subjects were included. Minimum total sample size was 62. Subjects were indoor heat-exposed workers who were exposed to occupational wet-bulb globe temperature (WBGT) of 28°C-30°C for 8 hours daily with 1 hour break, 5 days a week. The inclusion criterion was healthy subjects according to the result from annual medical check-up in 2019. The exclusion criteria were subjects who were taking vitamins and/or supplements that might cause disturbance in urine specific gravity and/or hydration status, pregnant and fasting. PRIMARY AND SECONDARY OUTCOME MEASURES: Area under the curve (AUC), sensitivity and specificity of urine specific gravity for the detection of urinary nephrin and urinary kidney injury molecule-1 (KIM-1) were analysed. Estimated glomerular filtration rate (eGFR) and quantitative albuminuria were also measured. RESULTS: WBGT in the work area of the subject was 28°C-30°C. There were 15 (12.6%) subjects who had eGFR <90 mL/min, but ≥60 mL/min. High serum vasopressin levels were found in 79 subjects with a mean of 6.54 (95% CI 5.94 to 7.14) ng/mL. Most subjects had nephrinuria (87.4%) with preserved renal function (87.4%). Several subjects had elevated urinary KIM-1 (10.9%) and albuminuria (7.6%). AUC of urine specific gravity for increased urinary nephrin was 81.7% (95% CI 68.8% to 94.6%) and statistically significant (p<0.001). Cut-off value of ≥1.018 for urine specific gravity has sensitivity of 71.2% and specificity of 80% for detecting elevation of urinary nephrin levels. CONCLUSION: Urine specific gravity with a cut-off value of ≥1.018 could be used to detect nephrinuria among heat-exposed workers.


Subject(s)
Heat Stress Disorders , Occupational Exposure , Renal Insufficiency, Chronic , Cross-Sectional Studies , Hot Temperature , Humans , Indonesia , Kidney , Occupational Exposure/adverse effects , Occupational Exposure/analysis , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/etiology , Specific Gravity
10.
Molecules ; 26(12)2021 Jun 08.
Article in English | MEDLINE | ID: covidwho-1264497

ABSTRACT

This paper presents a method of implementation and the results of aerosol dispersion tests in underground mine workings. Numerous tests were carried out to determine the potential risk of SARS-CoV-2 coronavirus infection in the underground environment of the mines. The influence of selected parameters of mine air on the possibility and method of aerosol transmission through ventilation routes was experimentally determined in real conditions. The concentration of additional aerosols in the class of ultrafine and fine aerosols increased with the distance from the generator, while the concentration of coarse particles decreased. Assuming the consumption of the solution with which aerosols were generated, even at a small level of 1 cm3/min., the number of additional aerosols was several hundred particles in one cubic centimeter of air at a distance of 50-70 m from the generator. The concentration of ultrafine particles in the range of 40-20,000 nm increased from 122 particles/cm3 to 209 particles/cm3 at air temperature of 12 °C and relative humidity of 95-96%, and from 90 particles/cm3 to 243 particles/cm3 at air temperature of 17 °C and relative humidity of 76-82%, with the increasing distance from the generator (10 m to 50 m).


Subject(s)
Aerosols/analysis , COVID-19/transmission , Coal Mining , Workplace/standards , Air/analysis , Environmental Monitoring/instrumentation , Environmental Monitoring/methods , Equipment Design , Humans , Occupational Exposure/analysis , Particle Size , Particulate Matter/analysis , Poland , SARS-CoV-2
11.
BMJ Case Rep ; 13(11)2020 Nov 03.
Article in English | MEDLINE | ID: covidwho-1186251

ABSTRACT

Fever is a widely recognised presenting symptom of COVID-19. Consequently, other febrile illnesses may be difficult to distinguish from COVID-19-leading to delays in diagnosis and treatment. One such illness is murine typhus, a fleaborne illness with worldwide distribution caused by Rickettsia typhi It often presents with fever, headache and myalgia, all of which have been commonly reported with COVID-19. Although the disease is usually mild with a good prognosis, there have been reports of severe illness and death. I present a case of murine typhus in a young male who had 2 weeks of headaches and daily fevers during the COVID-19 pandemic. He was ultimately tested for murine typhus when his occupation as a dog trainer was queried, and he experienced resolution of symptoms after treatment with doxycycline. During this pandemic, clinicians must be vigilant of other febrile illnesses whose symptoms overlap with COVID-19.


Subject(s)
Coronavirus Infections/diagnosis , Doxycycline/administration & dosage , Fever/diagnosis , Occupational Exposure/analysis , Pneumonia, Viral/diagnosis , Rickettsia typhi/isolation & purification , Typhus, Endemic Flea-Borne , Adult , Ambulatory Care/methods , Animals , Anti-Bacterial Agents/administration & dosage , Betacoronavirus , COVID-19 , Diagnosis, Differential , Disease Reservoirs/microbiology , Disease Transmission, Infectious , Dogs , Fever/etiology , Humans , Male , Pandemics , SARS-CoV-2 , Treatment Outcome , Typhus, Endemic Flea-Borne/diagnosis , Typhus, Endemic Flea-Borne/drug therapy , Typhus, Endemic Flea-Borne/microbiology , Typhus, Endemic Flea-Borne/physiopathology
12.
Int J Environ Res Public Health ; 18(4)2021 02 09.
Article in English | MEDLINE | ID: covidwho-1112711

ABSTRACT

BACKGROUND: No previous study has investigated the SARS-CoV-2 prevalence and the changes in the proportion of positive results due to lockdown measures from the angle of workers' vulnerability to coronavirus in Greece. Two community-based programs were implemented to evaluate the SARS-CoV-2 prevalence and investigate if the prevalence changes were significant across various occupations before and one month after lockdown. METHODS: Following consent, sociodemographic, clinical, and job-related information were recorded. The VivaDiag™ SARS-CoV-2 Antigen Rapid Test was used. Positive results confirmed by a real-time Reverse Transcriptase Polymerase Chain Reaction for SARS-COV-2. RESULTS: Positive participants were more likely to work in the catering/food sector than negative participants before the lockdown. Lockdown restrictions halved the new cases. No significant differences in the likelihood of being SARS-CoV-2 positive for different job categories were detected during lockdown. The presence of respiratory symptoms was an independent predictor for rapid antigen test positivity; however, one-third of newly diagnosed patients were asymptomatic at both time points. CONCLUSIONS: The catering/food sector was the most vulnerable to COVID-19 at the pre-lockdown evaluation. We highlight the crucial role of community-based screening with rapid antigen testing to evaluate the potential modes of community transmission and the impact of infection control strategies.


Subject(s)
COVID-19 Testing , COVID-19/diagnosis , COVID-19/epidemiology , Occupations , Antigens, Viral/analysis , Communicable Disease Control , Greece/epidemiology , Humans , Occupational Exposure/analysis , Prevalence
14.
J Oncol Pharm Pract ; 28(2): 343-352, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1079193

ABSTRACT

INTRODUCTION: Healthcare workers exposure to antineoplastic drugs can lead to adverse health effects. Guidelines promote the safe handling of antineoplastic drugs, but no safe exposure limit was determined. Regular surface sampling contributes to ensuring workers safety. METHODS: A cross-sectional monitoring is conducted once a year with voluntary Canadian centers, since 2010. Twelve standardized sampling sites were sampled. Samples were analyzed by high performance mass coupled liquid chromatography. The limits of detection (in ng/cm2) were: 0.001 for cyclophosphamide and gemcitabine; 0.3 for docetaxel and ifosfamide; 0.04 for 5-fluorouracil and paclitaxel; 0.003 for irinotecan; 0.002 for methotrexate; 0.01 for vinorelbine. RESULTS: The surfaces from 109 centers were sampled between 01/01/2020-18/06/2020. Twenty-six centers delayed their participation because of the COVID-19 pandemic. 1217 samples were analyzed. Surfaces were frequently contaminated with cyclophosphamide (34% positive, 75th percentile 0.00165 ng/cm2) and gemcitabine (16% and <0.001 ng/cm2). The armrest of patient treatment chairs (84% to at least one drug), the front grille inside the biological safety cabinet (BSC) (73%) and the floor in front of the BSC (55%) were frequently contaminated. Centers that prepared ≥5000 antineoplastic drugs annually had higher concentration of cyclophosphamide on their surfaces (p < 0.0001). Contamination measured on the surfaces was reduced from 2010 to 2020. CONCLUSIONS: This large-scale study showed reproducible long term follow up of the contamination of standardized sites of Canadian centers and a reduction in surface contamination from 2010 to 2020. Periodic surface sampling help centers meet their continuous improvements goals to reduce exposure as much as possible. The COVID-19 pandemic had a limited impact on the program.


Subject(s)
Antineoplastic Agents , COVID-19 , Occupational Exposure , Antineoplastic Agents/analysis , Canada , Cross-Sectional Studies , Cyclophosphamide/analysis , Environmental Monitoring , Equipment Contamination , Humans , Occupational Exposure/analysis , Pandemics , SARS-CoV-2
17.
J Occup Environ Med ; 62(12): 981-985, 2020 12.
Article in English | MEDLINE | ID: covidwho-998535

ABSTRACT

OBJECTIVE: The number of COVID-19 cases in Arizona is rapidly increasing, leading the country in the rate of new daily cases. Exposure among first responders remains unknown. METHODS: Rates of SARS-CoV-2 IgG among first responders in Arizona were determined, and attitudes/views about the impact of COVID-19 on their work life was analyzed. RESULTS: Of 3326 first responders, 50 (1.50%) tested positive for SARS-CoV-2 IgG. Most first responders thought antibody testing would help ease their anxieties (62.5%) and be beneficial to their work-life (60.6%). CONCLUSION: The rate of COVID-19 exposure among first responders in Arizona is low-1.50%. COVID-19 is a concern among many of the first responders, and antibody testing was beneficial in easing their anxieties about going to work and performing work-related duties.


Subject(s)
COVID-19/transmission , Emergency Responders , Occupational Diseases , Occupational Exposure/statistics & numerical data , Adolescent , Adult , Arizona/epidemiology , Attitude to Health , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/psychology , COVID-19 Testing , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Occupational Diseases/psychology , Occupational Exposure/adverse effects , Occupational Exposure/analysis , Young Adult
18.
J Occup Environ Hyg ; 18(2): 72-83, 2021 02.
Article in English | MEDLINE | ID: covidwho-975161

ABSTRACT

Simple plastic face shields have numerous practical advantages over regular surgical masks. In light of the spreading COVID-19 pandemic, the potential of face shields as a substitution for surgical masks was investigated. In order to determine the efficacy of the protective equipment we used a cough simulator. The protective equipment considered was placed on a manikin head that simulated human breathing. Concentration and size distribution of small particles that reached the manikin respiration pathways during the few tens of seconds following the cough event were monitored. Additionally, water sensitive papers were taped on the tested protective equipment and the manikin face. In the case of frontal exposure, for droplet diameter larger than 3 µm, the shield efficiency in blocking cough droplets was found to be comparable to that of regular surgical masks, with enhanced protection for portions of the face that the mask does not cover. Additionally, for finer particles, down to 0.3 µm diameter, a shield blocked about 10 times more fine particles than the surgical mask. When exposure from the side was considered, the performance of the shield was found to depend dramatically on its geometry. While a narrow shield allowed more droplets and aerosol to penetrate in comparison to a mask under the same configuration, a slightly wider shield significantly improved the performance. The source control potential of shields was also investigated. A shield, and alternatively, a surgical mask, were placed on the cough simulator, while the breathing simulator, situated 60 cm away in the jet direction, remained totally exposed. In both cases, no droplets or particles were found in the vicinity of the breathing simulator. Conducted experiments were limited to short time periods after expiratory events, and do not include longer time ranges associated with exposure to suspended aerosol. Thus, additional evidence regarding the risk posed by floating aerosol is needed to establish practical conclusions regarding actual transmittance reduction potential of face shields and surgical face masks.


Subject(s)
COVID-19/prevention & control , Inhalation Exposure/analysis , Masks/standards , Personal Protective Equipment/standards , SARS-CoV-2/isolation & purification , Aerosols/analysis , Air Microbiology , Cough/virology , Environmental Monitoring , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Inhalation Exposure/prevention & control , Materials Testing , Occupational Exposure/analysis , Occupational Exposure/prevention & control
19.
Anesthesiology ; 134(1): 61-71, 2021 01 01.
Article in English | MEDLINE | ID: covidwho-894652

ABSTRACT

BACKGROUND: Disease severity in coronavirus disease 2019 (COVID-19) may be associated with inoculation dose. This has triggered interest in intubation barrier devices to block droplet exposure; however, aerosol protection with these devices is not known. This study hypothesized that barrier devices reduce aerosol outside of the barrier. METHODS: Aerosol containment in closed, semiclosed, semiopen, and open barrier devices was investigated: (1) "glove box" sealed with gloves and caudal drape, (2) "drape tent" with a drape placed over a frame, (3) "slit box" with armholes and caudal end covered by vinyl slit diaphragms, (4) original "aerosol box," (5) collapsible "interlocking box," (6) "simple drape" over the patient, and (7) "no barrier." Containment was investigated by (1) vapor instillation at manikin's right arm with video-assisted visual evaluation and (2) submicrometer ammonium sulfate aerosol particles ejected through the manikin's mouth with ventilation and coughs. Samples were taken from standardized locations inside and around the barriers using a particle counter and a mass spectrometer. Aerosol evacuation from the devices was measured using standard hospital suction, a surgical smoke evacuator, and a Shop-Vac. RESULTS: Vapor experiments demonstrated leakage via arm holes and edges. Only closed and semiclosed devices and the aerosol box reduced aerosol particle counts (median [25th, 75th percentile]) at the operator's mouth compared to no barrier (combined median 29 [-11, 56], n = 5 vs. 157 [151, 166], n = 5). The other barrier devices provided less reduction in particle counts (133 [128, 137], n = 5). Aerosol evacuation to baseline required 15 min with standard suction and the Shop-Vac and 5 min with a smoke evacuator. CONCLUSIONS: Barrier devices may reduce exposure to droplets and aerosol. With meticulous tucking, the glove box and drape tent can retain aerosol during airway management. Devices that are not fully enclosed may direct aerosol toward the laryngoscopist. Aerosol evacuation reduces aerosol content inside fully enclosed devices. Barrier devices must be used in conjunction with body-worn personal protective equipment.


Subject(s)
Aerosols/analysis , COVID-19/prevention & control , Occupational Exposure/analysis , Occupational Exposure/prevention & control , Personal Protective Equipment , Aerosols/adverse effects , Cough/prevention & control , Cough/virology , Health Personnel , Humans , Intubation, Intratracheal/adverse effects
SELECTION OF CITATIONS
SEARCH DETAIL