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Are aerosols generated during lung function testing in patients and healthy volunteers? Results from the AERATOR study.
Sheikh, Sadiyah; Hamilton, Fergus W; Nava, George W; Gregson, Florence K A; Arnold, David T; Riley, Colleen; Brown, Jules; Reid, Jonathan P; Bzdek, Bryan R; Maskell, Nicholas A; Dodd, James William.
  • Sheikh S; Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, UK.
  • Hamilton FW; Department of Infection Science, North Bristol NHS Trust, Bristol, UK gushamilton@gmail.com.
  • Nava GW; Population Health Sciences, University of Bristol, Bristol, UK.
  • Gregson FKA; MRC Integrative Epidemiology Unit, Bristol, UK.
  • Arnold DT; Academic Respiratory Unit, University of Bristol, Bristol, UK.
  • Riley C; Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, UK.
  • Brown J; Academic Respiratory Unit, University of Bristol, Bristol, UK.
  • Reid JP; Anaesthetics and Intensive Care Department, North Bristol NHS Trust, Westbury on Trym, UK.
  • Maskell NA; Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, UK.
  • Dodd JW; Bristol Aerosol Research Centre, School of Chemistry, University of Bristol, Bristol, UK.
Thorax ; 77(3): 292-294, 2022 03.
Article in English | MEDLINE | ID: covidwho-1515322
ABSTRACT
Pulmonary function tests are fundamental to the diagnosis and monitoring of respiratory diseases. There is uncertainty around whether potentially infectious aerosols are produced during testing and there are limited data on mitigation strategies to reduce risk to staff. Healthy volunteers and patients with lung disease underwent standardised spirometry, peak flow and FENO assessments. Aerosol number concentration was sampled using an aerodynamic particle sizer and an optical particle sizer. Measured aerosol concentrations were compared with breathing, speaking and voluntary coughing. Mitigation strategies included a standard viral filter and a full-face mask normally used for exercise testing (to mitigate induced coughing). 147 measures were collected from 33 healthy volunteers and 10 patients with lung disease. The aerosol number concentration was highest in coughs (1.45-1.61 particles/cm3), followed by unfiltered peak flow (0.37-0.76 particles/cm3). Addition of a viral filter to peak flow reduced aerosol emission by a factor of 10 without affecting the results. On average, coughs produced 22 times more aerosols than standard spirometry (with filter) in patients and 56 times more aerosols in healthy volunteers. FENO measurement produced negligible aerosols. Cardiopulmonary exercise test (CPET) masks reduced aerosol emission when breathing, speaking and coughing significantly. Lung function testing produces less aerosols than voluntary coughing. CPET masks may be used to reduce aerosol emission from induced coughing. Standard viral filters are sufficiently effective to allow guidelines to remove lung function testing from the list of aerosol-generating procedures.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lung / Masks Type of study: Prognostic study Limits: Humans Language: English Journal: Thorax Year: 2022 Document Type: Article Affiliation country: Thoraxjnl-2021-217671

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lung / Masks Type of study: Prognostic study Limits: Humans Language: English Journal: Thorax Year: 2022 Document Type: Article Affiliation country: Thoraxjnl-2021-217671