Frank Phillips
Air filtration mitigates aerosol levels both during and after endoscopy procedures
Phillips, Frank; Crowley, Jane; Warburton, Samantha; Staniforth, Karren; Parra‐Blanco, Adolfo; Gordon, George S.D.
Authors
Jane Crowley
Samantha Warburton
Karren Staniforth
Adolfo Parra‐Blanco
Dr GEORGE GORDON GEORGE.GORDON@NOTTINGHAM.AC.UK
ASSOCIATE PROFESSOR
Abstract
Objectives: Upper gastrointestinal endoscopies are aerosol‐generating procedures, increasing the risk of spreading airborne pathogens. We aim to quantify the mitigation of airborne particles via improved ventilation, specifically laminar flow theatres and portable high‐efficiency particulate air (HEPA) filters, during and after upper gastrointestinal endoscopies. Methods: This observational study included patients undergoing routine upper gastrointestinal endoscopy in a standard endoscopy room with 15–17 air changes per hour, a standard endoscopy room with a portable HEPA filtration unit, and a laminar flow theatre with 300 air changes per hour. A particle counter (diameter range 0.3 μm‐25 μm) took measurements 10 cm from the mouth. Three analyses were performed: whole procedure particle counts, event‐based counts, and air clearance estimation using post‐procedure counts. Results: Compared to a standard endoscopy room, for whole procedures we observe a 28.5x reduction in particle counts in laminar flow (p < 0.001) but no significant effect of HEPA filtration (p = 0.50). For event analysis, we observe for lateral flow theatres reduction in particles >5 μm for oral extubation (12.2x, p < 0.01), reduction in particles <5 μm for coughing/gagging (6.9x, p < 0.05), and reduction for all sizes in anesthetic throat spray (8.4x, p < 0.01) but no significant effect of HEPA filtration. However, we find that in the fallow period between procedures HEPA filtration reduces particle clearance times by 40%. Conclusions: Laminar flow theatres are highly effective at dispersing aerosols immediately after production and should be considered for high‐risk cases where patients are actively infectious or the supply of personal protective equipment is limited. Portable HEPA filers can safely reduce the fallow time between procedures by 40%.
Citation
Phillips, F., Crowley, J., Warburton, S., Staniforth, K., Parra‐Blanco, A., & Gordon, G. S. (2023). Air filtration mitigates aerosol levels both during and after endoscopy procedures. DEN Open, 3(1), Article e231. https://doi.org/10.1002/deo2.231
Journal Article Type | Article |
---|---|
Acceptance Date | Mar 14, 2023 |
Online Publication Date | Apr 17, 2023 |
Publication Date | Apr 1, 2023 |
Deposit Date | May 3, 2023 |
Publicly Available Date | May 9, 2023 |
Journal | DEN Open |
Electronic ISSN | 2692-4609 |
Publisher | Wiley Open Access |
Peer Reviewed | Peer Reviewed |
Volume | 3 |
Issue | 1 |
Article Number | e231 |
DOI | https://doi.org/10.1002/deo2.231 |
Keywords | Aerosols, air conditioning, COVID‐19, endoscopy, infection control |
Public URL | https://nottingham-repository.worktribe.com/output/19778853 |
Publisher URL | https://onlinelibrary.wiley.com/doi/10.1002/deo2.231 |
Additional Information | © 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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Air filtration mitigates aerosol levels both during and afterendoscopy procedures
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https://creativecommons.org/licenses/by/4.0/
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