Cytosponge procedures produce fewer respiratory aerosols and droplets than oesophagogastroduodenoscopies

Gordon, George S.D.; Warburton, Samantha; Parkes, Sian; Kerridge, Abigail; Parra-Blanco, Adolfo; Ortiz-Fernandez-Sordo, Jacobo; Fitzgerald, Rebecca C.

Abstract

Esophagogastroduodenoscopies (EGD) are aerosol-generating procedures that may spread respiratory pathogens. We aim to investigate the production of airborne aerosols and droplets during Cytosponge procedures, which are being evaluated in large-scale research studies and National Health Service (NHS)implementation pilots to reduce endoscopy backlogs. We measured 18 Cytosponge and 37 EGD procedures using a particle counter (diameters = 0.3–25 μm), taking measurements 10 cm from the mouth. Two particle count analyses were performed: whole procedure and event-based. Direct comparison with duration-standardized EGD procedures shows that Cytosponge procedures produce 2.16× reduction (P < 0.001) for aerosols and no significant change for droplets (P = 0.332). Event-based analysis shows that particle production is driven by throat spray (aerosols: 138.1× reference, droplets: 16.2×), which is optional, and removal of Cytosponge (aerosols: 14.6×, droplets: 62.6×). Cytosponge burping produces less aerosols than EGD (2.82×, P < 0.05). Cytosponge procedures produce significantly less aerosols and droplets than EGD procedures and thus reduce two potential transmission routes for respiratory viruses.

• Journal Article Type: Article
• Acceptance Date: Oct 14, 2023
• Online Publication Date: Oct 28, 2023
• Publication Date: 2024-03
• Deposit Date: Apr 5, 2024
• Publicly Available Date: Apr 9, 2024
• Print ISSN: 1120-8694
• Electronic ISSN: 1442-2050
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 37
• Issue: 3
• Article Number: doad061
• DOI: https://doi.org/10.1093/dote/doad061
• Public URL: https://nottingham-repository.worktribe.com/output/21646313
• Publisher URL: https://academic.oup.com/dote/article/37/3/doad061/7332012