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.

Citation

Gordon, G. S., Warburton, S., Parkes, S., Kerridge, A., Parra-Blanco, A., Ortiz-Fernandez-Sordo, J., & Fitzgerald, R. C. (2024). Cytosponge procedures produce fewer respiratory aerosols and droplets than oesophagogastroduodenoscopies. Diseases of the Esophagus, 37(3), Article doad061. https://doi.org/10.1093/dote/doad061

• 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