Abstract

Background: Several medical procedures involving the respiratory tract are considered as ‘aerosol-generating procedures’. Aerosols from these procedures may be inhaled by bystanders, and there are consequent concerns regarding the transmission of infection or, specific to nebulized therapy, secondary drug exposure.

Aim: To assess the efficacy of a proprietary high-efficiency-particulate-air-filtering extractor tent on reducing the aerosol dispersal of nebulized bronchodilator drugs.

Methods: The study was conducted in an unoccupied outpatient room at St. James's Hospital, Dublin, Ireland. A novel real-time, fluorescent particle counter, the Wideband Integrated Bioaerosol Sensor (WIBS), monitored room air continuously for 3 h. Baseline airborne particle count and count during nebulization of bronchodilator drug solutions were recorded.

Findings: Nebulization within the tent prevented any increase over background level. Nebulization directly into room air resulted in mean fluorescent particle counts of 4.75 x 105/m3 and 4.21 x 105/m3 for Ventolin and Ipramol, respectively, representing more than 400-fold increases over mean background level. More than 99.3% of drug particles were <2 μm in diameter and therefore small enough to enter the lower respiratory tract.

Conclusion: The extractor tent was completely effective for the prevention of airborne spread of drug particles of respirable size from nebulized therapy. This suggests that extractor tents of this type would be efficacious for the prevention of airborne infection from aerosol-generating procedures during the COVID-19 pandemic.

Keywords

Air sampling, Airborne, Continuous monitoring, COVID-19, Environment, Nebulizer, Real-time analysis, WIBS

Publication Date

2021-01-20

Publication Title

Journal of Hospital Infection

Volume

110

ISSN

0195-6701

First Page

108

Last Page

113

Deposit Date

2026-08-11

Funding

This study was funded, in part, by a Healthcare Infection Society Major Project Grant (MRG/2015_07/012) to MBP, JS and BP. This publication emanated from research conducted with the financial support of Science Foundation Ireland (Grant No. 20/COV/0281). The Environmental Protection Agency (Ireland) purchased the WIBS-4A (EPA Project No. 2007 CCRP Project 4.4.6.b).

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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