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Efficacy of Environmental Measures in Reducing Potentially Infectious Bioaerosols During Sputum Induction

  • Dick Menzies (a1) (a2), Neill Adhikari (a1) (a2), Marie Arietta (a2) and Vivian Loo (a3)
Abstract
AbstractObjective:

To evaluate the airborne viable bacterial concentrations generated during sputum induction and their reduction with exhaust ventilation, ultraviolet germicidal irradiation (UVGI), or both.

Methods:

Exhaust ventilation, upper air UVGI lights, and a portable UVGI unit were operated independently or in combination while and after sputum induction was performed for 58 patients suspected of having active tuberculosis. Viable airborne bacteria were sampled with volumetric air samplers, grown on blood agar, and identified with standard techniques.

Results:

During and immediately after sputum induction, concentrations of airborne bacteria, particularly respiratory tract or oropharyngeal organisms, increased rapidly, regardless of environmental conditions. The subsequent rate of reduction of airborne bacteria was most rapid with the portable UVGI unit, followed by upper air UVGI with air mixing. Exhaust ventilation achieved high air changes per hour, but efficacy in reducing airborne bacterial concentrations was low. However, the continuous entrainment of bacteria-laden air from the hallway outside may have resulted in underestimation. The efficacy of a wall-mounted upper air UVGI fixture was significantly less if there was no air mixing. The irradiation from this fixture was of adequate germicidal intensity only in a narrow horizontal plane 2.5 m above the floor.

Conclusion:

Sputum induction was associated with a rapid and substantial increase in airborne bacteria despite the use of exhaust ventilation providing more than 30 air changes per hour, and the adjunct use of UVGI. This emphasizes that health-care workers involved in similar cough-inducing procedures performed for patients with suspected tuberculosis must wear appropriate personal respirators (Infect Control Hosp Epidemiol 2003;24:483-489)

Copyright
Corresponding author
Respiratory Epidemiology Unit, McGill University, 1110 Pine Ave. West, Montreal, Quebec, CanadaH3A 1A3
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3. PN Wenger , J Often , A Breeden , D Orfas , CM Beck-Sague , WR Jarvis . Control of nosocomial transmission of multidrug-resistant Mycobacterium tuberculosis among healthcare workers and HIV-infected patients. Lancet 1995;345:235240.

4. P Fella , P Rivera , M Hale , K Squires , K Sepkowitz . Dramatic decrease in tuberculin skin test conversion rate among employees at a hospital in New York City. Am J Infect Control 1995;23:352356.

5. SA Maloney , ML Pearson , MT Gordon , R Del Castillo , JF Boyle , WR Jarvis . Efficacy of control measures in preventing nosocomial transmission of multidrug-resistant tuberculosis to patients and health care workers. Ann Intern Med 1995;122:9095.

6. HM Blumberg , DL Watkins , PA-C Jeffrey , et al. Preventing the nosocomial transmission of tuberculosis. Ann Intern Med 1995;122:658663.

7. S Kellerman , JI Tokars , WR Jarvis . The cost of selected tuberculosis control measures at hospitals with a history of Mycobacterium tuberculosis outbreaks. Infect Control Hosp Epidemiol 1997;18:542547.

12. JE Perkins , AM Bahlke , HF Silverman . Effect of ultraviolet irradiation of classrooms on spread of measles in large rural central schools. Am J Public Health 1947;37:529537.

15. RI Menzies , A Fanning , L Yuan . Tuberculosis among health care workers. N Engl J Med 1995;332:9298.

16. MT McKenna , M Hutton , G Cauthen , IM Onorato . The association between occupation and tuberculosis: a population-based survey. Am J Respir Crit Care Med 1996;154:587593.

17. RI Menzies , A Fanning , L Yuan , JM Fitzgerald . Hospital ventilation and risk of tuberculous infection in Canadian health care workers. Ann Intern Med 2000;133:779789.

18. C Malasky , T Jordan , F Potulski , LB Reichman . Occupational tuberculosis infections among pulmonary physicians in training. American Review of Respiratory Disease 1990;142:505507.

19. C Anderson , N Inhaber , RI Menzies . Comparison of sputum induction with fiberoptic bronchoscopy in the diagnosis of tuberculosis. Am J Respir Crit Care Med 1995;152:15701574.

20. RI Menzies , K Schwartzman , V Loo , J Pasztor . Measuring ventilation of patient care areas in hospitals: description of a new protocol. Am J Respir Crit Care Med 1995;152:19921999.

23. KP Fennelly , EA Nardell . The relative efficacy of respirators and room ventilation in preventing occupational tuberculosis. Infect Control Hosp Epidemiol 1998;19:754759.

24. EA Nardell . Interrupting transmission from patients with unsuspected tuberculosis: a unique role for upper-room ultraviolet air disinfection. Am J Infect Control 1995;23:156164.

25. RL Riley , S Permutt , JE Kaufman . Convention, air mixing and ultraviolet air disinfection in rooms. Arch Environ Health 1971;22:200207.

26. M Nicas , SL Miller . A multi-zone model evaluation of the efficacy of upper-room air ultraviolet germicidal irradiation. Appl Occup Environ Hyg 1999;14:317328.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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