Mucophysiology Laboratory, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
BMC Public Health. 2013 Sep 8;13:811. doi: 10.1186/1471-2458-13-811.
The effectiveness of recommended measures, such as "cover your mouth when coughing", in disrupting the chain of transmission of infectious respiratory diseases (IRD) has been questioned. The objective of the current study was to determine the effectiveness of simple primary respiratory hygiene/cough etiquette maneuvers in blocking droplets expelled as aerosol during coughing.
In this study, 31 healthy non-smokers performed cough etiquette maneuvers in an effort to cover their voluntarily elicited best effort coughs in an open bench format. A laser diffraction system was used to obtain accurate, non-invasive, quantitative, real time measurements of the size and number of droplets emitted during the assessed cough etiquette maneuvers.
Recommended cough etiquette maneuvers did not block the release and dispersion of a variety of different diameter droplets to the surrounding environment. Droplets smaller than one-micron size dominate the total number of droplets leaked when practicing assessed maneuvers.
All the assessed cough etiquette maneuvers, performed as recommended, do not block droplets expelled as aerosol when coughing. This aerosol can penetrate profound levels of the respiratory system. Practicing these assessed primary respiratory hygiene/cough etiquette maneuvers would still permit direct, indirect, and/or airborne transmission and spread of IRD, such as influenza and Tuberculosis. All the assessed cough etiquette maneuvers, as recommended, do not fully interrupt the chain of transmission of IRD. This knowledge urges us all to critically review recommended CE and to search for new evidence-based procedures that effectively disrupt the transmission of respiratory pathogens. Interrupting the chain of transmission of IRD will optimize the protection of first responders, paramedics, nurses, and doctors working in triage sites, emergency rooms, intensive care units, and the general public against cough-droplet-spread diseases.
“咳嗽时捂住口鼻”等推荐措施在阻断传染性呼吸道疾病（IRD）传播链方面的有效性受到了质疑。本研究的目的是确定简单的初级呼吸道卫生/咳嗽礼仪措施在阻断咳嗽时作为气溶胶排出的飞沫的有效性。
在这项研究中，31 名健康不吸烟者在开放式长凳上以最大努力咳嗽，并进行咳嗽礼仪措施，以试图覆盖他们自愿引发的咳嗽。激光衍射系统用于对评估的咳嗽礼仪措施期间排放的飞沫的大小和数量进行准确、非侵入性、定量、实时测量。
推荐的咳嗽礼仪措施并不能阻止各种不同直径的飞沫在周围环境中的释放和扩散。当进行评估的措施时，小于 1 微米大小的飞沫主导泄漏的总飞沫数。
所有评估的咳嗽礼仪措施，如推荐的那样，在咳嗽时不能阻挡作为气溶胶排出的飞沫。这种气溶胶可以穿透呼吸系统的深层。练习这些评估的初级呼吸道卫生/咳嗽礼仪措施仍将允许 IRD（如流感和结核病）的直接、间接和/或空气传播和扩散。所有评估的咳嗽礼仪措施，如推荐的那样，并没有完全中断 IRD 的传播链。这一知识促使我们所有人批判性地审查推荐的 CE，并寻找新的基于证据的程序，以有效地阻断呼吸道病原体的传播。中断 IRD 的传播链将优化对在分诊点、急诊室、重症监护室和普通大众中工作的急救人员、护理人员、护士和医生的保护，使其免受咳嗽飞沫传播疾病的侵害。
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