Division of Rhinology, Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Department of Civil, Architectural, and Environmental Engineering, College of Engineering, Drexel University, Philadelphia, PA.
Int Forum Allergy Rhinol. 2020 Oct;10(10):1173-1179. doi: 10.1002/alr.22661. Epub 2020 Jul 24.
The coronavirus disease-2019 (COVID-19) pandemic has heightened the awareness of aerosol generation by human expiratory events and their potential role in viral respiratory disease transmission. Concerns over high severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) viral burden of mucosal surfaces has raised questions about the aerosol-generating potential and dangers of many otorhinolaryngologic procedures. However, the risks of aerosol generation and associated viral transmission by droplet or airborne routes for many otorhinolaryngology procedures are largely unknown. Indoor aerosol and droplet viral respiratory transmission risk is influenced by 4 factors: (1) aerosol or droplet properties; (2) indoor airflow; (3) virus-specific factors; and (4) host-specific factors. Herein we elaborate on known aerosol vs droplet properties, indoor airflow, and aerosol-generating events to provide context for risks of aerosol infectious transmission. We also provide simple but typically effective measures for mitigating the spread and inhalation of viral aerosols in indoor settings. Understanding principles of infectious transmission, aerosol and droplet generation, as well as concepts of indoor airflow, will assist in the integration of new data on SARS-CoV-2 transmission and activities that can generate aerosol to best inform on the need for escalation or de-escalation from current societal and institutional guidelines for protection during aerosol-generating procedures.
新型冠状病毒病（COVID-19）大流行提高了人们对人类呼气事件产生气溶胶及其在病毒性呼吸道疾病传播中的潜在作用的认识。对粘膜表面高载量严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的担忧引发了对许多耳鼻喉科手术产生气溶胶的潜力和危险的质疑。然而，许多耳鼻喉科手术产生飞沫或空气传播途径气溶胶的风险以及相关病毒传播的风险在很大程度上尚不清楚。室内气溶胶和飞沫病毒呼吸道传播的风险受 4 个因素的影响：（1）气溶胶或飞沫的特性；（2）室内气流；（3）病毒特异性因素；（4）宿主特异性因素。本文详细阐述了已知的气溶胶与飞沫特性、室内气流以及产生气溶胶的事件，为气溶胶感染性传播的风险提供了背景。我们还提供了简单但通常有效的措施来减轻室内环境中病毒气溶胶的传播和吸入。了解传染性传播、气溶胶和飞沫产生的原则以及室内气流的概念，将有助于整合有关 SARS-CoV-2 传播的新数据以及可能产生气溶胶的活动，从而更好地告知在产生气溶胶的手术期间是否需要升级或降低当前社会和机构指南的保护水平。
