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COVID-19:开放式牙科诊室中的牙科气溶胶污染及未来影响。

COVID-19: dental aerosol contamination in open plan dental clinics and future implications.

机构信息

University of Plymouth Peninsula Dental School, Plymouth, UK.

Newcastle University, Newcastle upon Tyne, UK.

出版信息

Evid Based Dent. 2021 Jan;22(2):54-55. doi: 10.1038/s41432-021-0168-0.


DOI:10.1038/s41432-021-0168-0
PMID:34172904
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8226348/
Abstract

Study design An experimental study design was used to investigate the spread of splatter/aerosol during simulated dental procedures on a mannequin in open plan clinic and dental clinical teaching laboratory settings. All experiments were based on crown preparation of an artificial maxillary central incisor using a high-speed air turbine over a ten-minute period. Fluorescein dye was introduced into the irrigation system of the handpiece (model 1) and the mannequin's mouth was used to simulate salivary flow (model 2) under varying experimental conditions (suction flow rate, cross ventilation and exposure time). Six experiments were conducted in the open plan clinic while three experiments were undertaken in the clinical laboratory. Customised rigs with collection platforms consisting of filter papers were placed in open plan bays and adjacent walkways. Samples were also collected from a 400 cm area in each of the eight adjacent bays. Time course experiments repeated the same procedures on three occasions in a clinical laboratory and utilised a rig with eight four-metre rods supporting collection platforms around a dental mannequin. The distribution of fluorescein dye was analysed by fluoroscopy and spectrofluorometry.Results Contamination levels showed variations under different experimental conditions. In the absence of suction and cross ventilation, contamination was observed at large distances. Use of suction reduced contamination in the operating bay by 53% and 81.83%, while cross ventilation reduced contamination in adjacent and distant areas by 80-89%. Minimal contamination was detected at a distance of >5 m from the operating bay, with the use of medium-volume suction demonstrating that 1.5-metre-high partitions with open fronts limit 99.99% of splatter from aerosol generating procedures (AGPs) to the operating bay. Minimal additional aerosol contamination was detected ten minutes after the procedure.Conclusions Contamination from dental AGPS has the potential to contaminate distant sites in open plan clinics. Risk of cross infection is small if the bays are >5 m apart and contamination can be minimised with the use of suction and cross ventilation.

摘要

研究设计 本实验采用模拟研究设计,在开放式临床诊室和牙科临床教学实验室环境下,于仿人头模型上进行模拟牙科学操作,以研究喷溅/气溶胶的扩散情况。所有实验均基于在 10 分钟内使用高速空气涡轮机对人造上颌中切牙进行牙冠预备。在不同的实验条件下(抽吸流量、交叉通风和暴露时间),将荧光染料引入手机(型号 1)的冲洗系统,并使用人头模型模拟唾液流动(模型 2)。在开放式临床诊室进行了 6 项实验,在临床实验室进行了 3 项实验。在开放式临床诊室中,使用定制的带有收集平台的装置,收集平台由滤纸制成,放置在开放式诊室的隔间和相邻通道中。还在每个相邻的 8 个隔间中收集了 400cm 面积的样本。在临床实验室中,时间进程实验重复了三次相同的程序,使用带有八个四米长杆的装置,在牙科人头模型周围支撑收集平台。通过荧光透视法和分光荧光光度法分析荧光染料的分布。结果 不同实验条件下的污染水平存在差异。在没有抽吸和交叉通风的情况下,在远距离观察到污染。使用抽吸可将操作室内的污染减少 53%和 81.83%,而交叉通风可将相邻和远距离区域的污染减少 80-89%。在距操作室 5 米以外的距离检测到最小的污染,使用中容量抽吸表明,高度为 1.5 米的带有开放正面的隔板可将气溶胶产生操作(AGP)产生的飞沫限制在操作室内的 99.99%。在操作结束 10 分钟后,检测到的气溶胶污染最小。结论 牙科 AGP 产生的污染有污染开放式临床诊室远距离区域的潜力。如果隔间相隔超过 5 米,则交叉感染的风险很小,并且可以通过使用抽吸和交叉通风来最小化污染。

相似文献

[1]
COVID-19: dental aerosol contamination in open plan dental clinics and future implications.

Evid Based Dent. 2021-1

[2]
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[3]
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[4]
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Int J Environ Res Public Health. 2021-4-4

[5]
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[6]
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Br Dent J. 2021-1-8

[7]
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J Dent. 2021-9

[8]
Simulated and clinical aerosol spread in common periodontal aerosol-generating procedures.

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[9]
Aerosol-Generating Procedures and Simulated Cough in Dental Anesthesia.

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[10]
Mitigating saliva aerosol contamination in a dental school clinic.

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引用本文的文献

[1]
Microbial Air Contamination in a Dental Setting Environment and Ultrasonic Scaling in Periodontally Healthy Subjects: An Observational Study.

Int J Environ Res Public Health. 2023-2-3

本文引用的文献

[1]
The Strategies to Support the COVID-19 Vaccination with Evidence-Based Communication and Tackling Misinformation.

Vaccines (Basel). 2021-2-1

[2]
Students' return to clinic.

Br Dent J. 2021-1

[3]
SARS-CoV-2: characterisation and mitigation of risks associated with aerosol generating procedures in dental practices.

Br Dent J. 2021-1-7

[4]
Dental education in the time of SARS-CoV-2.

Eur J Dent Educ. 2021-5

[5]
Dental procedure aerosols and COVID-19.

Lancet Infect Dis. 2021-4

[6]
Transmission routes of 2019-nCoV and controls in dental practice.

Int J Oral Sci. 2020-3-3

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