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医院诊室环境下的 COVID-19 感染防控。

Infection control for COVID-19 in hospital examination room.

机构信息

Safety and Health Organization, Chiba University, 1-33, Yayoi-Cho, Inage-ku, Chiba, Chiba, Japan.

Department of General Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.

出版信息

Sci Rep. 2022 Oct 29;12(1):18230. doi: 10.1038/s41598-022-22643-w.

DOI:10.1038/s41598-022-22643-w
PMID:36309548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9617229/
Abstract

Healthcare providers are vulnerable to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) because of their close proximity to patients with coronavirus disease 2019. SARS-CoV-2 is mainly transmitted via direct and indirect contact with respiratory droplets, and its airborne transmission has also been identified. However, evidence for environmental factors is scarce, and evidence-based measures to minimize the risk of infection in clinical settings are insufficient. Using computational fluid dynamics, we simulated exhalation of large and small aerosol particles by patients in an otolaryngology examination room, where medical procedures require the removal of a face mask. The effects of coughing were analyzed, as well as those of humidity as a controllable environmental factor and of a suction device as an effective control method. Our results show that a suction device can minimize aerosol exposure of healthcare workers by efficiently removing both large (11.6-98.2%) and small (39.3-99.9%) aerosol particles. However, for coughing patients, the removal efficiency varies inversely with the particle size, and the humidity notably affects the aerosol behavior, indicating the need for countermeasures against smaller aerosols. Overall, these results highlight the potential and limitation of using a suction device to protect against SARS-CoV-2 and future respiratory infections.

摘要

医护人员由于与 2019 年冠状病毒病患者近距离接触,容易感染严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)。SARS-CoV-2 主要通过直接和间接接触呼吸道飞沫传播,其空气传播也已被确定。然而,关于环境因素的证据很少,临床环境中降低感染风险的循证措施也不足。我们使用计算流体动力学模拟了耳鼻喉科检查室中患者呼出的大、小气溶胶颗粒,在此类医疗程序中需要摘下口罩。我们分析了咳嗽的影响,以及湿度作为可控环境因素和抽吸装置作为有效控制方法的影响。结果表明,抽吸装置可以通过有效去除大(11.6-98.2%)和小(39.3-99.9%)气溶胶颗粒,将医护人员的气溶胶暴露最小化。然而,对于咳嗽的患者,去除效率与颗粒尺寸成反比,湿度显著影响气溶胶行为,表明需要针对较小的气溶胶采取对策。总的来说,这些结果突出了使用抽吸装置来预防 SARS-CoV-2 和未来呼吸道感染的潜力和局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/1cb636c5d059/41598_2022_22643_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/bd5125003c49/41598_2022_22643_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/0d2fab2f07fa/41598_2022_22643_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/06b200de46c4/41598_2022_22643_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/1cb636c5d059/41598_2022_22643_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/bd5125003c49/41598_2022_22643_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/0d2fab2f07fa/41598_2022_22643_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/06b200de46c4/41598_2022_22643_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/248e/9617935/1cb636c5d059/41598_2022_22643_Fig4_HTML.jpg

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