Gastroenterology and Digestive Oncology Department, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris and Université Paris Cité, Paris, France.
United European Gastroenterol J. 2023 Mar;11(2):171-178. doi: 10.1002/ueg2.12355. Epub 2023 Jan 26.
The SARS-Cov-2 disease disrupted essential hospital procedures, such as gastrointestinal (GI) endoscopy, due to concerns about air transmission and the risk of exposing health care workers. With the spread of the pandemic, air transmission was considered as the main source of SARS-Cov2 transmission. This raised the problem of transmission by aerosolization of viral particles in operating rooms as well as endoscopy units. This is in line with the known airborne transmission of many other respiratory viruses. The risk of SARS-Cov-2 transmission during GI endoscopy was initially reduced by controlled measures, involving personal protections (mask…), restricted access to endoscopy rooms, and detection of infected patients. Gastrointestinal endoscopy generates aerosols, which may carry viruses. In addition, the endoscopy system may facilitate the diffusion of virus particles or fomites considering the forced-air cooling system used to maintain a stable temperature inside the box (25°C). The volume of air that goes through the light source box is high (240-300 m for a 1-h period). Moreover, the light system contains an air pump to inflate air inside the gut lumen. In order to isolate people from hazard, different levels of protection and solutions to avoid airborne transmission of microorganisms should be proposed, such as the reinforcement of personal protective equipment, the change in the way people work and engineering control of the risk.
SARS-CoV-2 疾病扰乱了基本的医院程序，如胃肠（GI）内窥镜检查，因为担心空气传播和暴露医护人员的风险。随着大流行的传播，空气传播被认为是 SARS-CoV2 传播的主要来源。这引发了手术室和内窥镜检查室中病毒颗粒气溶胶化传播的问题。这与许多其他呼吸道病毒的已知空气传播一致。最初，通过控制措施（包括个人防护（口罩等）、限制内窥镜室的进入和检测感染患者）来降低 GI 内窥镜检查期间 SARS-CoV-2 的传播风险。胃肠道内窥镜检查会产生气溶胶，其中可能携带病毒。此外，内窥镜系统可能会由于使用强制风冷系统来维持盒子内部的稳定温度（25°C）而促进病毒颗粒或媒介物的扩散。通过光源盒的空气量很高（1 小时内为 240-300 m）。此外，灯光系统包含一个气泵，用于向肠道腔内充气。为了将人们与危害隔离开来，应提出不同级别的保护措施和避免微生物空气传播的解决方案，例如加强个人防护设备、改变人们的工作方式和工程控制风险。
