Physics, School of Natural Sciences, Ryan Institute's Centre for Climate and Air Pollution Studies, College of Science & Engineering, University of Galway, H91 CF50, Galway, Ireland.
Physics, School of Natural Sciences, Ryan Institute's Centre for Climate and Air Pollution Studies, College of Science & Engineering, University of Galway, H91 CF50, Galway, Ireland; Department of Experimental Physics, Maynooth University, Maynooth, Co. Kildare, Ireland.
Eur J Pharm Sci. 2023 Aug 1;187:106474. doi: 10.1016/j.ejps.2023.106474. Epub 2023 May 22.
Open circuit aerosol therapy is associated with the potential for fugitive emissions of medical aerosol. Various nebulisers and interfaces are used in respiratory treatments, including the recent consideration of filtered interfaces. This study aims to quantify fugitive medical aerosols from various nebuliser types, in conjunction with different filtered and non-filtered interfaces.
For both simulated adult and paediatric breathing, four nebuliser types were assessed including; a small volume jet nebuliser (SVN), a breath enhanced jet nebuliser (BEN), a breath actuated jet nebuliser (BAN) and a vibrating mesh nebuliser (VMN). A combination of different interfaces were used including filtered and unfiltered mouthpieces, as well as open, valved and filtered facemasks. Aerosol mass concentrations were measured using an Aerodynamic Particle Sizer at 0.8 m and 2.0 m. Additionally, inhaled dose was assessed.
Highest mass concentrations recorded were 214 (177, 262) µg m at 0.8 m over 45-minute run. The highest and lowest fugitive emissions were observed for the adult SVN facemask combination, and the adult BAN filtered mouthpiece combination respectively. Fugitive emissions decreased when using breath-actuated (BA) mode compared to continuous (CN) mode on the BAN for the adult and paediatric mouthpiece combination. Lower fugitive emissions were observed when a filtered facemask or mouthpiece was used, compared to unfiltered scenarios. For the simulated adult, highest and lowest inhaled dose were 45.1 (42.6, 45.6)% and 11.0 (10.1,11.9)% for the VMN and SVN respectively. For the simulated paediatric, highest and lowest inhaled dose were 44.0 (42.4, 44.8)% and 6.1 (5.9, 7.0)% for the VMN and BAN CN respectively. Potential inhalation exposure of albuterol was calculated to be up to 0.11 µg and 0.12 µg for a bystander and healthcare worker respectively.
This work demonstrates the need for filtered interfaces in clinical and homecare settings to minimise fugitive emissions and to reduce the risk of secondary exposure to care givers.
开路气溶胶疗法可能导致医疗气溶胶逸散。各种雾化器和接口用于呼吸治疗，包括最近考虑使用过滤接口。本研究旨在定量评估各种雾化器类型在成人和儿童模拟呼吸下，与不同的过滤和非过滤接口联合使用时的医疗气溶胶逸散。
对于成人和儿童模拟呼吸，评估了四种雾化器类型，包括小容量射流雾化器（SVN）、呼吸增强射流雾化器（BEN）、呼吸驱动射流雾化器（BAN）和振动网孔雾化器（VMN）。使用不同的接口组合，包括过滤和非过滤的吸嘴，以及开放式、带阀和过滤面罩。使用空气动力学粒径谱仪在 0.8 m 和 2.0 m 处测量气溶胶质量浓度。此外，还评估了吸入剂量。
成人 SVN 面罩组合的 0.8 m 处 45 分钟运行时的记录最高气溶胶浓度为 214（177，262）µg m，成人 BAN 过滤吸嘴组合的最高和最低逸散排放。与成人和儿童吸嘴组合的连续（CN）模式相比，在 BAN 中使用呼吸驱动（BA）模式时，逸散排放减少。与非过滤情况相比，使用过滤面罩或吸嘴时，逸散排放较低。对于模拟成人，VMN 和 SVN 的最高和最低吸入剂量分别为 45.1（42.6，45.6）%和 11.0（10.1，11.9）%，对于模拟儿童，VMN 和 BAN CN 的最高和最低吸入剂量分别为 44.0（42.4，44.8）%和 6.1（5.9，7.0）%。计算出的沙丁胺醇潜在吸入暴露量对于旁观者和医护人员分别高达 0.11 µg 和 0.12 µg。
本研究表明，在临床和家庭护理环境中需要使用过滤接口，以最小化逸散排放并降低护理人员二次暴露的风险。
