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门诊医疗诊所空气中呼吸道病毒的职业暴露监测。

Occupational exposure monitoring of airborne respiratory viruses in outpatient medical clinics.

作者信息

Vass William B, Shirkhani Amin, Washeem Mohammad, Shankar Sripriya Nannu, Zhang Yuetong, Moquin Tracey L, Messcher Rebeccah L, Jansen Matthew D, Clugston James R, Walser Matthew P, Yang Yang, Lednicky John A, Fan Z Hugh, Wu Chang-Yu

机构信息

Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA.

Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA.

出版信息

Aerosol Sci Technol. 2024 Oct 23. doi: 10.1080/02786826.2024.2403580.

Abstract

Exposure to airborne respiratory viruses can be a health hazard in occupational settings. In this study, air sampling was conducted from January to March 2023 in two outpatient medical clinics-one primary care clinic and one clinic dedicated to the diagnosis and treatment of respiratory illnesses-for the purpose of assessing airborne respiratory virus presence. Work involved the operation of a BioSpot-VIVAS as a stationary air sampler and deployment of NIOSH BC-251 bioaerosol samplers as either stationary devices or personal air samplers worn by staff members. Results were correlated with deidentified clinical data from patient testing. Samples from seven days were analyzed for SARS-CoV-2, influenza A H1N1 and H3N2 viruses, and influenza B Victoria- and Yamagata-lineage viruses, with an overall 17.5% (17/97) positivity rate. Airborne viruses predominated in particles of aerodynamic diameters from 1-4 μm and were recovered in similar quantities from both clinics. BC-251 samplers (17.4%, 15/86) and VIVAS (18.2%, 2/11) collected detectable viruses at similar rates, but more numerous BC-251 samplers provided greater insight into virus presence across clinical spaces and job categories. 60% of samples from reception areas contained detectable virus, and exposure to significantly more virus (p = 0.0028) occurred at reception desks as compared to the "mobile" job categories of medical providers and nurses. Overall, this study provides valuable insights into the impacts of hazard mitigation controls tailored to reducing respiratory virus exposure and highlights the need for continued diligence toward exposure risk mitigation in outpatient medical clinics.

摘要

在职业环境中,接触空气传播的呼吸道病毒可能会对健康造成危害。在本研究中,于2023年1月至3月对两家门诊医疗诊所——一家初级保健诊所和一家专门诊断和治疗呼吸道疾病的诊所——进行了空气采样,目的是评估空气传播的呼吸道病毒的存在情况。工作包括操作BioSpot-VIVAS作为固定空气采样器,以及部署NIOSH BC-251生物气溶胶采样器,后者既可以作为固定设备,也可以作为工作人员佩戴的个人空气采样器。结果与来自患者检测的去识别化临床数据相关联。对七天的样本进行了分析,检测是否存在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)、甲型H1N1和H3N2流感病毒,以及乙型维多利亚系和山形系流感病毒,总体阳性率为17.5%(17/97)。空气传播病毒在空气动力学直径为1 - 4μm的颗粒中占主导地位,并且在两家诊所中回收的数量相似。BC-251采样器(17.4%,15/86)和VIVAS(18.2%,2/11)检测到病毒的速率相似,但更多的BC-251采样器能够更深入地了解临床空间和工作类别中的病毒存在情况。接待区60%的样本含有可检测到的病毒,与医疗服务提供者和护士等“流动”工作类别相比,在接待台接触到的病毒明显更多(p = 0.0028)。总体而言,本研究为针对减少呼吸道病毒暴露的危害缓解控制措施的影响提供了有价值的见解,并强调了在门诊医疗诊所持续努力减轻暴露风险的必要性。

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