Efficacy of an ambulance ventilation system in reducing EMS worker exposure to airborne particles from a patient cough aerosol simulator

@article{Lindsley2019EfficacyOA,
  title={Efficacy of an ambulance ventilation system in reducing EMS worker exposure to airborne particles from a patient cough aerosol simulator},
  author={William G Lindsley and Francoise M Blachere and Tia L McClelland and Dylan T Neu and Anna Mnatsakanova and Stephen B Martin and Kenneth R. Mead and John D. Noti},
  journal={Journal of Occupational and Environmental Hygiene},
  year={2019},
  volume={16},
  pages={804 - 816}
}
Abstract The protection of emergency medical service (EMS) workers from airborne disease transmission is important during routine transport of patients with infectious respiratory illnesses and would be critical during a pandemic of a disease such as influenza. However, few studies have examined the effectiveness of ambulance ventilation systems at reducing EMS worker exposure to airborne particles (aerosols). In our study, a cough aerosol simulator mimicking a coughing patient with an… 

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References

SHOWING 1-10 OF 31 REFERENCES

Dispersion and Exposure to a Cough-Generated Aerosol in a Simulated Medical Examination Room

A better understanding of the exposure of workers to cough aerosols from patients and of the relative efficacy of different types of respiratory PPE is provided, which will assist investigators in providing research-based recommendations for effective respiratory protection strategies in health care settings.

Role of mechanical ventilation in the airborne transmission of infectious agents in buildings

There is a need for well‐designed observational and intervention studies in buildings with better HVAC system characterization and measurements of both airborne exposures and disease outcomes, as well as for epidemiologic studies that specifically addressed the association of at least one heating, ventilating and/or air‐conditioning system‐related parameter with airborne disease transmission in buildings.

A Cough Aerosol Simulator for the Study of Disease Transmission by Human Cough-Generated Aerosols

A cough aerosol simulator that produces a human-like cough in a controlled environment and can be used with live pathogens, including influenza virus, to better understand the transmission of infectious diseases, develop improved techniques for infection control, and improve safety for healthcare workers and patients.

Variability of infectious aerosols produced during coughing by patients with pulmonary tuberculosis.

Collection of cough aerosol cultures is feasible and reproducible in a resource-limited setting and a minority of patients with TB produced culturable cough aerosols.

A Descriptive Analysis of Occupational Health Exposures in an Urban Emergency Medical Services System: 2007–2009

  • M. E. SayedR. KueC. McNeilK. Dyer
  • Medicine
    Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors
  • 2011
Abstract Introduction. Prehospital providers are exposed to various infectious disease hazards. Examining specific infectious exposures would be useful in describing their current trends as well as

Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community

It is shown that sneezing is rare and not important for—and that coughing is not required for—influenza virus aerosolization, and that upper and lower airway infection are independent and that fine-particle exhaled aerosols reflect infection in the lung.

The Emergency Medical Service Microbiome

Evidence is provided that EMS microbiomes are dynamic and important pathogen reservoirs, and it underscores the need for more widespread and in-depth microbiome studies to elucidate patterns of pathogen transmission.

Microbiological analysis of bioaerosols collected from Hospital Emergency Departments and ambulances.

The quantitative assessment of examined indoor air was similar to control outdoor air, and were relatively low; the level of microbiological contamination did not exceed 5×10<sup>3</sup> CFU/m<sup*3</Sup> which is recommended as an admissible level in public spaces in Poland.

Detection of Mycobacterium tuberculosis bacilli in bio-aerosols from untreated TB patients.

Molecular detection was more sensitive than mycobacterial culture on solid media, suggesting that further studies are required to determine whether this reflects a significant proportion of differentially detectable  bacilli in these samples.