Evidence-based aerosol clearance times in a healthcare environment.

Aerosol COVID-19

Journal

Infection prevention in practice
ISSN: 2590-0889
Titre abrégé: Infect Prev Pract
Pays: England
ID NLM: 101777928

Informations de publication

Date de publication:
Dec 2021
Historique:
received: 21 04 2021
accepted: 10 08 2021
pubmed: 21 8 2021
medline: 21 8 2021
entrez: 20 8 2021
Statut: ppublish

Résumé

As researchers race to understand the nature of COVID-19 transmission, healthcare institutions must treat COVID-19 patients while also safeguarding the health of staff and other patients. One aspect of this process involves mitigating aerosol transmission of the SARS-CoV2 virus. The U.S. Centers for Disease Control and Prevention (CDC) provides general guidance on airborne contaminant removal, but directly measuring aerosol clearance in clinical rooms provides empirical evidence to guide clinical procedure. We present a risk-assessment approach to empirically measuring and certifying the aerosol clearance time (ACT) in operating and procedure rooms to improve hospital efficiency while also mitigating the risk of nosocomial infection. Rooms were clustered based on physical and procedural parameters. Sample rooms from each cluster were randomly selected and tested by challenging the room with aerosol and monitoring aerosolized particle concentration until 99.9% clearance was achieved. Data quality was analysed and aerosol clearance times for each cluster were determined. Of the 521 operating and procedure rooms considered, 449 (86%) were issued a decrease in clearance time relative to CDC guidance, 32 (6%) had their clearance times increased, and 40 (8%) remained at guidance. The average clearance time change of all rooms assessed was a net reduction of 27.8%. The process described here balances the need for high-quality, repeatable data with the burden of testing in a functioning clinical setting. Implementation of this approach resulted in a reduction in clearance times for most clinical rooms, thereby improving hospital efficiency while also safeguarding patients and staff.

Sections du résumé

BACKGROUND BACKGROUND
As researchers race to understand the nature of COVID-19 transmission, healthcare institutions must treat COVID-19 patients while also safeguarding the health of staff and other patients. One aspect of this process involves mitigating aerosol transmission of the SARS-CoV2 virus. The U.S. Centers for Disease Control and Prevention (CDC) provides general guidance on airborne contaminant removal, but directly measuring aerosol clearance in clinical rooms provides empirical evidence to guide clinical procedure.
AIM OBJECTIVE
We present a risk-assessment approach to empirically measuring and certifying the aerosol clearance time (ACT) in operating and procedure rooms to improve hospital efficiency while also mitigating the risk of nosocomial infection.
METHODS METHODS
Rooms were clustered based on physical and procedural parameters. Sample rooms from each cluster were randomly selected and tested by challenging the room with aerosol and monitoring aerosolized particle concentration until 99.9% clearance was achieved. Data quality was analysed and aerosol clearance times for each cluster were determined.
FINDINGS RESULTS
Of the 521 operating and procedure rooms considered, 449 (86%) were issued a decrease in clearance time relative to CDC guidance, 32 (6%) had their clearance times increased, and 40 (8%) remained at guidance. The average clearance time change of all rooms assessed was a net reduction of 27.8%.
CONCLUSION CONCLUSIONS
The process described here balances the need for high-quality, repeatable data with the burden of testing in a functioning clinical setting. Implementation of this approach resulted in a reduction in clearance times for most clinical rooms, thereby improving hospital efficiency while also safeguarding patients and staff.

Identifiants

pubmed: 34414369
doi: 10.1016/j.infpip.2021.100170
pii: S2590-0889(21)00059-7
pmc: PMC8364401
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100170

Informations de copyright

© 2021 The Authors.

Références

Int J Infect Dis. 2020 Nov;100:476-482
pubmed: 32949774
Proc Natl Acad Sci U S A. 2021 Feb 23;118(8):
pubmed: 33563754
Science. 2020 Oct 16;370(6514):303-304
pubmed: 33020250
Am J Infect Control. 2007 Dec;35(10 Suppl 2):S65-164
pubmed: 18068815
Anaesthesia. 2021 Feb;76(2):182-188
pubmed: 33047327
Anaesthesia. 2021 Feb;76(2):151-155
pubmed: 33274761
JAMA Otolaryngol Head Neck Surg. 2021 Jul 22;:
pubmed: 34292321
Anaesthesia. 2021 Feb;76(2):174-181
pubmed: 33022093
Environ Int. 2020 Nov;144:106039
pubmed: 32822927
Indoor Air. 2002 Dec;12(4):211-4
pubmed: 12532752

Auteurs

Seth A Hara (SA)

Division of Engineering, Mayo Clinic, Rochester, MN, USA.

Timothy L Rossman (TL)

Division of Engineering, Mayo Clinic, Rochester, MN, USA.

Lukas Johnson (L)

Division of Facilities Management, Mayo Clinic, Rochester, MN, USA.

Christopher J Hogan (CJ)

University of Minnesota, Minneapolis, MN, USA.

William Sanchez (W)

Gastroenterology, Mayo Clinic, Rochester, MN, USA.

David P Martin (DP)

Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.

Mark B Wehde (MB)

Division of Engineering, Mayo Clinic, Rochester, MN, USA.

Classifications MeSH