Aerosol generation during coughing - Quantitative definition for aerosol
generating procedures: observational study
Abstract
Aim: The aim of the study was to determine the quantitative value of
high-risk aerosol generation during surgery. Background: Coughing is
commonly used as a reference of high-risk aerosol generation during
surgeries and other clinical procedures. Those procedures during which
aerosol generation exceeds the amount of aerosol produced by coughing
are referred to as high-risk AGPs. However, no golden standard about
quantitative levels of high-risk aerosol generation exists. Methods: 37
healthy volunteers recruited to cough in the operating room. Aerosol
particles, with the size of 0.3-10 µm, generated during coughing were
measured with Optical Particle Sizer from 40cm, 70cm and 100cm
distances. The distances reflected to potential distance where the staff
is working during surgeries. Volitional coughs were compared to
involuntary coughs measured with same set up during extubations.
Results: A total of 306 coughs were measured. Total aerosol
concentration during coughing averaged 1.706 ± 10.802 (range 0.000 –
88.157). Highest aerosol concentrations were measured furthest from the
source. No difference between volitional and involuntary coughs were
observed. Discussion: The aerosol concentrations, measured in this study
can be used as a reference level for high-risk aerosol generation in the
operating room environment when assessing the risk of operating room
staff´s exposure for aerosol particles