Human immunodeficiency virus-1 (HIV-1) in the vapors of surgical power instruments

Cool vapors and aerosols produced by several common surgical power instruments and hot smoke plumes generated with electrocautery on known HIV-1 innoculated blood were gently bubbled through sterile viral culture media. Tissue culture cells were then added and cell infection was detected by the appearance of HIV-1 P-24 core antigen assayed by ELISA in the culture medium. HIV-1 was cultured from cool aerosols and vapors generated by a 30,000 RPM spinning router tip, an instrument similar to the Midas Rex and the Stryker oscillating bone saw. No infectious HIV-1 was detected in aerosols generated by a Valley Lab electrocautery or with a manual wound irrigation syringe known as a Travenol Uromatic irrigator. We have demonstrated that HIV-1 can remain viable in cool aerosols generated by certain surgical power tools and this raises the possibility of HIV transmission to medical personnel exposed to aerosols similarly generated during the care of HIV infected patients. Further work is required to determine whether such a risk exists but caution should be exercised by those exposed to aerosols generated during procedures on HIV-1 infected patients.