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Bronchoscopy
Description
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Potential for occupational exposures to pathogens during bronchoscopy procedures.

Maryshe Zietsman1, Linh T Phan1, Rachael M Jones1

  • 1School of Public Health, University of Illinois at Chicago , Chicago , Illinois.

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Bronchoscopy procedures can increase infection risk for healthcare workers due to periodic aerosol spikes and frequent patient contact. Proper personal protective equipment (PPE) use and doffing are crucial to mitigate transmission risks during these aerosol-generating procedures.

Keywords:
Aerosol-generating proceduresbronchoscopycontact patternsinfection preventionpersonal protective equipment

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Area of Science:

  • Pulmonary Medicine
  • Infectious Disease Control
  • Occupational Health

Background:

  • Bronchoscopy is an aerosol-generating procedure with an unclear infection risk for healthcare personnel.
  • Understanding exposure pathways is vital for enhancing safety during bronchoscopies.

Purpose of the Study:

  • To characterize exposure pathways for healthcare providers during bronchoscopy.
  • To identify factors contributing to infection risk among bronchoscopists.

Main Methods:

  • Measured aerosol concentrations (0.2-10 µm) during 18 bronchoscopy procedures.
  • Recorded procedure details: patient coughs, suctioning, surface contacts, and personal protective equipment (PPE) use/doffing.
  • Assessed pulmonologist contact with patients, equipment, and surfaces.

Main Results:

  • Aerosol concentrations showed high variability, with periodic spikes, rather than consistent elevation.
  • Frequent patient coughing (median 65) and suctioning (median 6.5) occurred.
  • Pulmonologists had frequent contact with patients (mean 22.3), the bronchoscope (mean 19.4), surfaces (mean 31.2), and PPE (mean 17.3).
  • Non-adherence to recommended PPE doffing practices was common.

Conclusions:

  • Bronchoscopy is associated with transient increases in aerosol concentrations.
  • Frequent physical contacts and non-adherent PPE practices create opportunities for contact transmission.
  • Further research into specific transmission routes and improved safety protocols is warranted.