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Aerosol Generation During Peak Flow Testing: Clinical Implications for COVID-19
Yosuf W Subat1, Siva Kamal Guntupalli1, Pavol Sajgalik2
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Respiratory Care
|May 26, 2021
Summary
Peak flow testing generates ultrafine particles, but at low concentrations compared to the clinical environment. Standard infection control measures like masks are likely sufficient for asymptomatic patients.
Area of Science:
- Pulmonary Medicine
- Infectious Disease Control
- Aerosol Science
Background:
- Peak flow testing is a common ambulatory care procedure.
- Data on aerosol generation during peak flow testing is lacking.
- Understanding aerosol generation is crucial for SARS-CoV-2 transmission control.
Purpose of the Study:
- To quantify and characterize aerosol generation during peak flow testing.
- To assess the significance of aerosol generation in the context of SARS-CoV-2 transmission.
- To compare aerosol generation across different peak flow meters.
Main Methods:
- Five healthy volunteers performed peak flow maneuvers.
- Ambient air was sampled using devices detecting ultrafine particles (0.02-1 μm) and larger particles (0.3-10 μm).
- Peak flow meters were compared to baseline tidal breathing (masked and unmasked).
Main Results:
- Ultrafine particles were generated during peak flow testing.
- No significant difference in ultrafine particle concentration was found between different peak flow meters.
- Peak flow testing generated significantly more ultrafine particles than tidal breathing, but concentrations were low compared to ambient levels.
Conclusions:
- Aerosol generation occurs during peak flow testing.
- Concentrations of generated aerosols are low compared to the clinical environment.
- Surgical masks and eye protection are likely adequate for asymptomatic patients; COVID-19 testing is advised for symptomatic individuals.
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