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Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic

OBJECTIVES: Identify splatter/aerosol distribution from dental procedures in an open plan clinic and explore aerosol settling time after dental procedures. METHODS: In two experimental designs using simulated dental procedures on a mannequin, fluorescein dye was introduced: (1) into the irrigation s...

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Autores principales: Holliday, Richard, Allison, James R., Currie, Charlotte C., Edwards, David C., Bowes, Charlotte, Pickering, Kimberley, Reay, Sarah, Durham, Justin, Lumb, Joanna, Rostami, Nadia, Coulter, Jamie, Nile, Christopher, Jakubovics, Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787509/
https://www.ncbi.nlm.nih.gov/pubmed/33359041
http://dx.doi.org/10.1016/j.jdent.2020.103565
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author Holliday, Richard
Allison, James R.
Currie, Charlotte C.
Edwards, David C.
Bowes, Charlotte
Pickering, Kimberley
Reay, Sarah
Durham, Justin
Lumb, Joanna
Rostami, Nadia
Coulter, Jamie
Nile, Christopher
Jakubovics, Nicholas
author_facet Holliday, Richard
Allison, James R.
Currie, Charlotte C.
Edwards, David C.
Bowes, Charlotte
Pickering, Kimberley
Reay, Sarah
Durham, Justin
Lumb, Joanna
Rostami, Nadia
Coulter, Jamie
Nile, Christopher
Jakubovics, Nicholas
author_sort Holliday, Richard
collection PubMed
description OBJECTIVES: Identify splatter/aerosol distribution from dental procedures in an open plan clinic and explore aerosol settling time after dental procedures. METHODS: In two experimental designs using simulated dental procedures on a mannequin, fluorescein dye was introduced: (1) into the irrigation system of an air-turbine handpiece; (2) into the mannequin's mouth. Filter papers were placed in an open plan clinic to collect fluorescein. An 8-metre diameter rig was used to investigate aerosol settling time. Analysis was by fluorescence photography and spectrofluorometry. RESULTS: Contamination distribution varied across the clinic depending on conditions. Unmitigated procedures have the potential to deposit contamination at large distances. Medium volume dental suction (159 L/min air) reduced contamination in the procedural bay by 53%, and in other areas by 81-83%. Low volume suction (40 L/min air) was similar. Cross-ventilation reduced contamination in adjacent and distant areas by 80-89%. In the most realistic model (fluorescein in mouth, medium volume suction), samples in distant bays (≥5 m head-to-head chair distance) gave very low or zero readings (< 0.0016% of the fluorescein used during the procedure). Almost all (99.99%) of the splatter detected was retained within the procedural bay/walkway. After 10 min, very little additional aerosol settled. CONCLUSIONS: Cross-infection risk from dental procedures in an open plan clinic appears small when bays are ≥ 5 m apart. Dilution effects from instrument water spray were observed, and dental suction is of benefit. Most settled aerosol is detected within 10 min indicating environmental cleaning may be appropriate after this. Clinical Significance: Aerosols produced by dental procedures have the potential to contaminate distant sites and the majority of settled aerosol is detectable after 10 min. Dental suction and ventilation have a substantial beneficial effect. Contamination is likely to be minimal in open plan clinics at distances of 5 m or more.
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spelling pubmed-77875092021-01-07 Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic Holliday, Richard Allison, James R. Currie, Charlotte C. Edwards, David C. Bowes, Charlotte Pickering, Kimberley Reay, Sarah Durham, Justin Lumb, Joanna Rostami, Nadia Coulter, Jamie Nile, Christopher Jakubovics, Nicholas J Dent Article OBJECTIVES: Identify splatter/aerosol distribution from dental procedures in an open plan clinic and explore aerosol settling time after dental procedures. METHODS: In two experimental designs using simulated dental procedures on a mannequin, fluorescein dye was introduced: (1) into the irrigation system of an air-turbine handpiece; (2) into the mannequin's mouth. Filter papers were placed in an open plan clinic to collect fluorescein. An 8-metre diameter rig was used to investigate aerosol settling time. Analysis was by fluorescence photography and spectrofluorometry. RESULTS: Contamination distribution varied across the clinic depending on conditions. Unmitigated procedures have the potential to deposit contamination at large distances. Medium volume dental suction (159 L/min air) reduced contamination in the procedural bay by 53%, and in other areas by 81-83%. Low volume suction (40 L/min air) was similar. Cross-ventilation reduced contamination in adjacent and distant areas by 80-89%. In the most realistic model (fluorescein in mouth, medium volume suction), samples in distant bays (≥5 m head-to-head chair distance) gave very low or zero readings (< 0.0016% of the fluorescein used during the procedure). Almost all (99.99%) of the splatter detected was retained within the procedural bay/walkway. After 10 min, very little additional aerosol settled. CONCLUSIONS: Cross-infection risk from dental procedures in an open plan clinic appears small when bays are ≥ 5 m apart. Dilution effects from instrument water spray were observed, and dental suction is of benefit. Most settled aerosol is detected within 10 min indicating environmental cleaning may be appropriate after this. Clinical Significance: Aerosols produced by dental procedures have the potential to contaminate distant sites and the majority of settled aerosol is detectable after 10 min. Dental suction and ventilation have a substantial beneficial effect. Contamination is likely to be minimal in open plan clinics at distances of 5 m or more. Elsevier Ltd. 2021-02 2021-01-06 /pmc/articles/PMC7787509/ /pubmed/33359041 http://dx.doi.org/10.1016/j.jdent.2020.103565 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Holliday, Richard
Allison, James R.
Currie, Charlotte C.
Edwards, David C.
Bowes, Charlotte
Pickering, Kimberley
Reay, Sarah
Durham, Justin
Lumb, Joanna
Rostami, Nadia
Coulter, Jamie
Nile, Christopher
Jakubovics, Nicholas
Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title_full Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title_fullStr Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title_full_unstemmed Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title_short Evaluating contaminated dental aerosol and splatter in an open plan clinic environment: Implications for the COVID-19 pandemic
title_sort evaluating contaminated dental aerosol and splatter in an open plan clinic environment: implications for the covid-19 pandemic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787509/
https://www.ncbi.nlm.nih.gov/pubmed/33359041
http://dx.doi.org/10.1016/j.jdent.2020.103565
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