Aerosol generation in clinical settings and pulmonary effects of aerosol
Aerosol generating procedures (AGPs) are defined as any procedure releasing airborne particles <5 μm in size from the respiratory tract. There remains uncertainty about which dental procedures constitute an AGP and their risk. Furthermore, aerosol particle size and composition are dynamic, responding to environmental changes, which affects the amount of aerosol reaching or depositing in specific regions of the lung. Results from the AERosolisation And Transmission Of SARS-CoV-2 in Healthcare Settings (AERATOR) study will be presented. Here, we quantified the aerosol number concentration generated during a range of periodontal, oral surgery and orthodontic patient procedures using an aerodynamic particle sizer. Measurements were conducted with a sufficiently low background to detect a patient’s cough, enabling confident identification of aerosol. Phantom head control experiments for each procedure were performed under the same conditions. Where aerosol was detected during a patient procedure, we assessed whether the size distribution could be explained by the non-salivary contaminated instrument source in the respective phantom head control procedure. The aerosol size distribution for each procedure provided a robust fingerprint of aerosol emission from a source. The literature on pulmonary effects of AGPs, in terms of their distribution and deposition in the respiratory tree will also be reviewed.
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