Dataset Information

Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology.

ABSTRACT: Objective:During the COVID-19 era, a reliable method for tracing aerosols and droplets generated during otolaryngology procedures is needed to accurately assess contamination risk and to develop mitigation measures. Prior studies have not investigated the reliability of different fluorescent tracers for the purpose of studying aerosols and small droplets. Objectives include (1) comparing vitamin B2, fluorescein, and a commercial fluorescent green dye in terms of particle dispersion pattern, suspension into aerosols and small droplets, and fluorescence in aerosolized form and (2) determining the utility of vitamin B2 as a fluorescent tracer coating the aerodigestive tract mucosa in otolaryngology contamination models.

Methods:Vitamin B2, fluorescein, and a commercial fluorescent dye were aerosolized using a nebulizer and passed through the nasal cavity from the trachea in a retrograde-intubated cadaveric head. In another scenario, vitamin B2 was irrigated to coat the nasal cavity and nasopharyngeal mucosa of a cadaveric head for assessment of aerosol and droplet generation from endonasal drilling. A cascade impactor was used to collect aerosols and small droplets ?14.1?µm based on average aerodynamic diameter, and the collection chambers were visualized under UV light.

Results:When vitamin B2 was nebulized, aerosols ?5.4?µm were generated and the collected particles were fluorescent. When fluorescein and the commercial water tracer dye were nebulized, aerosols ?8.61?µm and ?2.08?µm respectively were generated, but the collected aerosols did not appear visibly fluorescent. Endonasal drilling in the nasopharynx coated with vitamin B2 irrigation yielded aerosols ?3.30?µm that were fluorescent under UV light.

Conclusion:Vitamin B2's reliability as a fluorescent tracer when suspended in aerosols and small droplets ?14.1?µm and known mucosal safety profile make it an ideal compound compared to fluorescein and commercial water-based fluorescent dyes for use as a safe fluorescent tracer in healthcare contamination models especially with human subjects.

SUBMITTER: Sim ES

PROVIDER: S-EPMC7429918 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology.

Sim Edward S ES Dharmarajan Harish H Boorgu Devi Sai Sri Kavya DSSK Goyal Lindsey L Weinstock Michael M Whelan Rachel R Freiser Monika E ME Corcoran Timothy E TE Jabbour Noel N Wang Eric E Chi David H DH

The Annals of otology, rhinology, and laryngology 20200814 3

<h4>Objective</h4>During the COVID-19 era, a reliable method for tracing aerosols and droplets generated during otolaryngology procedures is needed to accurately assess contamination risk and to develop mitigation measures. Prior studies have not investigated the reliability of different fluorescent tracers for the purpose of studying aerosols and small droplets. Objectives include (1) comparing vitamin B2, fluorescein, and a commercial fluorescent green dye in terms of particle dispersion patte ...[more]

PMID: 32795090

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Project description:Introduction Medical schools in the United Kingdom are under increasing pressure to provide more streamlined, applicable teaching due to rising numbers of trainee doctors but are failing to meet their educational need for otolaryngology. The recent novel coronavirus disease 2019 (COVID-19) pandemic has placed additional pressures on medical schools to adapt the medium over which the curriculum is delivered. The use of tactile learning with three-dimensional models and distanced learning via videoconferencing may provide alternative teaching methods to meet otolaryngology undergraduate learning requirements. This pilot study aimed to assess the differences in undergraduate student attitudes toward tactile learning via nontactile distanced learning and review their acceptability among this cohort. Methods Two groups of medical students observed a single educational event on the larynx and management of the airway. The learning opportunity was delivered in a lecture format with the lecturer demonstrating on an anatomical model of the larynx. Group one (tactile group) had an identical model to interact with during the lecture and were present within the lecture theater; group two (nontactile group) did not and observed the lecture via video link. Students were asked to rank their opinion to several statements about the session based on an 11-point Likert's scale and give qualitative feedback. Results All ranked feedback was mainly positive. Tactile learning was statistically equivalent to nontactile learning based on the ranked feedback from the students, except for "improvement in anatomical knowledge," for which the students believed tactile learning was superior ( p = 0.017). A variety of qualitative feedback was received by both groups. Conclusion This pilot study provides evidence for the acceptability among students of the use of nontactile distanced learning to deliver the otolaryngology undergraduate curriculum compared with tactile learning. This can provide the basis for larger studies to assess the educational impact of these different teaching methods.

Project description:ObjectivesThis review aimed to identify which dental procedures generate droplets and aerosols with subsequent contamination, and for these, characterise their pattern, spread and settle.Data resourcesMedline(OVID), Embase(OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science and LILACS databases were searched for eligible studies from each database's inception to May 2020 (search updated 11/08/20). Studies investigating clinical dental activities that generate aerosol using duplicate independent screening. Data extraction by one reviewer and verified by another. Risk of bias assessed through contamination measurement tool sensitivity assessment.Study selectionA total eighty-three studies met the inclusion criteria and covered: ultrasonic scaling (USS, n = 44), highspeed air-rotor (HSAR, n = 31); oral surgery (n = 11), slow-speed handpiece (n = 4); air-water (triple) syringe (n = 4), air-polishing (n = 4), prophylaxis (n = 2) and hand-scaling (n = 2). Although no studies investigated respiratory viruses, those on bacteria, blood-splatter and aerosol showed activities using powered devices produced greatest contamination. Contamination was found for all activities, and at the furthest points studied. The operator's torso, operator's arm and patient's body were especially affected. Heterogeneity precluded inter-study comparisons but intra-study comparisons allowed construction of a proposed hierarchy of procedure contamination risk: higher (USS, HSAR, air-water syringe, air polishing, extractions using motorised handpieces); moderate (slow-speed handpieces, prophylaxis, extractions) and lower (air-water syringe [water only] and hand scaling).ConclusionGaps in evidence, low sensitivity of measures and variable quality limit conclusions around contamination for procedures. A hierarchy of contamination from procedures is proposed for challenge/verification by future research which should consider standardised methodologies to facilitate research synthesis.Clinical significanceThis manuscript addresses uncertainty around aerosol generating procedures (AGPs) in dentistry. Findings indicate a continuum of procedure-related aerosol generation rather than the common binary AGP or non-AGP perspective. The findings inform discussion around AGPs and direct future research to support knowledge and decision making around COVID-19 and dental procedures.

Dataset Information

Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology.

Publications

Novel Use of Vitamin B2 as a Fluorescent Tracer in Aerosol and Droplet Contamination Models in Otolaryngology.

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