Increased microbial loading in aerosols produced by non-contact air-puff tonometer and relative suggestions for the prevention of coronavirus disease 2019 (COVID-19)

Guo, Hui; Li, Wei; Huang, Yingying; Li, Xiaoyan; Zhi, Li; Zhou, Hongxia; Sun, Enhua; Li, Li; Li, Jisheng

doi:10.1371/journal.pone.0240421

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…Some authors suggest that environmental contamination with SARS-CoV-2 is high in hospital settings where patients with COVID-19 are hospitalized [ 11 , 12 , 17 , 18 ]. Contamination of surfaces by asymptomatic individuals has also been demonstrated [ 10 ]; however, it is not yet clear whether asymptomatic individuals as well as patients with COVID-19 can contaminate the environment [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

First Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on the Surfaces of Tourist-Recreational Facilities in Italy

Montagna

Giglio

Calia

et al. 2021

IJERPH

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A Coronavirus disease (COVID-19), caused by a new virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spreads via direct contact through droplets produced by infected individuals. The transmission of this virus can also occur via indirect contact if objects and surfaces are contaminated by secretions from individuals with COVID-19 or asymptomatic carriers. Environmental contamination with SARS-CoV-2 is high in hospital settings; on the contrary, surface contamination in non-healthcare settings is still poorly studied. In this study, the presence of SARS-CoV-2 on the surfaces of 20 tourist-recreational facilities was investigated by performing a total of 100 swabs on surfaces, including refrigerator handles, handrails, counters, tables, and bathroom access doors. Six (6%) swabs from four (20%) tourist-recreational facilities tested positive for SARS-CoV-2; the surfaces that were involved were toilet door handles, refrigerator handles, handrails, and bar counters. This study highlights that SARS-CoV-2 is also present in non-healthcare environments; therefore, in order to limit this worrying pandemic, compliance with behavioral rules and the adoption of preventive and protective measures are of fundamental importance not only in healthcare or work environments but also in life environments.

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Section: Discussionmentioning

confidence: 99%

First Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on the Surfaces of Tourist-Recreational Facilities in Italy

Montagna

Giglio

Calia

et al. 2021

IJERPH

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“…However, contact of mucous membranes with a contaminated surface and/or with droplets can also lead to infection with SARS-CoV-2 [12]. There are many opportunities for environmental contamination (air and surfaces) with SARS-CoV-2 in hospital settings where COVID-19 patients may be present [4,7,8]. On the contrary, evidence regarding environmental spread of SARS-CoV-2 in the community is lacking.…”

Section: Discussionmentioning

confidence: 99%

“…[6] demonstrated that, when personal protective equipment is not used, droplet and inhalation transmission routes predominate over the contact route, contributing 35%, 57%, and 8.2% of the probability of infection. Some authors report that environmental contamination by SARS-CoV-2 is high in hospital settings [4,5,7,8] but it is not yet well known whether asymptomatic individuals can spread the infection in the same way as patients with coronavirus disease 2019 . Surface contamination by asymptomatic individuals has been demonstrated [9], but data in non-healthcare settings are still minimal.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 RNA and Supermarket Surfaces: A Real or Presumed Threat?

Caggiano

Triggiano

Apollonio

et al. 2021

IJERPH

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in March 2020 in Italy, leading to the pandemic of coronavirus disease 2019 (COVID-19) that continues to cause high global morbidity and mortality in human populations. Numerous studies have focused on the spread and persistence of the virus in the hospital setting. New scientific evidence shows that SARS-CoV-2 is present in different community environments. Although aerosol is one of the main routes of transmission for SARS-CoV-2, indirect contact through virus-contaminated surfaces could also play a key role. The survival and persistence of SARS-CoV-2 on surfaces appear to be influenced by the characteristics of the material, temperature, and humidity. In this study, we investigated the presence of SARS-CoV-2 RNA on surfaces in 20 supermarkets throughout the Apulia region during the lockdown period. We collected a total of 300 swab samples from various surfaces including supermarket scales, trolley handles, refrigerator and freezer handles, and keyboards. In total, 13 (4.3%) surfaces were positive for SARS-CoV-2 RNA contamination, with shopping trolley handles being the most frequently contaminated. This study showed that contamination in public spaces can occur, so we remark the importance to adopt adequate preventive measures, including environment ventilation, careful surfaces sanitation, hand hygiene, and correct usage of masks, to reduce the likelihood of virus transmission.

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“…However, such air pulses may lead to the dehiscence of the tear film and further generation of tear droplets. [8][9][10] By high-speed photography, the ejection of tear droplets after the impingement of air-puff had been captured, especially with the addition of lubricant drops. 8,9 Despite that the scatter of tear may consequently contaminate the surface of equipment, such droplet dispersion may be minimized by disinfection or application of shields.…”

mentioning

confidence: 99%

“…15 As the aerosol dispersion has been considered a potential route of COVID-19 transmission, 15 both the patients and operators may suffer the risk of exposure during the IOP measurement. The air samples collected after air-puff had revealed increasing microbial colonies in culture, 10 adding the risk of disease transmission. In light of this, studies about aerosols generated by NCT are instructive to the protection of fundamental examination in ophthalmology clinics.…”

mentioning

confidence: 99%

Assessment of temporal and spatial distribution patterns of aerosol produced by air-puff non-contact tonometer

Chen

Zhang

2021

European Journal of Ophthalmology

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Purpose To assess the distribution pattern of aerosol in the aspect of time and direction during the intraocular pressure (IOP) measurement by air-puff non-contact tonometer (NCT) and further offer references for protection from coronavirus disease-19 (COVID-19) in the routine ophthalmic examination. Method A single-center observational study was conducted in the ophthalmology clinics of Peking University Third Hospital. Two air quality detectors were equipped to assess the generated particulate matter (PM) concentration simultaneously within 30 s after IOP measurement in the outpatient hall. Detector A was fixed next to the NCT as a reference, while Detector B was fixed 1 meter away. The participants were divided into two groups depending on the position of Detector B. The generation of aerosol was compared within different groups and time intervals. Results 144 participants were enrolled in the final analysis. At a 1 m distance from the NCT, the PM2.5 concentration significantly increased at the 30 s ( Z = 2.898, Bonferroni-corrected P = 0.038) while the PM10 concentration increased immediately after the IOP measurement ( Z = 2.967, Bonferroni-corrected P = 0.030). The PM2.5 and PM10 concentrations at 1 m were significantly higher immediately ( Z = −2.183, P = 0.029; Z = −2.502, P = 0.012) and 30 s ( Z = −2.021, P = 0.043; Z = −2.071, P = 0.038) after the IOP measurements when the Detector B was vertical to the air jet on the lateral side. Conclusions NCT may produce aerosol after the IOP measurement by air-puff. The generated PM2.5 had a prolonged existence compared with PM10 at a 1 m distance. The lateral side of the air-puff direction may be of higher exposure risk to aerosol.

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Increased microbial loading in aerosols produced by non-contact air-puff tonometer and relative suggestions for the prevention of coronavirus disease 2019 (COVID-19)

Cited by 13 publications

References 21 publications

First Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on the Surfaces of Tourist-Recreational Facilities in Italy

First Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on the Surfaces of Tourist-Recreational Facilities in Italy

SARS-CoV-2 RNA and Supermarket Surfaces: A Real or Presumed Threat?

Assessment of temporal and spatial distribution patterns of aerosol produced by air-puff non-contact tonometer

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