Articles
Summary of: A pilot study of bioaerosol reduction using an air cleaning system during dental procedures - BDJ British Dental Journal
C. Hallier, D. W. Williams, A. J. C. Potts and M. A. O. Lewis British Dental Journal 2010; 209: E14
Read the full study on BDJ’s website by clicking here
Key Points
Dental procedures create bioaerosols that are a potential vector for transmission of infection in the dental surgery.
The use of an air cleaning system both before and during dental treatment can reduce the size of bioaerosols and therefore reduce the risk of spread of infection.
Air cleaning systems may have a useful role to play in the treatment of patients, in particular those who may be immune-compromised.
Background
Bioaerosols are defined as airborne particles of liquid or volatile compounds that contain living organisms or have been released from living organisms. The creation of bioaerosols is a recognized consequence of certain types of dental treatment and represents a potential mechanism for the spread of infection.
Objectives
The aims of the present study were to assess the bioaerosols generated by certain dental procedures and to evaluate the efficiency of a commercially available Air Cleaning System (ACS) designed to reduce bioaerosol levels.
Methods
Bioaerosol sampling was undertaken in the absence of clinical activity (baseline) and also during treatment procedures (cavity preparation using an air rotor, history and oral examination, ultrasonic scaling and tooth extraction under local anaesthesia). For each treatment, bioaerosols were measured for two patient episodes (with and without ACS operation) and between five and nine bioaerosol samples were collected. For baseline measurements, 15 bioaerosol samples were obtained. For bioaerosol sampling, environmental air was drawn on to blood agar plates using a bioaerosol sampling pump placed in a standard position 20 cm from the dental chair. Plates were incubated aerobically at 37°C for 48 hours and resulting growth quantified as colony forming units (cfu/m3). Distinct colony types were identified using standard methods. Results were analysed statistically using SPSS 12 and Wilcoxon signed rank tests.
Results
The ACS resulted in a significant reduction (p = 0.001) in the mean bioaerosols (cfu/m3) of all three clinics compared with baseline measurements. The mean level of bioaerosols recorded during the procedures, with or without the ACS activated respectively, was 23.9 cfu/m3 and 105.1 cfu/m3 (p = 0.02) for cavity preparation, 23.9 cfu/m3 and 62.2 cfu/m3 (p = 0.04) for history and oral examination; 41.9 cfu/m3 and 70.9 cfu/m3 (p = 0.01) for ultrasonic scaling and 9.1 cfu/m3 and 66.1 cfu/m3 (p = 0.01) for extraction. The predominant microorganisms isolated were Staphylococcus species and Micrococcus species.
Conclusion
These findings indicate potentially hazardous bioaerosols created during dental procedures can be significantly reduced using an air cleaning system.
Editor's summary
Infection control in dentistry continues to be a hot topic, and one that is the subject of much investigation: recent papers in this Journal have looked at contamination of photographic retractors1 and water quality in dental unit water lines.2 The requirements of HTM01-05 have focused our attention on cleaning of reusable dental instruments and the associated infection control risks. This article investigates an area that is arguably more difficult to control: the production of bioaerosols during dental treatment.
The authors studied the bioaerosols produced during four different dental procedures (cavity preparation using an air rotor, history taking and examination, ultrasonic scaling and tooth extraction), and the ability of an air cleaning system to reduce their levels. The bioaerosol levels were compared against baseline levels taken in the absence of clinical activity. All the procedures resulted in an increase in levels of bioaerosols, with cavity preparation producing the highest levels found in this study. The air cleaning system was effective in significantly reducing bioaerosol levels, although they were never reduced to the levels found at baseline.
Dentists are already familiar with the concept of bioaerosols. The use of aspiration, masks and eye protection are all aimed at reducing their impact, and the fact that transmission of airborne pathogens in the dental surgery is not a frequently reported problem suggests that they are generally effective – or at least effective enough. The authors acknowledge that an air cleaning system is probably not required in every dental setting, but suggest that it could be useful in certain clinical environments, for example in surgeries treating medically compromised patients. The significance of the article lies in its confirmation that in general, such a system can reduce bioaerosols and provide a safer working environment.
Rowena Milan, Managing Editor
Platinum Air Care’s Solution
The MedicAir® 2.0 is the best-in-class medical-grade air purifier system. It is used in thousands of dental applications globally. Learn more about the MedicAir® 2.0 by clicking here.
WHO: Air Pollution Is The World’s “Largest Single Environmental Risk” - HuffPost
Air pollution is the world's "largest single environmental risk", according to the World Health Assembly, which closed last week in Geneva. The assembly passed a "landmark" resolution on air pollution after debating the topic for the first time ever.
"The resolution highlights the key role national health authorities need to play in raising awareness about the potential to save lives and reduce health costs, if air pollution is addressed effectively," according to a press statement from the World Health Organisation (WHO). Air pollution annually accounts for eight million deaths worldwide — with more than half of these a result of exposure to indoor air pollution.
The resolution has stressed the need for strong cooperation across sectors. WHO member states have been asked to develop air quality monitoring systems and separate health registries that can keep an eye on all air-pollution related illnesses. States have been asked to "promote clean cooking,heating and lighting technologies and fuels; and strengthen international transfer of expertise, technologies and scientific data in the field of air pollution."
DOUGALL VIA GETTY IMAGES, NEW DELHI, INDIA: A Delhi motorcyclist wears an air-filter while waiting for the light to change at a downtown crossing, 05 June 2000 in New Delhi. India was rated the worst country in Asia for air, water and noise pollution by a private think-tank. The world celebrates Environment Day 05 June. (ELECTRONIC IMAGE) AFP PHOTO JOHN MACDOUGALL (Photo credit should read JOHN MACDOUGALL/AFP/Getty Images)
The WHO secretariat too will provide technical assistance to states to help take action on air pollution. It will help countries implement all WHO air quality guidelines, improve research on health effects of air pollution. By next year, WHO is expected to propose a "road map for an enhanced global response by the health sector that reduces the adverse health effects of air pollution."
India's Pollution Problem
While India was not part of the delegation from 14 countries that passed the resolution, it is perhaps here that the issue is most pressing. It has 13 of the world's top 25 most-polluted cities, and WHO last year ranked Delhi the most polluted city in the world.
Air pollution is a risk factor for ischemic heart disease, stroke, chronic obstructive pulmonary disease, asthma and cancer, according to WHO.
About half of the deaths due to acute lower respiratory infections, including pneumonia in children under five years can be due to household air pollution. Meanwhile fine particulate matter can cause lung cancer, according to WHO’s International Agency on Research for Cancer.
Aerosols and splatter in dentistry - Journal of the American Dental Association
A brief review of the literature and infection control implications
STEPHEN K. HARREL, D.D.S., JOHN MOLINARI, Ph.D.
Read the article directly by clicking here or read the PDF by clicking here.
Background
Aerosols and droplets are produced during many dental procedures. With the advent of the droplet-spread disease severe acute respiratory syndrome, or SARS, a review of the infection control procedures for aerosols is warranted.
Types of Studies Reviewed
The authors reviewed representative medical and dental literature for studies and reports that documented the spread of disease through an airborne route. They also reviewed the dental literature for representative studies of contamination from various dental procedures and methods of reducing airborne contamination from those procedures.
Results
The airborne spread of measles, tuberculosis and SARS is well-documented in the medical literature. The dental literature shows that many dental procedures produce aerosols and droplets that are contaminated with bacteria and blood. These aerosols represent a potential route for disease transmission. The literature also documents that airborne contamination can be minimized easily and inexpensively by layering several infection control steps into the routine precautions used during all dental procedures.
Clinical Implications
In addition to the routine use of standard barriers such as masks and gloves, the universal use of pre-procedural rinses and high-volume evacuation is recommended.
The production of airborne material during dental procedures is obvious to the dentist, the dental team and the patient. An aerosol cloud of particulate matter and fluid often is clearly visible during dental procedures. This cloud is evident during tooth preparation with a rotary instrument or air abrasion, during the use of an air-water syringe, during the use of an ultrasonic scaler and during air polishing. This ubiquitous aerosolized cloud is a combination of materials originating from the treatment site and from the dental unit waterlines, or DUWLs. It is common for the patient to comment on this cloud of material. With the advent of severe acute respiratory syndrome, or SARS, questions concerning the potential for the spread of infections from this aerosol may arise.
In this article, we review relevant literature that has addressed the presence and makeup of dental aerosols and splatter. We also assess the threats that may be inherent in this airborne material, including risk potential to patients and the dental team. We make recommendations for the control of dental aerosols and splatter.
- - - Read the article directly for more information - - -
More interesting information can be found in the PDF or article directly such as Disease transmission through an airborne route, dental aerosol and splatter, sources of airborne contamination during dental treatment, saliva and respiratory sources of contamination, contamination from the operative site, composition of dental aerosols, methods of reducing airborne contamination.
CONCLUSIONS
The aerosols and splatter generated during dental procedures have the potential to spread infection to dental personnel and other people in the dental office. While, as with all infection control procedures, it is impossible to completely eliminate the risk posed by dental aerosols, it is possible to minimize the risk with relatively simple and inexpensive precautions. We feel that the following procedures are appropriate as universal precautions whenever an aerosol is produced:
universal barrier precautions should be followed;
a preprocedural rinse should be used before treatment;
a rubber dam should be used where possible;
an HVE should be used for all procedures. The use of these precautions should reduce the risk of an aerosolized spreading of infection to a minimal level. Further, the universal application of these infection control strategies will reduce the employer’s legal exposure to the lowest possible level.
Platinum Air Care’s Solution
As mentioned in table 3 of the article (Methods of reducing airborne contamination), High-Efficiency Particulate Air Room Filters and Ultraviolet Treatment of Ventilation System is cited as “effective in reducing numbers of airborne organisms”.
The MedicAir® 2.0 ticks both of these boxes as it is equipped with an impressive H13 HEPA filter, Carbon filtration, and Ultra-Violet type-C light with a hydroxyl radical generation chamber. You can learn more about the MedicAir® 2.0 by clicking here.
Office printers emit hazardous particles: CBC special report
CBC News · Posted: Oct 22, 2007 10:10 AM ET | Last Updated: October 22, 2007
That office stalwart— the printer— may be a source of air pollution and a potential health hazard, a CBC investigations team has found.
Laser printers emit micro-particles that can affect air quality, researchers say. (CBC)
Office printers can release ultrafine particles, or UFP, that are so small scientists have only recently been able to measure them.
Researchers have raised concerns that tiny particles from sources such as printer toner, tobacco smoke, combustion soot, bacteria and mould could be absorbed into the lungs and cause eye, nose, throat and lung irritation.
UFPs have been linked in recent scientific studies to heart problems and lung disease.
The CBC retained Pinchin Environmental, an environmental, health and safety consulting firm, to undertake testing of office printers at three different locations in Winnipeg: CBC offices, Eco Centre Green Office and Wardrop Engineering Inc.
Pinchin measured emissions from the printers by placing particle monitors above the units. It also tested the number of particles in the air, also known as background levels, when the machines were off.
The tests revealed that small particles (less than 0.1 micrometres) were emitted in high quantities from 20 per cent of the printers tested at the CBC and 42 per cent of those tested at Wardrop. UFP concentrations returned to background levels within one to two minutes after reaching maximum concentrations.
Twenty-seven per cent of the printers in that study were considered high emitters, or printers that emit more than 10 times the UFP than was found in the ambient air. And one printer was found to emit levels of UFP more than 70 times higher than those found in the ambient air.
"These small particles remain airborne for much longer than the larger particles that tend to settle out, and also when you breathe them in, they tend to penetrate much deeper into your lung," said Stephan van Eeden, an associate professor, department of internal medicine at the University of British Columbia.
"There's also studies that some of these particles are so small that they can actually penetrate into the blood stream and affect blood vessels and the heart," he told CBC News.
"Just per mass, the amount of small particles that you inhale if you sit anything from two to three feet from the printer is about the same as sitting next to a person that smokes."
Australian study finds over a quarter of printers high emitters
The findings of the CBC-sponsored report echo the conclusions of another recent study by Australian scientists. Conducted by researchers at the Queensland University of Technology, the study measured the particle emissions of 62 printers.
It found that approximately 60 per cent of the investigated printers did not emit particles. But 40 per cent did emit particles and, of those, 27 per cent were high emitters.
Prof. Stephan van Eeden at UBC says some of the printer particles are so small they can penetrate into the blood stream and affect blood vessels and the heart. (CBC)
"Various types of printers are widely used in offices and homes around the world and they have become standard indoor electronic equipment," reads the study, published in the Aug. 1 issue of the American Chemical Society's Environmental Science and Technology journal.
"However, they are a potential source of indoor pollutants producing volatile organic compounds and ozone as well as a variety of particle emissions."
Lidia Morawska, an author of the Australian study, said that numerous health problems, such as cardiovascular problems or cancer, have been blamed on the ultrafine particles, depending on their composition.
"Even very small concentrations can be related to health hazards," she said. "Where the concentrations are significantly elevated means there is potentially a considerable hazard."
The study found that in tests with the printers that emitted the highest levels of small particulate, the effects were similar to exposure to cigarette smoke. "The highest printer particle number emission rate found in the chamber study was… close to the median value of submicrometre particle number emission rates for activities such as cigarette smoking, occurring in residential houses," it reads.
It also found that indoor particle counts in office air increased fivefold during work hours due to printer use. Printers emitted more particles when operating with new toner cartridges and when printing graphics and images that required more toner.
EPA steps up particle research
The Australian study identified a number of Hewlett Packard (HP) printers as high emitters, something the company disputes.
"After a preliminary review of the Queensland University of Technology research on particle emission characteristics of office printers, HP does not agree with its conclusion or some of the bold claims the authors have made recently in press reports," HP said in an official statement.
"There are no indications that ultrafine particle UFP emissions from laser printing systems are associated with special health risks."
The U.S. Environmental Protection Agency recently stepped up its efforts in identifying health effects brought on by ultrafine particulate. In 2005, it awarded $40 million US to five U.S. research centres to identify the sources of particulate matter most responsible for health problems.
The grants were awarded to Johns Hopkins University, Harvard University, the University of Rochester, the University of California at Davis, and the University of California at Los Angeles to study high-priority issues related to the effects of airborne particles on human health.
One of the EPA-funded studies, conducted by researchers at John Hopkins University in March 2006, found that short-term exposure to fine particulate matter increased hospital admissions for cardiovascular and respiratory diseases among the study's participants. The conditions noted included heart failure, chronic obstructive pulmonary disease and respiratory infections.
"The study shows an ongoing threat to human health from airborne particles," said Jonathan Samet, senior author of the study and chair of the Bloomberg School of Public Health department of epidemiology, in a release.
Health Canada says it's still studying issue
Health Canada spokesperson Joey Rathwell said Monday that the agency "is still in the information gathering stageconcerning this issue and cannot comment until the research is complete."
"Health Canada is, as part of the new government of Canada's regulatory framework on air emissions, consulting and gathering information that will support decisions on indoor air quality guidelines and product regulations," Rathwell told CBC News.
"In particular, we are in the process of updating our existing residential air quality guideline for particulate matter, and are as part of that process, reviewing existing and emerging scientific literature on sources of particles in the indoor environment."
This study will be examined in context with other literature in the field, Rathwell said.
Fire erupts at Wallaceburg Laundromat
“The business owner and some customers reportedly contacted firefighters after they noticed smoke coming from one of the clothes dryers.”
“The cause was ruled “accidental” and the damage is estimated at $175,000.”
The scene of a fire on Dufferin Avenue in Wallaceburg. November 30, 2021. (Photo courtesy of Toni Myers)
Chatham-Kent firefighters put out a blaze at Westown Laundromat in Wallaceburg. (Photo via @ckfiredept on Twitter.)
Amazon’s top doctor on why air quality is the biggest workplace health challenge of this century
KEY POINTS
Amazon chief health officer Vin Gupta says the biggest health challenge for public and work spaces this century will be ventilation and air quality.
This is not because of Covid alone, but the current pandemic should reinforce and elevate what existing public health research has shown: air quality at work is directly correlated to brain function and productivity.
Air quality researchers estimate we spend 90% of our lives, or 72 years of an 80-year life, indoors.
The U.S. is by no means out of the woods when it comes to the pandemic. While booster shots are being approved and the number of deaths may be plateauing, thousands of Americans are still dying each week and we are entering an uncertain cold and flu season with health systems already overwhelmed by Covid cases. New virus strains are also being monitored. But Vin Gupta, who is a health data and respiratory disease professor at the University of Washington and chief health officer for Amazon, says that over the course of the next four to five months, the nation should emerge from Covid feeling safer, and by March or April “renormalizing” what workplaces look like.
If workplaces are to be safer, though, and healthier and more productive, one big change needs to be made. Improvements to air filtration and ventilation systems were needed well before Covid, and Gupta says air quality will be the biggest challenge for public and workspaces of this century.
“Go back 100 years. The big issue that was killing people were communicable diseases passed fecal to oral,” Gupta said at the recent CNBC @Work Summit. The lack of good sanitation led to a rethinking in how society sanitized, and the development of sewer systems.
“100 years later, it is how do we ventilate public space and workplaces,” he said. “The big challenge of our time is how do we ventilate.”
Decades of research shows improving ventilation systems in work spaces improves brain function, but investment has lagged.
sturti | E+ | Getty Images
Gupta stressed that while Covid may be a catalyst for buildings to adopt better air quality systems, the research supporting investment in ventilation pre-dates Covid and shows that cognitive function and worker productivity get a boost with better air.
The research conducted by scientists at the Harvard T. H. Chan School of Public Health has shown across multiple studies that better-ventilated workspaces generate a return on investment.
“That’s just creating a better, healthier environment,” Gupta said. “These are the types of innovations that are cost-effective.”
The latest research on the impacts of air quality on cognitive function, the third study in a series, just came out last month. It concluded that, on average, cognitive scores were between 61% and 101% higher in green building designs than in conventional buildings, findings that the authors wrote have “wide-ranging implications” because the study was designed to mimic many typical daily indoor environments.
Before the pandemic, the science linking air quality to worker productivity wasn’t getting through to the decision makers in the world of building design and office management. The researchers noted in their work that three decades of supporting data has not led to an approach when it comes to building ventilation standards based on anything beyond “acceptable minimums.”
Adoption of enhanced ventilation strategies is lagging, and one of the primary authors of the ongoing research, Joseph Allen, who is an associate professor at the Harvard T. H. Chan School of Public Health and the director of its university’s Healthy Buildings program, has been calling for greater awareness and investment in air quality. In a piece for The Atlantic last week, Allen wrote the time has come to treat air quality as a must-have work benefit rather than trendy perks of the recent office era like gyms and coffee bars.
“Before the coronavirus pandemic, the interior designers and HR professionals who decide how offices look paid little attention to ventilation — an invisible variable that determines whether people can think well at their desk and whether coughs, colds, and other respiratory ills will circulate within a company,” Allen wrote.
One stat Allen likes to cite: People spend 90% of their lives indoors, or in an 80-year life, 72 years in spaces that probably haven’t taken care to design ventilation for optimal well-being.
Gupta said at the CNBC event that HVAC system improvements are not only cost-effective when measured by long-term productivity gains, but are good for workforce retention, a significant issue amid a tight labor market and health and safety concerns among many Americans about returning to physical workplaces.
Amazon has many health issues among its workforce and health-care solutions it is working on, from putting its new Amazon Care services in reach of its entire workforce, expanding those services as a nationwide business, to pharmacy services and solving chronic issues among workers in its warehouses, where it has been rolling out a slew of new wellness initiatives aimed at reducing physical injuries among manual laborers. Working conditions within Amazon warehouses are a major issue that has led to labor strife and union organizing drives.
Amazon and its large-tech peers may be in a better financial position to spend on health-care solutions than small- and medium-sized firms, but Gupta said employer spending on health — not only air quality but access to health-care services, including telehealth and virtual mental health services which he said will be a “raging” trend in the next decade — should not be viewed by the finance department as a cost, Gupta said, but as a cost-effective investment in the workforce.
He also said investment by companies in workplace health should include elevating medical strategy to a C-suite position. Gupta, who has been chief health officer at Amazon for 20 months, said, “If you don’t have a chief health officer or someone fulfilling this role for your organization, you should recruit one.”
Platinum Air Care’s Solution
Air purifiers are a necessity before and after any pandemic. There are a variety of health benefits to breathing pure air as opposed to dirty air, filled with bioaerosols, viruses, chemicals, particulates, and more. MedicAir® 2.0 medical-grade air purifier is designed to combat indoor air pollution, used in thousands of businesses, homes, and medical environments.