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Pharmaceutics 2019, 11(2), 75;

Investigation of the Quantity of Exhaled Aerosols Released into the Environment during Nebulisation

School of Physics & Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, Galway H91 CF50, Ireland
Aerogen, IDA Business Park, Dangan, Galway H91 HE94, Ireland
Author to whom correspondence should be addressed.
Received: 25 January 2019 / Revised: 5 February 2019 / Accepted: 8 February 2019 / Published: 12 February 2019
(This article belongs to the Special Issue Advances in Pulmonary Drug Delivery)
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Background: Secondary inhalation of medical aerosols is a significant occupational hazard in both clinical and homecare settings. Exposure to fugitive emissions generated during aerosol therapy increases the risk of the unnecessary inhalation of medication, as well as toxic side effects. Methods: This study examines fugitively-emitted aerosol emissions when nebulising albuterol sulphate, as a tracer aerosol, using two commercially available nebulisers in combination with an open or valved facemask or using a mouthpiece with and without a filter on the exhalation port. Each combination was connected to a breathing simulator during simulated adult breathing. The inhaled dose and residual mass were quantified using UV spectrophotometry. Time-varying fugitively-emitted aerosol concentrations and size distributions during nebulisation were recorded using aerodynamic particle sizers at two distances relative to the simulated patient. Different aerosol concentrations and size distributions were observed depending on the interface. Results: Within each nebuliser, the facemask combination had the highest time-averaged fugitively-emitted aerosol concentration, and values up to 0.072 ± 0.001 mg m−3 were recorded. The placement of a filter on the exhalation port of the mouthpiece yielded the lowest recorded concentrations. The mass median aerodynamic diameter of the fugitively-emitted aerosol was recorded as 0.890 ± 0.044 µm, lower the initially generated medical aerosol in the range of 2–5 µm. Conclusions: The results highlight the potential secondary inhalation of exhaled aerosols from commercially available nebuliser facemask/mouthpiece combinations. The results will aid in developing approaches to inform policy and best practices for risk mitigation from fugitive emissions. View Full-Text
Keywords: nebuliser; exhaled aerosol; fugitive emissions; secondary exposure; aerosol; inhalation therapy nebuliser; exhaled aerosol; fugitive emissions; secondary exposure; aerosol; inhalation therapy

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McGrath, J.A.; O’Sullivan, A.; Bennett, G.; O’Toole, C.; Joyce, M.; Byrne, M.A.; MacLoughlin, R. Investigation of the Quantity of Exhaled Aerosols Released into the Environment during Nebulisation. Pharmaceutics 2019, 11, 75.

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