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Open AccessArticle

Investigation of Fugitive Aerosols Released into the Environment during High-Flow Therapy

1
School of Physics & Centre for Climate and Air Pollution Studies, Ryan Institute, National University of Ireland Galway, H91 CF50 Galway, Ireland
2
Aerogen, IDA Business Park, Dangan, H91 HE94 Galway, Ireland
*
Author to whom correspondence should be addressed.
Pharmaceutics 2019, 11(6), 254; https://doi.org/10.3390/pharmaceutics11060254
Received: 7 May 2019 / Revised: 24 May 2019 / Accepted: 28 May 2019 / Published: 1 June 2019
(This article belongs to the Special Issue Advances in Pulmonary Drug Delivery)
Background: Nebulised medical aerosols are designed to deliver drugs to the lungs to aid in the treatment of respiratory diseases. However, an unintended consequence is the potential for fugitive emissions during patient treatment, which may pose a risk factor in both clinical and homecare settings. Methods: The current study examined the potential for fugitive emissions, using albuterol sulphate as a tracer aerosol during high-flow therapy. A nasal cannula was connected to a head model or alternatively, a interface was connected to a tracheostomy tube in combination with a simulated adult and paediatric breathing profile. Two aerodynamic particle sizers (APS) recorded time-series aerosol concentrations and size distributions at two different distances relative to the simulated patient. Results: The results showed that the quantity and characteristics of the fugitive emissions were influenced by the interface type, patient type and supplemental gas-flow rate. There was a trend in the adult scenarios; as the flow rate increased, the fugitive emissions and the mass median aerodynamic diameter (MMAD) of the aerosol both decreased. The fugitive emissions were comparable when using the adult breathing profiles for the nasal cannula and tracheostomy interfaces; however, there was a noticeable distinction between the two interfaces when compared for the paediatric breathing profiles. The highest recorded aerosol concentration was 0.370 ± 0.046 mg m−3 from the tracheostomy interface during simulated paediatric breathing with a gas-flow rate of 20 L/min. The averaged MMAD across all combinations ranged from 1.248 to 1.793 µm by the APS at a distance of 0.8 m away from the patient interface. Conclusions: Overall, the results highlight the potential for secondary inhalation of fugitive emissions released during simulated aerosol treatment with concurrent high-flow therapy. The findings will help in developing policy and best practice 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’Toole, C.; Bennett, G.; Joyce, M.; Byrne, M.A.; MacLoughlin, R. Investigation of Fugitive Aerosols Released into the Environment during High-Flow Therapy. Pharmaceutics 2019, 11, 254.

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