Aerosol Boxes Might Put Health Workers At Risk Instead Of Protecting Them, Study Shows

Aerosol boxes that health workers use when intubating COVID-19 patients may increase their risk of exposure to virus particles, a recent study shows.

In order to protect health workers from contracting the virus when they intubate coronavirus patients, the patient's head and neck are first covered by an aerosol box. Most aerosol boxes are made of transparent acrylic or polycarbonate sheet and will have holes at the sides for health personnel to perform the procedure.

While the boxes provide a simple and quick way to protect health workers, their safety and efficacy are never subjected to a clinical test. Also, no international guideline on personal protective equipment endorses the use of the boxes.

Experts have been raising concerns about the use of the devices, saying they may put health care personnel at risk. Despite the warnings, however, intensive care units in hospitals around the world continue to use aerosol boxes.

In the recent study, a team of researchers from Intensive Care and Anaesthesia Specialists at Eastern Health in Melbourne, Australia, tested the efficacy of five aerosol containment techniques, which include an aerosol box, a sealed box with and without suctions, as well as a vertical drape and a horizontal drape. Volunteers then held a bottle of harmless liquid just under their mouths while coughing every 30 seconds.

Researchers used detection devices to measure airborne particles of different sizes, with each particle spread being assessed every five minutes. The study found that when using aerosol boxes, exposure to various sizes of airborne particles is higher.

According to the study, published in the journal Anaesthesia on July 9, if coronavirus particles act in the same manner as the fluid used in the simulation, aerosol boxes increase the health worker's exposure to virus particles.

The lead researchers of the study, Peter Chan and Joanna Simpson, revealed that in some cases, the exposure risk with an aerosol box could even be by a factor of five times or higher.

"Spikes of airborne particles were clearly seen, coinciding with patient coughing. We believe that these represent particles escaping from the arm access holes in the aerosol box," the researchers said.

Chan added that if the devices were launched in the market and regulated, it would have been immediately recalled due to the potential risk.