TY - JOUR T1 - Efficacy of Various Mitigation Devices in Reducing Fugitive Emissions from Nebulizers JF - Respiratory Care SP - 394 LP - 403 DO - 10.4187/respcare.09546 VL - 67 IS - 4 AU - Lauren J Harnois AU - Amnah A Alolaiwat AU - Guoqiang Jing AU - James B Fink AU - Rajiv Dhand AU - Jie Li Y1 - 2022/04/01 UR - http://rc.rcjournal.com/content/67/4/394.abstract N2 - BACKGROUND: Fugitive aerosol concentrations generated by different nebulizers and interfaces in vivo and mitigation of aerosol dispersion into the environment with various commercially available devices are not known.METHODS: Nine healthy volunteers were given 3 mL saline with a small-volume nebulizer (SVN) or vibrating mesh nebulizer (VMN) with a mouthpiece, a mouthpiece with an exhalation filter, an aerosol mask with open ports for SVN and a valved face mask for VMN, and a face mask with a scavenger (Exhalo) in random order. Five of the participants received treatments using a face tent scavenger (Vapotherm) and a mask with exhalation filter with SVN and VMN in a random order. Treatments were performed in an ICU room with 2 particle counters positioned 1 and 3 ft from participants measuring aerosol concentrations at sizes of 0.3–10.0 μm at baseline, before, during, and after each treatment.RESULTS: Fugitive aerosol concentrations were higher with SVN than VMN and higher with a face mask than a mouthpiece. Adding an exhalation filter to a mouthpiece reduced aerosol concentrations of 0.3–1.0 μm in size for VMN and 0.3–3.0 μm for SVN (all P < .05). An Exhalo scavenger over the mask reduced 0.5–3.0 μm sized particle concentrations for SVN (all P < .05) but not VMN. Vapotherm scavenger and filter face mask reduced fugitive aerosol concentrations regardless of the nebulizer type.CONCLUSIONS: SVN produced higher fugitive aerosol concentrations than VMN, whereas face masks generated higher aerosol concentrations than mouthpieces. Adding an exhalation filter to the mouthpiece or a scavenger to the face mask reduced aerosol concentrations for both SVN and VMN. Vapotherm scavenger and filter face mask reduced fugitive aerosols as effectively as a mouthpiece with an exhalation filter. This study provides guidance for reducing fugitive aerosol emissions from nebulizers in clinical practice. ER -