Infection control of lung function equipment: a practical approach

Abstract

The degree of risk of cross-infection of patients via lung function testing equipment has yet to be quantified. Based on current evidence, elaborate precautions are not justified for the majority of patients attending the laboratory, but attention to appropriate routine cleaning and disinfection protocols is important. Disinfection and sterilization can be achieved by a variety of methods, although chemical methods should be used with caution. Identification of factors increasing the susceptibility or infectivity of particular patients is important in determining appropriate precautions. Where patients are known to be infectious or are immunocompromized, additional precautions such as using a barrier filter may be appropriate. However, because of cost constraints, the routine use of barrier filters is difficult to justify based on current evidence of minimal cross-infection associated with lung function equipment. Until further studies have been conducted to quantify the degree of risk of cross-infection that lung function test equipment poses, the recommendations given in this review provide a practical approach to dealing with this problem.

Clinical evaluation of a screen pneumotachograph as an in-line filter

“…For instance, a survey of the 19 respiratory function laboratories of the public hospitals of Paris (France) showed that 16 out of the 17 laboratories answering the questionnaire were already using in-line filters for spirometry in 1996, just four years after they came onto the market [15]. However, as explicitly mentioned by the ATS/ERS Task Force [7] and confirmed by a recent exchange of letters [16][17][18], ''the use of such filters is an area of controversy''. The ability of these filters to remove bacteria from the high flow produced by true [19] or simulated [20] forced expiration has been seriously questioned and the use of in-line filters does not eliminate the need for regular cleaning and decontamination of lung function equipment.…”

Turkish Thoracic Society national spirometry and laboratory standards

“…Ortamda ortaya çıkan biyolojik atıklar uygun şekilde yok edilmelidir (24,25). İnfekte olan ve olmayan atık-ların ayrılması da infeksiyon kontrolüne yardım eder.…”

Diagnostic Spirometry in Primary Care: Proposed standards for general practice compliant with American Thoracic Society and European Respiratory Society recommendations. A General Practice Airways Group (GPIAG)1 document, in association with the Association for Respiratory Technology & Physiology (ARTP)2 and Education for Health3 1www.gpiag.org 2 www.artp.org 3 www.educationforhealth.org.uk

“…44,45 Cross contamination through mucosal contact with spirometry equipment and aerosolisation of infective particles during forced expiratory manoeuvres are the main potential sources of infection. 46,47 Measures to reduce the risk to both staff and patients 48 are summarised in Table 2. Cross infection is more likely when inspiratory manoeuvres are undertaken.…”