Subscribe to RSS
DOI: 10.1055/a-1907-3939
A new system to prevent SARS-CoV-2 and microorganism air transmission through the air circulation system of endoscopes
Abstract
Background and study aims Evidence for the modes of transmission of SARS-CoV-2 remains controversial. Recently, the potential for airborne spread of SARS-CoV-2 has been stressed. Air circulation in gastrointestinal light source boxes and endoscopes could be implicated in airborne transmission of microorganisms.
Methods The ENDOBOX SC is a 600 × 600 mm cube designed to contain any type of machine used during gastrointestinal endoscopy. It allows for a 100-mm space between a machine and the walls of the ENDOBOX SC. To use the ENDOBOX SC, it is connected to the medical air system and it provides positive flow from the box to the endoscopy room. The ENDOBOX SC uses medical air to inflate the digestive tract and to decrease the temperature induced by the microprocessors or by the lamp. ENDOBOX SC has been investigated in different environments.
Results An endoscopic procedure performed without ventilation was interrupted after 40 minutes to prevent computer damage. During the first 30 minutes, the temperature increased from 18 °C to 31 °C with a LED system. The procedure with fans identified variations in temperature inside the ENDOBOX SC from 21 to 26 °C (± 5 °C) 1 hour after the start of the procedure. The temperature was stable for the next 3 hours.
Conclusions ENDOBOX SC prevents the increase in temperature induced by lamps and processors, allows access to all necessary connections into the endoscopic columns, and creates a sterile and positive pressure volume, which prevents potential contamination from microorganisms.
Publication History
Received: 17 May 2022
Accepted after revision: 18 July 2022
Article published online:
15 December 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; 52: 483-490
- 2 Dinoi A, Feltracco M, Chirizzi D. et al. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. Sci Total Environ 2022; 809: 151137
- 3 Yu ITS, Li Y, Wong TW. et al. Evidence of airborne transmission of the severe acute respiratory syndrome virus. N Engl J Med 2004; 350: 1731-1739
- 4 Morawska L, Milton DK. It is time to address airborne transmission of Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2020; 71: 2311-2313
- 5 Birgand G, Peiffer-Smadja N, Fournier S. et al. Assessment of air contamination by SARS-CoV-2 in hospital settings. JAMA Netw Open 2020; 3: e2033232
- 6 Port JR, Yinda CK, Avanzato VA. et al. Increased small particle aerosol transmission of B.1.1.7 compared with SARS-CoV-2 lineage A in vivo. Nat Microbiol 2022; 7: 213-223
- 7 Sagami R, Nishikiori H, Sato T. et al. Aerosols produced by upper gastrointestinal endoscopy: a quantitative evaluation. Am J Gastroenterol 2021; 116: 202-205
- 8 Jackson T, Deibert D, Wyatt G. et al. Classification of aerosol-generating procedures: a rapid systematic review. BMJ Open Resp Res 2020; 7: e000730
- 9 Hayee B, Thoufeeq M, Rees CJ. et al. Safely restarting GI endoscopy in the era of COVID-19. Gut 2020; 69: 2063-2070
- 10 Hayee B, The SCOTS II Project group, Bhandari P. et al. COVID-19 transmission following outpatient endoscopy during pandemic acceleration phase involving SARS-CoV-2 VOC 202012/01 variant in UK. Gut 2021; 70: 2227-2229
- 11 Chaussade S, Ali EA, Hallit R. et al. Air circulation in a gastrointestinal light source box and endoscope in the era of SARS-CoV-2 and airborne transmission of microorganisms. Endosc Int Open 2021; 09: E482-E486
- 12 Chaussade S, Hallit R, Abou AliE. et al. SARS-CoV-2 in endoscopy: a potential way of microorganismsʼ air transmission. Gut 2022; 71: 656-657
- 13 Matteo MV, Boškoski I, Costamagna G. SARS-COV-2 in endoscopy: still a long way to go. Gut 2021; 70: 1629-1631
- 14 Lednicky JA, Lauzardo M, Fan ZH. et al. Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients. Int J Infect Dis 2020; 100: 476-482
- 15 Somerville CC, Shoaib M, Kuschner CE. et al. Prospective analysis of SARS-CoV-2 dissemination to environmental surfaces during endoscopic procedures. Endosc Int Open 2021; 09: E701-E705
- 16 Jones RM, Brosseau LM. Aerosol transmission of infectious disease. J Occup Environment Med 2015; 57: 501-508
- 17 He R, Liu W, Elson J. et al. Airborne transmission of COVID-19 and mitigation using box fan air cleaners in a poorly ventilated classroom. Physics Fluids 2021; 33: 057107
- 18 Chan SM, Ma TW, Chong MK-C. et al. A proof of concept study: esophagogastroduodenoscopy is an aerosol-generating procedure and continuous oral suction during the procedure reduces the amount of aerosol generated. Gastroenterology 2020; 159: 1949-1951.e4
- 19 Boškoski I, Di Gemma A, Matteo MV. et al. Endoscopes used in positive and critically ill patients are SARS-CoV-2 negative at virological assessment. Gut 2021; 70: 1629-1631
- 20 Gregson FKA, Shrimpton AJ, Hamilton F. et al. Identification of the source events for aerosol generation during oesophago-gastro-duodenoscopy. Gut 2022; 71: 871-878
- 21 Klompas M, Baker M, Rhee C. What is an aerosol-generating procedure?. JAMA Surgery 2021; 156: 113-114
- 22 Vavricka S, Tutuian R, Imhof A. et al. Air suctioning during colon biopsy forceps removal reduces bacterial air contamination in the endoscopy suite. Endoscopy 2010; 42: 736-741
- 23 Wu Y, Guo C, Tang L. et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol 2020; 5: 434-435