Some aspects of the airborne transmission of infection

The relationship between the human body and the dissemination of potentially pathogenic particles and droplets is described. Airborne transmission of infection in operating theatres and a burns unit and the part played by the human microclimate and its interaction with ventilating air flows is discussed. The mechanisms by which different garment assemblies used for surgery can enhance particle dispersion are illustrated and the way that floor cleaning can increase the concentration of airborne organisms is described. The development of the successful use of ultra-clean air systems in orthopaedic implant surgery is reviewed. Relationships between contact and airborne transmission of disease are explored and ways by which containment strategies and metrics used in pharmaceutical and electronics manufacturing can be applied to the design and monitoring of healthcare areas is discussed. It is suggested that currently available techniques involving architectural, ventilation and operational aspects of healthcare provision, when properly applied, can markedly improve treatment outcomes that may otherwise be compromised by hospital-acquired infections involving both bacteria and viruses.

[1]  J. Scales,et al.  Levitation in treatment of large-area burns. , 1967, Lancet.

[2]  R P Clark,et al.  Proceedings: Aerobiological investigations in a new Regional Burns Unit. , 1975, The Journal of physiology.

[3]  ScienceDirect Revue générale de thermique , 1998 .

[4]  K. D. Allen,et al.  Hospital outbreak of multi-resistant Acinetobacter anitratus: an airborne mode of spread? , 1987, The Journal of hospital infection.

[5]  Clive B. Beggs,et al.  Bioaerosol Production on a Respiratory Ward , 2006 .

[6]  L G Pugh,et al.  Skin temperature during running‐‐a study using infra‐red colour thermography. , 1977, The Journal of physiology.

[7]  B. Collins,et al.  Hygiene of babie's incubators , 1975, The Lancet.

[8]  R. P. Clark,et al.  Clothing for use in clean-air environments , 1976, Journal of Hygiene.

[9]  Gary S. Settles,et al.  Computational Study of the Wake and Contaminant Transport of a Walking Human , 2005 .

[10]  L. A. Hopkins,et al.  Patient-support system using low-pressure air. , 1971, The Lancet.

[11]  H. Bernard,et al.  The Design and Utilization of Operating Theatres , 1985 .

[12]  Hilla Peretz,et al.  The , 1966 .

[13]  Convective Heat Loss from the Human Body , 1976 .

[14]  R N Cox,et al.  Aerodynamics of the human microenvironment. , 1969, Lancet.

[15]  J. Sung,et al.  Airflows Around Oxygen Masks , 2006, Chest.

[16]  O. G. Edholm,et al.  Man and his thermal environment , 1985 .

[17]  C. Keevil,et al.  Potential use of copper surfaces to reduce survival of epidemic meticillin-resistant Staphylococcus aureus in the healthcare environment. , 2006, The Journal of hospital infection.

[18]  O M Lidwell,et al.  Airborne contamination of wounds in joint replacement operations: the relationship to sepsis rates. , 1983, The Journal of hospital infection.

[19]  R. Blowers,et al.  DISPERSAL OF STAPHYLOCOCCUS AUREUS BY PATIENTS AND SURGICAL STAFF. , 1965, Lancet.

[20]  R. P. Clark Micro-Environmental Air Exchange Rates in Patient Support Systems , 1974 .

[21]  Gary S Settles,et al.  Images in clinical medicine. Coughing and aerosols. , 2008, The New England journal of medicine.

[22]  D. Vesley,et al.  Bacterial dispersion in relation to operating room clothing , 1976, Journal of Hygiene.

[23]  P V Nielsen,et al.  Dispersion of exhaled droplet nuclei in a two-bed hospital ward with three different ventilation systems. , 2006, Indoor air.

[24]  M L de Calcina-Goff,et al.  A method for determining the heat transfer and water vapour permeability of patient support systems. , 1999, Medical engineering & physics.

[25]  T. Elliott,et al.  Antimicrobial efficacy of copper surfaces against spores and vegetative cells of Clostridium difficile: the germination theory. , 2008, The Journal of antimicrobial chemotherapy.

[26]  J. Atkinson,et al.  Images in clinical medicine. New-onset clubbing associated with lung cancer. , 2008, The New England journal of medicine.

[27]  R. N. Cox,et al.  An application of aeronautical techniques to physiology 2. Particle transport within the human microenvironment , 1974, Medical and biological engineering.

[28]  A. Sleigh,et al.  CFD modelling of a hospital ward: Assessing risk from bacteria produced from respiratory and activity sources , 2008 .

[29]  I. Eames,et al.  Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises , 2006, Journal of Hospital Infection.

[30]  N. Toy,et al.  Natural convection around the human head. , 1975, The Journal of physiology.

[31]  R. P. Clark Air conditioning in hospital wards and operating theatres. , 1977, Engineering in medicine.

[32]  Air Movement in Laboratory Infections [and Discussion] , 1983 .

[33]  R. P. Clark Skin scales among airborne particles , 1974, Journal of Hygiene.

[34]  R P Clark,et al.  Forced convection around the human head. , 1975, The Journal of physiology.

[35]  P V Nielsen,et al.  Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review. , 2007, Indoor air.

[36]  P Andrew Sleigh,et al.  Aerial Dissemination of Clostridium difficile spores , 2008, BMC infectious diseases.

[37]  D. Seal,et al.  Electronic particle counting for evaluating the quality of air in operating theatres: a potential basis for standards? , 1990, The Journal of applied bacteriology.

[38]  W. Whyte,et al.  The reduction of bacteria in the operation room through the use of non‐woven clothing , 1978, The British journal of surgery.

[39]  E. A. Hathway,et al.  The ventilation of multiple-bed hospital wards: review and analysis. , 2008, American journal of infection control.

[40]  J. D. Haberman,et al.  MEDICAL THERMOGRAPHY. , 1965, The American journal of roentgenology, radium therapy, and nuclear medicine.

[41]  R P Clark,et al.  The ergonomics of ventilated operating theatre clothing. , 1988, Ergonomics.

[42]  Identification of Skin in Airborne Particulate Matter , 1973, Nature.