Abstract
ABSTRACTObjective: to analyze the scientific evidence on aerosols generated during cleaning activities of health products in the Central Service Department (CSD) and the impact of the negative pressure of the ambient air in the cleaning area to control the dispersion of aerosols to adjacent areas. Method: for this literature systematic review the following searches were done: search guidelines, manuals or national and international technical standards given by experts; search in the portal and databases PubMed, Scopus, CINAHL and Web of Science; and a manual search of scientific articles. Results: the five technical documents reviewed recommend that the CSD cleaning area should have a negative differential ambient air pressure, but scientific articles on the impact of this intervention were not found. The four articles included talked about aerosols formed after the use of a ultrasonic cleaner (an increased in the contamination especially during use) and pressurized water jet (formation of smaller aerosols 5μm). In a study, the aerosols formed from contaminated the hot tap water with Legionella pneumophila were evaluated. Conclusions: there is evidence of aerosol formation during cleanup activities in CSD. Studies on occupational diseases of respiratory origin of workers who work in CSD should be performed.
Highlights
Aerosols are generated and released by humans in various activities, such as breathing, talking, coughing and sneezing; Bathing with contaminated water; aerosolization of sewage waste in toilets or drainage system for outdoor environments; cleaning and rinsing surfaces indoors; spraying in agriculture(1)
It was defined as the guiding question of this review: Formation of aerosols occurs during cleaning activities of medical device (MD), and what is the impact of negative air pressure in the dispersion of these to adjacent areas?
The Central Service Department (CSD) was classified as level one “an area where it was not found the risk of health problems related to air quality, but some authorities, organizations and researchers suggest that the risk should be considered.”
Summary
Aerosols are generated and released by humans in various activities, such as breathing, talking, coughing and sneezing; Bathing with contaminated water; aerosolization of sewage waste in toilets or drainage system for outdoor environments; cleaning and rinsing surfaces indoors; spraying in agriculture(1). Aerosols are defined as smaller particles or equal to 5μm, that may or may not contain an infectious agent and, due to their size, can remain suspended in the atmosphere for hours, slowly being transported over long distances and achieve adjacent areas(2). Aerosols containing an infectious agent that remain in the environment can be inhaled by susceptible individuals, even if there is no close contact with the disposing source, or contaminated surfaces(3). The droplets that are larger than 5μm, remain suspended for a few seconds and quickly lay on the floor or other surfaces due to gravity. There are slight variations of the nomenclature and definition of sizes, the Brazilian National Health Surveillance Agency (ANVISA) uses the definition that aerosols are smaller than 5μm, which was adopted for this study(2-3)
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