Abstract
Objective:During the COVID-19 era, a reliable method for tracing aerosols and droplets generated during otolaryngology procedures is needed to accurately assess contamination risk and to develop mitigation measures. Prior studies have not investigated the reliability of different fluorescent tracers for the purpose of studying aerosols and small droplets. Objectives include (1) comparing vitamin B2, fluorescein, and a commercial fluorescent green dye in terms of particle dispersion pattern, suspension into aerosols and small droplets, and fluorescence in aerosolized form and (2) determining the utility of vitamin B2 as a fluorescent tracer coating the aerodigestive tract mucosa in otolaryngology contamination models.Methods:Vitamin B2, fluorescein, and a commercial fluorescent dye were aerosolized using a nebulizer and passed through the nasal cavity from the trachea in a retrograde-intubated cadaveric head. In another scenario, vitamin B2 was irrigated to coat the nasal cavity and nasopharyngeal mucosa of a cadaveric head for assessment of aerosol and droplet generation from endonasal drilling. A cascade impactor was used to collect aerosols and small droplets ≤14.1 µm based on average aerodynamic diameter, and the collection chambers were visualized under UV light.Results:When vitamin B2 was nebulized, aerosols ≤5.4 µm were generated and the collected particles were fluorescent. When fluorescein and the commercial water tracer dye were nebulized, aerosols ≤8.61 µm and ≤2.08 µm respectively were generated, but the collected aerosols did not appear visibly fluorescent. Endonasal drilling in the nasopharynx coated with vitamin B2 irrigation yielded aerosols ≤3.30 µm that were fluorescent under UV light.Conclusion:Vitamin B2’s reliability as a fluorescent tracer when suspended in aerosols and small droplets ≤14.1 µm and known mucosal safety profile make it an ideal compound compared to fluorescein and commercial water-based fluorescent dyes for use as a safe fluorescent tracer in healthcare contamination models especially with human subjects.
Highlights
Due to the global COVID-19 pandemic, there has been an increased interest in studying the aerodynamic properties of aerosols and droplets
Characterizing aerosols and droplets based on aerodynamic diameter is critical to assessing risk of contamination due to the varying routes of transmission and
Aerosols are defined as particles with an aerodynamic diameter ≤10 μm whereas droplets are characterized as those with diameters >10 μm
Summary
Due to the global COVID-19 pandemic, there has been an increased interest in studying the aerodynamic properties of aerosols and droplets. Characterizing aerosols and droplets based on aerodynamic diameter is critical to assessing risk of contamination due to the varying routes of transmission and infectious potential of viruses suspended in different sized particles. Aerosols are defined as particles with an aerodynamic diameter ≤10 μm whereas droplets are characterized as those with diameters >10 μm This is in accordance with differences in particle dispersion and deposition into upper and lower airways.[2] Multiple fluorescent tracers such as Glo Germ (Glo Germ Company, Moab, Utah) and fluorescein have been used in healthcare contamination models.[3,4] For risk assessment of otolaryngology procedures, fluorescein has been the primary tracer utilized.[5,6,7] these tracers are limited due to their potential toxicity in humans and unknown capacity to fluoresce in an aerosolized form. We evaluate the utility of riboflavin, vitamin B2, as a fluorescent aerosol tracer, compare its properties to conventional fluorescent tracers, and explore its potential applications in human studies
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