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Estimated dermal exposure to nebulized pharmaceuticals for a simulated home healthcare worker scenario.
Journal of Occupational and Environmental Hygiene ( IF 1.5 ) Pub Date : 2020-03-05 , DOI: 10.1080/15459624.2020.1724297
Simileoluwa Ishau 1 , John F Reichard 1 , Andrew Maier 2 , Mamadou Niang 1 , Michael Yermakov 1 , Sergey A Grinshpun 1
Affiliation  

The duties of home healthcare workers are extensive. One important task that is frequently performed by home healthcare workers is administration of nebulized medications, which may lead to significant dermal exposure. In this simulation study conducted in an aerosol exposure chamber, we administered a surrogate of nebulizer-delivered medications (dispersed sodium chloride, NaCl) to a patient mannequin. We measured the amount of NaCl deposited on the exposed surface of the home healthcare worker mannequin, which represented the exposed skin of a home healthcare worker. Factors such as distance and position of the home healthcare worker, room airflow rate and patient's inspiratory rate were varied to determine their effects on dermal exposure. There was a 2.78% reduction in dermal deposition for every centimeter the home healthcare worker moved away from the patient. Increasing the room's air exchange rate by one air change per hour increased dermal deposition by about 2.93%, possibly due to a decrease in near field particle settling. For every 10-degrees of arc the home healthcare worker is positioned from the left side of the patient toward the right and thus moving into the ventilation airflow direction, dermal deposition increased by about 4.61%. An increase in the patient's inspiratory rate from 15-30 L/min resulted in an average of 14.06% reduction in dermal deposition for the home healthcare worker, reflecting a relative increase in the aerosol fraction inhaled by the patient. The findings of this study elucidate the interactions among factors that contribute to dermal exposure to aerosolized pharmaceuticals administered by home healthcare workers. The results presented in this paper will help develop recommendations on mitigating the health risks related to dermal exposure of home healthcare workers.

中文翻译:

在模拟的家庭医护人员情况下,估算的雾化药物对皮肤的暴露量。

家庭保健人员的职责广泛。家庭保健工作者经常执行的一项重要任务是雾化药物的管理,这可能导致大量的皮肤接触。在烟雾暴露室内进行的这项模拟研究中,我们为患者的人体模型提供了由雾化器输送的药物(分散的氯化钠,NaCl)的替代物。我们测量了沉积在家庭医护人员模特暴露表面上的NaCl量,这表示家庭医护人员暴露的皮肤。改变诸如家庭护理人员的距离和位置,房间气流速率和患者的吸气速率等因素,以确定它们对皮肤暴露的影响。有一个2。家庭医护人员离开病人的每一厘米,皮肤沉积物减少了78%。将房间的空气交换速率提高一小时一小时,可能会使近场颗粒沉降减少,从而使皮肤沉积增加约2.93%。对于每10度的弧度,家庭护理人员将从患者的左侧向右侧放置,并因此向通风气流方向移动,真皮沉积增加了约4.61%。病人吸气速度从15-30 L / min的增加导致家庭医护人员的皮肤沉积平均减少14.06%,反映出病人吸入的气溶胶分数相对增加。这项研究的结果阐明了由家庭医疗保健人员管理的,导致皮肤接触雾化药物的因素之间的相互作用。本文介绍的结果将有助于制定有关减轻与家庭护理人员皮肤接触有关的健康风险的建议。
更新日期:2020-03-05
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