Modified bronchoscopy masks mitigate aerosols during gastroscopies

Digestive endoscopy has been proven to produce aerosols (1-3). This represents a risk of infection by COVID-19 and other airborne viruses. A number of protective barriers have been proposed to minimise that risk. Continuous suction of the oral cavity (1), shielding barriers (4,5), masks (6,7), and increasing the distance between patient and endoscopist (8) have been proposed as methods to reduce the exposure of endoscopists and endoscopy staff to aerosols. Here, we present a study that uses modified bronchoscopy masks (Explorer endoscopy facemask, Intersurgical Ltd., United Kingdom) to attenuate aerosol production at the patients mouth (bare mask shown in Fig. 1a and in use during an upper GI endoscopy in Fig. 1b). We find that this approach offers 47% (p=0.01) reduction in particle count for particles <5m in diameter (i.e. aerosols), which are known to spread SARS-CoV-2. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=77 SRC="FIGDIR/small/22283092v1_fig1.gif" ALT="Figure 1"> View larger version (16K): org.highwire.dtl.DTLVardef@17b3aa2org.highwire.dtl.DTLVardef@1466cb2org.highwire.dtl.DTLVardef@8a41c0org.highwire.dtl.DTLVardef@e2ca7b_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOFigure 1.C_FLOATNO Effect of mitigations on aerosol count. a) Photograph from procedure showing application of modified bronchoscopy mask to patient. b) Effect of modified bronchoscopy masks, showing significant reduction when being used in the <5{micro}m diameter range. *p<0.05, **p<0.01 C_FIG