Cytosponge procedures produce fewer respiratory aerosols and droplets than oesophagogastro-duodenoscopies

Abstract

AbstractBackground and AimsOesophagogastro duodenoscopies (OGD) are aerosol generating procedures (AGP) that may spread respiratory pathogens. We aim to investigate production of airborne aerosols and droplets during Cytosponge procedures, which are being evaluated in large-scale research studies and NHS implementation pilots to reduce endoscopy backlogs.Design and MethodsWe measured 18 Cytosponge and 37 OGD procedures using a particle counter (diameters 0.3μm-25μm) taking measurements 10cm from the mouth. Two particle count analyses were performed: whole procedure and event-based.ResultsDirect comparison with duration-standardised OGD procedures shows Cytosponge procedures produce 2.16x reduction (p<0.001) for aerosols and no significant change for droplets (p=0.332). Event-based analysis shows particle production is driven by throat spray (aerosols:138.1x reference, droplets:16.2x), which is optional, and removal of Cytosponge (aerosols:14.6x, droplets:62.6x). Cytosponge coughing produces less aerosols than OGD (2.82x,p<0.05).ConclusionsCytosponge procedures produce significantly less aerosols and droplets than OGD procedures and thus reduce two potential transmission routes for respiratory viruses.