P267 Assessment of the impact of nebuliser type on fugitive emissions in a treatment room when delivering inhaled medications

<h3>Rationale</h3> Nebulisers are widely used to deliver inhaled medications. Fugitive emissions are aerosols created by the nebuliser that are not inhaled by the patient. Fugitive emissions along with nebuliser exudate may potentially contain viral pathogens which can pose a risk to others in close proximity. A laboratory investigation was performed to assess the potential for exposure to fugitive emissions within a treatment room. <h3>Methods</h3> Fugitive emissions produced by 3 different nebuliser types (AeroEclipse* II BAN* Nebuliser -breath-actuated, NebuTech† HDN† breath-enhanced, and Aerogen† Ultra-vibrating mesh) were assessed using salbutamol as a tracer and simulating an adult receiving a nebuliser treatment. Aerosol filters attached to breathing simulators were positioned 0.8 and 2 meters away from the nebuliser to represent caregivers within the room. Collection areas were also established within the test room to measure the amount of fugitive emissions/exudate that may have reached the caregiver but were not inhaled. The mass of salbutamol recovered from filters and collection surfaces was analysed by HPLC. <h3>Results</h3> Total recovered emissions/exudate varied depending on the type of nebuliser used. The BAN* Nebuliser produced the lowest amount of fugitive emissions. The vibrating mesh nebuliser produced a significantly higher recovered amount directly below the nebuliser compared to the other two devices. The distance between the patient and the healthcare worker was not determined to be a significant factor in the amount of exposure to fugitive emissions. <h3>Conclusions</h3> Healthcare workers should be aware of the potential risks associated with fugitive emissions from nebulisers and ways to minimise exposure. The choice of nebuliser can significantly affect the amount of fugitive emissions and exudate produced in a treatment environment.