Micro- and nanoplastic release upon simulated cleaning of tracheostomy tubes: Experimental evaluation and particle characterization

Tracheostomy tubes represent essential airway devices frequently used for long-term patient management. Due to prolonged use and the necessity for repeated cleaning, these devices are continuously exposed to mechanical and environmental stress, which may lead to material degradation and particle release. Thus, the utilization of tracheostomy tubes in otorhinolaryngology and critical care settings introduces potential sources of micro- and nanoplastic exposure to a vulnerable patient group. Beyond direct inhalation through these devices, routine maintenance practices, particularly the use of cleaning brushes may further contribute to particle generation and release into the respiratory system. This study aims to investigate the extent of micro- and nanoplastic release resulting from new, factory-sealed tracheostomy tubes subjected to simulated cleaning procedures ranging from 100 cycles up to 20,000 cycles to represent repetitive mechanical stress, as a prerequisite for later assessments of the implications for patient health. These findings will support future evaluations within the context of medical device benefit risk assessment in line with regulatory requirements such as the E.U. Medical Device Regulation (MDR 2017/745)." • Simulated cleaning of tracheal cannula inner tubes released micro- and nanoplastics • Perforated inner tubes were more affected by mechanical stress than non-perforated tubes • Polymeric material of brush bristles and inner tubes was found in the rinsing water • Recommendations for cleaning of medical devices might need update