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Review
. 2017 May 22;12(5):e0178007.
doi: 10.1371/journal.pone.0178007. eCollection 2017.

A Scoping Review on Bio-Aerosols in Healthcare and the Dental Environment

Affiliations
Free PMC article
Review

A Scoping Review on Bio-Aerosols in Healthcare and the Dental Environment

Charifa Zemouri et al. PLoS One. .
Free PMC article

Abstract

Background: Bio-aerosols originate from different sources and their potentially pathogenic nature may form a hazard to healthcare workers and patients. So far no extensive review on existing evidence regarding bio-aerosols is available.

Objectives: This study aimed to review evidence on bio-aerosols in healthcare and the dental setting. The objectives were 1) What are the sources that generate bio-aerosols?; 2) What is the microbial load and composition of bio-aerosols and how were they measured?; and 3) What is the hazard posed by pathogenic micro-organisms transported via the aerosol route of transmission?

Methods: Systematic scoping review design. Searched in PubMed and EMBASE from inception to 09-03-2016. References were screened and selected based on abstract and full text according to eligibility criteria. Full text articles were assessed for inclusion and summarized. The results are presented in three separate objectives and summarized for an overview of evidence.

Results: The search yielded 5,823 studies, of which 62 were included. Dental hand pieces were found to generate aerosols in the dental settings. Another 30 sources from human activities, interventions and daily cleaning performances in the hospital also generate aerosols. Fifty-five bacterial species, 45 fungi genera and ten viruses were identified in a hospital setting and 16 bacterial and 23 fungal species in the dental environment. Patients with certain risk factors had a higher chance to acquire Legionella in hospitals. Such infections can lead to irreversible septic shock and death. Only a few studies found that bio-aerosol generating procedures resulted in transmission of infectious diseases or allergic reactions.

Conclusion: Bio-aerosols are generated via multiple sources such as different interventions, instruments and human activity. Bio-aerosols compositions reported are heterogeneous in their microbiological composition dependent on the setting and methodology. Legionella species were found to be a bio-aerosol dependent hazard to elderly and patients with respiratory complaints. But all aerosols can be can be hazardous to both patients and healthcare workers.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flowchart.
Fig 2
Fig 2. Bacterial or fungal loads in mean Log-10 CFU/m3 in hospitals.
* = passive sampling method; # active sampling method.
Fig 3
Fig 3. Bacterial or fungal loads in mean Log-10 CFU/m3 in hospitals, measured twice.
* = passive sampling method; # active sampling method.
Fig 4
Fig 4. Bacterial or fungal loads in mean Log-10 CFU/m3 in dental.
* = passive sampling method; # active sampling method.
Fig 5
Fig 5. Bacterial or fungal loads in mean Log-10 CFU/m3 in dental, measured twice.
* = passive sampling method; # active sampling method.

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MeSH terms

Grant support

The author(s) received no specific funding for this work.
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