Risk of bacterial exposure to the endoscopist's face during endoscopy

Gastrointest Endosc. 2019 Apr;89(4):818-824. doi: 10.1016/j.gie.2018.10.034. Epub 2018 Nov 1.


Background and aims: Nonuniversal use of facial protection during endoscopy may place endoscopists at risk of exposure to blood and body fluids; however, the frequency of exposure is unknown.

Methods: A prospective 6-month study of 4 gastroenterologists using a face shield during endoscopy was undertaken. The face shield was swabbed in a standardized fashion before and at the end of the session. Controls included pre- and post-swabs of face shields placed on the (1) endoscopy suite wall, (2) remote patient intake bay wall, and (3) after deliberate contamination with a colonoscope immediately after colonoscopy. The swabs were cultured for 48 hours, and growth was reported as no growth or by number of colony-forming units (CFUs). The groups were compared for +CFU rate and CFU number.

Results: A total of 1100 procedures were performed in 239 endoscopy sessions. The +CFU rate in the pre-endoscopy groups (2%-4.8%, not significant) was significantly lower than the postendoscopist face shield (45.8%, P < .001) and endoscopy suite wall groups (21.4%, P < .001), respectively. Using a cut-off of >15 CFUs as an indicator of definite exposure, the occurrence rate was 5.6 per 100 half days of endoscopy to the endoscopist's face and 3.4 per 100 half days of endoscopy 6 feet away.

Conclusions: This is the first study to quantify the rate of unrecognized exposure to the endoscopist's face to potentially infectious biologic samples during endoscopy (5.6/100 days of endoscopy). This exposure may result in transmission of infectious diseases. As such, we recommend the use of universal facial protection during GI endoscopy.

MeSH terms

  • Attitude of Health Personnel
  • Bacteria / isolation & purification*
  • Colonoscopy
  • Colony Count, Microbial
  • Culture Techniques
  • Endoscopy, Digestive System*
  • Endosonography
  • Gastroenterologists*
  • Humans
  • Incidence
  • Masks / microbiology*
  • Occupational Exposure / statistics & numerical data*
  • Prospective Studies