{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:58:51Z","timestamp":1785427131972,"version":"3.56.0"},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"unspecified","delay-in-days":140,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S2732494X26104136_as1\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To measure aerosol generation during various medical procedures that are potentially aerosol generating and determine whether these aerosols contain viral and\/or bacterial pathogens that may pose a risk to healthcare personnel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as2\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Observational.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as3\">\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Tertiary care academic hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as4\">\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>Convenience sample of adult patients undergoing one of the following procedures: extubation, bronchoscopy, mechanical ventilation, noninvasive ventilation, suctioning, nebulized medication administration (NMA), sputum induction, nasopharyngeal swab, or tracheostomy change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as5\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Four aerosol characterization instruments measured aerosol characteristics (particle mass, number, size); average baseline and procedure measurements were compared to identify changes in aerosolized particles associated with each type of procedure. SKC BioSamplers were used for viral and bacterial pathogen recovery. Clinical data were reviewed to examine patient characteristics that might impact pathogen recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as6\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 93 sampled procedures, differences between baseline versus procedure measurements were only notable for NMA and sputum induction. Smaller increases in some particle measurements were observed for the single extubation sample. None of the 248 BioSampler specimens were positive for a respiratory virus, even though for 39 procedures, the patient had a recent clinical specimen that was positive for a respiratory virus. Thirty-two samples (13%) had positive bacterial cultures, all of which represented common skin\/environmental contaminants or upper respiratory microbiota.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2732494X26104136_as7\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this study, significant aerosol generation was only observed during NMA and sputum induction. No viral pathogens and minimal bacteria were recovered from these medically generated aerosols. These data suggest that some procedures that are considered \u201caerosol-generating\u201d may pose little infectious risk to healthcare personnel.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ash.2026.10413","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:50:51Z","timestamp":1779357051000},"source":"Crossref","is-referenced-by-count":0,"title":["Characterization of aerosols generated during suspected aerosol-generating procedures in healthcare settings"],"prefix":"10.1017","volume":"6","author":[{"given":"Caroline A.","family":"O\u2019Neil","sequence":"first","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-4325","authenticated-orcid":false,"given":"Jiayu","family":"Li","sequence":"additional","affiliation":[{"name":"University of Miami College of Engineering"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan A.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Raliya","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0543-0443","authenticated-orcid":false,"given":"Yang","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Miami College of Engineering"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Leavey","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Traci L.","family":"Bricker","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey-Ann D.","family":"Burnham","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4700-8224","authenticated-orcid":false,"given":"Adrianus C.M.","family":"Boon","sequence":"additional","affiliation":[{"name":"Washington University In St Louis: Washington University in St Louis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1104-3738","authenticated-orcid":false,"given":"Pratim","family":"Biswas","sequence":"additional","affiliation":[{"name":"University of Miami College of Engineering"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9015-8378","authenticated-orcid":false,"given":"Hilary M.","family":"Babcock","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01yc7t268","id-type":"ROR","asserted-by":"publisher"}],"name":"Washington University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"S2732494X26104136_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2007.10.007"},{"key":"S2732494X26104136_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181b9e8b3"},{"key":"S2732494X26104136_ref31","first-page":"1335","article-title":"Characterization of aerosols generated during patient care activities","volume":"65","author":"ONeil","year":"2017","journal-title":"Clin Infect Dis"},{"key":"S2732494X26104136_ref24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056278"},{"key":"S2732494X26104136_ref17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000730"},{"key":"S2732494X26104136_ref4","unstructured":"4. 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Accessed September 11, 2025."},{"key":"S2732494X26104136_ref2","first-page":"93","article-title":"Cluster of severe acute respiratory syndrome cases among protected health care workers-Toronto, April 2003","volume":"29","author":"Ofner","year":"2003","journal-title":"Can Commun Dis Rep"},{"key":"S2732494X26104136_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis773"},{"key":"S2732494X26104136_ref3","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200305-715OC"},{"key":"S2732494X26104136_ref13","doi-asserted-by":"publisher","DOI":"10.1126\/science.abd9149"},{"key":"S2732494X26104136_ref26","doi-asserted-by":"publisher","DOI":"10.1128\/MMBR.00002-08"},{"key":"S2732494X26104136_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhin.2020.05.037"},{"key":"S2732494X26104136_ref6","doi-asserted-by":"publisher","DOI":"10.3201\/eid1904.111812"},{"key":"S2732494X26104136_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviromet.2011.05.030"},{"key":"S2732494X26104136_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"S2732494X26104136_ref35","first-page":"e50611","article-title":"The laboratory characterization of fugitive aerosol emissions from a standard jet nebulizer with and without a filtered mouthpiece","volume":"15","author":"Dhanak","year":"2023","journal-title":"Cureus"},{"key":"S2732494X26104136_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejps.2023.106474"},{"key":"S2732494X26104136_ref39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0015100"},{"key":"S2732494X26104136_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu127"},{"key":"S2732494X26104136_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15093"},{"key":"S2732494X26104136_ref22","doi-asserted-by":"publisher","DOI":"10.1080\/15459624.2019.1649414"},{"key":"S2732494X26104136_ref34","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10578"},{"key":"S2732494X26104136_ref7","unstructured":"7. Centers for Disease Control and Prevention (CDC). Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel. 2010, https:\/\/archive.cdc.gov\/www_cdc_gov\/h1n1flu\/guidelines_infection_control.htm. 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Centers for Disease Control and Prevention (CDC). Infection prevention and control strategies for seasonal influenza in healthcare settings. 2025, https:\/\/www.cdc.gov\/flu\/hcp\/infection-control\/healthcare-settings.html. Accessed September 11, 2025."},{"key":"S2732494X26104136_ref20","doi-asserted-by":"publisher","DOI":"10.1177\/1757177409106456"},{"key":"S2732494X26104136_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.2008.04119.x"},{"key":"S2732494X26104136_ref30","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis237"},{"key":"S2732494X26104136_ref33","doi-asserted-by":"publisher","DOI":"10.3310\/hta14460-02"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X26104136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:50:57Z","timestamp":1779357057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X26104136\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026]]}},"alternative-id":["S2732494X26104136"],"URL":"https:\/\/doi.org\/10.1017\/ash.2026.10413","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e151"}}