{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:58:05Z","timestamp":1768287485133,"version":"3.49.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,6,5]],"date-time":"2019-06-05T00:00:00Z","timestamp":1559692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U54CK000445-01"],"award-info":[{"award-number":["U54CK000445-01"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Providing care to patients with an infectious disease can result in the exposure of healthcare workers (HCWs) to pathogen-containing bodily fluids. We performed a series of experiments to characterize the magnitude of environmental contamination\u2014in air, on surfaces and on participants\u2014associated with seven common healthcare activities. The seven activities studied were bathing, central venous access, intravenous access, intubation, physical examination, suctioning and vital signs assessment. HCWs with experience in one or more activities were recruited to participate and performed one to two activities in the laboratory using task trainers that contained or were contaminated with fluorescein-containing simulated bodily fluid. Fluorescein was quantitatively measured in the air and on seven environmental surfaces. Fluorescein was quantitatively and qualitatively measured on the personal protective equipment (PPE) worn by participants. A total of 39 participants performed 74 experiments, involving 10\u201312 experimental trials for each healthcare activity. Healthcare activities resulted in diverse patterns and levels of contamination in the environment and on PPE that are consistent with the nature of the activity. Glove and gown contamination were ubiquitous, affirming the value of wearing these pieces of PPE to protect HCW\u2019s clothing and skin. Though intubation and suctioning are considered aerosol-generating procedures, fluorescein was detected less frequently in air and at lower levels on face shields and facemasks than other activities, which suggests that the definition of aerosol-generating procedure may need to be revised. Face shields may protect the face and facemask from splashes and sprays of bodily fluids and should be used for more healthcare activities.<\/jats:p>","DOI":"10.1093\/annweh\/wxz048","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T15:12:27Z","timestamp":1558451547000},"page":"784-796","source":"Crossref","is-referenced-by-count":13,"title":["Environmental and Personal Protective Equipment Contamination during Simulated Healthcare Activities"],"prefix":"10.1093","volume":"63","author":[{"given":"Rachel T","family":"Weber","sequence":"first","affiliation":[{"name":"School of Public Health, University of Illinois at Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8810-5971","authenticated-orcid":false,"given":"Linh T","family":"Phan","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Illinois at Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charissa","family":"Fritzen-Pedicini","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Illinois at Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-7900","authenticated-orcid":false,"given":"Rachael M","family":"Jones","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Illinois at Chicago, Chicago, IL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,5]]},"reference":[{"key":"2019080801144581800_CIT0001","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/bjd.15009","article-title":"Incidence and risk factors of blood splatter in dermatological surgery: how protective are full facial masks?","volume":"176","author":"Aguilar-Duran","year":"2017","journal-title":"Br J Dermatol"},{"key":"2019080801144581800_CIT0002","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1086\/673462","article-title":"Comparison of visual versus microscopic methods to detect blood splatter from an intravascular catheter with engineered sharps injury protection","volume":"34","author":"Ansari","year":"2013","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2019080801144581800_CIT0003","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.ajic.2014.08.001","article-title":"Method for investigating nursing behaviors related to isolation care","volume":"42","author":"Beam","year":"2014","journal-title":"Am J Infect Control"},{"key":"2019080801144581800_CIT0004","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1111\/j.1365-2672.2005.02798.x","article-title":"Microbial aerosol generation during laboratory accidents and subsequent risk assessment","volume":"100","author":"Bennett","year":"2006","journal-title":"J Appl Microbiol"},{"key":"2019080801144581800_CIT0005","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1080\/15459624.2017.1346799","article-title":"Transfer of bacteriophage MS2 and fluorescein from N95 filtering facepiece respirators to hands: measuring fomite potential","volume":"14","author":"Brady","year":"2017","journal-title":"J Occup Environ Hyg"},{"key":"2019080801144581800_CIT0006","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.ajic.2011.04.324","article-title":"Effect of single- versus double-gloving on virus transfer to health care workers\u2019 skin and clothing during removal of personal protective equipment","volume":"40","author":"Casanova","year":"2012","journal-title":"Am J Infect Control"},{"key":"2019080801144581800_CIT0007","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/1471-2334-6-151","article-title":"Clinical and epidemiological predictors of transmission in Severe Acute Respiratory Syndrome (SARS)","volume":"6","author":"Chen","year":"2006","journal-title":"BMC Infect Dis"},{"key":"2019080801144581800_CIT0008","volume-title":"Fundamentals of nursing: human health and function","author":"Craven","year":"2017","edition":"8"},{"key":"2019080801144581800_CIT0009","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1093\/infdis\/jiu127","article-title":"Exposure to influenza virus aerosols in the hospital setting: is routine patient care an aerosol generating procedure?","volume":"210","author":"Cummings","year":"2014","journal-title":"J Infect Dis"},{"key":"2019080801144581800_CIT0010","volume-title":"Clinical procedures in emergency medicine","author":"Custalow","year":"2010","edition":"5"},{"key":"2019080801144581800_CIT0011","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1164\/rccm.200305-715OC","article-title":"Transmission of severe acute respiratory syndrome during intubation and mechanical ventilation","volume":"169","author":"Fowler","year":"2004","journal-title":"Am J Respir Crit Care Med"},{"key":"2019080801144581800_CIT0012","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1007\/s11999-014-4094-8","article-title":"The gown-glove interface is a source of contamination: a comparative study","volume":"473","author":"Fraser","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"2019080801144581800_CIT0013","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.jemermed.2014.04.021","article-title":"Prevalence of difficult airway predictors in cases of failed prehospital endotracheal intubation","volume":"47","author":"Gaither","year":"2014","journal-title":"J Emerg Med"},{"key":"2019080801144581800_CIT0014","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jhin.2008.11.015","article-title":"Aerial dispersal of meticillin-resistant Staphylococcus aureus in hospital rooms by infected or colonised patients","volume":"71","author":"Gehanno","year":"2009","journal-title":"J Hosp Infect"},{"key":"2019080801144581800_CIT0015","volume-title":"Nondetects and data analysis: statistics for censored environmental data","author":"Helsel","year":"2005"},{"key":"2019080801144581800_CIT0016","first-page":"375","article-title":"A quantitative assessment of facial protection systems in elective hip arthroplasty","volume":"77","author":"Hirpara","year":"2011","journal-title":"Acta Orthop Belg"},{"key":"2019080801144581800_CIT0017","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/risa.12854","article-title":"Annual burden of occupationally-acquired influenza infections in hospitals and emergency departments in the United States","volume":"38","author":"Jones","year":"2018","journal-title":"Risk Anal"},{"key":"2019080801144581800_CIT0018","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1039\/C4EM00359D","article-title":"Evaluation of bioaerosol exposures during hospital bronchoscopy examinations","volume":"17","author":"Lavoie","year":"2015","journal-title":"Environ Sci Process Impacts"},{"key":"2019080801144581800_CIT0019","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1080\/15459624.2013.877591","article-title":"Efficacy of face shields against cough aerosol droplets from a cough simulator","volume":"11","author":"Lindsley","year":"2014","journal-title":"J Occup Environ Hyg"},{"key":"2019080801144581800_CIT0020","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/15459624.2014.973113","article-title":"Viable influenza A virus in airborne particles from human coughs","volume":"12","author":"Lindsley","year":"2015","journal-title":"J Occup Environ Hyg"},{"key":"2019080801144581800_CIT0021","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3201\/eid1002.030838","article-title":"SARS among critical care nurses, Toronto","volume":"10","author":"Loeb","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"2019080801144581800_CIT0022","first-page":"178","article-title":"Dissemination of respiratory secretions during tracheal tube suctioning in an intensive care unit","volume":"28","author":"Ng","year":"1999","journal-title":"Ann Acad Med Singapore"},{"key":"2019080801144581800_CIT0023","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1111\/j.1539-6924.2009.01253.x","article-title":"Relative contributions of four exposure pathways to influenza infection risk","volume":"29","author":"Nicas","year":"2009","journal-title":"Risk Anal"},{"key":"2019080801144581800_CIT0024","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1093\/cid\/cix535","article-title":"Characterization of aerosols generated during patient care activities","volume":"65","author":"O\u2019Neil","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2019080801144581800_CIT0025","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.ajic.2017.10.003","article-title":"Environmental and body contamination from cleaning vomitus in a health care setting: a simulation study","volume":"46","author":"Phan","year":"2018","journal-title":"Am J Infect Control"},{"key":"2019080801144581800_CIT0026","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.jhin.2018.01.021","article-title":"\u2018VIOLET\u2019: a fluorescence-based simulation exercise for training healthcare workers in the use of personal protective equipment","volume":"99","author":"Poller","year":"2018","journal-title":"J Hosp Infect"},{"key":"2019080801144581800_CIT0027","volume-title":"Useful procedures in medical practice","author":"Roberts","year":"1986"},{"key":"2019080801144581800_CIT0028","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.ajic.2007.10.007","article-title":"2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings","volume":"35","author":"Siegel","year":"2007","journal-title":"Am J Infect Control"},{"key":"2019080801144581800_CIT0029","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1086\/588701","article-title":"Detection of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci on the gowns and gloves of healthcare workers","volume":"29","author":"Snyder","year":"2008","journal-title":"Infect Control Hosp Epidemiol"},{"key":"2019080801144581800_CIT0030","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1177\/1757177417741972","article-title":"Recipes for simulated vomitus","volume":"19","author":"Su","year":"2018","journal-title":"J Infect Prev"},{"key":"2019080801144581800_CIT0031","volume-title":"Practical medical procedures at a glance","author":"Thomas","year":"2015"},{"key":"2019080801144581800_CIT0032","doi-asserted-by":"crossref","first-page":"e56278","DOI":"10.1371\/journal.pone.0056278","article-title":"Influenza aerosols in UK hospitals during the H1N1 (2009) pandemic \u2013 the risk of aerosol generation during medical procedures","volume":"8","author":"Thompson","year":"2013","journal-title":"PLoS One"},{"key":"2019080801144581800_CIT0033","doi-asserted-by":"crossref","first-page":"e35797","DOI":"10.1371\/journal.pone.0035797","article-title":"Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: a systematic review","volume":"7","author":"Tran","year":"2012","journal-title":"PLoS One"}],"container-title":["Annals of Work Exposures and Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/annweh\/advance-article-pdf\/doi\/10.1093\/annweh\/wxz048\/28768514\/wxz048.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/annweh\/article-pdf\/63\/7\/784\/29108321\/wxz048.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T15:37:40Z","timestamp":1569253060000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annweh\/article\/63\/7\/784\/5511547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,5]]},"references-count":33,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,6,5]]},"published-print":{"date-parts":[[2019,8,7]]}},"URL":"https:\/\/doi.org\/10.1093\/annweh\/wxz048","relation":{},"ISSN":["2398-7308","2398-7316"],"issn-type":[{"value":"2398-7308","type":"print"},{"value":"2398-7316","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,6,5]]}}}