{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:19:45Z","timestamp":1791040785032,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,5,8]],"date-time":"2020-05-08T00:00:00Z","timestamp":1588896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Healthcare workers are at risk of infection during the severe acute respiratory syndrome coronavirus\u20102 pandemic. International guidance suggests direct droplet transmission is likely and airborne transmission occurs only with aerosol\u2010generating procedures. Recommendations determining infection control measures to ensure healthcare worker safety follow these presumptions. Three mechanisms have been described for the production of smaller sized respiratory particles (\u2018aerosols\u2019) that, if inhaled, can deposit in the distal airways. These include: laryngeal activity such as talking and coughing; high velocity gas flow; and cyclical opening and closure of terminal airways. Sneezing and coughing are effective aerosol generators, but all forms of expiration produce particles across a range of sizes. The 5\u2010\u03bcm diameter threshold used to differentiate droplet from airborne is an over\u2010simplification of multiple complex, poorly understood biological and physical variables. The evidence defining aerosol\u2010generating procedures comes largely from low\u2010quality case and cohort studies where the exact mode of transmission is unknown as aerosol production was never quantified. We propose that transmission is associated with time in proximity to severe acute respiratory syndrome coronavirus\u20101 patients with respiratory symptoms, rather than the procedures per se. There is no proven relation between any aerosol\u2010generating procedure with airborne viral content with the exception of bronchoscopy and suctioning. The mechanism for severe acute respiratory syndrome coronavirus\u20102 transmission is unknown but the evidence suggestive of airborne spread is growing. We speculate that infected patients who cough, have high work of breathing, increased closing capacity and altered respiratory tract lining fluid will be significant producers of pathogenic aerosols. We suggest several aerosol\u2010generating procedures may in fact result in less pathogen aerosolisation than a dyspnoeic and coughing patient. Healthcare workers should appraise the current evidence regarding transmission and apply this to the local infection prevalence. Measures to mitigate airborne transmission should be employed at times of risk. However, the mechanisms and risk factors for transmission are largely unconfirmed. Whilst awaiting robust evidence, a precautionary approach should be considered to assure healthcare worker safety.<\/jats:p>","DOI":"10.1111\/anae.15093","type":"journal-article","created":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T18:31:31Z","timestamp":1587407491000},"page":"1086-1095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":271,"title":["Airborne transmission of severe acute respiratory syndrome coronavirus\u20102 to healthcare workers: a narrative review"],"prefix":"10.1111","volume":"75","author":[{"given":"N. M.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine Prince of Wales Hospital Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Norton","sequence":"additional","affiliation":[{"name":"Emergency Department Oamaru Hospital New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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