Real-World Evidence on the Effectiveness of Plexiglass Barriers in Reducing Aerosol Exposure

Main Article Content

Jennifer L. Cadnum
Annette L. Jencson
Samir Memic
Andrew O. Osborne
Maria M. Torres-Teran
Brigid M. Wilson
Abhishek Deshpande
Curtis J. Donskey

Abstract

 4255

Reprinted with permission, Cleveland Clinic Foundation ©2022. All Rights Reserved


Background: Barriers are commonly installed in workplace situations where physical distancing cannot be maintained to reduce the risk for transmission of respiratory viruses. Although some types of barriers have been shown to reduce exposure to aerosols in laboratory-based testing, limited information is available on the efficacy of barriers in real-world settings. 


Methods: In an acute care hospital, we tested the effectiveness of in-use plexiglass barriers in reducing exposure of staff to aerosolized particles. A nebulizer was used to release 5% NaCl aerosol 1 meter from staff members with and without the barrier positioned between the point of aerosol release and the hospital staff. Particle counts on the staff side of the barrier were measured using a 6-channel particle counter. A condensed moisture (fog) generating device was used to visualize the airflow patterns. 


Results: Of 13 in-use barriers tested, 6 (46%) significantly reduced aerosol particle counts detected behind the barrier, 6 (46%) reduced particle counts to a modest, non-significant degree, and 1 (8%) significantly increased particle counts behind the barrier. Condensed moisture fog accumulated in the area where staff were seated behind the barrier that increased particle exposure, but not behind the other barriers. After repositioning the ineffective barrier, the condensed moisture fog no longer accumulated behind the barrier and aerosol exposure was reduced. 


Conclusion: In real-world settings, plexiglass barriers vary widely in effectiveness in reducing staff exposure to aerosols, and some barriers may increase risk for exposure if not positioned correctly. Devices that visualize airflow patterns may be useful as simple tools to assess barriers. 

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Cadnum J, Jencson A, Memic S, Osborne A, Torres-Teran M, Wilson B, Deshpande A, Donskey C. Real-World Evidence on the Effectiveness of Plexiglass Barriers in Reducing Aerosol Exposure. PAI [Internet]. 2022 Nov. 4 [cited 2022 Nov. 30];7(2):66-77. Available from: https://www.paijournal.com/index.php/paijournal/article/view/533
Section
Articles

References

1. Centers for Disease Control and Prevention. Ventilation in Buildings. Accessed July 2, 2022. Available from: https://www.cdc.gov/coronavirus/2019-ncov/community/ventilation.html.

2. Zabarsky TF, Bhullar D, Silva SY, Mana TSC, Ertle MT, Navas ME, Donskey CJ. What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection? Am J Infect Control. 2021;49(3):392-5. doi: 10.1016/j.ajic.2020.08.004. PubMed PMID: 32795495; PMCID: PMC7419261.

3. Jinadatha C, Jones LD, Choi H, Chatterjee P, Hwang M, Redmond SN, Navas ME, Zabarsky TF, Bhullar D, Cadnum JL, Donskey CJ. Transmission of SARS-CoV-2 in Inpatient and Outpatient Settings in a Veterans Affairs Health Care System. Open Forum Infect Dis. 2021;8(8):ofab328. doi: 10.1093/ofid/ofab328. PubMed PMID: 34426792; PMCID: PMC8344547.

4. Jones LD, Chan ER, Cadnum JL, Redmond SN, Navas ME, Zabarsky TF, Eckstein EC, Kovach JD, Linger M, Zimmerman PA, Donskey CJ. Investigation of a cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in a hospital administration building. Infect Control Hosp Epidemiol. 2022:1-7. doi: 10.1017/ice.2022.45. PubMed PMID: 35189996.

5. Chan ER, Jones LD, Redmond SN, Navas ME, Kachaluba NM, Zabarsky TF, Bhullar D, Cadnum JL, Zimmerman PA, Donskey CJ. Use of whole-genome sequencing to investigate a cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in emergency department personnel. Infect Control Hosp Epidemiol. 2022;43(10):1485-7. doi: 10.1017/ice.2021.208. PubMed PMID: 33941299; PMCID: PMC8144813.

6. Occupational Safety and Health Administration. Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace Accessed July 2, 2022. Available from: https://www.osha.gov/coronavirus/safewor.

7. Herstein JJ, Degarege A, Stover D, Austin C, Schwedhelm MM, Lawler JV, Lowe JJ, Ramos AK, Donahue M. Characteristics of SARS-CoV-2 Transmission among Meat Processing Workers in Nebraska, USA, and Effectiveness of Risk Mitigation Measures. Emerg Infect Dis. 2021;27(4):1032-8. doi: 10.3201/eid2704.204800. PubMed PMID: 33591249; PMCID: PMC8007314.

8. Porter KA, Ramaswamy M, Koloski T, Castrodale L, McLaughlin J. COVID-19 among workers in the seafood processing industry: Implications for prevention measures - Alaska, March-October 2020. MMWR Morb Mortal Wkly Rep. 2021;70:622-626. doi: 10.15585/mmwr.mm7017a4. PMCID: PMC8084125.

9. Cadnum JL, Jencson AL, Donskey CJ. Do plexiglass barriers reduce the risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)? Infect Control Hosp Epidemiol. 2021:1-4. doi: 10.1017/ice.2021.383. PubMed PMID: 34726150.

10. Bartels J, Estill CF, Chen IC, Neu D. Laboratory study of physical barrier efficiency for worker protection against SARS-CoV-2 while standing or sitting. Aerosol Sci Technol. 2022;56(3):295-303. doi: 10.1080/02786826.2021.2020210. PubMed PMID: 35677842; PMCID: PMC9170184.

11. Jones LD, Chan ER, Zabarsky TF, Cadnum JL, Navas ME, Redmond SN, Kovach JD, Linger M, Rutala WA, Zimmerman PA, Donskey CJ. Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Patient Transport Van. Clin Infect Dis. 2022;74(2):339-42. doi: 10.1093/cid/ciab347. PubMed PMID: 33893474; PMCID: PMC8135457.

12. Cadnum JL, Jencson AL, Alhmidi H, Zabarsky TF, Donskey CJ. Airflow patterns in double occupancy patient rooms may contribute to roommate-to-roommate transmission of severe acute respiratory syndrome coronavirus 2. Clin Infect Dis. 2022 Apr 27;ciac334. doi: 10.1093/cid/ciac334. PubMed PMID: 35476020; PMCID: PMC9129113.

13. Kwon KS, Park JI, Park YJ, Jung DM, Ryu KW, Lee JH. Evidence of Long-Distance Droplet Transmission of SARS-CoV-2 by Direct Air Flow in a Restaurant in Korea. J Korean Med Sci. 2020;35(46):e415. doi: 10.3346/jkms.2020.35.e415. PubMed PMID: 33258335; PMCID: PMC7707926.

14. Lu J, Gu J, Li K, Xu C, Su W, Lai Z, Zhou D, Yu C, Xu B, Yang Z. COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020;26(7):1628-1631. doi: 10.3201/eid2607.200764. PubMed PMID: 32240078; PMCID: PMC7323555.

15. Cadnum JL, Donskey CJ. If you can't measure it, you can't improve it: Practical tools to assess ventilation and airflow patterns to reduce the risk for transmission of severe acute respiratory syndrome coronavirus 2 and other airborne pathogens. Infect Control Hosp Epidemiol. 2022;43(7):915-917. doi: 10.1017/ice.2022.103. PubMed PMID: 35379373; PMCID: PMC9021581.

16. Cadnum JL, Bolomey A, Jencson AL, Wilson BM, Donskey CJ. Effectiveness of commercial portable air cleaners and a do-it-yourself minimum efficiency reporting value (MERV)-13 filter box fan air cleaner in reducing aerosolized bacteriophage MS2. Infection Control & Hospital Epidemiology. 2022:1-3. doi: 10.1017/ice.2022.5.

17. Dhand R, Li J. Coughs and Sneezes: Their Role in Transmission of Respiratory Viral Infections, Including SARS-CoV-2. Am J Respir Crit Care Med. 2020;202(5):651-659. doi: 10.1164/rccm.202004-1263PP. PubMed PMID: 32543913; PMCID: PMC7462404.

18. Wang CC, Prather KA, Sznitman J, Jimenez JL, Lakdawala SS, Tufekci Z, Marr LC. Airborne transmission of respiratory viruses. Science. 2021;373(6558). doi: 10.1126/science.abd9149. PubMed PMID: 34446582; PMCID: PMC8721651.

19. El Hassan M, Assoum H, Bukharin N, Al Otaibi H, Mofijur M, Sakout A. A review on the transmission of COVID-19 based on cough/sneeze/breath flows. Eur Phys J Plus. 2022;137(1):1. doi: 10.1140/epjp/s13360-021-02162-9. PubMed PMID: 34909366; PMCID: PMC8660964.

Most read articles by the same author(s)