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Medical devices
Disinfectant tunnels: a solution to the problem or a problem on its own?
  1. Siew Hui Michelle Koh1,
  2. Si Ling Young1,
  3. Hui Zhong Chai1,
  4. Adrian Kwok Wai Chan2,
  5. Aik Hong Philine Chan1,
  6. Jun Chun Chia1,
  7. Frederick Teo3,
  8. Soh Hui Qing3,
  9. Thun How Ong1,
  10. Ghee Chee Phua1
  1. 1 Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore
  2. 2 Respiratory and Critical Care Medicine, Mount Elizabeth Novena Hospital, Singapore
  3. 3 Temasek International, Singapore
  1. Correspondence to Dr Siew Hui Michelle Koh, Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore 168753, Singapore; michelle.koh.s.h{at}singhealth.com.sg

https://doi.org/10.1136/bmjinnov-2021-000931

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    What are the new findings

    • This is the first pilot study to look at the bronchoconstrictive effects of aerosolised BAC.

    • Findings from this pilot study suggest that BAC disinfectant tunnels/booths cause bronchoconstriction even when used with a surgical face mask. With N95 respirators, no conclusive objective evidence of bronchoconstriction was made, but subjective symptoms were reported.

    • Hence, conclusion regarding safety cannot be made.

    How might it impact on healthcare in the future

    • This study suggests that despite use of surgical masks, short-term BAC exposure, even at reduced concentrations, can cause bronchoconstrictive effects and hence is not safe to be used in a disinfectant booth or tunnel.

    • While the idea of an automatic disinfection system that performs contactless disinfection of exterior surfaces to arrest further infection is ideal, more research is needed to determine the optimal and safest methods in doing so.

    Introduction

    The Coronavirus disease 2019 (COVID-19) pandemic has impacted the health and socioeconomic status of millions of people worldwide. COVID-19–related health policies1 2 introduced around the world contain methods to curb the transmission of the virus, and these include border control measures, contact tracing and lockdown. As the world enters the third year of living in the COVID-19 pandemic, countries have attempted lifting movement restrictions only to face yet another wave of the virus transmission, resulting in the continuous cycle of transmission, lockdown and re-opening.3 To break this cycle or delay the next wave, Cacciapaglia et al 4 suggested that the key was to limit the number of persons infected during the inter-wave strolling period. However, aside from the commonly used approach of movement restrictions that has negative impacts on the economy and mental health,5 6 another approach that could be considered would be physical devices that can prevent spread of viruses.

    Novel ideas on automated disinfectant devices have emerged as a means to reduce risks of viral transmission. One such …

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    Footnotes

    • Contributors SHMK: literature review, data acquisition, statistical analysis, drafting of manuscript and final validation of manuscript. SLY: literature review, data acquisition, statistical analysis, drafting of manuscript and final validation of manuscript. HZC: data acquisition and final validation of manuscript. AKWC: data acquisition, drafting of manuscript and final validation of manuscript. AHPC: final drafting of manuscript. JCC: data acquisition and final validation of manuscript. FT: data acquisition and final validation of manuscript. SHQ: data acquisition and final validation of manuscript. THO: data acquisition, drafting of manuscript and final validation of manuscript. GCP: data acquisition and final validation of manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.