Without face protection, endoscopists face unnecessary infection risk — 2 study findings

A study published in Gastrointestinal Endoscopy examined how often endoscopists were exposed to blood and bodily fluids if their face was unprotected during a procedure.

Researchers conducted a prospective six-month study of four gastroenterologists. The four gastroenterologists all used a face shield during endoscopy. The shields were swabbed before and at the end of every sessions. Researchers also swabbed the endoscopy suite wall, the remote patient intake bay and after deliberate contamination with a colonoscopy after colonoscopy. Researchers then cultured the swabs for 48 hours and recorded colony-forming units.

The gastroenterologists performed 1,100 procedures in 239 endoscopy sessions.

What they found:

1. The colony-forming unit rate in preendoscopy groups was significantly lower than the postendoscopist face shield group (45.8 percent) and endoscopy wall groups (21.4 percent).

2. Researchers used a cut-off of greater than 15CFUs to indicate definite exposure. They noted occurrence rates of 5.6 per 100 half days of endoscopy to the endoscopist's face and 3.4 per 100 half days of endoscopy from six feet away.

Researchers concluded, "This exposure may result in transmission of infectious diseases. As such, we recommend the use of universal facial protection during GI endoscopy."

Commenting on the study, Norfolk-based Eastern Virginia Medical School Chief of Gastroenterology David Johnson, MD, said he'd immediately begin recommending his staff wear face shields.

He told Medscape, "These results tell us that a lot of the physicians and staff have contact with the patient secretions that we don't recognize. … This information to me is incredibly provocative, and although it needs to be confirmed, it is nonetheless a game-changer for me. I'm changing my recommendations for my staff, ensuring that we have adequate protection with the facial plastic shields, and raising awareness of this in a very proactive way."

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