What are the effects of portable air cleaners with a high-efficiency particulate air filter on aerosol removal in dental surgeries?

Design Volumetric air flow was measured in a number of dental surgeries to calculate the air change rate per hour (ACHvent). In each surgery, measurements of aerosol removal by ventilation alone, and then with ventilation provided by a high-efficiency particulate air filter (PAC), were completed. The concentrations of aerosol particles of various sizes were recorded at baseline, after an initial period of incense burn, and then after 30 minutes of observation with and without the use of the PAC or ventilation system.Sample selection Ten dental surgeries with differing baseline ventilation rates had the concentrations of 0.3, 0.5 and 1.0 μm aerosol particles measured at 0 minutes, after 5 minutes of incense burn and then after 30 minutes of observation, firstly without the PAC system in operation and then with the PAC system in use.Data analysis For the 0.3 μm particles, velocities of aerosol removal were assessed by analysing the concentration decay constants with ventilation alone and ventilation with the PAC. Aerosol removal velocities were assessed by the time needed to reach 95% and 100% removal of accumulated aerosol particles.Results ACHvent in the ten different surgeries varied from 3-45. The concentration decay constants for the 0.3 μm particles with ventilation alone and ventilation with the PAC were correlated to the mechanical ventilation rate and combined respectively. For rooms with ACHvent of less than 15, accumulated aerosol particles could not be removed by ventilation alone in 30 minutes. The PAC accelerated aerosol removal and reduced aerosol accumulation, and with the use of the PAC in addition to ventilation, accumulated aerosols were removed completely in 4-12 minutes. The PAC was shown to be more beneficial in rooms with poor ventilation and the added effectiveness of the PAC in aerosol removal was inversely correlated with the ACHvent by ventilation.Conclusions Although the air change rate differed considerably among dental surgeries, this study suggests that the addition of the PAC with a HEPA filter significantly increased aerosol removal and lessened aerosol accumulation, particularly in rooms with low ventilation rates.