ArticleThorax2022
Aerosol emission from the respiratory tract: an analysis of aerosol generation from oxygen delivery systems.
Article in Thorax, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Generation of Aerosols by Noninvasive Respiratory Support Modalities: A Systematic Review and Meta-Analysis.JAMA network open · 2023Pooled it
- Are medical procedures that induce coughing or involve respiratory suctioning associated with increased generation of aerosols and risk of SARS-CoV-2 infection? A rapid systematic review.The Journal of hospital infection · 2021Pooled it
- Respiratory Particle Emissions in Tracheostomized Outpatients: Comparable to Healthy Volunteers.Laryngoscope investigative otolaryngology · 2026Article
- Determinants of respiratory tract aerosol generation in a diverse clinical population: an observational study.BMJ open respiratory research · 2025Observational
- Aerosol emission and exposure in non-invasive ventilation.Scientific reports · 2025Article
- Creating respiratory pathogen-free environments in healthcare and nursing-care settings: a comprehensive review.GeroScience · 2025Review
- The multi-dimensional challenges of controlling respiratory virus transmission in indoor spaces: Insights from the linkage of a microscopic pedestrian simulation and SARS-CoV-2 transmission model.PLoS computational biology · 2024Article
- A quantitative evaluation of aerosol generation during cardiopulmonary resuscitation.Anaesthesia · 2024Article
- The respiratory oxygenation index for identifying the risk of orotracheal intubation in COVID-19 patients receiving high-flow nasal cannula oxygen.Critical care science · 2024Observational
- Multimodal prevention of emergence cough following nasal endoscopic surgery under general anesthesia: a double-blind randomized trial.Frontiers in medicine · 2024Article
- Aerosol generation during coughing: an observational study.The Journal of laryngology and otology · 2023Observational
- Size distribution and relationship of airborne SARS-CoV-2 RNA to indoor aerosol in hospital ward environments.Scientific reports · 2023Article
- Lessons from COVID-19 in the management of acute respiratory failure.Breathe (Sheffield, England) · 2023Review
- Highlights from the Respiratory Failure and Mechanical Ventilation 2022 Conference.ERJ open research · 2023Article
- Risk of Bacterial Exposure to the Anesthesiologist's Face During Intubation and Extubation.Infection and drug resistance · 2023Article
- Re-evaluating our language when reducing risk of SARS-CoV-2 transmission to healthcare workers: Time to rethink the term, "aerosol-generating procedures".Virology journal · 2022Review
- Anaesthetists' current practice and perceptions of aerosol-generating procedures: a mixed-methods study.Anaesthesia · 2022Article
- Lessons for sleep medicine learned from the COVID-19 pandemic.Breathe (Sheffield, England) · 2022Review
- Airborne Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospitals: Effects of Aerosol-Generating Procedures, HEPA-Filtration Units, Patient Viral Load, and Physical Distance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic?Indoor air · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 2 institutions in 1 country.
Funding
Abstract
introductioncontinuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) provide enhanced oxygen delivery and respiratory support for patients with severe COVID-19. CPAP and HFNO are currently designated as aerosol-generating procedures despite limited high-quality experimental data. We aimed to characterise aerosol emission from HFNO and CPAP and compare with breathing, speaking and coughing. MATERIALS AND
methodsHealthy volunteers were recruited to breathe, speak and cough in ultra-clean, laminar flow theatres followed by using CPAP and HFNO. Aerosol emission was measured using two discrete methodologies, simultaneously. Hospitalised patients with COVID-19 had cough recorded using the same methodology on the infectious diseases ward.
resultsIn healthy volunteers (n=25 subjects; 531 measures), CPAP (with exhalation port filter) produced less aerosol than breathing, speaking and coughing (even with large >50 L/min face mask leaks). Coughing was associated with the highest aerosol emissions of any recorded activity. HFNO was associated with aerosol emission, however, this was from the machine. Generated particles were small (<1 µm), passing from the machine through the patient and to the detector without coalescence with respiratory aerosol, thereby unlikely to carry viral particles. More aerosol was generated in cough from patients with COVID-19 (n=8) than volunteers.
conclusionsIn healthy volunteers, standard non-humidified CPAP is associated with less aerosol emission than breathing, speaking or coughing. Aerosol emission from the respiratory tract does not appear to be increased by HFNO. Although direct comparisons are complex, cough appears to be the main aerosol-generating risk out of all measured activities.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.