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Endoscopists who do not Wear Face Shields at Risk for Infection
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Physicians and assisting staff who do not wear protective masks during endoscopy are at risk for exposures that could result in the transmission of infectious diseases, according to research published in Gastrointestinal Endoscopy.
Asif Khalid, MD, of the VA Pittsburgh Healthcare System and the University of Pittsburgh Medical Center, and colleagues wrote that the use of face masks by endoscopists varies due to a lack of evidence-based guidelines.
“While endoscopy staff discard used gloves and gowns, and wash hands after performing endoscopy, we doubt colleagues that do not use face shields wash their faces in between cases,” Khalid told Healio Gastroenterology and Liver Disease. “Inadvertently touching our face and then patients may serve to spread pathogenic bacteria between patients.”
To explore the frequency of exposures, Khalid and colleagues conducted a prospective, six-month study of four gastroenterologists. Over the course of 1,100 procedures that took place during 239 endoscopy sessions, the endoscopists swabbed their face shields before and after the sessions. Researchers also placed control shields on the endoscopy suite wall and in the remote patient intake bay wall. Investigators also deliberately contaminated separate shields with a colonoscope immediately after a procedure.
After 48 hours of culture, researchers recorded growth by colony-forming units (CFU) and compared groups for +CFU rate and CFU number.
Khalid and colleagues found that the +CFU rate in the pre-endoscopy groups (2%–4%) was lower than the post-endoscopy face shield (45.8%; P < .001) and suite wall groups (21.4%; P < .001). The occurrence rate was 5.6 per 100 half days of endoscopy to the endoscopist’s face and 3.4 per 100 of endoscopy six feet away.
“GI endoscopists and assisting staff are at risk of being exposed to pathogens while performing endoscopic procedures, but the magnitude of this risk has remained unclear,” Khalid said. “Our results compel us to urge our colleagues to use facial protection during endoscopy and provide a basis for GI units to develop guidelines for personal protective equipment use.”
Khalid said future studies are needed to further assess this risk. – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
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