Engineering and Administrative Controls to Contain Aerosolized Ribavirin: Results of Simulation and Application to One Patient

Background Concern persists over the possible effects of ribavirin exposure on health-care workers. Because personal protective equipment is considered the least appropriate control measure, we devised and evaluated a double-tent system to reduce caregiver exposure. Materials & Methods We combined commercially available components (including tent canopy, oxygen hood, tubing, and vacuum units) to provide continuous exhaust and containment of ribavirin aerosol being administered to infants and children up to a weight of about 20 kg while maintaining a stable oxygen concentration. Administrative controls were invoked. Personal-breathing-zone sampling and area sampling were performed during a 5-hour simulation and during an 18-hour treatment period. Results No detectable levels of ribavirin were noted. CONCLUSION: These preliminary results suggest that health-care workers can be adequately protected by such controls. However, we emphasize that until further studies are performed using these controls, personal protective equipment should be mandatory for bedside health-care workers .