Project Summary
Aerosol-generating procedures (AGPs) are medical procedures that produce aerosols that can be laden with
pathogens if the patient has a viral infection, such as SARS-CoV-2 or in¿uenza. These aerosols pose a signi¿cant
risk to health care workers, as they can linger in the air for extended periods of time and are small enough to
bypass ordinary surgical masks. There is currently no established, unambiguous way to evaluate the risks to
healthcare workers associated with a speci¿c AGP, nor is there a rigorous method by which to assess a proposed
risk-mitigation strategy. To address this gap, a ¿ow visualization technique must be developed that can be applied
in a clinical setting during actual medical procedures and is capable of detecting aerosol-laden ¿ows produced
by AGPs or potential AGPs.
In this R21 proposal, we will adapt background-oriented schlieren (BOS) visualization, a method from ¿uid
mechanics, into a technique that can be applied to study ¿ows produced by AGPs. The R21 project is high
risk with no published preliminary data, but the PIs have successfully demonstrated visualziation of aerosols
produced by jet ventilation, a speci¿c type of AGP, using BOS in a proof-of-concept experiment. The proposed
work is signi¿cant and timely, as assessment of the risk associated with AGPs is extremely important in the
context of the COVID-19 pandemic. We will use the novel BOS technique to assess risks and evaluate mitigation
strategies for three speci¿c AGPs in both ex vivo and in vivo conditions.
Speci¿c Aim 1: Develop a human-scale BOS system and establish a procedure for evaluating the risk
of AGPs in a clinical setting.
Speci¿c Aim 2: Quantify the risk of aerosol exposure under different simulated and in-vivo conditions,
and identify strategies to mitigate the risks.
The signi¿cance and impact of the proposed research will be in developing a tool for unambiguously evaluat-
ing the risks associated with AGPs in realistic clinical settings, and urgently-needed risk assessments for three
speci¿c AGPs and experimentally veri¿ed risk mitigation strategies for each.