General hygienic aspects

• It should be emphasized that to date there is no publication documenting cross-contamination of a patient via a spirometer. HIV can also not be transferred by saliva. Spirometry is therefore reasonably safe. Even so anyone in charge of spirometric tests should make every effort to prevent cross-contamination.
• Some electronic spirometers are used solely for forced expiratory maneuvers, the patient never breathing in through the equipment. This minimizes any risks of bacterial infections. However, even then it is mandatory that equipment is regularly cleaned and disinfected.
• Bacteria thrive in a moist environment. Therefore when putting a transducer away see to it that water can run off, and that the transducer dries up quickly.
• Each patient should have a fresh mouthpiece. Disposable mouthpieces are the most convenient and safest. If you do not use disposables, clean the mouthpieces after use, disinfect them in alcohol 95%, rinse them with water, and leave them to dry in a dry and clean place.
• Some patients are known to harbor virulent bacteria in their airways: Pseudomonas aeruginosa, or Pseudomonas sepacia. The equipment should be disinfected each time after use by such patients. The same holds for patients with tuberculosis in whom bacteria are demonstrable in their sputum.
• Immune-compromised patients, such as HIV-positives and patients treated with cytostatic drugs, should perform spirometry on instruments which have been disinfected immediately before the assessments. Patients with cystic fibrosis are similarly entitled to using a spirometer disinfected shortly before they are tested.