Inhalation Equipment Hygiene: a Belgian National survey

Nebulizers are a potential source of contamination of the respiratory tract. Nevertheless, only a few clear guidelines regarding cleaning and disinfection of nebulizers are available. This survey aims to analyze the common household methods used by CF patients in Belgium. A questionnaire about type of nebulizer, methods and frequency of cleaning, disinfection, and drying was established by physiotherapists at the Belgian CF centers. The Belgian CF Association sent theiR questionnaire to all Belgian CF patients . Of the 903 questionnaires distributed, 379 were returned. 52,40 and 8 % of patients used a vibrating-mesh nebulizer, jet nebulizer or ultrasonic device, respectively. Ninety-eight percent of patients cleaned their material, and soap was used by 35% of patients.Disinfection was performed by 91 % of the patients and was daily performed by 57% of the patients.Thermal disinfection ( boiling water or sterilizer), a hypochlorite-based solution of acetic acid solution was used by 44, 29, and 25 % of patients respectively to disinfect their nebulizers. Thermal disinfection was used by 37 and 53% of patients using a classical or vibrating-mesh nebulizer. After cleaning or disinfection, 91 % of the material was dried. The high percentage of Belgian CF patients disinfecting their nebulizer proves that they seem aware of the hygiene problem. The lack of unanimous guidelines in Belgium at the time of the study perhaps explains the variety of methods used. The arrival of vibrating-mesh nebulizers has led to a change in disinfection methods.