Scotland Revises Respiratory Infection Guidelines After AERATOR Aerosol Measurements

{"The AERATOR team measured exhaled aerosols in ultraclean operating theatres using the PLUME device during routine clinical care. They recorded particle counts for intubation, bronchoscopy, non-invasive ventilation and other procedures previously labelled high-risk. Most produced lower emissions than voluntary coughing or loud talking by the same patients, directly contradicting the binary AGP classification used since 2007.","Scottish guidance now assesses transmission risk by pathogen, patient symptoms, procedure duration and staff exposure rather than procedure name alone. This change aligns PPE requirements with measured aerosol output and individual vulnerability. England retains a shortened AGP list while Wales has adopted the Scottish model; the divergence highlights how observational aerosol data can drive policy faster than consensus statements from WHO or CDC.","The study design captured real-time emissions in clinical environments but did not track downstream infections, leaving open whether reduced aerosol output correlates with lower staff acquisition rates. Next required evidence includes prospective cohort studies linking the new risk matrix to documented transmission events and staff seroconversion across multiple NHS boards.","Health boards will audit PPE usage and respiratory infection incidence quarterly; results are expected within 18 months and will determine whether the risk-based approach is retained or modified."}