PONE-D-21-11593

Biosafety devices to control the spread of potentially contaminated dispersion particles. New associated strategies for health environments.

PLOS ONE

Dear Dr. Montalli,

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Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The study has been rigously performed and reported. The paper needs to be proof read. Grammatical errors have been noticed, 98-102; 279-81. Statistical equations could be elaborated. Limitations of the study need to be addressed.

Reviewer #2: It is an important concern about the aerosol spread in dental therapy and operation especially in the background of the COVID-19 pandemic. I commend the authors’ effort on experimental investigation on airborne bioaerosol control during a simulation drill operation. But there are still important issues which I strongly recommend the authors think about and make improvement.

Major issue 1: Organization of the paper

Comment 1. The organization and the citation of the figures in this manuscript is really confusing to the readers. Just for two examples:

a) The citation of Figure 1 in Line 146 and Line 199 indicate the figure should be the illustration of the test environment and sampling location. But the Figure 1 is actually the CFU measurement results.

b) Both Figure 4 and Figure 4(supplementary) cannot support the citation in Line 295 to Line 299 of the manuscript.

Comment 2. Some experiments mentioned in material and methods. But the corresponding results and discussion are missing. For an example, I did not find the results and discussion about PCDP suspension in the dental clinical room and presence measurement outside the clinical room.

Major issue 2: Validation of the experiment. And Connection between the object and supporting data

Comment 3. The topic of this manuscript is about the control the spread of bioaerosols in health environment. But the experiments were just actually designed to validate the bioaerosol concentration control. The emission sources were placed on all available dental chairs rather than part of the chairs or maybe just one chair. The results of the measurement outside the clinic room are missing. It is impossible for readers to evaluate the control effect of bio-particles spread of the measures mentioned in the paper. On the other hand, the authors should also make introductions on if such strategies or measures could be applied in other health care environment as specified in the tittle.

Comment 4. In the negative control group (Line 279 to 284), the petri dishes indicated wide contamination. The largest observation is 11.3 (6.1) for IBBD group. It is not normal according to my previous research experience and indicate the dishes are not well protected or the preparation did not fulfil the requirements of aseptic operation.

Major issue 3: Limitation of the biosafety risk of UV technology

Comment 5. UV technology is one of most traditional, easily available and widely used disinfection technology. But there are also concerns about the biosafety risk especially for short term radiation, such as 15min in this manuscript. Major concerns include:

a) Variation might happen to the pathogens after UV radiation.

b) The biggest concern is about the pathogen variation on the resistance for antibiotic.

According to a 12 months airborne bacterial monitoring in a hospital in 2004 in Guangxi, China (Yanhua Chen, Hui Li, Yiping Lu and Lingsha Huang, Distribution of bacteriological spectrum in the air of hospital and analysis of their drug resistance, Chinese Journal of Antibiotics, 2006, 31(008):505-506 (in Chinese)):

a) 450 bacterium strains were collected during 833 samplings in 90 locations

b) 72.0% show resistance to penicillin

c) 76.9% show resistance to ampicillin

d) Above 40% show resistance to new antibiotics such as cephalosporins and quinolones

e) The drug-resistance rate in the hospital is much higher than the other monitoring results in communities, which is believed highly relatedly with the wide use the UV disinfection instruments in hospitals in underdeveloped area

Another research published in 2010 (Yan Wang, Yao Zhou and Yinghua Zhang et al., Impact of Ultraviolet Irradiation on Bacterial Drug Resistance, Chinese Journal of Nosocomiology, 2010, 020(021):3355-3356,3363. (in Chinese)) indicate obvious change drug resistance of Serratia marcescens on amoxicillin, aztreonam and cefuroxime after short term UV irradiation and generation multiplication.

I would recommend that the authors make necessary analysis about the minimum dose of the UV radiation, and consider the possibility of extending the radiation time. Or list the related risk and concerns.

Major issue 4: English expression of the paper

Comment 6. I am not a native English speaker. But there are obvious errors in some sentences and expressions such as “The radiometer was operated with specified precision at room temperature of 22°C to 53% relative humidity” in Line 215 to 216. These would cause confusion and misunderstanding of readers. So, I recommend the authors re-check the expression and fix all errors.

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Reviewer #1: Yes: Bhanu Lakhani

Reviewer #2: No

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Biosafety devices to control the spread of potentially contaminated dispersion particles. New associated strategies for health environments.

PONE-D-21-11593R1

Dear Dr. Montalli,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Amitava Mukherjee, ME, Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No