Plastic bottles adapted to fit asthma spacers

A young patient at Red Cross War Memorial Hospital demonstrates how the spacer works.

Red Cross War Memorial Children’s Hospital has found a way to mass produce plastic bottles for a cheap alternative to asthma pump spacers.

The development could prove crucial for asthmatics, who are at higher risk from Covid-19, and to stop the spread of respiratory droplets that spread the virus.

Asthma treatment is usually given by an inhaler, but to get medication more effectively to the lungs in a crisis, the use of a spacer along with the inhaler, or a nebuliser is required.

The hospital has worked with Polyoak Packaging and Habitat Industries to come up with a bottle that has a custom blow-mould base with an indentation in the shape of an asthma-pump nozzle.

Red Cross Children’s Hospital’s Professor Heather Zar first pioneered bottle spacers back in the late 90s, and they have been used in the children’s hospital since then. But holes had to be burnt in the bottles, and it was a laborious process.

Professor Michael Levin, the hospital’s head of allergy who headed up the project to produce the new bottle spacers, said they had been producing a few hundred a year when they had needed to produce tens of thousands to meet the need in the country’s public health service.

The new production process changes all that.

“During production when the bottle is blown and the plastic is
still soft, air is blasted into the
bottle base which creates the inhaler size extrusion,” said Professor Levin.

The only manual bit of
the process, he said, was slicing off the indentation, leaving a perfect-fit attachment hole for the inhaler.

“Polyoak has even been able to include the Allergy Foundation website address on the base of the bottle,” he said.

Mass production of these bottle spacers began at the beginning of April, and 13 000 units were donated and delivered to the Western Cape Health Central Medical Depot (CMD).

The bottle-spacer programme was about bridging the gap be-
tweenexpensivecommercial spacers and the need in poor communities, said the children’s hospital spokesperson, Dwayne
Evans.

“The team has tested and evaluated the efficacy of using plastic bottle spacers, which are immediately available, instead of expensive spacers.”

Mr Evans said the plastic bottle spacer not only allowed the medication to work much more effectively, but it had the added benefit of minimising droplets in the air and ultimately reduced the risk of Covid-19 infection for staff and patients.

Heideveld day hospital senior family physician Dr Elma de Vries said her nursing staff were impressed with how well the pump and spacer technique worked for patients presenting with a tight chest.

“We hope that if we are able to give patients these bottle spacers to take home, then there will be fewer emergency care visits just for a nebulisation in future.”

Children’s hospital medical manager Dr Anita Parbhoo said the initiative could take a low-cost clinically-effective solution to patients across the province, and potentially the country.

Polyoak Packaging group technical sales manager Roger Kerr said it had been good working with the children’s hospital.

“It is not our core business, though in a short space of time, we managed to come up with a solution to help make the lives easier for people who have asthma,” he said.

Mr Kerr said they were preparing to send thousands of
bottle spacers to Johannesburg as well.