Looking for tips to resume CO breath testing?

Public Health England (PHE) have announced that Stop Smoking Services (SSS) can resume breath CO testing in the UK. It might be helpful to know that Bedfont® and Intermedical have been working alongside global governing health bodies including PHE to help safely re-establish breath testing in clinical practice. As a result we have made many helpful resources available to safeguard both patients and healthcare professionals when performing breath tests during COVID-19.

Following meticulous analysis regarding the risk of COVID-19 transmission when performing breath tests, PHE have concluded that the risk of COVID-19 virus transmission via use of CO monitors is minimal (3).  A number of factors have been considered to reach this conclusion, including the following:

  • CO monitoring is not classed as an Aerosol Generating Procedure (AGP) (3). This means the testing procedure is unlikely to result in the release of airborne particles (aerosols) from the respiratory tract (1) which can potentially contain infectious viruses such as COVID-19.
  • Use of infection control filters with CO monitors which has been tested by an accredited test house to prove they safely and effectively remove a high proportion of bacteria and viruses. The typical size of coronavirus particles range from 120- 160 nanometres in diameter (2), in comparison, CO monitor filters are tested with a significantly smaller virus model and have been proved to remove virus particles as small as 24 nanometres.

We recommend following the below steps to minimise risk to your patients whilst CO breath testing takes place in your clinics:

1.)   It is strongly recommended hygiene practices such as good hand washing technique is maintained.

2.)   A symptom screening questionnaire should be filled out by the patient before they undergo any breath testing procedure.

3.)   When carrying out the CO breath test, ensure a 2m distance (where possible) is maintained between you and the patient, using verbal instructions on how to use the monitor.

4.)   Do not stand directly in front of the patient and the device whilst a breath test is being performed.

5.)   Ensure the room where CO testing is taking place is well ventilated.

6.)   It is recommended the monitors and filters are thoroughly wiped down between each patient (before and after breath testing) with alcohol-free anti-bacterial and anti-viral wipes. (Products containing alcohol can affect the CO sensors so please check the manufacturer’s website on guidance for alternative cleaning methods).

7.)   Use additional Personal Protective Equipment (PPE) when seeing a patient for CO monitoring. Requirements for minimum amount of PPE that must be worn varies across the UK, therefore we strongly recommend you consult your local guidelines.

8.)   Once the patient has completed their breath test, ask them to dispose of any single use consumables (mouthpieces) in the clinical waste bins and ask them to wash/Sanitise their hands after this has been completed.

If, however, you are not ready to resume CO monitoring face-to-face, Bedfont offer a single patient use CO monitor and app, iCOquit® Smokerlyzer, ® ideal for monitoring patients remotely.

The COVID-19 pandemic is continuously evolving everyday as we continuously adapt and evolve everyday life and CO monitoring is no exception. However, as we gain more of an understanding of the virus we become more proficient in how we can keep each other safe whilst resuming key services for the public.

Stay Safe Everyone

For more information, follow our coronavirus page.


1. 6. COVID-19 infection prevention and control guidance: aerosol generating procedures [Internet]. GOV.UK. 2020 [cited 18 November 2020]. Available from: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-infection-prevention-and-control-guidance-aerosol-generating-procedures

2. COVID-19/SARS-CoV-2 Pandemic | FPM [Internet]. FPM. 2020 [cited 18 November 2020]. Available from: https://www.fpm.org.uk/blog/covid-19-sars-cov-2-pandemic/

3. NCSCT – National Centre for Smoking Cessation and Training [Internet]. Ncsct.co.uk. 2020 [cited 18 November 2020]. Available from: https://www.ncsct.co.uk/