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Routine pulmonary function tests may require patients to perform maximal inspiratory and expiratory breathing maneuvers. They may be asked to re breathe via the
breathing circuits and equipment, which may be difficult to disinfect between patients. Infection can be transmitted by direct or indirect contact via mouthpieces and immediate proximal surfaces of the valves or tubing within the equipment, and possibly by aerosol droplet formation. Patients performing pulmonary function tests may generate flows (peak expiratory flows) as high as 12 L·s-1 (720 L·min-1). Infective droplets may be expelled during these forced 
expirations, which could contaminate the pulmonary function equipment. A subsequent patient carrying out the same maneuver on this equipment could inhale these infective droplets during the forced inspiratory phase.
Very few bacteria are required to facilitate the infectious process of some diseases, such as tuberculosis, and therefore the potential risk of
cross-infection using this particular type of equipment may be comparatively high. In order to essentially 
eliminate any potential risk of cross-infection, a bacterial/viral filter can be placed between the patient’s mouth and the test equipment. It is common practice to use bacterial/viral filters when patients are known to be
infectious or immunocompromised. However, as the infectious status of many patients is unknown, it may
be prudent to presuppose that any patient performing the tests could be infectious. Using a single-use
bacterial/viral filter for all patients overcomes this issue<<Click Here for additional references on filter utilization>>
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