[IMGLEFT]http://www.themouthpiece.com/images/tmpnews.gif[/IMGLEFT] Always blow your own trumpet! Potential cross-infection hazards through salivary and respiratory secretions in the sharing of brass and woodwind musical instruments during music therapy sessions An interesting extract from an article published on Science Direct... makes you think about allowing friends to use your instrument. Music therapy has developed as an important part of various hospital patients' management. The participation of the patient in some form of music-making using the voice, musical instruments and listening, with the music therapist, allows the patient to enhance their emotional well-being and promote an increased sense of self-awareness. At present, there are approximately 300 music therapists in the UK registered with the professional body, the Association of Professional Music Therapists (APMT). Instrumental music-making is also very popular with the general public, both adults and children alike. However in both forms of music-making, the potential exists for the sharing of musical instruments, raising infection control issues, particularly in the music therapy setting in hospitals. Playing woodwind and brass instruments involves forced expulsion of a continuous airflow from the lungs through the mouth into the instrument to produce a tone. This tone is created at the interface between instrument and the player's mouth by either vibration of a reed in the case of woodwind instruments, or with the lips in the case of brass instruments. The flute and recorder, although considered woodwind instruments, physically behave more like brass instruments, as they do not require a reed to initiate the sound. As a result, both woodwind and brass instruments, particularly the mouthpiece, become contaminated with salivary secretions, as well as oro-pharyngeal and upper airways' secretions, which can eventually lead to biofilm formation in the mouthpiece. In general music-making swapping of instruments occurs for several reasons, including the trial of other people's instruments, and this is more common with brass players than with woodwind players. To date, there have been no reports of person-to-person transmission of pathogenic organisms by this mechanism, which has led to acute infection. Saliva may harbour several bacterial and viral pathogens and the musical instruments themselves may be contaminated with potentially pathogenic organisms.Of particular concern is the potential for the transmission of the Gram-negative respiratory pathogens, Pseudomonas aeruginosa and Burkholderia cepacia complex during inpatient music therapy sessions involving patients with cystic fibrosis (CF) or by the sharing of musical instrumentals in households with CF siblings. In general, the communal use and sharing of instruments, particularly mouthpieces, should be discouraged without appropriate cleaning, due to the potential of cross contamination with salivary and respiratory secretions. The APMT in the UK has produced guidelines entitled ‘APMT Guidelines on Hygiene of Instruments’ which should be consulted for guidance and which can be obtained by contacting the APMT via their website (http://www.apmt.org.uk).