Spacer devices are commonly recommended for use with a metered dose inhaler to improve coordination of administration of drug particles to the lungs. However, they are not always readily available in South African public healthcare facilities. This has led to an innovative approach to creating spacer devices using recycled 440mL/500mL plastic bottles (Zar et al.,2005). By incorporating the latest technology of a 3D-printer, we have designed a mold for our starter kit that can be utilized in the process of converting these plastic beverage bottles into a spacer device.
This kit includes the following, which can be found on this page, or acquired by contacting Dr Ebrabim (contact details below).
● Instructional Videos - visually entails how to make these spacer devices.
● A Standard Operating Procedure document - of the correct procedures to follow for making the bottle spacers.
● A 3D printed mold - used in the process of converting 440mL/500mL plastic bottles into a spacer device. Alternatively the STL files can also be accessed on this page to allow self printing of the molds if a 3D printer is available.
● An Ideal Bottle Description - help to include and exclude certain bottle types found in South Africa.
● A pictorial Patient Information Label - displays how to use the bottle spacer with an MDI.
These starter kits are available for distribution to South African healthcare facilities - Please see
contact details below. A community project is created by encouraging the public to help
healthcare workers by collecting these bottles, giving them an opportunity to get engaged with
their local healthcare facilities.
Why is this significant?
Asthma is a chronic respiratory condition, resulting in inflammation of the inside walls of airway tracts (WebMD, 2021). It was determined to be the most prevalent chronic illness within South Africa (The Global Asthma Network, The Global Asthma Report, 2018). This is problematic especially in children, but can be controlled with the aid of spacer devices. These devices can be expensive and difficult to access. Alternative low-cost spacer devices made using plastic bottles are currently available and have been proven to be just as effective as conventional spacer devices (Zar et al., 1999). We have compiled this online spacer molding kit which is sustainable and easily accessible for healthcare facilities. Plastic cooldrink bottles are a common pollutant in the environment. Thus, recycling these into spacer devices provide a more sustainable option than mass-produced spacers, as we provide another option to simply throwing away your plastic cooldrink bottles.
All aspects of the project were made to be easily available by the creation of this website and
incorporated procedures in an easy-to-follow video format.
Instructional Videos on Making a Bottle-spacer
These videos demonstrate the process of making a bottle-spacer device from 440/500ml bottles
using the starter kit provided, and follows a 4 part sequence:
Step 1 - Pre-washing, recommending how to wash the bottles once collected.
Step 2 - Spacer Molding, shows how to safely and efficiently mold the bottles.
Step 3 - Quality Control, on how to clean off excess plastic pieces.
Step 4 - Post-washing, which demonstrates how to wash the molded bottles.
Ideal Bottle
The information below provides an outline as to which bottles are best to use, and what to exclude, based on certain characteristics of the plastic beverage bottles. Please note that all juice bottles are not to be utilised as a bottle spacer. Our recommendation of an ideal bottle is the Jive® 440mL and Double ‘‘O’’® 500mL bottles, but others may be considered.
Table of Ideal Bottle Characteristics
Patient Instruction Label
The printable label below visually demonstrates how patients should use the bottle-spacer
device with their MDI. This label could be displayed in the pharmacy or handed to patients
directly.
[Patient Instruction Label.pdf]
Contact Information
For any queries or information regarding acquiring the Starter Kit packs, please contact Dr
Naushaad Ebrahim on via email nebrahim@uwc.ac.za.
About Us
As of 2022, we are 4th Year Pharmacy students at the University of the Western Cape: Aakifah
Ahmed, Sidney Boer, Shae Lia Hendricks, Tayla Myburgh, Humaira Sima and Arencheo
Wagner. This project was conducted under the supervision of Dr Naushaad Ebrahim .
References:
● Zar, H. J., Streun, S., Levin, M., & Weinberg, E. G. (2005). Randomised controlled trial of
the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in
acute lower airway obstruction. https://doi.org/10.1136/adc.2006.101642
● WebMD. 2021. Asthma. [online] Available at:
[Accessed 22 March 2022].
● The Global Asthma Network, 2018. The Global Asthma Report. Auckland, New Zealand,
p.55.
● Zar HJ, Brown G, Donson H, Brathwaite N, Mann MD, Weinberg EG. (1999)
Home-made spacers for bronchodilator therapy in children with acute asthma: a
randomised trial. https://doi.org/10.1016/s0140-6736(98)12445-5
This kit includes the following, which can be found on this page, or acquired by contacting Dr Ebrabim (contact details below).
● Instructional Videos - visually entails how to make these spacer devices.
● A Standard Operating Procedure document - of the correct procedures to follow for making the bottle spacers.
● A 3D printed mold - used in the process of converting 440mL/500mL plastic bottles into a spacer device. Alternatively the STL files can also be accessed on this page to allow self printing of the molds if a 3D printer is available.
● An Ideal Bottle Description - help to include and exclude certain bottle types found in South Africa.
● A pictorial Patient Information Label - displays how to use the bottle spacer with an MDI.
These starter kits are available for distribution to South African healthcare facilities - Please see
contact details below. A community project is created by encouraging the public to help
healthcare workers by collecting these bottles, giving them an opportunity to get engaged with
their local healthcare facilities.
Why is this significant?
Asthma is a chronic respiratory condition, resulting in inflammation of the inside walls of airway tracts (WebMD, 2021). It was determined to be the most prevalent chronic illness within South Africa (The Global Asthma Network, The Global Asthma Report, 2018). This is problematic especially in children, but can be controlled with the aid of spacer devices. These devices can be expensive and difficult to access. Alternative low-cost spacer devices made using plastic bottles are currently available and have been proven to be just as effective as conventional spacer devices (Zar et al., 1999). We have compiled this online spacer molding kit which is sustainable and easily accessible for healthcare facilities. Plastic cooldrink bottles are a common pollutant in the environment. Thus, recycling these into spacer devices provide a more sustainable option than mass-produced spacers, as we provide another option to simply throwing away your plastic cooldrink bottles.
All aspects of the project were made to be easily available by the creation of this website and
incorporated procedures in an easy-to-follow video format.
Instructional Videos on Making a Bottle-spacer
These videos demonstrate the process of making a bottle-spacer device from 440/500ml bottles
using the starter kit provided, and follows a 4 part sequence:
Step 1 - Pre-washing, recommending how to wash the bottles once collected.
Step 2 - Spacer Molding, shows how to safely and efficiently mold the bottles.
Step 3 - Quality Control, on how to clean off excess plastic pieces.
Step 4 - Post-washing, which demonstrates how to wash the molded bottles.
Step 1 - Pre - Washing |
Step 2 - Spacer Molding |
Step 3 - Quality Control | Step 4 - Post - washing |
Standard Operating Procedure (SOP) The videos above follow the guidelines set out If access to a 3D printer is available, the in the SOP document which is available as text molds can be printed using the .stl files below. [Standard Operating Procedure.pdf] |
3D Mold STL Files If access to a 3D printer is available, the molds can be printed using the stl. files as below. [Support Base 1.stl] [Safety Mold 2.stl] |
The information below provides an outline as to which bottles are best to use, and what to exclude, based on certain characteristics of the plastic beverage bottles. Please note that all juice bottles are not to be utilised as a bottle spacer. Our recommendation of an ideal bottle is the Jive® 440mL and Double ‘‘O’’® 500mL bottles, but others may be considered.
Table of Ideal Bottle Characteristics
CHARACTERISTIC | IDEAL BOTTLE CHARACTERISTICS |
Bottle Size | 440ml or 500ml |
Bottle Shape | Cylindrical throughout |
Bottle colour | Colourless, transparent bottle |
Blisters present on inside of bottle |
None |
Ridges present on inside of the bottle |
None |
Availability in stores | Freely available |
Patient Instruction Label
The printable label below visually demonstrates how patients should use the bottle-spacer
device with their MDI. This label could be displayed in the pharmacy or handed to patients
directly.
[Patient Instruction Label.pdf]
Contact Information
For any queries or information regarding acquiring the Starter Kit packs, please contact Dr
Naushaad Ebrahim on via email nebrahim@uwc.ac.za.
About Us
As of 2022, we are 4th Year Pharmacy students at the University of the Western Cape: Aakifah
Ahmed, Sidney Boer, Shae Lia Hendricks, Tayla Myburgh, Humaira Sima and Arencheo
Wagner. This project was conducted under the supervision of Dr Naushaad Ebrahim .
References:
● Zar, H. J., Streun, S., Levin, M., & Weinberg, E. G. (2005). Randomised controlled trial of
the efficacy of a metered dose inhaler with bottle spacer for bronchodilator treatment in
acute lower airway obstruction. https://doi.org/10.1136/adc.2006.101642
● WebMD. 2021. Asthma. [online] Available at:
● The Global Asthma Network, 2018. The Global Asthma Report. Auckland, New Zealand,
p.55.
● Zar HJ, Brown G, Donson H, Brathwaite N, Mann MD, Weinberg EG. (1999)
Home-made spacers for bronchodilator therapy in children with acute asthma: a
randomised trial. https://doi.org/10.1016/s0140-6736(98)12445-5