[Exhaled droplets and Covid-19]. / Mängden utandade partiklar varierar stort mellan individer.

Exhaled droplets are composed of water, salts and organic material and the physical designation is particles. These particles vary in size from 0.01 µm to very large, e g produced during coughing. The respiratory tract lining fluid (RTLF) is the main source of the particles. Large and small exhaled particles are produced in central airways, vocal cords and mouth whereas small particles (< about 5 µm) are produced also in small airways, generated during inspiration by the airway closure/opening mechanism. These particles are composed mainly of surfactant. Exhaled small particles may carry virus and cause airborne transmission and infection, which may be an important transmission route indoors. Ventilation, concentration of people, activities and face mask occurrence influence the risk of infection. Outdoor transmission is in addition influenced by outdoor pollution and wind speed.

Fresh and Oxidized Emissions from In-Use Transit Buses Running on Diesel, Biodiesel, and CNG.

The potential effect of changing to a nonfossil fuel vehicle fleet was investigated by measuring primary emissions (by extractive sampling of bus plumes) and secondary mass formation, using a Gothenburg Potential Aerosol Mass (Go:PAM) reactor, from 29 in-use transit buses. Regarding fresh emissions, diesel (DSL) buses without a diesel particulate filter (DPF) emitted the highest median mass of particles, whereas compressed natural gas (CNG) buses emitted the lowest (MdEFPM 514 and 11 mg kgfuel-1, respectively). Rapeseed methyl ester (RME) buses showed smaller MdEFPM and particle sizes than DSL buses. DSL (no DPF) and hybrid-electric RME (RMEHEV) buses exhibited the highest particle numbers (MdEFPN 12 × 1014 # kgfuel-1). RMEHEV buses displayed a significant nucleation mode ( Dp< 20 nm). EFPN of CNG buses spanned the highest to lowest values measured. Low MdEFPN and MdEFPM were observed for a DPF-equipped DSL bus. Secondary particle formation resulting from exhaust aging was generally important for all the buses (79% showed an average EFPM:AGED/EFPM:FRESH ratio >10) and fuel types tested, suggesting an important nonfuel dependent source. The results suggest that the potential for forming secondary mass should be considered in future fuel shifts, since the environmental impact is different when only considering the primary emissions.

The effect of exhalation flow on endogenous particle emission and phospholipid composition.

Exhaled particles constitute a micro-sample of respiratory tract lining fluid. Inhalations from low lung volumes generate particles in small airways by the airway re-opening mechanism. Forced exhalations are assumed to generate particles in central airways by mechanisms associated with high air velocities. To increase knowledge on how and where particles are formed, different breathing manoeuvres were compared in 11 healthy volunteers. Particles in the 0.41-4.55µm diameter range were characterised and sampled. The surfactant lipid dipalmitoylphosphatidylcholine (DPPC) was quantified by mass spectrometry. The mass of exhaled particles increased by 150% (95% CI 10-470) for the forced exhalation and by 470% (95% CI 150-1190) for the airway re-opening manoeuvre, compared to slow exhalations. DPPC weight percent concentration (wt%) in particles was 2.8wt% (95%CI 1.4-4.2) and 9.4wt% (95%CI 8.0-10.8) for the forced and the airway re-opening manoeuvres, respectively. In conclusion, forced exhalation and airway re-opening manoeuvres generate particles from different airway regions having different DPPC concentration.

Exhaled Particles After a Standardized Breathing Maneuver.

BACKGROUND: Particles in exhaled air (PEx) provide samples of respiratory tract lining fluid from small airways and offer a new opportunity to monitor pathological changes. The exhaled particles are produced by reopening of closed small airways and contain surfactant. The amount of PEx varies by orders of magnitude among subjects. A standardized breathing pattern reduces the variation, but it remains large and the reasons are unknown. The aim of the present study was to assess to what extent sex, age, body size, and spirometry results explain the interindividual variation of PEx among healthy middle-aged subjects. METHODS: The PExA® instrument was used to measure PEx in 126 healthy middle-aged nonsmoking subjects participating in the European Respiratory Community Health Survey (ERCS-III). The subjects performed a standardized breathing maneuver involving expiration to residual volume, a breath-hold of 3 seconds, a full inspiration, and then a full expiration into the PExA instrument. PEx number concentrations were expressed per exhalation and per exhaled liter. Age and anthropometric and spirometric variables were analyzed as potential predictors. RESULTS: PEx/L was consistently and negatively associated to lung size-related variables and accordingly lower in men than in women. PEx/Exhalation was similar in women and men. Increasing age was associated with increasing PEx. Reference equations are presented based on age, weight, and spirometry variables and independent of sex. These predictors explained 28%-29% of the interindividual variation. CONCLUSIONS: The interindividual variation of PEx after a standardized breathing maneuver is large and the considered predictors explain a minor part only.

Respiratory symptoms, sleep-disordered breathing and biomarkers in nocturnal gastroesophageal reflux.

BACKGROUND: Nocturnal gastroesophageal reflux (nGER) is associated with respiratory symptoms and sleep-disordered breathing (SDB), but the pathogenesis is unclear. We aimed to investigate the association between nGER and respiratory symptoms, exacerbations of respiratory symptoms, SDB and airway inflammation. METHODS: Participants in the European Community Respiratory Health Survey III in Iceland with nGER symptoms (n = 48) and age and gender matched controls (n = 42) were studied by questionnaires, exhaled breath condensate (EBC), particles in exhaled air (PEx) measurements, and a home polygraphic study. An exacerbation of respiratory symptoms was defined as an episode of markedly worse respiratory symptoms in the previous 12 months. RESULTS: Asthma and bronchitis symptoms were more common among nGER subjects than controls (54 % vs 29 %, p = 0.01; and 60 % vs 26 %, p < 0.01, respectively), as were exacerbations of respiratory symptoms (19 % vs 5 %, p = 0.04). Objectively measured snoring was more common among subjects with nGER than controls (snores per hour of sleep, median (IQR): 177 (79-281) vs 67 (32-182), p = 0.004). Pepsin (2.5 ng/ml (0.8-5.8) vs 0.8 ng/ml (0.8-3.6), p = 0.03), substance P (741 pg/ml (626-821) vs 623 pg/ml (562-676), p < 0.001) and 8-isoprostane (3.0 pg/ml (2.7-3.9) vs 2.6 pg/ml (2.2-2.9), p = 0.002) in EBC were higher among nGER subjects than controls. Albumin and surfactant protein A in PEx were lower among nGER subjects. These findings were independent of BMI. CONCLUSION: In a general population sample, nGER is associated with symptoms of asthma and bronchitis, as well as exacerbations of respiratory symptoms. Also, nGER is associated with increased respiratory effort during sleep. Biomarker measurements in EBC, PEx and serum indicate that micro-aspiration and neurogenic inflammation are plausible mechanisms.

Surfactant Protein A in Exhaled Endogenous Particles Is Decreased in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Pilot Study.

BACKGROUND: Exhaled, endogenous particles are formed from the epithelial lining fluid in small airways, where surfactant protein A (SP-A) plays an important role in pulmonary host defense. Based on the knowledge that chronic obstructive pulmonary disease (COPD) starts in the small airway epithelium, we hypothesized that chronic inflammation modulates peripheral exhaled particle SP-A and albumin levels. The main objective of this explorative study was to compare the SP-A and albumin contents in exhaled particles from patients with COPD and healthy subjects and to determine exhaled particle number concentrations. METHODS: Patients with stable COPD ranging from moderate to very severe (n = 13), and healthy non-smoking subjects (n = 12) were studied. Subjects performed repeated breath maneuvers allowing for airway closure and re-opening, and exhaled particles were optically counted and collected on a membrane using the novel PExA® instrument setup. Immunoassays were used to quantify SP-A and albumin. RESULTS: COPD patients exhibited significantly lower SP-A mass content of the exhaled particles (2.7 vs. 3.9 weight percent, p = 0.036) and lower particle number concentration (p<0.0001) than healthy subjects. Albumin mass contents were similar for both groups. CONCLUSIONS: Decreased levels of SP-A may lead to impaired host defense functions of surfactant in the airways, contributing to increased susceptibility to COPD exacerbations. SP-A in exhaled particles from small airways may represent a promising non-invasive biomarker of disease in COPD patients.

Influence of humidity, temperature, and radicals on the formation and thermal properties of secondary organic aerosol (SOA) from ozonolysis of ß-pinene.

The influence of water and radicals on SOAs produced by ß-pinene ozonolysis was investigated at 298 and 288 K using a laminar flow reactor. A volatility tandem differential mobility analyzer (VTDMA) was used to measure the evaporation of the SOA, enabling the parametrization of its volatility properties. The parameters extracted included the temperature at which 50% of the aerosol had evaporated (T(VFR0.5)) and the slope factor (S(VFR)). An increase in S(VFR) indicates a broader distribution of vapor pressures for the aerosol constituents. Reducing the reaction temperature increased S(VFR) and decreased T(VFR0.5) under humid conditions but had less effect on T(VFR0.5) under dry conditions. In general, higher water concentrations gave lower T(VFR0.5) values, more negative S(VFR) values, and a reduction in total SOA production. The radical conditions were changed by introducing OH scavengers to generate systems with and without OH radicals and with different [HO2]/[RO2] ratios. The presence of a scavenger and lower [HO2]/[RO2] ratio reduced SOA production. Observed changes in S(VFR) values could be linked to the more complex chemistry that occurs in the absence of a scavenger and indicated that additional HO2 chemistry gives products with a wider range of vapor pressures. Updates to existing ozonolysis mechanisms with routes that describe the observed responses to water and radical conditions for monoterpenes with endocyclic and exocyclic double bonds are discussed.

Effects of breath holding at low and high lung volumes on amount of exhaled particles.

Exhaled breath contains particles originating from the respiratory tract lining fluid. The particles are thought to be generated during inhalation, by reopening of airways closed in the preceding expiration. The aim here was to explore processes that control exhaled particle concentrations. The results show that 5 and 10s breath holding at residual volume increased the median concentration of particles in exhaled air by 63% and 110%, respectively, averaged over 10 subjects. An increasing number of closed airways, developing on a timescale of seconds explains this behaviour. Breath holds of 5, 10 and 20s at total lung capacity decreased the concentration to 63%, 45% and 28% respectively, of the directly exhaled concentration. The decrease in particle concentration after breath holding at total lung capacity is caused by gravitational settling in the alveoli and associated bronchioles. The geometry employed here when modelling the deposition is however not satisfactory and ways of improving the description are discussed.

Influence of film dimensions on film droplet formation.

BACKGROUND: Aerosol particles may be generated from rupturing liquid films through a droplet formation mechanism. The present work was undertaken with the aim to throw some light on the influence of film dimensions on droplet formation with possible consequences for exhaled breath aerosol formation. METHODS: The film droplet formation process was mimicked by using a purpose-built device, where fluid films were spanned across holes of known diameters. As the films burst, droplets were formed and the number and size distributions of the resulting droplets were determined. RESULTS: No general relation could be found between hole diameter and the number of droplets generated per unit surface area of fluid film. Averaged over all film sizes, a higher surface tension yielded higher concentrations of droplets. Surface tension did not influence the resulting droplet diameter, but it was found that smaller films generated smaller droplets. CONCLUSIONS: This study shows that small fluid films generate droplets as efficiently as large films, and that droplets may well be generated from films with diameters below 1 mm. This has implications for the formation of film droplets from reopening of closed airways because human terminal bronchioles are of similar dimensions. Thus, the results provide support for the earlier proposed mechanism where reopening of closed airways is one origin of exhaled particles.

Relation between humidity and size of exhaled particles.

BACKGROUND: Aerosol particles are generated in human airways, and leave the body with exhaled air. These particles may carry indicators of various lung conditions. To fully utilize the information provided by endogenously produced exhaled particles, it is important to understand their formation mechanism and physical properties. The scope of this work was to measure number size distributions of exhaled aerosol particles at various surrounding relative humidities (RH) in order to gain some knowledge of the size distribution at the point of particle generation. METHODS: Number size distributions of exhaled particles were measured at various RHs, using an optical particle counter. Breathing with airway closure was employed. RESULTS: A relation between particle volume and RH was fitted to experimental data and used to predict how exhaled droplets behave at RHs not easily accessible by experiments. The diameter of an exhaled particle is reduced by a factor of 0.42 when the RH is changed from 99.5 to 75% at 309 K. Calculations also show that the droplets are concentrated solutions near saturation at 75% RH. CONCLUSIONS: It is concluded that the particles are supersaturated liquid particles, rather than crystalline solids, in ambient air with RH below 75%. A size distribution related to the aerosol at the moment of formation is given. A successful detailed formation mechanism should be able to accommodate the size distribution predicted at 99.5% RH.

Effect of airway opening on production of exhaled particles.

The technique of sampling exhaled air is attractive because it is noninvasive and so allows repeated sampling with ease and no risk for the patient. Knowledge of the biomarkers' origin is important to correctly understand and interpret the data. Endogenous particles, formed in the airways, are exhaled and reflect chemical composition of the respiratory tract lining fluid. However, the formation mechanisms and formation sites of these particles are unknown. We hypothesize that airway opening following airway closure causes production of airborne particles that are exhaled. The objective of this study was to examine production of exhaled particles following varying degrees of airway closure. Ten healthy volunteers performed three different breathing maneuvers in which the initial lung volume preceding an inspiration to total lung capacity was varied between functional residual capacity (FRC) and residual volume (RV). Exhaled particle number concentrations in the size interval 0.30-2.0 microm were recorded. Number concentrations of exhaled particles showed a 2- to 18-fold increase after exhalations to RV compared with exhalations where no airway closure was shown [8,500 (810-28,000) vs. 1,300 (330-13,000) particles/expired liter, P = 0.012]. The difference was most noticeable for the smaller size range of particles (<1 microm). There were significant correlations between particle concentrations for the different maneuvers. Our results show that airway reopening following airway closure is an important mechanism for formation of endogenous exhaled particles and that these particles originate from the terminal bronchioles.

Airway monitoring by collection and mass spectrometric analysis of exhaled particles.

We describe a new method for simultaneously collecting particles in exhaled air for subsequent chemical analysis and measuring their size distribution. After forced exhalation, particles were counted and collected in spots on silicon wafers with a cascade impactor. Several phospholipids were identified by time-of-flight secondary ion mass spectrometric analysis of the collected spots, suggesting that the particles originated from the lower airways. The amount of particles collected in ten exhalations was sufficient for characterizing the phospholipid composition. The feasibility of the technique in respiratory research is demonstrated by analysis of the phospholipid composition of exhaled particles from healthy controls, patients with asthma, and patients with cystic fibrosis. We believe this technology will be useful for monitoring patients with respiratory disease and has a high potential to detect new biomarkers in exhaled air.

Influence of OH scavenger on the water effect on secondary organic aerosol formation from ozonolysis of limonene, Delta3-carene, and alpha-pinene.

The effect of OH scavengers on how water vapor influences the formation of secondary organic aerosol (SOA) in ozonolysis of limonene, Delta3-carene, and alpha-pinene at low concentrations has been investigated by using a laminar flow reactor. Cyclohexane and 2-butanol (3-40 x 10(13) molecules cm(-3)) were used as scavengers and compared to experiments without any scavenger. The reactions were conducted at 298 K and at relative humidities between <10 and 80%. The yield of SOA decreased in the order "no scavenger" > 2-butanol > cyclohexane. The effect of water vapor was similar for 2-butanol and without a scavenger, with an increase in particle number and mass concentration with increasing relative humidity. The water effect for cyclohexane was more complex, depending on the terpene, scavenger concentration, and SOA concentration. The water effect seems to be influenced by the HO2/RO2 ratio. The results are discussed in relation to the currently suggested mechanism for alkene ozonolysis and to atmospheric importance. The results imply that the ozone-initiated oxidation of terpenes needs revision in order to fully account for the role of water in the chemical mechanism.

Impact of humidity on the ozone initiated oxidation of limonene, delta3-carene, and alpha-pinene.

The effect of water on the initial secondary organic aerosol (SOA) formation from gas-phase ozonolysis of limonene, delta3-carene, and alpha-pinene (-3 and approximately 1.5 x 10(11) molecule cm(-3) reacted) has been investigated in a flow reactor at controlled relative humidity (RH), temperature (298 +/- 0.4 K), and reaction time (270 +/- 2 s). Low amounts of terpene converted minimize the impact of secondary reactions. A comparison of the SOA formation from the three terpenes was made for initial rate of reactions being around 7.5 x 10(8) and 15 x 10(8) molecule cm(-3) s(-1). The most efficient species in producing SOA was limonene, while alpha-pinene was the least efficient. The results showed that an enhancement in water vapor concentration (<2-85% RH) caused an increase in both integrated mass (M10-300nm) and total number (N10-300nm). The effect on number and mass were a factor of 2-3 and 4-8, respectively. Physical water up-take can partly explain the increase in mass, but not the observed increase in number. Therefore it was concluded that the increase in water concentration must, by a gas-phase reaction, produce more low volatility product(s).

Flux of organic compounds from grass measured by relaxed eddy accumulation technique.

Fluxes of some Volatile Organic Compounds (VOC) from grass were measured at a golf course in western Sweden, using the Relaxed Eddy Accumulation (REA) technique. The sampling was done by collecting VOC onto adsorbent tubes and the analysis was performed by thermal desorption followed by GC/MS. High emissions were observed after cutting. Transient fluxes of (Z)-3-hexenyl acetate (0.51 microg m(-2) s(-1)), (Z)-3-hexen-1-ol (0.14 microg m(-2) s(-1)) and (Z)-3-hexenal (0.40 microg m(-2) s(-1)) were measured, even at low temperatures. The REA technique requires a relatively large fetch area that is sometimes not available. Therefore, a procedure for correcting measured fluxes from a limited fetch is suggested.