Effect of ventilation improvement during a tuberculosis outbreak in underventilated university buildings.

The role of ventilation in preventing tuberculosis (TB) transmission has been widely proposed in infection control guidance. However, conclusive evidence is lacking. Modeling suggested the threshold of ventilation rate to reduce effective reproductive ratio (ratio between new secondary infectious cases and source cases) of TB to below 1 is corresponding to a carbon dioxide (CO2 ) level of 1000 parts per million (ppm). Here, we measured the effect of improving ventilation rate on a TB outbreak involving 27 TB cases and 1665 contacts in underventilated university buildings. Ventilation engineering decreased the maximum CO2 levels from 3204 ± 50 ppm to 591-603 ppm. Thereafter, the secondary attack rate of new contacts in university dropped to zero (mean follow-up duration: 5.9 years). Exposure to source TB cases under CO2 >1000 ppm indoor environment was a significant risk factor for contacts to become new infectious TB cases (P < .001). After adjusting for effects of contact investigation and latent TB infection treatment, improving ventilation rate to levels with CO2 <1000 ppm was independently associated with a 97% decrease (95% CI: 50%-99.9%) in the incidence of TB among contacts. These results show that maintaining adequate indoor ventilation could be a highly effective strategy for controlling TB outbreaks.

Reduction of cooking oil fume exposure following an engineering intervention in Chinese restaurants.

BACKGROUND: A new engineering intervention measure, an embracing air curtain device (EACD), was used to increase the capture efficiency of cooker hoods and reduce cooking oil fume (COF) exposure in Chinese restaurants. METHODS: An EACD was installed in six Chinese restaurants where the cooks complained of COF exposure. Before- and after-installation measurements were taken to compare changes in particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) in kitchen air, and changes in levels of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA). The association between PM and PAHs in air and 8-OHdG and MDA in urine was evaluated by linear mixed-effects regression analysis. RESULTS: Results showed that geometric mean kitchen air levels of PM(10), PM(2.5), PM(1.0) and total particulate PAHs were significantly reduced after the EACDs were introduced. Urinary levels of 8-OHdG and MDA in cooks were also significantly lower after EACD instalment. PM(2.5), PM(1.0) and benzo(a)pyrene (BaP) levels were positively associated with urinary 8-OHdG levels after adjusting for key personal covariates. Urinary MDA levels in cooks were also positively associated with BaP levels after adjusting for key personal covariates. CONCLUSION: This study demonstrates that the EACD is effective for reducing COF and oxidative stress levels in cooks working in Chinese kitchens.

Environmental and occupational health response to SARS, Taiwan, 2003.

Industrial hygiene specialists from the National Institute for Occupational Safety and Health (NIOSH) visited hospitals and medical centers throughout Taiwan. They assisted with designing and evaluating ventilation modifications for infection control, developed guidelines for converting hospital rooms into SARS patient isolation rooms, prepared designs for the rapid conversion of a vacated military facility into a SARS screening and observation facility, assessed environmental aspects of dedicated SARS hospitals, and worked in concert with the Taiwanese to develop hospital ventilation guidelines. We describe the environmental findings and observations from this response, including the rapid reconfiguration of medical facilities during a national health emergency, and discuss environmental challenges should SARS or a SARS-like virus emerge again.

Development and characterization of a wake-controlled exterior hood.

A wake-controlled exterior hood was developed to overcome the negative influence of cross draft on an exterior hood and avoid the operation inconvenience caused by the enclosure of an airflow capture booth. This new type of local exterior hood used the hood suction flow to stabilize the dynamic vortex shedding that was induced when a crossflow passed over a blockage plate, and therefore formed a hydrodynamics-stabilized local isolation area for efficient removing of the contaminant. The development process was performed in a test section of an open-circuit wind tunnel. The blockage plate and the exterior hood model were placed in a wind-tunnel test section so that the crossflow could be freely supplied by the airstream of the wind tunnel. The laser light sheet flow visualization method and the laser Doppler velocimeter were employed to reveal the characteristics of the flow field. Primary influential parameters were factored out of the measured velocity results so that a design procedure was proposed. Experiments using hot-wire type alcohol sensors to measure the toluene vapor concentration distributions showed that the capture efficiency of this type of actively controlled hood was remarkably higher than that of an uncontrolled hood.