Performance evaluation of selected n95 respirators and surgical masks when challenged with aerosolized endospores and inert particles.

The objective of this study was to assess how the relative efficiency of N95 respirators and surgical masks might vary with different challenge aerosols, utilizing a standardized manikin head form as a surrogate to human participation. A Collision nebulizer aerosolized B. anthracis Sterne strain endospores and polystyrene latex (PSL) particles to evaluate 11 models of N95 respirators and surgical masks. An automated breathing simulator, calibrated to normal tidal volume and active breathing rate, mimicked human respiration. A manikin head form with N95 respirators or surgical masks, and manikin head form without N95 respirators or surgical masks were placed in the bioaerosol chamber. An AGI-30 sampler filled with phosphate buffered water was fitted behind the mouth of each manikin head form to collect endospore bioaerosol samples. PSL aerosols concentrations were quantified by an ARTI Hand Held Particle Counter. Geometric Mean (GM) relative efficiency of N95 respirators and surgical masks challenged with endospore bioaerosol ranged from 34-65%. In PSL aerosol experiments, GM relative efficiency ranged from 35-64% for 1.3 µm particles. GM filtration efficiency of all N95 and surgical N95 respirators filter media evaluated was ≥99% when challenged with particles ≥0.1 µm. GM filtration efficiency of surgical mask filter media ranged from 70-83% with particles ≥0.1 µm and 74-92% with 1.3 µm PSL particles. Relative efficiencies of N95 respirators and surgical masks challenged with aerosolized B. anthracis endospores and PSL were similar. Relative efficiency was similar between N95 respirators and surgical masks on a manikin head form despite clear differences in filtration efficiency. This study further highlights the importance of face seal leakage in the respiratory protection provided by N95 respirators, and demonstrates it on a human surrogate.

Isolation of antibiotic-resistant bacteria from the air plume downwind of a swine confined or concentrated animal feeding operation.

OBJECTIVE: In this study we evaluated the levels of antibiotic- and multidrug-resistant bacteria in bioaerosols upwind, within, and downwind at locations 25 m, 50 m, 100 m, and 150 m from a swine confined animal feeding operation. DESIGN: We used Andersen two-stage samplers to collect bacterial samples, the replicate plate method to isolate organisms, and the Kirby-Bauer disk diffusion method to determine antibiotic resistance. RESULTS: The percentage of organisms resistant to at least two antibiotic classes and all four classes evaluated were, respectively, 2.1 and 3.0 times higher inside (n = 69) than upwind (n = 59) of the facility. Staphylococcus aureus was the most prevalent organism recovered. Concentrations of antibiotic-resistant S. aureus decreased with increasing distance from the facility. Using Fisher's exact methods, the change in distribution of antibiotic resistance profiles for each antibiotic was statistically significant (oxytetracycline, p = 0.010; tetracycline, p = 0.014; ampicillin, p = 0.007; erythromycin, p = 0.035); however, this relationship was not seen with lincomycin and penicillin (p > 0.05) . In addition, the levels of antibiotic-resistant S.aureus 25 m downwind were significantly greater than the levels from samples taken upwind from the facility for the same four antibiotics (p < 0.05) . The percentage of resistant group A streptococci and fecal coliform increased within the facility compared with upwind values for all antibiotics evaluated,except for lincomycin. The percentage of resistant total coliform organisms increased within the facility compared with upwind values for oxytetracycline and tetracycline. CONCLUSIONS: Bacterial concentrations with multiple antibiotic resistances or multidrug resistance were recovered inside and outside to (at least) 150 m downwind of this facility at higher percentages than upwind. Bacterial concentrations with multiple antibiotic resistances were found within and downwind of the facility even after subtherapeutic antibiotics were discontinued. This could pose a potential human health effect for those who work within or live in close proximity to these facilities.

Effectiveness of selected surgical masks in arresting vegetative cells and endospores when worn by simulated contagious patients.

OBJECTIVE: The objective of this study was to quantify the effectiveness of selected surgical masks in arresting vegetative cells and endospores in an experimental model that simulated contagious patients. SETTING: Laboratory. METHODS: Five commercially available surgical masks were tested for their ability to arrest infectious agents. Surgical masks were placed over the nose and mouth of mannequin head forms (Simulaids adult model Brad CPR torso). The mannequins were retrofitted with a nebulizer attached to an automated breathing simulator calibrated to a tidal volume of 500 mL/breath and a breathing rate of 20 breaths/min, for a minute respiratory volume of 10 L/min. Aerosols of endospores or vegetative cells were generated with a modified microbiological research establishment-type 6-jet collision nebulizer, while air samples were taken with all-glass impinger (AGI-30) samplers downstream of the point source. All experiments were conducted in a horizontal bioaerosol chamber. RESULTS: Mean arrestance of bioaerosols by the surgical masks ranged from 48% to 68% when the masks were challenged with endospores and from 66% to 76% when they were challenged with vegetative cells. When the arrestance of endospores was evaluated, statistical differences were observed between some pairs, though not all, of the models evaluated. There were no statistically significant differences in arrestance observed between models of surgical masks challenged with vegetative cells. CONCLUSIONS: The arrestance of airborne vegetative cells and endospores by surgical masks worn by simulated contagious patients supports surgical mask use as one of the recommended cough etiquette interventions to limit the transmission of airborne infectious agents.

Feasibility of selected prophylactic barriers in arrestance of airborne bacterial vegetative cells and endospores.

BACKGROUND: Transmission of infection by airborne agents is a risk for health care personnel, patients, and visitors. This risk is heightened in regions without access to environmental controls and personal protective equipment. The ability of 2 prophylactic barriers (ie, semitransparent netting for insect control) to arrest bioaerosols was assessed for potential use within the malarial zones. METHODS: Barriers (pore sizes of 0.8 mm and 0.25 mm) were challenged with bioaerosols of vegetative cells and endospores of Bacillus anthracis strain Sterne 34F2 using a bioaerosol chamber. Barriers were also challenged with airborne inert polystyrene latex particles of known diameters (0.1, 0.43, 0.6, 1.3, 3.2, and 8.0 µm), and the arrestance provided by barrier with the 0.25 mm pore size was expressed as a function of aerodynamic diameter of challenge aerosols. RESULTS: Barrier with the 0.8 mm pore size provided no significant arrestance of aerosols, whereas the barrier with the 0.25 mm pore size provided an 8% arrestance of vegetative cells and a 13% arrestance of endospores. No arrestance at or below the 0.6 µm particle size was observed. CONCLUSION: The level of arrestance provided by these prophylactic barriers does not justify their use as a sole method of preventing transmission.

Bacterial plume emanating from the air surrounding swine confinement operations.

The objective of this study was to evaluate the levels of bacteria in the air plume immediately upwind at 25 m and downwind at locations 25 m, 50 m, 100 m, and 150 m from a confined animal feeding operation (CAFO). It was hypothesized that this would give insight into determining the maximal distance that bacterial organisms release from a CAFO could travel, which would be important in determining the optimal siting distance for future CAFO in relation to high population areas. The Andersen two-stage sampler was used to collect all of the bacterial samples from the animal confinement facilities. The data show a marked increase in bacterial CFUs/m3 inside the facility (18,132 CFU/m3 average) versus upwind (63 CFU/m3 average) anda steady down wind decrease out to approximately 150 m. Staphylococcus aureus was found to account for 76% of the organisms recovered. We conclude that the optimal placement of a swine CAFO would be at least 200 m from a residential area.

Ultraviolet germicidal irradiation disinfection of Stachybotrys chartarum.

The ultraviolet germicidal irradiation (UVGI) dose necessary to inactivate fungal spores on an agar surface and the efficacy of UVGI were determined for cultures of Stachybotrys chartarum (ATCC 208877). This study employed a UVGI testing unit consisting of four chambers with a 9-W, Phillips, low pressure, mercury UVGI lamp in each chamber. The testing unit's apertures were adjusted to provide 50, 100, 150, and 200 microW/cm2 of uniform flux to the Petri dish surfaces, resulting in a total UVGI surface dose ranging from 12 to 144 mJ/cm2. The UVGI dose necessary to inactivate 90% of the S. chartarum was greater than the maximum dose of 144 mJ/cm2 evaluated in this study. While UVGI has been used to inactivate several strains of culturable fungal spores, S. chartarum was not susceptible to an appropriate dose of UVGI. The results of this study may not correlate directly to the effect of UVGI on airborne fungal spores. However, they indicate that current technology may not be efficacious as a supplement to ventilation unless it can provide higher doses of UVGI to kill spores, such as S. chartarum, traveling through the irradiated zone.

Disinfection of selected Aspergillus spp. using ultraviolet germicidal irradiation.

AIMS: The efficacy of ultraviolet germicidal irradiation (UVGI) and the UVGI dose necessary to inactivate fungal spores on an agar surface for cultures of Aspergillus flavus and Aspergillus fumigatus were determined. METHODS AND RESULTS: A four-chambered UVGI testing unit with a 9-W, Phillips, low pressure, mercury UVGI lamp in each chamber was used in this study. An aperture was adjusted to provide 50, 100, 150, and 200 micro W/cm2 of uniform flux to the surfaces of the Petri dish, resulting in a total UVGI dose to the surface of the Petri dishes ranging from 12 to 96 mJ/cm2. The UVGI dose necessary to inactivate 90% of the A. flavus and A. fumigatus was 35 and 54 mJ/cm2, respectively. CONCLUSIONS: UVGI can be used to inactivate culturable fungal spores. Aspergillus flavus was more susceptible than A. fumigatus to UVGI. SIGNIFICANCE AND IMPACT OF THE STUDY: These results may not be directly correlated to the effect of UVGI on airborne fungal spores, but they indicate that current technology may not be efficacious as a supplement to ventilation unless it can provide higher doses of UVGI to kill spores traveling through the irradiated zone.

Airborne antibiotic resistant and nonresistant bacteria and fungi recovered from two swine herd confined animal feeding operations.

Inhalation of microorganisms could be a health concern for workers inside and downwind of animal confinement units. Using the Andersen two-stage viable microbial particle sizing sampler, air samples were collected from locations upwind, inside, and downwind during two visits to two swine herd confined animal feeding operations. Six samples were taken at each location on each site. Bacteria isolated from each site were then tested for antibiotic resistance using the Kirby-Bauer disc diffusion method. Resistant bacterial forms were found inside and downwind of the swine confinement facilities, indicating that resistant organisms were being produced in and released from these facilities. Resistance to a battery of antibiotics including ampicillin, erythromycin, oxytetracycline, penicillin, tetracycline, and tylosin was found in the following bioaerosols: Staphylococcus aureus, Salmonella spp., and fecal coliforms. The major conclusion reached by this study was that bacteria were recovered inside and downwind of these facilities in levels that previous studies had stated could cause a potential human health hazard.