Low-cost interventions to improve ventilation in long-term care facilities.

Residents of long-term care facilities are particularly vulnerable to communicable diseases. Low-cost interventions to increase air exchange rates (AERs) may be useful in reducing the transmission of airborne communicable diseases between long-term care residents and staff. In this study, carbon dioxide gas was used as a tracer to evaluate the AER associated with the implementation of low-cost ventilation interventions. Under baseline conditions with the room's door closed, the mean AER was 0.67 ACH; while baseline conditions with the door open had a significantly higher mean AER of 3.87 ACH (p < 0.001). Subsequently opening a window with the door open increased mean AER by 1.49 ACH (p = 0.012) and adding a fan in the window further increased mean AER by 1.87 ACH (p < 0.001). Regression analyses indicated that the flow rate of air entering through the window, both passively and through the use of a fan, was significantly associated with an increase in AER (p < 0.001). These results indicate that low-cost interventions that pull outside air into resident rooms were effective in improving the air exchange rates in these facilities. While implementation of these interventions is dependent on facility rules and isolation requirements of residents with airborne communicable diseases, these interventions remain viable options for long-term care facilities to improve resident room ventilation without requiring costly ventilation system upgrades.

Re-opening the pediatric pulmonary function laboratory during the ongoing COVID-19 pandemic.

The COVID-19 pandemic continues with new waves of intensification. This review provides an update based on international recommendations concerning the conduct of pulmonary function testing in a manner to limit risk to both patient and tester.

Infection risk in cable cars and other enclosed spaces.

As virus-laden aerosols can accumulate and remain suspended for hours in insufficiently ventilated enclosed spaces, indoor environments can heavily contribute to the spreading of airborne infections. In the COVID-19 pandemics, the role possibly played by cable cars has attracted media attention following several outbreaks in ski resort. To assess the real risk of infection, we experimentally characterize the natural ventilation in cable cars and develop a general stochastic model of infection in an arbitrary indoor space that accounts for the epidemiological situation, the virological parameters, and the indoor characteristics (ventilation rate and occupant number density). As a results of the high air exchange rate (we measured up to 180 air changes per hour) and the relatively short duration of the journey, the infection probability in cable cars traveling with open windows is remarkably lower than in other enclosed spaces such as aircraft cabins, train cars, offices, classrooms, and dining rooms. Accounting for the typical duration of the stay, the probability of infection during a cable-car ride is lower by two to three orders of magnitude than in the other examples considered (the highest risk being estimated in case of a private gathering in a poorly ventilated room). For most practical purposes, the infection probability can be approximated by the inhaled viral dose, which provides an upper bound and allows a simple comparison between different indoor situations once the air exchange rate and the occupant number density are known. Our approach and findings are applicable to any indoor space in which the viral transmission is predominately airborne and the air is well mixed.

Evaluation of ventilation, indoor air quality, and probability of viral infection in an outdoor dining enclosure.

In 2020, many cities closed indoor dining to curb rising COVID-19 cases. While restaurants in warmer climates were able to serve outdoors year-round, restaurants in colder climates adopted various solutions to continually operate throughout the colder months, such as the use of single-party outdoor dining enclosures to allow for the continuation of outdoor dining. This study evaluates indoor air quality and the air exchange rate using carbon dioxide as a tracer gas in a dining enclosure (12.03 m3) and models the probability of COVID-19 infection within such an enclosure. The air exchange rates were determined during two trials for the following scenarios: (1) door closed, (2) door opened, and (3) door opened intermittently every 15 min for 1 min per opening. The probability of COVID-19 infection was evaluated for each of these scenarios for 1 hr, with occupancy levels of two, four, and six patrons. The Wells-Riley equation was used to predict the probability of infection inside the dining enclosure. The air exchange rates were lowest in the closed-door scenarios (0.29-0.59 ACH), higher in the intermittent scenarios (2.36-2.49 ACH), and highest in the open-door scenarios (3.61 to 33.35 ACH). As the number of subjects inside the enclosure increased, the carbon dioxide accumulation increased in the closed-door and intermittent scenarios. There was no identifiable accumulation of carbon dioxide in the open-door scenario. The probability of infection (assuming one infected person without a mask) was inversely proportional to the airflow rate, and ranged from 0.0002-0.84 in the open-door scenario, 0.0034-0.94 for the intermittent scenarios, and 0.015-1.0 for the closed-door scenarios. The results from this study indicate that under typical use, the indoor air quality inside dining enclosures degrades during occupancy. The probability of patrons and workers inside dining enclosures being infected with COVID-19 is high when dining or serving a party with an infected person.

Ventilation procedures to minimize the airborne transmission of viruses in classrooms.

Reducing the transmission of SARS-CoV-2 through indoor air is the key challenge of the COVID-19 pandemic. Crowded indoor environments, such as schools, represent possible hotspots for virus transmission since the basic non-pharmaceutical mitigation measures applied so far (e.g. social distancing) do not eliminate the airborne transmission mode. There is widespread consensus that improved ventilation is needed to minimize the transmission potential of airborne viruses in schools, whether through mechanical systems or ad-hoc manual airing procedures in naturally ventilated buildings. However, there remains significant uncertainty surrounding exactly what ventilation rates are required, and how to best achieve these targets with limited time and resources. This paper uses a mass balance approach to quantify the ability of both mechanical ventilation and ad-hoc airing procedures to mitigate airborne transmission risk in the classroom environment. For naturally-ventilated classrooms, we propose a novel feedback control strategy using CO2 concentrations to continuously monitor and adjust the airing procedure. Our case studies show how such procedures can be applied in the real world to support the reopening of schools during the pandemic. Our results also show the inadequacy of relying on absolute CO2 concentration thresholds as the sole indicator of airborne transmission risk.

Estimate of the critical exposure time based on 70 confirmed COVID-19 cases.

The transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurs via contact with contaminated surfaces and inhalation of large airborne droplets and aerosols. As growing evidence of airborne SARS-CoV-2 transmission has been reported worldwide, ventilation is an effective method of reducing the infection probability of SARS-CoV-2. This leads to such questions as "What is a sufficient ventilation rate for avoiding the risk of COVID-19 infection?" Therefore, this study evaluates the critical ventilation rates according to room size and exposure time when a susceptible person is in the same room as an infector. The analytical results were based on data obtained from 70 confirmed COVID-19 cases transmitted in confined spaces without an operational ventilation system. The results reveal that even with active ventilation (20 h-1 air exchange rate), the critical exposure time for a susceptible person with a COVID-19 infector in a small space of 20 m3 is less than 1 h. For other cases (different space sizes), the estimated air exchange rates for avoiding the risk of infection are generally higher than various requirements for good indoor air quality. The findings of this study will provide guidelines for determining sufficient ventilation rates to protect against the highly contagious COVID-19.

Relationships between home ventilation rates and respiratory health in the Colorado Home Energy Efficiency and Respiratory Health (CHEER) study.

BACKGROUND: As societies adopt green building practices to reduce energy expenditures and emissions that contribute to climate change, it is important to consider how such building design changes influence health. These practices typically focus on reducing air exchange rates between the building interior and the outdoor environment to minimize energy loss, the health effects of which are not well characterized. This study aims to evaluate the relationship between air exchange rates and respiratory health in a multi-ethnic population living in low-income, urban homes. METHODS: The Colorado Home Energy Efficiency and Respiratory Health (CHEER) study is a cross-sectional study that enrolled 302 people in 216 non-smoking, low-income single-family homes, duplexes and town-homes from Colorado's Northern Front Range. A blower door test was conducted and the annual average air exchange rate (AAER) was estimated for each home. Respiratory health was assessed using a structured questionnaire based on standard instruments. We estimated the association between AAER and respiratory symptoms, adjusting for relevant confounders. RESULTS: Air exchange rates in many homes were high compared to prior studies (median 0.54 air changes per hour, range 0.10, 2.17). Residents in homes with higher AAER were more likely to report chronic cough, asthma and asthma-like symptoms, including taking medication for wheeze, wheeze that limited activities and dry cough at night. Allergic symptoms were not associated with AAER in any models. The association between AAER and asthma-like symptoms was stronger for households located in areas with high potential exposure to traffic related pollutants, but this was not consistent across all health outcomes. CONCLUSIONS: While prior studies have highlighted the potential hazards of low ventilation rates in residences, this study suggests high ventilation rates in single-family homes, duplexes and town-homes in urban areas may also have negative impacts on respiratory health, possibly due to the infiltration of outdoor pollutants.

Impact of constructional energy-saving measures on radon levels indoors.

Energy-efficient building refurbishment has the aim of saving energy and thus reducing CO2 emissions. Increased energy efficiency of a building often implies reduced air exchange. Together with other indoor air quality problems, this may lead to an increase in indoor radon concentration (Rn-222). In order to investigate the extent of this problem, measurements of radon concentration in energy-efficient refurbished and low-energy houses (passive houses) were carried out. Track etch detectors were exposed in each type of building over a period of 1 year. A reference sample of non-refurbished non-passive buildings was drawn from the National Radon Database for comparison. Buildings were selected that have the same radon relevant properties and were built on comparable geological subsoil like those investigated. The reference sample was compiled in such a way that the measured values from the rooms on the ground floor of the refurbished and passive houses were each assigned a measured value from the database. The statistical analysis shows that the houses refurbished for energy efficiency have a wider distribution of radon concentrations indoors than the non-refurbished ones. Both the mean value and the median of the radon concentration have nearly doubled in buildings refurbished for energy efficiency. The difference is statistically significant. On the other hand, there is no significant difference between the distributions of passive houses and houses not refurbished for energy efficiency.

Indoor ozone/human chemistry and ventilation strategies.

This study aimed to better understand and quantify the influence of ventilation strategies on occupant-related indoor air chemistry. The oxidation of human skin oil constituents was studied in a continuously ventilated climate chamber at two air exchange rates (1 h-1 and 3 h-1 ) and two initial ozone mixing ratios (30 and 60 ppb). Additional measurements were performed to investigate the effect of intermittent ventilation ("off" followed by "on"). Soiled t-shirts were used to simulate the presence of occupants. A time-of-flight-chemical ionization mass spectrometer (ToF-CIMS) in positive mode using protonated water clusters was used to measure the oxygenated reaction products geranyl acetone, 6-methyl-5-hepten-2-one (6-MHO) and 4-oxopentanal (4-OPA). The measurement data were used in a series of mass balance models accounting for formation and removal processes. Reactions of ozone with squalene occurring on the surface of the t-shirts are mass transport limited; ventilation rate has only a small effect on this surface chemistry. Ozone-squalene reactions on the t-shirts produced gas-phase geranyl acetone, which was subsequently removed almost equally by ventilation and further reaction with ozone. About 70% of gas-phase 6-MHO was produced in surface reactions on the t-shirts, the remainder in secondary gas-phase reactions of ozone with geranyl acetone. 6-MHO was primarily removed by ventilation, while further reaction with ozone was responsible for about a third of its removal. 4-OPA was formed primarily on the surfaces of the shirts (~60%); gas-phase reactions of ozone with geranyl acetone and 6-MHO accounted for ~30% and ~10%, respectively. 4-OPA was removed entirely by ventilation. The results from the intermittent ventilation scenarios showed delayed formation of the reaction products and lower product concentrations compared to continuous ventilation.

Indoor air quality in energy-efficient dwellings: Levels and sources of pollutants.

Worldwide, public policies are promoting energy-efficient buildings and accelerating the thermal renovation of existing buildings. The effects of these changes on the indoor air quality (IAQ) in these buildings remain insufficiently understood. In this context, a field study was conducted in 72 energy-efficient dwellings to describe the pollutants known to be associated with health concerns. Measured parameters included the concentrations of 19 volatile organic compounds and aldehydes, nitrogen dioxide, particulate matter (PM2.5 ), radon, temperature, and relative humidity. The air stuffiness index and night-time air exchange rate were calculated from the monitored carbon dioxide (CO2 ) concentrations. Indoor and outdoor measurements were performed at each dwelling during 1 week in each of the two following seasons: heating and non-heating. Moreover, questionnaires were completed by the occupants to characterize the building, equipment, household, and occupants' habits. Perspective on our results was provided by previous measurements made in low-energy European dwellings. Statistical comparisons with the French housing stock and a pilot study showed higher concentrations of terpenes, that is, alpha-pinene and limonene, and hexaldehyde in our study than in previous studies. Alpha-pinene and hexaldehyde are emitted by wood or wood-based products used for the construction, insulation, decoration, and furnishings of the dwellings, whereas limonene is more associated with discontinuous sources related to human activities.

Indoor particle dynamics in a school office: determination of particle concentrations, deposition rates and penetration factors under naturally ventilated conditions.

Recently, the problem of indoor particulate matter pollution has received much attention. An increasing number of epidemiological studies show that the concentration of atmospheric particulate matter has a significant effect on human health, even at very low concentrations. Most of these investigations have relied upon outdoor particle concentrations as surrogates of human exposures. However, considering that the concentration distribution of the indoor particulate matter is largely dependent on the extent to which these particles penetrate the building and on the degree of suspension in the indoor air, human exposures to particles of outdoor origin may not be equal to outdoor particle concentration levels. Therefore, it is critical to understand the relationship between the particle concentrations found outdoors and those found in indoor micro-environments. In this study, experiments were conducted using a naturally ventilated office located in Qingdao, China. The indoor and outdoor particle concentrations were measured at the same time using an optical counter with four size ranges. The particle size distribution ranged from 0.3 to 2.5 µm, and the experimental period was from April to September, 2016. Based on the experimental data, the dynamic and mass balance model based on time was used to estimate the penetration rate and deposition rate at air exchange rates of 0.03-0.25 h-1. The values of the penetration rate and deposition velocity of indoor particles were determined to range from 0.45 to 0.82 h-1 and 1.71 to 2.82 m/h, respectively. In addition, the particulate pollution exposure in the indoor environment was analyzed to estimate the exposure hazard from indoor particulate matter pollution, which is important for human exposure to particles and associated health effects. The conclusions from this study can serve to provide a better understanding the dynamics and behaviors of airborne particle entering into buildings. And they will also highlight effective methods to reduce exposure to particles in office buildings.

Small, Smart, Fast, and Cheap: Microchip-Based Sensors to Estimate Air Pollution Exposures in Rural Households.

Over the last 20 years, the Kirk R. Smith research group at the University of California Berkeley-in collaboration with Electronically Monitored Ecosystems, Berkeley Air Monitoring Group, and other academic institutions-has developed a suite of relatively inexpensive, rugged, battery-operated, microchip-based devices to quantify parameters related to household air pollution. These devices include two generations of particle monitors; data-logging temperature sensors to assess time of use of household energy devices; a time-activity monitoring system using ultrasound; and a CO2-based tracer-decay system to assess ventilation rates. Development of each system involved numerous iterations of custom hardware, software, and data processing and visualization routines along with both lab and field validation. The devices have been used in hundreds of studies globally and have greatly enhanced our understanding of heterogeneous household air pollution (HAP) concentrations and exposures and factors influencing them.

Impacts of Changes of Indoor Air Pressure and Air Exchange Rate in Vapor Intrusion Scenarios.

There has, in recent years, been increasing interest in understanding the transport processes of relevance in vapor intrusion of volatile organic compounds (VOCs) into buildings on contaminated sites. These studies have included fate and transport modeling. Most such models have simplified the prediction of indoor air contaminant vapor concentrations by employing a steady state assumption, which often results in difficulties in reconciling these results with field measurements. This paper focuses on two major factors that may be subject to significant transients in vapor intrusion situations, including the indoor air pressure and the air exchange rate in the subject building. A three-dimensional finite element model was employed with consideration of daily and seasonal variations in these factors. From the results, the variations of indoor air pressure and air exchange rate are seen to contribute to significant variations in indoor air contaminant vapor concentrations. Depending upon the assumptions regarding the variations in these parameters, the results are only sometimes consistent with the reports of several orders of magnitude in indoor air concentration variations from field studies. The results point to the need to examine more carefully the interplay of these factors in order to quantitatively understand the variations in potential indoor air exposures.

Air exchange rates and migration of VOCs in basements and residences.

UNLABELLED: Basements can influence indoor air quality by affecting air exchange rates (AERs) and by the presence of emission sources of volatile organic compounds (VOCs) and other pollutants. We characterized VOC levels, AERs, and interzonal flows between basements and occupied spaces in 74 residences in Detroit, Michigan. Flows were measured using a steady-state multitracer system, and 7-day VOC measurements were collected using passive samplers in both living areas and basements. A walk-through survey/inspection was conducted in each residence. AERs in residences and basements averaged 0.51 and 1.52/h, respectively, and had strong and opposite seasonal trends, for example, AERs were highest in residences during the summer, and highest in basements during the winter. Airflows from basements to occupied spaces also varied seasonally. VOC concentration distributions were right-skewed, for example, 90th percentile benzene, toluene, naphthalene, and limonene concentrations were 4.0, 19.1, 20.3, and 51.0 µg/m(3), respectively; maximum concentrations were 54, 888, 1117, and 134 µg/m(3). Identified VOC sources in basements included solvents, household cleaners, air fresheners, smoking, and gasoline-powered equipment. The number and type of potential VOC sources found in basements are significant and problematic, and may warrant advisories regarding the storage and use of potentially strong VOCs sources in basements. PRACTICAL IMPLICATIONS: Few IAQ studies have examined basements. A sizable volume of air can flow between the basement and living area, and AERs in these two zones can differ considerably. In many residences, the basement contains significant emission sources and contributes a large fraction of VOC concentrations found in the living area. Exposures can be lowered by removing VOC sources from the basement; other exposure management options, such as local ventilation or isolation, are unlikely to be practical.

Air exchange rates from atmospheric CO2 daily cycle.

We propose a new approach for measuring ventilation air exchange rates (AERs). The method belongs to the class of tracer gas techniques, but is formulated in the light of systems theory and signal processing. Unlike conventional CO2 based methods that assume the outdoor ambient CO2 concentration is constant, the proposed method recognizes that photosynthesis and respiration cycle of plants and processes associated with fuel combustion produce daily, quasi-periodic, variations in the ambient CO2 concentrations. These daily variations, which are within the detection range of existing monitoring equipment, are utilized for estimating ventilation rates without the need of a source of CO2 in the building. Using a naturally-ventilated residential apartment, AERs obtained using the new method compared favorably (within 10%) to those obtained using the conventional CO2 decay fitting technique. The new method has the advantages that no tracer gas injection is needed, and high time resolution results are obtained.

Comparison of airborne bacteria and fungi in different built environments in selected cities in five climate zones of China.

Bioaerosols in different built environments and climate zones have unique effects on occupant health, which demands comparisons of their characteristics to make targeted control measures. This study investigated bioaerosol distribution in five different climate zones across China with four building types (n = 686 rooms). The results showed significant disparities in bioaerosol concentrations among various buildings and climate zones. The bacterial concentrations in residences (536 ± 647 CFU/m3) were significantly higher than in schools, offices, and hospitals owing to different built environments and human activities. The highest mean value of fungal concentration was found in schools (826 ± 955 CFU/m3) due to their greater landscaping area. The bacterial concentrations in the cold zone (307 ± 506 CFU/m3) and the hot summer and cold winter zone (214 ± 180 CFU/m3) were significantly lower than in the other three climate zones. The fungal concentrations in the severe cold zone (709 ± 900 CFU/m3) and the hot summer and warm winter zone (1094 ± 832 CFU/m3) were significantly higher than in the other three climate zones; the lower the indoor temperature (T) and the higher the air exchange rate, the lower the indoor airborne bacterial concentration; the lower the relative humidity (RH), the lower the indoor airborne fungi. In addition, a higher air exchange rate could also reduce the effect of occupant density on indoor bacterial concentration. The results of this study provide valuable data on bioaerosol profiles in various built environments and climate zones and highlight the significance of T, RH, and air exchange rate on indoor bioaerosol concentrations.

Comparison of the rate of certain trace metals accumulation in indoor plants for smoking and non-smoking areas.

Tobacco smoke causes to release severe toxic metals into the environment. It is recognized as the most significant issue in indoor air quality. Pollution and toxic substances in smoke quickly spread and penetrate the indoor environment. Environmental tobacco smoke is responsible for lowering indoor air quality. There is much evidence that poor air quality occurs with inadequate ventilation conditions in indoor environments. The plants have been observed to absorb the smoke in the environment into their own body like a sponge. The plant species in this study can be used easily in almost every office, home, or other indoor areas. Using indoor plants is very beneficial in biomonitoring and absorbing these trace metals. Some indoor plants have shown successful performance as biomonitors for health-damaging pollutants. The study aims to determine the concentration of three trace metals (Cu, Co, and Ni) using five indoor ornamentals frequently used in smoking areas, namely D. amoena, D. marginata, F. elastica, S. wallisii, and Y. massengena. The Ni uptake and its accumulation in S. wallisii, and Y. massengena increased in correlation with smoke areas. However, the rate of accumulation of Co and Cu was found to be independent due to consideration of the environmental emissions. Consequently, our results suggest that F. elastica is more resistant to smoking, whereas S. wallisii would be a better choice as a biomonitoring plant of tobacco smoke.

Assessment of SARS-CoV-2 airborne infection transmission risk in public buses.

Public transport environments are thought to play a key role in the spread of SARS-CoV-2 worldwide. Indeed, high crowding indexes (i.e. high numbers of people relative to the vehicle size), inadequate clean air supply, and frequent extended exposure durations make transport environments potential hotspots for transmission of respiratory infections. During the COVID-19 pandemic, generic mitigation measures (e.g. physical distancing) have been applied without also considering the airborne transmission route. This is due to the lack of quantified data about airborne contagion risk in transport environments. In this study, we apply a novel combination of close proximity and room-scale risk assessment approaches for people sharing public transport environments to predict their contagion risk due to SARS-CoV-2 respiratory infection. In particular, the individual infection risk of susceptible subjects and the transmissibility of SARS-CoV-2 (expressed through the reproduction number) are evaluated for two types of buses, differing in terms of exposure time and crowding index: urban and long-distance buses. Infection risk and reproduction number are calculated for different scenarios as a function of the ventilation rates (both measured and estimated according to standards), crowding indexes, and travel times. The results show that for urban buses, the close proximity contribution significantly affects the maximum occupancy to maintain a reproductive number of <1. In particular, full occupancy of the bus would be permitted only for an infected subject breathing, whereas for an infected subject speaking, masking would be required. For long-distance buses, full occupancy of the bus can be maintained only if specific mitigation solutions are simultaneously applied. For example, for an infected person speaking for 1 h, appropriate filtration of the recirculated air and simultaneous use of FFP2 masks would permit full occupancy of the bus for a period of almost 8 h. Otherwise, a high percentage of immunized persons (>80%) would be needed.

Air exchange rate and pollutant dispersion inside compact urban street canyons with combined wind and thermal driven natural ventilations: Effects of non-uniform building heights and unstable thermal stratifications.

In the present work, a delicate CFD research of a multi-street canyon model with varying thermal stratifications and non-uniformities of buildings was conducted to investigate the street ventilation and pollutant dispersion between the compact urban blocks. Non-isothermal turbulent wind flow, temperature field and pollutant dispersion in a two-dimensional computational domain were solved by the Renormalization Group (RNG) k-ε turbulence model along with the enhanced wall treatment. Present numerical results indicated that the variation of ground heating intensity has a significant influence on the airflow pattern in the step-down case, and the distribution of pollutants in the street canyons mainly depends on the variation of the upper clockwise vortex. The canyon ventilation performance became better as the unstable thermal stratification strengthened. Similarly, the increase of ground heating intensity could reduce ADF (atmospheric dispersion factor) in the step-down case and ADF became the lowest when Ri = -3.92 was maintained. Additionally, the increase of building unevenness further complicated the canyon airflow structure, which aggravated the pollution of the canyon. In the step-down configuration, as the standard deviation of adjacent building height gradually increases, canyon ventilation could be further enhanced. For the step-up configuration, the best ventilation performance was found at σH = 16.7 %. ADF of adjacent canyons also varied greatly. When σH = 33.3 % was maintained, the peak and bottom values of ADF were discovered in the step-up and step-down cases, respectively. Present research has provided a theoretical reference for guiding urban design and improve living environment in modern compact cities.