Respiratory aerosol particle emission and simulated infection risk is greater during indoor endurance than resistance exercise.

Pathogens such as severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), influenza, and rhinoviruses are transmitted by airborne aerosol respiratory particles that are exhaled by infectious subjects. We have previously reported that the emission of aerosol particles increases on average 132-fold from rest to maximal endurance exercise. The aims of this study are to first measure aerosol particle emission during an isokinetic resistance exercise at 80% of the maximal voluntary contraction until exhaustion, second to compare aerosol particle emission during a typical spinning class session versus a three-set resistance training session. Finally, we then used this data to calculate the risk of infection during endurance and resistance exercise sessions with different mitigation strategies. During a set of isokinetic resistance exercise, aerosol particle emission increased 10-fold from 5,400 ± 1,200 particles/min at rest to 59,000 ± 69,900 particles/min during a set of resistance exercise. We found that aerosol particle emission per minute is on average 4.9-times lower during a resistance training session than during a spinning class. Using this data, we determined that the simulated infection risk increase during an endurance exercise session was sixfold higher than during a resistance exercise session when assuming one infected participant in the class. Collectively, this data helps to select mitigation measures for indoor resistance and endurance exercise classes at times where the risk of aerosol-transmitted infectious disease with severe outcomes is high.

Coronavirus Disease 2019 and Airborne Transmission: Science Rejected, Lives Lost. Can Society Do Better?

This is an account that should be heard of an important struggle: the struggle of a large group of experts who came together at the beginning of the COVID-19 pandemic to warn the world about the risk of airborne transmission and the consequences of ignoring it. We alerted the World Health Organization about the potential significance of the airborne transmission of SARS-CoV-2 and the urgent need to control it, but our concerns were dismissed. Here we describe how this happened and the consequences. We hope that by reporting this story we can raise awareness of the importance of interdisciplinary collaboration and the need to be open to new evidence, and to prevent it from happening again. Acknowledgement of an issue, and the emergence of new evidence related to it, is the first necessary step towards finding effective mitigation solutions.

Risk of SARS-CoV-2 in a car cabin assessed through 3D CFD simulations.

In this study, the risk of infection from SARS-CoV-2 Delta variant of passengers sharing a car cabin with an infected subject for a 30-min journey is estimated through an integrated approach combining a recently developed predictive emission-to-risk approach and a validated CFD numerical model numerically solved using the open-source OpenFOAM software. Different scenarios were investigated to evaluate the effect of the infected subject position within the car cabin, the airflow rate of the HVAC system, the HVAC ventilation mode, and the expiratory activity (breathing vs. speaking). The numerical simulations here performed reveal that the risk of infection is strongly influenced by several key parameters: As an example, under the same ventilation mode and emitting scenario, the risk of infection ranges from zero to roughly 50% as a function of the HVAC flow rate. The results obtained also demonstrate that (i) simplified zero-dimensional approaches limit proper evaluation of the risk in such confined spaces, conversely, (ii) CFD approaches are needed to investigate the complex fluid dynamics in similar indoor environments, and, thus, (iii) the risk of infection in indoor environments characterized by fixed seats can be in principle controlled by properly designing the flow patterns of the environment.

Human exposure to aerosol from indoor gas stove cooking and the resulting nervous system responses.

Our knowledge of the effects of exposure to indoor ultrafine particles (sub-100 nm, #/cm3 ) on human brain activity is very limited. The effects of cooking ultrafine particles (UFP) on healthy adults were assessed using an electroencephalograph (EEGs) for brain response. Peak ultrafine particle concentrations were approximately 3 × 105 particle/cm3, and the average level was 1.64 × 105 particle/cm3 . The average particle number emission rate (S) and the average number decay rate (a+k) for chicken frying in brain experiments were calculated to be 2.82 × 1012 (SD = 1.83 × 1012 , R2  = 0.91, p = 0.0013) particles/min, 0.47 (SD = 0.30, R2  = 0.90, p < 0.0001) min-1 , respectively. EEGs were recorded before and during cooking (14 min) and 30 min after the cooking sessions. The brain fast-wave band (beta) decreased during exposure, similar to people with neurodegenerative diseases. It subsequently increased to its pre-exposure condition for 70% of the study participants after 30 min. The brain slow-wave band to fast-wave band ratio (theta/beta ratio) increased during and after exposure, similar to observed behavior in early-stage Alzheimer's disease (AD) patients. The brain then tended to return to its normal condition within 30 min following the exposure. This study suggests that chronically exposed people to high concentrations of cooking aerosol might progress toward AD.

What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic?

The question of whether SARS-CoV-2 is mainly transmitted by droplets or aerosols has been highly controversial. We sought to explain this controversy through a historical analysis of transmission research in other diseases. For most of human history, the dominant paradigm was that many diseases were carried by the air, often over long distances and in a phantasmagorical way. This miasmatic paradigm was challenged in the mid to late 19th century with the rise of germ theory, and as diseases such as cholera, puerperal fever, and malaria were found to actually transmit in other ways. Motivated by his views on the importance of contact/droplet infection, and the resistance he encountered from the remaining influence of miasma theory, prominent public health official Charles Chapin in 1910 helped initiate a successful paradigm shift, deeming airborne transmission most unlikely. This new paradigm became dominant. However, the lack of understanding of aerosols led to systematic errors in the interpretation of research evidence on transmission pathways. For the next five decades, airborne transmission was considered of negligible or minor importance for all major respiratory diseases, until a demonstration of airborne transmission of tuberculosis (which had been mistakenly thought to be transmitted by droplets) in 1962. The contact/droplet paradigm remained dominant, and only a few diseases were widely accepted as airborne before COVID-19: those that were clearly transmitted to people not in the same room. The acceleration of interdisciplinary research inspired by the COVID-19 pandemic has shown that airborne transmission is a major mode of transmission for this disease, and is likely to be significant for many respiratory infectious diseases.

Effects of air pollution on health: A mapping review of systematic reviews and meta-analyses.

BACKGROUND: There has been a notable increase in knowledge production on air pollution and human health. OBJECTIVE: To analyze the state of the art on the effects of air pollution on human health through a mapping review of existing systematic reviews and meta-analyses (SRs and MAs). METHODS: The systematic mapping review was based on the recommendations for this type of scientific approach in environmental sciences. The search was performed using PubMed, Web of Science, Scopus, Cinahl, and Cochrane Library databases, from their inception through June 2020. RESULTS: Among 3401 studies screened, 240 SRs and MAs satisfied the inclusion criteria. Five research questions were answered. There has been an overall progressive increase in publications since 2014. The majority of the SRs and MAs were carried out by researchers from institutions in China, the US, the UK, and Italy. Most studies performed a meta-analysis (161). In general, the reviews support the association of air pollution and health outcomes, and analyzed the effects of outdoor air pollution. The most commonly investigated health outcome type was the respiratory (mainly asthma and COPD), followed by cardiovascular outcomes (mainly stroke). Particulate matter (with a diameter of 2.5 µm (PM2.5) and 10 µm (PM10) or less) and nitrogen dioxide (NO2) were the most widely investigated pollutants in the reviews. The general population was the most common sample in the reviews, followed by children, and adults. The majority of the reviews investigated health outcomes of respiratory diseases in children, as well as cardiovascular diseases in all ages. Combining health outcomes and air pollutants, PM2.5 was included in a higher number of reviews in eight health outcomes, mainly cardiovascular diseases. DISCUSSION: The majority of SRs and MAs showed that air pollution has harmful effects on health, with a focus on respiratory and cardiovascular outcomes. Future studies should extend the analysis to psychological and social aspects influenced by air pollution.

Ultrafine particle emission from floor cleaning products.

The new particle formation due to the use of cleaning products containing volatile organic compounds (VOCs) in indoor environments is well documented in the scientific literature. Indeed, the physical-chemical process occurring in particle nucleation due to VOC-ozone reactions was deepened as well as the effect of the main influencing parameters (ie, temperature, ozone). Nonetheless, proper quantification of the emission under actual meteo-climatic conditions and ozone concentrations is not available. To this end, in the present paper the emission factors of newly generated ultrafine particles due to the use of different floor cleaning products under actual temperature and relative humidity conditions and ozone concentrations typical of the summer periods were evaluated. Tests in a chamber and in an actual indoor environment were performed measuring continuously particle number concentrations and size distributions during cleaning activities. The tests revealed that a significant particle emission in the nucleation mode was present for half of the products under investigation with emission factors up to 1.1 × 1011 part./m2 (8.8 × 1010 part./mLproduct ), then leading to an overall particle emission comparable to other well-known indoor sources when cleaning wide surfaces.

Transmission of SARS-CoV-2 by inhalation of respiratory aerosol in the Skagit Valley Chorale superspreading event.

During the 2020 COVID-19 pandemic, an outbreak occurred following attendance of a symptomatic index case at a weekly rehearsal on 10 March of the Skagit Valley Chorale (SVC). After that rehearsal, 53 members of the SVC among 61 in attendance were confirmed or strongly suspected to have contracted COVID-19 and two died. Transmission by the aerosol route is likely; it appears unlikely that either fomite or ballistic droplet transmission could explain a substantial fraction of the cases. It is vital to identify features of cases such as this to better understand the factors that promote superspreading events. Based on a conditional assumption that transmission during this outbreak was dominated by inhalation of respiratory aerosol generated by one index case, we use the available evidence to infer the emission rate of aerosol infectious quanta. We explore how the risk of infection would vary with several influential factors: ventilation rate, duration of event, and deposition onto surfaces. The results indicate a best-estimate emission rate of 970 ± 390 quanta/h. Infection risk would be reduced by a factor of two by increasing the aerosol loss rate to 5 h-1 and shortening the event duration from 2.5 to 1 h.

Vehicle interior air quality conditions when travelling by taxi.

Vehicle interior air quality (VIAQ) was investigated inside 14 diesel/non-diesel taxi pairs operating simultaneously and under normal working conditions over six weekday hours (10.00-16.00) in the city of Barcelona, Spain. Parameters measured included PM10 mass and inorganic chemistry, ultrafine particle number (N) and size, lung surface deposited area (LDSA), black carbon (BC), CO2, CO, and a range of volatile organic compounds (VOCs). Most taxi drivers elected to drive with windows open, thus keeping levels of CO2 and internally-generated VOCs low but exposing them to high levels of traffic-related air pollutants entering from outside and confirming that air exchange rates are the dominant influence on VIAQ. Median values of N and LDSA (both sensitive markers of VIAQ fluctuations and likely health effects) were reduced to around 104 #/cm3 and < 20 µm2/cm3 respectively under closed conditions, but more than doubled with windows open and sometimes approached 105 #/cm3 and 240 µm2/cm3. In exceptional traffic conditions, transient pollution peaks caused by outside infiltration exceeded N = 106 #/cm3 and LDSA= 1000 µm2/cm3. Indications of self-pollution were implicated by higher BC and CO levels, and larger UFP sizes, measured inside diesel taxis as compared to their non-diesel pair, and the highest concentrations of CO (>2 ppm) were commonly associated with older, high-km diesel taxis. Median PM10 concentrations (67 µg/m3) were treble those of urban background, mainly due to increased levels of organic and elemental carbon, with source apportionment calculations identifying the main pollutants as vehicle exhaust and non-exhaust particles. Enhancements in PM10 concentrations of Cr, Cu, Sn, Sb, and a "High Field Strength Element" zircon-related group characterised by Zr, Hf, Nb, Y and U, are attributed mainly to the presence of brake-derived PM. Volatile organic compounds display a mixture which reflects the complexity of traffic-related organic carbon emissions infiltrating the taxi interior, with 2-methylbutane and n-pentane being the most abundant VOCs, followed by toluene, m-xylene, o-xylene, 1,2,4-trimethylbenzene, ethylbenzene, p-xylene, benzene, and 1,3,5-trimethylbenzene. Internally sourced VOCs included high monoterpene concentrations from an air freshener, and interior off-gassing may explain why the youngest taxi registered the highest content of alkanes and aromatic compounds. Carbon dioxide concentrations quickly climbed to undesirable levels (>2500 ppm) under closed ventilation conditions and could stay high for much of the working day. Taxi drivers face daily occupational exposure to traffic-related air pollutants and would benefit from a greater awareness of VIAQ issues, notably the use of ventilation, to encourage them to minimise possible health effects caused by their working environment.

Characterization of Hairdresser Exposure to Airborne Particles during Hair Bleaching.

Respiratory symptoms among hairdressers are often ascribed to the use of bleaching powders that contain persulfate salts. Such salts can act as allergens and airway irritants but the mechanisms behind the negative health effects are not fully known. In order to understand why some hairdressers experience respiratory symptoms during, and after, sessions of hair bleaching, it is of importance to characterize how exposure occurs. In this work we used time and particle size resolved instrumentation with the aim to measure the concentration of particles that hairdressers are exposed to during sessions of hair bleaching. We also used filter samples to collect particles for quantitative determination of persulfate (S2O8(2-)) content and for analysis by light microscopy. Two different types of bleaching powders were used, one marked as dust-free and one without this marking (denoted regular). The time resolved instrumentation revealed that particles <10 µm were emitted, specifically when the regular powder was prepared and mixed with hydrogen peroxide. In contrast to other research our work also revealed that supercoarse particles (>10 µm) were emitted during application of the bleaching, when both the regular and the dust-free powders were used. The measured level of persulfate, sampled in the breathing zone of the hairdressers, was on average 26 µg m(-3) when the regular powder was used and 11 µg m(-3) when the dust-free powder was used. This indicates that use of dust-free powder does not eliminate exposure to persulfates, it only lowers the concentration. We show that the site of sampling, or position of the hairdresser with regards to the hair being bleached, is of high importance in the determination of persulfate levels and exposure. This work focuses on the physical and chemical characterization of the particles released to the air and the results are important for accurate exposure assessments. Accurate assessments may in turn lead to a better understanding of why some hairdressers experience respiratory symptoms from hair bleaching sessions.

Children's personal exposure to air pollution in rural villages in Bhutan.

Exposure assessment studies conducted in developing countries have been based on fixed-site monitoring to date. This is a major deficiency, leading to errors in estimating the actual exposures, which are a function of time spent and pollutant concentrations in different microenvironments. This study quantified school children's daily personal exposure to ultrafine particles (UFP) using real-time monitoring, as well as volatile organic compounds (VOCs) and NO2 using passive sampling in rural Bhutan in order to determine the factors driving the exposures. An activity diary was used to track children's time activity patterns, and difference in mean exposure levels across sex and indoor/outdoor were investigated with ANOVA. 82 children, attending three primary schools participated in this study; S1 and S2 during the wet season and S3 during the dry season. Mean daily UFP exposure (cm(-3)) was 1.08×10(4) for children attending S1, 9.81×10(3) for S2, and 4.19×10(4) for S3. The mean daily NO2 exposure (µg m(-3)) was 4.27 for S1, 3.33 for S2 and 5.38 for S3 children. Likewise, children attending S3 also experienced higher daily exposure to a majority of the VOCs than those attending S1 and S2. Time-series of UFP personal exposures provided detailed information on identifying sources of these particles and quantifying their contributions to the total daily exposures for each microenvironment. The highest UFP exposure resulted from cooking/eating, contributing to 64% of the daily exposure, due to firewood combustion in houses using traditional mud cookstoves. The lowest UFP exposures were during the hours that children spent outdoors at school. The outcomes of this study highlight the significant contributions of lifestyle and socio-economic factors in personal exposures and have applications in environmental risk assessment and household air pollution mitigation in Bhutan.

Urban air quality comparison for bus, tram, subway and pedestrian commutes in Barcelona.

Access to detailed comparisons in air quality variations encountered when commuting through a city offers the urban traveller more informed choice on how to minimise personal exposure to inhalable pollutants. In this study we report on an experiment designed to compare atmospheric contaminants inhaled during bus, subway train, tram and walking journeys through the city of Barcelona. Average number concentrations of particles 10-300 nm in size, N, are lowest in the commute using subway trains (N<2.5×10(4) part. cm(-3)), higher during tram travel and suburban walking (2.5×10(4) cm(-3)5.0×10(4) cm(-3)), with extreme transient peaks at busy traffic crossings commonly exceeding 1.0×10(5) cm(-3) and accompanied by peaks in Black Carbon and CO. Subway particles are coarser (mode 90 nm) than in buses, trams or outdoors (<70 nm), and concentrations of fine particulate matter (PM2.5) and Black Carbon are lower in the tram when compared to both bus and subway. CO2 levels in public transport reflect passenger numbers, more than tripling from outdoor levels to >1200 ppm in crowded buses and trains. There are also striking differences in inhalable particle chemistry depending on the route chosen, ranging from aluminosiliceous at roadsides and near pavement works, ferruginous with enhanced Mn, Co, Zn, Sr and Ba in the subway environment, and higher levels of Sb and Cu inside the bus. We graphically display such chemical variations using a ternary diagram to emphasise how "air quality" in the city involves a consideration of both physical and chemical parameters, and is not simply a question of measuring particle number or mass.

Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide.

The objective of this study was to compare the short-term respiratory effects due to the inhalation of electronic and conventional tobacco cigarette-generated mainstream aerosols through the measurement of the exhaled nitric oxide (eNO). To this purpose, twenty-five smokers were asked to smoke a conventional cigarette and to vape an electronic cigarette (with and without nicotine), and an electronic cigarette without liquid (control session). Electronic and tobacco cigarette mainstream aerosols were characterized in terms of total particle number concentrations and size distributions. On the basis of the measured total particle number concentrations and size distributions, the average particle doses deposited in alveolar and tracheobronchial regions of the lungs for a single 2-s puff were also estimated considering a subject performing resting (sitting) activity. Total particle number concentrations in the mainstream resulted equal to 3.5±0.4×10(9), 5.1±0.1×10(9), and 3.1±0.6×10(9) part. cm(-3) for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively. The corresponding alveolar doses for a resting subject were estimated equal to 3.8×10(10), 5.2×10(10) and 2.3×10(10) particles. The mean eNO variations measured after each smoking/vaping session were equal to 3.2ppb, 2.7ppb and 2.8ppb for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively; whereas, negligible eNO changes were measured in the control session. Statistical tests performed on eNO data showed statistically significant differences between smoking/vaping sessions and the control session, thus confirming a similar effect on human airways whatever the cigarette smoked/vaped, the nicotine content, and the particle dose received.

School children's personal exposure to ultrafine particles in the urban environment.

There has been considerable scientific interest in personal exposure to ultrafine particles (UFP). In this study, the inhaled particle surface area doses and dose relative intensities in the tracheobronchial and alveolar regions of lungs were calculated using measured 24-h UFP time series of school children personal exposures. Bayesian hierarchical modeling was used to determine mean doses and dose intensities for the various microenvironments. Analysis of measured personal exposures for 137 participating children from 25 schools in the Brisbane Metropolitan Area showed similar trends for all participating children. Bayesian regression modeling was performed to calculate the daily proportion of children's total doses in different microenvironments. The proportion of total daily alveolar doses for home, school, commuting, and other were 55.3%, 35.3%, 4.5%, and 5.0%, respectively, with the home microenvironment contributing a majority of children's total daily dose. Children's mean indoor dose was never higher than the outdoor's at any of the schools, indicating there were no persistent indoor particle sources in the classrooms during the measurements. Outdoor activities, eating/cooking at home, and commuting were the three activities with the highest dose intensities. Children's exposure during school hours was more strongly influenced by urban background particles than traffic near the school.

Metrological assessment of a portable analyzer for monitoring the particle size distribution of ultrafine particles.

Adverse health effects caused by worker exposure to ultrafine particles have been detected in recent years. The scientific community focuses on the assessment of ultrafine aerosols in different microenvironments in order to determine the related worker exposure/dose levels. To this end, particle size distribution measurements have to be taken along with total particle number concentrations. The latter are obtainable through hand-held monitors. A portable particle size distribution analyzer (Nanoscan SMPS 3910, TSI Inc.) was recently commercialized, but so far no metrological assessment has been performed to characterize its performance with respect to well-established laboratory-based instruments such as the scanning mobility particle sizer (SMPS) spectrometer. The present paper compares the aerosol monitoring capability of the Nanoscan SMPS to the laboratory SMPS in order to evaluate whether the Nanoscan SMPS is suitable for field experiments designed to characterize particle exposure in different microenvironments. Tests were performed both in a Marple calm air chamber, where fresh diesel particulate matter and atomized dioctyl phthalate particles were monitored, and in microenvironments, where outdoor, urban, indoor aged, and indoor fresh aerosols were measured. Results show that the Nanoscan SMPS is able to properly measure the particle size distribution for each type of aerosol investigated, but it overestimates the total particle number concentration in the case of fresh aerosols. In particular, the test performed in the Marple chamber showed total concentrations up to twice those measured by the laboratory SMPS-likely because of the inability of the Nanoscan SMPS unipolar charger to properly charge aerosols made up of aggregated particles. Based on these findings, when field test exposure studies are conducted, the Nanoscan SMPS should be used in tandem with a condensation particle counter in order to verify and correct the particle size distribution data.

The relative contributions of traffic and non-traffic sources in ultrafine particle formations in Tehran mega city.

Emissions of ultrafine particles (UFPs; diameter < 100 nm) are strongly associated with traffic-related emissions and are a growing global concern in urban environments. The aim of this study was to investigate the variations of particle number concentration (PNC) with a diameter > 10 nm at nine stations and understand the major sources of UFPs (primary vs. secondary) in Tehran megacity. The study was carried out in Tehran in 2020. NOx and PNC were reported from a total of nine urban site locations in Tehran and BC concentrations were examined at two monitoring stations. Data from all stations showed diurnal changes with peak morning and evening rush hours. The hourly PNC was correlated with NOx. PNCs in Tehran were higher compared to those of many cities reported in the literature. The highest concentrations were at District 19 station (traffic) and the lowest was at Punak station (residential) such that the average PNC varied from 8.4 × 103 to 5.7 × 104 cm-3. In Ray and Sharif stations, the average contributions of primary and secondary sources of PNC were 67 and 33%, respectively. Overall, we conclude that a decrease in primary emission leads to a decrease in the total concentration of aerosols, despite an increase in the formation of new particles by photo nucleation.

Human exposure to aerosol from indoor gas stove cooking and the resulting cardiovascular system responses.

The effect of cooking aerosol on the human heart was investigated in this study. The heart rate and blood pressure of 33 healthy adults were monitored before, exactly after, and two hours post-exposure (30 minutes, 60 minutes, 90 minutes, and 120 minutes after cooking). One hundred twenty grams of ground beef was fried in sunflower oil for twenty minutes using a gas stove without ventilation. Ultrafine particles, indoor temperature, relative humidity, carbon dioxide, oil, and meat temperatures were monitored during the experiment. The average particle emission rate (S) and average decay rate (a+k) for meat frying were found to be 2.09×1013 (SD=3.94 ×1013, R2=0.98, P <0.0001) particles/min, and 0.055 (SD=0.019, R2=0.91, P <0.0001) particles/min, respectively. No statistically significant changes in diastolic blood pressure (DBP) and heart rate (HR) were observed. The average systolic blood pressure (SBP) statistically significantly increased from 98 mmHg (before the exposure) to 106 mmHg 60 minutes after the exposure. The results suggested that frying emission statistically significantly impacted blood pressure.

Mandating indoor air quality for public buildings.

If some countries lead by example, standards may increasingly become normalized.