Quantity and size distribution of cough-generated aerosol particles produced by influenza patients during and after illness.

The question of whether influenza is transmitted to a significant degree by aerosols remains controversial, in part, because little is known about the quantity and size of potentially infectious airborne particles produced by people with influenza. In this study, the size and amount of aerosol particles produced by nine subjects during coughing were measured while they had influenza and after they had recovered, using a laser aerosol particle spectrometer with a size range of 0.35 to 10 µm. Individuals with influenza produce a significantly greater volume of aerosol when ill compared with afterward (p = 0.0143). When the patients had influenza, their average cough aerosol volume was 38.3 picoliters (pL) of particles per cough (SD 43.7); after patients recovered, the average volume was 26.4 pL per cough (SD 45.6). The number of particles produced per cough was also higher when subjects had influenza (average 75,400 particles/cough, SD 97,300) compared with afterward (average 52,200, SD 98,600), although the difference did not reach statistical significance (p = 0.1042). The average number of particles expelled per cough varied widely from patient to patient, ranging from 900 to 302,200 particles/cough while subjects had influenza and 1100 to 308,600 particles/cough after recovery. When the subjects had influenza, an average of 63% of each subject's cough aerosol particle volume in the detection range was in the respirable size fraction (SD 22%), indicating that these particles could reach the alveolar region of the lungs if inhaled by another person. This enhancement in aerosol generation during illness may play an important role in influenza transmission and suggests that a better understanding of this phenomenon is needed to predict the production and dissemination of influenza-laden aerosols by people infected with this virus. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a PDF file of demographic information, influenza test results, and volume and peak flow rate during each cough and a PDF file containing number and size of aerosol particles produced.].

Measurement capability of field portable organic vapor monitoring instruments under different experimental conditions.

The performance of field portable direct-reading organic vapor monitors (DROVMs) was evaluated under a variety of experimental conditions. Four of the DROVMs had photoionization detectors (ppbRAE, IAQRAE, MultiRAE, and Century Toxic Vapor Analyzer), one had a flame ionization detector (Century Toxic Vapor Analyzer), and one was a single-beam infrared spectrophotometer (SapphIRe). Four of each DROVM (two Century Toxic Vapor Analyzers and SapphIRes) were tested. The DROVMs were evaluated at three temperatures (4 degrees C, 21 degrees C, and 38 degrees C), three relative humidities (30%, 60%, and 90%), and two hexane concentrations (5 ppm and 100 ppm). These conditions were selected to provide a range within the operational parameters of all the instruments. At least four replicate trials were performed across the 18 experimental conditions (3 temperatures x 3 relative humidities x 2 concentrations). To evaluate performance, the 4-hr time-weighted average readings from the DROVMs in a given trial were compared with the average of two charcoal tube concentrations using pairwise comparison. The pairwise comparison criterion was +/-25% measurement agreement between each individual DROVM and the DROVMs as a group and the average charcoal tube concentration. The ppbRAE group performed the best with 40% of all readings meeting the comparison criterion followed by the SapphIRe group at 39%. Among individual DROVMs, the best performer was a SapphIRe, with 57% of its readings meeting the criterion. The data was further analyzed by temperature, humidity, and concentration. The results indicated the performance of some DROVMs may be affected by temperature, humidity, and/or concentration. The ppbRAE group performed best at 21 degrees C with the percentage of readings meeting the criterion increasing to 63%. At the 5 ppm concentration, 44% of the ppbRAE group readings met the criterion, while at 100 ppm, only 35% did. The results indicate that monitors can be used as survey tools. Based on the data, the inconsistent performance of these DROVMs may not allow them to be used for determining compliance with occupational exposure limits.