Laser: A boon during the COVID pandemic in aerosol mitigation - A systematic review

The scientific community was always intrigued by the indoor air quality in dental offices. The unexpected emergence of the COVID pandemic has put greater challenges on dental professionals. Shortly after the declaration of coronavirus as a pandemic by the World Health Organization in March 2020, the American Dental Association abstained the dental society from providing routine dental procedures. An evidence-based review of the literature was conducted electronically using three databases, PubMed, Science Direct, and Google Scholar between January 2005 to December 2021. Three articles were selected for the qualitative analysis out of 41 screened articles from the databases. The evidence suggests that there is a significant reduction in aerosol generation with laser when compared to conventional treatment modalities. Laser-assisted treatment procedures bring the dentist and patients a step closer to providing safe dental treatments and reducing the risk of transmission of disease.

Monitoring of indoor bioaerosol for the detection of SARS-CoV-2 in different hospital settings.

Background: Spore Trap is an environmental detection technology, already used in the field of allergology to monitor the presence and composition of potentially inspirable airborne micronic bioparticulate. This device is potentially suitable for environmental monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in hospital, as well as in other high-risk closed environments. The aim of the present study is to investigate the accuracy of the Spore Trap system in detecting SARS-CoV-2 in indoor bioaerosol of hospital rooms. Methods: The Spore Trap was placed in hospital rooms hosting patients with documented SARS-CoV-2 infection (n = 36) or, as a negative control, in rooms where patients with documented negativity to a Real-Time Polymerase Chain Reaction molecular test for SARS-CoV-2 were admitted (n = 10). The monitoring of the bioaerosol was carried on for 24 h. Collected samples were analyzed by real-time polymerase chain reaction. Results: The estimated sensitivity of the Spore Trap device for detecting SARS-CoV-2 in an indoor environment is 69.4% (95% C.I. 54.3-84.4%), with a specificity of 100%. Conclusion: The Spore Trap technology is effective in detecting airborne SARS-CoV-2 virus with excellent specificity and high sensitivity, when compared to previous reports. The SARS-CoV-2 pandemic scenario has suggested that indoor air quality control will be a priority in future public health management and will certainly need to include an environmental bio-investigation protocol.

Multiple Monitoring Stations in Big Cities: First Example of Three Spore Traps in Rome

(1) Background: Rome is a municipality with an area of 1287 km2 and presents floristic-vegetational complexity that is reflected in the composition of aerospora, which are responsible for pollinosis. The presence of airborne pollen can be detected by pollen monitoring. The large extent of the city's territory makes it possible to verify possible changes in pollen composition in different sites of the city. With this in mind, a study was conducted to assess the differences in airborne pollen concentration, considering phenological and production indicators at three different sites in the city. (2) Methods: Pollen data of eight taxa were considered, Alnus spp., Castanea sativa Miller, Cupressaceae-Taxaceae, Olea europaea L., Platanaceae, Poaceae, Quercus spp., and Urticaceae, during 2020 and 2021, using three monitoring samplers. The airborne pollen concentration and the seasons of the three centers were calculated and compared with each other. (3) Results: The diversity between the three samplers shows a phenological succession in accordance with the microclimatic diversity present in the city. The heterogeneity of the airborne pollen concentration reflects the floristic-vegetational diversity, while qualitative and quantitative parameters indicate a homogeneous flowering trend reflecting the seasonality of the various species. (4) Conclusions: The present work and the Italian geographic context suggest the need for a greater number of sampling points to guarantee a true localization of the data. Having several sampling stations also contributes to the protection of health and green areas, which are difficult to manage, conserve, and maintain.

Aerosol suppression from a handpiece using viscoelastic solution in confined dental office

Aerosolized droplets are produced en masse in dental practices;these aerosols disperse in the surrounding space, posing a health threat if the patient is infected with a transmittable disease, particularly COVID-19. Here, a viscoelastic polyacrylic acid (PAA) solution was used to minimize liquid aerosolization and limit the travel distance of aerosols. The PAA concentration was varied to evaluate its effect on aerosolization and droplet size resulting from procedures using dental handpieces, which include tooth cutting, grinding, and polishing. In addition, a thermocouple was inserted at the center of the model tooth to measure its temperature during a handpiece operation. The temperature data suggest that the cooling performance of the PAA solution is comparable to that of pure water in operations in the occlusal and facial directions. The PAA solution droplets splattered on the patient's facial area during the handpiece operation are markedly larger than those of pure water, which is evidence of the settling of the PAA droplets, preventing further transmission. Accordingly, the travel distance of the aerosolized PAA droplets was limited by viscoelastic resistance to droplet detachment. This comparison of the aerosol suppression capability between water and PAA solutions confirms the benefit of using viscoelastic solutions for various dental operations. Published under an exclusive license by AIP Publishing.

A review of airborne contaminated microorganisms associated with human diseases

Biological contaminants refer to environmental contamination and food source with living microorganisms such as bacteria, molds, viruses, and fungi, in addition to mites, house dust, and pollen. Temperature, relative humidity, movement of air, and sources of nutrients have influenced the presence and spread of biological contaminants. Numerous living microorganisms can grow independently on each other, such as bacteria and fungi. Viruses (a small obligate parasite) depend on other living organisms for their development and for performing vital functions. Indoor air can contaminate with biological contaminants by a different status, including living, dead, or debris of the dead microorganisms which were transported through ventilation systems, when the microorganism components dissolve in water. They become aerosolized when the contaminants are physically disturbed, like in renovation or construction, and when the contaminants discharge harmful gases into the indoor environment. Most studies conducted in recent years agree that air pollution rates are increasing, bringing more risks to human health, as pollution is related to the risk of heart and lung disease and its effect on children, especially infants and newborns. Also, environmental pollution may have become the most dangerous disaster faced by humans, because it means environment retrogradation in which humans lives as a result of an imbalance within the compatibility of the constituent elements and loses its ability to carry out its natural role in self-removal of contaminants by the natural factors noticeable within air, land, and water. In some cases, many common infections can spread through airborne contaminated microorganisms such as Mycobacterium tuberculosis, measles virus (MV), influenza virus, Morbillivirus, chickenpox virus, norovirus, enterovirus, less commonly coronavirus, adenovirus, and respiratory syncytial virus (RSV). When an infected person coughs, talks, sneezes, has throat secretions, and releases nasal into the air, the airborne infection can spread. Bacteria or viruses spread out noticeably in the air or ground and transport to other persons or surfaces. This review provides the conception of biological contaminants and their properties, nature of the indoor environment, and adverse health effects associated with biological contaminants. © 2022 Medical Journal of Babylon. All rights reserved.

Suppress the aerosol generation from the air turbine handpiece in dental clinics

The COVID-19 pandemic imposes a severe challenge to the health care providers and patients in dental clinics as the dental procedures produce abundant airborne materials. Although dental practices use a multi-layered protective procedure to reduce the potential danger from dental aerosols, it is still beneficial to suppress the aerosol generation from the origin as much as possible. Reducing the aerosol generation (especially the droplets of smaller diameters) from the very beginning will ease the burden on all subsequent layers of protection. In this work, we first provide a relatively complete picture of the structure of the spray produced by the air turbine handpiece. We found that the spray consists of two domains: one is the canopy shaped centrifugal zone and the other is a dense ballistic spray core. The droplets from the centrifugal zone are much smaller than those of the spray core and, hence, are more prone to stay in the air. The location of the centrifugal zone also makes it more challenging to be contained by the mouth or rubber dam. To suppress the atomization of the centrifugal zone, we used the food-additive carboxymethylcellulose sodium (CMC-Na) water solutions of different concentrations. The data show that the viscoelastic property of the 0.5 wt. % CMC-Na water solution can effectively suppress the aerosol generation of the centrifugal zone. (C) 2022 Author(s).

Aerosol Test Chambers: Current State and Practice During the COVID-19 Pandemic.

Respiratory infectious disease outbreaks such as those caused by coronaviruses and influenza, necessitate the use of specialized aerosol test chambers to study aspects of these causative agents including detection, efficacy of countermeasures, and aerosol survivability. The anthrax attacks from 2001 and earlier biowarfare and biodefense also influenced the study of biological aerosols to learn about how certain pathogens transmit either naturally or through artificial means. Some high containment biological laboratories, which work with Risk Group 3 and 4 agents in biosafety level -3, biosafety level-4 containment, are equipped with aerosol test chambers to enable the study of high-risk organisms in aerosolized form. Consequently, the biomedical, military and environmental sectors have specific applications when studying bioaerosols which may overlap while being different. There are countless aerosol test chambers worldwide and this number along with numerous high containment biological laboratories underscores the need for technical standards, regulatory and dual-use compliance. Here we survey common aerosol test chambers and their history, current use, and practice. Our findings reinforce the importance and need for continued collaboration among the multi-disciplinary fields studying aerobiology and biological aerosols.

Bioaerosols and airborne transmission: Integrating biological complexity into our perspective.

There is broad consensus that airborne disease transmission continues to be the thematic focus of COVID-19, the complexities and understanding of which continues to complicate our attempts to control this pandemic. Masking used as both personal protection and source reduction predominates our society at present and, other than vaccination, remains the public health measure that will faithfully reduce aerosol transmission and overall disease burden (Gandhi and Marr, 2021). Early in the advent of the COVID-19 pandemic, and especially after preliminary recognition of airborne transmission, there was considerable efforts in the application of computational fluid dynamics (CFD) modeling aerosols as well as risk models calculations, the products of which were detailed in the literature (Morawska et al., 2020; Buonanno et al., 2020a) and even disseminated in media destined for the public. As the respiratory pathway emerged as the dominant exposure pathway for SARSCoV-2 transmission, much of what was promoted from CFD was applied to risk models to estimate community infection and in some cases expected clinical outcome. COVID-19 proved to fit the profile of an obligate respiratory-transmitted pathogen, and the plausibility of using aerosol modeling when silhouetted with emerging COVID-19 epidemiology provided ample evidence for promotion of masking and ventilation optimization as a required public health measure. Masking is often included as a factor in developed risk models and it remains an essentially important part of our response to this airborne threat, and ultimately will agnostically reduce disease burden although efforts to improve ventilation in indoor spaces remain a challenge. Arguably the most important concept in the airborne transmission of infectious agents is the biologically active componentry that comprises the aerosol particle and the functional dynamic nature of particle contents. Specifically, the innate generation, transport, and ultimate deposition/disposition of bioaerosols; the aerosol particles that nearly exclusively harbor bioactive components, including viruses, when disease agents are transmitted through the air.

Detecting Airborne Pollen Using an Automatic, Real-Time Monitoring System: Evidence from Two Sites.

Airborne pollen monitoring has been an arduous task, making ecological applications and allergy management virtually disconnected from everyday practice. Over the last decade, intensive research has been conducted worldwide to automate this task and to obtain real-time measurements. The aim of this study was to evaluate such an automated biomonitoring system vs. the conventional 'gold-standard' Hirst-type technique, attempting to assess which may more accurately provide the genuine exposure to airborne pollen. Airborne pollen was monitored in Augsburg since 2015 with two different methods, a novel automatic Bio-Aerosol Analyser, and with the conventional 7-day recording Hirst-type volumetric trap, in two different sites. The reliability, performance, accuracy, and comparability of the BAA500 Pollen Monitor (PoMo) vs. the conventional device were investigated, by use of approximately 2.5 million particles sampled during the study period. The observations made by the automated PoMo showed an average accuracy of approximately 85%. However, it also exhibited reliability problems, with information gaps within the main pollen season of between 17 to 19 days. The PoMo automated algorithm had identification issues, mainly confusing the taxa of Populus, Salix and Tilia. Hirst-type measurements consistently exhibited lower pollen abundances (median of annual pollen integral: 2080), however, seasonal traits were more comparable, with the PoMo pollen season starting slightly later (median: 3 days), peaking later (median: 5 days) but also ending later (median: 14 days). Daily pollen concentrations reported by Hirst-type traps vs. PoMo were significantly, but not closely, correlated (r = 0.53-0.55), even after manual classification. Automatic pollen monitoring has already shown signs of efficiency and accuracy, despite its young age; here it is suggested that automatic pollen monitoring systems may be more effective in capturing a larger proportion of the airborne pollen diversity. Even though reliability issues still exist, we expect that this new generation of automated bioaerosol monitoring will eventually change the aerobiological era, as known for almost 70 years now.

Direct and quantitative capture of viable bacteriophages from experimentally contaminated indoor air: A model for the study of airborne vertebrate viruses including SARS-CoV-2.

AIM: The air indoors has profound health implications as it can expose us to pathogens, allergens and particulates either directly or via contaminated surfaces. There is, therefore, an upsurge in marketing of air decontamination technologies, but with no proper validation of their claims. We addressed the gap through the construction and use of a versatile room-sized (25 m3 ) chamber to study airborne pathogen survival and inactivation. METHODS AND RESULTS: Here, we report on the quantitative recovery and detection of an enveloped (Phi6) and a non-enveloped bacteriophage (MS2). The two phages, respectively, acted as surrogates for airborne human pathogenic enveloped (e.g., influenza, Ebola and coronavirus SARS-CoV-2) and non-enveloped (e.g., norovirus) viruses from indoor air deposited directly on the lawns of their respective host bacteria using a programmable slit-to-agar air sampler. Using this technique, two different devices based on HEPA filtration and UV light were tested for their ability to decontaminate indoor air. This safe, relatively simple and inexpensive procedure augments the use of phages as surrogates for the study of airborne human and animal pathogenic viruses. CONCLUSIONS: This simple, safe and relatively inexpensive method of direct recovery and quantitative detection of viable airborne phage particles can greatly enhance their applicattion as surrogates for the study of vertebrate virus survival in indoor air and assessment of technologies for their decontamination. SIGNIFICANCE AND IMPACT OF THE STUDY: The safe, economical and simple technique reported here can be applied widely to investigate the role of indoor air for virus survival and transmission and also to assess the potential of air decontaminating technologies.

Higher airborne pollen concentrations correlated with increased SARS-CoV-2 infection rates, as evidenced from 31 countries across the globe.

Pollen exposure weakens the immunity against certain seasonal respiratory viruses by diminishing the antiviral interferon response. Here we investigate whether the same applies to the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is sensitive to antiviral interferons, if infection waves coincide with high airborne pollen concentrations. Our original hypothesis was that more airborne pollen would lead to increases in infection rates. To examine this, we performed a cross-sectional and longitudinal data analysis on SARS-CoV-2 infection, airborne pollen, and meteorological factors. Our dataset is the most comprehensive, largest possible worldwide from 130 stations, across 31 countries and five continents. To explicitly investigate the effects of social contact, we additionally considered population density of each study area, as well as lockdown effects, in all possible combinations: without any lockdown, with mixed lockdown-no lockdown regime, and under complete lockdown. We found that airborne pollen, sometimes in synergy with humidity and temperature, explained, on average, 44% of the infection rate variability. Infection rates increased after higher pollen concentrations most frequently during the four previous days. Without lockdown, an increase of pollen abundance by 100 pollen/m3 resulted in a 4% average increase of infection rates. Lockdown halved infection rates under similar pollen concentrations. As there can be no preventive measures against airborne pollen exposure, we suggest wide dissemination of pollen-virus coexposure dire effect information to encourage high-risk individuals to wear particle filter masks during high springtime pollen concentrations.

Unifying atmospheric biology research for the U.S. scientific community.

A global COVID-19 pandemic, rising asthma and allergies, along with climate change impacting storm intensity and frequency, point to an urgent need to unify U.S. atmospheric biology research. To this end, we briefly define atmospheric biology, summarize its fragmented history, and then outline how to unify the field to provide benefits for the U.S. science community and its citizens. Atmospheric biology refers to the study of concentrations, sources, sinks, transformation, and impacts of airborne microorganisms inclusive of pollen, fungal spores, algae, lichens, bacteria, viruses, cellulose fibers, and other biomolecules or fragments of cells. Here our focus is biological particles, both respirable (PM10 ) and systemic (PM2.5 ). Due to its interdisciplinary dependencies and broadness of scales from nanometers to kilometers, atmospheric biology research is highly fragmented in the U.S. science community. It lacks shared paradigms and common vocabulary. This deficit calls for recognizing atmospheric biology as a research community in its own right, thereby linking human health to climate change. We need to recognize atmospheric biology's importance to national security and science diplomacy. Advanced atmospheric biology research is being conducted in Europe, Russia, and China, not in the United States.