The effect of activity and face masks on exhaled particles in children.

Importance: Despite the high burden of respiratory infections among children, the production of exhaled particles during common activities and the efficacy of face masks in children have not been sufficiently studied. Objective: To determine the effect of type of activity and mask usage on exhaled particle production in children. Methods: Healthy children were asked to perform activities that ranged in intensity (breathing quietly, speaking, singing, coughing, and sneezing) while wearing no mask, a cloth mask, or a surgical mask. The concentration and size of exhaled particles were assessed during each activity. Results: Twenty-three children were enrolled in the study. Average exhaled particle concentration increased by intensity of activity, with the lowest particle concentration during tidal breathing (1.285 particles/cm3 [95% CI 0.943, 1.627]) and highest particle concentration during sneezing (5.183 particles/cm3 [95% CI 1.911, 8.455]). High-intensity activities were associated with an increase primarily in the respirable size (≤ 5 µm) particle fraction. Surgical and cloth masks were associated with lower average particle concentration compared to no mask (P = 0.026 for sneezing). Surgical masks outperformed cloth masks across all activities, especially within the respirable size fraction. In a multivariable linear regression model, we observed significant effect modification of activity by age and by mask type. Interpretation: Similar to adults, children produce exhaled particles that vary in size and concentration across a range of activities. Production of respirable size fraction particles (≤ 5 µm), the dominant mode of transmission of many respiratory viruses, increases significantly with coughing and sneezing and is most effectively reduced by wearing surgical face masks.

Near-field exposure of pathogen-laden respiratory particles based on statistical evaluation of one emitting person indoors

Risk assessment models typically assume ideal mixing, in which the pathogen-laden aerosol particles emitted by a person are evenly distributed in the room. This study points out the local deviation from this idealized assumption and a correlation between the level of pathogen concentration and the distance from the emitter. For this purpose, several numerical studies (CFD) were analyzed, and a validation experiment was performed. Statistical evaluation of the spatial pathogen distribution was used to determine the potential exposure to elevated pathogen concentrations. Compared to an ideally mixed room, at a distance of 1.5 m, the mixing ventilation cases show a 25% risk of being exposed to twice the amount of pathogens and a 5% risk to more than 5 times the assumed value. For displacement ventilation there is a 75% chance of being exposed to less pathogens than in complete mixing at a distance of 1 m. The measurement values agree with the simulation results. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

SARS-CoV-2 risk assessment for a 30-minute car journey

In this paper a numerical methodology for close proximity exposure (<2m) is applied to the analysis of aerosol airborne dispersion and SARS-CoV-2 potential infection risk during short journeys in passenger cars. It consists of a three-dimensional transient Eulerian-Lagrangian numerical model coupled with a recently proposed SARS-CoV-2 emission approach, using the open-source software OpenFOAM. The numerical tool, validated by Particle Image Velocimetry (PIV), is applied to the simulation of aerosol droplets emitted by a contagious subject in a car cabin during a 30-minute journey and to the integrated risk assessment for SARS-CoV-2 for the other passengers. The effects of different geometrical and thermo-fluid-dynamic influence parameters are investigated, showing that both the position of the infected subject and the ventilation system design affect the amount of virus inhaled and the highest-risk position inside the passenger compartment. Calculated infection risk, for susceptible passengers in the car, can reach values up to 59%. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Influence of two-dimensional expiratory airflow variations on respiratory particle propagation during pronunciation of the fricative [f].

Propagation of respiratory particles, potentially containing viable viruses, plays a significant role in the transmission of respiratory diseases (e.g., COVID-19) from infected people. Particles are produced in the upper respiratory system and exit the mouth during expiratory events such as sneezing, coughing, talking, and singing. The importance of considering speaking and singing as vectors of particle transmission has been recognized by researchers. Recently, in a companion paper, dynamics of expiratory flow during fricative utterances were explored, and significant variations of airflow jet trajectories were reported. This study focuses on respiratory particle propagation during fricative productions and the effect of airflow variations on particle transport and dispersion as a function of particle size. The commercial ANSYS-Fluent computational fluid dynamics (CFD) software was employed to quantify the fluid flow and particle dispersion from a two-dimensional mouth model of sustained fricative [f] utterance as well as a horizontal jet flow model. The fluid velocity field and particle distributions estimated from the mouth model were compared with those of the horizontal jet flow model. The significant effects of the airflow jet trajectory variations on the pattern of particle transport and dispersion during fricative utterances were studied. Distinct differences between the estimations of the horizontal jet model for particle propagation with those of the mouth model were observed. The importance of considering the vocal tract geometry and the failure of a horizontal jet model to properly estimate the expiratory airflow and respiratory particle propagation during the production of fricative utterances were emphasized.

Effectiveness of a portable personal air cleaner in reducing the airborne transmission of respiratory pathogens

The airborne transmission in indoor environments represents the main pathway of respiratory pathogens, and most of the indoor environments do not have adequate ventilation to contain the risk of infection. This is particularly relevant for gathering spaces such as restaurants, schools, offices, etc. due to the long exposure times and high crowding levels. In this paper we investigated the effectiveness of a novel patented personal air cleaner in reducing the airborne transmission of respiratory pathogens both in close proximity (considering a typical face-to-face configuration at a conversational distance) and in shared indoor environments despite maintaining distancing (lecture room). The effectiveness of the portable protection device was investigated using complex transient 3D Computational Fluid Dynamics (CFD) numerical simulations. The mathematical model employed, validated through experimental measurements, is based on a Eulerian-Lagrangian approach, describing the air flow as the continuous phase and infectious respiratory particles as the discrete phase. The CFD analyses revealed that the air cleaner could strongly reduce the inhalation of respiratory pathogens in both the investigated scenarios. The air cleaner effectiveness in the case of a close proximity scenario, expressed as relative reduction of volume of infectious respiratory particles inhaled by the exposed subject, resulted >92%. In the case of use in a shared indoor environment, instead, during a 2-h lesson, the relative reduction of volume concentration of infectious particles in the breathing zone of the exposed subject was >99%. © 2023 Elsevier Ltd

Experimental measurement of respiratory particles dispersed by wind instruments and analysis of the associated risk of infection transmission

Activities such as singing or playing a wind instrument release respiratory particles into the air that may contain pathogens and thus pose a risk for infection transmission. Here we report measurements of the size distribution, number, and volume concentration of exhaled particles from 31 healthy musicians playing 20 types of wind instruments using aerosol size spectrometry complemented with in-line holography in a strictly controlled cleanroom environment. We find that playing wind instruments carries a lower risk of airborne disease transmission than speaking or singing. We attribute this to the fact that the resonators of wind instruments act as filters for particles >10 µm in diameter, which were found in high abundance right after a brass mouthpiece but very rarely at the instrument bell end. We have also measured the size-dependent filtering properties of different types of filters that can be used as instrument masks. Based on these measurements, we calculated the risk of airborne transmission of SARS-CoV-2 in different near- and far-field scenarios with and without masking and/or distancing. We conclude that in all cases where there is a possibility that the musician is infectious, the only safe measure to prevent airborne transmission of the disease is the use of well-fitting and well-filtering masks for the instrument and the susceptible person. © 2022 The Author(s)

Evaluation of Respiratory Particle Emission during Otorhinolaryngological Procedures in the Context of the SARS-CoV-2 Pandemic.

Understanding the risk of infection by routine medical examination is important for the protection of the medical personnel. In this study we investigated respiratory particles emitted by patients during routine otolaryngologic procedures and assessed the risks for the performing physician. We developed two experimental setups to measure aerosol and droplet emission during rigid/flexible laryngoscopy, rhinoscopy, pharyngoscopy, otoscopy, sonography and patient interview for subjects with and without masks. A high-speed-camera setup was used to detect ballistic droplets (approx. > 100 µm) and an aerosol-particle-sizer was used to detect aerosol particles in the range of 0.3 µm to 10 µm. Aerosol particle counts were highly increased for coughing and slightly increased for heavy breathing in subjects without masks. The highest aerosol particle counts occurred during rigid laryngoscopy. During laryngoscopy and rhinoscopy, the examiner was exposed to increased particle emission due to close proximity to the patient's face and provoked events such as coughing. However, even during sonography or otoscopy without a mask, aerosol particles were expelled close to the examiner. The physician's exposure to respiratory particles can be reduced by deliberate choice of examination technique depending on medical indication and the use of appropriate equipment for the examiners and the patients (e.g., FFP2 masks for both).

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.

Mathematical modeling of ventilation in classrooms as decrease in the risk of contagion by COVID-19

In indoor spaces, there is evidence of the importance of transmission of the SARS-CoV-2 virus by air through aerosols, especially in poorly ventilated conditions. Viruses are exhaled by infected people into respiratory particles with sizes less than 50 microns (microdroplets) that are suspended in the air (aerosols) and can be transported to distances greater than 2 meters within a closed room, such as classrooms. Therefore, in closed school environments, the conditions of occupation and ventilation are essential to determine and minimize the risk of transmission of the virus. There are various techniques to physically assess the air change rate (ACH) in an indoor space or to estimate it indirectly by measuring carbon dioxide (CO2). However, these procedures could be complex for an untrained community or in the absence of a CO2 monitor. The application of mathematical models allows alternatively to evaluate the ventilation conditions from the estimation of ACH or the concentration of CO2 in an intramural space. Some mathematical models were included as part of a guide developed for the evaluation and monitoring of ventilation in school settings. In this work, the application of mass balance models is presented, under conditions of complete mixing, in a classroom in order to estimate ACH from the volume and occupation of the room. Likewise, mathematical expressions are developed to estimate the concentration of CO2 and evaluate the risk of contagion to COVID-19 in situations with and without ventilation. From simple mathematical expressions, it is contributed to the evaluation of the ventilation conditions of classrooms to avoid possible outbreaks of contagion in face-to-face education. © 2021 IEEE.

A Risk Assessment Of Pathogen Transport During An Indoor Orchestra Performance

The COVID-19 pandemic has shown that airborne pathogens and viruses have a detrimental impact on the health and well-being of an individual in an indoor space. Respiratory particles are released as droplets of varying velocities and diameters, where smaller droplets (aerosols) linger in air for prolonged periods, increasing the infection risk of individuals in an enclosed space. The pandemic has raised concerns regarding the safety of musicians due to respiratory particles released through woodwind and brass instruments. A collaboration with the Buffalo Philharmonic Orchestra was pursued to assess the risk of infection and develop strategies to mitigate the spread of respiratory particles using computational fluid dynamics. A coupled Eulerian-Lagrangian modeling approach was employed to examine the airflow patterns and airborne particle pathogen transport induced by the musicians in the music hall. The investigation considered three brass instruments (trumpet, tuba, trombone), without and with a bell covering. It was observed that the dispersion of particles for each instrument depended on the bell design and orientation of the instrument. For example, the trumpet produced a higher concentration of respiratory particles compared to a tuba, which has its tubing wrapped. Additionally, the effect of using bell covers (cloth covering on the opening of the brass instruments) showed that the covers reduced the number of pathogens escaping the instruments by capturing large respiratory particles and reducing the escaping velocity of small particles. Reduced particle velocities at the instrument opening meant that the particles traveled shorter distances, which helped mitigate the spread of virus in the music hall. Moreover, the efficacy of using Plexiglas partitions on the sides and in front of the musicians limited the transmission of pathogens from one musician to another. Overall, the findings of this study helped strategize the location of musicians based on the type of instruments being played and the operating conditions in the music hall to decrease the airborne transmission of the novel Coronavirus. © 2021 by ASME.

Effects of HVAC Settings And Windows Open Or Close On The SARS-COV-2 Virus Transmission Inside A Mass Transit System Bus

With the current outbreak of SARS-CoV-2, public transportation is a key area which must be investigated to ensure both passenger safety and efficiency of passenger transport to best serve the community and reduce environmental footprint. In this paper, the transport of the SARS-CoV-2 virus through human respiratory particles is examined using transient Computational Fluid Dynamics (CFD) simulations to determine the impacts different ventilation configurations on the probability of viral exposure. The motion of the viral particles was simulated first by solving for the flow field inside the bus using a proprietary Navier-Stokes finite-volume solver, RavenCFD by Corvid Technologies, and then using Lagrangian particle tracking (LPT) post processing techniques. The LPT methods used allowed for the injection of respiratory particles, according to distributions found in literature, which included sneezing, coughing, and speaking. To fully investigate the problem space the moving bus was modeled with the windows in various states of closure and with various HVAC configurations. In all scenarios, a volumetric Viral Mean Exposure Time (VMET), which considers the viral load calculations, was used to quantify the various exposure risk of all passengers on the bus. It was found that the most efficient ventilation system on a public transport bus was to keep the windows closed and HVAC of main cabin at maximum to minimize the viral exposure within the bus. © 2021 by ASME.

Simulating near-field enhancement in transmission of airborne viruses with a quadrature-based model.

Some infectious diseases, such as influenza, tuberculosis, and SARS-CoV-2, may be transmitted when virus-laden particles expelled from an infectious person are inhaled by someone else, which is known as the airborne transmission route. These virus-laden particles are more concentrated in the expiratory jet of an infectious person than elsewhere in a well-mixed room, but this near-field enhancement in virion exposure has not been well quantified. Transmission of airborne viruses depends on factors that are inherently variable and, in many cases, poorly constrained, and quantifying this uncertainty requires large ensembles of model simulations that span the variability in input parameters. However, models that are well-suited to simulate the near-field evolution of respiratory particles are also computationally expensive, which limits the exploration of parametric uncertainty. In order to perform many simulations that span the wide variability in factors governing airborne transmission, we developed the Quadrature-based model of Respiratory Aerosol and Droplets (QuaRAD). QuaRAD is an efficient framework for simulating the evolution of virus-laden particles after they are expelled from an infectious person, their deposition to the nasal cavity of a susceptible person, and the subsequent risk of initial infection. We simulated 10 000 scenarios to quantify the risk of initial infection by a particular virus, SARS-CoV-2. The predicted risk of infection was highly variable among scenarios and, in each scenario, was strongly enhanced near the infectious individual. In more than 50% of scenarios, the physical distancing needed to avoid near-field enhancements in airborne transmission was beyond the recommended safe distance of two meters (six feet) if the infectious person is not wearing a mask, though this distance defining the near-field extent was also highly variable among scenarios; the variability in the near-field extent is explained predominantly by variability in expiration velocity. Our findings suggest that maintaining at least two meters of distance from an infectious person greatly reduces exposure to airborne virions; protections against airborne transmission, such as N95 respirators, should be available when distancing is not possible.

A laboratory model demonstrating the protective effects of surgical masks, face shields, and a combination of both in a speaking simulation.

BACKGROUND: The protection against aerosol transmission provided by masks vs face shields or in combination when speaking indoors is not well understood. METHODS: To simulate a human source, an aerosol generating system was made using a bacterial suspension in a nebulizer attached to an oxygen cylinder. A fan connected to the nebulizer created aerosols. Transmitted aerosols were detected using blood agar plates at 0.1524 and 1.8288 meters from source, simulating exposed person. The study was performed under controlled conditions at room temperature in a biohazard hood with high-efficiency particulate air (HEPA) filter and UV light. RESULTS: When face shields were used alone, significant numbers of bacterial colonies grew on blood agar plates. When a mask used alone for both the subjects (source and exposed), the blood agar yielded minimal colony forming units at both distances. When face shields were used in combination with masks, no significant improvement was observed as compared to masks alone. DISCUSSION: Our results were similar to what have been observed in related studies. CONCLUSIONS: Surgical masks alone provided good protection, surpassing the protection provided by face shields alone. Both used together provided the best protection, although the combined protection was similar to surgical masks use alone.