A systematic review and meta-analysis of indoor bioaerosols in hospitals: The influence of heating, ventilation, and air conditioning.

OBJECTIVES: To evaluate (1) the relationship between heating, ventilation, and air conditioning (HVAC) systems and bioaerosol concentrations in hospital rooms, and (2) the effectiveness of laminar air flow (LAF) and high efficiency particulate air (HEPA) according to the indoor bioaerosol concentrations. METHODS: Databases of Embase, PubMed, Cochrane Library, MEDLINE, and Web of Science were searched from 1st January 2000 to 31st December 2020. Two reviewers independently extracted data and assessed the quality of the studies. The samples obtained from different areas of hospitals were grouped and described statistically. Furthermore, the meta-analysis of LAF and HEPA were performed using random-effects models. The methodological quality of the studies included in the meta-analysis was assessed using the checklist recommended by the Agency for Healthcare Research and Quality. RESULTS: The mean CFU/m3 of the conventional HVAC rooms and enhanced HVAC rooms was lower than that of rooms without HVAC systems. Furthermore, the use of the HEPA filter reduced bacteria by 113.13 (95% CI: -197.89, -28.38) CFU/m3 and fungi by 6.53 (95% CI: -10.50, -2.55) CFU/m3. Meanwhile, the indoor bacterial concentration of LAF systems decreased by 40.05 (95% CI: -55.52, -24.58) CFU/m3 compared to that of conventional HVAC systems. CONCLUSIONS: The HVAC systems in hospitals can effectively remove bioaerosols. Further, the use of HEPA filters is an effective option for areas that are under-ventilated and require additional protection. However, other components of the LAF system other than the HEPA filter are not conducive to removing airborne bacteria and fungi. LIMITATION OF STUDY: Although our study analysed the overall trend of indoor bioaerosols, the conclusions cannot be extrapolated to rare, hard-to-culture, and highly pathogenic species, as well as species complexes. These species require specific culture conditions or different sampling requirements. Investigating the effects of HVAC systems on these species via conventional culture counting methods is challenging and further analysis that includes combining molecular identification methods is necessary. STRENGTH OF THE STUDY: Our study was the first meta-analysis to evaluate the effect of HVAC systems on indoor bioaerosols through microbial incubation count. Our study demonstrated that HVAC systems could effectively reduce overall bioaerosol concentrations to maintain better indoor air quality. Moreover, our study provided further evidence that other components of the LAF system other than the HEPA filter are not conducive to removing airborne bacteria and fungi. PRACTICAL IMPLICATION: Our research showed that HEPA filters are more effective at removing bioaerosols in HVAC systems than the current LAF system. Therefore, instead of opting for the more costly LAF system, a filter with a higher filtration rate would be a better choice for indoor environments that require higher air quality; this is valuable for operating room construction and maintenance budget allocation.

COVID surveillance robot: Monitoring social distancing constraints in indoor scenarios.

Observing social/physical distancing norms between humans has become an indispensable precaution to slow down the transmission of COVID-19. We present a novel method to automatically detect pairs of humans in a crowded scenario who are not maintaining social distancing, i.e. about 2 meters of space between them using an autonomous mobile robot and existing CCTV (Closed-Circuit TeleVision) cameras. The robot is equipped with commodity sensors, namely an RGB-D (Red Green Blue-Depth) camera and a 2-D lidar to detect social distancing breaches within their sensing range and navigate towards the location of the breach. Moreover, it discreetly alerts the relevant people to move apart by using a mounted display. In addition, we also equip the robot with a thermal camera that transmits thermal images to security/healthcare personnel who monitors COVID symptoms such as a fever. In indoor scenarios, we integrate the mobile robot setup with a static wall-mounted CCTV camera to further improve the number of social distancing breaches detected, accurately pursuing walking groups of people etc. We highlight the performance benefits of our robot + CCTV approach in different static and dynamic indoor scenarios.

Cause analysis of PM2.5 pollution during the COVID-19 lockdown in Nanning, China.

To analyse the cause of the atmospheric PM2.5 pollution that occurred during the COVID-19 lockdown in Nanning, Guangxi, China, a single particulate aerosol mass spectrometer, aethalometer, and particulate Lidar coupled with monitoring near-surface gaseous pollutants, meteorological conditions, remote fire spot sensing by satellite and backward trajectory models were utilized during 18-24 February 2020. Three haze stages were identified: the pre-pollution period (PPP), pollution accumulation period (PAP) and pollution dissipation period (PDP). The dominant source of PM2.5 in the PPP was biomass burning (BB) (40.4%), followed by secondary inorganic sources (28.1%) and motor vehicle exhaust (11.7%). The PAP was characterized by a large abundance of secondary inorganic sources, which contributed 56.1% of the total PM2.5 concentration, followed by BB (17.4%). The absorption Ångström exponent (2.2) in the PPP was higher than that in the other two periods. Analysis of fire spots monitored by remote satellite sensing indicated that open BB in regions around Nanning City could be one of the main factors. A planetary boundary layer-relative humidity-secondary particle matter-particulate matter positive feedback mechanism was employed to elucidate the atmospheric processes in this study. This study highlights the importance of understanding the role of BB, secondary inorganic sources and meteorology in air pollution formation and calls for policies for emission control strategies.

Transport of Aerosols in Underground Mine Workings in Terms of SARS-CoV-2 Virus Threat.

This paper presents a method of implementation and the results of aerosol dispersion tests in underground mine workings. Numerous tests were carried out to determine the potential risk of SARS-CoV-2 coronavirus infection in the underground environment of the mines. The influence of selected parameters of mine air on the possibility and method of aerosol transmission through ventilation routes was experimentally determined in real conditions. The concentration of additional aerosols in the class of ultrafine and fine aerosols increased with the distance from the generator, while the concentration of coarse particles decreased. Assuming the consumption of the solution with which aerosols were generated, even at a small level of 1 cm3/min., the number of additional aerosols was several hundred particles in one cubic centimeter of air at a distance of 50-70 m from the generator. The concentration of ultrafine particles in the range of 40-20,000 nm increased from 122 particles/cm3 to 209 particles/cm3 at air temperature of 12 °C and relative humidity of 95-96%, and from 90 particles/cm3 to 243 particles/cm3 at air temperature of 17 °C and relative humidity of 76-82%, with the increasing distance from the generator (10 m to 50 m).

Monitoring changes in human activity during the COVID-19 shutdown in Las Vegas using infrasound microbarometers.

While studies of urban acoustics are typically restricted to the audio range, anthropogenic activity also generates infrasound (<20 Hz, roughly at the lower end of the range of human hearing). Shutdowns related to the COVID-19 pandemic unintentionally created ideal conditions for the study of urban infrasound and low frequency audio (20-500 Hz), as closures reduced human-generated ambient noise, while natural signals remained relatively unaffected. An array of infrasound sensors deployed in Las Vegas, NV, provides data for a case study in monitoring human activity during the pandemic through urban acoustics. The array records a sharp decline in acoustic power following the temporary shutdown of businesses deemed nonessential by the state of Nevada. This decline varies spatially across the array, with stations close to McCarran International Airport generally recording the greatest declines in acoustic power. Further, declines in acoustic power fluctuate with the time of day. As only signals associated with anthropogenic activity are expected to decline, this gives a rough indication of periodicities in urban acoustics throughout Las Vegas. The results of this study reflect the city's response to the pandemic and suggest spatiotemporal trends in acoustics outside of shutdowns.

Aerosol emission of adolescents voices during speaking, singing and shouting.

Since the outbreak of the COVID-19 pandemic, singing activities for children and young people have been strictly regulated with far-reaching consequences for music education in schools and ensemble and choir singing in some places. This is also due to the fact, that there has been no reliable data available on aerosol emissions from adolescents speaking, singing, and shouting. By utilizing a laser particle counter in cleanroom conditions we show, that adolescents emit fewer aerosol particles during singing than what has been known so far for adults. In our data, the emission rates ranged from 16 P/s to 267 P/s for speaking, 141 P/s to 1240 P/s for singing, and 683 P/s to 4332 P/s for shouting. The data advocate an adaptation of existing risk management strategies and rules of conduct for groups of singing adolescents, like gatherings in an educational context, e.g. singing lessons or choir rehearsals.

Comparison of Low-Cost Particulate Matter Sensors for Indoor Air Monitoring during COVID-19 Lockdown.

This study shows the results of air monitoring in high- and low-occupancy rooms using two combinations of sensors, AeroTrak8220(TSI)/OPC-N3 (AlphaSense, Great Notley, UK) and OPC-N3/PMS5003 (Plantower, Beijing, China), respectively. The tests were conducted in a flat in Warsaw during the restrictions imposed due to the COVID-19 lockdown. The results showed that OPC-N3 underestimates the PN (particle number concentration) by about 2-3 times compared to the AeroTrak8220. Subsequently, the OPC-N3 was compared with another low-cost sensor, the PMS5003. Both devices showed similar efficiency in PN estimation, whereas PM (particulate matter) concentration estimation differed significantly. Moreover, the relationship among the PM1-PM2.5-PM10 readings obtained with the PMS5003 appeared improbably linear regarding the natural indoor conditions. The correlation of PM concentrations obtained with the PMS5003 suggests an oversimplified calculation method of PM. The studies also demonstrated that PM1, PM2.5, and PM10 concentrations in the high- to low-occupancy rooms were about 3, 2, and 1.5 times, respectively. On the other hand, the use of an air purifier considerably reduced the PM concentrations to similar levels in both rooms. All the sensors showed that frying and toast-making were the major sources of particulate matter, about 10 times higher compared to average levels. Considerably lower particle levels were measured in the low-occupancy room.

Enriched Aerosol-to-Hydrosol Transfer for Rapid and Continuous Monitoring of Bioaerosols.

Bioaerosols, including infectious diseases such as COVID-19, are a continuous threat to global public safety. Despite their importance, the development of a practical, real-time means of monitoring bioaerosols has remained elusive. Here, we present a novel, simple, and highly efficient means of obtaining enriched bioaerosol samples. Aerosols are collected into a thin and stable liquid film by the unique interaction of a superhydrophilic surface and a continuous two-phase centrifugal flow. We demonstrate that this method can provide a concentration enhancement ratio of ∼2.4 × 106 with a collection efficiency of ∼99.9% and an aerosol-into-liquid transfer rate of ∼95.9% at 500 nm particle size (smaller than a single bacterium). This transfer is effective in both laboratory and external ambient environments. The system has a low limit of detection of <50 CFU/m3air using a straightforward bioluminescence-based technique and shows significant potential for air monitoring in occupational and public-health applications.

An integrated system of air sampling and simultaneous enrichment for rapid biosensing of airborne coronavirus and influenza virus.

Point-of-care risk assessment (PCRA) for airborne viruses requires a system that can enrich low-concentration airborne viruses dispersed in field environments into a small volume of liquid. In this study, airborne virus particles were collected to a degree above the limit of detection (LOD) for a real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). This study employed an electrostatic air sampler to capture aerosolized test viruses (human coronavirus 229E (HCoV-229E), influenza A virus subtype H1N1 (A/H1N1), and influenza A virus subtype H3N2 (A/H3N2)) in a continuously flowing liquid (aerosol-to-hydrosol (ATH) enrichment) and a concanavalin A (ConA)-coated magnetic particles (CMPs)-installed fluidic channel for simultaneous hydrosol-to-hydrosol (HTH) enrichment. The air sampler's ATH enrichment capacity (EC) was evaluated using the aerosol counting method. In contrast, the HTH EC for the ATH-collected sample was evaluated using transmission-electron-microscopy (TEM)-based image analysis and real-time qRT-PCR assay. For example, the ATH EC for HCoV-229E was up to 67,000, resulting in a viral concentration of 0.08 PFU/mL (in a liquid sample) for a viral epidemic scenario of 1.2 PFU/m3 (in air). The real-time qRT-PCR assay result for this liquid sample was "non-detectable" however, subsequent HTH enrichment for 10 min caused the "non-detectable" sample to become "detectable" (cycle threshold (CT) value of 33.8 ± 0.06).

Development of a personal passive air sampler for estimating exposure to effective chlorine while using chlorine-based disinfectants.

With an increasing use of indoor disinfectants such as chlorine (Cl2 ) and hypochlorous acid, a convenient sampler for estimating exposure to oxidants, such as effective chlorine, is necessary. Here, we developed a personal passive air sampler (PPAS) composed of a redox dye, o-dianisidine, in a polydimethylsiloxane (PDMS) sheet. o-Dianisidine readily reacts with gaseous oxidants generated by bleach usage, and its color changes as the reaction progresses; hence, personal exposure to effective chlorine could be easily detected by the naked eye, while cumulative exposure could be determined by measuring concentrations of o-dianisidine reacting with it. The PPAS was calibrated, and a sampling rate of 0.00253 m3 /h was obtained using a small test chamber. The PPAS was tested with the help of ten volunteers whose personal exposure to Cl2 -equivalent gas was estimated after bathrooms were cleaned using spray and liquid-type household disinfection products, and the accumulated exposure-gas concentrations ranged from 69 to 408 ppbv and 148 to 435 ppbv, respectively. These PPAS-derived exposure concentrations were approximately two orders lower than those estimated using ConsExpo, suggesting a significant overestimation by prevailing screening models, possibly due to the ignorance of transformation reactions.

Diagnostic methods and potential portable biosensors for coronavirus disease 2019.

Timely detection and diagnosis are urgently needed to guide epidemiological measures, infection control, antiviral treatment, and vaccine research. In this review, biomarkers/indicators for diagnosis of coronavirus disease 2019 (COVID-19) or detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the environment are summarized and discussed. It is concluded that the detection methods targeting antibodies are not suitable for screening of early and asymptomatic cases since most patients had an antibody response at about 10 days after onset of symptoms. However, antibody detection methods can be combined with quantitative real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) to significantly improve the sensitivity and specificity of diagnosis, and boost vaccine research. Fast, sensitive and accurate detection methods targeting antigens need to be developed urgently. Various specimens for diagnosis or detection are compared and analyzed. Among them, deep throat saliva and induced sputum are desired for RT-qPCR test or other early detection technologies. Chest computerized tomography (CT) scan, RT-qPCR, lateral flow immunochromatographic strip (LFICS) for diagnosis of COVID-19 are summarized and compared. Specially, potential electrochemical (EC) biosensor, surface enhanced Raman scattering (SERS)-based biosensor, field-effect transistor (FET)-based biosensor, surface plasmon resonance (SPR)-based biosensor and artificial intelligence (AI) assisted diagnosis of COVID-19 are emphasized. Finally, some commercialized portable detection device, current challenges and future directions are discussed.