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1.
Front Public Health ; 10: 829466, 2022.
Article in English | MEDLINE | ID: covidwho-1776030

ABSTRACT

Aim: To examine the human exposure to perchlorate, nitrate, and thiocyanate, and their associations with oral pain (OP) in the general population from the U.S. Methods: A total of 13,554 participants were enrolled in the National Health and Nutrition Examination Survey. The urinary perchlorate, nitrate, and thiocyanate were measured using ion chromatography coupled with an electrospray tandem mass spectrometry. The multivariable linear and logistic regressions were performed to explore the associations of the urinary perchlorate, nitrate, and thiocyanate, with the prevalence of oral pain. Restricted cubic splines were used to explore the non-linearity. Results: There are 3,129 OP cases. There was a higher urinary level of perchlorate, nitrate, and thiocyanate in OP. We found that urinary thiocyanate was positively associated with OP (odds ratio [OR] = 1.06; [1, 1.13]; p = 0.049). Restricted cubic spines revealed that urinary thiocyanate was in a U-shape association with OP. Conclusions: Urinary thiocyanate was in a U-shape association with OP, suggesting that we should keep the exposure of thiocyanate under a reasonable range.


Subject(s)
Mouth , Nitrates , Pain , Perchlorates , Thiocyanates , Environmental Exposure/adverse effects , Humans , Mouth/physiopathology , Nitrates/urine , Nutrition Surveys , Pain/epidemiology , Perchlorates/urine , Thiocyanates/urine , United States/epidemiology
2.
Front Public Health ; 9: 733667, 2021.
Article in English | MEDLINE | ID: covidwho-1775871

ABSTRACT

Background: Environmental tobacco smoke (ETS) exposure in children ranks one of the major public health problems in our time. Poor parental knowledge, attitude, and practice (KAP) on ETS often contribute to worse exposure of the kids. Thus, we aimed to document parental KAP regarding tobacco use, smoking cessation and children's ETS exposure, and to analyse how knowledge and attitude relate to practice. Methods: Self-administered KAP questionnaires were distributed to smoking parents recruited from the pediatric unit at the Prince of Wales Hospital, which provides pediatric service to a population of 1.2 million in Hong Kong. The 60-item questionnaire had a range of 0-38 for knowledge, 0-44 for attitude, and 0-40 for practice. Descriptive analyses were performed for KAP response, regression analyses were performed for the exploration of associations and identification of predictive indicators. Results: 145 smoking parents (mean age: 38.0 ± 6.7 yrs.; male: 85.5%) were included. Less than half (39.3%) of them reported a smoke-free policy at home. Among those parents who had private cars, less than half (45.2%) of them had smoke-free policy in their car that they never smoked in the car. Only 25.5% of the participants correctly answered ≥70% of the knowledge questions, and 11.8 % of the participants gave favorable responses to ≥70% of the attitude questions. The total knowledge and the total attitudes score were positively associated (r = 0.49, 95% CI: 0.35-0.79, p < 0.001), yet they were only modestly correlated with parental practice on children's ETS exposure. By multivariate regressions, potential predictive factors for more favorable parental KAP included higher household income, lower parental nicotine dependence level and breastfeeding practice. Conclusions: Parental KAP related to tobacco use and children's ETS exposure needs improvement to address the significant gap between recommended and actual practice. The weak association between knowledge and practice suggested that parental education alone is not adequate to combat ETS exposure in children.


Subject(s)
Smoking Cessation , Tobacco Smoke Pollution , Adult , Child , Environmental Exposure , Health Knowledge, Attitudes, Practice , Humans , Male , Parents , Tobacco Use
3.
J Acoust Soc Am ; 151(3): 1532, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1752758

ABSTRACT

Health Canada, in collaboration with Advanis, conducted the Canadian Perspectives on Environmental Noise Survey (CPENS) to investigate expectations and attitudes toward environmental noise in rural and non-rural Canada. The CPENS, a 26-item questionnaire, was completed online by 6647 randomly selected Canadians, age 18 y and older between April and May 2021. The prevalence of reporting their area as often or always calm, quiet, and relaxing was 76.8%, 64%, and 48.4% in rural/remote, suburban, and urban, respectively. A high expectation of quiet was less prevalent yet followed the same pattern: rural/remote (58.2%), suburban (37.4%), and urban (21.8%). Self-reported health status and noise sensitivity were unrelated to geographic region. A high magnitude of non-specific sleep disturbance over the previous 12 months was reported by 7.8% overall; highest among urban dwellers (9.8%), followed by suburban (7.2%) and rural/remote (5.5%) dwellers (p < 0.01). High annoyance toward road traffic noise was 8.5% overall, and significantly higher in urban (10.5%), relative to suburban (7.9%) and rural/remote (6.6%) areas (p < 0.0001). Annoyance toward noise from rail, aircraft, mining, industry, marine activity, construction, wind turbines, and landscaping equipment is reported. The analysis also explores potential differences between Indigenous Peoples of Canada and non-Indigenous Canadians in their attitudes and expectations toward environmental noise.


Subject(s)
Environmental Exposure , Noise , Adolescent , Canada/epidemiology , Health Status , Humans , Noise/adverse effects , Self Report
4.
Int J Environ Res Public Health ; 19(5)2022 03 06.
Article in English | MEDLINE | ID: covidwho-1742425

ABSTRACT

Air pollution exposure has become ubiquitous and is increasingly detrimental to human health. Small Particulate matter (PM) is one of the most harmful forms of air pollution. It can easily infiltrate the lungs and trigger several respiratory diseases, especially in vulnerable populations such as children and elderly people. In this work, we start by leveraging a retrospective study of 416 children suffering from respiratory diseases. The study revealed that asthma prevalence was the most common among several respiratory diseases, and that most patients suffering from those diseases live in areas of high traffic, noise, and greenness. This paved the way to the construction of the MOREAIR dataset by combining feature abstraction and micro-level scale data collection. Unlike existing data sets, MOREAIR is rich in context-specific components, as it includes 52 temporal or geographical features, in addition to air-quality measurements. The use of Random Forest uncovered the most important features for the understanding of air-quality distribution in Moroccan urban areas. By linking the medical data and the MOREAIR dataset, we observed that the patients included in the medical study come mostly from neighborhoods that are characterized by either high average or high variations of pollution levels.


Subject(s)
Air Pollutants , Air Pollution , Respiration Disorders , Aged , Air Pollutants/analysis , Air Pollution/analysis , Child , Environmental Exposure/analysis , Humans , Particulate Matter/analysis , Retrospective Studies
5.
Environ Monit Assess ; 194(4): 275, 2022 Mar 14.
Article in English | MEDLINE | ID: covidwho-1739368

ABSTRACT

Since air pollution compromise the respiratory system and COVID-19 disease is caused by a respiratory virus, it is expected that air pollution plays an important role in the current COVID-19 pandemic. Exploratory studies have observed positive associations between air pollution and COVID-19 cases, deaths, fatality, and mortality rate. However, no study focused on Brazil, one of the most affected countries by the pandemic. Thus, this study aimed to understand how long-term exposure to PM10, PM2.5, and NO2 contributed to COVID-19 fatality and mortality rates in São Paulo state in 2020. Air quality data between 2015 and 2019 in 64 monitoring stations within 36 municipalities were considered. The COVID-19 fatality was calculated considering cases and deaths from the government's official data and the mortality rate was calculated considering the 2020 population. Linear regression models were well-fitted for PM2.5 concentration and fatality (R2 = 0.416; p = 0.003), NO2 concentration and fatality (R2 = 0.232; p = 0.005), and NO2 concentration and mortality (R2 = 0.273; p = 0.002). This study corroborates other authors' findings and enriches the discussion for having considered a longer time series to represent long-term exposure to the pollutants and for having considered one of the regions with the highest incidence of COVID-19 in the world. Thus, it reinforces measures to reduce the concentration of air pollutants which are essential for public health and will increase the chance to survive in future respiratory disease epidemics.


Subject(s)
Air Pollution , COVID-19 , Brazil/epidemiology , COVID-19/mortality , Cities/epidemiology , Environmental Exposure , Environmental Monitoring , Humans , Pandemics
6.
J Prev Med Public Health ; 54(5): 376-379, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1737129

ABSTRACT

Elemental mercury exposure can result in significant toxicity. Source decontamination and remediation are often required after larger elemental mercury exposures, but the details of these processes are infrequently reported. In the case described herein, a 64-year-old woman and her husband were exposed to elemental mercury in their home after the husband purchased it online for the purpose of recreational barometer calibration. After the mercury reportedly spilled during the calibration process, a vacuum cleaner was used to decontaminate the affected surface; this led to extensive mercury contamination of the home. The couple was relocated from the home while remediation occurred over the course of several weeks. Vacuum cleaning of an elemental mercury spill can lead to extensive volatilization and recirculation of mercury vapor. For smaller mercury spills, careful removal of visible mercury beads by using an eyedropper, cardboard, and masking tape is recommended. Larger spills require professional decontamination and remediation and may necessitate involvement of governmental resources. Vacuum cleaning should not be used as an initial method of decontamination after elemental mercury exposure. Careful attention to source decontamination can reduce the emotional and financial costs associated with extensive remediation after elemental mercury exposure.


Subject(s)
Mercury , Decontamination , Environmental Exposure , Female , Humans , Middle Aged , Spouses , United States
7.
J Infect Dis ; 225(5): 768-776, 2022 03 02.
Article in English | MEDLINE | ID: covidwho-1722480

ABSTRACT

BACKGROUND: We determined the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in air and on surfaces in rooms of patients hospitalized with coronavirus disease 2019 (COVID-19) and investigated patient characteristics associated with SARS-CoV-2 environmental contamination. METHODS: Nasopharyngeal swabs, surface, and air samples were collected from the rooms of 78 inpatients with COVID-19 at 6 acute care hospitals in Toronto from March to May 2020. Samples were tested for SARS-CoV-2 ribonucleic acid (RNA), cultured to determine potential infectivity, and whole viral genomes were sequenced. Association between patient factors and detection of SARS-CoV-2 RNA in surface samples were investigated. RESULTS: Severe acute respiratory syndrome coronavirus 2 RNA was detected from surfaces (125 of 474 samples; 42 of 78 patients) and air (3 of 146 samples; 3 of 45 patients); 17% (6 of 36) of surface samples from 3 patients yielded viable virus. Viral sequences from nasopharyngeal and surface samples clustered by patient. Multivariable analysis indicated hypoxia at admission, polymerase chain reaction-positive nasopharyngeal swab (cycle threshold of ≤30) on or after surface sampling date, higher Charlson comorbidity score, and shorter time from onset of illness to sampling date were significantly associated with detection of SARS-CoV-2 RNA in surface samples. CONCLUSIONS: The infrequent recovery of infectious SARS-CoV-2 virus from the environment suggests that the risk to healthcare workers from air and near-patient surfaces in acute care hospital wards is likely limited.


Subject(s)
COVID-19 , Nasopharynx/virology , SARS-CoV-2/isolation & purification , Adult , Aged , Air Microbiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Nucleic Acid Testing , Canada/epidemiology , Environmental Exposure , Health Personnel , Humans , Inpatients , Middle Aged , Pandemics/prevention & control , SARS-CoV-2/genetics
8.
Int J Environ Res Public Health ; 19(5)2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1715371

ABSTRACT

The large availability of both air pollution and COVID-19 data, and the simplicity to make geographical correlations between them, led to a proliferation of ecological studies relating the levels of pollution in administrative areas to COVID-19 incidence, mortality or lethality rates. However, the major drawback of these studies is the ecological fallacy that can lead to spurious associations. In this frame, an increasing concern has been addressed to clarify the possible role of contextual variables such as municipalities' characteristics (including urban, rural, semi-rural settings), those of the resident communities, the network of social relations, the mobility of people, and the responsiveness of the National Health Service (NHS), to better clarify the dynamics of the phenomenon. The objective of this paper is to identify and collect the municipalities' and community contextual factors and to synthesize their information content to produce suitable indicators in national environmental epidemiological studies, with specific emphasis on assessing the possible role of air pollution on the incidence and severity of the COVID-19 disease. A first step was to synthesize the content of spatial information, available at the municipal level, in a smaller set of "summary indexes" that can be more easily viewed and analyzed. For the 7903 Italian municipalities (1 January 2020-ISTAT), 44 variables were identified, collected, and grouped into five information dimensions a priori defined: (i) geographic characteristics of the municipality, (ii) demographic and anthropogenic characteristics, (iii) mobility, (iv) socio-economic-health area, and (v) healthcare offer (source: ISTAT, EUROSTAT or Ministry of Health, and further ad hoc elaborations (e.g., OpenStreetMaps)). Principal component analysis (PCA) was carried out for the five identified dimensions, with the aim of reducing the large number of initial variables into a smaller number of components, limiting as much as possible the loss of information content (variability). We also included in the analysis PM2.5, PM10 and NO2 population weighted exposure (PWE) values obtained using a four-stage approach based on the machine learning method, "random forest", which uses space-time predictors, satellite data, and air quality monitoring data estimated at the national level. Overall, the PCA made it possible to extract twelve components: three for the territorial characteristics dimension of the municipality (variance explained 72%), two for the demographic and anthropogenic characteristics dimension (variance explained 62%), three for the mobility dimension (variance explained 83%), two for the socio-economic-health sector (variance explained 58%) and two for the health offer dimension (variance explained 72%). All the components of the different dimensions are only marginally correlated with each other, demonstrating their potential ability to grasp different aspects of the spatial distribution of the COVID-19 pathology. This work provides a national repository of contextual variables at the municipality level collapsed into twelve informative factors suitable to be used in studies on the association between chronic exposure to air pollution and COVID-19 pathology, as well as for investigations on the role of air pollution on the health of the Italian population.


Subject(s)
Air Pollution , COVID-19 , Air Pollution/adverse effects , Air Pollution/analysis , COVID-19/epidemiology , Environmental Exposure/analysis , Epidemiologic Studies , Humans , SARS-CoV-2 , State Medicine
9.
Int J Environ Res Public Health ; 19(3)2022 01 26.
Article in English | MEDLINE | ID: covidwho-1686732

ABSTRACT

Humans are exposed to a diverse mixture of chemical and non-chemical exposures across their lifetimes. Well-designed epidemiology studies as well as sophisticated exposure science and related technologies enable the investigation of the health impacts of mixtures. While existing statistical methods can address the most basic questions related to the association between environmental mixtures and health endpoints, there were gaps in our ability to learn from mixtures data in several common epidemiologic scenarios, including high correlation among health and exposure measures in space and/or time, the presence of missing observations, the violation of important modeling assumptions, and the presence of computational challenges incurred by current implementations. To address these and other challenges, NIEHS initiated the Powering Research through Innovative methods for Mixtures in Epidemiology (PRIME) program, to support work on the development and expansion of statistical methods for mixtures. Six independent projects supported by PRIME have been highly productive but their methods have not yet been described collectively in a way that would inform application. We review 37 new methods from PRIME projects and summarize the work across previously published research questions, to inform methods selection and increase awareness of these new methods. We highlight important statistical advancements considering data science strategies, exposure-response estimation, timing of exposures, epidemiological methods, the incorporation of toxicity/chemical information, spatiotemporal data, risk assessment, and model performance, efficiency, and interpretation. Importantly, we link to software to encourage application and testing on other datasets. This review can enable more informed analyses of environmental mixtures. We stress training for early career scientists as well as innovation in statistical methodology as an ongoing need. Ultimately, we direct efforts to the common goal of reducing harmful exposures to improve public health.


Subject(s)
National Institute of Environmental Health Sciences (U.S.) , Research Design , Environmental Exposure/analysis , Epidemiologic Methods , Epidemiologic Studies , Humans , Risk Assessment , United States
10.
Environ Res ; 208: 112758, 2022 05 15.
Article in English | MEDLINE | ID: covidwho-1637740

ABSTRACT

BACKGROUND: Air pollution exposure may make people more vulnerable to COVID-19 infection. However, previous studies in this area mostly focused on infection before May 2020 and long-term exposure. OBJECTIVE: To assess both long-term and short-term exposure to air pollution and COVID-19 incidence across four case surges from 03/1/2020 to 02/28/2021. METHODS: The cohort included 4.6 million members from a large integrated health care system in southern California with comprehensive electronic medical records (EMR). COVID-19 cases were identified from EMR. Incidence of COVID-19 was computed at the census tract-level among members. Prior 1-month and 1-year averaged air pollutant levels (PM2.5, NO2, and O3) at the census tract-level were estimated based on hourly and daily air quality data. Data analyses were conducted by each wave: 3/1/2020-5/31/2020, 6/1/202-9/30/2020, 10/1/2020-12/31/2020, and 1/1/2021-2/28/2021 and pooled across waves using meta-analysis. Generalized linear mixed effects models with Poisson distribution and spatial autocorrelation were used with adjustment for meteorological factors and census tract-level social and health characteristics. Results were expressed as relative risk (RR) per 1 standard deviation. RESULTS: The cohort included 446,440 COVID-19 cases covering 4609 census tracts. The pooled RRs (95% CI) of COVID-19 incidence associated with 1-year exposures to PM2.5, NO2, and O3 were 1.11 (1.04, 1.18) per 2.3 µg/m3,1.09 (1.02, 1.17) per 3.2 ppb, and 1.06 (1.00, 1.12) per 5.5 ppb respectively. The corresponding RRs (95% CI) associated with prior 1-month exposures were 1.11 (1.03, 1.20) per 5.2 µg/m3 for PM2.5, 1.09 (1.01, 1.17) per 6.0 ppb for NO2 and 0.96 (0.85, 1.08) per 12.0 ppb for O3. CONCLUSION: Long-term PM2.5 and NO2 exposures were associated with increased risk of COVID-19 incidence across all case surges before February 2021. Short-term PM2.5 and NO2 exposures were also associated. Our findings suggest that air pollution may play a role in increasing the risk of COVID-19 infection.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollutants/toxicity , Air Pollution/analysis , COVID-19/epidemiology , Environmental Exposure/analysis , Humans , Incidence , Particulate Matter/analysis , Particulate Matter/toxicity , SARS-CoV-2
11.
Yonsei Med J ; 63(Suppl): S1-S13, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1636324

ABSTRACT

Digital technologies have emerged in various dimensions of human life, ranging from education to professional services to well-being. In particular, health products and services have expanded by the use and development of artificial intelligence, mobile health applications, and wearable electronic devices. Such advancements have enabled accurate and updated tracking and modeling of health conditions. For instance, digital health technologies are capable of measuring environmental pollution and predicting its adverse health effects. Several health conditions, including chronic airway diseases such as asthma and chronic obstructive pulmonary disease, can be exacerbated by pollution. These diseases impose substantial health burdens with high morbidity and mortality. Recently, efforts have been made to develop digital technologies to alleviate such conditions. Moreover, the COVID-19 pandemic has facilitated the application of telemedicine and telemonitoring for patients with chronic airway diseases. This article reviews current trends and studies in digital technology utilization for investigating and managing environmental exposure and chronic airway diseases. First, we discussed the recent progression of digital technologies in general environmental healthcare. Then, we summarized the capacity of digital technologies in predicting exacerbation and self-management of airway diseases. Concluding these reviews, we provided suggestions to improve digital health technologies' abilities to reduce the adverse effects of environmental exposure in chronic airway diseases, based on personal exposure-response modeling.


Subject(s)
Artificial Intelligence , COVID-19 , Delivery of Health Care , Environmental Exposure/adverse effects , Humans , Pandemics , SARS-CoV-2
12.
Int J Environ Res Public Health ; 19(2)2022 Jan 14.
Article in English | MEDLINE | ID: covidwho-1625572

ABSTRACT

According to the World Bank Group, 36 of the 50 most polluted cities in the European Union are in Poland. Thus, ambient air pollution and its detrimental health effects are a matter of immense importance in Poland. This narrative review aims to analyse current findings on air pollution and health in Poland, with a focus on respiratory diseases, including COVID-19, as well as the Poles' awareness of air pollution. PubMed, Scopus and Google Scholar databases were searched. In total, results from 71 research papers were summarized qualitatively. In Poland, increased air pollution levels are linked to increased general and respiratory disease mortality rates, higher prevalence of respiratory diseases, including asthma, lung cancer and COVID-19 infections, reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The proximity of high traffic areas exacerbates respiratory health problems. People living in more polluted regions (south of Poland) and in the winter season have a higher level of air pollution awareness. There is an urgent need to reduce air pollution levels and increase public awareness of this threat. A larger number of multi-city studies are needed in Poland to consistently track the burden of diseases attributable to air pollution.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Air Pollutants/analysis , Air Pollutants/toxicity , Air Pollution/analysis , Air Pollution/statistics & numerical data , Environmental Exposure/analysis , Environmental Exposure/statistics & numerical data , Humans , Particulate Matter/analysis , Particulate Matter/toxicity , Poland/epidemiology , SARS-CoV-2
13.
Environ Int ; 159: 107022, 2022 01 15.
Article in English | MEDLINE | ID: covidwho-1616484

ABSTRACT

BACKGROUND: Under-5 mortality rate is an important indicator in Millennium Development Goals and Sustainable Development Goals. To date, no nationally representative studies have examined the effects of fine particulate matter (PM2.5) air pollution on under-5 mortality. OBJECTIVE: To investigate the association of short-term exposure to PM2.5 with under-5 mortality from total and specific causes in China. METHODS: We used the national Maternal and Child Health Surveillance System to identify under-5 mortality cases during the study period of 2009 to 2019. We adopted a time-stratified case-crossover study design at the individual level to capture the effect of short-term exposure to daily PM2.5 on under-5 mortality, using conditional logistic regression models. RESULTS: A total of 61,464 under-5 mortality cases were included. A 10 µg/m3 increase in concentrations of PM2.5 on lag 0-1 d was significantly associated with a 1.15% (95%confidence interval: 0.65%, 1.65%) increase in under-5 mortality. Mortality from diarrhea, pneumonia, digestive diseases, and preterm birth were significantly associated with exposure to PM2.5. The effect estimates were larger for neonatal mortality (<28 days), female children, and in warm seasons. We observed steeper slopes in lower ranges (<50 µg/m3) of the concentration-response curve between PM2.5 and under-5 mortality, and positive associations remained below the 24-h PM2.5 concentration limit recommended by WHO Air Quality Guidelines and China Air Quality Standards. CONCLUSIONS: This nationwide case-crossover study in China demonstrated that acute exposure to PM2.5 may significantly increase the risk of under-5 mortality, with larger effects for neonates, female children, and during warm seasons. Relevant control strategies are needed to remove this roadblock to achieving under-5 mortality targets in developing countries.


Subject(s)
Air Pollutants , Air Pollution , Premature Birth , Air Pollutants/adverse effects , Air Pollutants/analysis , Air Pollution/adverse effects , Air Pollution/analysis , Child, Preschool , China/epidemiology , Cross-Over Studies , Environmental Exposure/adverse effects , Environmental Exposure/analysis , Female , Humans , Infant , Infant, Newborn , Mortality , Particulate Matter/adverse effects , Particulate Matter/analysis
14.
MMWR Morb Mortal Wkly Rep ; 70(5152): 1778-1781, 2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1596398

ABSTRACT

The COVID-19 pandemic has resulted in school closures and reduction of in-person learning (1). In August 2021, the Lake County Health Department (LCHD) in Illinois introduced a Test to Stay (TTS) strategy, whereby unvaccinated students, teachers, and staff members with certain school-related COVID-19 exposures could remain in school and participate in school-related extracurricular activities. Eligibility to participate in TTS required the following conditions to be met: 1) the exposure occurred while both the person with COVID-19 (index patient) and the close contact were masked; 2) the close contact remained asymptomatic, practiced consistent mask wearing, and maintained physical distancing; and 3) the close contact underwent testing for SARS-CoV-2 (the virus that causes COVID-19) on days 1, 3, 5, and 7 after exposure to the index patient. LCHD permitted kindergarten through grade 12 (K-12) schools in Lake County to implement TTS; 90 schools, representing 31 school districts in Lake County, implemented TTS during August 9-October 29, 2021. During the implementation period, 258 COVID-19 cases were reported. Among 1,035 students and staff members enrolled in TTS, the secondary attack risk (number of close contacts who received a positive SARS-CoV-2 test result within 14 days after exposure to an index patient, divided by total number of close contacts) was 1.5% (16 of 1,035). Among the 16 secondary cases identified, all were in students, and none appeared to transmit SARS-CoV-2 to other school-based contacts. However, nine tertiary cases were identified among household contacts of the 16 secondary cases, and four of the nine were fully vaccinated. Assuming a maximum of 8 missed school days for every 10-day quarantine period, up to 8,152 in-person learning days were saved among TTS participants. Implementation of TTS with other concurrent prevention strategies, including masking and physical distancing, limited further spread of SARS-CoV-2 within K-12 schools and allowed students to safely sustain in-person learning. Although vaccination remains the leading public health recommendation to protect against COVID-19 for those aged ≥5 years, schools might consider TTS as an option for allowing close contacts who are not fully vaccinated to remain in the classroom as an alternative to home quarantine.


Subject(s)
COVID-19 Testing , COVID-19/prevention & control , Quarantine/methods , Schools , Students , Adolescent , COVID-19/epidemiology , COVID-19/transmission , Child , Child, Preschool , Environmental Exposure , Humans , Illinois/epidemiology , Masks
15.
MMWR Morb Mortal Wkly Rep ; 70(5152): 1773-1777, 2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1593939

ABSTRACT

On July 12, 2021, the California Department of Public Health updated COVID-19 school guidance, allowing a Test to Stay (TTS) strategy to increase access to in-person learning* (1). The TTS strategy enabled unvaccinated students, exposed in school to a person infected with SARS-CoV-2 (the virus that causes COVID-19), to remain in school while under quarantine, if both the infected person and the exposed person wore masks correctly and consistently throughout the exposure. To stay in school during the quarantine period, the exposed student must remain asymptomatic, wear a mask at school, and undergo twice weekly testing for SARS-CoV-2. To date, few studies have evaluated the impact of TTS on transmission (2-4). This study evaluated a TTS strategy implemented by Los Angeles County Department of Public Health (LAC DPH). During September 20-October 31, 2021, among 78 school districts, one half permitted TTS; in total, 432 (21%) of 2,067 schools adopted TTS. TTS schools did not experience increases in COVID-19 incidence among students after TTS implementation, and in 20 identified outbreaks in TTS schools,† no tertiary transmission was identified. The ratio of student COVID-19 incidence in TTS districts to that in non-TTS districts was similar before and after TTS adoption (rate ratio = 0.5). Non-TTS schools lost an estimated 92,455 in-person school days during September 20-October 31 while students were in quarantine, compared with no lost days among quarantined students in TTS schools. Non-TTS schools cited resource-related reasons for not adopting TTS; 75% of these schools were in LAC's most disadvantaged neighborhoods. Preliminary data from LAC suggest that a school-based TTS strategy does not increase school transmission of SARS-CoV-2, and might greatly reduce loss of in-person school days; however, TTS might have barriers to implementation and require resources that are not available for some schools. Continued efforts to simplify school quarantine strategies might help to ensure that all students have access to safe in-person education. Although vaccination remains the leading public health recommendation to protect against COVID-19 for persons aged ≥5 years, schools might consider TTS as an option for allowing students with a school exposure who are not fully vaccinated to remain in the classroom as an alternative to home quarantine.


Subject(s)
COVID-19 Testing , COVID-19/prevention & control , Quarantine/methods , Schools , Students , Adolescent , COVID-19/epidemiology , Child , Child, Preschool , Environmental Exposure , Humans , Los Angeles/epidemiology , Masks
16.
Am J Respir Crit Care Med ; 205(6): 651-662, 2022 03 15.
Article in English | MEDLINE | ID: covidwho-1562065

ABSTRACT

Rationale: Risk factors for coronavirus disease (COVID-19) mortality may include environmental exposures such as air pollution. Objectives: To determine whether, among adults hospitalized with PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), long-term air pollution exposure is associated with the risk of mortality, ICU admission, or intubation. Methods: We performed a retrospective analysis of SARS-CoV-2 PCR-positive patients admitted to seven New York City hospitals from March 8, 2020, to August 30, 2020. The primary outcome was mortality; secondary outcomes were ICU admission and intubation. We estimated the annual average fine particulate matter (particulate matter ⩽2.5 µm in aerodynamic diameter [PM2.5]), nitrogen dioxide (NO2), and black carbon (BC) concentrations at patients' residential address. We employed double robust Poisson regression to analyze associations between the annual average PM2.5, NO2, and BC exposure level and COVID-19 outcomes, adjusting for age, sex, race or ethnicity, hospital, insurance, and the time from the onset of the pandemic. Results: Among the 6,542 patients, 41% were female and the median age was 65 (interquartile range, 53-77) years. Over 50% self-identified as a person of color (n = 1,687 [26%] Hispanic patients; n = 1,659 [25%] Black patients). Air pollution exposure levels were generally low. Overall, 31% (n = 2,044) of the cohort died, 19% (n = 1,237) were admitted to the ICU, and 16% (n = 1,051) were intubated. In multivariable models, a higher level of long-term exposure to PM2.5 was associated with an increased risk of mortality (risk ratio, 1.11 [95% confidence interval, 1.02-1.21] per 1-µg/m3 increase in PM2.5) and ICU admission (risk ratio, 1.13 [95% confidence interval, 1.00-1.28] per 1-µg/m3 increase in PM2.5). In multivariable models, neither NO2 nor BC exposure was associated with COVID-19 mortality, ICU admission, or intubation. Conclusions: Among patients hospitalized with COVID-19, a higher long-term PM2.5 exposure level was associated with an increased risk of mortality and ICU admission.


Subject(s)
Air Pollution/adverse effects , COVID-19/epidemiology , Environmental Exposure/adverse effects , Adult , Aged , COVID-19/diagnosis , COVID-19/therapy , Carbon/adverse effects , Critical Care , Female , Hospitalization , Humans , Intubation, Intratracheal , Male , Middle Aged , New York City , Nitrogen Dioxide/adverse effects , Particulate Matter/adverse effects , Respiration, Artificial , Retrospective Studies , Risk Factors , Time Factors
17.
J Infect Dis ; 225(5): 768-776, 2022 03 02.
Article in English | MEDLINE | ID: covidwho-1545982

ABSTRACT

BACKGROUND: We determined the burden of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in air and on surfaces in rooms of patients hospitalized with coronavirus disease 2019 (COVID-19) and investigated patient characteristics associated with SARS-CoV-2 environmental contamination. METHODS: Nasopharyngeal swabs, surface, and air samples were collected from the rooms of 78 inpatients with COVID-19 at 6 acute care hospitals in Toronto from March to May 2020. Samples were tested for SARS-CoV-2 ribonucleic acid (RNA), cultured to determine potential infectivity, and whole viral genomes were sequenced. Association between patient factors and detection of SARS-CoV-2 RNA in surface samples were investigated. RESULTS: Severe acute respiratory syndrome coronavirus 2 RNA was detected from surfaces (125 of 474 samples; 42 of 78 patients) and air (3 of 146 samples; 3 of 45 patients); 17% (6 of 36) of surface samples from 3 patients yielded viable virus. Viral sequences from nasopharyngeal and surface samples clustered by patient. Multivariable analysis indicated hypoxia at admission, polymerase chain reaction-positive nasopharyngeal swab (cycle threshold of ≤30) on or after surface sampling date, higher Charlson comorbidity score, and shorter time from onset of illness to sampling date were significantly associated with detection of SARS-CoV-2 RNA in surface samples. CONCLUSIONS: The infrequent recovery of infectious SARS-CoV-2 virus from the environment suggests that the risk to healthcare workers from air and near-patient surfaces in acute care hospital wards is likely limited.


Subject(s)
COVID-19 , Nasopharynx/virology , SARS-CoV-2/isolation & purification , Adult , Aged , Air Microbiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , COVID-19 Nucleic Acid Testing , Canada/epidemiology , Environmental Exposure , Health Personnel , Humans , Inpatients , Middle Aged , Pandemics/prevention & control , SARS-CoV-2/genetics
18.
Emerg Microbes Infect ; 11(1): 91-94, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1541488

ABSTRACT

In order to assess the risk of SARS-CoV-2 infection, transmission and reservoir development in swine, we combined results of an experimental and two observational studies. First, intranasal and intratracheal challenge of eight pigs did not result in infection, based on clinical signs and PCR on swab and lung tissue samples. Two serum samples returned a low positive result in virus neutralization, in line with findings in other infection experiments in pigs. Next, a retrospective observational study was performed in the Netherlands in the spring of 2020. Serum samples (N =417) obtained at slaughter from 17 farms located in a region with a high human case incidence in the first wave of the pandemic. Samples were tested with protein micro array, plaque reduction neutralization test and receptor-binding-domain ELISA. None of the serum samples was positive in all three assays, although six samples from one farm returned a low positive result in PRNT (titers 40-80). Therefore we conclude that serological evidence for large scale transmission was not observed. Finally, an outbreak of respiratory disease in pigs on one farm, coinciding with recent exposure to SARS-CoV-2 infected animal caretakers, was investigated. Tonsil swabs and paired serum samples were tested. No evidence for infection with SARS-CoV-2 was found. In conclusion, Although in both the experimental and the observational study few samples returned low antibody titer results in PRNT infection with SARS-CoV-2 was not confirmed. It was concluded that sporadic infections in the field cannot be excluded, but large-scale SARS-CoV-2 transmission among pigs is unlikely.


Subject(s)
COVID-19/veterinary , SARS-CoV-2/physiology , Swine Diseases/epidemiology , Swine Diseases/transmission , Swine Diseases/virology , Animals , Environmental Exposure , Netherlands/epidemiology , Public Health Surveillance , Retrospective Studies , Swine
19.
Environ Sci Process Impacts ; 24(1): 17-31, 2022 Jan 26.
Article in English | MEDLINE | ID: covidwho-1541261

ABSTRACT

Microplastics (MPs) are a group of emerging contaminants that have attracted increasing scientific and societal attention over the past decade due to their ubiquitous detection in all environmental compartments. So far, most studies on MPs focus on characterizing their occurrence, fate, and impact in the aquatic environment. Therefore, very little is known about the magnitude, patterns, and associated risks of human exposure to MPs, particularly indoors. This is a significant research gap given that people spend most of their time (up to 90%) indoors, which is exacerbated over the past year by COVID-19 lockdown measures. Critical evaluation of the existing literature revealed the presence of MPs at higher concentrations in indoor air and dust (from homes and offices) compared to outdoors. This was attributed to several factors including: indoor MPs sources (e.g. furniture, textiles), increased deposition of atmospheric MPs indoors, and less atmospheric mixing and dilution compared to outdoor air. Current understanding is that indoor human exposure to MPs occurs via a combination of inhalation, ingestion, and dermal contact. Dietary intake was considered the major pathway of human exposure to MPs until recent studies revealed potential high exposure via inhalation. Moreover, exposure via inadvertent dust ingestion and dermal contact cannot be neglected, particularly for young children. This is alarming due to the potential toxic implications of MPs exposure. Early toxicological evidence indicates that small MPs (<20 µm) can cause oxidative stress and inflammation, while particles <5 µm can be engulfed by cells and translocated to accumulate in different organs. Also, there is increasing concern over potential leaching of toxic chemicals used as plastic additives (e.g. plasticizers and flame retardants) upon exposure to MPs due to their large surface area. However, MPs exposure and risk assessment in humans is still in its infancy and more research is necessary to provide the knowledge base required for regulations to protect human health and environment against MPs.


Subject(s)
Air Pollution, Indoor , COVID-19 , Flame Retardants , Air Pollution, Indoor/analysis , Child, Preschool , Communicable Disease Control , Dust/analysis , Environmental Exposure/analysis , Environmental Monitoring , Flame Retardants/analysis , Humans , Microplastics , Plastics , SARS-CoV-2
20.
Environ Sci Pollut Res Int ; 29(16): 23407-23418, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1527495

ABSTRACT

This study aimed at investigating aircraft noise exposure levels, their annoyance, and potential health effects among communities living within airport catchment areas during the COVID-19 pandemic. Both field measurements and an online survey approach were used to investigate aircraft noise exposure levels, annoyance, and general health effects among residents living near Muscat International Airport (MCT) in Muscat, Oman, amid the COVID-19 period. The study found a drastic decline in aircraft noise levels due to the introduction of COVID-19 intervention measures such as lockdowns, social distancing, and closure of airports. In June 2020, during the COVID-19 pandemic, average daily aircraft noise levels of LAeq (39.9 dB(A)) and Lmax (49.7 dB(A)) was observed compared to the previous year (April-May 2019) of 58.5 and 76.8 dB(A), indicating aircraft noise reductions level of 32% and 35%, respectively. The results of the online social survey among 187 participants showed that most (58.8%) of the respondents did not feel that the level of noise produced by aircraft causes annoyance. During the day, the vast majority of the interviewees did not complain of any annoyance during the morning (45.5%), afternoon (39.6%), and evening (31%) with only < 4% of residents have reported a very high degree of annoyance of during COVID-19 pandemic period. Very few people (17%) did complain of experiencing general health problems while 29% did not know of any potential health effects that could be attributed to aircraft noise exposures. Aircraft noise annoyance complaints among the As-Seeb residents during the pre-COVID-19 pandemic periods were reported to be extremely high reaching about 84% compared to 41% during this current COVID-19 pandemic period. These findings support the need to develop future sustainable noise mitigation policies in order to help reduce noise exposures and improve human health during post-COVID-19 pandemic periods.


Subject(s)
COVID-19 , Noise, Transportation , Aircraft , COVID-19/epidemiology , Communicable Disease Control , Environmental Exposure , Humans , Noise, Transportation/adverse effects , Oman/epidemiology , Pandemics
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