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1.
Environ Sci Technol ; 56(9): 5641-5652, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1783919

ABSTRACT

Evidence suggests that human exposure to airborne particles and associated contaminants, including respiratory pathogens, can persist beyond a single microenvironment. By accumulating such contaminants from air, clothing may function as a transport vector and source of "secondary exposure". To investigate this function, a novel microenvironmental exposure modeling framework (ABICAM) was developed. This framework was applied to a para-occupational exposure scenario involving the deposition of viable SARS-CoV-2 in respiratory particles (0.5-20 µm) from a primary source onto clothing in a nonhealthcare setting and subsequent resuspension and secondary exposure in a car and home. Variability was assessed through Monte Carlo simulations. The total volume of infectious particles on the occupant's clothing immediately after work was 4800 µm3 (5th-95th percentiles: 870-32 000 µm3). This value was 61% (5-95%: 17-300%) of the occupant's primary inhalation exposure in the workplace while unmasked. By arrival at the occupant's home after a car commute, relatively rapid viral inactivation on cotton clothing had reduced the infectious volume on clothing by 80% (5-95%: 26-99%). Secondary inhalation exposure (after work) was low in the absence of close proximity and physical contact with contaminated clothing. In comparison, the average primary inhalation exposure in the workplace was higher by about 2-3 orders of magnitude. It remains theoretically possible that resuspension and physical contact with contaminated clothing can occasionally transmit SARS-CoV-2 between humans.


Subject(s)
COVID-19 , Clothing , Humans , Inhalation Exposure , Monte Carlo Method , SARS-CoV-2
2.
Sci Rep ; 12(1): 2529, 2022 02 15.
Article in English | MEDLINE | ID: covidwho-1692535

ABSTRACT

Although titanium dioxide (TiO2) is a suspected human carcinogen when inhaled, fiber-grade TiO2 (nano)particles were demonstrated in synthetic textile fibers of face masks intended for the general public. STEM-EDX analysis on sections of a variety of single use and reusable face masks visualized agglomerated near-spherical TiO2 particles in non-woven fabrics, polyester, polyamide and bi-component fibers. Median sizes of constituent particles ranged from 89 to 184 nm, implying an important fraction of nano-sized particles (< 100 nm). The total TiO2 mass determined by ICP-OES ranged from 791 to 152,345 µg per mask. The estimated TiO2 mass at the fiber surface ranged from 17 to 4394 µg, and systematically exceeded the acceptable exposure level to TiO2 by inhalation (3.6 µg), determined based on a scenario where face masks are worn intensively. No assumptions were made about the likelihood of the release of TiO2 particles itself, since direct measurement of release and inhalation uptake when face masks are worn could not be assessed. The importance of wearing face masks against COVID-19 is unquestionable. Even so, these results urge for in depth research of (nano)technology applications in textiles to avoid possible future consequences caused by a poorly regulated use and to implement regulatory standards phasing out or limiting the amount of TiO2 particles, following the safe-by-design principle.


Subject(s)
Masks , Spectrophotometry, Atomic , Titanium/analysis , COVID-19/prevention & control , COVID-19/virology , Humans , Inhalation Exposure/analysis , Metal Nanoparticles/chemistry , Microscopy, Electron, Transmission , Particle Size , SARS-CoV-2/isolation & purification , Social Control, Formal , Textiles/analysis
4.
Viruses ; 13(12)2021 12 17.
Article in English | MEDLINE | ID: covidwho-1580426

ABSTRACT

There is strong evidence associating the indoor environment with transmission of SARS-CoV-2, the virus that causes COVID-19. SARS-CoV-2 can spread by exposure to droplets and very fine aerosol particles from respiratory fluids that are released by infected persons. Layered mitigation strategies, including but not limited to maintaining physical distancing, adequate ventilation, universal masking, avoiding overcrowding, and vaccination, have shown to be effective in reducing the spread of SARS-CoV-2 within the indoor environment. Here, we examine the effect of mitigation strategies on reducing the risk of exposure to simulated respiratory aerosol particles within a classroom-style meeting room. To quantify exposure of uninfected individuals (Recipients), surrogate respiratory aerosol particles were generated by a breathing simulator with a headform (Source) that mimicked breath exhalations. Recipients, represented by three breathing simulators with manikin headforms, were placed in a meeting room and affixed with optical particle counters to measure 0.3-3 µm aerosol particles. Universal masking of all breathing simulators with a 3-ply cotton mask reduced aerosol exposure by 50% or more compared to scenarios with simulators unmasked. While evaluating the effect of Source placement, Recipients had the highest exposure at 0.9 m in a face-to-face orientation. Ventilation reduced exposure by approximately 5% per unit increase in air change per hour (ACH), irrespective of whether increases in ACH were by the HVAC system or portable HEPA air cleaners. The results demonstrate that mitigation strategies, such as universal masking and increasing ventilation, reduce personal exposure to respiratory aerosols within a meeting room. While universal masking remains a key component of a layered mitigation strategy of exposure reduction, increasing ventilation via system HVAC or portable HEPA air cleaners further reduces exposure.


Subject(s)
Air Pollution, Indoor/prevention & control , Inhalation Exposure/prevention & control , Masks , Physical Distancing , Ventilation , Air Conditioning , COVID-19/prevention & control , Humans , SARS-CoV-2/isolation & purification
5.
Obstet Gynecol ; 138(4): 616-621, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1462518

ABSTRACT

OBJECTIVE: To characterize respiratory emissions produced during labor and vaginal delivery vis-à-vis the potential for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: Observational study of three women who tested negative for SARS-CoV-2 and had uncomplicated vaginal deliveries. Using background-oriented schlieren imaging, we evaluated the propagation of respiratory emissions produced during the labor course and delivery. The primary outcome was the speed and propagation of breath over time, calculated through processed images collected throughout labor and delivery. RESULTS: In early labor with regular breathing, the speed of the breath was 1.37 meters/s (range 1.20-1.55 meters/s). The breath appeared to propagate faster with a cough during early labor at a speed of 1.69 meters/s (range 1.22-2.27 meters/s). During the second stage of labor with Valsalva and forced expiration, the propagation speed was 1.79 meters/s (range 1.71-1.86 meters/s). CONCLUSION: Labor and vaginal delivery increase the propagation of respiratory emissions that may increase risk of respiratory transmission of SARS-CoV-2.


Subject(s)
Air Microbiology , COVID-19/transmission , Inhalation Exposure/analysis , Labor, Obstetric/physiology , Respiration , Adult , Delivery, Obstetric/methods , Disease Transmission, Infectious , Female , Humans , Pregnancy , SARS-CoV-2 , Vagina , Young Adult
6.
Sci Rep ; 11(1): 19910, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1462025

ABSTRACT

Face masks are a primary preventive measure against airborne pathogens. Thus, they have become one of the keys to controlling the spread of the COVID-19 virus. Common examples, including N95 masks, surgical masks, and face coverings, are passive devices that minimize the spread of suspended pathogens by inserting an aerosol-filtering barrier between the user's nasal and oral cavities and the environment. However, the filtering process does not adapt to changing pathogen levels or other environmental factors, which reduces its effectiveness in real-world scenarios. This paper addresses the limitations of passive masks by proposing ADAPT, a smart IoT-enabled "active mask". This wearable device contains a real-time closed-loop control system that senses airborne particles of different sizes near the mask by using an on-board particulate matter (PM) sensor. It then intelligently mitigates the threat by using mist spray, generated by a piezoelectric actuator, to load nearby aerosol particles such that they rapidly fall to the ground. The system is controlled by an on-board micro-controller unit that collects sensor data, analyzes it, and activates the mist generator as necessary. A custom smartphone application enables the user to remotely control the device and also receive real-time alerts related to recharging, refilling, and/or decontamination of the mask before reuse. Experimental results on a working prototype confirm that aerosol clouds rapidly fall to the ground when the mask is activated, thus significantly reducing PM counts near the user. Also, usage of the mask significantly increases local relative humidity levels.


Subject(s)
COVID-19/prevention & control , Inhalation Exposure/prevention & control , Masks , Particulate Matter/isolation & purification , Respiratory Protective Devices , SARS-CoV-2/isolation & purification , Aerosols/isolation & purification , Air Microbiology , Equipment Design , Filtration/instrumentation , Humans , Mobile Applications , Particle Size , Smart Materials/chemistry , Smartphone
7.
PLoS One ; 16(10): e0258191, 2021.
Article in English | MEDLINE | ID: covidwho-1456093

ABSTRACT

Face coverings are a key component of preventive health measure strategies to mitigate the spread of respiratory illnesses. In this study five groups of masks were investigated that are of particular relevance to the SARS-CoV-2 pandemic: re-usable, fabric two-layer and multi-layer masks, disposable procedure/surgical masks, KN95 and N95 filtering facepiece respirators. Experimental work focussed on the particle penetration through mask materials as a function of particle diameter, and the total inward leakage protection performance of the mask system. Geometric mean fabric protection factors varied from 1.78 to 144.5 for the fabric two-layer and KN95 materials, corresponding to overall filtration efficiencies of 43.8% and 99.3% using a flow rate of 17 L/min, equivalent to a breathing expiration rate for a person in a sedentary or standing position conversing with another individual. Geometric mean total inward leakage protection factors for the 2-layer, multi-layer and procedure masks were <2.3, while 6.2 was achieved for the KN95 masks. The highest values were measured for the N95 group at 165.7. Mask performance is dominated by face seal leakage. Despite the additional filtering layers added to cloth masks, and the higher filtration efficiency of the materials used in disposable procedure and KN95 masks, the total inward leakage protection factor was only marginally improved. N95 FFRs were the only mask group investigated that provided not only high filtration efficiency but high total inward leakage protection, and remain the best option to protect individuals from exposure to aerosol in high risk settings. The Mask Quality Factor and total inward leakage performance are very useful to determine the best options for masking. However, it is highly recommended that testing is undertaken on prospective products, or guidance is sought from impartial authorities, to confirm they meet any implied standards.


Subject(s)
Filtration/instrumentation , Masks/statistics & numerical data , N95 Respirators/statistics & numerical data , Textiles , Equipment Reuse , Inhalation Exposure/prevention & control
8.
Sci Rep ; 11(1): 19403, 2021 09 30.
Article in English | MEDLINE | ID: covidwho-1447324

ABSTRACT

The ongoing worldwide outbreak of COVID-19 has set personal protective equipment in the spotlight. A significant number of countries impose the use of facemasks in public spaces and encourage it in the private sphere. Even in countries where relatively high vaccination rates are achieved at present, breakthrough infections have been frequently reported and usage of facemasks in certain settings has been recommended again. Alternative solutions, including community masks fabricated using various materials, such as cotton or jersey, have emerged alongside facemasks following long-established standards (e.g., EN 149, EN 14683). In the present work, we present a computational model to calculate the ability of different types of facemasks to reduce the exposure to virus-laden respiratory particles, with a focus on the relative importance of the filtration properties and the fitting on the wearer's face. The model considers the facemask and the associated leakage, the transport of respiratory particles and their accumulation around the emitter, as well as the fraction of the inhaled particles deposited in the respiratory system. Different levels of leakages are considered to represent the diversity of fittings likely to be found among a population of non-trained users. The leakage prevails over the filtration performance of a facemask in determining the exposure level, and the ability of a face protection to limit leakages needs to be taken into account to accurately estimate the provided protection. Filtering facepieces (FFP) provide a better protection efficiency than surgical and community masks due to their higher filtration efficiency and their ability to provide a better fit and thus reduce the leakages. However, an improperly-fitted FFP mask loses a critical fraction of its protection efficiency, which may drop below the protection level provided by properly-worn surgical and community masks.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Filtration/instrumentation , Masks/standards , SARS-CoV-2 , Aerosols , Air Microbiology , COVID-19/virology , Disease Transmission, Infectious/prevention & control , Filtration/standards , Humans , Inhalation Exposure/prevention & control , Models, Theoretical , Particle Size
9.
PLoS Pathog ; 17(8): e1009865, 2021 08.
Article in English | MEDLINE | ID: covidwho-1443861

ABSTRACT

While evidence exists supporting the potential for aerosol transmission of SARS-CoV-2, the infectious dose by inhalation remains unknown. In the present study, the probability of infection following inhalation of SARS-CoV-2 was dose-dependent in a nonhuman primate model of inhalational COVID-19. The median infectious dose, assessed by seroconversion, was 52 TCID50 (95% CI: 23-363 TCID50), and was significantly lower than the median dose for fever (256 TCID50, 95% CI: 102-603 TCID50), resulting in a group of animals that developed an immune response post-exposure but did not develop fever or other clinical signs of infection. In a subset of these animals, virus was detected in nasopharyngeal and/or oropharyngeal swabs, suggesting that infected animals without signs of disease are able to shed virus and may be infectious, which is consistent with reports of asymptomatic spread in human cases of COVID-19. These results suggest that differences in exposure dose may be a factor influencing disease presentation in humans, and reinforce the importance of public health measures that limit exposure dose, such as social distancing, masking, and increased ventilation. The dose-response data provided by this study are important to inform disease transmission and hazard modeling, and, ultimately, mitigation strategies. Additionally, these data will be useful to inform dose selection in future studies examining the efficacy of therapeutics and vaccines against inhalational COVID-19, and as a baseline in healthy, young adult animals for assessment of the importance of other factors, such as age, comorbidities, and viral variant, on the infectious dose and disease presentation.


Subject(s)
COVID-19/transmission , COVID-19/virology , Macaca fascicularis , Seroconversion , Animals , Chlorocebus aethiops , Disease Models, Animal , Female , Fever/virology , Inhalation Exposure , Male , Vero Cells , Viral Load
10.
J Aerosol Med Pulm Drug Deliv ; 34(5): 293-302, 2021 09.
Article in English | MEDLINE | ID: covidwho-1440594

ABSTRACT

Background: The precaution of airborne transmission of viruses, such as influenza, SARS, MERS, and COVID-19, is essential for reducing infection. In this study, we applied a zero-valent nanosilver/titania-chitosan (nano-Ag0/TiO2-CS) filter bed, whose broad-spectrum antimicrobial efficacy has been proven previously, for the removal of viral aerosols to minimize the risk of airborne transmission. Methods: The photochemical deposition method was used to synthesize the nano-Ag0/TiO2-CS antiviral material. The surface morphology, elemental composition, and microstructure of the nano-Ag0/TiO2-CS were analyzed by a scanning electron microscopy/energy dispersive X-ray spectroscopy and a transmission electron microscopy, respectively. The MS2 bacteriophages were used as surrogate viral aerosols. The antiviral efficacy of nano-Ag0/TiO2-CS was evaluated by the MS2 plaque reduction assay (PRA) and filtration experiments. In the filtration experiments, the MS2 aerosols passed through the nano-Ag0/TiO2-CS filter, and the MS2 aerosol removal efficiency was evaluated by an optical particle counter and culture method. Results and Conclusions: In the MS2 PRA, 3 g of nano-Ag0/TiO2-CS inactivated 97% of MS2 bacteriophages in 20 mL liquid culture (2 ± 0.5 × 1016 PFU/mL) within 2 hours. The removal efficiency of nano-Ag0/TiO2-CS filter (thickness: 6 cm) for MS2 aerosols reached up to 93%. Over 95% of MS2 bacteriophages on the surface of the nano-Ag0/TiO2-CS filter were inactivated within 20 minutes. The Wells-Riley model predicted that when the nano-Ag0/TiO2-CS filter was used in the ventilation system, airborne infection probability would reduce from 99% to 34.6%. The nano-Ag0/TiO2-CS filter could remain at 50% of its original antiviral efficiency after continuous operation for 1 week, indicating its feasibility for the control of the airborne transmission.


Subject(s)
Air Filters , Air Microbiology , Chitosan/chemistry , Filtration/instrumentation , Inhalation Exposure/prevention & control , Levivirus/isolation & purification , Metal Nanoparticles , Silver/chemistry , Titanium/chemistry , Aerosols , COVID-19/prevention & control , COVID-19/transmission , Equipment Design , Humans , Inhalation Exposure/adverse effects , Levivirus/pathogenicity , SARS-CoV-2/isolation & purification , SARS-CoV-2/pathogenicity
11.
Pak J Biol Sci ; 24(9): 920-927, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1431004

ABSTRACT

<b>Background and Objective:</b> COVID-19 is a fast-spreading worldwide pandemic caused by SARS-CoV-2. The World Health Organization recommended wearing face masks. Masks have become an urgent necessity throughout the pandemic, the study's goal was to track the impact of wearing masks on immunological responses. <b>Materials and Methods:</b> This study was conducted on 40 healthy people who were working in health care at Nineveh Governorate Hospitals from September-December, 2020. They wore face masks at work for more than 8 months for an average of 6 hrs a day. The control sample included 40 healthy individuals, who wore masks for very short periods. All samples underwent immunological and physiological tests to research the effects of wearing masks for extended periods within these parameters. <b>Results:</b> The results showed a significant decrease in total White Blood Count and the absolute number of neutrophils, lymphocytes, monocytes and phagocytic activity. However, there was a significant increase in the absolute number of eosinophils in participants compared with the control. The results also suggested there were no significant differences in IgE, haemoglobin concentration and blood O<sub>2 </sub>saturation in participants who wore masks for more than 6 hrs compared to the control group. The results showed a significant increase in pulse rate in participants who wore masks for more than 6 hrs compared to the control group. The results also showed a strong correlation coefficient between the time of wearing masks and some immunological, haematological parameters. <b>Conclusion:</b> Wearing masks for long periods alters immunological parameters that initiate the immune response, making the body weaker in its resistance to infectious agents.


Subject(s)
COVID-19/prevention & control , Inhalation Exposure/prevention & control , Leukocytes/immunology , Masks , Occupational Exposure/prevention & control , Phagocytes/immunology , SARS-CoV-2/pathogenicity , Adult , Biomarkers/blood , COVID-19/transmission , Case-Control Studies , Female , Heart Rate , Hemoglobins/metabolism , Humans , Immunoglobulin E/blood , Inhalation Exposure/adverse effects , Leukocyte Count , Male , Masks/adverse effects , Middle Aged , Occupational Exposure/adverse effects , Occupational Health , Oxygen/blood , Personnel, Hospital , Phagocytosis , Time Factors
13.
West J Emerg Med ; 22(5): 1045-1050, 2021 Aug 17.
Article in English | MEDLINE | ID: covidwho-1405508

ABSTRACT

INTRODUCTION: The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Plastic face shields may have advantages over regular medical masks. Although many designs of face shields exist, there is a paucity of evidence regarding the efficacy of shield designs against droplet transmissions. There is even less published evidence comparing various face shields. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission. METHODS: We simulated droplet transmission via coughing using a heavy-duty chemical spray bottle filled with fluorescein. A standard-adult sized mannequin head was used. The mannequin head wore various face shields and was positioned to face the spray bottle at either a 0°, 45°, or 90° angle. The spray bottle was positioned at and sprayed from 30 centimeters (cm), 60 cm, or 90 cm away from the head. These steps were repeated for all face shields used. Control was a mannequin that wore no PPE. A basic mask was also tested. We collected data for particle count, total area of particle distribution, average particle size, and percentage area covered by particles. We analyzed percent covered by particles using a repeated measures mixed-model regression with Tukey-Kramer pairwise comparison. RESULTS: We used least square means to estimate the percentage area covered by particles. Wearing PPE regardless of the design reduced particle transmission to the mannequin compared to the control. The LCG mask had the lowest square means of 0.06 of all face-shield designs analyzed. Tukey-Kramer pairwise comparison showed that all PPEs had a decrease in particle contamination compared to the control. LCG shield was found to have the least contamination compared to all other masks (P < 0.05). CONCLUSION: Results suggest the importance of wearing a protective covering against droplet transmission. The LCG shield was found to decrease facial contamination by droplets the most of any tested protective equipment.


Subject(s)
Aerosols/analysis , COVID-19/prevention & control , Infection Control , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Inhalation Exposure/prevention & control , Masks/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , COVID-19/epidemiology , Cough , Delivery of Health Care , Humans , Manikins , Masks/standards , Particle Size , Personal Protective Equipment/standards , SARS-CoV-2
16.
J Hazard Mater ; 423(Pt A): 127001, 2022 02 05.
Article in English | MEDLINE | ID: covidwho-1363291

ABSTRACT

This study assessed the composition of single-use face mask materials, quantified the concentration of phthalate esters in masks and evaluated associated inhalation exposure risk. All the mask samples, including 12 surgical and four N95/P1/P2 masks, were identified to be made of polypropylene, with polyethylene terephthalate present in the N95/P1/P2 masks. Di-methyl phthalate, di-n-butyl phthalate, di-ethyl phthalate, di-isobutyl phthalate and di(2-ethylhexyl) phthalate were frequently detected and their concentration summed up 55 ± 35 ~ 1700 ± 140 ng per surgical mask and 2300 ± 150 ~ 5200 ± 800 ng per N95/P1/P2 mask. Our simulation experiment suggested a mean loss of 13 - 71% of phthalate mass depending on compounds, during 5-hour wearing of these masks. This resulted in an estimated daily intake of individual compounds no higher than 20 ng/kg/day for adults and 120 ng/kg/day for toddlers, which were at least 80 times lower compared to relevant tolerable daily intake values. Two interventional trials were conducted where a volunteer wore a mask for four hours and urine samples were collected before and after the mask wearing. No obvious increase was observed for the urinary concentration of any phthalate metabolite, indicating minimal contribution to overall exposure to phthalate esters.


Subject(s)
Environmental Pollutants , Phthalic Acids , Adult , Dibutyl Phthalate , Environmental Exposure/analysis , Esters , Humans , Inhalation Exposure/analysis , Masks
18.
Opt Express ; 29(12): 18688-18704, 2021 Jun 07.
Article in English | MEDLINE | ID: covidwho-1259231

ABSTRACT

The transmission of airborne pathogens represents a major threat to worldwide public health. Ultraviolet light irradiation can contribute to the sanification of air to reduce the pathogen transmission. We have designed a compact filter for airborne pathogen inactivation by means of UVC LED sources, whose effective irradiance is enhanced thanks to high reflective surfaces. We used ray-tracing and computational fluid dynamic simulations to model the device and to maximize the performance inside the filter volume. Simulations also show the inhibition of SARS-Cov-2 in the case of high air fluxes. This study demonstrates that current available LED technology is effective for air sanification purposes.


Subject(s)
Air Microbiology , COVID-19/prevention & control , Disinfection/instrumentation , Equipment Design , Infection Control/methods , SARS-CoV-2 , Ultraviolet Rays , Disinfection/methods , Humans , Inhalation Exposure/prevention & control , Pneumonia, Viral/prevention & control
20.
Health Phys ; 121(1): 73-76, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1232236

ABSTRACT

ABSTRACT: This work considers the implications of cloth masks due to the COVID-19 pandemic on suspected plutonium inhalations and dose assessment. In a plutonium inhalation scenario, the greater filtration efficiency for large particles exhibited by cloth masks can reduce early fecal excretion without a corresponding reduction in dose. For plutonium incidents in which cloth masks are worn, urinary excretion should be the preferred method of inferring dose immediately after the inhalation, and fecal excretion should be considered unreliable for up to 10 days.


Subject(s)
COVID-19/prevention & control , Feces/chemistry , Inhalation Exposure/statistics & numerical data , Masks , Occupational Exposure/statistics & numerical data , Plutonium/analysis , Radiation Exposure/statistics & numerical data , Radiation Monitoring , Humans , Inhalation Exposure/prevention & control , Occupational Exposure/prevention & control , Plutonium/pharmacokinetics , Radiation Exposure/prevention & control , Radiation Monitoring/methods , Respiratory System/chemistry
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