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1.
PLoS One ; 17(8): e0272122, 2022.
Article in English | MEDLINE | ID: covidwho-2009687

ABSTRACT

During the COVID-19 pandemic, a number of infection clusters associated with choral singing have been reported. Singing generates droplets and carries the risk of spreading infection. However, no reports have explored droplet flight and aerosol production rates by singing and speaking in Japanese. First, we conducted an observation experiment evaluating the maximum flight distance and number of droplets generated by singing in Japanese, using a high-speed camera and particle counter. Twenty amateur choir members, 10 male and 10 female (five members for each of the four voices), participated in the experiment. Subsequently, although the maximum distance that droplets traveled by singing in Japanese was 61 cm for men (median of 46.5, interquartile range, 36-57) and 56 cm for women (median of 27.5, interquartile range, 20-50), droplets were observed anteriorly and laterally to be up to 66.8 cm. At the singer's mouth, ≥ 5 µm droplets were observed, whereas not observed at 1 meter toward the front of the singers in women and men, respectively. In German singing, droplets were observed up to 111 cm toward the front of the singer, possibly reflecting differences in pronunciation. In Japanese reading aloud, droplets were also observed up to 47 cm toward the front, whereas no droplet dispersion was observed by speaking the Japanese /a/ vowel or singing with wearing surgical mask toward the front. The aerosols produced when reading singing the /u/ vowels were significantly higher than those in other vowels. When singing in a choral group, keeping a sufficient distance at the front and side is recommended in minimizing infectious spread. If distance is not possible, practicing with /a/ vowels and avoiding consonants may be an alternative method. Our observations lasted only 50 seconds per song, and further observational studies are needed to determine the dynamics of aerosols that stay for long periods.


Subject(s)
COVID-19 , Singing , Female , Humans , Japan , Male , Pandemics , Voice Quality
2.
Respir Res ; 23(1): 208, 2022 Aug 16.
Article in English | MEDLINE | ID: covidwho-2002180

ABSTRACT

BACKGROUND: Chronic obstructive pulmonary disease (COPD) and interstital lung disease (ILD) are incurable conditions characterised by airflow limitation, persisting respiratory symptoms, and progressive respiratory failure. People living with COPD or ILD often suffer from chronic and severe breathlessness, with limited treatment options and low engagement rates with current therapies. Group singing represents a potential community-based therapy to improve quality of life for patients with COPD or ILD and breathlessness. METHODS: This protocol papers describes SINFONIA, a parallel, double-arm, randomised, blinded-analysis, mixed-methods phase II/III trial of guided, online group singing that will be conducted over 24 months. Adults with confirmed COPD or ILD, on stable treatment for at least four weeks at time of recruitment, with a modified Medical Research Council (mMRC) dyspnoea score of two or greater, who are capable and willing to give consent, and not currently participating in pulmonary rehabilitation will be eligible to participate. Carers may optionally enrol in the trial. Data will be collected on quality of life, anxiety and depression, breathlessness, mastery of breathing, exercise tolerance, loneliness, healthcare utilisation, and carer quality of life (optional). Participants will be randomised 1:1 to intervention or control arms with intervention arm attending one 90 min, guided, online, group singing session per week for 12 weeks and control arm continuing routine care. Phase II of the trial aims to determine the feasibility and acceptability of guided, online group singing and will collect preliminary data on effectiveness. Phase III aims to determine whether guided, online group singing has an effect on quality of life with the primary outcome being a between arm difference in quality of life (36-item Short Form Survey) measured at 12 weeks. DISCUSSION: SINFONIA is the first study is the first of its kind in Australia and to our knowledge, the first to deliver the singing intervention program entirely online. Determining the feasibility, acceptability, and effectiveness of guided, online group singing is an important step towards improving low-cost, low-risk, community-based therapeutic options for patients living with COPD or ILD and breathlessness. TRIAL REGISTRATION: Phase II- ACTRN12621001274864 , registered 20th September 2021; Phase III- ACTRN12621001280897 , registered 22nd September 2021.


Subject(s)
Lung Diseases, Interstitial , Pulmonary Disease, Chronic Obstructive , Singing , Adult , Caregivers , Clinical Trials, Phase II as Topic , Dyspnea , Humans , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life , Randomized Controlled Trials as Topic
3.
Codas ; 34(6): e20210095, 2022.
Article in Portuguese, English | MEDLINE | ID: covidwho-1963166

ABSTRACT

PURPOSE: To analyze and compare the degree of cervical disability in singers with dysphonia and in singers without self-reported vocal complaints. METHODS: A cross-sectional observational analysis. Sixty-two singers participated in the study: Thirty-two singers without vocal complaints and 30 singers with a speech-language pathology and otorhinolaryngological diagnosis of dysphonia. For singers without vocal complaints, two questionnaires were applied via Google Forms: A three-question questionnaire regarding vocal complaints and how each singer perceived their speaking and singing voice, and the Copenhagen Neck Functional Disability Scale (CNFDS). Data on singers with dysphonia were extracted from a database previously collected by a team of researchers at the speech-language pathology department of the Federal University of Minas Gerais. The difference in data collection methodology between the two groups was due to restrictions presented by the coronavirus pandemic. The Mann-Whitney test was used to compare the two groups, at a significance level of 5%. RESULTS: There was a significant difference between the groups (p=0.0001), demonstrating that singers with dysphonia suffered more from cervical pain and discomfort than singers without vocal complaints. CONCLUSION: Singers with dysphonia have more cervical pain and discomfort than singers without vocal complaints, thus presenting with greater cervical disability.


OBJETIVO: analisar e comparar o grau de incapacidade cervical em cantoras disfônicas e em cantoras sem queixas vocais autorreferidas. MÉTODO: estudo observacional analítico transversal. Participaram do estudo 32 cantoras sem queixas vocais e 30 cantoras com diagnóstico fonoaudiológico e otorrinolaringológico de disfonia. Para as cantoras sem queixas vocais foram utilizados dois questionários aplicados virtualmente via GoogleForms, sendo um questionário composto por três perguntas referentes às queixas vocais e como cada cantora percebia sua voz de falada e de forma cantada e a Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC). Os dados referentes às cantoras disfônicas foram extraídos de um banco de dados previamente coletado por uma equipe de pesquisadores no Observatório de Saúde Funcional em Fonoaudiologia da Universidade Federal de Minas Gerais e a diferença na metodologia de coleta de dados entre os dois grupos deu-se devido às restrições apresentadas pela pandemia causada pelo coronavírus. Para a comparação entre os dois grupos, foi utilizado o teste Mann-Whitney e foi considerado um nível de significância de 5%. RESULTADOS: Houve diferença significativa entre os grupos (p=0,0001), demonstrando que as cantoras disfônicas sofrem mais com dores e desconfortos cervicais do que as cantoras sem queixas vocais. CONCLUSÃO: cantoras disfônicas apresentam mais dor e desconforto cervical do que as cantoras sem queixas vocais, caracterizando uma maior incapacidade cervical.


Subject(s)
Dysphonia , Singing , Voice Disorders , Cross-Sectional Studies , Dysphonia/diagnosis , Hoarseness , Humans , Neck Pain , Surveys and Questionnaires , Voice Disorders/diagnosis , Voice Quality
4.
Indoor Air ; 32(6): e13064, 2022 06.
Article in English | MEDLINE | ID: covidwho-1909399

ABSTRACT

The exhalation of aerosols during musical performances or rehearsals posed a risk of airborne virus transmission in the COVID-19 pandemic. Previous research studied aerosol plumes by only focusing on one risk factor, either the source strength or convective transport capability. Furthermore, the source strength was characterized by the aerosol concentration and ignored the airflow rate needed for risk analysis in actual musical performances. This study characterizes aerosol plumes that account for both the source strength and convective transport capability by conducting experiments with 18 human subjects. The source strength was characterized by the source aerosol emission rate, defined as the source aerosol concentration multiplied by the source airflow rate (brass 383 particle/s, singing 408 particle/s, and woodwind 480 particle/s). The convective transport capability was characterized by the plume influence distance, defined as the sum of the horizontal jet length and horizontal instrument length (brass 0.6 m, singing 0.6 m and woodwind 0.8 m). Results indicate that woodwind instruments produced the highest risk with approximately 20% higher source aerosol emission rates and 30% higher plume influence distances compared with the average of the same risk indicators for singing and brass instruments. Interestingly, the clarinet performance produced moderate source aerosol concentrations at the instrument's bell, but had the highest source aerosol emission rates due to high source airflow rates. Flute performance generated plumes with the lowest source aerosol emission rates but the highest plume influence distances due to the highest source airflow rate. Notably, these comprehensive results show that the source airflow is a critical component of the risk of airborne disease transmission. The effectiveness of masking and bell covering in reducing aerosol transmission is due to the mitigation of both source aerosol concentrations and plume influence distances. This study also found a musician who generated approximately five times more source aerosol concentrations than those of the other musicians who played the same instrument. Despite voice and brass instruments producing measurably lower average risk, it is possible to have an individual musician produce aerosol plumes with high source strength, resulting in enhanced transmission risk; however, our sample size was too small to make generalizable conclusions regarding the broad musician population.


Subject(s)
Air Pollution, Indoor , COVID-19 , Respiratory Aerosols and Droplets , Singing , Aerosols/analysis , Air Pollution, Indoor/analysis , COVID-19/transmission , Humans , Music , Pandemics , Respiratory Aerosols and Droplets/virology
5.
Perspect Public Health ; 142(2): 102-116, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1741878

ABSTRACT

AIMS: (1) To catalogue and map all singing for health and wellbeing groups in the Republic of Ireland (ROI); (2) determine how they prioritise health outcomes; (3) understand what they consider success; and (4) identify gaps in provision. METHODS: A novel mixed-methods survey was distributed electronically through SING Ireland (the Choir Association of Ireland), artsandhealth.ie, and to 2736 potential stakeholders with links to singing for health and wellbeing and singing on social prescription (SSP) from October 2020 to April 2021. Thematic analysis was used to analyse four open-ended survey questions. RESULTS: A total of 185 singing for health and wellbeing groups were identified, with varied representation in each of the ROI's 26 counties. 35 groups were noted to have links to SSP. Gaps in provision for clinical and individual populations and for SSP were identified. Six themes related to the success of group singing for health and wellbeing programmes were determined: fostering and funding social and community connections; the people and the approach; enjoyment and atmosphere; musical and personal growth, programmatic structure and musical content; and the impact of Covid. CONCLUSION: The first-ever national mapping of group singing for health and wellbeing in the ROI, and one of few internationally, this study may serve as a roadmap for gathering information about existing singing for health and wellbeing provision and identifying geographical and clinical gaps internationally. Recommendations are included for future research to address gaps in provision, explore the feasibility of integrating SSP more widely and for further public health investment.


Subject(s)
COVID-19 , Group Processes , Health Status , Singing , Emotions , Humans , Ireland , Public Health
6.
Health Promot Int ; 37(Supplement_1): i4-i17, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1713659

ABSTRACT

This article explores the impact of online Irish traditional singing sessions on health and well-being during the COVID-19 pandemic. Singing sessions are unique facets of Ireland's music tradition that saw dramatic closure, interruption and digital transition in response to COVID-19 social distancing measures. This study highlights a gap in health promotion literature with regard to traditional singing sessions as a group singing activity and examines the potential for online group singing activities to have positive impacts on the health and well-being of participants. While traditional singing sessions foreground solo performances, they are quintessentially group activities, and include community engagement and active participation from singers and listeners alike. Through an online survey (n = 108), and ethnographic interviews (n = 3), this study explores potential health and well-being implications of online traditional singing sessions, and reveals four main areas of impact: social connection, enjoyment, cognitive motivation and timekeeping. The study suggests that online traditional singing sessions can promote health and well-being in participants, particularly during times of isolation.


This article explores the impact of online Irish traditional singing sessions on health and well-being during the COVID-19 pandemic. Singing sessions are unique facets of Ireland's music tradition which were forced to move online due to COVID-19 restrictions. This study used an online survey (n = 108), and interviews (n = 3), to explore the impact of these online sessions on the well-being of their participants. Findings showed the impacts to be overwhelmingly positive, particularly in four main areas: social connection, enjoyment, cognitive motivation, and timekeeping. This study highlights the value of traditional singing sessions as group singing activities for the purposes of health and well-being promotion, and suggests that online group singing activities can be beneficial, particularly during times of isolation.


Subject(s)
COVID-19 , Singing , Health Promotion , Humans , Pandemics , Surveys and Questionnaires
7.
Clin Infect Dis ; 74(10): 1722-1728, 2022 05 30.
Article in English | MEDLINE | ID: covidwho-1707710

ABSTRACT

BACKGROUND: Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) superspreading events suggest that aerosols play an important role in driving the coronavirus disease 2019 (COVID-19) pandemic. To better understand how airborne SARS-CoV-2 transmission occurs, we sought to determine viral loads within coarse (>5 µm) and fine (≤5 µm) respiratory aerosols produced when breathing, talking, and singing. METHODS: Using a G-II exhaled breath collector, we measured viral RNA in coarse and fine respiratory aerosols emitted by COVID-19 patients during 30 minutes of breathing, 15 minutes of talking, and 15 minutes of singing. RESULTS: Thirteen participants (59%) emitted detectable levels of SARS-CoV-2 RNA in respiratory aerosols, including 3 asymptomatic and 1 presymptomatic patient. Viral loads ranged from 63-5821 N gene copies per expiratory activity per participant, with high person-to-person variation. Patients earlier in illness were more likely to emit detectable RNA. Two participants, sampled on day 3 of illness, accounted for 52% of total viral load. Overall, 94% of SARS-CoV-2 RNA copies were emitted by talking and singing. Interestingly, 7 participants emitted more virus from talking than singing. Overall, fine aerosols constituted 85% of the viral load detected in our study. Virus cultures were negative. CONCLUSIONS: Fine aerosols produced by talking and singing contain more SARS-CoV-2 copies than coarse aerosols and may play a significant role in SARS-CoV-2 transmission. Exposure to fine aerosols, especially indoors, should be mitigated. Isolating viable SARS-CoV-2 from respiratory aerosol samples remains challenging; whether this can be more easily accomplished for emerging SARS-CoV-2 variants is an urgent enquiry necessitating larger-scale studies.


Subject(s)
COVID-19 , Singing , Aerosols , Humans , RNA, Viral/genetics , SARS-CoV-2 , Viral Load
8.
J R Soc Interface ; 19(187): 20210833, 2022 02.
Article in English | MEDLINE | ID: covidwho-1706677

ABSTRACT

Speaking and singing are activities linked to increased aerosol particle emissions from the respiratory system, dependent on the utilized vocal intensity. As a result, these activities have experienced considerable restrictions in enclosed spaces since the onset of the COVID-19 pandemic due to the risk of infection from the SARS-CoV-2 virus, transmitted by virus-carrying aerosols. These constraints have affected public education and extracurricular activities for children as well, from in-person music instruction to children's choirs. However, existing risk assessments for children have been based on emission measurements of adults. To address this, we measured the particle emission rates of 15 pre-adolescent children, all eight to ten years old, with a laser particle counter for the test conditions: breathing at rest, speaking, singing and shouting. Compared with values taken from 15 adults, emission rates for breathing, speaking and singing were significantly lower for children. Particle emission rates were reduced by a factor of 4.3 across all conditions, whereas emitted particle volume rates were reduced by a factor of 4.8. These data can supplement SARS-CoV-2 risk management scenarios for various school and extracurricular settings.


Subject(s)
COVID-19 , Singing , Adolescent , Adult , Aerosols , Child , Humans , Pandemics , SARS-CoV-2
9.
BMJ Open ; 11(12): e058953, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1598545

ABSTRACT

INTRODUCTION: Parkinson's disease can be associated with speech deterioration and low communication confidence which in turn compromises social interaction. Therapeutic singing is an engaging method for combatting speech decline; however, face-to-face delivery can limit access to group singing. The aim of this study is to test the feasibility and acceptability of an online mode of delivery for a Parkinson's singing intervention (ParkinSong) as well as remote data collection procedures. METHODS AND ANALYSIS: This ParkinSong Online feasibility trial is a single-arm, pre-post study of online singing delivery and remote data collection for 30 people living with Parkinson's. The primary outcome measure is feasibility: recruitment, retention, attendance, safety, intervention fidelity, acceptability and associated costs. Secondary outcomes are speech (loudness, intelligibility, quality, communication-related quality of life) and wellbeing (apathy, depression, anxiety, stress, health-related quality of life). This mode of delivery aims to increase the accessibility of singing interventions. ETHICS AND DISSEMINATION: Ethics approval was obtained from The University of Melbourne Human Research Ethics Committee (2021-14465-16053-3) and the trial has been prospectively registered. Results will be presented at national and international conferences, published in a peer-reviewed journal, and disseminated to the Parkinson's community, researchers and policymakers. TRIAL REGISTRATION NUMBER: ACTRN12621000940875.


Subject(s)
Parkinson Disease , Singing , Telemedicine , Feasibility Studies , Humans , Parkinson Disease/complications , Parkinson Disease/therapy , Quality of Life , Telemedicine/methods
10.
Sci Rep ; 11(1): 24183, 2021 12 17.
Article in English | MEDLINE | ID: covidwho-1585792

ABSTRACT

COVID-19 has restricted singing in communal worship. We sought to understand variations in droplet transmission and the impact of wearing face masks. Using rapid laser planar imaging, we measured droplets while participants exhaled, said 'hello' or 'snake', sang a note or 'Happy Birthday', with and without surgical face masks. We measured mean velocity magnitude (MVM), time averaged droplet number (TADN) and maximum droplet number (MDN). Multilevel regression models were used. In 20 participants, sound intensity was 71 dB for speaking and 85 dB for singing (p < 0.001). MVM was similar for all tasks with no clear hierarchy between vocal tasks or people and > 85% reduction wearing face masks. Droplet transmission varied widely, particularly for singing. Masks decreased TADN by 99% (p < 0.001) and MDN by 98% (p < 0.001) for singing and 86-97% for other tasks. Masks reduced variance by up to 48%. When wearing a mask, neither singing task transmitted more droplets than exhaling. In conclusion, wide variation exists for droplet production. This significantly reduced when wearing face masks. Singing during religious worship wearing a face mask appears as safe as exhaling or talking. This has implications for UK public health guidance during the COVID-19 pandemic.


Subject(s)
COVID-19/transmission , Disease Transmission, Infectious/prevention & control , Face , Masks , Singing/physiology , Adult , COVID-19/epidemiology , COVID-19/virology , Cross-Sectional Studies , Exhalation/physiology , Female , Humans , Male , Pandemics/prevention & control , Risk Factors , SARS-CoV-2/physiology , Virus Shedding/physiology
13.
BMJ Open Respir Res ; 8(1)2021 11.
Article in English | MEDLINE | ID: covidwho-1515306

ABSTRACT

Singing is an increasingly popular activity for people with chronic obstructive pulmonary disease (COPD). Research to date suggests that 'Singing for Lung Health' may improve various health measures, including health-related quality-of-life. Singing and breathing are closely linked processes affecting one another. In this narrative review, we explore the physiological rationale for 'Singing for Lung Health' as an intervention, focusing on the abnormalities of pulmonary mechanics seen in COPD and how these might be impacted by singing. The potential beneficial physiological mechanisms outlined here require further in-depth evaluation.


Subject(s)
Pulmonary Disease, Chronic Obstructive , Singing , Humans , Lung , Pulmonary Disease, Chronic Obstructive/therapy , Quality of Life
14.
Public Health ; 194: 196-201, 2021 May.
Article in English | MEDLINE | ID: covidwho-1392511

ABSTRACT

OBJECTIVES: In the face of the SARS-CoV-2 pandemic, people with dementia and their carers are contending with serious challenges to their health and wellbeing, due to risk of severe illness, limiting of social contact and disruption to usual activities. Many forms of support for people with dementia and their carers, including singing groups, have moved online using videoconferencing. Previous research has demonstrated the benefits of group singing, which include cognitive stimulation, meaningful activity and peer support. However, although we know which aspects of the singing group experience participants find helpful, we do not know how this experience translates into an online videoconferencing format, and this is a very new field with little existing research. This article reviews the literature pertinent to online singing interventions and uses the findings to develop some suggestions for running an online singing group. STUDY DESIGN: SCOPING REVIEW. METHODS: Systematic literature searches were conducted in EMBASE, Medline, CINAHL, PsycINFO and Web of Science. Owing to the paucity of existing research, searches were also conducted in Google Scholar. The scope of the review covered five related areas: online music making and music therapy, telemedicine and telecare, everyday technology for people with dementia, digital arts and dementia, and use of technology for social interaction and leisure. Our analysis aimed to integrate the results to inform the implementation of online singing groups for people with dementia. RESULTS: Scoping of evidence from discrete fields of enquiry and different disciplinary traditions can inform the delivery of online singing in dementia. This literature also yields useful insights into the role of the carer and how best to support participants to use technology. Barriers and facilitators to online singing were found to relate both to the technology and to the individual participant. CONCLUSION: Lockdown restrictions have led to much innovation, and this is likely to lead to changes in practice even after normal life resumes. The suggestions in this article will be helpful primarily for practitioners moving into online work and researchers investigating this novel area. They may also be useful to commissioners and policymakers because they reflect current knowledge about best practice.


Subject(s)
Dementia/therapy , Music Therapy/methods , Singing , Telemedicine , COVID-19/epidemiology , Humans
15.
Indoor Air ; 31(6): 1798-1814, 2021 11.
Article in English | MEDLINE | ID: covidwho-1268113

ABSTRACT

The spread of breathing air when playing wind instruments and singing was investigated and visualized using two methods: (1) schlieren imaging with a schlieren mirror and (2) background-oriented schlieren (BOS). These methods visualize airflow by visualizing density gradients in transparent media. The playing of professional woodwind and brass instrument players, as well as professional classical trained singers were investigated to estimate the spread distances of the breathing air. For a better comparison and consistent measurement series, a single high note, a single low note, and an extract of a musical piece were investigated. Additionally, anemometry was used to determine the velocity of the spreading breathing air and the extent to which it was quantifiable. The results showed that the ejected airflow from the examined instruments and singers did not exceed a spreading range of 1.2 m into the room. However, differences in the various instruments have to be considered to assess properly the spread of the breathing air. The findings discussed below help to estimate the risk of cross-infection for wind instrument players and singers and to develop efficacious safety precautions, which is essential during critical health periods such as the current COVID-19 pandemic.


Subject(s)
Air Movements , Singing , Air Pollution, Indoor , COVID-19 , Humans
16.
Environ Health Perspect ; 129(4): 47002, 2021 04.
Article in English | MEDLINE | ID: covidwho-1264202

ABSTRACT

BACKGROUND: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. OBJECTIVES: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. METHODS: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented. RESULTS: The expelled volume of aerosols was highest for a sneeze, followed by a cough, singing, speaking, and breathing. After 20 min of exposure, at 107 RNA copies/mL in mucus, all mean illness risks were largely estimated to be below 0.001, except for the "high" sneeze scenario. At virus concentrations above 108 RNA copies/mL, and after 2 h of exposure, in the high and "low" sneeze scenarios, the high cough scenario and the singing scenario, risks exceeded 0.01 and may become very high, whereas the low coughing scenario, the high and low speaking scenarios and the breathing scenario remained below 0.1. After 2 h of exposure, singing became the second highest risk scenario. One air exchange per hour reduced risk of illness by about a factor of 2. Six air exchanges per hour reduced risks of illness by a factor of 8-13 for the sneeze and cough scenarios and by a factor of 4-9 for the other scenarios. DISCUSSION: The large variation in the volume of expelled aerosols is discussed. The model calculations indicated that SARS-CoV-2 transmission via aerosols outside of the 1.5-m social distancing norm can occur. Virus concentrations in aerosols and/or the amount of expelled aerosol droplets need to be high for substantial transmission via this route. AirCoV2 is made available as interactive computational tool. https://doi.org/10.1289/EHP7886.


Subject(s)
Aerosols , COVID-19/transmission , Pandemics/prevention & control , Risk Assessment/methods , SARS-CoV-2 , Air Microbiology , COVID-19/prevention & control , Cough , Disease Transmission, Infectious , Humans , Singing , Sneezing
17.
BMJ Open Respir Res ; 8(1)2021 05.
Article in English | MEDLINE | ID: covidwho-1247381

ABSTRACT

INTRODUCTION: Participating in singing is considered to have a range of social and psychological benefits. However, the physiological demands of singing and its intensity as a physical activity are not well understood. METHODS: We compared cardiorespiratory parameters while completing components of Singing for Lung Health sessions, with treadmill walking at differing speeds (2, 4 and 6 km/hour). RESULTS: Eight healthy adults were included, none of whom reported regular participation in formal singing activities. Singing induced acute physiological responses that were consistent with moderate intensity activity (metabolic equivalents: median 4.12, IQR 2.72-4.78), with oxygen consumption, heart rate and volume per breath above those seen walking at 4 km/hour. Minute ventilation was higher during singing (median 22.42 L/min, IQR 16.83-30.54) than at rest (11 L/min, 9-13), lower than 6 km/hour walking (30.35 L/min, 26.94-41.11), but not statistically different from 2 km/hour (18.77 L/min, 16.89-21.35) or 4 km/hour (23.27 L/min, 20.09-26.37) walking. CONCLUSIONS: Our findings suggest the acute metabolic demands of singing are comparable with walking at a moderately brisk pace, hence, physical effects may contribute to the health and well-being benefits attributed to singing participation. However, if physical training benefits result remains uncertain. Further research including different singing styles, singers and physical performance impacts when used as a training modality is encouraged. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov registry (NCT04121351).


Subject(s)
Cardiorespiratory Fitness/physiology , Heart Rate/physiology , Lung/physiology , Oxygen Consumption/physiology , Singing/physiology , Walking/physiology , Adult , Exercise Test , Female , Healthy Volunteers , Humans , Male , Metabolic Flux Analysis/methods , Music , Physical Exertion/physiology , Respiratory Function Tests/methods , Warm-Up Exercise
18.
Clin Infect Dis ; 72(10): e639-e641, 2021 05 18.
Article in English | MEDLINE | ID: covidwho-1232186

ABSTRACT

Choral singing has become a major risk during the coronavirus disease 2019 (COVID-19) pandemic due to high infection rates. Our visualization and velocimetry results reveal that the majority of droplets expelled during singing follow the ambient airflow pattern. These results point toward the possibility of COVID-19 spread by small airborne droplets during singing.


Subject(s)
COVID-19 , Singing , Aerosols , Humans , Pandemics , SARS-CoV-2
19.
PLoS One ; 16(4): e0250308, 2021.
Article in English | MEDLINE | ID: covidwho-1206196

ABSTRACT

OBJECTIVE: To evaluate the evidence of aerosol generation across tasks involved in voice and speech assessment and intervention, to inform better management and to reduce transmission risk of such diseases as COVID-19 in healthcare settings and the wider community. DESIGN: Systematic literature review. DATA SOURCES AND ELIGIBILITY: Medline, Embase, Scopus, Web of Science, CINAHL, PubMed Central and grey literature through ProQuest, The Centre for Evidence-Based Medicine, COVID-Evidence and speech pathology national bodies were searched up until August 13th, 2020 for articles examining the aerosol-generating activities in clinical voice and speech assessment and intervention within speech pathology. RESULTS: Of the 8288 results found, 39 studies were included for data extraction and analysis. Included articles were classified into one of three categories: research studies, review articles or clinical guidelines. Data extraction followed appropriate protocols depending on the classification of each article (e.g. PRISMA for review articles). Articles were assessed for risk of bias and certainty of evidence using the GRADE system. Six behaviours were identified as aerosol generating. These were classified into three categories: vegetative acts (coughing, breathing), verbal communication activities of daily living (speaking, loud voicing), and performance-based tasks (singing, sustained phonation). Certainty of evidence ranged from very low to moderate with variation in research design and variables. CONCLUSIONS: This body of literature helped to both identify and categorise the aerosol-generating behaviours involved in speech pathology clinical practice and confirm the low level of evidence throughout the speech pathology literature pertaining to aerosol generation. As many aerosol-generating behaviours are common human behaviours, these findings can be applied across healthcare and community settings. SYSTEMATIC REVIEW REGISTRATION: Registration number CRD42020186902 with PROSPERO International Prospective Register for Systematic Reviews.


Subject(s)
Aerosols/adverse effects , COVID-19/transmission , Verbal Behavior/physiology , Aerosols/metabolism , COVID-19/metabolism , Cough/physiopathology , Phonation/physiology , SARS-CoV-2/pathogenicity , Singing/physiology , Speech/physiology , Speech-Language Pathology/methods
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