Aerodynamic performance of a ventilation system for droplet control by coughing in a hospital isolation ward.

Over 766 million people have been infected by coronavirus disease 2019 (COVID-19) in the past 3 years, resulting in 7 million deaths. The virus is primarily transmitted through droplets or aerosols produced by coughing, sneezing, and talking. A full-scale isolation ward in Wuhan Pulmonary Hospital is modeled in this work, and water droplet diffusion is simulated using computational fluid dynamics (CFD). In an isolation ward, a local exhaust ventilation system is intended to avoid cross-infection. The existence of a local exhaust system increases turbulent movement, leading to a complete breakup of the droplet cluster and improved droplet dispersion inside the ward. When the outlet negative pressure is 4.5 Pa, the number of moving droplets in the ward decreases by approximately 30% compared to the original ward. The local exhaust system could minimize the number of droplets evaporated in the ward; however, the formation of aerosols cannot be avoided. Furthermore, 60.83%, 62.04%, 61.03%, 60.22%, 62.97%, and 61.52% of droplets produced through coughing reached patients in six different scenarios. However, the local exhaust ventilation system has no apparent influence on the control of surface contamination. In this study, several suggestions with regards to the optimization of ventilation in wards and scientific evidence are provided to ensure the air quality of hospital isolation wards.

Influence of natural ventilation design on the dispersion of pathogen-laden droplets in a coach bus.

Natural ventilation is an energy-efficient design approach to reduce infection risk (IR), but its optimized design in a coach bus environment is less studied. Based on a COVID-19 outbreak in a bus in Hunan, China, the indoor-outdoor coupled CFD modeling approach is adopted to comprehensively explore how optimized bus natural ventilation (e.g., opening/closing status of front/middle/rear windows (FW/MW/RW)) and ceiling wind catcher (WCH) affect the dispersion of pathogen-laden droplets (tracer gas, 5 µm, 50 µm) and IR. Other key influential factors including bus speed, infector's location, and ambient temperature (Tref) are also considered. Buses have unique natural ventilation airflow patterns: from bus rear to front, and air change rate per hour (ACH) increases linearly with bus speed. When driving at 60 km/h, ACH is only 6.14 h-1 and intake fractions of tracer gas (IFg) and 5 µm droplets (IFd) are up to 3372 ppm and 1394 ppm with ventilation through leakages on skylights and no windows open. When FW and RW are both open, ACH increases by 43.5 times to 267.50 h-1, and IFg and IFd drop rapidly by 1-2 orders of magnitude compared to when no windows are open. Utilizing a wind catcher and opening front windows significantly increases ACH (up to 8.8 times) and reduces IF (5-30 times) compared to only opening front windows. When the infector locates at the bus front with FW open, IFg and IFd of all passengers are <10 ppm. More droplets suspend and further spread in a higher Tref environment. It is recommended to open two pairs of windows or open front windows and utilize the wind catcher to reduce IR in coach buses.

Indoor air surveillance and factors associated with respiratory pathogen detection in community settings in Belgium.

Currently, the real-life impact of indoor climate, human behaviour, ventilation and air filtration on respiratory pathogen detection and concentration are poorly understood. This hinders the interpretability of bioaerosol quantification in indoor air to surveil respiratory pathogens and transmission risk. We tested 341 indoor air samples from 21 community settings in Belgium for 29 respiratory pathogens using qPCR. On average, 3.9 pathogens were positive per sample and 85.3% of samples tested positive for at least one. Pathogen detection and concentration varied significantly by pathogen, month, and age group in generalised linear (mixed) models and generalised estimating equations. High CO2 and low natural ventilation were independent risk factors for detection. The odds ratio for detection was 1.09 (95% CI 1.03-1.15) per 100 parts per million (ppm) increase in CO2, and 0.88 (95% CI 0.80-0.97) per stepwise increase in natural ventilation (on a Likert scale). CO2 concentration and portable air filtration were independently associated with pathogen concentration. Each 100ppm increase in CO2 was associated with a qPCR Ct value decrease of 0.08 (95% CI -0.12 to -0.04), and portable air filtration with a 0.58 (95% CI 0.25-0.91) increase. The effects of occupancy, sampling duration, mask wearing, vocalisation, temperature, humidity and mechanical ventilation were not significant. Our results support the importance of ventilation and air filtration to reduce transmission.

CFD Simulations of Ventilation and Interunit Dispersion in Dormitory Complex: A Case Study of Epidemic Outbreak in Shanghai.

Since the beginning of March 2022, a new round of COVID-19 outbreaks in Shanghai has led to a sharp increase in the number of infected people. It is important to identify possible pollutant transmission routes and predict potential infection risks for infectious diseases. Therefore, this study investigated the cross-diffusion of pollutants caused by natural ventilation, including external windows and indoor ventilation windows, under three wind directions in a densely populated building environment with the CFD method. In this study, CFD building models were developed based on an actual dormitory complex and surrounding buildings under realistic wind conditions to reproduce the airflow fields and transmission paths of pollutants. This paper adopted the Wells-Riley model to assess the risk of cross-infection. The biggest risk of infection was when a source room was located on the windward side, and the risk of infection in other rooms on the same side as the source room was large in the windward direction. When pollutants were released from room 8, north wind resulted in the highest concentration of pollutants in room 28, reaching 37.8%. This paper summarizes the transmission risks related to the indoor and outdoor environments of compact buildings.

Hydrogen peroxide emissions from surface cleaning in a single-family residence.

High levels of reactive chemicals may be emitted to the indoor air during household surface cleaning, leading to poorer air quality and potential health hazards. Hydrogen peroxide (H2O2)-based cleaners have gained popularity in recent years, especially in times of COVID-19. Still, little is known regarding the effects of H2O2 cleaning on indoor air composition. In this work we monitored time-resolved H2O2 concentrations during a cleaning campaign in an occupied single-family residence using a cavity ring-down spectroscopy (CRDS) H2O2 analyzer. During the cleaning experiments, we investigated how unconstrained (i.e., "real-life") surface cleaning with a hydrogen peroxide solution influenced the indoor air quality of the house, and performed controlled experiments to investigate factors that could influence H2O2 levels including surface area and surface material, ventilation, and dwell time of the cleaning solution. Mean peak H2O2 concentrations observed following all surface cleaning events were 135 ppbv. The factors with the greatest effect on H2O2 levels were distance of the cleaned surface from the detector inlet, type of surface cleaned, and solution dwell time.

Ventilation Improvements Among K-12 Public School Districts - United States, August-December 2022.

Improving ventilation has been one of several COVID-19 prevention strategies implemented by kindergarten through grade 12 (K-12) schools to stay open for safe in-person learning. Because transmission of SARS-CoV-2 occurs through inhalation of infectious viral particles, it is important to reduce the concentration of and exposure time to infectious aerosols (1-3). CDC examined reported ventilation improvement strategies among U.S. K-12 public school districts using telephone survey data collected during August-December 2022. Maintaining continuous airflow through school buildings during active hours was the most frequently reported strategy by school districts (50.7%); 33.9% of school districts reported replacement or upgrade of heating, ventilation, and air conditioning (HVAC) systems; 28.0% reported installation or use of in-room air cleaners with high-efficiency particulate air (HEPA) filters; and 8.2% reported installation of ultraviolet (UV) germicidal irradiation (UVGI) devices, which use UV light to kill airborne pathogens, including bacteria and viruses. School districts in National Center for Education Statistics (NCES) city locales, the West U.S. Census Bureau region, and those designated by U.S. Census Bureau Small Area Income Poverty Estimates (SAIPE) as high-poverty districts reported the highest percentages of HVAC system upgrades and HEPA-filtered in-room air cleaner use, although 28%-60% of all responses were unknown or missing. Federal funding remains available to school districts to support ventilation improvements. Public health departments can encourage K-12 school officials to use available funding to improve ventilation and help reduce transmission of respiratory diseases in K-12 settings.

Effects of classroom cleaning on student health: a longitudinal study.

BACKGROUND: School districts across the world have been grappling with how to keep their schools open, students healthy, and prevent the spread of viruses in their communities. OBJECTIVE: The aims of this study included assessing both (1) the effectiveness of enhanced classroom cleaning and disinfecting protocol on surface biocontamination and (2) the associations between surface biocontamination and student absence due to illnesses. METHODS: Cleaning effectiveness was assessed using quantitative adenosine triphosphate (ATP) measurements during a 10-week study period in a sample of 34 public schools (15,814 students), of a district located in the Western US. The schools were randomly assigned to 17 intervention schools implementing enhanced cleaning and disinfecting protocol and 17 control schools cleaning as usual. General estimating equations (GEEs) were used for modeling associations between ATP levels and weekly aggregates of student absences due to respiratory and gastrointestinal illnesses, which were recorded by the schools according to district wide protocol. RESULTS: The weekly average ATP levels on logarithmic scale were 5.02 (SD 0.53) and 5.26 (SD 0.48) in the intervention and control schools, respectively, where the difference is statistically significant (p < 0.001). The probability of weekly absence due to gastrointestinal illness was significantly associated with ATP levels (parameter estimate 1.16, 95% CI 1.01-1.34, per unit (log) increase of weekly average ATP), where the model accounts for student level, gender, ethnic group, and socioeconomic status as well as for school level attendance, total absence ratio, and ventilation adequacy in classrooms. Associations were not found between ATP levels and weekly probability of any absence, or absence due to respiratory illness. SIGNIFICANCE: Enhanced cleaning resulted in a significantly lower level of biocontamination on desktops in the intervention group. In addition, a statistically significant association was established between ATP levels on classroom desks and probability of absence due to gastrointestinal illness. IMPACT: We found that enhanced cleaning protocol, including bi-weekly cleaning of classroom desks, as well as training of custodians and teachers, monitoring of effectiveness, and feedback, yielded a moderate but statistically significantly lower level of biocontamination on desktops, indicated by quantitative ATP monitoring. Within the range of weekly average desktop ATP levels observed, the probability of reported absence due to gastrointestinal illness is estimated to increase from 0.021 to 0.026. Based on the results, enhanced surface cleaning and monitoring its effectiveness is a possible district, state, or even national level policy to support healthy school environments.

The Influence of Ventilation Measures on the Airborne Risk of Infection in Schools: A Scoping Review.

OBJECTIVES: To review the risk of airborne infections in schools and evaluate the effect of intervention measures reported in field studies. BACKGROUND: Schools are part of a country's critical infrastructure. Good infection prevention measures are essential for reducing the risk of infection in schools as much as possible, since these are places where many individuals spend a great deal of time together every weekday in a small area where airborne pathogens can spread quickly. Appropriate ventilation can reduce the indoor concentration of airborne pathogens and reduce the risk of infection. METHODS: A systematic search of the literature was conducted in the databases Embase, MEDLINE, and ScienceDirect using keywords such as school, classroom, ventilation, carbon dioxide (CO2) concentration, SARS-CoV-2, and airborne transmission. The primary endpoint of the studies selected was the risk of airborne infection or CO2 concentration as a surrogate parameter. Studies were grouped according to the study type. RESULTS: We identified 30 studies that met the inclusion criteria, six of them intervention studies. When specific ventilation strategies were lacking in schools being investigated, CO2 concentrations were often above the recommended maximum values. Improving ventilation lowered the CO2 concentration, resulting in a lower risk of airborne infections. CONCLUSIONS: The ventilation in many schools is not adequate to guarantee good indoor air quality. Ventilation is an important measure for reducing the risk of airborne infections in schools. The most important effect is to reduce the time of residence of pathogens in the classrooms.

Targeted reduction of airborne viral transmission risk in long-term residential aged care.

COVID-19 has demonstrated the devastating consequences of the rapid spread of an airborne virus in residential aged care. We report the use of CO2-based ventilation assessment to empirically identify potential 'super-spreader' zones within an aged care facility, and determine the efficacy of rapidly implemented, inexpensive, risk reduction measures.

Estimation of Occupancy Using IoT Sensors and a Carbon Dioxide-Based Machine Learning Model with Ventilation System and Differential Pressure Data.

Infectious diseases such as the COVID-19 pandemic have necessitated preventive measures against the spread of indoor infections. There has been increasing interest in indoor air quality (IAQ) management. Air quality can be managed simply by alleviating the source of infection or pollution, but the person within a space can be the source of infection or pollution, thus necessitating an estimation of the exact number of people occupying the space. Generally, management plans for mitigating the spread of infections and maintaining the IAQ, such as ventilation, are based on the number of people occupying the space. In this study, carbon dioxide (CO2)-based machine learning was used to estimate the number of people occupying a space. For machine learning, the CO2 concentration, ventilation system operation status, and indoor-outdoor and indoor-corridor differential pressure data were used. In the random forest (RF) and artificial neural network (ANN) models, where the CO2 concentration and ventilation system operation modes were input, the accuracy was highest at 0.9102 and 0.9180, respectively. When the CO2 concentration and differential pressure data were included, the accuracy was lowest at 0.8916 and 0.8936, respectively. Future differential pressure data will be associated with the change in the CO2 concentration to increase the accuracy of occupancy estimation.

Event-Specific Transmission Forecasting of SARS-CoV-2 in a Mixed-Mode Ventilated Office Room Using an ANN.

The emerging novel variants and re-merging old variants of SARS-CoV-2 make it critical to study the transmission probability in mixed-mode ventilated office environments. Artificial neural network (ANN) and curve fitting (CF) models were created to forecast the R-Event. The R-Event is defined as the anticipated number of new infections that develop in particular events occurring over the course of time in any defined space. In the spring and summer of 2022, real-time data for an office environment were collected in India in a mixed-mode ventilated office space in a composite climate. The performances of the proposed CF and ANN models were compared with respect to traditional statistical indicators, such as the correlation coefficient, RMSE, MAE, MAPE, NS index, and a20-index, in order to determine the merit of the two approaches. Thirteen input features, namely the indoor temperature (TIn), indoor relative humidity (RHIn), area of opening (AO), number of occupants (O), area per person (AP), volume per person (VP), CO2 concentration (CO2), air quality index (AQI), outer wind speed (WS), outdoor temperature (TOut), outdoor humidity (RHOut), fan air speed (FS), and air conditioning (AC), were selected to forecast the R-Event as the target. The main objective was to determine the relationship between the CO2 level and R-Event, ultimately producing a model for forecasting infections in office building environments. The correlation coefficients for the CF and ANN models in this case study were 0.7439 and 0.9999, respectively. This demonstrates that the ANN model is more accurate in R-Event prediction than the curve fitting model. The results show that the proposed ANN model is reliable and significantly accurate in forecasting the R-Event values for mixed-mode ventilated offices.

CO2 Concentrations and Thermal Comfort Analysis at Onsite and Online Educational Environments.

In building areas with high occupancy, such as classrooms, transmission routes of SARS-CoV-2 are increased when indoor air quality is deficient. Under this scenario, universities have adopted ventilation measures to mitigate contagious environments. However, the lack of adequate equipment or designs in old educational buildings is a barrier to reach minimum requirements. This study aims to quantify the indoor air quality and thermal comfort at universities and compare it to conditions in students' households. In this regard, several classrooms in buildings of the Polytechnic University of Catalonia were monitored for temperature, CO2 concentration and relative humidity. The people who used these classrooms were surveyed about their comfort perceptions. A sample of students was also monitored at their homes where they reported to studying during the exam period. By means of point-in-time surveys, students reported their daily comfort, for comparison with the monitored data. The results show that the recommendations for CO2 concentration, temperature, and relative humidity are not always met in any of the study spaces. These factors are more critical at universities due to the high occupancy. In addition, the surveys highlighted the perception that the environment is better at home than at university.

Recommendations for ventilation of remodeled negative-pressure isolation wards for COVID-19 patients: A comparison of international guidelines.

This mini-review provides the practice guideline recommendations for ventilation of remodeled negative-pressure isolation wards for COVID-19 Patients. Remodeled "quasi-negative-pressure" isolation wards had been proved a feasible, inexpensive, safe, and effective measure to contain nosocomial outbreaks. We should first determine the minimum required ventilation volume of an isolation ward based on the severity of COVID-19 patients. Mechanical ventilation remains the mainstay for achieving the requirement, while the assistance of recirculation is also helpful. Beyond adequate ventilation volume, the "clean to less-clean" directional airflow remains the golden rule for the solution of indoor ventilation. The virus-laden exhaust should be treated with HEPA/UV device or be kept away from living organisms, buildings, and air inlets.

Impact of ventilation and avoidance measures on SARS-CoV-2 risk of infection in public indoor environments.

BACKGROUND: The literature includes many studies which individually assess the efficacy of protective measures against the spread of the SARS-CoV-2 virus. This study considers the high infection risk in public buildings and models the quality of the indoor environment, related safety measures, and their efficacy in preventing the spread of the SARS-CoV-2 virus. METHODS: Simulations are created that consider protective factors such as hand hygiene, face covering and engagement with Covid-19 vaccination programs in reducing the risk of infection in a university foyer. Furthermore, a computational fluid dynamics model is developed to simulate and analyse the university foyer under three ventilation regimes. The probability of transmission was measured across different scenarios. FINDINGS: Estimates suggest that the Delta variant requires the air change rate to be increased >1000 times compared to the original strain, which is practically not feasible. Consequently, appropriate hygiene practices, such as wearing masks, are essential to reducing secondary infections. A comparison of different protective factors in simulations found the overall burden of infections resulting from indoor contact depends on (i) face mask adherence, (ii) quality of the ventilation system, and (iii) other hygiene practices. INTERPRETATION: Relying on ventilation, whether natural, mechanical, or mixed, is not sufficient alone to mitigate the risk of aerosol infections. This is due to the internal configuration of the indoor space in terms of (i) size and number of windows, their location and opening frequency, as well as the position of the air extraction and supply inlets, which often induce hotspots with stagnating air, (ii) the excessive required air change rate. Hence, strict reliance on proper hygiene practices, namely adherence to face coverings and hand sanitising, are essential. Consequently, face mask adherence should be emphasized and promoted by policymakers for public health applications. Similar research may need to be conducted using a similar approach on the Omicron (B.1.1.529) variant.

The Trade-Off between Airborne Pandemic Control and Energy Consumption Using Air Ventilation Solutions.

Airborne diseases cause high mortality and adverse socioeconomic consequences. Due to urbanization, more people spend more time indoors. According to recent research, air ventilation reduces long-range airborne transmission in indoor settings. However, air ventilation solutions often incur significant energy costs and ecological footprints. The trade-offs between energy consumption and pandemic control indoors have not yet been thoroughly analyzed. In this work, we use advanced sensors to monitor the energy consumption and pandemic control capabilities of an air-conditioning system, a pedestal fan, and an open window in hospital rooms, classrooms, and conference rooms. A simulation of an indoor airborne pandemic spread of Coronavirus (COVID-19) is used to analyze the Pareto front. For the three examined room types, the Pareto front consists of all three air ventilation solutions, with some ventilation configurations demonstrating significant inefficiencies. Specifically, air-conditioning is found to be efficient only at a very high energy cost and fans seem to pose a reasonable alternative. To conclude, a more informed ventilation policy can bring about a more desirable compromise between energy consumption and pandemic spread control.

Response to the COVID-19 Pandemic in Classrooms at the University of the Basque Country through a User-Informed Natural Ventilation Demonstrator.

The COVID-19 pandemic has generated a renewed interest in indoor air quality to limit viral spread. In the case of educational spaces, due to the high concentration of people and the fact that most of the existing buildings do not have any mechanical ventilation system, the different administrations have established natural ventilation protocols to guarantee an air quality that reduces risk of contagion by the SARS-CoV-2 virus after the return to the classrooms. Many of the initial protocols established a ventilation pattern that opted for continuous or intermittent ventilation to varying degrees of intensity. This study, carried out on a university campus in Spain, analyses the performance of natural ventilation activated through the information provided by monitoring and visualisation of real-time data. In order to carry out this analysis, a experiment was set up where a preliminary study of ventilation without providing information to the users was carried out, which was then compared with the result of providing live feedback to the occupants of two classrooms and an administration office in different periods of 2020, 2021 and 2022. In the administration office, a CO2-concentration-based method was applied retrospectively to assess the risk of airborne infection. This experience has served as a basis to establish a route for user-informed improvement of air quality in educational spaces in general through low-cost systems that allow a rational use of natural ventilation while helping maintain an adequate compromise between IAQ, comfort and energy consumption, without having to resort to mechanical ventilation systems.

Stratum Ventilation: Enabling Simultaneous Energy Conservation and Air Purification in Subway Cars.

The supply of fresh air for underground rail transit systems is not as simple as opening windows, which is a conventional ventilation (CV) measure adopted in aboveground vehicles. This study aims to improve contaminant dilution and air purification in subway car ventilation systems and the safety of rail transit post-coronavirus disease pandemic era. We designed an air conditioning (AC) terminal system combined with stratum ventilation (SV) to enable energy consumption reduction for subway cars. We experimentally tested the effectiveness of a turbulence model to investigate ventilation in subway cars. Further, we compared the velocity fields of CV and SV in subway cars to understand the differences in their airflow organizations and contaminant removal efficiencies, along with the energy savings of four ventilation scenarios, based on the calculations carried out using computational fluid dynamics. At a ventilation flow rate of 7200 m3/h, the CO2 concentration and temperature in the breathing areas of seated passengers were better in the SV than in the CV at a rate of 8500 m3/h. Additionally, the energy-saving rate of SV with AC cooling was 14.05%. The study provides new ideas for reducing the energy consumption of rail transit and broadens indoor application scenarios of SV technology.

Ventilation improvement and evaluation of its effectiveness in a Japanese manufacturing factory.

A coronavirus disease 2019 (COVID-19) cluster emerged in a manufacturing factory in early August 2021. In November 2021, we conducted a ventilation survey using the tracer gas method. Firstly, we reproduce the situation at the time of cluster emergence and examined whether the ventilation in the office was in a condition that increased the risk of aerosol transmission. Secondly, we verified the effectiveness of the factory's own countermeasure implemented immediately after the August cluster outbreak. Furthermore, we verified the effectiveness of several additional improvement measures on the factory's own countermeasures already installed in August. Under the conditions of the cluster emergence, the air changes per hour (ACH) value was 0.73 ACH on average. The ACH value was less than 2 ACH recommended by the Ministry of Health, Labour, and Welfare, suggesting an increased risk of aerosol transmission. The factory's own countermeasures taken immediately in August were found to be effective, as the ACH value increased to 3.41 ACH on average. Moreover, it was confirmed that additional improvement measures on the factory's own countermeasures increased the ACH value to 8.33 ACH on average. In order to prevent the re-emergence of COVID-19 clusters due to aerosol infection in the office, it was found that while continuing the factory's own countermeasure, additional improvement measures should also be added depending on the number of workers in the room. In a company, it is important that workers themselves continue to take infection control measures autonomously, and confirming the effectiveness of the measures will help maintain workers' motivation. We believe it is helpful that external researchers in multiple fields and internal personnel in charge of the health and safety department and occupational health work together to confirm the effectiveness of conducted measures, such as in this case.