Practical Indicators for Risk of Airborne Transmission in Shared Indoor Environments and Their Application to COVID-19 Outbreaks.

Some infectious diseases, including COVID-19, can undergo airborne transmission. This may happen at close proximity, but as time indoors increases, infections can occur in shared room air despite distancing. We propose two indicators of infection risk for this situation, that is, relative risk parameter (Hr) and risk parameter (H). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and aerosol-removal rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend that is consistent with airborne infection and enable recommendations to minimize transmission risk. Transmission in typical prepandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, influenza, and tuberculosis were also assessed. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at higher risk parameter values. Because both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on masking, ventilation and aerosol-removal rates, number of occupants, and duration of exposure, to investigate airborne transmission.

Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of 'airborne' whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six 'myths' are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.

Penicillium expansum strain isolated from indoor building material was able to grow on gypsum board and emitted guttation droplets containing chaetoglobosins and communesins A, B and D.

AIMS: Emission of toxic metabolites in guttation droplets of common indoor fungi is not well documented. The aims of this study were (i) to compare mycotoxins in biomass and guttation droplets from indoor fungi from a building following health complaints among occupants, (ii) to identify the most toxic strain and to test if mycotoxins in guttation liquids migrated trough air and (iii) to test if toxigenic Penicillium expansum strains grew on gypsum board. METHODS AND RESULTS: Biomass suspensions and guttation droplets from individual fungal colonies representing Aspergillus, Chaetomium, Penicillium, Stachybotrys and Paecilomyces were screened toxic to mammalian cells. The most toxic strain, RcP61 (CBS 145620), was identified as Pen. expansum Link by sequence analysis of the ITS region and a calmodulin gene fragment, and confirmed by the Westerdijk Institute based on ITS and beta-tubulin sequences. The strain was isolated from a cork liner, was able to grow on gypsum board and to produce toxic substances in biomass extracts and guttation droplets inhibiting proliferation of somatic cells (PK-15, MNA, FL) in up to 20 000-fold dilutions. Toxic compounds in biomass extracts and/or guttation droplets were determined by HPLC and LC-MS. Strain RcP61 produced communesins A, B and D, and chaetoglobosins in guttation droplets (the liquid emitted from them) and biomass extracts. The toxins of the guttation droplets migrated c. 1 cm through air and condensed on a cool surface. CONCLUSIONS: The mycotoxin-containing guttation liquids emitted by Pen. expansum grown on laboratory medium exhibited airborne migration and were >100 times more toxic in bioassays than guttation droplets produced by indoor isolates of the genera Aspergillus, Chaetomium, Stachybotrys and Paecilomyces. SIGNIFICANCE AND IMPACT OF THE STUDY: Toxic exudates produced by Pen. expansum containing communesins A, B and D, and chaetoglobosins were transferable by air. This may represent a novel mechanism of mycotoxin dispersal in indoor environment.

Indoor Trichoderma strains emitting peptaibols in guttation droplets.

AIMS: The production of peptaibols, toxic secondary metabolites of Trichoderma, in the indoor environment is not well-documented. Here, we investigated the toxicity of peptaibols in the guttation droplets and biomass of Trichoderma strains isolated from problematic buildings. METHODS AND RESULTS: Seven indoor-isolated strains of T. atroviride, T. trixiae, T. paraviridescens and T. citrinoviride were cultivated on malt extract agar, gypsum boards and paperboards. Their biomass extracts and guttation droplets were highly cytotoxic in resting and motile boar sperm cell assays and in inhibition of somatic cell proliferation assays. The toxins were identified with HPLC/ESI-MS/MS as trichorzianines, trilongins, trichostrigocins and trichostrigocin-like peptaibols. They exhibited toxicity profiles similar to the reference peptaibols alamethicin, trilongins, and trichorzianine TA IIIc purified from T. atroviride H1/226. Particular Trichoderma strains emitted the same peptaibols in both their biomasses and exudate droplets. The trilongin-producing T. citrinoviride SJ40 strain grew at 37°C. CONCLUSIONS: To our knowledge, this is the first report of indoor-isolated Trichoderma strains producing toxic peptaibols in their guttation droplets. SIGNIFICANCE AND IMPACT OF THE STUDY: This report proves that indoor isolates of Trichoderma release peptaibols in their guttation droplets. The presence of toxins in these types of exudates may serve as a mechanism of aerosol formation for nonvolatile toxins in the indoor air.

Potential effects of permeable and hygroscopic lightweight structures on thermal comfort and perceived IAQ in a cold climate.

UNLABELLED: In this study, we simulated and measured the effect of permeable and hygroscopic lightweight structures on indoor air quality (IAQ) and thermal comfort in a cold climate. The potential effect of hygroscopic mass was assessed with the simulation of extreme cases, where permeable and hygroscopic lightweight structures with unfinished surfaces were compared with impermeable and non-hygroscopic ones. Measurements were conducted in 78 rooms of 46 newly built detached timber-framed houses and analyzed according to hygroscopic surface materials and envelope permeability. From the simulations, it was shown that permeable and hygroscopic structures considerably improved perceived air quality in summer, when a ventilation rate of 6 l/s pers. in the non-hygroscopic case corresponded roughly to 4 l/s pers. in the hygroscopic case. However, window airing and furnishing will reduce this difference in practice. Both simulated and measured results showed that permeable and hygroscopic structures significantly reduced peak indoor relative humidity levels and daily changes in relative humidity, but had no long-term effects. Measured results also indicated that completely non-hygroscopic houses did not exist in reality. PRACTICAL IMPLICATIONS: Limited knowledge is available about building envelope and ventilation system interactions with consequent effects on indoor climate. To take such effects adequately into account in design and construction of buildings, solid scientific data explaining the significance of the phenomena studied are needed. We have demonstrated that moisture exchange has evidently enough importance to be taken into account in future building simulation tools.

Fungal spore transport through a building structure.

The study carried out laboratory measurements with a full-scale timber frame structure to determine penetration of inert particles with size distribution from 0.6 to 4 microm and spores of Penicillium and Cladosporium through the structure. Pressure difference over and air leakage through the structure were varied. Measurements at moderate pressure differences resulted in the penetration factors within the range of 0.05-0.2 for inert particles, and indicated also the penetration of fungal spores through the structure. The measurements showed that the penetration was highly dependent on pressure difference over the structure but not on holes in surface boards of the structure. The results show that surface contacts between the frames and mineral wool may have a significant effect on penetration. The penetration was approximately constant within particle size rage of 0.6-2.5 microm, but particles with diameter of 4.0 microm did not penetrate through the structure at all even at a higher-pressure difference of 20 Pa, except in the case of direct flow-path through the structure. Results have important consequences for practical design showing that penetration of fungal spores through the building envelope is difficult to prevent by sealing. The only effective way to prevent penetration seems to be balancing or pressurizing the building. In cold climates, moisture condensation risk should be taken into account if pressure is higher indoors than outdoors. Determined penetration factors were highly dependent on the pressure difference. Mechanical exhaust ventilation needs a special consideration as de-pressurizing the building may cause health risk if there is hazardous contamination in the building envelope exists.

Microbial contamination of indoor air due to leakages from crawl space: a field study.

Mechanical exhaust ventilation system is typical in apartment buildings in Finland. In most buildings the base floor between the first floor apartments and crawl space is not air tight. As the apartments have lower pressure than the crawl space due to ventilation, contaminated air may flow from the crawl space to the apartments. The object of this study was to find out whether a potential air flow from crawl space has an influence on the indoor air quality. The results show that in most cases the concentration of fungal spores was clearly higher in the crawl space than inside the building. The size distribution of fungal spores depended on the fungal species. Correlation between the fungal spores in the crawl space and indoors varied with microbial species. Some species have sources inside the building, which confounds the possible relation between crawl pace and indoor concentrations. Some species, such as Acremonium, do not normally have a source indoors, but its concentration in the crawl space was elevated; our measurements showed also elevated concentrations of Acremonium in the air of the apartments. This consistent finding shows a clear linkage between fungal spores in the indoor air and crawl space. We conclude that a building with a crawl space and pressure difference over the base floor could be a potential risk for indoor air quality in the first floor apartments.