Concordance of SARS-CoV-2 RNA in Aerosols From a Nurses Station and in Nurses and Patients During a Hospital Ward Outbreak.

Importance: Aerosol-borne SARS-CoV-2 has not been linked specifically to nosocomial outbreaks. Objective: To explore the genomic concordance of SARS-CoV-2 from aerosol particles of various sizes and infected nurses and patients during a nosocomial outbreak of COVID-19. Design, Setting, and Participants: This cohort study included patients and nursing staff in a US Department of Veterans Affairs inpatient hospital unit and long-term-care facility during a COVID-19 outbreak between December 27, 2020, and January 8, 2021. Outbreak contact tracing was conducted using exposure histories and screening with reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2. Size-selective particle samplers were deployed in diverse clinical areas of a multicampus health care system from November 2020 to March 2021. Viral genomic sequences from infected nurses and patients were sequenced and compared with ward nurses station aerosol samples. Exposure: SARS-CoV-2. Main Outcomes and Measures: The primary outcome was positive RT-PCR results and genomic similarity between SARS-CoV-2 RNA in aerosols and human samples. Air samplers were used to detect SARS-CoV-2 RNA in aerosols on hospital units where health care personnel were or were not under routine surveillance for SARS-CoV-2 infection. Results: A total of 510 size-fractionated air particle samples were collected. Samples representing 3 size fractions (>10 µm, 2.5-10 µm, and <2.5 µm) obtained at the nurses station were positive for SARS-CoV-2 during the outbreak (3 of 30 samples [10%]) and negative during 9 other collection periods. SARS-CoV-2 partial genome sequences for the smallest particle fraction were 100% identical with all 3 human samples; the remaining size fractions shared >99.9% sequence identity with the human samples. Fragments of SARS-CoV-2 RNA were detected by RT-PCR in 24 of 300 samples (8.0%) in units where health care personnel were not under surveillance and 7 of 210 samples (3.3%; P = .03) where they were under surveillance. Conclusions and Relevance: In this cohort study, the finding of genetically identical SARS-CoV-2 RNA fragments in aerosols obtained from a nurses station and in human samples during a nosocomial outbreak suggests that aerosols may have contributed to hospital transmission. Surveillance, along with ventilation, masking, and distancing, may reduce the introduction of community-acquired SARS-CoV-2 into aerosols on hospital wards, thereby reducing the risk of hospital transmission.

Quantifying factors affecting contributions of roadway exhaust and non-exhaust emissions to ambient PM10-2.5 and PM2.5-0.2 particles.

Traffic-related particulate matter (PM) plays an important role in urban air pollution. However, sources of urban pollution are difficult to distinguish. This study utilises a mobile particle concentrator platform and statistical tools to investigate factors affecting roadway ambient coarse particle (PM10-2.5) and fine particle (PM2.5-0.2) concentrations in greater Boston, USA. Positive matrix factorization (PMF) identified six PM10-2.5 sources (exhaust, road salt, brake wear, regional pollution, road dust resuspension and tyre-road abrasion) and seven fine particle sources. The seven PM2.5-0.2 sources include the six PM10-2.5 sources and a source rich in Cr and Ni. Non- exhaust traffic-related sources together accounted for 65.6% and 29.1% of the PM10-2.5 and PM2.5-0.2 mass, respectively. While the respective contributions of exhaust sources were 10.4% and 20.7%. The biggest non-exhaust contributor in the PM10-2.5 was road dust resuspension, accounting for 29.6%, while for the PM2.5-0.2, the biggest non-exhaust source was road-tyre abrasion, accounting for 12.3%. We used stepwise general additive models (sGAMs) and found statistically significant (p < 0.05) effects of temperature, number of vehicles and rush hour periods on exhaust, brake wear, road dust resuspension and road-tyre abrasion with relative importance between 19.1 and 62.2%, 12.5-42.1% and 4.4-42.2% of the sGAM model's explained variability. Speed limit and road type were also important factors for exhaust, road-tyre and brake wear sources. Meteorological variables of wind speed and relative humidity were significantly associated with both coarse and fine road dust resuspension and had a combined relative importance of 38% and 48%. The quantifying results of the factors that influence traffic-related sources can offer key insights to policies aiming to improve near-road air quality.

Characterization of hospital airborne SARS-CoV-2.

BACKGROUND: The mechanism for spread of SARS-CoV-2 has been attributed to large particles produced by coughing and sneezing. There is controversy whether smaller airborne particles may transport SARS-CoV-2. Smaller particles, particularly fine particulate matter (≤ 2.5 µm in diameter), can remain airborne for longer periods than larger particles and after inhalation will penetrate deeply into the lungs. Little is known about the size distribution and location of airborne SARS-CoV-2 RNA. METHODS: As a measure of hospital-related exposure, air samples of three particle sizes (> 10.0 µm, 10.0-2.5 µm, and ≤ 2.5 µm) were collected in a Boston, Massachusetts (USA) hospital from April to May 2020 (N = 90 size-fractionated samples). Locations included outside negative-pressure COVID-19 wards, a hospital ward not directly involved in COVID-19 patient care, and the emergency department. RESULTS: SARS-CoV-2 RNA was present in 9% of samples and in all size fractions at concentrations of 5 to 51 copies m-3. Locations outside COVID-19 wards had the fewest positive samples. A non-COVID-19 ward had the highest number of positive samples, likely reflecting staff congregation. The probability of a positive sample was positively associated (r = 0.95, p < 0.01) with the number of COVID-19 patients in the hospital. The number of COVID-19 patients in the hospital was positively associated (r = 0.99, p < 0.01) with the number of new daily cases in Massachusetts. CONCLUSIONS: More frequent detection of positive samples in non-COVID-19 than COVID-19 hospital areas indicates effectiveness of COVID-ward hospital controls in controlling air concentrations and suggests the potential for disease spread in areas without the strictest precautions. The positive associations regarding the probability of a positive sample, COVID-19 cases in the hospital, and cases in Massachusetts suggests that hospital air sample positivity was related to community burden. SARS-CoV-2 RNA with fine particulate matter supports the possibility of airborne transmission over distances greater than six feet. The findings support guidelines that limit exposure to airborne particles including fine particles capable of longer distance transport and greater lung penetration.

Trace element concentrations in ambient air as a function of distance from road.

Traffic-related air pollution is associated with various adverse health effects. In the absence of more complicated exposure assessment techniques, many environmental health studies have used the natural logarithm of distance to road as a proxy for traffic-related exposures. However, research validating this proxy and further explaining the spatial patterns and elemental composition of traffic-related particulate matter air pollution remains limited. In this study, we collected air samples using a mobile particle concentrator that allowed for high sample loading from major roadways in the Greater Boston Area. We found that concentrations of Cl, Ti, V, Cr, Mn, Fe, Co, Cu, Zn, Sr, Zr, Sn, Ba, and Pb were significantly associated with the natural logarithm of distance to road in coarse particulate matter, and total fine particulate mass concentrations of Al, Ca, Ti, Cr, Mn, Fe, Cu, and Zn were significantly associated with natural logarithm of distance to road in fine particulate matter. Road type (A1 or A2 [primary roads or highways] versus A3 [secondary and connecting roads]) was not a significant predictor of any traffic-related elements in particulate matter air pollution. Our results help identify traffic-related elements in particulate matter air pollution and support the use of logarithm of distance to road as a proxy for traffic-related particulate matter air pollution exposure assessment in epidemiological studies.

Trace element mass fractions in road dust as a function of distance from road.

Road dust particles play an important role in atmospheric pollution and are associated with adverse human health effects. Traffic emissions are a major source of particles in road dust. However, there has been limited information about the relationship between distance from road and traffic-related elements levels in road dust. We investigated the relationships between proximity to the nearest major roadway and trace element mass fractions in PM10 and PM2.5 re-suspended from the road surface, based on measurements at three different distance ranges. We found that mass fractions of Ba, Cu, Zr, Zn, Cl, Co, Cr, Ca, Ti in PM10 road dust as well as Zr, Cu, Cl, Zn, Cr, Ti, Mn, Ca, Ni, and Fe in PM2.5 road dust, significantly decreased with distance from major road. Most of these elements are associated with road traffic emissions, including both tailpipe and non-tailpipe emissions. The decrease rates differed among elements due to differences in local traffic contributions. The decreases for elements which are mainly associated with non-tailpipe traffic emissions (e.g., Ba, Zr) were more dramatic. Our results indicate that traffic emissions, especially non-tailpipe emissions, contribute substantially to road dust, suggesting the need for control strategies for non-tailpipe emissions. Implications: We investigated the relationships between road proximity with trace element mass fractions in PM10 and PM2.5 re-suspended from the road surface. We observed significant decrease of traffic-related elements in PM10 and PM2.5 road dust with log distance from major road. We also found that the mass fractions for elements, which mainly come from traffic decrease more sharply compared to elements which come from both traffic and other sources. Our results indicate that traffic emissions contribute substantially to road dust, and imply that the distance to major road can be used as a proxy for ambient exposure.

Exercising in the urban center: Inflammatory and cardiovascular effects of prolonged exercise under air pollution.

The aim of this study was to investigate, in a well-controlled experimental environment, whether air pollution from an urban center would affect inflammatory and cardiorespiratory responses during prolonged moderate exercise (i.e., 90 min). Ten healthy men performed two experimental trials under filtered and polluted air, inside an environmental chamber located in Sao Paulo downtown, Brazil. Blood samples were obtained at rest, 30, 60, and 90 min of the exercise to determine the serum cytokines concentration, while arterial pressure was recorded immediately after the exercise. The serum cytokines were not altered until 60 min of exercise for both conditions (P > 0.05). Otherwise, at 90 min of exercise, the IL-6 (P = 0.047) and vascular endothelial growth factor (VEGF) (P = 0.026) were significantly higher and IL-10 tended to decrease (P = 0.061) in polluted air condition compared to filtered air condition. In addition, both systolic (P = 0.031) and diastolic (P = 0.009) arterial pressure were higher in polluted air condition than filtered air condition. These findings demonstrate that the exercise of longer duration (i.e., 90 min), but not of shorter duration (i.e., <60 min), performed in vehicular air pollution condition results in pronounced pro-inflammatory and increased arterial pressure responses.