Three dimensional analysis of the exhalation flow in the proximity of the mouth.

The human exhalation flow is characterized in this work from the three-dimensional velocimetry results obtained by using the stereo particle image velocimetry (SPIV) measurement technique on the flow emitted from a realistic airway model. For this purpose, the transient exhalation flow through the mouth of a person performing two different breaths corresponding to two metabolic rates, standing relaxed (SR) and walking active (WA), is emulated and studied. To reproduce the flow realistically, a detailed three-dimensional model obtained from computed tomography measurements on real subjects is used. To cope with the variability of the experimental data, a subsequent analysis of the results is performed using the TR-PIV (time resolved particle image velocimetry) technique. Exhalation produces a transient jet that becomes a puff when flow emission ends. Three-dimensional vector fields of the jet velocity are obtained in five equally spaced transverse planes up to a distance of Image 1 from the mouth at equally spaced time instants Image 2 which will be referred to as phases (φ), from the beginning to the end of exhalation. The time evolution during exhalation of the jet area of influence, the velocity field and the jet air entrainment have been characterized for each of the jet cross sections. The importance of the use of realistic airway models for the study of this type of flow and the influence of the metabolic rate on its development are also analyzed. The results obtained contribute to the characterization of the human exhalation as a pathway of the transmission of pathogens such as SARS-CoV-2 virus.

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.

Short-range airborne transmission of expiratory droplets between two people.

The occurrence of close proximity infection for many respiratory diseases is often cited as evidence of large droplet and/or close contact transmission. We explored interpersonal exposure of exhaled droplets and droplet nuclei of two standing thermal manikins as affected by distance, humidity, ventilation, and breathing mode. Under the specific set of conditions studied, we found a substantial increase in airborne exposure to droplet nuclei exhaled by the source manikin when a susceptible manikin is within about 1.5 m of the source manikin, referred to as the proximity effect. The threshold distance of about 1.5 m distinguishes the two basic transmission processes of droplets and droplet nuclei, that is, short-range modes and the long-range airborne route. The short-range modes include both the conventional large droplet route and the newly defined short-range airborne transmission. We thus reveal that transmission occurring in close proximity to the source patient includes both droplet-borne (large droplet) and short-range airborne routes, in addition to the direct deposition of large droplets on other body surfaces. The mechanisms of the droplet-borne and short-range airborne routes are different; their effective control methods also differ. Neither the current droplet precautions nor dilution ventilation prevents short-range airborne transmission, so new control methods are needed.

Influence of air stability and metabolic rate on exhaled flow.

The characteristics of contaminant transport and dispersion of exhaled flow from a manikin are thoroughly studied in this article with respect to the influence of two important factors: air stability conditions and metabolic rates. Four cases with the combinations of stable and neutral conditions as well as lower (1.2 met) and higher (2 met) metabolic rates for a breathing thermal manikin are employed. The exhaled contaminant is simulated by smoke and N2 O to visualize and measure the contaminant distribution both around and in front of the manikin. The results show that the microenvironment around the manikin body can be affected by different air distribution patterns and metabolic heating. Under stable conditions, the exhaled contaminant from mouth or nose is locked and stratified at certain heights, causing potentially high contaminant exposure to others. In addition, velocity profiles of the pulsating exhaled flow, which are normalized by mean peak velocities, present similar shapes to a steady jet. The outlet velocity close to the mouth shows decrement with both exhalation temperature and body plume. The velocity decay and concentration decay also show significant dependence on air stability and metabolic level.

Measuring the exhaled breath of a manikin and human subjects.

Due to scarcity of accurate information and available data of actual human breathing, this investigation focuses on characterizing the breathing dynamic process based on the measurement of healthy human subjects. The similarities and differences between one breathing thermal manikin and the human subjects, including geometry and breathing functions, were thoroughly studied. As expected, actual human breathing is more complicated than that of the manikin in terms of airflow fluctuations, individual differences, and exhaled flow directions. The simplification of manikin mouth structure could result in overestimated exhaled velocity and contaminant concentration. Furthermore, actual human breathing appears to be relatively stable and reproducible for an individual person in several conditions and is also accompanied by some uncertainties simultaneously. The averaged values are used to analyze the overall characteristics of actual human breathing. There are different characteristics of the exhaled breath between male and female subjects with or without wearing a nose clip. The experimental results obtained from the measurement of human subjects may be helpful for manikin specification or validation and accuracy assessment of CFD simulations.

Protected zone ventilation and reduced personal exposure to airborne cross-infection.

The main objective of this study was to examine the performance of protected zone ventilation (PZV) and hybrid protected zone ventilation (HPZV) to reduce the direct exposure to exhaled air from others' breathing. Experimental measurements are carried out to test the performance of PZV in a full-scale office room with two breathing thermal manikins. The measurements were performed under three configurations, including two standing manikins at different distances: 0.35, 0.5, and 1.1 m. When the supply air velocity is increased to 4 m/s in the downward plane jet, the dimensionless concentration is 40% lower than for fully mixed ventilation, which can be considered as a measure of protection from the zoning condition. The measurement results showed that in both the PZV and the HPZV system it is possible to decrease the transmission of tracer gas from one manikin to the opposite manikin; therefore, it probably would reduce the risk of air borne cross-infection between two people at the same relative positions. The results suggest that PZV and HPZV may be used to reduce the exposure of people in a protected zone from indoor pollutants emitted in a source zone.

The risk of airborne cross-infection in a room with vertical low-velocity ventilation.

UNLABELLED: Downward flow ventilation systems are one of the most recommended ventilation strategies when contaminants in rooms must be removed and people must be protected from the risk of airborne cross-infection. This study is based on experimental tests carried out in a room with downward flow ventilation. Two breathing thermal manikins are placed in a room face to face. One manikin's breathing is considered to be the contaminated source to simulate a risky situation with airborne cross-infection. The position of the manikins in relation to the diffuser and the location of diffuser in the room as well as the distance between the manikins are being changed to observe the influence of these factors on the personal exposure of the target manikin. The results show that the DWF in different situations often is unable to penetrate the microenvironment generated by the manikins. The downward ventilation system can give an unexpected high level of contaminant exposure of the target manikin, when the distance between the manikins is reduced. PRACTICAL IMPLICATIONS: Several guidelines recommend the downward ventilation system to reduce the risk of cross-infection between people in hospital rooms. This study shows that this recommendation should be taken into careful consideration. It is important to be aware of people position, position to other thermal loads in the room, and especially be aware of the distance between people if the exposure to the exhaled contaminants wants to be reduced.

Distribution of exhaled contaminants and personal exposure in a room using three different air distribution strategies.

UNLABELLED: The level of exposure to human exhaled contaminants in a room depends not only on the air distribution system but also on people's different positions, the distance between them, people's activity level and height, direction of exhalation, and the surrounding temperature and temperature gradient. Human exhalation is studied in detail for different distribution systems: displacement and mixing ventilation as well as a system without mechanical ventilation. Two thermal manikins breathing through the mouth are used to simulate the exposure to human exhaled contaminants. The position and distance between the manikins are changed to study the influence on the level of exposure. The results show that the air exhaled by a manikin flows a longer distance with a higher concentration in case of displacement ventilation than in the other two cases, indicating a significant exposure to the contaminants for one person positioned in front of another. However, in all three cases, the exhalation flow of the source penetrates the thermal plume, causing an increase in the concentration of contaminants in front of the target person. The results are significantly dependent on the distance and position between the two manikins in all three cases. PRACTICAL IMPLICATIONS: Indoor environments are susceptible to contaminant exposure, as contaminants can easily spread in the air. Human breathing is one of the most important biological contaminant sources, as the exhaled air can contain different pathogens such as viruses and bacteria. This paper addresses the human exhalation flow and its behavior in connection with different ventilation strategies, as well as the interaction between two people in a room. This is a key factor for studying the airborne infection risk when the room is occupied by several persons. The paper only takes into account the airborne part of the infection risk.

CFD and ventilation research.

UNLABELLED: There has been a rapid growth of scientific literature on the application of computational fluid dynamics (CFD) in the research of ventilation and indoor air science. With a 1000-10,000 times increase in computer hardware capability in the past 20 years, CFD has become an integral part of scientific research and engineering development of complex air distribution and ventilation systems in buildings. This review discusses the major and specific challenges of CFD in terms of turbulence modelling, numerical approximation, and boundary conditions relevant to building ventilation. We emphasize the growing need for CFD verification and validation, suggest ongoing needs for analytical and experimental methods to support the numerical solutions, and discuss the growing capacity of CFD in opening up new research areas. We suggest that CFD has not become a replacement for experiment and theoretical analysis in ventilation research, rather it has become an increasingly important partner. PRACTICAL IMPLICATIONS: We believe that an effective scientific approach for ventilation studies is still to combine experiments, theory, and CFD. We argue that CFD verification and validation are becoming more crucial than ever as more complex ventilation problems are solved. It is anticipated that ventilation problems at the city scale will be tackled by CFD in the next 10 years.

Observing and quantifying airflows in the infection control of aerosol- and airborne-transmitted diseases: an overview of approaches.

With concerns about the potential for the aerosol and airborne transmission of infectious agents, particularly influenza, more attention is being focused on the effectiveness of infection control procedures to prevent hospital-acquired infections by this route. More recently a number of different techniques have been applied to examine the temporal-spatial information about the airflow patterns and the movement of related, suspended material within this air in a hospital setting. Closer collaboration with engineers has allowed clinical microbiologists, virologists and infection control teams to assess the effectiveness of hospital isolation and ventilation facilities. The characteristics of human respiratory activities have also been investigated using some familiar engineering techniques. Such studies aim to enhance the effectiveness of such preventive measures and have included experiments with human-like mannequins using various tracer gas/particle techniques, real human volunteers with real-time non-invasive Schlieren imaging, numerical modelling using computational fluid dynamics, and small scale physical analogues with water. This article outlines each of these techniques in a non-technical manner, suitable for a clinical readership without specialist airflow or engineering knowledge.

Differentiation of closely related fungi by electronic nose analysis.

In this work the potential of electronic nose analysis for differentiation of closely related fungi has been described. A total of 20 isolates of the cheese-associated species Geotrichum candidum, Penicillium camemberti, P. nordicum, and P. roqueforti and its closely related species P. paneum, P. carneum as well as the noncheese-associated P. expansum have been investigated by electronic nose, GC-MS, and LC-MS analysis. The isolates were inoculated on yeast extract sucrose agar in 20-mL headspace flasks and electronic nose analysis was performed daily for a 7-d period. To assess which volatile metabolites the electronic nose potentially responded to, volatile metabolites were collected by diffusive sampling overnight onto tubes containing Tenax TA, between the 7th and 8th day of incubation. Volatiles were analyzed by gas chromatography coupled to mass spectrometry and the results indicated that mainly alcohols (ethanol, 2-methyl-1-propanol, and 3-methyl-1-butanol) and ketones (acetone, 2-butanone, and 2-pentanone) were produced at this stage. The volatile metabolite profile proved to be species specific. Nonvolatile metabolites were collected on the 8th day of incubation and mycotoxin analysis was performed by high pressure liquid chromatography coupled to a diode array detector and a time of flight mass spectrometer. Several mycotoxins were detected in samples from the species P. nordicum, P. roqueforti, P. paneum, P. carneum, and P. expansum. Differentiation of closely related mycotoxin producing fungi incubated on yeast extract sucrose agar has been achieved, indicating that there is a potential for predicting production of mycotoxins on food and feedstuffs by electronic nose analysis.

Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review.

There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements in hospitals, schools and offices in relation to the spread of airborne infectious diseases, suggest the existence of a knowledge gap. Our study reveals a strong need for a multidisciplinary study in investigating disease outbreaks, and the impact of indoor air environments on the spread of airborne infectious diseases.

Dispersion of exhaled droplet nuclei in a two-bed hospital ward with three different ventilation systems.

UNLABELLED: Effective ventilation in general hospital wards is important for controlling the airborne transmission of infectious respiratory diseases. Experiments have been carried out to increase our understanding of the interaction of the breathing flows of two individuals in a full-scale experimental hospital ward with three ventilation systems, i.e. mixing, downward and displacement ventilation. Two life-size breathing thermal manikins were used to simulate a source patient and a receiving patient. The exhalation jet from a bed-lying manikin was visualized using smoke. N2O was used as tracer gas to simulate the droplet nuclei exhaled by patients; and the spatial distribution of its concentrations was measured. Our experimental results show that for both mixing and downward ventilation, the exhaled jet penetrates a short distance and is diluted quickly by ventilation air. The exhaled droplet nuclei are well mixed in the ward. Bed distance does not affect the personal exposure of the receiving patient. For displacement ventilation, the exhaled jet can penetrate a long distance. A high concentration layer of exhaled droplet nuclei because of thermal stratification locking has also been observed with displacement ventilation. This work is useful for identifying an appropriate ventilation method that can remove droplet nuclei more effectively and minimize the risk of cross-infections in a hospital ward environment. PRACTICAL IMPLICATIONS: As one of the major potential sources for infectious droplet nuclei in a hospital environment, exhalation flows of an infected patient can interact with the respiratory activities of other close individuals and with the room ventilation systems. Our latest results provide information on the penetration of exhalation jets into the ambient environment in different ventilation systems. This work is useful in identifying an appropriate and effective ventilation method for removing droplet nuclei more effectively, and thus minimizing the risk of cross-infections in hospital wards with multiple beds.

Computational fluid dynamics and room air movement.

UNLABELLED: Computational Fluid Dynamics (CFD) and new developments of CFD in the indoor environment as well as quality considerations are important elements in the study of energy consumption, thermal comfort and indoor air quality in buildings. The paper discusses the quality level of Computational Fluid Dynamics and the involved schemes (first, second and third order schemes) by the use of the Smith and Hutton problem on the mass fraction transport equation. The importance of "false" or numerical diffusion is also addressed in connection with the simple description of a supply opening. The different aspects of boundary conditions in the indoor environment as, e.g., the simulation of Air Terminal Devices and the simulation of furnishings and occupants are discussed. The prediction of the flow in a room with a three-dimensional wall jet by the use of different turbulence models such as the k-epsilon model, the V2-f model and the Reynolds Stress model is addressed in the last chapter of the paper. PRACTICAL IMPLICATIONS: The use of computational Fluid Dynamics as a practical design method for room air distribution is widespread. It is important to consider the quality of the predictions in order to obtain a sufficient level of accuracy. It is also important to work with a practical description of supply openings as well as with the right level of details in the occupied zone and the right turbulence model. All these aspects are addressed in the article.

Effect of weak acid preservatives on growth of bakery product spoilage fungi at different water activities and pH values.

Inhibition of spoilage organisms from bakery products by weak acid preservatives in concentrations of 0%, 0.003%, 0.03% and 0.3% (w/v) was investigated experimentally on a substrate media with water activity (a(w)) and pH ranging from sourdough-fermented acidic rye bread to alkaline intermediate moisture sponge cake types (a(w) 0.80-0.95, pH 4.7-7.4). Initially, rye bread conditions (a(w) 0.94-0.97 and pH 4.4-4.8) in combination with calcium propionate were investigated. Results showed that the highest concentration of propionate (0.3%) at all conditions apart from high a(w) (0.97) and high pH (4.8) totally inhibited fungal growth for a 2-week period, with the exception of Penicillium roqueforti, Penicillium commune and Eurotium rubrum. Characteristically for the major spoiler of rye bread, P. roqueforti, all three isolates tested were stimulated by propionate and the stimulation was significantly enhanced at high water activity levels. The effect of propionate on production of secondary metabolites (mycophenolic acid, rugulovasine, echinulin, flavoglaucin) was also studied, and variable or isolate dependent results were found. Subsequently, a screening experiment representing a wider range of bakery products was conducted using calcium propionate, potassium sorbate and sodium benzoate. The obtained data was modelled using survival analysis to determine 'spoilage-free time' for the fungi. At the low a(w) level (0.80) only Eurotium species grew within the test period of 30 days. Higher water activity levels as well as higher pH values decreased spoilage-free times of the fungi. The preservative calcium propionate was less effective than potassium sorbate and sodium benzoate.

Impact of turbulence anisotropy near walls in room airflow.

UNLABELLED: The influence of different turbulence models used in computational fluid dynamics predictions is studied in connection with room air movement. The turbulence models used are the high Re-number kappa-epsilon model and the high Re-number Reynolds stress model (RSM). The three-dimensional wall jet is selected for the work. The growth rate parallel to the wall in a three-dimensional wall jet is large compared with the growth rate perpendicular to the wall, and it is large compared with the growth rate in a free circular jet. It is shown that it is not possible to predict the high growth rate parallel with a surface in a three-dimensional wall jet by the kappa-epsilon turbulence model. Furthermore, it is shown that the growth rate can be predicted to a certain extent by the RSM with wall reflection terms. The flow in a deep room can be strongly influenced by details as the growth rate of a three-dimensional wall jet. Predictions by a kappa-epsilon model and RSM show large deviations in the occupied zone. Measurements and observations of streamline patterns in model experiments indicate that a reasonable solution is obtained by the RSM compared with the solution obtained by the kappa-epsilon model. PRACTICAL IMPLICATIONS: Computational fluid dynamics (CFD) is often used for the prediction of air distribution in rooms and for the evaluation of thermal comfort and indoor air quality. The most used turbulence model in CFD is the kappa-epsilon model. This model often produces good results; however, some cases require more sophisticated models. The prediction of a three-dimensional wall jet is improved if it is made by a Reynolds stress model (RSM). This model improves the prediction of the velocity level in the jet and in some special cases it may influence the entire flow in the occupied zone.

Antifungal activity of essential oils evaluated by two different application techniques against rye bread spoilage fungi.

AIMS: To study how antifungal activity of natural essential oils depends on the assay method used. METHODS AND RESULTS: Oils of bay, cinnamon leaf, clove, lemongrass, mustard, orange, sage, thyme and two rosemary oils were tested by two methods: (1) a rye bread-based agar medium was supplemented with 100 and 250 microl l-1 essential oil and (2) real rye bread was exposed to 136 and 272 microl l-1 volatile oil in air. Rye bread spoilage fungi were used for testing. Method 1 proved thyme oil to be the overall best growth inhibitor, followed by clove and cinnamon. On the contrary, orange, sage and rosemary oils had very limited effects. Mustard and lemongrass were the most effective oils by the volatile method, and orange, sage and one rosemary showed some effects. Oil compositions were analysed by gas chromatography-mass spectrography. CONCLUSIONS: Antifungal effects of the essential oils depended on the application method. Larger phenolic compounds such as thymol and eugenol (thyme, cinnamon and clove) had best effect applied directly to medium, whereas smaller compounds such as allyl isothiocyanate and citral (mustard and lemongrass) were most efficient when added as volatiles. SIGNIFICANCE AND IMPACT OF THE STUDY: This study proves that the method used for screening essential oils as potential antimicrobials should correspond with the application sought.

Quality control of computational fluid dynamics in indoor environments.

Computational fluid dynamics (CFD) is used routinely to predict air movement and distributions of temperature and concentrations in indoor environments. Modelling and numerical errors are inherent in such studies and must be considered when the results are presented. Here, we discuss modelling aspects of turbulence and boundary conditions, as well as aspects related to numerical errors, with emphasis on choice of differencing scheme and computational grid. Illustrative examples are given to stress the main points related to numerical errors. Finally, recommendations are given for improving the quality of CFD calculations, as well as guidelines for the minimum information that should accompany all CFD-related publications to enable a scientific judgment of the quality of the study.

Dispersal of exhaled air and personal exposure in displacement ventilated rooms.

The influence of the human exhalation on flow fields, contaminant distributions, and personal exposure in displacement ventilated rooms is studied together with the effects of physical movement. Experiments are conducted in full-scale test rooms with life-sized breathing thermal manikins. Numerical simulations support the experiments. Air exhaled through the mouth can lock in a thermally stratified layer, if the vertical temperature gradient in breathing zone height is sufficiently large. With exhalation through the nose, exhaled air flows to the upper part of the room. The exhalation flow from both nose and mouth is able to penetrate the breathing zone of another person standing nearby. The stratification of exhaled air breaks down if there is physical movement in the room. As movement increases, the concentration distribution in the room will move towards a fully mixed situation. The protective effect of the boundary layer flow around the body of a moving person disappears at low speed, and is reduced for a seated person placed nearby due to horizontal air movements, which can also cause rebreathing of exhaled air for the seated person. The results indicate that the effect of the exhalation flow is no acute problem in most normal ventilation applications. However, exhalation and local effects caused by movement may be worth considering if one wishes to contain contaminants in certain areas, as in the case of tobacco smoking, in hospitals and clinics, or in certain industries.

Influence of local airflow on the pollutant emission from indoor building surfaces.

This article reports the results of an investigation, based on fundamental fluid dynamics and mass transfer theory, carried out to obtain a general understanding of the mechanisms involved in the emissions from building materials in ventilated rooms. In addition, a generally applicable method for the prediction of surface emissions is proposed. The work focused on the emission of vapours and gases and no particulate emissions were considered. The methods used were numerical calculations by computational fluid dynamics (CFD) and full-scale laboratory experiments. It was found that the emissions are a strong function of air-change rate, local air velocity and local turbulence, as the mass transfer coefficient increases in proportion to these parameters. The findings further show that the mass transfer coefficient increases in proportion to the velocity when the emission is controlled by evaporation from the surface. With regard to diffusion-controlled emissions, the mass transfer coefficient is unaffected by the velocity.