Risk Of Airborne Transmission Research Articles

Airborne Transmission Risk in Urban Buses: A Computational Fluid Dynamics Study

The Heat, Ventilation, Air Conditioning (HVAC) systems in urban buses promote high particle motion. In this paper the effect of centralized roof-top HVAC on virus transmission by droplets caused by sneezing and coughing was studied with the Lagrangian approach while the transmission through aerosols caused by breathing and talking was modeled with the Eulerian tracer method. It was found that the large droplets (> 200 μm) can travel more than 3 m without being affected by the airflow. On the other hand, the small droplets (< 5 μm) are easily dragged, dispersed, and also captured by the HVAC. On the other hand, aerosols are quickly spread by the HVAC. It was found that the centralized roof-top HVAC reduces the concentration in the central zone, but it is ineffective to renew the air in the front and rear sides. The Wells-Riley risk model showed that the average risk across the whole bus can be reduced to a half and a quarter by renewing the air of the cabin 10 times per hour.

Quantifying the role of airborne transmission in the spread of COVID-19.

There is an ongoing debate on the different transmission modes of SARS-CoV-2 and their relative contributions to the pandemic. In this paper, we employ a simple mathematical model, which incorporates both the human-to-human and environment-to-human transmission routes, to study the transmission dynamics of COVID-19. We focus our attention on the role of airborne transmission in the spread of the disease in a university campus setting. We conduct both mathematical analysis and numerical simulation, and incorporate published experimental data for the viral concentration in the air to fit model parameters. Meanwhile, we compare the outcome to that of the standard SIR model, utilizing a perturbation analysis in the presence of multiple time scales. Our data fitting and numerical simulation results show that the risk of airborne transmission for SARS-CoV-2 strongly depends on how long the virus can remain viable in the air. If the time for this viability is short, the airborne transmission route would be inconsequential in shaping the overall transmission risk and the total infection size. On the other hand, if the infectious virus can persist in aerosols beyond a few hours, then airborne transmission could play a much more significant role in the spread of COVID-19.

Exploring the potentials of micro-environment ventilation in mitigating airborne transmission risk

In the background of COVID-19, new requirements are occurring in the novel ventilation systems to mitigate airborne transmission risk in indoor environments. In this study, two micro-environment ventilation systems: personalized ventilation combined with radiant panel system (PVRP) and low velocity unit combined with radiant panel system (LVRP) were studied to explore the potential of reducing the airborne infection risk. In a simulated double layout office, the droplets generated by a thermal breathing manikin were used to simulate the breathing process of an infected person. Opposite the manikin, a heated dummy was as an exposed person. During the 102-minute measurement, the results show that the infection risk at the inhaled air with micro-environment systems is lowest. The heat gain levels do have much effect on infection risk with the PVRP system, but higher heat gain will increase the risk slightly with the LVRP system.

Large eddy simulation of cough jet dynamics, droplet transport, and inhalability over a ten minute exposure.

High fidelity simulations of expiratory events such as coughing provide the opportunity to predict the fate of the droplets from the turbulent jet cloud produced from a cough. It is well established that droplets carrying infectious pathogens with diameters of remain suspended in the air for several hours and transported by the air currents over considerable distances (e.g., in meters). This study used a highly resolved mesh to capture the multiphase turbulent buoyant cloud with suspended droplets produced by a cough. The cough droplets' dispersion was subjected to thermal gradients and evaporation and allowed to disperse between two humans standing 2 m apart. A nasal cavity anatomy was included inside the second human to determine the inhaled droplets. Three diameter ranges characterized the droplet cloud, , which made up 93% of all droplets by number; 5 to 100 μm comprised 3%, and m comprising 4%. The results demonstrated the temporal evolution of the cough event, where a jet is first formed, followed by a thermally driven puff cloud with the latter primarily composed of droplets under 5 μm diameter, moving with a vortex string structure. After the initial cough, the data were interpolated onto a more coarse mesh to allow the simulation to cover ten minutes, equivalent to 150 breathing cycles. We observe that the critical diameter size susceptible to inhalation was , although most inhaled droplets after 10 min by the second human were approximately . These observations offer insight into the risk of airborne transmission and numerical metrics for modeling and risk assessment.

Effectiveness of personalized air curtain in reducing exposure to airborne cough droplets

To minimize infection risk of airborne transmission during close contact, a personalized air curtain (PAC) system was proposed to protect users from airborne droplets. This work investigated the performance of PAC in reducing exposure to airborne droplets through two thermal manikins in close proximity (0.82 m). A cough generator was put into one of the manikins (an infected person) to release cough droplets to simulate coughing activities. Concentration of airborne droplets in the inhalation zone of the other manikin, as a healthy person (HP), was measured. The effect of PAC with different flow rates (from 9 L/s to 27 L/s) and distances to the HP (15 cm–65 cm) on exposure to airborne droplets was investigated. The performance of PAC was further compared with that of personalized ventilation (PV), integrated PAC-PV, and partitions. Visualization experiments were performed to observe the interaction between the cough jet and PAC, PV, PAC-PV, and partitions. The results showed that exposure reduction caused by PAC was from 42% to 87% considering the flow rate and distance between HP and PAC. When the PAC velocity increased to ‘critical velocity’, i.e., 5 m/s, the exposure reduction was nearly stable and the distance between PAC and HP has almost no influence on the exposure reduction. Besides, exposure reduction of integrated PAC-PV was between 94% and 98%, showing a quite good performance in reducing airborne droplets. The results indicated that PAC and PAC-PV could be used as mitigation measures to protect users and reduce exposure to airborne droplets.

Evaluating heating, ventilation, and air-conditioning systems toward minimizing the airborne transmission risk of Mucormycosis and COVID-19 infections in built environment

This ongoing global pandemic of the COVID-19 has generated a significant international concern for our respiratory health. For instance, the breakout of the COVID-19 pandemic was directly linked to the spread of infectious particles in indoor environments between humans, underlining the significance of rigorous and effective actions to limit the transmission of diseases. Recently, Mucormycosis infections in COVID-19 patients have been identified. This investigation aims to investigate potential infection control HVAC solutions for indoor environments, as well as their core mechanisms for reducing infectious disease risk through simulation models of a valid building in a hot climatic region. Considering recent international recommendations, the investigation relies on a methodology of testing a validated building energy model to several systems in the light of infectious diseases prevention. All proposed models are exposed to cost analysis in line with carbon emissions, and indoor thermal conditions. The analysis outlined through parametric simulations, the effectiveness of the proposed DOAS in supplying 100% fresh ventilation air and enhancing the control of the indoor relative humidity simultaneously. Finally, through an enviro-economic assessment, the study concluded that the DOAS model reduced the CO2 emissions to 691 tons, with a potential of reducing HVAC and whole-building energy use by 37% and 16%, respectively in the hot arid climate, with a return on investment of about 6%.

Multiple airflow patterns in human microenvironment and the influence on short-distance airborne cross-infection – A review

The global spread of the coronavirus disease 2019 (COVID-19) has increased the demand of effective control of the disease transmission between people, especially when they are in close distance between each other. The microenvironment between the people in short distance contains multiple airflow patterns that directly affect the disease transmission. By understanding and respecting this special localized environment, the airborne cross-infection at both short and long distance can be minimized. This paper gives an overview of the flow fields in human microenvironment. The exhalation flow from different respiratory activities, e.g. normal breathing, speaking, coughing or sneezing is considered as a part of the microenvironment. The dynamics of the exhalation flow and the contained droplets or aerosols are summarized from previous studies. The factors influencing the flow fields in human microenvironment are discussed, including both the physiological factors of the occupants and the environmental factors in the ventilated context (macroenvironment). Effective control of these influencing factors can be helpful to mitigate airborne transmission risk between individuals. This paper highlights the importance of better understanding of the dynamics and transmission routes of the expelled virus-laden droplets or aerosols, which are largely affected by complex flow interactions in human microenvironment.

Clinical characteristics that help decide to do a fundoscopy in neuro-ophthalmology clinic amid the COVID-19 pandemic

Fundoscopy is a useful tool in diagnosing neuro-ophthalmology disorders, especially for detecting papilledema and optic disc edema. However, there is a risk of airborne transmission that should be considered before doing the examination. Some clinical characteristics may help in deciding to do a fundoscopy examination.

Airborne Particle Control Methods in Dental Clinics

Background and Objectives: The COVID-19 pandemic has highlighted the risk of airborne transmission of infections in health-care facilities such as dental clinics. In this experimental study, methods to control airborne particles in a simulated dental clinic setting were measured and compared using a low cost and convenient technique. Materials and Methods: Particles representing inhalable airborne particles were generated using smoke from incense sticks and their concentration measured by handheld particle sensors whereas using different engineering controls for the particle removal in dental clinic equivalent settings. Measurements were made at short (&lt;3 ft) and intermediate (between 3 and 6 ft) distance from the source. The particle filtration through surgical masks and N95 masks was also studied. Results: Natural ventilation, by keeping windows open, can reduce intermediate range particles (removal of 4.7% of ambient particles/min). However, in closed facilities without natural ventilation, particle removal by air purifier combined with overhead fan or with high volume evacuators was found most suitable for intermediate range particles (25.9%/min) and for short range particles (27.6%/min), respectively. N95 masks were found to filter out 99.5% of the generated PM 2.5 particles. Conclusions: Potentially inhalable airborne particles can persist in the air of a dental clinic. The use of N95 masks and environmental controls is essential for the dental team's safety. The choice of an engineering control is governed by multiple factors explained in the study. Smoke particles generated by incense sticks and measurement by handheld particle sensors are low-cost methods to estimate the effectiveness of airborne particle controls.

Exploring the potentials of personalized ventilation in mitigating airborne infection risk for two closely ranged occupants with different risk assessment models

In the context of COVID-19, new requirements are occurring in ventilation systems to mitigate airborne transmission risk in indoor environment. Personalized ventilation (PV) which directly delivers clean air to the occupant’s breathing zone is considered as a promising solution. To explore the potentials of PV in preventing the spread of infectious aerosols between closely ranged occupants, experiments were conducted with two breathing thermal manikins with three different relative orientations. Nebulized aerosols were used to mimic exhaled droplets transmitted between the occupants. Four risk assessment models were applied to evaluate the exposure or infection risk affected by PV with different operation modes. Results show that PV was effective in reducing the user’s infection risk compared with mixing ventilation alone. Relative orientations and operation modes of PV significantly affected its performance in airborne risk control. The infection risk of SARS-CoV-2 was reduced by 65% with PV of 9 L/s after an exposure duration of 2 h back-to-back as assessed by the dose–response model, indicating effective protection effect of PV against airborne transmission. While the side-by-side orientation was found to be the most critical condition for PV in airborne risk control as it would accelerate diffusion of infectious droplets in lateral diffusion to occupants by side. Optimal designs of PV for closely ranged occupants were hereby discussed. The four risk assessment models were compared and validated by experiments with PV, implying basically consistent rules of the predicted risk with PV among the four models. The relevance and applicability of these models were discussed to provide a basis for risk assessment with non-uniformly distributed pathogens indoor.

Air Flow Experiments on a Train Carriage—Towards Understanding the Risk of Airborne Transmission

A series of experiments was undertaken on an intercity train carriage aimed at providing a “proof of concept” for three methods in improving our understanding of airflow behaviour and the accompanied dispersion of exhaled droplets. The methods used included the following: measuring CO2 concentrations as a proxy for exhaled breath, measuring the concentrations of different size fractions of aerosol particles released from a nebuliser, and visualising the flow patterns at cross-sections of the carriage by using a fog machine and lasers. Each experiment succeeded in providing practical insights into the risk of airborne transmission. For example, it was shown that the carriage is not well mixed over its length, however, it is likely to be well mixed along its height and width. A discussion of the suitability of the fresh air supply rates on UK train carriages is also provided, drawing on the CO2 concentrations measured during these experiments.

Predictive and retrospective modelling of airborne infection risk using monitored carbon dioxide

The risk of long range, herein ‘airborne', infection needs to be better understood and is especially urgent during the COVID-19 pandemic. We present a method to determine the relative risk of airborne transmission that can be readily deployed with either modelled or monitored CO2 data and occupancy levels within an indoor space. For spaces regularly, or consistently, occupied by the same group of people, e.g. an open-plan office or a school classroom, we establish protocols to assess the absolute risk of airborne infection of this regular attendance at work or school. We present a methodology to easily calculate the expected number of secondary infections arising from a regular attendee becoming infectious and remaining pre/asymptomatic within these spaces. We demonstrate our model by calculating risks for both a modelled open-plan office and by using monitored data recorded within a small naturally ventilated office. In addition, by inferring ventilation rates from monitored CO2, we show that estimates of airborne infection can be accurately reconstructed, thereby offering scope for more informed retrospective modelling should outbreaks occur in spaces where CO2 is monitored. Well-ventilated spaces appear unlikely to contribute significantly to airborne infection. However, even moderate changes to the conditions within the office, or new variants of the disease, typically result in more troubling predictions.

Modeling and multiobjective optimization of indoor airborne disease transmission risk and associated energy consumption for building HVAC systems

The COVID-19 pandemic has renewed interest in assessing how the operation of HVAC systems influences the risk of airborne disease transmission in buildings. Various processes, such as ventilation and filtration, have been shown to reduce the probability of disease spread by removing or deactivating exhaled aerosols that potentially contain infectious material. However, such qualitative recommendations fail to specify how much of these or other disinfection techniques are needed to achieve acceptable risk levels in a particular space. An additional complication is that application of these techniques inevitably increases energy costs, the magnitude of which can vary significantly based on local weather. Moreover, the operational flexibility available to the HVAC system may be inherently limited by equipment capacities and occupant comfort requirements. Given this knowledge gap, we propose a set of dynamical models that can be used to estimate airborne transmission risk and energy consumption for building HVAC systems based on controller setpoints and a forecast of weather conditions. By combining physics-based material balances with phenomenological models of the HVAC control system, it is possible to predict time-varying airflows and other HVAC variables, which are then used to calculate key metrics. Through a variety of examples involving real and simulated commercial buildings, we show that our models can be used for monitoring purposes by applying them directly to transient building data as operated, or they may be embedded within a multi-objective optimization framework to evaluate the tradeoff between infection risk and energy consumption. By combining these applications, building managers can determine which spaces are in need of infection risk reduction and how to provide that reduction at the lowest energy cost. The key finding is that both the baseline infection risk and the most energy-efficient disinfection strategy can vary significantly from space to space and depend sensitively on the weather, thus underscoring the importance of the quantitative predictions provided by the models.

Airborne transmission of SARS-CoV-2 in indoor environments: A comprehensive review

The COVID-19 pandemic has caused millions of deaths and great economic loss globally. There has been substantial evidence supporting the airborne transmission of SARS-CoV-2. Airborne route has been considered as a major transmission pathway, which can spread the disease over a longer distance and time. The viral loads in the respiratory tract of a virus carrier are typically below 109 RNA copies/mL and are related to the emission rate of pathogens. Most particles expelled during respiratory activities are smaller than 1-2µm in diameter. Viral aerosols can remain infectious for hours under typical indoor conditions. Sunlight contributes greatly to the viability inactivation of SARS-CoV-2. The outbreaks in different scenarios are reviewed based on existing data. Most outbreaks were related to long-term care facilities, K-12 schools, restaurants, retail facilities, and offices. The Wells-Riley model for estimating the risk of airborne transmission is introduced, along with model parameters such as the quanta generation rate, virus-containing particle size distribution, and inactivation rate. The effectiveness of various IAQ control strategies for mitigating the airborne transmission risk is analyzed, including PPE, ventilation strategies, partitions, air cleaning, and disinfection technologies, and occupancy control strategies. Both benefits and costs should be considered in designing the control strategies.

The Facility Infection Risk Estimator™: A web application tool for comparing indoor risk mitigation strategies by estimating airborne transmission risk

The COVID-19 pandemic created needs for (a) estimating the existing airborne risk of infection from SARS-CoV-2 in existing facilities and new designs and (b) estimating and comparing the impacts of engineering and behavioural strategies for contextually reducing that risk. This paper presents the development of a web application to meet these needs, the Facility Infection Risk Estimator™, and its underlying Wells–Riley based model. The model specifically estimates (a) the removal efficiencies of various settling, ventilation, filtration and virus inactivation strategies and (b) the associated probability of infection, given the room physical parameters and number of individuals infected present with either influenza or SARS-CoV-2. A review of the underlying calculations and associated literature is provided, along with the model's validation against two documented spreading events. The error between modelled and actual number of additional people infected, normalized by the number of uninfected people present, ranged from roughly –18.4% to +9.7%. The more certain one can be regarding the input parameters (such as for new designs or existing buildings with adequate field verification), the smaller these normalized errors will be, likely less than ±15%, making it useful for comparing the impacts of different risk mitigation strategies focused on airborne transmission.

Optimal control of high-rise building mechanical ventilation system for achieving low risk of COVID-19 transmission and ventilative cooling.

As suggested by many guidelines, a high ventilation rate is required to dilute the indoor virus particles and reduce the airborne transmission risk, i.e., dilution ventilation (DV). However, high ventilation rates may result in high energy costs. Ventilative cooling (VC), which requires high ventilation rates like DV, is an option to reduce the cooling energy consumption. By combining DV and VC, this paper investigated the operation of the mechanical ventilation system in high-rise buildings during the COVID-19 pandemic, aiming to minimizing the cooling related energy consumption and reducing COVID-19 transmission. First, a modified Wells-Riley model was proposed to calculate DV rates. The ventilation rate required to achieve VC was also introduced. Then, a new ventilation control strategy was proposed for achieving DV and VC. Finally, a case study was conducted on a real high-rise building, where the required DV rate and the impact of the settings of the mechanical ventilation on the energy savings were evaluated. The results indicate that the required ventilation rates vary from 36 m3/s to 3306 m3/s depending on the protective measures. When the occupants follow the protective measures, the proper settings of the mechanical ventilation system can reduce energy consumption by around 40%.

The airborne contagiousness of respiratory viruses: A comparative analysis and implications for mitigation

The infectious emission rate is a fundamental input parameter for airborne transmission risk assessment, but data are limited due to reliance on estimates from chance superspreading events. This study assesses the strength of a predictive estimation approach developed by the authors for SARS-CoV-2 and uses novel estimates to compare the contagiousness of respiratory pathogens. We applied the approach to SARS-CoV-1, SARS-CoV-2, MERS, measles virus, adenovirus, rhinovirus, coxsackievirus, seasonal influenza virus and Mycobacterium tuberculosis (TB) and compared quanta emission rate (ERq) estimates to literature values. We calculated infection risk in a prototypical classroom and barracks to assess the relative ability of ventilation to mitigate airborne transmission. Our median standing and speaking ERq estimate for SARS-CoV-2 (2.7 quanta h−1) is similar to active, untreated TB (3.1 quanta h−1), higher than seasonal influenza (0.17 quanta h−1), and lower than measles virus (15 quanta h−1). We calculated event reproduction numbers above 1 for SARS-CoV-2, measles virus, and untreated TB in both the classroom and barracks for an activity level of standing and speaking at low, medium and high ventilation rates of 2.3, 6.6 and 14 L per second per person (L s–1 p–1), respectively. Our predictive ERq estimates are consistent with the range of values reported over decades of research. In congregate settings, current ventilation standards are unlikely to control the spread of viruses with upper quartile ERq values above 10 quanta h−1, such as SARS-CoV-2, indicating the need for additional control measures.

Measuring interpersonal transmission of expiratory droplet nuclei in close proximity

Increasing evidence supports the significant role of short-range airborne transmission of viruses when in close contact with a source patient. A full-scale ventilated room (Cleanliness: ISO 14644–1 Class 5) and two face-to-face standing breathing thermal manikins were used to simulate a source individual and a susceptible person. Monodisperse particle generation and measurement techniques were used to evaluate the effect of virus-laden droplet nuclei size on short-range airborne transmission risk. We analysed four particle sizes (1.0, 1.5, 2.5, and 5.0 µm) to simulate the transport of exhaled droplet nuclei within an interpersonal distance of 0.5 m. The results indicated that the size distribution of airborne droplet nuclei could significantly influence transmission, with the inhalation fraction decreasing with increasing droplet nuclei size. Additionally, results showed that proximity to the source manikin could influence transmission. Inhalation fraction decreased with increasing interpersonal distance, fitting well with the 1/ d rule of droplet nuclei concentration decay. Our findings improve the understanding of the mechanism of the disease transmission.

Operation of air‐conditioning and sanitary equipment for SARS‐CoV‐2 infectious disease control

It is still undetermined if the main infection route of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the virus that leads to coronavirus disease 2019 (COVID‐19), is infection through droplet, contact, or airborne transmission. However, confined spaces with poor ventilation are cited as a risk factor for group outbreaks, and there is growing interest in the effects of intervention through the appropriate operation of air‐conditioning and sanitary equipment to reduce the risk of airborne transmission. This study first offers an outline of the characteristics of the novel coronavirus disease and the cluster outbreak case reports that have been clarified until now. Subsequently, we describe the appropriate operating conditions for building equipment that are effective in reducing the risk of infection and also highlight specificities for each building use based on the guidance provided by healthcare institutions and with reference to the standard recommendations by Western academic societies related to building equipment.

Ventilation procedures to minimize the airborne transmission of viruses in classrooms

Reducing the transmission of SARS-CoV-2 through indoor air is the key challenge of the COVID-19 pandemic. Crowded indoor environments, such as schools, represent possible hotspots for virus transmission since the basic non-pharmaceutical mitigation measures applied so far (e.g. social distancing) do not eliminate the airborne transmission mode. There is widespread consensus that improved ventilation is needed to minimize the transmission potential of airborne viruses in schools, whether through mechanical systems or ad-hoc manual airing procedures in naturally ventilated buildings. However, there remains significant uncertainty surrounding exactly what ventilation rates are required, and how to best achieve these targets with limited time and resources. This paper uses a mass balance approach to quantify the ability of both mechanical ventilation and ad-hoc airing procedures to mitigate airborne transmission risk in the classroom environment. For naturally-ventilated classrooms, we propose a novel feedback control strategy using CO2 concentrations to continuously monitor and adjust the airing procedure. Our case studies show how such procedures can be applied in the real world to support the reopening of schools during the pandemic. Our results also show the inadequacy of relying on absolute CO2 concentration thresholds as the sole indicator of airborne transmission risk.