Human exhalation characterization with the aid of schlieren imaging technique

Design of customizable personal protective equipment for 3-D printing: Performance evaluation of N95 respirators using computational fluid dynamics

3-D printing the structural components of facemasks and personal protective equipment (PPE) based on 3-D facial scans creates a high degree of customizability. As a result, the facemask fits more comfortably with its user's specific facial characteristics, filters contaminants more effectively with its increased sealing effect, and minimizes waste with its cleanable and reusable plastic structure compared to other baseline models. In this work, 3-D renditions of the user's face taken with smartphone laser scanning techniques were used to generate customized computer-aided design (CAD) models for the several components of an N95 respirator, which are each designed with considerations for assembly and 3-D printing constraints. Thorough analyses with computational fluid dynamics (CFD) simulations were carried out to verify the respirator's efficiency in filtering airborne contaminants to comply with industry safety guidelines and generate data to showcase the relationships between various input and output design parameters. This involved a comparative study to identify the ideal cross-sectional geometry of exposed filter fabric, a sensitivity study to evaluate the respirator's ability to protect the user in various scenarios, and the 3-D printing of several prototypes to estimate printing time, cost of materials, and comfort level at the user's face. Results showed that the combination of different digital tools can increase efficiency in the design, performance assessment, and production of customized N95-rated respirators.

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.

Development of multi-generation lower respiratory tract model and insights into the transport and deposition characteristics of inhalable particles

Airborne particles can spread quickly and enter human respiratory system via inhalation, causing chronic diseases, even cancer. Although recent studies have informed of toxicity of various pollutants, understanding the transport and deposition characteristics of particles in lower respiratory tract is still challenging. The current study proposes a novel model to simulate flow field change from the entrance of lower respiratory tract to pulmonary acinus, while studying particle transport and deposition characteristics. This model for lower respiratory tract with several bronchial extensions containing virtual pulmonary acinus is calculated using computational fluid dynamics and dynamics mesh. The results showed that in the first 10 generations of the lower respiratory tract, vortices and gravity interfered with particles' trajectory, affecting particle deposition distribution. For the first to the tenth-generation respiratory tract, coarse particles were deposited throughout almost the whole respiratory tract model. In contrast, ultrafine particles did not deposit in the higher-generation respiratory tract. The particle enrichment ability of various lobes was uneven with three particle deposition fraction variation patterns. Virtual pulmonary acinus influenced particle deposition and distribution because of vortex ring's trapped ability during expansion and contraction. This new attempt to build a virtual pulmonary acinus model to simulate particle deposition effects in human respiratory system may provide a reference for studying the toxicities of inhalable particles in the exposed human body.

Consideration on size, velocity and path of droplets emitted during running

BACKGROUND

People began to wear face masks during physical activities due to spread of COVID-19. There are no previous studies about the need for wearing masks while running.

METHODS

Assuming a citizen runner who runs full marathon in 4 hours, we verified the path and the amount of droplet dispersal, setting a humanoid mannequin with a mask in simulated running environment (Experiment 1). We also had six adults exercise in the same environment to examine droplet behaviors when not wearing a face mask (Experiment 2). Average droplet size was determined, and repeated measures ANOVA was carried out to examine statistical significance. To evaluate observed droplet behaviors, theoretical solutions of the downfall motion of large droplets were then derived, taking air resistance into consideration.

RESULTS

Experiment 1: wearing a face mask caused more droplets to adhere to the face; Experiment 2: droplets were emitted in conversation, coughing or sneezing, and they fell within social distancing. Average droplet size was not sensitive to the wind velocity. It could vary with a significant difference for time and wind velocity. Observed velocity and path of droplet can be expressed by the theoretical solutions.

CONCLUSIONS

Velocity and path of large droplets can be expressed by the theoretical solution of particles in downfall motion under air resistance. We therefore conclude that wearing a mask while running gives adverse effects in preventing infection. Possibility of droplet transmission while running is considered low even when not wearing a face mask, as long as social distancing is ensured.

Quantitatively Visualizing Airborne Disease Transmission Risks of Different Exhalation Activities through CO2 Imaging

Aerosol transmission has played a leading role in COVID-19 pandemic. However, there is still a poor understanding about how it is transmitted. This work was designed to study the exhaled breath flow dynamics and transmission risks under different exhaling modes. Using an infrared photography device, exhaled flow characteristics of different breathing activities, such as deep breathing, dry coughing, and laughing, together with the roles of mouth and nose were characterized by imaging CO2 flow morphologies. Both mouth and nose played an important role in the disease transmission though in the downward direction for the nose. In contrast to the trajectory commonly modeled, the exhaled airflows appeared with turbulent entrainments and obvious irregular movements, particularly the exhalations involving mouth were directed horizontal and had a higher propagation capacity and transmission risk. While the cumulative risk was high for deep breathing, those transient ones from dry coughing, yawning, and laughing were also shown to be significant. Various protective measures including masks, canteen table shields, and wearable devices were visually demonstrated to be effective for altering the exhaled flow directions. This work is useful to understanding the risk of aerosol infection and guiding the formulation of its prevention and control strategies. Experimental data also provide important information for refining model boundary conditions.

A frontal air intake may improve the natural ventilation in urban buses

In this report we analyze the air flow across the open windows (natural ventilation) of an urban bus model and the consequent dispersion of aerosols emitted in the passengers area. The methods include computational fluid dynamics simulations and three ways to characterize the dispersion of passive tracers: a continuous concentration-based model, a discrete random model and a parametric scalar based on the so-called mean age of air. We also conducted experiments using a 1:10 scale bus model and [Formula: see text] as a passive tracer to assess the ventilation characteristics. We found that dispersion and expulsion of aerosols is driven by a negative pressure in the standard bus design equipped with lateral windows. Also, the average age of air is 6 minutes while the air flow promotes aerosol accumulation to the front (driver's area). To speed up the expulsion of aerosols and reduce their in-cabin accumulation, we propose a bus bodywork prototype having a frontal air intake. All the numerical models and experiments conducted in this work agreed that the expulsion of aerosols in this novel configuration is significantly increased while the average age of air is reduced to 50 seconds. The average air flow also changes with the presence of frontal air intakes and, as a consequence, the expulsion of aerosols is now driven by a frontal velocity field.

Current and potential approaches on assessing airflow and particle dispersion in healthcare facilities: a systematic review

An indoor environment in a hospital building requires a high indoor air quality (IAQ) to overcome patients' risks of getting wound infections without interrupting the recovery process. However, several problems arose in obtaining a satisfactory IAQ, such as poor ventilation design strategies, insufficient air exchange, improper medical equipment placement and high door opening frequency. This paper presents an overview of various methods used for assessing the IAQ in hospital facilities, especially in an operating room, isolation room, anteroom, postoperative room, inpatient room and dentistry room. This review shows that both experimental and numerical methods demonstrated their advantages in the IAQ assessment. It was revealed that both airflow and particle tracking models could result in different particle dispersion predictions. The model selection should depend on the compatibility of the simulated result with the experimental measurement data. The primary and secondary forces affecting the characteristics of particle dispersion were also discussed in detail. The main contributing forces to the trajectory characteristics of a particle could be attributed to the gravitational force and drag force regardless of particle size. Meanwhile, the additional forces could be considered when there involves temperature gradient, intense light source, submicron particle, etc. The particle size concerned in a healthcare facility should be less than 20 μm as this particle size range showed a closer relationship with the virus load and a higher tendency to remain airborne. Also, further research opportunities that reflect a more realistic approach and improvement in the current assessment approach were proposed.

Development of an Easily Reproducible Cough Simulator With Droplets and Aerosols for Rapidly Testing Novel Personal Protective Equipment

INTRODUCTION

The current COVID-19 pandemic has produced numerous innovations in personal protective equipment, barrier devices, and infection mitigation strategies, which have not been validated. During high-risk procedures such as airway manipulation, coughs are common and discrete events that may expose healthcare workers to large amounts of viral particles. A simulated cough under controlled circumstances can rapidly test novel devices and protocols and thus aid in their evaluation and the development of implementation guidelines. Physiologic cough simulators exist but require significant expertise and specialized equipment not available to most clinicians.

METHODS

Using components commonly found in healthcare settings, a cough simulator was designed for clinicians to easily assemble and use. Both droplet and aerosol particle generators were incorporated into a bimodal experimental system. High-speed flash photography was used for data collection.

RESULTS

Using a gas flow analyzer, video recordings, and high-speed digital photography, the cough and particle simulators were quantitatively and qualitatively compared with known physiologic cough parameters and in vivo Schlieren imaging of human coughs.

CONCLUSIONS

Based on our validation studies, this cough and particle simulator model approximates a physiologic, human cough in the context of testing personal protective equipment, barrier devices, and infection prevention measures.

Overview of the Role of Spatial Factors in Indoor SARS-CoV-2 Transmission: A Space-Based Framework for Assessing the Multi-Route Infection Risk

The COVID-19 pandemic has lasted from 2019 to 2022, severely disrupting human health and daily life. The combined effects of spatial, environmental, and behavioral factors on indoor COVID-19 spread and their interactions are usually ignored. Especially, there is a lack of discussion on the role of spatial factors in reducing the risk of virus transmission in complex and diverse indoor environments. This paper endeavours to summarize the spatial factors and their effects involved in indoor virus transmission. The process of release, transport, and intake of SARS-CoV-2 was reviewed, and six transmission routes according to spatial distance and exposure way were classified. The triangular relationship between spatial, environmental and occupant behavioral parameters during virus transmission was discussed. The detailed effects of spatial parameters on droplet-based, surface-based and air-based transmission processes and virus viability were summarized. We found that spatial layout, public-facility design and openings have a significant indirect impact on the indoor virus distribution and transmission by affecting occupant behavior, indoor airflow field and virus stability. We proposed a space-based indoor multi-route infection risk assessment framework, in which the 3D building model containing detailed spatial information, occupant behavior model, virus-spread model and infection-risk calculation model are linked together. It is also applicable to other, similar, respiratory infectious diseases such as SARS, influenza, etc. This study contributes to developing building-level, infection-risk assessment models, which could help building practitioners make better decisions to improve the building's epidemic-resistance performance.

The physics of respiratory particle generation, fate in the air, and inhalation

Given that breathing is one of the most fundamental physiological functions, there is an urgent need to broaden our understanding of the fluid dynamics that governs it. There would be many benefits from doing so, including a better assessment of respiratory health, a basis for more precise delivery of pharmaceutical drugs for treatment, and the understanding and potential minimization of respiratory infection transmission. We review the physics of particle generation in the respiratory tract, the fate of these particles in the air on exhalation and the physics of particle inhalation. The main focus is on evidence from experimental studies. We conclude that although there is qualitative understanding of the generation of particles in the respiratory tract, a basic quantitative knowledge of the characteristics of the particles emitted during respiratory activities and their fate after emission, and a theoretical understanding of particle deposition during inhalation, nevertheless the general understanding of the entire process is rudimentary, and many open questions remain.

Ventilation strategies to reduce airborne transmission of viruses in classrooms: A systematic review of scientific literature

The recent pandemic due to SARS-CoV-2 has brought to light the need for strategies to mitigate contagion between human beings. Apart from hygiene measures and social distancing, air ventilation highly prevents airborne transmission within enclosed spaces. Among others, educational environments become critical in strategic planning to control the spread of pathogens and viruses amongst the population, mainly in cold conditions. In the event of a virus outbreak - such as COVID or influenza - many school classrooms still lack the means to guarantee secure and healthy environments. The present review examines school contexts that implement air ventilation strategies to reduce the risk of contagion between students. The analysed articles present past experiences that use either natural or mechanical systems assessed through mathematical models, numerical models, or full-scale experiments. For naturally ventilated classrooms, the studies highlight the importance of the architectural design of educational spaces and propose strategies for aeration control such as CO₂-based control and risk-infection control. When it comes to implementing mechanical ventilation in classrooms, different systems with different airflow patterns are assessed based on their ability to remove airborne pathogens considering parameters like the age of air and the generation of airflow streamlines. Moreover, studies report that programmed mechanical ventilation systems can reduce risk-infection during pandemic events. In addition to providing a systematic picture of scientific studies in the field, the findings of this review can be a valuable reference for school administrators and policymakers to implement the best strategies in their classroom settings towards reducing infection risks.

Temporal-spatial risk assessment of COVID-19 under the influence of urban spatial environmental parameters: The case of Shenyang city

Respiratory infection is the main route for the transmission of coronavirus pneumonia, and the results have shown that the urban spatial environment significantly influences the risk of infection. Based on the Wells-Riley model of respiratory infection probability, the study determined the human respiratory-related parameters and the effective influence range; extracted urban morphological parameters, assessed the ventilation effects of different spatial environments, and, combined with population flow monitoring data, constructed a method for assessing the risk of Covid-19 respiratory infection in urban-scale grid cells. In the empirical study in Shenyang city, a severe cold region, urban morphological parameters, population size, background wind speed, and individual behavior patterns were used to calculate the distribution characteristics of temporal and spatial concomitant risks in urban areas grids under different scenarios. The results showed that the correlation between the risk of respiratory infection in urban public spaces and the above variables was significant. The exposure time had the greatest degree of influence on the probability of respiratory infection risk among the variables. At the same time, the change in human body spacing beyond 1 m had a minor influence on the risk of infection. Among the urban morphological parameters, building height had the highest correlation with the risk of infection, while building density had the lowest correlation. The actual point distribution of the epidemic in Shenyang from March to April 2022 was used to verify the evaluation results. The overlap rate between medium or higher risk areas and actual cases was 78.55%. The planning strategies for epidemic prevention and control were proposed for the spatial differentiation characteristics of different risk elements. The research results can accurately classify the risk level of urban space and provide a scientific basis for the planning response of epidemic prevention and control and the safety of public activities.

The emission and dynamics of droplets from human expiratory activities and COVID-19 transmission in public transport system: A review

The public transport system, containing a large number of passengers in enclosed and confined spaces, provides suitable conditions for the spread of respiratory diseases. Understanding how diseases are transmitted in public transport environment is of vital importance to public health. However, this is a highly multidisciplinary matter and the related physical processes including the emissions of respiratory droplets, the droplet dynamics and transport pathways, and subsequently, the infection risk in public transport, are poorly understood. To better grasp the complex processes involved, a synthesis of current knowledge is required. Therefore, we conducted a review on the behaviors of respiratory droplets in public transport system, covering a wide scope from the emission profiles of expiratory droplets, the droplet dynamics and transport, to the transmission of COVID-19 in public transport. The literature was searched using related keywords in Web of Science and PubMed and screened for suitability. The droplet size is a key parameter in determining the deposition and evaporation, which together with the exhaled air velocity largely determines the horizontal travel distance. The potential transmission route and transmission rate in public transport as well as the factors influencing the virus-laden droplet behaviors and virus viability (such as ventilation system, wearing personal protective equipment, air temperature and relative humidity) were also discussed. The review also suggests that future studies should address the uncertainties in droplet emission profiles associated with the measurement techniques, and preferably build a database based on a unified testing protocol. Further investigations based on field measurements and modeling studies into the influence of different ventilation systems on the transmission rate in public transport are also needed, which would provide scientific basis for controlling the transmission of diseases.

The source control effect of personal protection equipment and physical barrier on short-range airborne transmission

In order to control the spread of Covid-19, authorities provide various prevention guidelines and recommendations for health workers and the public. Personal protection equipment (PPE) and physical barrier are the most widely applied prevention measures in practice due to their affordability and ease of implementation. This study aims to investigate the effect of PPE and physical barriers on mitigating the short-range airborne transmission between two people in a ventilated environment. Four types of PPE (surgical mask, two types of face shield, and mouth visor), and two different sizes of the physical barrier were tested in a controlled environment with two life-size breathing thermal manikins. The PPE was worn by the source manikin to test the efficiency of source control. The measurement results revealed that the principles of PPE on preventing short-range droplet and airborne transmission are different. Instead of filtering the fine droplet nuclei, they mainly redirect the virus-laden exhalation jet and avoid the exhaled flow entering the target's inhalation region. Physical barriers can block the spreading of droplet nuclei and create a good micro environment at short distances between persons. However, special attention should be paid to arranging the physical barrier and operating the ventilation system to avoid the stagnant zone where the contaminant accumulates.

Influence of wearing masks on exhaled air aerodynamics

Since aerosol inhalation is the most common mechanism for COVID-19 infection, the respiratory protective devices (RPDs) have the highest importance in personal protection. The aim of this study was to assess the efficiency of 10 different RPDs in shortening the travelling distance of exhaled air by range measurement using the schlieren imaging technique. When a RPD is worn by a person resting in a seated position, the expired air does not exceed the human convective boundary layer (CBL). Instead, the CBL lifts the expired aerosols vertically up. Thus, they have a prolonged travelling time in the surrounding air and become less harmful by several mechanisms of virus content decay. Coughing as well as expiration valves can cause far reaching expiration air clouds that cross horizontally the human CBL by opening leakage airway corridors into different directions. Measured by the range of expired air an FFP2 mask provided high security under all conditions tested. A non-vented full-face mask with two viral filters performed even better because of its airtight fit and the excellent filtering capacity of the viral filters during inspiration and expiration, even during cough manoeuvres.

Airborne particle dispersion by high flow nasal oxygen: An experimental and CFD analysis

High Flow Nasal Oxygen (HFNO) therapy offers a proven means of delivering respiratory support to critically ill patients suffering from viral illness such as COVID-19. However, the therapy has the potential to modify aerosol generation and dispersion patterns during exhalation and thereby put healthcare workers at increased risk of disease transmission. Fundamentally, a gap exists in the literature with regards to the effect of the therapy on the fluid dynamics of the exhalation jet which is essential in understanding the dispersion of aerosols and hence quantifying the disease transmission risk posed by the therapy. In this paper, a multi-faceted approach was taken to studying the aerosol-laden exhalation jet. Schlieren imaging was used to visualise the flow field for a range of expiratory activities for three healthy human volunteers receiving HFNO therapy at flow rates of 0-60 L/min. A RANS turbulence model was implemented using the CFD software OpenFOAM and used to perform a parametric study on the influence of exhalation velocity and duration on the dispersion patterns of non-evaporating droplets in a room environment. A dramatic increase in the turbulence of the exhalation jet was observed when HFNO was applied. Quantitative analysis indicated that the mean exhalation velocity was increased by 2.2-3.9 and 2.3-3 times that for unassisted breathing and coughing, respectively. A 1-2 second increase was found in the exhalation duration. The CFD model showed that small droplets (10-40 μm) were most greatly affected, where a 1 m/s increase in velocity and 1 s increase in duration caused an 80% increase in axial travel distance.

Indoor aerosol science aspects of SARS-CoV-2 transmission

Knowledge about person-to-person transmission of SARS-CoV-2 is reviewed, emphasizing three components: emission of virus-containing particles and drops from infectious persons; transport and fate of such emissions indoors; and inhalation of viral particles by susceptible persons. Emissions are usefully clustered into three groups: small particles (diameter 0.1-5 µm), large particles (5-100 µm), and ballistic drops (>100 µm). Speaking generates particles and drops across the size spectrum. Small particles are removed from indoor air at room scale by ventilation, filtration, and deposition; large particles mainly deposit onto indoor surfaces. Proximate exposure enhancements are associated with large particles with contributions from ballistic drops. Masking and social distancing are effective in mitigating transmission from proximate exposures. At room scale, masking, ventilation, and filtration can contribute to limit exposures. Important information gaps prevent a quantitative reconciliation of the high overall global spread of COVID-19 with known transmission pathways. Available information supports several findings with moderate-to-high confidence: transmission occurs predominantly indoors; inhalation of airborne particles (up to 50 µm in diameter) contributes substantially to viral spread; transmission occurs in near proximity and at room scale; speaking is a major source of airborne SARS-CoV-2 virus; and emissions can occur without strong illness symptoms.

The spread of breathing air from wind instruments and singers using schlieren techniques

The spread of breathing air when playing wind instruments and singing was investigated and visualized using two methods: (1) schlieren imaging with a schlieren mirror and (2) background-oriented schlieren (BOS). These methods visualize airflow by visualizing density gradients in transparent media. The playing of professional woodwind and brass instrument players, as well as professional classical trained singers were investigated to estimate the spread distances of the breathing air. For a better comparison and consistent measurement series, a single high note, a single low note, and an extract of a musical piece were investigated. Additionally, anemometry was used to determine the velocity of the spreading breathing air and the extent to which it was quantifiable. The results showed that the ejected airflow from the examined instruments and singers did not exceed a spreading range of 1.2 m into the room. However, differences in the various instruments have to be considered to assess properly the spread of the breathing air. The findings discussed below help to estimate the risk of cross-infection for wind instrument players and singers and to develop efficacious safety precautions, which is essential during critical health periods such as the current COVID-19 pandemic.

Contamination of multiuse eyedrop bottles by exhaled air from patients wearing face masks during the COVID-19 pandemic: Schlieren imaging analysis

PURPOSE

To determine whether mask-induced redirected exhaled air through the superior mask gap contacts multiuse eyedrop bottles during drop administration and the efficacy of interventions to reduce such exposure.

SETTING

Academic ophthalmology center.

DESIGN

Interventional analysis.

METHODS

Schlieren airflow imaging was taken of an examinee wearing frequently used face masks and enacting common clinical scenarios-with and without manual occlusion of the superior mask gap and/or neck extension-and maximum visible vertical breath plume height was quantified. Bottle height during eyedrop administration was measured for 4 ophthalmologists during instillation to 8 eyes of 4 subjects.

RESULTS

Breath plume height (mean ± SD 275.5 ± 16.3 mm) was significantly greater than mean bottle height (13.9 ± 4.7 mm; P < .01). Plume height was reduced with manual mask occlusion vs without (P < .01) and was also lower than mean bottle height with manual mask occlusion (P < .01) but not in the absence of occlusion (P < .01). Neck extension alone did not adequately redirect liberated breath to prevent contact with a bottle.

CONCLUSIONS

Exhaled air liberated from commonly worn patient face masks was able to contact multiuse eyedrop bottles during eyedrop administration. These findings have important patient safety implications during the coronavirus disease 2019 pandemic and with other respiratory pathogens because these multiuse bottles could potentially serve as vectors of disease. Occlusion of the superior mask gap significantly reduces breath contamination and should be strongly considered by eyecare providers during drop administration in eye clinics.

Safety and Reverence: How Roman Catholic Liturgy Can Respond to the COVID-19 Pandemic

The current COVID-19 pandemic is a major challenge for many religious denominations. The Roman Catholic Church strongly depends on physical communal worship and sacraments. Disagreements grow concerning the best balance between safety and piety. To address this issue, I review the major transmission risks for the SARS-CoV-2 virus and list certain measures to enhance the safety of the Roman Catholic Liturgy without compromising its intrinsic beauty and reverent spiritual attitude. This can be achieved through assimilation of several traditional elements into the modern liturgy. I emphasize that religious leadership and decision-making should be transparent and based on inclusiveness, pluralism, best scientific evidence and voluntary cooperation.

Modeling Aerial Transmission of Pathogens (Including the SARS-CoV-2 Virus) through Aerosol Emissions from E-Cigarettes

We examine the plausibility of aerial transmission of pathogens (including the SARS-CoV-2 virus) through respiratory droplets that might be carried by exhaled e-cigarette aerosol (ECA). Given the lack of empiric evidence on this phenomenon, we consider available evidence on cigarette smoking and respiratory droplet emission from mouth breathing through a mouthpiece as convenient proxies to infer the capacity of vaping to transport pathogens in respiratory droplets. Since both exhaled droplets and ECA droplets are within the Stokes regime, the ECA flow acts effectively as a visual tracer of the expiratory flow. To infer quantitatively the direct exposure distance, we consider a model that approximates exhaled ECA flow as an axially symmetric intermittent steady starting jet evolving into an unstable puff, an evolution that we corroborate by comparison with photographs and videos of actual vapers. On the grounds of all this theoretical modeling, we estimate for low-intensity vaping (practiced by 80–90% of vapers) the emission of 6–210 (median 39.9, median deviation 67.3) respiratory submicron droplets per puff and a horizontal distance spread of 1–2 m, with intense vaping possibly emitting up to 1000 droplets per puff in the submicron range with a distance spread over 2 m. The optical visibility of the ECA flow has important safety implications, as bystanders become instinctively aware of the scope and distance of possible direct contagion through the vaping jet.

The investigation of the influence of thermal plume and breathing on sleeping microenvironment

Most of humans' lifetime was spent indoor, especially in bedroom. Thus, understanding the characteristics of the sleep microenvironment is a prerequisite for better control and improvement of our sleeping environment. This study investigated the temperature and velocity field above the heads of sleeping people with supine postures, and explored the interactions between the thermal plume and the breathing airflow, where both the thermal manikins and real human subjects were used in our experiment settings. Three different breathing modes were considered in this study, where the non-breathing mode was used to investigate the characteristics of the thermal plume, and the synergy of the mouth and nose breathing mode on the thermal plume was also investigated. The results showed that the thermal plume of a supine posture person was not strong compared to that of a standing or sitting person, and the breathing airflow could influence the development of the thermal plume. Over the head of a sleeping person, the velocity of the thermal plume could be increased by both of the breathing modes, but no significant difference in the velocity and temperature field was found for the two breathing modes. It was also found that pollutants near the bed surface could be brought to the breathing zone with low velocity airflow, but could be blocked by the nasal exhalation jet. The findings in this study could provide theoretical support and guidance to improve the air quality in the breathing zone.

Characterization of Aerosol Generation During Various Intensities of Exercise

Background

Characterization of aerosol generation during exercise can inform the development of safety recommendations in the face of COVID-19.

Research Question

Does exercise at various intensities produce aerosols in significant quantities?

Study Design and Methods

In this experimental study, subjects were eight healthy volunteers (six men, two women) who were 20 to 63 years old. The 20-minute test protocol of 5 minutes rest, four 3-minute stages of exercise at 25%, 50%, 75%, and 100% of age-predicted heart rate reserve, and 3 minutes active recovery was performed in a clean, controlled environment. Aerosols were measured by four particle counters that were place to surround the subject.

Results

Age averaged 41 ± 14 years. Peak heart rate was 173 ± 17 beat/min (97% predicted); peak maximal oxygen uptake was 33.9 ± 7.5 mL/kg/min; and peak respiratory exchange ratio was 1.22 ± 0.10. Maximal ventilation averaged 120 ± 23 L/min, while cumulative ventilation reached 990 ± 192 L. Concentrations increased exponentially from start to 20 minutes (geometric mean ± geometric SD particles/liter): Fluke >0.3 μm = 66 ± 1.8 → 1605 ± 3.8; 0.3-1.0 μm = 35 ± 2.2 → 1095 ± 4.6; Fluke 1.0-5.0 μm = 21 ± 2.0 → 358 ± 2.3; P-Trak anterior = 637 ± 2.3 → 5148 ± 3.0; P-Trak side = 708 ± 2.7 → 6844 ± 2.7; P-Track back = 519 ± 3.1 → 5853 ± 2.8. All increases were significant at a probability value of <.05. Exercise at or above 50% of predicted heart rate reserve showed statistically significant increases in aerosol concentration.

Interpretation

Our data suggest exercise testing is an aerosol-generating procedure and, by extension, other activities that involve exercise intensities at or above 50% of predicted heart rate reserve. Results can guide recommendations for safety of exercise testing and other indoor exercise activities.

A dynamical overview of droplets in the transmission of respiratory infectious diseases

The outbreak of the coronavirus disease has drawn public attention to the transmission of infectious pathogens, and as major carriers of those pathogens, respiratory droplets play an important role in the process of transmission. This Review describes respiratory droplets from a physical and mechanical perspective, especially their correlation with the transmission of infectious pathogens. It covers the important aspects of (i) the generation and expulsion of droplets during respiratory activities, (ii) the transport and evolution of respiratory droplets in the ambient environment, and (iii) the inhalation and deposition of droplets in the human respiratory tract. State-of-the-art experimental, computational, and theoretical models and results are presented, and the corresponding knowledge gaps are identified. This Review stresses the multidisciplinary nature of its subject and appeals for collaboration among different fields to fight the present pandemic.

Study on the transmission route of virus aerosol particles and control technology of air conditioning in the enclosed space

The patient's breathing and air conditioning system in the enclosed space are the main factors that cause indoor cross-infection. However, the research on the influence and the control mechanism of different air conditioning systems on the transmission path of virus aerosol particles exhaled by patients is still limited. To evaluate the effects of different air conditioning systems on the spread of human exhaled pollutants, computational fluid dynamics (CFD) was used to study the movement and diffusion of exhaled air from two rows of 12 sitting adults in a hospital's closed transfusion room. In this paper, three different air conditioning systems are considered: Ceil-supply and Down-return (Ceil-to-Down), Up-supply and Down-return (Up-to-Down), Down-supply and Up-return (Down-to-Up). The distribution of exhaled air velocity, temperature, and virus particle concentration were studied, and it is found that the horizontal diffusion distance of exhaled pollutants is about 0.75 -1.1 m. When up to down systems are used, the air conditioning system shall be closed in time in case of respiratory infectious diseases, so as to avoid cross-infection in the enclosed space. A relatively clean air area with a height of about 1.1 m will be formed, which can inhibit the transmission of the virus to a certain extent when using the down-to-up system. But for those who are exposed to the enclosed space for a long time, the down-to-up system is not the most suitable air conditioning system.

A review on the applied techniques of exhaled airflow and droplets characterization

In the last two decades, multidisciplinary research teams worked on developing a comprehensive understanding of the transmission mechanisms of airborne diseases. This article reviews the experimental studies on the characterization of the exhaled airflow and the droplets, comparing the measured parameters, the advantages, and the limitations of each technique. To characterize the airflow field, the global flow-field techniques-high-speed photography, schlieren photography, and PIV-are applied to visualize the shape and propagation of the exhaled airflow and its interaction with the ambient air, while the pointwise measurements provide quantitative measurements of the velocity, flow rate, humidity and temperature at a single point in the flow field. For the exhaled droplets, intrusive techniques are used to characterize the size distribution and concentration of the droplets' dry residues while non-intrusive techniques can measure the droplet size and velocity at different locations in the flow field. The evolution of droplets' size and velocity away from the source has not yet been thoroughly experimentally investigated. Besides, there is a lack of information about the temperature and humidity fields composed by the interaction of the exhaled airflow and the ambient air.

Investigation of exhaled pollutant distribution in the breathing microenvironment in a displacement ventilated room with indoor air stability conditions

This study experimentally studied the dispersion of exhaled pollutant in the breathing microenvironment (BM) in a room equipped with a displacement ventilation (DV) system and indoor air stability conditions (i.e., stable and unstable conditions). The vertical temperature differences and the carbon dioxide (CO₂) concentration in the BM were measured. Results show that when DV is combined with the stable condition (DS), pollutant tends to accumulate in the BM, leading to a high pollutant concentration in this region. Whereas, when DV is combined with the unstable condition (DU), pollutant diffuses to a relatively wider area beyond the BM, thus the pollutant concentration in the BM is substantially reduced. Moreover, increasing the flow rate can reduce the pollutant concentration in the BM of the DS but yields little difference of the DU. In addition, personal exposure intensity increases with time, and the DS has a relatively higher increase rate than DU. The results suggest that indoor air stability will affect the performance of DV systems. DS will lead to a higher health risk for people when they stay in the indoor environment with pollutant sources, and DU is recommended for minimizing pollutant level in the BM in order to reduce the pollutant concentration and providing better air environments for the occupants.

Speech can produce jet-like transport relevant to asymptomatic spreading of virus

Many scientific reports document that asymptomatic and presymptomatic individuals contribute to the spread of COVID-19, probably during conversations in social interactions. Droplet emission occurs during speech, yet few studies document the flow to provide the transport mechanism. This lack of understanding prevents informed public health guidance for risk reduction and mitigation strategies, e.g., the "6-foot rule." Here we analyze flows during breathing and speaking, including phonetic features, using orders-of-magnitude estimates, numerical simulations, and laboratory experiments. We document the spatiotemporal structure of the expelled airflow. Phonetic characteristics of plosive sounds like "P" lead to enhanced directed transport, including jet-like flows that entrain the surrounding air. We highlight three distinct temporal scaling laws for the transport distance of exhaled material including 1) transport over a short distance (<0.5 m) in a fraction of a second, with large angular variations due to the complexity of speech; 2) a longer distance, ∼1 m, where directed transport is driven by individual vortical puffs corresponding to plosive sounds; and 3) a distance out to about 2 m, or even farther, where sequential plosives in a sentence, corresponding effectively to a train of puffs, create conical, jet-like flows. The latter dictates the long-time transport in a conversation. We believe that this work will inform thinking about the role of ventilation, aerosol transport in disease transmission for humans and other animals, and yield a better understanding of linguistic aerodynamics, i.e., aerophonetics.

Effects of personalized ventilation interventions on airborne infection risk and transmission between occupants

The role of personalized ventilation (PV) in protecting against airborne disease transmission between occupants was evaluated by considering two scenarios with different PV alignments. The possibility that PV may facilitate the transport of exhaled pathogens was explored by performing experiments with droplets and applying PV to a source or/and a target manikin. The risk of direct and indirect exposure to droplets in the inhalation zone of the target was estimated, with these exposure types defined according to their different origins. The infection risk of influenza A, a typical disease transmitted via air, was predicted based on a dose-response model. Results showed that the flow interactions between PV and the infectious exhaled flow would facilitate airborne transmission between occupants in two ways. First, application of PV to the source caused more than 90% of indirect exposure of the target. Second, entrainment of the PV jet directly from the infectious exhalation increased direct exposure of the target by more than 50%. Thus, these scenarios for different PV application modes indicated that continuous exposure to exhaled influenza A virus particles for 2 h would correspond with an infection probability ranging from 0.28 to 0.85. These results imply that PV may protect against infection only when it is maintained with a high ventilation efficiency at the inhalation zone, which can be realized by reduced entrainment of infectious flow and higher clean air volume. Improved PV design methods that could maximize the positive effects of PV on disease control in the human microenvironment are discussed.

Qualitative and quantitative schlieren optical measurement of the human thermal plume

A new large-field, high-sensitivity, single-mirror coincident schlieren optical instrument has been installed at the Bauhaus-Universität Weimar for the purpose of indoor air research. Its performance is assessed by the non-intrusive measurement of the thermal plume of a heated manikin. The schlieren system produces excellent qualitative images of the manikin's thermal plume and also quantitative data, especially schlieren velocimetry of the plume's velocity field that is derived from the digital cross-correlation analysis of a large time sequence of schlieren images. The quantitative results are compared with thermistor and hot-wire anemometer data obtained at discrete points in the plume. Good agreement is obtained, once the differences between path-averaged schlieren data and planar anemometry data are reconciled.

Close contact behavior in indoor environment and transmission of respiratory infection

Close contact was first identified as the primary route of transmission for most respiratory infections in the early 20th century. In this review, we synthesize the existing understanding of the mechanisms of close contact transmission. We focus on two issues: the mechanism of transmission in close contact, namely the transmission of the expired particles between two people, and the physical parameters of close contact that affect the exposure of particles from one individual to another, or how the nature of close contact plays a role in transmission. We propose the existence of three sub-routes of transmission: short-range airborne, large droplets, and immediate body-surface contact. We also distinguish a "body contact," which is defined with an interpersonal distance of zero, from a close contact. We demonstrate herein that the short-range airborne sub-route may be most common. The timescales over which data should be collected to assess the transmission risk during close contact events are much shorter than those required for the distant airborne or fomite routes. The current paucity of high-resolution data over short distances and timescales makes it very difficult to assess the risk of infection in these circumstances.

Study on the motion law of aerosols produced by human respiration under the action of thermal plume of different intensities

Predicting influence of human thermal plume on the diffusion of respiration-produced particles is an important issue for improving indoor air quality through eliminating infectious microbes efficiently. In this study, the Large Eddy Simulation was utilized to predict the effects of thermal plume of different intensities on particle diffusion. Three postures of the human body model and three room temperatures were considered. The results show that the convective heat transfer coefficient on the surface of the human body varies greatly with different postures. The coefficient is the largest when the model is in sitting posture, leading to the greatest heat transfer rate. Meanwhile, the thermal plume generated by bending the thigh increases the size of the facial thermal plume in horizon direction. The increase of the difference between indoor temperature and skin temperature causes an increase of the convective heat transfer of the manikin, leading to stronger airflow in front of the face. The thicker and faster the human thermal plume is, the more difficult it is penetrated by aerosols produced by nasal breathing, finally resulting in most particles distributed within 0.2 m thick under the roof.

Airborne transmission between room occupants during short-term events: Measurement and evaluation

This study experimentally examines and compares the dynamics and short-term events of airborne cross-infection in a full-scale room ventilated by stratum, mixing and displacement air distributions. Two breathing thermal manikins were employed to simulate a standing infected person and a standing exposed person. Four influential factors were examined, including separation distance between manikins, air change per hour, positioning of the two manikinsand air distribution. Tracer gas technique was used to simulate the exhaled droplet nuclei from the infected person and fast tracer gas concentration meters (FCM41) were used to monitor the concentrations. Real-time and average exposure indices were proposed to evaluate the dynamics of airborne exposure. The time-averaged exposure index depends on the duration of exposure time and can be considerably different during short-term events and under steady-state conditions. The exposure risk during short-term events may not always decrease with increasing separation distance. It changes over time and may not always increase with time. These findings imply that the control measures formulated on the basis of steady-state conditions are not necessarily appropriate for short-term events.

Airborne spread of expiratory droplet nuclei between the occupants of indoor environments: A review

This article reviews past studies of airborne transmission between occupants in indoor environments, focusing on the spread of expiratory droplet nuclei from mouth/nose to mouth/nose for non-specific diseases. Special attention is paid to summarizing what is known about the influential factors, the inappropriate simplifications of the thermofluid boundary conditions of thermal manikins, the challenges facing the available experimental techniques, and the limitations of available evaluation methods. Secondary issues are highlighted, and some new ways to improve our understanding of airborne transmission indoors are provided. The characteristics of airborne spread of expiratory droplet nuclei between occupants, which are influenced correlatively by both environmental and personal factors, were widely revealed under steady-state conditions. Owing to the different boundary conditions used, some inconsistent findings on specific influential factors have been published. The available instrumentation was too slow to provide accurate concentration profiles for time-dependent evaluations of events with obvious time characteristics, while computational fluid dynamics (CFD) studies were mainly performed in the framework of inherently steady Reynolds-averaged Navier-Stokes modeling. Future research needs in 3 areas are identified: the importance of the direction of indoor airflow patterns, the dynamics of airborne transmission, and the application of CFD simulations.

Nature and characteristics of temperature background effect for interactive respiration process

Indoor air quality (IAQ) is much more crucial to human health than its atmospheric air quality counterpart. Improving indoor air environment requires investigating how different indoor air stability affects airflow trajectory. By presenting both manikin experiment and Computational Fluid Dynamics (CFD) simulation, we find that temperature background effect, i.e., indoor air stability, which is a measure of the nature or attribute of the capacity to keep the original or initial inertia force or inertia transmission state instead of turbulence diffusion or transmission restraining state, i.e., a kind of inertia stability, rather than a turbulence diffusion characteristic stability, is markedly affecting the interactive respiration process. So we define and derive a new parameter called G c number as a criterion to judge air stability. Furthermore, we find the phenomenon of inertia conjugation. Air stability and inertia conjugation, which named together as temperature background effect, work together on interactive respiration process. This work gives us a re-orientation of temperature difference agents and thus improves human being's living environment.