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Selestin Raja I, Kim C, Oh N, Park JH, Hong SW, Kang MS, Mao C, Han DW. Tailoring photobiomodulation to enhance tissue regeneration. Biomaterials 2024; 309:122623. [PMID: 38797121 DOI: 10.1016/j.biomaterials.2024.122623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/25/2024] [Accepted: 05/19/2024] [Indexed: 05/29/2024]
Abstract
Photobiomodulation (PBM), the use of biocompatible tissue-penetrating light to interact with intracellular chromophores to modulate the fates of cells and tissues, has emerged as a promising non-invasive approach to enhancing tissue regeneration. Unlike photodynamic or photothermal therapies that require the use of photothermal agents or photosensitizers, PBM treatment does not need external agents. With its non-harmful nature, PBM has demonstrated efficacy in enhancing molecular secretions and cellular functions relevant to tissue regeneration. The utilization of low-level light from various sources in PBM targets cytochrome c oxidase, leading to increased synthesis of adenosine triphosphate, induction of growth factor secretion, activation of signaling pathways, and promotion of direct or indirect gene expression. When integrated with stem cell populations, bioactive molecules or nanoparticles, or biomaterial scaffolds, PBM proves effective in significantly improving tissue regeneration. This review consolidates findings from in vitro, in vivo, and human clinical outcomes of both PBM alone and PBM-combined therapies in tissue regeneration applications. It encompasses the background of PBM invention, optimization of PBM parameters (such as wavelength, irradiation, and exposure time), and understanding of the mechanisms for PBM to enhance tissue regeneration. The comprehensive exploration concludes with insights into future directions and perspectives for the tissue regeneration applications of PBM.
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Affiliation(s)
| | - Chuntae Kim
- Institute of Nano-Bio Convergence, Pusan National University, Busan, 46241, Republic of Korea; Center for Biomaterials Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, 02792, Republic of Korea
| | - Nuri Oh
- Department of Chemistry and Biology, Korea Science Academy of KAIST, Busan, 47162, Republic of Korea
| | - Ji-Ho Park
- Department of Bio and Brain Engineering and KAIST Institute for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Republic of Korea
| | - Suck Won Hong
- Department of Cogno-Mechatronics Engineering, College of Nanoscience & Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Moon Sung Kang
- Department of Cogno-Mechatronics Engineering, College of Nanoscience & Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea
| | - Chuanbin Mao
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China.
| | - Dong-Wook Han
- Institute of Nano-Bio Convergence, Pusan National University, Busan, 46241, Republic of Korea; Department of Cogno-Mechatronics Engineering, College of Nanoscience & Nanotechnology, Pusan National University, Busan, 46241, Republic of Korea.
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Crews C, Angwaawie P, Abdul-Mumin A, Yabasin IB, Attivor E, Dibato J, Coffee MP. Assessing ventilation through ambient carbon dioxide concentrations across multiple healthcare levels in Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003287. [PMID: 39141637 PMCID: PMC11324151 DOI: 10.1371/journal.pgph.0003287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/26/2024] [Indexed: 08/16/2024]
Abstract
Infection prevention and control (IPC) measures safeguard primary healthcare systems, especially as the infectious disease landscape evolves due to climate and environmental change, increased global mobility, and vaccine hesitancy and inequity, which can introduce unexpected pathogens. This study explores the importance of an "always-on," low-cost IPC approach, focusing on the role of natural ventilation in health facilities, particularly in low-resource settings. Ambient carbon dioxide (CO2) levels are increasingly used as a measure of ventilation effectiveness allowing for spot checks and targeted ventilation improvements. Data were collected through purposive sampling in Northern Ghana over a three-month period. Levels of CO2 ppm (parts per million) were measured by a handheld device in various healthcare settings, including Community-Based Health Planning and Services (CHPS) facilities, municipal and teaching hospitals, and community settings to assess ventilation effectiveness. Analyses compared CO2 readings in community and hospital settings as well as in those settings with and without natural ventilation. A total of 40 facilities were evaluated in this study; 90% were healthcare facilities and 75% had natural ventilation (with an open window, door or wall). Facilities that relied on natural ventilation were mostly community health centers (60% vs 0%) and more commonly had patients present (83% vs 40%) compared with facilities without natural ventilation. Facilities with natural ventilation had significantly lower CO2 concentrations (CO2 ppm: 663 vs 1378, p = 0.0043) and were more likely to meet international thresholds of CO2 < 800 ppm (87% vs 10%, p = <0.0001) and CO2 < 1000 ppm (97% vs 20%, p = <0.0001). The adjusted odds ratio of low CO2 in the natural facilities compared with non-natural were: odds ratios, OR (95% CI): 21.7 (1.89, 247) for CO2 < 800 ppm, and 16.8 (1.55, 183) for CO2 < 1000 ppm. Natural ventilation in these facilities was consistently significantly associated with higher likelihood of low CO2 concentrations. Improved ventilation represents one cost-effective layer of IPC. This study highlights the continuing role natural ventilation can play in health facility design in community health care clinics. Most health facilities met standard CO2 thresholds, particularly in community health facilities. Further research is needed to optimize the use of natural ventilation. The use of a handheld devices to track a simple metric, CO2 levels, could improve appreciation of ventilation among healthcare workers and public health professionals and allow for them to target improvements. This study highlights potential lessons in the built environment of community primary health facilities as a blueprint for low-cost, integrated multi-layer IPC measures to mitigate respiratory illness and anticipate future outbreaks.
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Affiliation(s)
- Cecilia Crews
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Paul Angwaawie
- Ghana Health Service, Health Directorate, Nkwanta South, Ghana
| | - Alhassan Abdul-Mumin
- Department of Pediatrics and Child Health, University for Development Studies School of Medicine, Tamale, Ghana
- Department of Pediatrics and Child Health, Tamale Teaching Hospital, Tamale, Ghana
| | - Iddrisu Baba Yabasin
- Department of Anaesthesiology and Intensive Care, University for Development Studies School of Medicine, Tamale, Ghana
| | - Evans Attivor
- Nkwanta South Municipal Health Directorate, Nkwanta South, Ghana
| | - John Dibato
- Melbourne EpiCentre, Department of Medicine at Royal Melbourne Hospital, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Megan P. Coffee
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, United States of America
- Division of Infectious Diseases and Immunology, Department of Medicine, NYU Grossman School of Medicine, New York, New York, United States of America
- Health Unit, International Rescue Committee, New York, New York, United States of America
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Zhang Y, Feng W. Impact of the coronavirus disease 2019 pandemic on the diversity of notifiable infectious diseases: a case study in Shanghai, China. PeerJ 2024; 12:e17124. [PMID: 38495754 PMCID: PMC10941765 DOI: 10.7717/peerj.17124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has not only posed significant challenges to public health but has also impacted every aspect of society and the environment. In this study, we propose an index of notifiable disease outbreaks (NDOI) to assess the impact of COVID-19 on other notifiable diseases in Shanghai, China. Additionally, we identify the critical factors influencing these diseases using multivariate statistical analysis. We collected monthly data on 34 notifiable infectious diseases (NIDs) and corresponding environmental and socioeconomic factors (17 indicators) from January 2017 to December 2020. The results revealed that the total number of cases and NDOI of all notifiable diseases decreased by 47.1% and 52.6%, respectively, compared to the period before the COVID-19 pandemic. Moreover, the COVID-19 pandemic has led to improved air quality as well as impacted the social economy and human life. Redundancy analysis (RDA) showed that population mobility, particulate matter (PM2.5), atmospheric pressure, and temperature were the primary factors influencing the spread of notifiable diseases. The NDOI is beneficial in establishing an early warning system for infectious disease epidemics at different scales. Furthermore, our findings also provide insight into the response mechanisms of notifiable diseases influenced by social and environmental factors.
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Affiliation(s)
- Yongfang Zhang
- School of Chemistry and Chemical Engineering, Zhoukou Normal University, Zhoukou, China
| | - Wenli Feng
- School of Chemistry and Chemical Engineering, Zhoukou Normal University, Zhoukou, China
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Wang Y, Wang L, Ma W, Zhao H, Han X, Zhao X. Development of a novel dynamic nosocomial infection risk management method for COVID-19 in outpatient settings. BMC Infect Dis 2024; 24:214. [PMID: 38369460 PMCID: PMC10875793 DOI: 10.1186/s12879-024-09058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Application of accumulated experience and management measures in the prevention and control of coronavirus disease 2019 (COVID-19) has generally depended on the subjective judgment of epidemic intensity, with the quality of prevention and control management being uneven. The present study was designed to develop a novel risk management system for COVID-19 infection in outpatients, with the ability to provide accurate and hierarchical control based on estimated risk of infection. METHODS Infection risk was estimated using an auto regressive integrated moving average model (ARIMA). Weekly surveillance data on influenza-like-illness (ILI) among outpatients at Xuanwu Hospital Capital Medical University and Baidu search data downloaded from the Baidu Index in 2021 and 22 were used to fit the ARIMA model. The ability of this model to estimate infection risk was evaluated by determining the mean absolute percentage error (MAPE), with a Delphi process used to build consensus on hierarchical infection control measures. COVID-19 control measures were selected by reviewing published regulations, papers and guidelines. Recommendations for surface sterilization and personal protection were determined for low and high risk periods, with these recommendations implemented based on predicted results. RESULTS The ARIMA model produced exact estimates for both the ILI and search engine data. The MAPEs of 20-week rolling forecasts for these datasets were 13.65% and 8.04%, respectively. Based on these two risk levels, the hierarchical infection prevention methods provided guidelines for personal protection and disinfection. Criteria were also established for upgrading or downgrading infection prevention strategies based on ARIMA results. CONCLUSION These innovative methods, along with the ARIMA model, showed efficient infection protection for healthcare workers in close contact with COVID-19 infected patients, saving nearly 41% of the cost of maintaining high-level infection prevention measures and enhancing control of respiratory infections.
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Affiliation(s)
- Yuncong Wang
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Lihong Wang
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Wenhui Ma
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Huijie Zhao
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Xu Han
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China
| | - Xia Zhao
- Hospital Infection Management Division, Xuanwu Hospital Capital Medical University, No. 45 ChangChun Street, Xicheng District, Beijing, 100053, People's Republic of China.
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Vallée A. Green hospitals face to climate change: Between sobriety and resilience. Heliyon 2024; 10:e24769. [PMID: 38298726 PMCID: PMC10828801 DOI: 10.1016/j.heliyon.2024.e24769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/26/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024] Open
Abstract
Climate change poses a critical challenge to global health, influencing social and environmental determinants such as housing, air and water quality, and food security. This article explores the profound impact of climate change on health, projecting an additional 250,000 annual deaths from various climate-related diseases between 2030 and 2050. Healthcare systems significantly contribute to global carbon emissions. The concept of the "Green Hospital" is introduced as a paradigm shift in healthcare, focusing on optimizing resource efficiency and minimizing environmental impact. This concept encompasses renewable energy integration, natural lighting, sustainable materials, green roofs, and smart building management systems. Several challenges remain major, such as medical waste management, water conservation, chemical use, pollution, and plastic usage in healthcare settings. Moreover, obstacles to green hospital initiatives should be resolved, including system redundancy, regulatory compliance, operational demands, financial constraints, and cultural resistance. Conclusively, an urgent reformation of healthcare systems is needed to align with eco-friendly and sustainable practices, highlighting the necessity to reduce CO2 emissions and manage resources and waste more effectively to meet the evolving health needs of a growing and aging global population.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, 92150, France
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6
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Zhou R, Wu R, Wang L, Yang H. Increasing ratio of opportunistic infections associated with sunshine exposure and economic level burdening Chinese inflammatory bowel disease hospitalized patients: the first nationwide survey from 2014 to 2019. BMC Public Health 2024; 24:133. [PMID: 38195452 PMCID: PMC10777555 DOI: 10.1186/s12889-024-17635-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND The rising prevalence of opportunistic infections (OIs) in inflammatory bowel disease (IBD) in conjunction with the use of biologics/immunosuppressive agents has garnered attention. However, there is a dearth of research on OIs in Mainland China. This study seeks to evaluate the national ratio trend of OIs in IBD and elucidate the influence of economic and climate factors on IBD patients with OIs and their outcomes. METHODS The nationwide data was obtained from the Inpatient medical record home page via the Health Statistics and Information Reporting System (HSRS). Patients diagnosed with IBD were enlisted for participation, and their demographic and clinical information, encompassing infection type, surgical procedures, and expenses, were gathered. The National Bureau of Statistics provided data on monthly sunshine exposure hours and yearly Gross Domestic Product (GDP). RESULTS Findings indicate that between 2014 and 2019, a total of 381,752 patients with IBD were admitted to hospitals, with 364,249 patients lacking OIs and 17,503 patients presenting with OIs. The annual proportion of OIs exhibited an upward trend, rising from 3.54% in 2014 to 4.81% in 2019. There was a significant correlation observed between individuals who identified as male, those who visited hospitals in southern regions, or those originating from areas with lower GDP or shorter sunshine exposure hours, and a higher incidence of OIs. Among patients diagnosed with either Crohn's disease (CD) or ulcerative colitis (UC), Clostridium difficile was found to be the most prevalent infection, followed by Epstein-Barr virus and cytomegalovirus. Furthermore, the occurrence of OIs was found to be associated with an increased rate of surgical interventions in UC patients. CONCLUSIONS The rising prevalence of OIs among hospitalized patients with IBD necessitates heightened attention towards mitigating associated risk factors, particularly among IBD patients residing in less developed regions or experiencing limited exposure to sunlight. This approach aims to minimize hospital stays and associated costs.
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Affiliation(s)
- Runing Zhou
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Ruixian Wu
- Center for Health Statistics and Information, National Health Commission, Beijing, 100044, China
| | - Li Wang
- Department of Epidemiology and Biostatistics, School of Basic Medicine Peking Union Medical College, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, 100005, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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7
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Meng L, Zhou C, Xu Y, Liu F, Zhou C, Yao M, Li X. The lagged effect and attributable risk of apparent temperature on hand, foot, and mouth disease in Changsha, China: a distributed lag non-linear model. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:11504-11515. [PMID: 36094702 DOI: 10.1007/s11356-022-22875-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
Hand, foot, and mouth disease (HFMD) is the leading Category C infectious disease affecting millions of children in China every year. In the context of global climate change, the understanding and quantification of the impact of weather factors on human health are particularly critical to the development and implementation of climate change adaptation and mitigation strategies. The aim of this study was to quantify the attributable burden of a combined bioclimatic indicator (apparent temperature) on HFMD and to identify temperature-specific sensitive populations. A total of 123,622 HFMD cases were included in the study. The non-linear relationship between apparent temperature and the incidence of HFMD was approximately M-shaped, with hot weather being more likely to be attributable than cold conditions, of which moderately hot accounting for the majority of cases (21,441, 17.34%). Taking the median apparent temperature (19.2 °C) as reference, the cold effect showed a short acute effect with the highest risk on the day of lag 0 (RR = 1.086, 95% CI: 1.024 ~ 1.152), whereas the hot effect lasted longer with the greatest risk at a lag of 7 days (RR = 1.081, 95% CI: 1.059 ~ 1.104). Subgroup analysis revealed that males, children under 3 years old, and scattered children tended to be more vulnerable to HFMD in hot weather, while females, those aged 3 ~ 5 years, and nursery children were sensitive to cold conditions. This study suggests that high temperatures have a greater impact on HFMD than low temperatures as well as lasting longer, of particular concern being moderately high temperatures rather than extreme temperatures. Early intervention takes on greater importance during cold days, while the duration of HFMD intervention must be longer during hot days.
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Affiliation(s)
- Lijun Meng
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Fuqiang Liu
- Hunan Provincial Center for Disease Control and Prevention, Changsha, 410005, Hunan, China
| | - Cui Zhou
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Meng Yao
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiang Ya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
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Argyropoulos CD, Skoulou V, Efthimiou G, Michopoulos AK. Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 16:477-533. [PMID: 36467894 PMCID: PMC9703444 DOI: 10.1007/s11869-022-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.
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Affiliation(s)
| | - Vasiliki Skoulou
- B3 Challenge Group, Chemical Engineering, School of Engineering, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Georgios Efthimiou
- Centre for Biomedicine, Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX UK
| | - Apostolos K. Michopoulos
- Energy & Environmental Design of Buildings Research Laboratory, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
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Li H, Zhou SYD, Neilson R, An XL, Su JQ. Skin microbiota interact with microbes on office surfaces. ENVIRONMENT INTERNATIONAL 2022; 168:107493. [PMID: 36063613 DOI: 10.1016/j.envint.2022.107493] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/25/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
The indoor environment is recognized as a potential contributor to human health impacts through resident microbiomes. Indoor surface microbial communities are formed from several sources, environmental and anthropogenic. In this study, we characterized the bacterial and fungal communities from various sources typical of a working office environment including dust, fingers, and computer keyboards and mice. The composition of the dust bacterial community was significantly different from the other tested surfaces (P < 0.05), whereas the dust fungal community was only significantly different from fingers (P < 0.05). Bacterial and fungal communities were both shaped by deterministic processes, and bacterial communities had a higher migration rate. Results of a network analysis showed that the microbial community interactions of keyboards and mice were mainly competitive. Fast expectation-maximization microbial source tracking (FEAST) identified the sources of > 70 % of the keyboard and mouse microbial communities. Biomarkers for each sample types were identified by LDA Effect Size (LEfSE) analysis, some of which were soil-derived and potential anthropogenic pathogens, indicating the potential for exchange of microbes among outdoor, human and indoor surfaces. The current study shows that the source of microorganisms at the office interface is highly traceable and that their migration is linked to human activity. The migration of potentially pathogenic microbes were identified, emphasising the importance of personal hygiene.
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Affiliation(s)
- Hu Li
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, China.
| | - Shu-Yi-Dan Zhou
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; Key Laboratory of Vegetation Restoration and Management of Degraded Ecosystems, South China Botanical Garden, Chinese Academy of Sciences, 723 Xingke Road, Tianhe District, Guangzhou 510650, China
| | - Roy Neilson
- Ecological Sciences, The James Hutton Institute, Dundee DD2 5DA, Scotland, UK
| | - Xin-Li An
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, China
| | - Jian-Qiang Su
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, 1799 Jimei Road, Xiamen 361021, China; University of Chinese Academy of Sciences, 19A Yuquan Road, Beijing 100049, China
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10
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Jimenez JL, Marr LC, Randall K, Ewing ET, Tufekci Z, Greenhalgh T, Tellier R, Tang JW, Li Y, Morawska L, Mesiano‐Crookston J, Fisman D, Hegarty O, Dancer SJ, Bluyssen PM, Buonanno G, Loomans MGLC, Bahnfleth WP, Yao M, Sekhar C, Wargocki P, Melikov AK, Prather KA. What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic? INDOOR AIR 2022; 32:e13070. [PMID: 36040283 PMCID: PMC9538841 DOI: 10.1111/ina.13070] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/25/2022] [Accepted: 05/30/2022] [Indexed: 05/05/2023]
Abstract
The question of whether SARS-CoV-2 is mainly transmitted by droplets or aerosols has been highly controversial. We sought to explain this controversy through a historical analysis of transmission research in other diseases. For most of human history, the dominant paradigm was that many diseases were carried by the air, often over long distances and in a phantasmagorical way. This miasmatic paradigm was challenged in the mid to late 19th century with the rise of germ theory, and as diseases such as cholera, puerperal fever, and malaria were found to actually transmit in other ways. Motivated by his views on the importance of contact/droplet infection, and the resistance he encountered from the remaining influence of miasma theory, prominent public health official Charles Chapin in 1910 helped initiate a successful paradigm shift, deeming airborne transmission most unlikely. This new paradigm became dominant. However, the lack of understanding of aerosols led to systematic errors in the interpretation of research evidence on transmission pathways. For the next five decades, airborne transmission was considered of negligible or minor importance for all major respiratory diseases, until a demonstration of airborne transmission of tuberculosis (which had been mistakenly thought to be transmitted by droplets) in 1962. The contact/droplet paradigm remained dominant, and only a few diseases were widely accepted as airborne before COVID-19: those that were clearly transmitted to people not in the same room. The acceleration of interdisciplinary research inspired by the COVID-19 pandemic has shown that airborne transmission is a major mode of transmission for this disease, and is likely to be significant for many respiratory infectious diseases.
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Affiliation(s)
- Jose L. Jimenez
- Department of Chemistry and Cooperative Institute for Research in Environmental SciencesUniversity of ColoradoBoulderColoradoUSA
| | - Linsey C. Marr
- Department of Civil and Environmental EngineeringVirginia TechBlacksburgVirginiaUSA
| | | | | | - Zeynep Tufekci
- School of JournalismColumbia UniversityNew YorkNew YorkUSA
| | - Trish Greenhalgh
- Department of Primary Care Health SciencesMedical Sciences DivisionUniversity of OxfordOxfordUK
| | | | - Julian W. Tang
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Yuguo Li
- Department of Mechanical EngineeringUniversity of Hong KongHong KongChina
| | - Lidia Morawska
- International Laboratory for Air Quality and HeathQueensland University of TechnologyBrisbaneQueenslandAustralia
| | | | - David Fisman
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Orla Hegarty
- School of Architecture, Planning & Environmental PolicyUniversity College DublinDublinIreland
| | - Stephanie J. Dancer
- Department of MicrobiologyHairmyres Hospital, Glasgow, and Edinburgh Napier UniversityGlasgowUK
| | - Philomena M. Bluyssen
- Faculty of Architecture and the Built EnvironmentDelft University of TechnologyDelftThe Netherlands
| | - Giorgio Buonanno
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoItaly
| | - Marcel G. L. C. Loomans
- Department of the Built EnvironmentEindhoven University of Technology (TU/e)EindhovenThe Netherlands
| | - William P. Bahnfleth
- Department of Architectural EngineeringThe Pennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Maosheng Yao
- College of Environmental Sciences and EngineeringPeking UniversityBeijingChina
| | - Chandra Sekhar
- Department of the Built EnvironmentNational University of SingaporeSingaporeSingapore
| | - Pawel Wargocki
- Department of Civil EngineeringTechnical University of DenmarkLyngbyDenmark
| | - Arsen K. Melikov
- Department of Civil EngineeringTechnical University of DenmarkLyngbyDenmark
| | - Kimberly A. Prather
- Scripps Institution of OceanographyUniversity of California San DiegoLa JollaCaliforniaUSA
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11
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Hobday R, Collignon P. An Old Defence Against New Infections: The Open-Air Factor and COVID-19. Cureus 2022; 14:e26133. [PMID: 35875284 PMCID: PMC9300299 DOI: 10.7759/cureus.26133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 12/02/2022] Open
Abstract
Outdoors, the risks of transmission of COVID-19 and many other respiratory infections are low. Several environmental factors are known to reduce the viability of viruses and other infectious pathogens in the air. They include variations in temperature, relative humidity, solar ultraviolet radiation, and dilution effects. But one agent that reduces the viability of both viruses and bacteria outdoors, the germicidal open-air factor (OAF), has not been properly recognized for decades. This is despite robust evidence that the OAF can influence both the survival of airborne pathogens and the course of infections. The germicidal effects of outdoor air were widely exploited during the late 19th and early 20th centuries. Firstly, in the treatment of tuberculosis patients who underwent 'open-air therapy' in sanatoria; and secondly by military surgeons during the First World War. They used the same open-air regimen in specially designed hospital wards to disinfect and heal severe wounds among injured soldiers. It was also used on influenza patients during the 1918-19 pandemic. Later, in the 1950s, open-air disinfection and treatment of burns were proposed in the event of nuclear warfare. During the 1960s, the OAF briefly returned to prominence when biodefence scientists conducted experiments proving that open air has a potent germicidal effect. When this work ended in the 1970s, interest in the OAF again fell away, and it remains largely ignored. The COVID-19 pandemic has revived interest in understanding the transmission dynamics and survival of viruses in the air. The pandemic has also stimulated research in the science and practice of improved ventilation to control respiratory infections. Such work is incomplete without an appreciation of the inactivation of viruses and other pathogens by the OAF, but this needs further investigation as a matter of urgency. Research to better understand the conditions under which the OAF can be preserved indoors is urgently needed. We need to review building design with better regard to infection control and patient recovery. But we need to act without delay, as there is already sufficient evidence to show that public health generally would improve if more emphasis was placed on increased exposure to outdoor air.
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Izadyar N, Miller W. Ventilation strategies and design impacts on indoor airborne transmission: A review. BUILDING AND ENVIRONMENT 2022; 218:109158. [PMID: 35573806 PMCID: PMC9075988 DOI: 10.1016/j.buildenv.2022.109158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 outbreak has brought the indoor airborne transmission issue to the forefront. Although ventilation systems provide clean air and dilute indoor contaminated air, there is strong evidence that airborne transmission is the main route for contamination spread. This review paper aims to critically investigate ventilation impacts on particle spread and identify efficient ventilation strategies in controlling aerosol distribution in clinical and non-clinical environments. This article also examines influential ventilation design features (i.e., exhaust location) affecting ventilation performance in preventing aerosols spread. This paper shortlisted published documents for a review based on identification (keywords), pre-processing, screening, and eligibility of these articles. The literature review emphasizes the importance of ventilation systems' design and demonstrates all strategies (i.e., mechanical ventilation) could efficiently remove particles if appropriately designed. The study highlights the need for occupant-based ventilation systems, such as personalized ventilation instead of central systems, to reduce cross-infections. The literature underlines critical impacts of design features like ventilation rates and the number and location of exhausts and suggests designing systems considering airborne transmission. This review underpins that a higher ventilation rate should not be regarded as a sole indicator for designing ventilation systems because it cannot guarantee reducing risks. Using filtration and decontamination devices based on building functionalities and particle sizes can also increase ventilation performance. This paper suggests future research on optimizing ventilation systems, particularly in high infection risk spaces such as multi-storey hotel quarantine facilities. This review contributes to adjusting ventilation facilities to control indoor aerosol transmission.
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Affiliation(s)
- Nima Izadyar
- School of Built Environment, College of Engineering and Science, Victoria University, Melbourne, VIC, Australia
| | - Wendy Miller
- School of Architecture & Built Environment, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, QLD, 4001, Australia
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13
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A Review on Building Design as a Biomedical System for Preventing COVID-19 Pandemic. BUILDINGS 2022. [DOI: 10.3390/buildings12050582] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sustainable design methods aim to obtain architectural solutions that assure the coexistence and welfare of human beings, inorganic structures, and living things that constitute ecosystems. The novel coronavirus emergence, inadequate vaccines against the present severe acute respiratory syndrome-coronavirus-(SARS-CoV-2), and increases in microbial resistance have made it essential to review the preventative approaches used during pre-antibiotic periods. Apart from low carbon emissions and energy, sustainable architecture for facilities, building designs, and digital modeling should incorporate design approaches to confront the impacts of communicable infections. This review aims to determine how architectural design can protect people and employees from harm; it models viewpoints to highlight the architects’ roles in combating coronavirus disease 2019 (COVID-19) and designing guidelines as a biomedical system for policymakers. The goals include exploring the hospital architecture evolution and the connection between architectural space and communicable infections and recommending design and digital modeling strategies to improve infection prevention and controls. Based on a wide-ranging literature review, it was found that design methods have often played important roles in the prevention and control of infectious diseases and could be a solution for combating the wide spread of the novel coronavirus or coronavirus variants or delta.
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Giampieri A, Ma Z, Ling-Chin J, Roskilly AP, Smallbone AJ. An overview of solutions for airborne viral transmission reduction related to HVAC systems including liquid desiccant air-scrubbing. ENERGY (OXFORD, ENGLAND) 2022; 244:122709. [PMID: 34840405 PMCID: PMC8605622 DOI: 10.1016/j.energy.2021.122709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 05/31/2023]
Abstract
The spread of the coronavirus SARS-CoV-2 affects the health of people and the economy worldwide. As air transmits the virus, heating, ventilation and air-conditioning (HVAC) systems in buildings, enclosed spaces and public transport play a significant role in limiting the transmission of airborne pathogens at the expenses of increased energy consumption and possibly reduced thermal comfort. On the other hand, liquid desiccant technology could be adopted as an air scrubber to increase indoor air quality and inactivate pathogens through temperature and humidity control, making them less favourable to the growth, proliferation and infectivity of microorganisms. The objectives of this study are to review the role of HVAC in airborne viral transmission, estimate its energy penalty associated with the adoption of HVAC for transmission reduction and understand the potential of liquid desiccant technology. Factors affecting the inactivation of pathogens by liquid desiccant solutions and possible modifications to increase their heat and mass transfer and sanitising characteristics are also described, followed by an economic evaluation. It is concluded that the liquid desiccant technology could be beneficial in buildings (requiring humidity control or moisture removal in particular when viruses are likely to present) or in high-footfall enclosed spaces (during virus outbreaks).
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Key Words
- ASHRAE, American Society of Heating, Refrigerating and Air-Conditioning Engineers
- Airborne viral transmission
- CIBSE, Chartered Institution of Building Services Engineers
- COP, Coefficient of performance
- COVID-19
- COVID-19, Coronavirus disease 19
- CaCl2, Calcium chloride
- Economic analysis
- HCO2K, Potassium formate
- HEPA, High-efficiency particulate air filter
- HVAC energy consumption
- HVAC, Heating, ventilation and air-conditioning
- Humidity control
- IAQ, Indoor air quality
- IBV, Infectious bronchitis virus
- IL, Ionic liquid
- LiBr, Lithium bromide
- LiCl, Lithium chloride
- Liquid desiccant
- MERS-CoV, Middle East respiratory syndrome coronavirus
- MERV, Minimum efficiency reporting value
- PRRSV, Porcine reproductive and respiratory syndrome virus
- REHVA, Federation of European Heating, Ventilation and Air Conditioning Associations
- SARS-CoV-1, Severe acute respiratory syndrome coronavirus 1
- SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2
- TEG, Triethylene glycol
- TGEV, Transmissible gastroenteritis virus
- UVA, Long-wave ultraviolet light
- UVB, Middle-wave ultraviolet light
- UVC, Short-wave ultraviolet light
- UVGI, Ultraviolet germicidal irradiation
- WHO, World Health Organization
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Affiliation(s)
- A Giampieri
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
| | - Z Ma
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
| | - J Ling-Chin
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
| | - A P Roskilly
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
| | - A J Smallbone
- Department of Engineering, Durham University, Durham, DH1 3LE, United Kingdom
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Singh R. Studying the Double Paradox in Air Conditioning at Indian Airports for Airborne Infection Prevention and Filtration of Harmful Suspended Particulate Matter. Cureus 2022; 14:e23748. [PMID: 35509738 PMCID: PMC9058289 DOI: 10.7759/cureus.23748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2022] [Indexed: 11/05/2022] Open
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Application of Machine Learning to Study the Association between Environmental Factors and COVID-19 Cases in Mississippi, USA. MATHEMATICS 2022; 10. [PMID: 36092863 PMCID: PMC9455279 DOI: 10.3390/math10060850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Because of the large-scale impact of COVID-19 on human health, several investigations are being conducted to understand the underlying mechanisms affecting the spread and transmission of the disease. The present study aimed to assess the effects of selected environmental factors such as temperature, humidity, dew point, wind speed, pressure, and precipitation on the daily increase in COVID-19 cases in Mississippi, USA, during the period from January 2020 to August 2021. A machine learning model was used to predict COVID-19 cases and implement preventive measures if necessary. A statistical analysis using Python programming showed that the humidity ranged from 56% to 78%, and COVID-19 cases increased from 634 to 3546. Negative correlations were found between temperature and COVID-19 incidence rate (−0.22) and between humidity and COVID-19 incidence rate (−0.15). The linear regression model showed the model linear coefficients to be 0.92 and −1.29, respectively, with the intercept being 55.64. For the test dataset, the R2 score was 0.053. The statistical analysis and machine learning show that there is no linear dependence of temperature and humidity with the COVID-19 incidence rate.
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Environmental Design Strategies to Decrease the Risk of Nosocomial Infection in Medical Buildings Using a Hybrid MCDM Model. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2021:5534607. [PMID: 35126892 PMCID: PMC8814348 DOI: 10.1155/2021/5534607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022]
Abstract
The prevention and control of nosocomial infection (NI) are becoming increasingly difficult, and its mechanism is becoming increasingly complex. A globally aging population means that an increasing proportion of patients have a susceptible constitution, and the frequent occurrence of severe infectious diseases has also led to an increase in the cost of prevention and control of NI. Medical buildings' spatial environment design for the prevention of NI has been a hot subject of considerable research, but few previous studies have summarized the design criteria for a medical building environment to control the risk of NI. Thus, there is no suitable evaluation framework to determine whether the spatial environment of a medical building is capable of inhibiting the spread of NI. In the context of the global spread of COVID-19, it is necessary to evaluate the performance of the existing medical building environment in terms of inhibiting the spread of NI and to verify current environmental improvement strategies for the efficient and rational use of resources. This study determines the key design elements for the spatial environment of medical buildings, constructs an evaluation framework using exploratory factor analysis, verifies the complex dominant influence relationship, and prioritizes criteria in the evaluation framework using the decision-making trial and evaluation laboratory- (DEMATEL-) based analytical network process (ANP) (DANP). Using representative real cases, this study uses the technique for order preference by similarity to ideal solution (TOPSIS) to evaluate and analyze the performance with the aspiration level of reducing the NI risk. A continuous and systematic transformation design strategy for these real cases is proposed. The main contributions of this study include the following: (1) it creates a systematic framework that allows hospital decision-makers to evaluate the spatial environment of medical buildings; (2) it provides a reference for making design decisions to improve the current situation using the results of a performance evaluation; (3) it draws an influential network relation map (INRM) and the training of influence weights (IWs) for criteria. The sources of practical problems can be identified by the proposed evaluation framework, and the corresponding strategy can be proposed to avoid the waste of resources for the prevention of epidemics.
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Dancer SJ, Cormack K, Loh M, Coulombe C, Thomas L, Pravinkumar SJ, Kasengele K, King MF, Keaney J. Healthcare-acquired clusters of COVID-19 across multiple wards in a Scottish health board. J Hosp Infect 2021; 120:23-30. [PMID: 34863874 PMCID: PMC8634690 DOI: 10.1016/j.jhin.2021.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/10/2021] [Accepted: 11/22/2021] [Indexed: 12/23/2022]
Abstract
Background Healthcare-acquired COVID-19 has been an additional burden on hospitals managing increasing numbers of patients with SARS-CoV-2. One acute hospital (W) among three in a Scottish healthboard experienced an unexpected surge of COVID-19 clusters. Aim To investigate possible causes of COVID-19 clusters at Hospital W. Methods Daily surveillance provided total numbers of patients and staff involved in clusters in three acute hospitals (H, M and W) and care homes across the healthboard. All clusters were investigated and documented, along with patient boarding, community infection rates and outdoor temperatures from October 2020 to March 2021. Selected SARS-CoV-2 strains were genotyped. Findings There were 19 COVID-19 clusters on 14 wards at Hospital W during the six-month study period, lasting from two to 42 days (average, five days; median, 14 days) and involving an average of nine patients (range 1–24) and seven staff (range 0–17). COVID-19 clusters in Hospitals H and M reflected community infection rates. An outbreak management team implemented a control package including daily surveillance; ward closures; universal masking; screening; restricting staff and patient movement; enhanced cleaning; and improved ventilation. Forty clusters occurred across all three hospitals before a January window-opening policy, after which there were three during the remainder of the study. Conclusion The winter surge of COVID-19 clusters was multi-factorial, but clearly exacerbated by moving trauma patients around the hospital. An extended infection prevention and control package including enhanced natural ventilation helped reduce COVID-19 clusters in acute hospitals.
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Affiliation(s)
- S J Dancer
- Department of Microbiology, NHS Lanarkshire & Edinburgh Napier University, UK.
| | - K Cormack
- Quality Directorate, NHS Lanarkshire, UK
| | - M Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - C Coulombe
- Infection Prevention & Control, NHS Lanarkshire, UK
| | - L Thomas
- Infection Prevention & Control, NHS Lanarkshire, UK
| | | | - K Kasengele
- Department of Public Health, NHS Lanarkshire, UK
| | - M-F King
- School of Civil Engineering, University of Leeds, Leeds, UK
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The role of UV and blue light in photo-eradication of microorganisms. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY 2021. [DOI: 10.1016/j.jpap.2021.100064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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20
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Kaushal P, Sangwan G, Rana K, Biswal M, Kaur M, Lakshmi P. Implementation status of national airborne infection control guidelines in the health care facilities of a North Indian State: A mixed method study. PUBLIC HEALTH IN PRACTICE 2021; 2:100149. [PMID: 36101590 PMCID: PMC9461529 DOI: 10.1016/j.puhip.2021.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Healthcare-acquired infection (HCAIs), have become a significant cause of morbidity as well as mortality among the hospitalized patients and health care workers. The implementation of air-borne infection control measures play an important role in prevention of health care acquired infections (HCAIs). Hence, this study was planned to assess the implementation status of National Airborne Infection Control Guidelines in the health care settings of a North Indian State. Study design A mixed method study was planned in all the 13 health facilities of Himachal Pradesh having both the Anti-Retroviral Therapy (ART) Centre and Directly observed Treatment Short course (DOTS) for TB center in the same facility. Methods The implementation of airborne infection control measures was evaluated using a Standardized Health Care Facility Airborne Infection Risk Assessment Tool and an observational checklist. In-depth interviews are conducted with hospital staff. At all health facilities, risk assessment and implementation of airborne infection control was evaluated by using a pretested semi-structured questionnaire. The qualitative data was analyzed manually and transcripts prepared from hand written notes and audio tape records were analyzed thematically. Results Only 5 out of 13 health facilities were having specially designated airborne infection control committee. The incidence of tuberculosis among hospital staff was 2.32% at secondary level health care facilities and 0.35% at tertiary care level health facilities. Among the tuberculosis cases, maximum were nursing staff (59.5%) as compared to other categories of health care workers. Improper functioning of health care system and individual factors were main reasons for deficiencies in the implementation of air-borne infection control measures. Conclusion The health care facilities were not implementing the infection control measure to the fullest both at secondary and tertiary care health facilities. There is a need to set up the surveillance of airborne infections in the hospital and especially the passive surveillance of tuberculosis among health care workers. The implementation of airborne infection control measures was evaluated by using standardized tools and checklist. In-depth interviews were conducted with the hospital staff. There were gaps in implementation at all the three levels i.e. administrative, environmental and individual levels. There is a need to set up the surveillance of air borne infections in the hospitals. Passive surveillance of tuberculosis among health care workers should be implemented.
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21
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Dancer SJ. Reducing the risk of COVID-19 transmission in hospitals: focus on additional infection control strategies. ACTA ACUST UNITED AC 2021; 39:752-758. [PMID: 34658477 PMCID: PMC8511651 DOI: 10.1016/j.mpsur.2021.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Hospitals under pressure from the COVID-19 pandemic have experienced an additional challenge due to clusters of hospital-acquired COVID-19 infection occurring on non-COVID-19 wards. These clusters have involved both staff and patients and compromise staffing, bed management and routine care, especially delivery of elective surgical procedures. They have also contributed towards the overall morbidity and mortality of the pandemic. COVID-19 infection rates are rising again, so it is important to consider implementing additional activities designed to impede transmission of SARS-CoV-2 in acute hospitals. These aim to protect staff, patients and visitors, and conserve safe and continued access for patients needing routine and emergency surgical interventions. Current infection prevention strategies include hand hygiene; patient and staff screening; surveillance; personal protective equipment; cohorting and isolation; and enhanced cleaning. Additional activities include restriction of staff and patient movement; COVID-19 pathways for wards, operating theatres and outpatient services; bathroom management; and ensuring fresh air in the absence of effective mechanical ventilation systems. Seasonal pressures and spread of more contagious and/or vaccine-tolerant variants will continue to disrupt routine and emergency care of non-COVID-19 patients, as well as increase the risk of COVID-19 infection for staff and patients. Supplementary practical and cost-effective actions to limit spread in hospitals are explored in this article.
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Affiliation(s)
- Stephanie J Dancer
- is a Consultant Microbiologist in NHS Lanarkshire and Professor of Microbiology at Edinburgh Napier University, Edinburgh, UK. Conflicts of interest: The author is a member of the 'Group of 36', which is an international collaboration of scientists and clinicians working on the role of airborne transmission of SARS-CoV-2; she was also a member of the 2020 COVID-19 DEFRA committee reporting to SAGE
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22
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Low-Invasive CO2-Based Visual Alerting Systems to Manage Natural Ventilation and Improve IAQ in Historic School Buildings. HERITAGE 2021. [DOI: 10.3390/heritage4040191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children spend a large part of their growing years in schools, and as they are more sensitive to some pollutants than adults, it is essential to monitor and maximize the indoor air quality (IAQ) in classrooms. Many schools are located in historic and heritage buildings, and improving the IAQ, preserving the architectural features, poses a great challenge. The aim of the study is to evaluate the effectiveness of a low-invasiveness, low-cost, smart CO2-based visual alerting systems to manage natural ventilation and improve IAQ in historic school buildings. Indoor and outdoor parameters were monitored for three weeks in four schools with different levels of education (two classrooms per school; device installed in one only). Based on indoor CO2 concentration, air temperature and relative humidity, the device suggests when windows should be opened to ventilate. The comparison between the two classrooms show that the effectiveness of the device is highly dependent on the occupants: (i) reduction in the average CO2 concentrations of up to 42% in classrooms with frontal lesson and full occupancy, (ii) the device is not the most ideal solution for kindergarten due to the young age of the pupils, and (iii) it is more used during mild outdoor temperatures.
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Matuka DO, Duba T, Ngcobo Z, Made F, Muleba L, Nthoke T, Singh TS. Occupational Risk of Airborne Mycobacterium tuberculosis Exposure: A Situational Analysis in a Three-Tier Public Healthcare System in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910130. [PMID: 34639431 PMCID: PMC8508202 DOI: 10.3390/ijerph181910130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022]
Abstract
This study aimed to detect airborne Mycobacterium tuberculosis (MTB) at nine public health facilities in three provinces of South Africa and determine possible risk factors that may contribute to airborne transmission. Personal samples (n = 264) and stationary samples (n = 327) were collected from perceived high-risk areas in district, primary health clinics (PHCs) and TB facilities. Quantitative real-time (RT) polymerase chain reaction (PCR) was used for TB analysis. Walkabout observations and work practices through the infection prevention and control (IPC) questionnaire were documented. Statistical analysis was carried out using Stata version 15.2 software. Airborne MTB was detected in 2.2% of samples (13/572), and 97.8% were negative. District hospitals and Western Cape province had the most TB-positive samples and identified risk areas included medical wards, casualty, and TB wards. MTB-positive samples were not detected in PHCs and during the summer season. All facilities reported training healthcare workers (HCWs) on TB IPC. The risk factors for airborne MTB included province, type of facility, area or section, season, lack of UVGI, and ineffective ventilation. Environmental monitoring, PCR, IPC questionnaire, and walkabout observations can estimate the risk of TB transmission in various settings. These findings can be used to inform management and staff to improve the TB IPC programmes.
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Affiliation(s)
- Dikeledi O. Matuka
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Thabang Duba
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Zethembiso Ngcobo
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Felix Made
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Lufuno Muleba
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Tebogo Nthoke
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Tanusha S. Singh
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
- Department of Clinical Microbiology and Infectious Disease, School of Pathology, University of the Witwatersrand, Johannesburg 2000, South Africa
- Department of Environmental Health, School of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa
- Correspondence:
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Ventilation-Associated Particulate Matter Is a Potential Reservoir of Multidrug-Resistant Organisms in Health Facilities. Life (Basel) 2021; 11:life11070639. [PMID: 34209235 PMCID: PMC8307074 DOI: 10.3390/life11070639] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/14/2021] [Accepted: 06/29/2021] [Indexed: 02/03/2023] Open
Abstract
Most healthcare-associated infections (HCAIs) develop due to the colonisation of patients and healthcare workers by multidrug-resistant organisms (MDRO). Here, we investigated whether the particulate matter from the ventilation systems (Vent-PM) of health facilities can harbour MDRO and other microbes, thereby acting as a potential reservoir of HCAIs. Dust samples collected in the ventilation grilles and adjacent air ducts underwent a detailed analysis of physicochemical properties and biodiversity. All Vent-PM samples included ultrafine PM capable of reaching the alveoli. Strikingly, >70% of Vent-PM samples were contaminated, mostly by viruses (>15%) or multidrug-resistant and biofilm-producing bacterial strains (60% and 48% of all bacteria-contaminated specimens, respectively). Total viable count at 1 m from the ventilation grilles was significantly increased after opening doors and windows, indicating an association between air flow and bacterial contamination. Both chemical and microbial compositions of Vent-PM considerably differed across surgical vs. non-surgical and intensive vs. elective care units and between health facilities located in coal and chemical districts. Reduced diversity among MDRO and increased prevalence ratio in multidrug-resistant to the total Enterococcus spp. in Vent-PM testified to the evolving antibiotic resistance. In conclusion, we suggest Vent-PM as a previously underestimated reservoir of HCAI-causing pathogens in the hospital environment.
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Aviv D, Chen KW, Teitelbaum E, Sheppard D, Pantelic J, Rysanek A, Meggers F. A fresh (air) look at ventilation for COVID-19: Estimating the global energy savings potential of coupling natural ventilation with novel radiant cooling strategies. APPLIED ENERGY 2021; 292:116848. [PMID: 33776191 PMCID: PMC7983460 DOI: 10.1016/j.apenergy.2021.116848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/23/2021] [Accepted: 03/16/2021] [Indexed: 05/03/2023]
Abstract
Radiant cooling-assisted natural ventilation is an innovative technical approach that combines new radiant cooling technology with natural ventilation to increase fresh air delivery into buildings year-round with minimal energy cost and improvment of air quality. Currently, the standard paradigm for HVAC (heating, ventilation and air conditioning) is based on central air systems that tie the delivery of heating and cooling to the delivery of fresh air. To prevent heat loss, the delivery of fresh air must be tightly controlled and is often limited through recirculation of already heated or cooled air. Buildings are designed with airtight envelopes, which do not allow for natural ventilation, and depend on energy-intensive central-air systems. As closed environments, buildings have become sites of rapid COVID-19 transmission. In this research, we demonstrate the energy cost of increasing outdoor air supply with standard systems per COVID-19 recommendations and introduce an alternative HVAC paradigm that maximizes the decoupling of ventilation and thermal control. We first consider a novel analysis of the energy costs of increasing the amount of conditioned fresh air using standard HVAC systems to address COVID-19 concerns. We then present an alternative that includes a novel membrane-assisted radiant system we have studied for cooling in humid climates, in place of an air conditioning system. The proposed system can work in conjunction with natural ventilation and thus decreases the risk of indoor spread of infectious diseases and significantly lowers energy consumption in buildings. Our results for modeling HVAC energy in different climates show that increasing outdoor air in standard systems can double cooling costs, while increasing natural ventilation with radiant systems can halve costs. More specifically, it is possible to add up to 100 days' worth of natural ventilation while saving energy when coupling natural ventilation and radiant systems. This combination decreases energy costs by 10-45% in 60 major cities globally, while increasing fresh air intake.
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Affiliation(s)
- Dorit Aviv
- University of Pennsylvania, Philadelphia, PA, USA
| | | | - Eric Teitelbaum
- Princeton University, Princeton, NJ, USA
- AIL Research, Hopewell, NJ, USA
| | | | - Jovan Pantelic
- University of California, Berkeley, CA, USA
- KU Leuven, Leuven, Belgium
| | - Adam Rysanek
- University of British Columbia, Vancouver, BC, Canada
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Geng Y, Li G, Zhang L. The Impact of COVID-19 Interventions on Influenza and Mycobacterium Tuberculosis Infection. Front Public Health 2021; 9:672568. [PMID: 34095074 PMCID: PMC8175651 DOI: 10.3389/fpubh.2021.672568] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/27/2021] [Indexed: 12/26/2022] Open
Abstract
A series of public health interventions have been implemented to prevent the transmission of SARS-CoV-2 in China. However, the effect of non-pharmaceutical interventions to COVID-19 on the incidence of the influenza virus and Mycobacterium tuberculosis infections is not clear. In current study, we analyzed surveillance data on influenza and Mycobacterium tuberculosis from Henan Provincial People’s Hospital in Zhengzhou, Henan province, China from 2019 to 2020. The monthly positive test rate for influenza and Mycobacterium tuberculosis to estimate transmissibility changes was calculated. The positive detection rate of influenza A declined significantly during the implementation of inventions in 2020, from a total positive rate of 17.69% in 2019 to 5.77% in 2020. Similarly, a 2.15% reduction in positive detective rate was seen for influenza B, from a total positive rate of 5.15% in 2019 to 3% in 2020. The positive rate curve of Mycobacterium tuberculosis measured by x-pert in 2020 remained above the curve in 2019 from March to June, and August, showing the rising trend under these precautions. Our study suggests that non-pharmaceutical public health interventions likely reduced influenza transmission significantly and have less effect on Mycobacterium tuberculosis transmission in 2020.
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Affiliation(s)
- Yiman Geng
- Department of Clinical Laboratory, Henan Provincial People's Hospital, Peolple's Hospital of Zhengzhou University, Zhengzhou, China
| | - Gang Li
- Department of Clinical Laboratory, Henan Provincial People's Hospital, Peolple's Hospital of Zhengzhou University, Zhengzhou, China
| | - Leiliang Zhang
- Institute of Basic Medicine, The First Affiliated Hospital of Shandong First Medical University, Shandong, China.,Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Shandong, China
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Walker GJ, Foster S. <xml><?covid-license?></xml>Airborne transmission of covid-19: reduce the viral load in inhaled air. BMJ 2021; 373:n1198. [PMID: 33980685 DOI: 10.1136/bmj.n1198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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B L, QF H, WP L, XY S, JJ W. Decrease of respiratory diseases in one social children welfare institute in Shanxi Province during COVID-19. J Public Health (Oxf) 2021; 43:61-66. [PMID: 32876673 PMCID: PMC7499666 DOI: 10.1093/pubmed/fdaa150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 11/18/2022] Open
Abstract
Background To assess the impact of disinfection measures on the incidence of common diseases in children welfare institute during the epidemic of Corona Virus Disease 2019 (COVID-19), and provide a basis for the daily disinfection management of children welfare institute. Methods This study surveyed and analyzed common diseases among children under the age of 14 in one social children welfare institute in Shanxi Province from January to May in 2018–2020 by the year-on-year method. Results The prevalence rate of respiratory diseases in 2020 was a significantly negative growth compared with 2018 and 2019. There was no obvious pattern of changes in digestive diseases group. Conclusion In view of the above anti-epidemic measures, it indicates that the children gathering institutions should strengthen effective personal protection and public health management to reduce infectious disease among children.
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Affiliation(s)
- Liu B
- Address correspondence to Jingjing Wei, E-mail:
| | | | | | - Shi XY
- Department of Pediatrics, Shanxi Medical University, Taiyuan 030001, China
| | - Wei JJ
- Address correspondence to Jingjing Wei, E-mail:
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29
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Magnini VP, Zehrer A. Subconscious influences on perceived cleanliness in hospitality settings. INTERNATIONAL JOURNAL OF HOSPITALITY MANAGEMENT 2021; 94:102761. [PMID: 34866740 PMCID: PMC8631804 DOI: 10.1016/j.ijhm.2020.102761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/15/2020] [Accepted: 11/01/2020] [Indexed: 05/28/2023]
Abstract
Due to the COVID-19 pandemic, now and for years to come, guests at hospitality venues will have heightened awareness with regard to formulating their perceptions of cleanliness. While perceived cleanliness has received attention in our existing body of literature, this conceptual paper integrates potential subconscious influencers on cleanliness perceptions into our understanding. Specifically, findings contained in various streams of research suggest that a number of factors can have subconscious influences on individuals' perceptions of cleanliness in service environments. Such factors include the degree of lighting, the presence of plants / greenery, the shininess of surfaces, the use of ambient scents, the use of white bedding, and the presence of cleaning staff. Evidently, the sooner hospitality venues (particularly airlines, lodging operations, restaurants, and cruise ships) are perceived as clean and safe, the faster they will recover from the pandemic. As such, this paper is rich with both practical and research implications.
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Affiliation(s)
| | - Anita Zehrer
- Family Business Center, MCI Management Center, Innsbruck, Austria
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Božič A, Kanduč M. Relative humidity in droplet and airborne transmission of disease. J Biol Phys 2021; 47:1-29. [PMID: 33564965 PMCID: PMC7872882 DOI: 10.1007/s10867-020-09562-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/22/2020] [Indexed: 02/06/2023] Open
Abstract
A large number of infectious diseases are transmitted by respiratory droplets. How long these droplets persist in the air, how far they can travel, and how long the pathogens they might carry survive are all decisive factors for the spread of droplet-borne diseases. The subject is extremely multifaceted and its aspects range across different disciplines, yet most of them have only seldom been considered in the physics community. In this review, we discuss the physical principles that govern the fate of respiratory droplets and any viruses trapped inside them, with a focus on the role of relative humidity. Importantly, low relative humidity-as encountered, for instance, indoors during winter and inside aircraft-facilitates evaporation and keeps even initially large droplets suspended in air as aerosol for extended periods of time. What is more, relative humidity affects the stability of viruses in aerosol through several physical mechanisms such as efflorescence and inactivation at the air-water interface, whose role in virus inactivation nonetheless remains poorly understood. Elucidating the role of relative humidity in the droplet spread of disease would permit us to design preventive measures that could aid in reducing the chance of transmission, particularly in indoor environment.
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Affiliation(s)
- Anže Božič
- Department of Theoretical Physics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Matej Kanduč
- Department of Theoretical Physics, Jožef Stefan Institute, Ljubljana, Slovenia
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Rai S, Singh DK, Kumar A. Microbial, environmental and anthropogenic factors influencing the indoor microbiome of the built environment. J Basic Microbiol 2021; 61:267-292. [PMID: 33522603 DOI: 10.1002/jobm.202000575] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/03/2021] [Accepted: 01/10/2021] [Indexed: 12/25/2022]
Abstract
A built environment is a human-made environment providing surroundings for human occupancy, activities, and settlement. It is supposed to safeguard humans from all undesirable and harmful pollutants; however, indoor concentrations of some pollutants are much greater than that of the outdoors. Bioaerosols infiltrate from the outdoors in addition to many indoor sources of bioaerosols including the use of various chemicals as well as activities like cooking, smoking, cleaning, or even normal movement. They are also associated with a number of serious health concerns. Various ecological factors associated with the generation, the persistence as well as the dispersal of these microbial components of indoor bioaerosols, are discussed in this review, that have not been considered all together till now. The factors like microbial taxa, environmental factors, and anthropogenic activities (human occupancy, activities, and impact of urbanization) are addressed in the review. Effects of both indoor environmental factors like architectural design, lighting, ventilation, temperature, humidity, indoor/outdoor ratio, particulate matter, indoor chemistry as well as outdoor environmental factors like geography, seasons, and meteorology on the microbial concentrations have been discussed. Efforts are underway to design selective pressures for microbes to create a healthy symbiotic built microbiome as the "right" indoor microbiome is a "healthy" indoor microbiome.
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Affiliation(s)
- Sandhya Rai
- Department of Zoology, Deshbandhu College, University of Delhi, New Delhi, India
| | - Dileep K Singh
- Department of Zoology, University of Delhi, Delhi, India
| | - Amod Kumar
- Department of Zoology, Kirori Mal College, University of Delhi, Delhi, India
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Tang JW, Bahnfleth WP, Bluyssen PM, Buonanno G, Jimenez JL, Kurnitski J, Li Y, Miller S, Sekhar C, Morawska L, Marr LC, Melikov AK, Nazaroff WW, Nielsen PV, Tellier R, Wargocki P, Dancer SJ. Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Hosp Infect 2021; 110:89-96. [PMID: 33453351 PMCID: PMC7805396 DOI: 10.1016/j.jhin.2020.12.022] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- J W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - W P Bahnfleth
- Department of Architectural Engineering, The Pennsylvania State University, State College, PA, USA
| | - P M Bluyssen
- Faculty of Architecture and the Built Environment, Delft University of Technology, Delft, The Netherlands
| | - G Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | - J L Jimenez
- Department of Chemistry and CIRES, University of Colorado, Boulder, CO, USA
| | - J Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Y Li
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - S Miller
- Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - C Sekhar
- Department of Building, National University of Singapore, Singapore
| | - L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - L C Marr
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - A K Melikov
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - W W Nazaroff
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - P V Nielsen
- Faculty of Engineering and Science, Department of Civil Engineering, Aalborg University, Aalborg, Denmark
| | - R Tellier
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - P Wargocki
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - S J Dancer
- Department of Microbiology, NHS Lanarkshire, Glasgow, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
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Lighting in the Home and Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020609. [PMID: 33445763 PMCID: PMC7828303 DOI: 10.3390/ijerph18020609] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 12/20/2022]
Abstract
Poor housing is an important determinant of poor health. One key aspect of housing quality is lighting. Light is important for visual performance and safety, and also plays a vital role in regulating human physiological functions. This review aims to synthesise existing evidence on the relationship between lighting in the home and health and recommends areas for future research. Three databases were searched for relevant literature using pre-defined inclusion criteria. Study quality was assessed using the Newcastle Ottawa Scale. Extracted data were qualitatively synthesised according to type of lighting (natural light, artificial light and light at night) and stratified by broad health domains (physical, mental and sleep health). Of the 4043 records retrieved, 28 studies met the inclusion criteria. There was considerable heterogeneity in light exposure metrics used and specific health outcome assessed by the studies. Lighting in the home can negatively affect health but the current evidence base is limited to a small number of studies in different domains of light and health. Further research surrounding specific health outcomes is required to better inform housing quality assessments and lighting practises in the home.
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Zia H, Singh R, Seth M, Ahmed A, Azim A. Engineering Solutions for Preventing Airborne Transmission in Hospitals with Resource Limitation and Demand Surge. Indian J Crit Care Med 2021; 25:453-460. [PMID: 34045813 PMCID: PMC8138644 DOI: 10.5005/jp-journals-10071-23792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Among the various strategies for the prevention of airborne transmission, engineering measures are placed high in the hierarchy of control. Modern hospitals in high-income countries have mechanical systems of building ventilation also called HVAC (heating, ventilation, and air-conditioning) but installation and maintenance of such systems is a challenging and resource-intensive task. Even when the state-of-the-art technology was used to build airborne infection isolation rooms (AIIRs), recommended standards were often not met in field studies. The current coronavirus disease-2019 pandemic has highlighted the need to find cost-effective and less resource-intensive engineering solutions. Moreover, there is a need for the involvement of interdisciplinary teams to find innovative infection control solutions and doctors are frequently lacking in their understanding of building ventilation-related problems as well as their possible solutions. The current article describes building ventilation strategies (natural ventilation and hybrid ventilation) for hospitals where HVAC systems are either lacking or do not meet the recommended standards. Other measures like the use of portable air cleaning technologies and temporary negative-pressure rooms can be used as supplementary strategies in situations of demand surge. It can be easily understood that thermal comfort is compromised in buildings that are not mechanically fitted with HVAC systems, therefore the given building ventilation strategies are more helpful when climatic conditions are moderate or other measures are combined to maintain thermal comfort.
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Affiliation(s)
- Hina Zia
- Department of Architecture, Jamia Millia Islamia (Central University), New Delhi, India
| | - Ritu Singh
- Department of Trauma and Emergency, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Manu Seth
- Department of Critical Care Medicine and Anesthesiology, Nishat Hospital and Research Centre, Lucknow, Uttar Pradesh, India
| | - Armin Ahmed
- Department of Critical Care Medicine, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Afzal Azim
- Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Emmanuel U, Osondu ED, Kalu KC. Architectural design strategies for infection prevention and control (IPC) in health-care facilities: towards curbing the spread of Covid-19. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:1699-1707. [PMID: 33145025 PMCID: PMC7596836 DOI: 10.1007/s40201-020-00580-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/24/2020] [Indexed: 05/06/2023]
Abstract
Background Sustainable design strategies are targeted at finding architectural solutions that reassure the well-being and coexistence of inorganic features, living organisms, and humans that make up the ecosystem. The emergence of the novel coronavirus, an increase in microbial resistance, and lack of a vaccine for the present pandemic have made it imperative to appraise the preventive strategies employed during the pre-antibiotic period. Sustainable architecture for children's hospital design and childcare facilities, apart from low energy and carbon emission, must integrate design strategies to confront the impact of infectious diseases. Aim The aim of the paper is to identify how the space patients and health-care workers0 occupy can be made safer from an architectural design perspective with the view of developing guidelines for policymakers and highlighting the architect's role in combating the pandemic. Objectives The objectives include; to examine the evolution of medical architecture and the nexus between infectious diseases and architectural space and suggest a design approach that enhances infection prevention and control (IPC). Method The paper relied on existing literature, interviews, and interactions with healthcare workers. Results/Conclusion The findings showed that design strategies have always played a significant role in infection prevention and control (IPC) and could as well be a panacea for curbing the spread of Covid -19.
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Affiliation(s)
- Udomiaye Emmanuel
- Department of Architectural Technology, Akanu Ibiam Federal Polytechnic, Uwana, Nigeria
| | - Eze Desy Osondu
- Department of Architectural Technology, Akanu Ibiam Federal Polytechnic, Uwana, Nigeria
| | - Kalu Cheche Kalu
- Department of Architectural Technology, Akanu Ibiam Federal Polytechnic, Uwana, Nigeria
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Rehman Y, Rehman N. Association of climatic factors with COVID-19 in Pakistan. AIMS Public Health 2020; 7:854-868. [PMID: 33294487 PMCID: PMC7719562 DOI: 10.3934/publichealth.2020066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/06/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Environmental factors such as wind, temperature, humidity, and sun exposure are known to affect influenza and viruses such as severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) transmissions. COVID-19 is a new pandemic with very little information available about its transmission and association with environmental factors. The goal of this paper is to explore the association of environmental factors on daily incidence rate, mortality rate, and recoveries of COVID-19. METHODS The environmental data for humidity, temperature, wind, and sun exposure were recorded from metrological websites and COVID-19 data such as the daily incidence rate, death rate, and daily recovery were extracted from the government's official website available to the general public. The analysis for each outcome was adjusted for factors such as lock down status, nationwide events, and the number of daily tests performed. Analysis was completed with negative binominal regression log link using generalised linear modelling. RESULTS Daily temperature, sun exposure, wind, and humidity were not significantly associated with daily incidence rate. Temperature and nationwide social gatherings, although non-significant, showed trends towards a higher chance of incidence. An increase in the number of daily testing was significantly associated with higher COVID-19 incidences (effect size ranged from 2.17-9.96). No factors were significantly associated with daily death rates. Except for the province of Balochistan, a lower daily temperature was associated with a significantly higher daily recovery rate. DISCUSSION Environmental factors such as temperature, humidity, wind, and daily sun exposure were not consistently associated with COVID-19 incidence, death rates, or recovery. More policing about precautionary measures and ensuring diagnostic testing and accuracy are needed.
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Affiliation(s)
- Yasir Rehman
- Canadian Academy of Osteopathy, 66 Ottawa Street North, Canada
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Abstract
To examine the effects of temperature on the daily cases of hand, foot, and mouth disease (HFMD).Data on the daily cases of HFMD in Lanzhou from 2008 to 2015 were obtained, and meteorological data from the same period were collected. A distributed lag nonlinear model was fitted to reveal the relationship between the daily mean temperature and the daily cases of HFMD.From 2008 to 2015, 25,644 cases were reported, of which children under 5 years of age accounted for 78.68% of cases. The highest peak of HFMD cases was usually reported between April to July each year. An inverse V-shaped relationship was observed between daily mean temperature and HFMD cases; a temperature of 18°C was associated with a maximum risk of HFMD. The relative risk (RR) was 1.57 (95% confidence interval: 1.23-1.23), and boys and children aged 3 to 5 years were populations with the highest risk. The cumulative risks of high temperature (20.2°C and 25.2°C) in the total, age-specific, and gender-specific groups peaked on lag 14 days; RR was higher in girls than in boys and in children aged 1 to 2 years than in other age groups. However, the effects of low temperature (-5.3°C, 2.0°C, and 12.8°C) were not significant for both gender-specific and age-specific patients.High temperature may increase the risk of HFMD, and boys and children aged 3 to 5 years were at higher risks on lag 0 day; however, the cumulative risks in girls and children aged 1 to 2 years increased with the increasing number of lag days.
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Affiliation(s)
- Jinyu Wang
- School of Basic Medical Science, Lanzhou University
| | - Sheng Li
- The First People's Hospital of Lanzhou City, Lanzhou, PR China
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Haerana BT, Prihartono NA, Riono P, Djuwita R, Syarif S, Hadi EN, Kaswandani N. Prevalence of tuberculosis infection and its relationship to stunting in children (under five years) household contact with new tuberculosis cases. Indian J Tuberc 2020; 68:350-355. [PMID: 34099200 DOI: 10.1016/j.ijtb.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/15/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Children who inhabit the same house with tuberculosis (TB) patients are at high risk for infection and illness with TB. Nutritional status (stunting) in children is related to the child's ability to withstand MTB (Mycobacterium Tuberculosis). This study aims to estimated the prevalence of tuberculosis infection and its relationship to stunting in children (under five years) with household contact (HHC) with new TB cases. METHODS A cross-sectional design was implemented. Conducted in July 2018-April 2019 at 13 Public Health Center in Makassar City. The sample size was calculated using one sample situation-about precision formula. Samples were children under five who had contact with new diagnosed TB cases. Tuberculosis infection was measured by TST (tuberculin skin test). Logistic regression with causal model to examine TB infection relationship with stunting and covariate variable, analyzed using Stata/MP 13.0 software. RESULTS One hundred twenty-six (126) eligible children. Prevalence of tuberculosis infection was 38.10%. Frequency of stunted was 31 children (24.60%). Stunted nutritional status (aPR): 2.36, 95% CI 1.60-3.44), boys (aPR: 1.47, 95% CI 0.96-2.25), not getting BCG immunization (aPR: 1.58, 95%) CI 0.89-2.82), and high contact intensity (aPR: 2.62, 95% CI 1.10-6.22) best predicted the tuberculosis infection in children with TB case household contacts with a model contribution of 64%. CONCLUSION Stunted nutritional status (moderate and severe), boys, not getting BCG immunization, and high contact intensity are the determinants of TB infection transmission in children HHC with TB. Children under five years of age who have close contact with TB cases should be targeted for priority interventions to prevent the transmission of TB infection and progressing to TB cases.
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Affiliation(s)
- Bs Titi Haerana
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia; Department of Public Health, Universitas Islam Negeri Alauddin Makassar, Indonesia.
| | | | - Pandu Riono
- Department of Biostatistics, Faculty of Public Health, University of Indonesia, Indonesia
| | - Ratna Djuwita
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia
| | - Syahrizal Syarif
- Department of Epidemiology, Faculty of Public Health, University of Indonesia, Indonesia
| | - Ella Nurlaella Hadi
- Department of Health Education and Behavioral Sciences, University of Indonesia, Indonesia
| | - Nastiti Kaswandani
- Pediatric Department, RSCM Hospital, Faculty of Medicine, University of Indonesia, Indonesia
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Review of ventilation strategies to reduce the risk of disease transmission in high occupancy buildings. INTERNATIONAL JOURNAL OF THERMOFLUIDS 2020; 7. [PMCID: PMC7487204 DOI: 10.1016/j.ijft.2020.100045] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
An unforeseen pandemic is facing the world caused by a corona virus known as SARS-CoV-2. Numerous measures are being put in place to try and reduce the spread of this deadly disease, with the most effective response to the outbreak being mass quarantines, a public health technique borrowed from the Middle Ages. The widely accepted main transmission mechanism is through droplet borne pathways. However, many researchers and studies are considering that this virus can also spread via the airborne route and remain for up to three hours in the air. This is leading to questions as to whether enough is being done regarding ventilation to reduce the risk of the spread of this or other diseases that may be air borne. Ventilation and air conditioning systems are the main focus when it comes to the transmission of such deadly pathogens and should be appropriately designed and operated. This paper reviews and critically evaluates the current ventilation strategies used in buildings to assess the state of the art and elaborates if there is room for further development, especially for high occupancy buildings, to reduce or eradicate the risk of pathogen transmission and adapt ventilation measures to new threats posed by pandemics.
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Dancer SJ. Covid-19 exposes the gaps in infection prevention and control. Infect Dis Health 2020; 25:223-226. [PMID: 32863200 PMCID: PMC7437566 DOI: 10.1016/j.idh.2020.08.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 12/19/2022]
Abstract
•Covid-19 has highlighted how little we really know about controlling infection. •The SARS-CoV-2 pandemic has ignited a tsunami of interest in basic hygiene. •Despite a shaky evidence base, hygienic activities have propelled infection control onto the global stage. •Covid-19 has compelled us to re-examine the chain of transmission as never before.
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Affiliation(s)
- Stephanie J Dancer
- Dept. of Microbiology, Hairmyres Hospital, NHS Lanarkshire, Scotland, UK; School of Applied Sciences, Edinburgh Napier University, Scotland, UK.
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Li S, Yang Z, Hu D, Cao L, He Q. Understanding building-occupant-microbiome interactions toward healthy built environments: A review. FRONTIERS OF ENVIRONMENTAL SCIENCE & ENGINEERING 2020; 15:65. [PMID: 33145119 PMCID: PMC7596174 DOI: 10.1007/s11783-020-1357-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/30/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Built environments, occupants, and microbiomes constitute a system of ecosystems with extensive interactions that impact one another. Understanding the interactions between these systems is essential to develop strategies for effective management of the built environment and its inhabitants to enhance public health and well-being. Numerous studies have been conducted to characterize the microbiomes of the built environment. This review summarizes current progress in understanding the interactions between attributes of built environments and occupant behaviors that shape the structure and dynamics of indoor microbial communities. In addition, this review also discusses the challenges and future research needs in the field of microbiomes of the built environment that necessitate research beyond the basic characterization of microbiomes in order to gain an understanding of the causal mechanisms between the built environment, occupants, and microbiomes, which will provide a knowledge base for the development of transformative intervention strategies toward healthy built environments. The pressing need to control the transmission of SARS-CoV-2 in indoor environments highlights the urgency and significance of understanding the complex interactions between the built environment, occupants, and microbiomes, which is the focus of this review.
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Affiliation(s)
- Shuai Li
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Zhiyao Yang
- Lyles School of Civil Engineering, Purdue University, West Lafayette, IN 47907 USA
| | - Da Hu
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Liu Cao
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
| | - Qiang He
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996 USA
- Institute for a Secure & Sustainable Environment, University of Tennessee, Knoxville, TN 37996 USA
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Ghamrawy A, Ibrahim NN, Abd El-Wahab EW. How accurate is the diagnosis of rheumatic fever in Egypt? Data from the national rheumatic heart disease prevention and control program (2006-2018). PLoS Negl Trop Dis 2020; 14:e0008558. [PMID: 32804953 PMCID: PMC7451991 DOI: 10.1371/journal.pntd.0008558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 08/27/2020] [Accepted: 07/02/2020] [Indexed: 01/10/2023] Open
Abstract
Rheumatic heart disease (RHD) as a chronic sequela of repeated episodes of acute rheumatic fever (ARF), remains a cause of cardiac morbidity in Egypt although it is given full attention through a national RHD prevention and control program. The present report reviews our experience with subjects presenting with ARF or its sequelae in a single RHD centre and describes the disease pattern over the last decade. A cross-sectional study was conducted in El-Mahalla RHD centre between 2006 and 2018. A total of 17014 individual were enrolled and evaluated. Diagnosis ARF was based on the 2015 revised Jones criteria and RHD was ruled in by echocardiography. The majority of the screened subjects were female (63.2%), in the age group 5-15 years (64.6%), rural residents (61.2%), had primary education (43.0%), and of low socioeconomic standard (50.2%). The total percentage of cases presenting with ARF sequelae was 29.3% [carditis/RHD (10.8%), rheumatic arthritis (Rh.A) (14.9%), and Sydenham's chorea (0.05%)]. Noticeably, 72% were free of any cardiac insult, of which 37.7% were victims of misdiagnoses made elsewhere by untrained practitioners who prescribed for them long term injectable long-acting penicillin [Benzathine Penicillin G (BPG)] without need. About 54% of the study cohort reported the occurrence of recurrent attacks of tonsillitis of which 65.2% underwent tonsillectomy. Among those who experienced tonsillectomy and/or received BPG in the past, 14.5% and 22.3% respectively had eventually developed RHD. Screening of family members of some RHD cases who needed cardiac surgery revealed 20.7% with undiagnosed ARF sequalae [RHD (56.0%) and Rh.A (52.2%)]. Upon the follow-up of RHD cases, 1.2% had improved, 98.4% were stable and 0.4% had their heart condition deteriorated. Misdiagnosis of ARF or its sequelae and poor compliance with BPG use may affect efforts being exerted to curtail the disease. Updating national guidelines, capacity building, and reliance on appropriate investigations should be emphasized. Since the genetic basis of RHD is literally confirmed, a family history of RHD warrants screening of all family members for early detection of the disease.
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Affiliation(s)
- Alaa Ghamrawy
- Department of Non-Communicable Diseases, Ministry of Health and Population, Cairo, Egypt
| | - Nermeen N. Ibrahim
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Ekram W. Abd El-Wahab
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- * E-mail:
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Qi H, Li Y, Zhang J, Chen Y, Guo Y, Xiao S, Hu J, Wang W, Zhang W, Hu Y, Li Z, Zhang Z. Quantifying the risk of hand, foot, and mouth disease (HFMD) attributable to meteorological factors in East China: A time series modelling study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 728:138548. [PMID: 32361359 DOI: 10.1016/j.scitotenv.2020.138548] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/21/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hand, foot, and mouth disease (HFMD) is a widespread infectious disease in China. Associated meteorological factors have been widely studied, but their attributable risks have not been well quantified. OBJECTIVES The study aimed to quantify the HFMD burden attributable to temperature and other meteorological factors. METHODS The daily counts of HFMD and meteorological factors in all 574 counties of East China were obtained for the period from 2009 to 2015. The exposure-lag-response relationships between meteorological factors and HFMD were quantified by using a distributed lag non-linear model for each county and the estimates from all the counties were then pooled using a multivariate mete-regression model. Attributable risks were estimated for meteorological variables according to the exposure-lag-response relationships obtained before. RESULTS The study included 4,058,702 HFMD cases. Non-optimal values of meteorological factors were attributable to approximately one third of all HFMD cases, and the attributable numbers of non-optimal ambient temperature, relative humidity, wind speed and sunshine hours were 815,942 (95% CI: 796,361-835,888), 291,759 (95% CI: 226,183-358,494), 92,060 (95% CI: 59,655-124,738) and 62,948 (95% CI: 20,621-105,773), respectively. The exposure-response relationship between temperature and HFMD was non-linear with an approximate "M" shape. High temperature had a greater influence on HFMD than low temperature did. There was a geographical heterogeneity related to water body, and more cases occurred in days with moderate high and low temperatures than in days with extreme temperature. The effects of meteorological factors on HFMD were generally consistent across subgroups. CONCLUSIONS Non-optimal temperature is the leading risk factor of HFMD in East China, and moderate hot and moderate cold days had the highest risk. Developing subgroup-targeted and region-specific programs may minimize the adverse consequences of non-optimum weather on HFMD risk.
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Affiliation(s)
- Hongchao Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Department of Biostatistics, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, Netherlands
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, China
| | - Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, 27 Rainforest Walk, Clayton, VIC 3800, Australia
| | - Shuang Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Jian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Wenge Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Academy of Military Medical Sciences, 27 Taiping Rd, Haidian District, Beijing, China
| | - Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China
| | - Zhongjie Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, 155 Changbai Rd, Changping District, Beijing, China.
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, 138 Yixueyuan Rd, Xuhui District, Shanghai, China; Key Laboratory of Public Health Safety, Ministry of Education, 138 Yixueyuan Rd, Xuhui District, Shanghai, China.
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Tyagi R, Gupta V, Kumar R, Wander GS. Traditional Indian practices: Time to revisit and re-adopt for a healthier lifestyle. J Anaesthesiol Clin Pharmacol 2020; 36:S166-S171. [PMID: 33100675 PMCID: PMC7574014 DOI: 10.4103/joacp.joacp_299_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/07/2020] [Accepted: 06/13/2020] [Indexed: 11/04/2022] Open
Abstract
The COVID-19 pandemic has affected human life significantly. In spite of significant advancement of medical technology, management is still focused on preventive strategies due to non availability of vaccine or any definitive treatment. The preventive strategies include hand hygiene, social distancing, isolation/quarantine along with the methods for boosting immunity. The ancient literature and several traditional practices of our country guide a hygienic life style and address several preventive aspects of transmission of infection across the society. Furthermore, healthy eating habits and use of various herbs and spices as regular food ingredients has been proven for boosting the immunity. In this review, we have tried to correlate the traditional practices with the available scientific evidences.
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Affiliation(s)
- Ruchita Tyagi
- Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vivek Gupta
- Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Rajiv Kumar
- Department of Cardiac Surgery, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - G S Wander
- Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
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Zemouri C, Awad SF, Volgenant CMC, Crielaard W, Laheij AMGA, de Soet JJ. Modeling of the Transmission of Coronaviruses, Measles Virus, Influenza Virus, Mycobacterium tuberculosis, and Legionella pneumophila in Dental Clinics. J Dent Res 2020; 99:1192-1198. [PMID: 32614681 PMCID: PMC7444020 DOI: 10.1177/0022034520940288] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Dental health care workers are in close contact to their patients and are therefore at higher risk for contracting airborne infectious diseases. The transmission rates of airborne pathogens from patient to dental health care workers are unknown. With the outbreaks of infectious diseases, such as seasonal influenza, occasional outbreaks of measles and tuberculosis, and the current pandemic of the coronavirus disease COVID-19, it is important to estimate the risks for dental health care workers. Therefore, the transmission probability of these airborne infectious diseases was estimated via mathematical modeling. The transmission probability was modeled for Mycobacterium tuberculosis, Legionella pneumophila, measles virus, influenza virus, and coronaviruses per a modified version of the Wells-Riley equation. This equation incorporated the indoor air quality by using carbon dioxide as a proxy and added the respiratory protection rate from medical face masks and N95 respirators. Scenario-specific analyses, uncertainty analyses, and sensitivity analyses were run to produce probability rates. A high transmission probability was characterized by high patient infectiousness, the absence of respiratory protection, and poor indoor air quality. The highest transmission probabilities were estimated for measles virus (100%), coronaviruses (99.4%), influenza virus (89.4%), and M. tuberculosis (84.0%). The low-risk scenario leads to transmission probabilities of 4.5% for measles virus and 0% for the other pathogens. From the sensitivity analysis, it shows that the transmission probability is strongly driven by indoor air quality, followed by patient infectiousness, and the least by respiratory protection from medical face mask use. Airborne infection transmission of pathogens such as measles virus and coronaviruses is likely to occur in the dental practice. The risk magnitude, however, is highly dependent on specific conditions in each dental clinic. Improved indoor air quality by ventilation, which reduces carbon dioxide, is the most important factor that will either strongly increase or decrease the probability of the transmission of a pathogen.
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Affiliation(s)
- C Zemouri
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - S F Awad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation, Doha, Qatar
| | - C M C Volgenant
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - W Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - A M G A Laheij
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - J J de Soet
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Martischang R, Peters A, Reart AN, Pittet D. The voice of nurses in hospital epidemiology and infection control: An example from the 19th century. Int J Infect Dis 2020; 96:119-120. [PMID: 32325274 DOI: 10.1016/j.ijid.2020.04.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/10/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Romain Martischang
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Alexandra Peters
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Didier Pittet
- Infection Control Programme and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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47
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Measures for preventing nosocomial infection with SARS-CoV-2 in hematology departments. Ann Hematol 2020; 99:1933-1938. [PMID: 32601797 PMCID: PMC7323882 DOI: 10.1007/s00277-020-04127-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
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48
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The need to adapt the rescue chain for out-of-hospital cardiac arrest during the COVID-19 pandemic: Experience from the Paris Fire Brigade Basic Life Support and Advanced Life Support teams. Resuscitation 2020; 153:56-57. [PMID: 32540262 PMCID: PMC7292001 DOI: 10.1016/j.resuscitation.2020.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 11/28/2022]
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50
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Brown N, Buse C, Lewis A, Martin D, Nettleton S. Air care: an 'aerography' of breath, buildings and bugs in the cystic fibrosis clinic. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:972-986. [PMID: 32406081 DOI: 10.1111/1467-9566.13104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
With significant relevance to the Covid-19 pandemic, this paper contributes to emerging 'aerographic' research on the socio-materialities of air and breath, based on an in-depth empirical study of three hospital-based lung infection clinics treating people with cystic fibrosis. We begin by outlining the changing place of atmosphere in hospital design from the pre-antibiotic period and into the present. We then turn to the first of three aerographic themes where air becomes a matter of grasping and visualising otherwise invisible airborne infections. This includes imagining patients located within bodily spheres or 'cloud bodies', conceptually anchored in Irigaray's thoughts on the 'forgetting of the air' and Sloterdijk's immunitary 'spherology' of the body. Our second theme explores the material politics of air, air conditioning, window design and the way competing 'air regimes' come into conflict with each other at the interface of buildings, bodies and the biotic. Our final theme attends to the 'cost of air', the aero-economic problem of atmospheric scarcity within modern high-rise, deep-density healthcare architectures.
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Affiliation(s)
- Nik Brown
- Department of Sociology, University of York, York, UK
| | - Chrissy Buse
- Department of Sociology, University of York, York, UK
| | - Alan Lewis
- The School of Social Sciences, University of Manchester, Manchester, UK
| | - Daryl Martin
- Department of Sociology, University of York, York, UK
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