Assessment of airborne bacteria and noroviruses in air emission from a new highly-advanced hospital wastewater treatment plant

Filling the knowledge gap: Scoping review regarding sampling methods, assays, and further requirements to assess airborne viruses

Assessment of occupational exposure to viruses is crucial to identify virus reservoirs and sources of dissemination at an early stage and to help prevent spread between employees and to the general population. Measuring workers' exposure can facilitate assessment of the effectiveness of protective and mitigation measures in place. The aim of this scoping review is to give an overview of available methods and those already implemented for airborne virus' exposure assessment in different occupational and indoor environments. The results retrieved from the different studies may contribute to the setting of future standards and guidelines to ensure a reliable risk characterization in the occupational environments crucial for the implementation of effective control measures. The search aimed at selecting studies between January 1st 2010 and June 30th 2023 in the selected databases. Fifty papers on virus exposure assessment fitted the eligibility criteria and were selected for data extraction. Overall, this study identified gaps in knowledge regarding virus assessment and pinpointed the needs for further research. Several discrepancies were found (transport temperatures, elution steps, …), as well as a lack of publication of important data related to the exposure conditions (contextual information). With the available information, it is impossible to compare results between studies employing different methods, and even if the same methods are used, different conclusions/recommendations based on the expert judgment have been reported due to the lack of consensus in the contextual information retrieved and/or data interpretation. Future research on the field targeting sampling methods and in the laboratory regarding the assays to employ should be developed bearing in mind the different goals of the assessment.

Emission Characteristics of Aerosols Generated during the Micro-Nano Bubble Aeration Process in Wastewater

Micro-nano bubble (MNB) aeration is an emerging technology that considerably enhances the aeration efficiency of wastewater. This study evaluates, for the first time, aerosolization at the water-air interface during MNB aeration. Our results show that the concentration of culturable mixed microorganisms (i.e., bacteria, fungi, and intestinal bacteria) in the in situ MNB generation (MNBs-G) phase is 2170 CFU/m3, 1.38 and 1.58-fold higher than those in medium-bubble aeration (MBA; 1568 CFU/m3) and small-bubble aeration (SBA; 1376 CFU/m3) aerosols, respectively. Conversely, the concentration of culturable mixed microorganisms in the MNB persistent dissolved oxygen (MNBs-O) phase is only 914 CFU/m3. Microbiological analysis shows a lower abundance of bacterial pathogens in MNBs-G (34.12%) and MNBs-O (34.02%) phases than in MBA (39.63%) and SBA (38.87%) aerosols. Acinetobacter is prevalent in MNBs-G (14.76%) and MNBs-O (8.22%) aerosols, whereas Bacillus and Arcobacter are prevalent in MBA (23.96%) and SBA (6.92%) aerosols, respectively. The total concentrations of chemicals [i.e., total organic carbon, water-soluble ions, and metal(loid)s] in aerosols formed via MNB aeration (205.98-373.74 μg/m3) are lower than those in MBA and SBA (398.69-594.92 μg/m3). Compared to MBA and SBA, the MNBs-G phase exhibits higher emissions of 12 elements in aerosols (i.e., NO3-, NO2-, Ca2+, Na+, K+, Mg2+, Zn, Cd, Fe, Mn, As, and Cr), whereas the MNBs-O phase generally shows lower emissions. These findings highlight the potential of optimized MNB aeration technology in considerably mitigating aerosol emissions and thereby advancing environmental sustainability in wastewater treatment.

Comparative analysis of bioaerosol emissions: Seasonal dynamics and exposure risks in hospital vs. municipal wastewater treatment systems

Hospital wastewater is known to contain various pathogenic microorganisms and harmful substances. During the hospital wastewater treatment process, the bioaerosols released may encapsulate these pathogens, leading to human infection. This study undertook an investigation to compare the dispersion characteristics and seasonal variations of bioaerosols from hospital and municipal sewage. The results indicated that the airborne bacterial concentration from hospital sewage (119 ± 118 CFU/m3) was higher than municipal sewage (46 ± 19 CFU/m3), with the highest concentration observed in summer. The dominant bacterial genera present in bioaerosols from both sewages were alike, with the proportions varied by sewage types and the structure mainly influenced by seasonal factors. Bacteroides, Escherichia-Shigella and Streptococcus were identified as the most prevalent pathogenic genera in spring, summer and winter bioaerosols, respectively, while Pseudomonas and Acinetobacter were abundant in autumn. Although the non-carcinogenic risk associated with bioaerosols was low (<1), the presence of pathogenic species and their potential synergistic interactions elevated the overall exposure risk. The diffusion modeling results demonstrated that bioaerosol emissions from the surface of hospital sewage can reach up to 10570 CFU/m3 in summer and can spread more than 300 m downwind. The potential pathogenicity of bioaerosols was also highest in summer, which may pose a health hazard to populations located downwind. Therefore, the management and control of bioaerosols from sewage should be strengthened, especially in summer.

Global diversity of airborne pathogenic bacteria and fungi from wastewater treatment plants

Wastewater treatment plants (WWTPs) have been recognized as one of the major potential sources of the spread of airborne pathogenic microorganisms under the global pandemic of COVID-19. The differences in research regions, wastewater treatment processes, environmental conditions, and other aspects in the existing case studies have caused some confusion in the understanding of bioaerosol pollution characteristics. In this study, we integrated and analyzed data from field sampling and performed a systematic literature search to determine the abundance of airborne microorganisms in 13 countries and 37 cities across four continents (Asia, Europe, North America, and Africa). We analyzed the concentrations of bioaerosols, the core composition, global diversity, determinants, and potential risks of airborne pathogen communities in WWTPs. Our findings showed that the culturable bioaerosol concentrations of global WWTPs are 102-105 CFU/m3. Three core bacterial pathogens, namely Bacillus, Acinetobacter, and Pseudomonas, as well as two core fungal pathogens, Cladosporium and Aspergillus, were identified in the air across global WWTPs. WWTPs have unique core pathogenic communities and distinct continental divergence. The sources of airborne microorganisms (wastewater) and environmental variables (relative humidity and air contaminants) have impacts on the distribution of airborne pathogens. Potential health risks are associated with the core airborne pathogens in WWTPs. Our study showed the specificity, multifactorial influences, and potential pathogenicity of airborne pathogenic communities in WWTPs. Our findings can improve the understanding of the global diversity and biogeography of airborne pathogens in WWTPs, guiding risk assessment and control strategies for such pathogens. Furthermore, they provide a theoretical basis for safeguarding the health of WWTP workers and ensuring regional ecological security.

Application of wastewater-based epidemiology for monitoring COVID-19 in hospital and housing wastewaters

An alternative and complementary diagnostic method of surveillance is provided by wastewater-based surveillance (WBS), particularly in low-income nations like Nepal with scant wastewater treatment facilities and clinical testing infrastructure. In this study, a total of 146 water samples collected from two hospitals (n = 63) and three housing wastewaters (n = 83) from the Kathmandu Valley over the period of March 2021-Febraury 2022 were investigated for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using quantitative reverse transcription TaqMan PCR assays targeting the N and E genes. Of the total, 67 % (98/146) samples were positive for SARS-CoV-2 RNA either by using N- or E-gene assay, with concentrations ranging from 3.6 to 9.1 log10 copies/L. There was a significant difference found between positive ratio (Chi-square test, p < 0.05) and concentration (t-test, p = 0.009) of SARS-CoV-2 RNA detected from hospital wastewater and housing waters. Wastewater data are correlated with COVID-19 active cases, indicating significance in specific areas like the Hospital (APFH) (p < 0.05). According to the application of a bivariate linear regression model (p < 0.05), the concentrations of N gene may be used to predict the COVID-19 cases in the APFH. Remarkably, SARS-CoV-2 RNA was detected prior to, during, and following clinical case surges, implying that wastewater surveillance could serve as an early warning system for public health decisions. The significance of WBS in tracking and managing pandemics is emphasized by this study, especially in resource-constrained settings.

A Pilot Study of Aerosolization of Infectious Murine Norovirus in an Experimental Setup

Human norovirus is transmitted mainly via the faecal-oral route, but norovirus disease outbreaks have been reported in which airborne transmission has been suggested as the only explanation. We used murine norovirus (MNV) as a surrogate for human norovirus to determine the aerosolization of infectious norovirus in an experimental setup. A 3-l air chamber system was used for aerosolization of MNV. Virus in solution (6 log10 TCID50/ml) was introduced into the nebulizer for generating aerosols and a RAW 264.7 cell dish without a lid was placed in the air chamber. Cell culture medium samples were taken from the dishes after the aerosol exposure time of 30 or 90 min, and the dishes were placed in a 37 °C, 5% CO2 incubator and inspected with a light microscope for viral cytopathic effects (CPEs). We determined both the infectious MNV TCID50 titre and used an RT-qPCR assay. During the experiments, virus infectivity remained stable for 30 and 90 min in the MNV solution in the nebulizer. Infectious MNV TCID50 values/ml of 2.89 ± 0.29 and 3.20 ± 0.49 log10 were measured in the chamber in RAW 264.7 cell dish media after the 30-min and 90-min exposure, respectively. The MNV RNA loads were 6.20 ± 0.24 and 6.93 ± 1.02 log10 genome copies/ml, respectively. Later, a typical MNV CPE appeared in the aerosol-exposed RAW cell dishes. We demonstrated that MNV was aerosolized and that it remained infectious in the experimental setup used. Further studies required for understanding the behaviour of MNV in aerosols can thus be performed.

Spatiotemporal distribution, interactions and toxic effect of microorganisms and ARGs/MGEs from the bioreaction tank in hospital sewage treatment facility

Antibiotic resistance genes (ARGs) can be emitted from wastewater to ambient air and impose unignorable inhalable hazards, which could be exacerbated in antibiotic-concentrated hospital sewage. However, whether the ARG-carrying pathogens are more likely to infect cells remains largely unknown. Here, this study investigated and analyzed the spatiotemporal distribution, interaction, and toxicity of airborne microorganisms and their hosting ARGs in a hospital sewage treatment facility. The average concentration of ARGs/MGEs in sewage of bioreaction tank (BRT-W) was 2.27 × 104 gene copies/L. In the air of bioreaction tank (BRT-A), the average concentration of ARGs/MGEs was 15.86 gene copies/m3. In the four seasons, the ARGs concentration of sewage gradually decreased over time; The concentration of ARGs in the air first decreased and then increased. In spring, the concentration of ARGs/MGEs (qacedelta1-01) in BRT-W was highest (1.05 × 105 gene copies/L); The concentration of ARGs/MGEs (strB) in BRT-A in winter was higher than other seasons (26.18 gene copies/m3). Different from the past, this study also paid attention to the pathogenic potential of ARGs/MGEs in the air. The results of cell experiments showed that the cytotoxicity of drug-resistant Escherichia coli could reach Grade V. This suggested that the longer the drug-resistant E. coli were exposed to cells, the greater the cytotoxicity. Moreover, the cytotoxicity of bacteria increased with the increase in exposure time. In spring, the toxic effect of ARGs/MGEs in sewage of BRT-W was highest. Traceability analysis proved that BRT-W was an essential source of microorganisms and ARGs/MGEs in BRT-A. Furthermore, the combined risk of people exposed to the air of BRT in spring was higher than that in other seasons.

Potential pathogenic microorganisms in rural wastewater treatment process: Succession characteristics, concentration variation, source exploration, and risk assessment

Pathogenic microorganisms can cause infection, sepsis, and other diseases in humans. Although municipal wastewater plants are important sources and sinks for potential pathogenic microorganisms, data on rural wastewater treatment processes are limited. The proximity of rural wastewater facilities to human settlements and the trend toward wastewater resourcing could pose risks to humans. Here, a typical village in southern China was selected to analyze potential pathogenic microorganisms in wastewater, sewage sludge, and aerosols during the collection, treatment, and discharge of domestic wastewater. The succession characteristics and concentration variations of potential pathogenic microorganisms throughout the wastewater treatment process were identified using high-throughput sequencing and culture methods. Bacteria-associated health risks in facility aerosols were estimated based on average daily dose rates from inhalation and dermal exposure. Lower amounts of pathogenic bacteria and pathogenic fungi were detected in the effluent of the 1-ton treatment scale and the 10-ton treatment scale facilities, compared to those in the influent. Pathogen effluent concentrations were significantly lower than influent concentrations after treatment in rural wastewater facilities. 16 and 29 potential pathogenic bacteria and fungi were detected in aerosols from wastewater treatment facilities, respectively. Furthermore, the potential pathogen concentrations were higher than those in the background air. Aerobic units are the main source of pathogen emissions from aerosols. There were 42 potential pathogenic bacteria and 34 potential pathogenic fungi in the sewage sludge. Biochemical units were the main source of potential pathogens in sewage sludge, and more potential airborne pathogens originated from wastewater. In rural wastewater resourcing processes with greater pollutant exposure, the effluent of rural wastewater treatment facilities (WWTFs), downstream rivers, and facility aerosols, could be important potential sources of microbial risk. Inhalation is the main pathway of human exposure to airborne bacteria. Therefore, more attention should be focused on microbiological risk in rural wastewater treatment processes.

Antibiotic resistance genes associated with size-segregated bioaerosols from wastewater treatment plants: A review

The antibiotic-resistant pollution in size-segregated bioaerosols from wastewater treatment plants (WWTPs) is of increasing concern due to its public health risks, but an elaborate review is still lacking. This work overviewed the profile, mobility, pathogenic hosts, source, and risks of antibiotic resistance genes (ARGs) in size-segregated bioaerosols from WWTPs. The dominant ARG type in size-segregated bioaerosols from WWTPs was multidrug resistance genes. Treatment units that equipped with mechanical facilities and aeration devices, such as grilles, grit chambers, biochemical reaction tanks, and sludge treatment units, were the primary sources of bioaerosol antibiotic resistome in WWTPs. Higher enrichment of antibiotic resistome in particulate matter with an aerodynamic diameter of <2.5 μm, was found along the upwind-downwind-WWTPs gradient. Only a small portion of ARGs in inhalable bioaerosols from WWTPs were flanked by mobile genetic elements. The pathogens with multiple drug resistance had been found in size-segregated bioaerosols from WWTPs. Different ARGs or antibiotic resistant bacteria have different aerosolization potential associated with bioaerosols from various treatment processes. The validation of pathogenic antibiotic resistance bacteria, deeper investigation of ARG mobility, emission mechanism of antibiotic resistome, and development of treatment technologies, should be systematically considered in future.

Pollution characteristics and potential health effects of airborne microplastics and culturable microorganisms during urban haze in Harbin, China

In this study, active sampling technology was used to collect microplastics (MPs) and microorganisms simultaneously on haze days in Harbin, China. Airborne MPs concentrations in Junior high school (162.4 ± 44.6 particles/m3) with high vehicular and pedestrian traffic was higher than those in University (63.2 ± 21.8 particles/m3) and Park (12.8 ± 5.5 particles/m3). More airborne MPs were detected in the night samples than in the morning and noon samples. The majority (69.06 %) of airborne MPs measured less than 100 μm, with fibers (69.4 %) being the predominant form. Polyesters and polyethylene were the dominant polymers. In addition, airborne MPs concentrations were positively correlated with microorganisms and PM10 concentrations, and the health hazards associated with microorganisms and MPs exposure via inhalation far exceeded those associated with skin contact, which can serve as a theoretical foundation for considering MPs as indicators of air quality in the future.

The BioCascade Impactor: A novel device for direct collection of size-fractionated bioaerosols into liquid medium

The ability to collect size-fractionated airborne particles that contain viable bacteria and fungi directly into liquid medium while also maintaining their viability is critical for assessing exposure risks. In this study, we present the BioCascade impactor, a novel device designed to collect airborne particles into liquid based on their aerodynamic diameter in three sequential stages (>9.74 μm, 3.94-9.74 μm, and 1.38-3.94 μm when operated at 8.5 L/min). Aerosol samples containing microorganisms - either Saccharomyces kudriavzevii or Micrococcus luteus, were used to evaluate the performance of the BioCascade (BC) paired with either the VIable Virus Aerosol Sampler (VIVAS) or a gelatin filter (GF) as stage 4 to collect particles <1.38 μm. Stages 2 and 3 collected the largest fractions of viable S. kudriavzevii when paired with VIVAS (0.468) and GF (0.519), respectively. Stage 3 collected the largest fraction of viable M. luteus particles in both BC+VIVAS (0.791) and BC+GF (0.950) configurations. The distribution function of viable microorganisms was consistent with the size distributions measured by the Aerodynamic Particle Sizer. Testing with both bioaerosol species confirmed no internal loss and no re-aerosolization occurred within the BC. Irrespective of the bioaerosol tested, stages 1, 3 and 4 maintained ≥80% of viability, while stage 2 maintained only 37% and 73% of viable S. kudriavzevii and M. luteus, respectively. The low viability that occurred in stage 2 warrants further investigation. Our work shows that the BC can efficiently size-classify and collect bioaerosols without re-aerosolization and effectively maintain the viability of collected microorganisms.

Aerosol Transmission of Norovirus

Norovirus (NoV) is a major cause of acute gastroenteritis outbreaks worldwide. A comprehensive understanding of the transmission mode is of great significance for the prevention and control of the NoV infection. Currently, the transmission modes of NoV include contact, food-borne, water-borne and aerosol transmission. The first three modes are more common, while aerosol transmission is seldom reported. In this paper, the source, generation mechanism, infectivity, sampling and related outbreaks of NoV aerosol are summarized and discussed.

Distribution characteristics and potential risks of bioaerosols during scattered farming

In most economically underdeveloped areas, scattered farming and human‒livestock cohabitation are common. However, production of bioaerosols and their potential harm in these areas have not been previously researched. In this study, bioaerosol characteristics were analyzed in scattered farming areas in rural Northwest China. The highest bacteria, fungi, and Enterobacteria concentrations were 125609 ± 467 CFU/m³, 25175 ± 10305 CFU/m³, and 4167 ± 592 CFU/m³, respectively. Most bioaerosols had particle sizes >3.3 μm. A total of 71 bacterial genera and 16 fungal genera of potential pathogens were identified, including zoonotic potential pathogenic genera. Moreover, our findings showed that the scattered farming pattern of human‒animal cohabitation can affect the indoor air environment in the surrounding area, leading to chronic respiratory diseases in the occupants. Therefore, relevant government departments and farmers should enhance their awareness of bioaerosol risks and consider measures that may be taken to reduce them.

Culturable and inhalable airborne bacteria in a semiunderground municipal wastewater treatment plant: Distribution, transmission, and health risk assessment

Airborne pathogens constitute a growing threat to global public health. Wastewater treatment plants (WWTPs) are important sources of airborne bacteria, which pose great health risks to the employee and nearby residents. In this study, the distribution, transmission and health risk of the airborne culturable and inhalable bacteria carried by PM2.5 in a semiunderground WWTP were evaluated. The concentrations of culturable bacteria in the air were 21.2-1431.1 CFU/m3, with the main contributions of primary and biological treatments. The relative abundances of culturable and total inhalable bacterial taxa were positively correlated (p < 0.05). However, certain bacteria, including Bacillus, Acinetobacter and Enterococcus, exhibited high reproductive capacity despite their low concentration in the air, suggesting that they can survive and regrow in suitable environments. Transmission modeling revealed that the concentrations of airborne bacteria exponentially decreased with distance from 18.67 to 24.12 copies /m3 at the source to 0.06-0.14 copies /m3 at 1000 m downwind. The risks of 8-h exposure in this WWTP except the outlet exceeded the reference value recommended by WHO, which were primarily dependent on P. aeruginosa, Salmonella, and E. coli. Management practices should consider improved controls for bioaerosols in order to reduce the risk of disease transmission.

A cohort study of wastewater treatment plant workers: Association between levels of biomarkers of systemic inflammation and exposure to bacteria and fungi, and endotoxin as measured using two methods

Work in wastewater treatment plants (WWTPs) can be associated with exposure to airborne microorganisms and endotoxin from the working environment. The aim of this study was to obtain knowledge about whether serum levels of the markers of systemic inflammation, C-reactive protein (CRP) and serum amyloid A (SAA), are associated with personal exposure to endotoxin, measured using the Limulus (endotoxin_Limulus) and the rFC (endotoxin_rFC) assays, as well as bacteria and fungi in a cohort of WWTP workers. Exposure and blood samples were collected for 11 workers over one year. Exposure to endotoxin_Limulus-day and endotoxin_rFC-day correlated significantly (r = 0.80, p<0.0001, n = 104), but endotoxin_Limulus-day was 4.4 (Geometric mean (GM) value) times higher than endotoxin_rFC-day (p<0.0001). The endotoxin_Limulus-day, endotoxin_rFC-day, bacteria, and fungal exposure as well as serum levels of CRP_-day (GM=1.4 mg/l) and SAA_-day (GM=12 mg/l) differed between workers. Serum levels of SAA_day correlated significantly with CRP_day (r = 0.30, p = 0.0068). The serum levels of CRP_day were associated significantly with exposure to endotoxin_Limulus-day. Exposure, SAA and CRP data were also analyzed as av. of each season, and SAA_season was associated positively and significantly with endotoxin_{Limulus-season} and endotoxin_rFC-season and negatively with fungal_season exposure. In conclusion, CRP_day was associated with the endotoxin_Limulus-day and SAA_season with endotoxin_{Limulus-season} and endotoxin_rFC-season exposure. Thus, we hereby document that WWTP workers are exposed to airborne endotoxin which seems to have a negative impact on their health.

Hospital wastewater treatment methods and its impact on human health and environments

The scientific development and economic advances have led to the identification of many pathogenic agents in hospital effluents. Hospital wastewaters are qualitatively similar to municipal wastewaters, with the difference that these wastewaters contain toxic and infectious substances and compounds that can be dangerous for the health of the environment, employees of these centers, and the entire community. Therefore, in the last few years, it has been emphasized that all hospitals and medical and health centers should have a treatment facility for their produced wastewater so that the health of the society and people is not threatened. An issue that is not paid attention to has become one of the environmental problems and concerns of the world today. The present study focused on the investigate hospital wastewater treatment methods and its impact on human health and the environment. In this narrative study, the first literature search was performed with four hundred and twenty-three articles were retrieved based on PubMed, Elsevier, Web of science, Spring, and Google Scholar databases. The results of this study showed that wastewater from hospitals and medical centers can play a significant impress in polluting soil and aquatic environments and spreading infectious diseases. According to the mentioned contents, collection and treatment of hospital wastewater is essential. In addition, if hospital wastewater enters the wastewater collection network without knowing its characteristics or with incomplete treatment and finally enters the municipal wastewater treatment plant. It causes many problems, including disturbing the balance of the biological system of the treatment plant. Purification and disposal of hospital wastewater is considered a vital action based on environmental standards. The results of this study also showed that the treatment methods of this type of hospital wastewater can play a significant role in reducing the spread of diseases caused by hospital wastewater treatment, including infectious diseases. The results of this study can be very useful for politicians, the managers of the Ministry of Energy and Health and the Environmental Organization in choosing the appropriate methods and process to reduce hospital wastewater and increase the efficiency of hospital wastewater treatment plants.

What are the disease burden and its sensitivity analysis of workers exposing to Staphylococcus aureus bioaerosol during warm and cold periods in a wastewater treatment plant?

Biological treatment in wastewater treatment plants releases high amounts of pathogenic bioaerosols. Quantitative microbial risk assessment is a framework commonly used for quantitative risk estimation for occupational exposure scenarios. However, the quantitative contributions of health-risk-estimate inputted parameters remain ambiguous. Therefore, this research aimed to study the disease burden of workers exposed to Staphylococcus aureus bioaerosol during warm and cold periods and strictly quantify the contributions of the inputted parameters by sensitivity analysis on the basis of Monte Carlo simulation. Results showed that the disease health risk burden of workers in the warm period was 1.15-6.11 times higher than that of workers in the cold period. The disease health risk burden of workers without personal protective equipment was 23.83-36.55 times higher than that of workers with personal protective equipment. Sensitivity analysis showed that exposure concentration and aerosol ingestion rate were the first and second predominant factors, respectively; the sensitivity partitioning coefficient of the former was 1.17-1.35 times the value of the latter. In addition, no remarkable differences were revealed in the sensitivity percentage ratio between warm and cold periods. The findings could contribute to the mitigation measures for the management of public health risks.

Characteristics, non-carcinogenic risk assessment and prediction by HYSPLIT of bioaerosol released from Hospital and Municipal Sewage, China

Bioaerosol is a new type of pollutant, which is related to the spread of many diseases. In particular, the bioaerosol produced in the hospital sewage treatment process contains many pathogenic bacteria, which will impact patients and surrounding residents. In this study, the biochemical tank (BRT) of the hospital sewage treatment station (HSTS) and municipal wastewater treatment plant (MWTP) were used as sampling points. The results showed that the concentration of bacteria (1843 CFU/m³) in bioaerosol produced by BRT of HSTS was higher than that in the air at BRT of MWTP (1278 CFU/m³). The proportion of small-size bacteria (<3.3 µm) in the air of HSTS and MWTP was similar. However, the abundance of small-size pathogenic bacteria in HSTS was higher than that in MWTP, such as Acinetobacter and Arcobacter. The dominant bacteria in HSTS and MWTP were different under different particle sizes. The dominant bacterial genera of bioaerosol in HSTS under different particle sizes were similar (Acinetobacter, Arcobacter, Comamonas); There were significant differences in the dominant bacterial genera of bioaerosol in MWTP under different particle sizes. The dominant strains with particle sizes ranging from 0 ∼ 0.43 µm were Acinetobacter (23.22%). Kocuria (15.13%) accounted for a relatively high proportion in the aerosol of 0.43 µm ∼ 0.65 µm. The dominant strains with particle sizes of 0.65 µm ∼ 1.1 µm and 1.1 µm ∼ 2.1 µm were relatively single, and Exiguobacterium and Paenibacillus accounted for 51.51% and 60.15%, respectively. Source tracker showed that most of the pathogenic bacteria in bioaerosols came from sewage. One hour later, the concentration of particulate matter in the place 200 m away from BRT of HSTS (1 × 10^-10 mg/m³) was higher than that in MWTP (1 × 10^-11 mg/m³). The hazard quotient (HQ) of people around HSTS (HQ_male: 1.70 × 10^-1; HQ_female: 1.36 × 10^-1) was higher than that of MWTP (HQ_male: 1.18 × 10^-1; HQ_female: 9.40 × 10^-2). Pathogenic bacteria (Acinetobacter, Arcobacter) were detected in HSTS and MWTP and the BugBase phenotype prediction results showed potential pathogenicity. More attention should be paid to the protection of the people. It is suggested to strengthen the air sterilization treatment near HSTS according to the diffusion trajectory of bioaerosol, and the surrounding personnel should wear N95 and other protective masks.

Submicron aerosols share potential pathogens and antibiotic resistomes with wastewater or sludge

Generation of size-segregated aerosols is an important eco-environmental problem in wastewater treatment plants (WWTPs), but the characteristics of potential pathogens and antibiotic resistomes in submicron aerosols (PM_1.0) were almost unknown. Here, 16S rRNA gene amplification and shotgun metagenome sequencing were respectively used to study the profiles of potential pathogens and antibiotic resistance genes (ARGs) in PM_1.0 from a full-scale WWTP. Acinetobacter and sul1 were respectively the predominant potential pathogens and ARG subtypes in PM_1.0 from aeration process. A total of 9 potential pathogens and 147 ARG subtypes, were shared among WWTP-PM_1.0, wastewater/sludge, and ambient air. Significant differences of potential pathogens or ARGs were found between WWTP-PM_1.0 and wastewater/sludge, however, wastewater/sludge had more crucial source contribution than the ambient air. Moreover, 13 potential pathogens and 40 ARG subtypes were easily aerosolized in PM_1.0 from at least one of the treatment units. ARGs were mainly harbored by Proteobacteria, and multidrug resistance genes were the most ARG type carried by potential pathogens. Taken together, this study indicates the prevalence of potential pathogens, ARGs, and ARG-carrying potential pathogens in WWTP-PM_1.0, which highlights the potential risk of PM_1.0 in spreading potential pathogens and antibiotic resistomes into the air environments.

Estimating acceptable exposure time for bioaerosols emission in a wastewater treatment plant by reverse quantitative microbial risk assessment based on various risk benchmarks

Populations exposed to bioaerosols over time in wastewater treatment plants (WWTPs) will be infected. Then, the reverse quantitative microbial risk assessment (QMRA) provides a quantitative framework for the estimation of acceptable exposure time to protect people from excessive exposure and then manage their health risk. In this study, the acceptable exposure time for staffs and visiting researchers exposed to S. aureus or E. coli bioaerosols emitted from aeration ponds in WWTPs was estimated and analyzed by Monte Carlo simulation-based reverse QMRA (using the 1E-4 pppy suggested by the US EPA or 1E-6 DALYs pppy suggested by the WHO as benchmarks). The 1E-3 and 1E-2 pppy were selected as a series of loose annual infection risk benchmarks to calculate a practical acceptable exposure time. The results showed that for the acceptable exposure time in each specific exposure scenario, the exposure of females was consistently 0.3-0.4 times longer than that of males; the exposure of staffs was 3.6-3.9 times shorter than that of visiting researchers; the exposures of populations in the rotating-disc aeration mode were consistently 6.3-6.6 and 2.8-3.1 times longer than those in the microporous aeration mode for S. aureus and E. coli bioaerosols, respectively. The acceptable exposure time with the use of personal protective equipment (PPE) was 33.4-35.0 times as long as that without PPE. The US EPA benchmark is stricter than the WHO benchmark with regard to the estimation of the acceptable exposure time of S. aureus or E. coli bioaerosols. The 1E-3 pppy is more appropriate and practical than the US EPA benchmark, but the 1E-2 pppy is notably too loose for health risk management. This research can assist managers of WWTPs to formulate a justified exposure time and develop applicable administrative and personal intervention strategies. The results can enrich the knowledge bases of reverse QMRA to elect a series of loose health-based target risk benchmarks for health risk management.

Determination of murine norovirus aerosol concentration during toilet flushing

Murine norovirus (MNV) was used as a surrogate for human viral pathogens (e.g., norovirus) to determine if toilet flushing resulted in the aerosolization of virus. A flushometer type toilet was seeded with a viral solution of 105 and 106 PFU mL-1 of MNV and then flushed. Upon flushing, two bioaerosol samplers were activated to collect aerosolized MNV. Prior to the experiment, two optical particle counters monitored particle size and number distribution of aerosol produced from flushing a toilet across height, position, and side. The location with the highest mean particle concentration, was behind the toilet and 0.15 m above the toilet bowl rim, which is where bioaerosol sampling occurred. Bioaerosol and toilet water samples were collected, extracted and then quantified using RT-ddPCR. The concentration of MNV collected after seeding the toilet water ranged from 2.18 × 105 to 9.65 × 106 total copies of MNV. Positive samples of airborne MNV were detected with collected concentrations ranging from 383 to 684 RNA copies/m3 of air. This study provides evidence that viral pathogens may be aerosolized when a toilet is flushed. Furthermore, the MNV used in this study is a model organism for human norovirus and may be generalizable to other viral pathogens (e.g., coronavirus). This study suggests that virus is aerosolized from toilet flushing and may contribute to human exposure to viral pathogens.

Seasonal fluctuation of aerosolization ratio of bioaerosols and quantitative microbial risk assessment in a wastewater treatment plant

Wastewater treatment plants (WWTPs) play a vital role in public health because it can emit a large quantity of bioaerosols. Exposure to bioaerosols from WWTPs is a potential health risk to WWTP workers and surrounding residents. In this study, the seasonal fluctuation of aerosolization ratios of several bioaerosols and quantitative health risks of the WWTP workers and the surrounding residents exposed to total coliform, fecal coliform, and enterococcal bioaerosols were analyzed. Results showed that the aerosolization ratio of airborne bacteria was higher in the cold seasons and lower in the warm seasons, whereas the aerosolization ratio of airborne fungi was the highest in summer. The aerosolization ratio of airborne fungi was evidently higher than that of other bioaerosols. Moreover, the aerosolization ratio under the inverted umbrella aerator mode was generally higher than that under the microporous aerator mode. For each exposure scenario, the health risks of males were generally 7.2-26.7% higher than those of females. The health risks of the exposure population exposed to total coliform and enterococcal bioaerosols were generally higher in warm seasons, whereas those of the population exposed to fecal coliform bioaerosol were the highest in winter. Additionally, the health risks of exposure population without masks under the imprudent/conservative estimate all exceeded the benchmarks. However, when equipped with masks, all the exposure populations' health risks decreased 1-2 orders of magnitude and approached acceptable levels. This research methodically provides new scientific data on the aerosolization ratio of microorganism bioaerosols in a WWTP and promotes the comprehension of their quantitative health risks under imprudent/conservative estimates.

Multi-antibiotic resistant bacteria in landfill bioaerosols: Environmental conditions and biological risk assessment

Landfills, as well as other waste management facilities are well-known bioaerosols sources. These places may foment antibiotic-resistance in bacterial bioaerosol (A.R.B.) due to inadequate pharmaceutical waste disposal. This issue may foster the necessity of using last-generation antibiotics with extra costs in the health care system, and deaths. The aim of this study was to reveal the multi-antibiotic resistant bacterial bioaerosol emitted by a sanitary landfill and the surrounding area. We evaluated the influence of environmental conditions in the occurrence of A.R.B. and biological risk assessment. Antibiotic resistance found in the bacteria aerosols was compared with the AWaRE consumption classification. We used the BIOGAVAL method to assess the workers' occupational exposure to antibiotic-resistant bacterial bioaerosols in the landfill. This study confirmed the multi-antibiotic resistant in bacterial bioaerosol in a landfill and in the surrounding area. Obtained mean concentrations of bacterial bioaerosols, as well as antibiotic-resistant in bacterial bioaerosol (A.R.B.), were high, especially for fine particles that may be a threat for human health. Results suggest the possible risk of antibiotic-resistance interchange between pathogenic and non-pathogenic species in the landfill facilities, thus promoting antibiotic multi-resistance genes spreading into the environment.

Characteristics of size-segregated aerosols emitted from an aerobic moving bed biofilm reactor at a full-scale wastewater treatment plant

Aerosol emissions from wastewater treatment plants (WWTPs) have been associated with health reverberation but studies about characteristics of size-segregated aerosol particulate matter (PM) are scarce. In this study, the measurement of particulate number size distribution in the range of < 10 µm, and the collection of PM_10-2.5, PM_2.5-1.0 and PM_1.0, were conducted from an aerobic moving bed biofilm reactor (MBBR) at a full-scale WWTP. MBBR aerosols showed a unimodal number size distribution, with the majority of particles (>94%) in the ultrafine size range (<100 nm). For toxic metal(loid)s or potential pathogens, significant differences were found within MBBR aerosols (PM_10-2.5, PM_2.5-1.0, and PM_1.0), and also between MBBR aerosols and wastewater. Both wastewater and ambient air had important source contributions for MBBR aerosols. The compositions of toxic metal(loid)s in PM_1.0, and the populations of potential bacterial or fungal pathogens in PM_10-2.5 and PM_2.5-1.0, were dominated by that from wastewater. Compared to PM_10-2.5 and PM_2.5-1.0, PM_1.0 had the highest aerosolization potential for the toxic metal(loid)s of As, Cd, Co, Cr, Li, Mn, Ni, U, and Zn, and the genera of Acinetobacter, Pseudomonas and Fusarium. Due to the size-segregated specialty, targeted measures should be employed to reduce the health risks. CAPSULE: The compositions of toxic metal(loid)s in PM_1.0, and the populations of potential pathogens in PM_10-2.5 and PM_2.5-1.0, were dominated by that from wastewater.

Atmospheric dispersion and transmission of Legionella from wastewater treatment plants: A 6-year case-control study

Legionnaires Disease incidence has risen in the Netherlands in recent years. For the majority of the cases, the source of infection is never identified. Two Dutch wastewater treatment plants (WWTPs) have previously been identified as source of outbreaks of Legionnaires Disease (LD) among local residents. The objective of this study is to examine if LD patients in the Netherlands are more exposed to aerosols originating from WWTPs than controls.

METHODS

An atmospheric dispersion model was used to generate nationwide exposure maps of aerosols from 776 WWTPs in the Netherlands. Municipal sewage treatment plants and industrial WWTPs were both included. Exposure of LD cases and controls at the residential address was compared, in a matched case-control design using a conditional logistic regression. Cases were notified LD cases with onset of disease in the period 2013-2018 in the Netherlands (n = 1604).

RESULTS

Aerosols dispersed over a large part of the Netherlands, but modelled concentrations are estimated to be elevated in close proximity to WWTPs. A statistically significant association was found between LD and the calculated annual average aerosol concentrations originating from WWTPs (odds-ratio: 1.32 (1.06-1.63)). This association remained significant when the two outbreak-related WWTPs were removed from the analysis (odds-ratio: 1.28 (1.03-1.58)).

CONCLUSION

LD cases were more exposed to aerosols from WWTPs than controls. This indicates that exposure to aerosols dispersed from WWTPs caused Legionnaires Disease in residents living near WWTPs in the period 2013-2018. In order to investigate which characteristics of WWTPs are associated with an increased LD risk, the WWTP database should be updated and more data is needed on the presence and survival of aerosolized Legionella bacteria to improve the Legionella dispersion modelling. Furthermore, it is recommended to further investigate how aerosol dispersion of WWTPs can effectively be reduced in order to reduce the potential health risk.

DISPERSION OF AEROSOLIZED BACTERIA FROM ASIAN ELEPHANTS (ELEPHAS MAXIMUS)

Transmission of tuberculosis typically requires close and prolonged contact with an infected individual. However, several cases of transmission between elephants and from elephants to humans or other animals without direct contact or over long distances have been reported. Elephants have been shown to be capable of producing aerosolized bacterial droplets, suggesting a possible route of transmission that is magnified by the size and force of the elephant respiratory tract. To investigate the dispersion and viability of aerosolized bacteria generated from the elephant respiratory tract, a pre-existing model with a proxy organism was used. A six-stage Andersen sampler was used to detect the proxy organism, a commensal elephant respiratory bacterium, at different locations around an elephant barn at a zoo. The amount of proxy organism detected at various time points and distances from the elephants indicates they are capable of dispersing viable bacterial aerosols further than humans can. The concentration of these aerosols is dependent on proximity to the elephants and does not remain at a high level for prolonged periods of time. These findings support the model of aerosol-mediated transmission of bacteria from elephants and can be used to improve disease management practices and prevent the spread of pathogens from elephants in zoos and other facilities.

A state-of-the-art review on WWTP associated bioaerosols: Microbial diversity, potential emission stages, dispersion factors, and control strategies

Wastewater treatment plants (WWTPs) associated bioaerosols have emerged as one of the critical sustainability indicators, ensuring health and well-being of societies and cities. In this context, this review summarizes the various wastewater treatment technologies which have been studied with a focus of bioaerosols emissions, potential emission stages, available sampling strategies, survival and dispersion factors, dominant microbial species in bioaerosols, and possible control approaches. Literature review revealed that most of the studies were devoted to sampling, enumerating and identifying cultivable microbial species of bioaerosols, as well as measuring their concentrations. However, the role of treatment technologies and their operational factors are investigated in limited studies only. Moreover, few studies have been reported to investigate the presence and concentrations of air borne virus and fungi in WWTP, as compared to bacterial species. The common environmental factors, affecting the survival and dispersion of bioaerosols, are observed as relative humidity, temperature, wind speed, and solar illumination. Further, research studies on recent episodes of COVID-19 (SARS-CoV-2 virus) pandemic also revealed that continuous and effective surveillance on WWTPs associated bioaerosols may led to early sign for future pandemics. The evaluation of reported data is bit complicated, due to the variation in sampling approaches, ambient conditions, and site activities of each study. Therefore, such studies need a standardized methodology and improved guidance to help informed future policies, contextual research, and support a robust health-based risk assessment process. Based on this review, an integrated sampling and analysis framework is suggested for future WWTPs to ensure their sustainability at social and/or health associated aspects.

The novel SARS-CoV-2 pandemic: Possible environmental transmission, detection, persistence and fate during wastewater and water treatment

The contagious SARS-CoV-2 virus, responsible for COVID-19 disease, has infected over 27 million people across the globe within a few months. While literature on SARS-CoV-2 indicates that its transmission may occur predominantly via aerosolization of virus-laden droplets, the possibility of alternate routes of transmission and/or reinfection via the environment requires considerable scientific attention. This review aims to collate information on possible transmission routes of this virus, to ascertain its fate in the environment. Concomitant with the presence of SARS-CoV-2 viral RNA in faeces and saliva of infected patients, studies also indicated its occurrence in raw wastewater, primary sludge and river water. Therefore sewerage system could be a possible route of virus outbreak, a possible tool to assess viral community spread and future surveillance technique. Hence, this review looked into detection, occurrence and fate of SARS-CoV-2 during primary, secondary, and tertiary wastewater and water treatment processes based on published literature on SARS-CoV and other enveloped viruses. The review also highlights the need for focused research on occurrence and fate of SARS-CoV-2 in various environmental matrices. Utilization of this information in environmental transmission models developed for other enveloped and enteric viruses can facilitate risk assessment studies. Preliminary research efforts with SARS-CoV-2 and established scientific reports on other coronaviruses indicate that the threat of virus transmission from the aquatic environment may be currently non-existent. However, the presence of viral RNA in wastewater provides an early warning that highlights the need for effective sewage treatment to prevent a future outbreak of SARS-CoV-2.

Quantitative microbial risk assessment for occupational health of temporary entrants and staffs equipped with various grade PPE and exposed to microbial bioaerosols in two WWTPs

Purpose

This study was to evaluate the occupational health risks of infection from Gram-negative bacteria and Staphylococcus aureus bioaerosols to temporary entrants and staffs equipped with various grade personal protection equipment (PPE) related to wastewater treatment plants (WWTPs).

Methods

This study determined the emission concentrations of Gram-negative bacteria and Staphylococcus aureus bioaerosols from two WWTPs under various aeration modes. Then, a strict quantitative microbial risk assessment (QMRA) was performed on several exposure scenarios associated with occupational health risks of temporary entrants (researchers, visitors, and inspectors) and staffs (field engineer and laboratory technician).

Results

Although the bioaerosol concentrations were generally regarded as safe according to existing standards, these bioaerosols’ health risks were still unacceptable. The microbial bioaerosols posed considerable infection health risks in WWTPs. These risks were generally above the WHO and US EPA benchmarks. The health risks of females were always smaller than those of male of grown-up age group. Staffs that had been exposed to bioaerosols for a long time were found to have higher health risks compared with temporary entrants. In addition, field engineers equipped with PPE rendered low health risks, thus revealing that wearing PPE could effectively reduce the occupational health risks.

Conclusion

This study provided novel data and enriched the knowledge of microbial bioaerosol emission’s health risks from various aeration modes in WWTPs. Management decisions could be executed by authorities on the basis of the results of QMRA for field engineers equipped with PPE to reduce the related occupational health risks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01663-5.

Emission characteristics of bioaerosol and quantitative microbiological risk assessment for equipping individuals with various personal protective equipment in a WWTP

Wastewater treatment plants (WWTPs) are a nonnegligible source of bioaerosols that can pose health risks to workers and nearby residents. Thus, this study systematically investigated the emission characteristics of the size distribution and concentration of Staphylococcus aureus bioaerosol in a WWTP. Then, the research focused on the quantitative microbiological risk assessment (QMRA) of workers and nearby residents for equipping them with various grades personal protective equipment (PPE). Results showed that the peak proportion of the size distributions of bioaerosol particles in the three sources all obtained a size range between 3.3 and 4.7 μm. In the residential building, the peak proportion was larger (>7.0 μm). Referring to the three sources, the average bioaerosol concentrations were in the following sequence: inverted umbrella aerator tank > residual sludge storage yard > microporous aerator tank. The health risks of residents were generally 1-2 orders of magnitude higher than the other two exposure scenarios and were clearly beyond the benchmarks. Meanwhile, the health risks of the field engineer were usually lower than those of the staff at the residual sludge storage yard. In general, equipping workers and residents with PPE could at least decrease the health risks by one order of magnitude, and higher-grade PPE could appropriately promote the reduction of health risks. This research systematically delivered a series of novel data about the emission characteristics of Staphylococcus aureus bioaerosol in a WWTP. It advanced the understanding of the quantitative health risks of equipping individuals with various PPE.

The effect of mixing and free-floating carrier media on bioaerosol release from wastewater: a multiscale investigation with Bacillus globigii

Aeration tanks in wastewater treatment plants (WWTPs) are significant sources of bioaerosols, which contain microbial contaminants and can travel miles from the site of origin, risking the health of operators and the general public. One potential mitigation strategy is to apply free-floating carrier media (FFCM) to suppress bioaerosol emission. This article presents a multiscale study on the effects of mixing and FFCM on bioaerosol release using Bacillus globigii spores in well-defined liquid media. Bioaerosol release, defined as percentage of spores aerosolized during a 30 minute sampling period, ranged from 6.09 × 10-7% to 0.057%, depending upon the mixing mode and intensity. Bioaerosol release increased with the intensity of aeration (rotating speed in mechanical agitation and aeration rate in diffused aeration). A surface layer of polystyrene beads reduced bioaerosol released by >92% in the bench-scale studies and >74% in the pilot-scale study. This study discovered strong correlations (R2 > 0.82) between bioaerosol release and superficial gas velocity, Froude number, and volumetric gas flow per unit liquid volume per minute. The Reynolds number was found to be poorly correlated with bioaerosol release (R2 < 0.5). This study is a significant step toward the development of predictive models for full scale systems.

A cohort study of cucumber greenhouse workers' exposure to microorganisms as measured using NGS and MALDI-TOF MS and biomarkers of systemic inflammation

Work in greenhouses entails exposure to airborne fungi and bacteria. The aims of this study are to obtain knowledge about whether exposure to fungal and bacterial genera and species during work in a cucumber greenhouse is affected by work tasks, and whether a cohort of greenhouse workers' serum levels of serum amyloid A (SAA) and C-reactive protein (CRP), biomarkers of systemic inflammation, are associated with this. Data on personal exposure to airborne fungal and bacterial species measured over 4 years as well as serum levels of SAA and CRP sampled over two years were analyzed. For data analysis, the main work tasks were grouped into three different groups, called 'grouped work task'. Microorganisms were identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF MS) and next-generation sequencing (NGS). The 'daily exposure' of greenhouse workers' were as follows: 4.8 × 10⁴ CFU bacteria/m³, 1.4 × 10⁶ CFU fungi/m³, and 392 EU/m³ of endotoxin. Workers were exposed to many different microbial species including several species within the genera Acinetobacter, Bacillus, Microbacterium, Pseudomonas, Staphylococcus, and Streptomyces. The genera Ralstonia and Cladosporium were found in most samples. The exposure levels as well as the microbial composition were associated significantly with grouped work task and season with high exposures during tasks in close contact with mature and old plants and in the autumn. CRP and SAA levels were also associated with exposure level and grouped work tasks. The Shannon-Wiener indices were not different in the 3 'grouped work tasks'. Several specific species including e.g. Halomonas elongata, Stenotrophomonas maltophilia, Podosphaera fusca, and Wallemia spp. were found frequently or in high concentrations in the exposures associated with the highest levels of CRP and SAA. The microorganisms S. maltophilia, P. fusca, and Wallemia spp. were also found on the cucumber plant leaves. In conclusion, both exposure level and the species composition seem to have an effect on the serum levels of CRP and SAA of exposed workers. The greenhouse workers were exposed to only a few species characterized as human pathogens.

The bioaerosols emitted from toilet and wastewater treatment plant: a literature review

The aerosols harboring microorganisms and viruses released from the wastewater system into the air have greatly threatened the health and safety of human beings. The wastewater systems, including toilet and wastewater treatment plant (WWTP), are the major locations of epidemic infections due to the extensive sources of aerosols, as well as multifarious germs and microorganisms. Viruses and microorganisms may transport from both toilet and hospital into municipal pipes and subsequently into WWTP, which accounts for the main source of bioaerosols dispersed in the air of the wastewater system. This review aims to elaborate the generation, transmission, and diffusion processes of bioaerosols at toilet and WWTP. Moreover, the main factors affecting bioaerosol transmission and the corresponding prevention strategies for the airborne and inhaled bioaerosols are also discussed. Collectively, this review highlights the importance of managing bioaerosol occurrence in the wastewater system, which has aroused increasing concern from the public.

Study of the generation and diffusion of bioaerosol under two aeration conditions

Given that studies on actual sewage treatment plants are often affected by environmental conditions, it is challenging to clearly understand the associated bioaerosol generation and diffusion characteristics during the aeration process. Therefore, to enhance understanding in this regard, in this study, bioaerosol generator was used to simulate bioaerosol generation and diffusion under two aeration modes, i.e., bubble bottom aeration and brush surface aeration. The total concentration range of culturable bacteria in the bioaerosol produced by bubble bottom aeration and that produced by brush surface aeration were 300-3000 CFU/m³. Under bubble bottom aeration, the generated bioaerosol was symmetrically distributed around the source point, whereas under brush surface aeration, it was primarily distributed in the forward direction of the rotating brush surface. These bioaerosols from bubble bottom aeration predominantly consisted of particles with sizes below 3.3 μm, particularly those with sizes in the range 1.1-2.1 μm. On the contrary, the bioaerosols produced via brush surface aeration predominantly consisted of particles with sizes above 3.3 μm. The distribution characteristics of population structure in the two aeration modes were consistent with the distribution characteristics of concentration in the corresponding models. Additionally, the results showed that when the aeration process is unaffected by environmental conditions (particle matters, wind direct, wind speed, etc.), the bioaerosol components originate primarily from the parent sewage or sludge, and do not diffuse far from the source point. Therefore, source reduction (capping or sealing) can be recommended as the primary control strategy for bioaerosols in sewage treatment plants. The adoption of such measures will significantly limit the diffusion of bioaerosols, thereby reducing the potential risks associated with human exposure.

Wastewater treatment plant workers' exposure and methods for risk evaluation of their exposure

Work in wastewater treatment plants (WWTPs) can be associated with respiratory symptoms and diarrhea. The aim of this study was to obtain knowledge about WWTP workers' exposure to airborne bacteria and endotoxin, and the inflammatory potential (TIP) of their exposure, and to evaluate the risk posed by the exposure by 1) calculating a hazard index and relating the exposure to suggested occupational exposure limits (OELs), 2) estimating the potential deposition of bacteria in the airways, 3) relating it to the risk group classification of bacteria by the European Union, and 4) estimating the TIP of the personal exposure. A cohort of 14 workers were followed over one year. Bioaerosols were collected using personal and stationary samplers in a grid chamber house and an aeration tank area. Airborne bacteria were identified using (MALDI-TOF MS), and TIP of exposure was measured using HL-60 cells. A significant effect of season, work task, and person was found on the personal exposure. A hazard index based on exposure levels indicates that the risk caused by inhalation is low. In relation to suggested OELs, 14% and 34% of the personal exposure were exceeded for endotoxin (≥50 EU/m³) and bacteria (≥500 CFU/m³). At least 70% of the airborne bacteria in the grid chamber house and the aeration tank area could potentially deposit in the lower respiratory tract. From the personal samples, three of 131 bacterial species, Enterobacter cloacae, Staphylococcus aureus, and Yersinia enterocolitica are classified within Risk Group 2. Seven additional bacteria from the stationary samples belong to Risk Group 2. The bacterial species composition was affected significantly by season (p = 0.014) and by sampling type/area (p = 0.001). The TIP of WWTP workers' exposure was higher than of a reference sample, and the highest TIP was measured in autumn. TIP of personal exposure correlated with bacterial exposure. Based on the geometric average exposures to endotoxin (9.2 EU/m³) and bacteria (299 CFU/m³) and based on the calculated hazard index, the risk associated with exposure is low. However, since 43 of 106 exposure levels exceed suggested OELs, the TIP of exposure was elevated and associated with bacterial exposure, and WWTP workers were exposed to pathogenic bacteria, a continued focus on preventive measures is important. The identification of bacteria to species level in personal samples was necessary in the risk assessment, and measurement of the microbial composition made the source tracking possible.

Spatio-temporal variations of airborne bacteria from the municipal wastewater treatment plant: a case study in Ahvaz, Iran

The study of bioaerosol dispersion in wastewater treatment plants (WWTPs) has received considerable attention. This study aimed to investigate the seasonal changes and spatial distributions of airborne bacteria around different parts of Ahvaz WWTP, the capital city of Khuzestan Province, Iran, over 4 months in the cold and warm seasons. Samples were collected from 2 and 10-m intervals of grit chamber (GCh), primary sludge dewatering basin (PSDB), aeration tank (AT), as well as 60-m upstream (US) and downstream (DS) of the WWTP. Further, bacteria in the indoor air of administrative building (AB) of WWTP were investigated. Bioaerosols were collected by passive sampling method. The total bacteria count was 105.3 ± 98.5 CFU/plate/h. The dominant bacteria stood 2 m away from the AT with an average 244.2 ± 73.1 CFU/plate/h in the warm season while they were the lowest with an average 43 ± 11.4 CFU/plate/h in the 10-m distance of the GCh in the cold season. According to the sequencing results, the dominant bacterial species included Bacillus pumilus (26.7%), Staphylococcus arlettae (23.2%), Kocuria turfanensis (13.6%) and Alicycliphilus (9.2%), respectively. There was a positive relationship between the release of bacteria, temperature and wind speed. However, there was a significant negative correlation between total bacteria concentration and humidity. There are accumulative perils to WWTP workers and neighbors exposed by persistent exposure to airborne bacteria. Therefore, AT should be paid more attention as a dominant source of airborne bacteria emissions, especially in the warm season.

Strategies for managing N95 mask shortages at water resource recovery facilities during pandemics: a review

As the numbers of COVID-19 cases grew globally, the severe shortages of health care respiratory protective equipment impacted the ability of water resource recovery facilities (WRRFs) to acquire N95 masks for worker protection. While the Occupational Safety and Health Administration (OSHA) encourages WRRFs to conduct job safety assessments to mitigate risks from bioaerosols, it does not provide clear guidance on respiratory protection requirements, leaving the use of N95 masks across the industry non-standardized and difficult to justify. Strategies need to be developed to cope with shortages during pandemics, and these should take into consideration a WRRF's size and disinfection equipment available. Our objective is to provide an overview of respiratory protection-related practices recommended for health care professionals that apply to WRRFs (e.g., elimination, substitution, extended use, reuse, disinfection). Reviewed N95 mask disinfection strategies included using hydrogen peroxide, autoclaving, moist heat, dry heat, ultraviolet germicidal irradiation (UVGI), ethylene oxide, chlorine and ethanol. Of these, dry heat, autoclaving and UVGI present the most promise for WRRFs, with UVGI being limited to larger utilities. We recommend that WRRFs work closely with disinfection technology manufacturers, mask providers, health and safety staff and inspectors to develop suitable programs to cope with N95 mask shortages during pandemics.

Microbial emission levels and diversities from different land use types

Bioaerosol particles, originated from many different earth ground sources, have unique health impacts, including respiratory infections, allergic reactions, and toxic effects. Here, we applied a portable high-flow sampler HighBioTrap to collect and investigate bioaerosol emissions from 13 different land types (forest, wetland, lake, bare soil, cropland, wastewater treatment facility, street, livestock farm, smeltery and garden) that are heavily or less affected by humans. Plate cultivation, real-time quantitative PCR analysis (q-PCR) and high-throughput gene sequencing analysis were used to characterize bacterial and fungal levels as well as their community structures emitted from different land use types. Results showed that there were statistically significant differences in biological emission levels (up to 100-fold difference) and diversity among different land use types. Cropland, sewage plant street and smeltery heavily affected by human activities were found to exhibit higher bioaerosol emission levels, with Massilia genus detected as the dominant species. In contrast, some land types (lakes, forests, gardens, and wetland) less affected by humans were found to emit lower bioaerosol levels but with higher culturability, e.g., up to 16% for wetland. In addition, the microbiological structures of these land-use types usually had higher species richness and diversity, yet different dominant species. For some land types such as streets in Beijing, the microbial community appeared to be skewed with an over 80% relative abundance of a specific dominant species such as Massilia. Other detected dominant species also included Acinetobacter and Brevundimonas for street, and Sphingomonas for wetland. For fungal community, Naganishia, Alternaria, Penicillium, and Aureobasidium were detected to be most abundant. RDA analysis showed metals and ions could to some extent affect the microbial community structures. This work highlights that the human activities could substantially affect the airborne microbiota, which in turn could affect local human health and ecosystems. On the other hand, the results here provide important references for quantitatively estimating the microbial emissions from the earth into the atmosphere.

Bioaerosol in a typical municipal wastewater treatment plant: concentration, size distribution, and health risk assessment

An investigation on bioaerosol in a wastewater treatment plant (WWTP) located in Xi'an, China, was conducted to understand the characteristics of bioaerosol released from wastewater and sludge treatment facilities because the bioaerosols may pose a threat to human health. Using the Andersen impactor sampler collection and colony-counting method, bioaerosol concentrations and size distributions were detected. The risk quotient method was used to evaluate the health risks associated with inhalation of bioaerosol for WWTP staff, based on the average daily dose rates of exposure. The health risk in relation to Legionella pneumophila was quantitatively calculated using quantitative microbial risk assessment (QMRA), based on the assumption of the percentage. The maximum concentration of airborne bacteria (3,767 ± 280 colony forming units (CFU)/m³) and fungi (8,775 ± 406 CFU/m³) occurred from the aerated grit chamber and sludge thickening house, respectively, which all exceeded 500 CFU/m³ as the acceptable guideline proposed by the American Conference of Governmental Industrial Hygienists. The particle size of airborne bacteria was mainly distributed in the first three stages (>3.3 µm), while that of airborne fungi was from the second to the fourth stage (2.1-7.0 µm). The hazard index exposure to bioaerosol for adult males and females by inhalation were higher than 1. The proportion of L. pneumophila should be strictly controlled below 10^-8, based on the QMRA approach.

Linking aerosol characteristics of size distributions, core potential pathogens and toxic metal(loid)s to wastewater treatment process

Wastewater treatment plants (WWTPs) play important roles in water purification but are also important source of aerosols. However, the relationship between aerosol characteristics and wastewater treatment process remains poorly understood. In this study, aerosols were collected over a 24-month period from a WWTP using a modified anaerobic-anoxic-oxic process. The aerated tank (AerT) was characterized by the highest respiratory fraction (RF) concentrations (861-1525 CFU/m³) and proportions (50.76%-65.96%) of aerosol particles. Fourteen core potential pathogens and 15 toxic metal(loid)s were identified in aerosols. Mycobacterium was the genus that aerosolized most easily in fine grid, pre-anoxic tank, and AerT. High wastewater treatment efficiency may increase the emission of RF and core potential pathogens. The median size of activated sludge, richness of core potential pathogens in wastewater, and total suspended particulates were the most influential factors directly related to the RF proportions, core community of potential pathogens, and composition of toxic metal(loid)s in WWTP aerosols, respectively. Relative humidity, temperature, input and removal of biochemical oxygen demand, dissolved oxygen, and mixed liquor suspended solids could also directly or indirectly affect the aerosol characteristics. This study enhances the mechanistic understanding of linking aerosol characteristics to treatment processes and has important implications for targeted manipulation.

The Optimization of Methods for the Collection of Aerosolized Murine Norovirus

Globally, norovirus is the most common gastroenteritis causing pathogen. Annually, norovirus causes 685 million cases of acute gastroenteritis and 200,000 deaths, worldwide. Recent evidence has suggested that norovirus can also be spread via aerosolization; however, an indoor generation source has yet to be determined. We optimized a sampling method for the collection of aerosolized norovirus using murine norovirus (MNV) as a surrogate. Optimization of the sampling method was performed using two bioaerosol samplers (SKC BioSampler and the NIOSH Bioaerosol Cyclone Sampler 251) and two sampling media (Hanks Balanced Salt Solution [HBSS] and Phosphate Buffered Saline [PBS]). Murine norovirus was aerosolized in a bioaerosol chamber and later collected using each sampler/media combination. Collected MNV was quantified using quantitative polymerase chain reaction (qPCR). Intact capsids of MNV were assessed using propidium monoazide dye in combination with qPCR and confirmed with transmission electron microscopy. Ten trials were conducted, with each trial lasting for 30 min. The SKC BioSampler collected a significantly higher concentration of MNV than the NIOSH-251 sampler did (p-value < 0.0001). However, there were no significant differences in the relative percent of MNV that remained viable between both samplers (p-value = 0.2215). The use of HBSS sampling media yielded a higher concentration of MNV than PBS media (p-value = 0.0125). However, PBS media maintained viability at a significantly higher percentage than HBSS media (p-value < 0.0001). The results support the optimization of a sampling method for the collection of aerosolized MNV and possibly norovirus in different sampling environments.

Contribution of hospitals to the occurrence of enteric protists in urban wastewater

We assessed the potential contribution of hospitals to contaminations of wastewater by enteric protists, including Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in raw wastewater. Wastewater samples were collected from storage tanks in two hospitals and one associated wastewater treatment plant in Shanghai, China, from March to November 2009. Enteric pathogens were detected and identified using PCR and DNA sequencing techniques. Among a total of 164 samples analyzed, 31 (18.9%), 45 (27.4%), and 122 (74.4%) were positive for Cryptosporidium spp., G. duodenalis, and E. bieneusi, respectively. Altogether, three Cryptosporidium species, four G. duodenalis assemblages, and 12 E. bieneusi genotypes were detected. Cryptosporidium hominis, G. duodenalis sub-assemblage AII, and E. bieneusi genotype D were the dominant ones in wastewater from both hospitals and the wastewater treatment plant. A similar distribution in genotypes of enteric pathogens was seen between samples from hospitals and the wastewater treatment plant, suggesting that humans are one of the major sources for these pathogens and hospitals are important contributors of enteric parasites in urban wastewater. Data from this study might be useful in the formulation of preventive measures against environmental contamination of waterborne pathogens.

A short review of bioaerosol emissions from gas bioreactors: Health threats, influencing factors and control technologies

Bioaerosols have widely been a concern due to their potential harm to human health caused by the carrying and spreading of harmful microorganisms. Biofiltration has been generally used as a green and effective technology for processing VOCs. However, bioaerosols can be emitted into the atmosphere as secondary pollutants from the biofiltration process. This review presents an overview of bioaerosol emissions from gas bioreactors. The mechanism of bioaerosols production and the effect of biofiltration on bioaerosol emissions were analyzed. The results showed that the bioaerosol emission concentrations were generally exceeded 10⁴ CFU m^-3, which would damage to human health. Biomass, inlet gas velocity, moisture content, temperature, and some other factors have significant influences on bioaerosol emissions. Moreover, as a result of the analysis done herein, different inactivation technologies and microbial immobilization of bioaerosols were proposed and evaluated as a potential solution for reducing bioaerosols emissions. The purpose of this paper is to make more people realize the importance of controlling the emissions of bioaerosols in the biofiltration process and to make the treatment of VOCs by biotechnology more environmentally friendly. Additionally, the present work intends to increase people's awareness in regards to the control of bioaerosols, including microbial fragment present in bioaerosols.

Potential Respiratory Deposition and Species Composition of Airborne Culturable, Viable, and Non-Viable Fungi during Occupancy in a Pig Farm

Fungal species composition and site of deposition within the airways affects whether diseases develop and where they may arise. The aim of this study is to obtain knowledge regarding the potential deposition of airborne culturable, viable, and non-viable fungi in the airways of pig farm workers, and how this composition changes over multiple sampling days. Airborne fungi were sampled using impactors and subsequently analyzed using amplicon sequencing and matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) fingerprinting. The geometric mean aerodynamic diameter (Dg) of airborne particles with culturable airborne fungi were not affected by sampling days and ranged in size between 3.7 and 4.6 µm. Amplicon sequencing of the internal transcribed spacer region of the rRNA gene operon, in combination with DNA interchelating agents, revealed a large presence of non-viable fungi, but several pathogenic and toxic fungal species were detected in the viable portion. The diversity was found to be significantly associated with the sampling day but did not change significantly over multiple sampling rounds during the same day. The non-viable fraction contained genera typically associated with the pig gastrointestinal tract, such as Kazachstania and Vishniacozyma. In conclusion, the Dg of culturable fungi was between 3.7 and 4.6 µm, and the Dg of the viable and total fungi was 1.5 and 2.1 µm, respectively. The species composition changed over the multiple sampling days.

Characteristics and interactions of bioaerosol microorganisms from wastewater treatment plants

Bacteria and fungi are abundant and ubiquitous in bioaerosols from wastewater treatment plants (WWTPs). However, the specificity and interactions of bioaerosol microorganism, particularly of potential pathogens, from WWTPs are still poorly understood. In this study, we investigated 9 full-scale WWTPs in different areas of China for 3 years, and found microbial variations in bioaerosols to be associated with regions, seasons, and processes. Relative humidity, total suspended particulates, wind speed, temperature, total organic carbon, NH₄⁺, Cl^- and Ca²⁺ were the major factors influencing this variation, and meteorological factors were more strongly associated with the variation than chemical composition. In total, 95 and 22 potential bacterial and fungal pathogens were detected in bioaerosols, respectively. The linear discriminant analysis effect size method suggested that Serratia, Yersinia, Klebsiella, and Bacillus were discriminative genera in bioaerosols on the whole, and were also hub niches in the interactions within potential bacterial pathogens, based on network analysis. Strong co-occurrences such as Serratia-Bacillus and Staphylococcus-Candida, and co-exclusions such as Rhodotorula-Cladosporium and Pseudomonas-Candida, were found within and between potential bacterial and fungal pathogens in bioaerosols from WWTPs. This study furthers understanding of the biology and ecology of bioaerosols from WWTPs, and offers a theoretical basis for determining bioaerosol control.

Size distribution, biological characteristics and emerging contaminants of aerosols emitted from an urban wastewater treatment plant

Air-liquid exchange process could spread pathogens and pharmaceutical emerging pollutants into the air as aerosol particles in an Urban wastewater treatment plants (UWTPs). These particles can later be transported to places where such pollution is unforeseen. In this study, measurements were conducted in the aeration area of a UWTP in northern Taiwan. According to this investigation, nanoparticles are major contributors to both the number and volume concentration of particles. Most fluorescent particles may be bacterial aggregates or fungal species. Moreover, nine common emerging contaminants were analyzed and found in both air and water samples. Among these contaminants, the most abundant chemicals in the air were erythromycin-H₂O (191.45 pg/m³) and methamphetamine (39.02 pg/m³). These results imply that UWTPs could be an emission source of emerging contaminants and bioaerosols, and the potential risk of inhalation exposure should be carefully evaluated.

Effect of aeration mode on aerosol characteristics from the same wastewater treatment plant

Aeration and mechanical agitation are the main drivers of aerosol generation in wastewater treatment plants (WWTPs). However, the effect of aeration mode on aerosol characteristics remains poorly understood. In this study, horizontal rotor aeration and fine bubble aeration in the same WWTP were selected to identify the effect on the emission, size distribution, microbial and chemical composition. For bacteria, fungi, Enterobacteriaceae, Staphylococcus aureus, and Pseudomonas aeruginosa in aerosols, the horizontal rotor aeration had higher contributions to the emissions than the fine bubble aeration. Horizontal rotor aeration generated a more coarse fraction (size > 7 μm) and a comparable respirable fraction (RF; size < 3.3 μm) compared with those of fine bubble aeration. More types of potential pathogens were generated by horizontal rotor aeration. The most easily aerosolized genera generated by horizontal rotor aeration and fine bubble aeration, were Trichosporon and Mycobacterium, with the aerosolization factors of 633.70 and 192.56, respectively. For Cl^-, SO₄^2-, NO₃^-, Zn, Ba, Cd, Sc, V, Rb, Ca, K, Ca, K, Mg, Na and Si in the aerosols, the contributions of fine bubble aeration were higher than those of horizontal rotor aeration. Due to the aerosol specialty from the different aeration modes, targeted manipulations should be employed to reduce the exposure risks.

Hospital wastewater treatment scenario around the globe

Wastewaters generated from hospitals contain pharmaceuticals residues, pathogens, chemical reagents, radionuclide, and other harmful matter. The wastewater characteristics, quantity, and handling methods have not only variations among countries but also within a country. Some hazardous substances of hospital wastewaters (HWWs) may have a regulatory status and should be treated accordingly while others have characteristics similar to that of domestic sewage. At a global level, guidelines do exist for treatment of these HWWs. But literatures have shown that legislation has various loopholes in implementation. This chapter outlines the current status of management and handling of HWWs around the major industrial hubs of worlds in two categories of developed (the United States, United Kingdom, and Europe) and developing (India, China, Iran, and Bangladesh) countries. Various literatures and guidelines of these countries have been referred which mainly highlight different treatment scenarios and status of coverage of HWW management guidelines.

Characteristics of submicron aerosols produced during aeration in wastewater treatment

Submicron aerosols (SAs) emitted during wastewater treatment may harm the human circulation system, respiratory cells, and deep lungs. Despite this threat, SAs remain poorly understood. In this study, a laboratory simulation aerosol generator was manufactured, and the particle number size distributions, aerosol liquid water content (ALWC), and chemical and microbial composition of SAs from aeration were analyzed. Under stable aeration conditions, the unimodal SA size distribution ranged from 68 to 350 nm. The ALWC of peak size (170 nm) was 11-21 μg/m³. Na was the dominant major element in SAs with the concentration of 5.61 μg/m³. Total organic carbon accounted for 97% of the total carbon in the SAs. Arcobacter, Methanobrevibacter, and Fusarium were the dominant SA bacteria, archaea, and fungi, respectively, and a number of viruses were also detected. Thirty-two antibiotic resistant genes, and virulence factors of which 23% were offensive virulence factors, were detected in the SAs. The results predicted that 2% of the genes in SAs were directly related to human health. Thus, SAs may pose disproportionately high risks to human health.