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Zhang Y, Jiang F, Li F, Lu S, Liu Z, Wang Y, Chi Y, Jiang C, Zhang L, Chen Q, He Z, Zhao X, Qiao J, Xu X, Leung KMY, Liu X, Wu F. Global daily mask use estimation in the pandemic and its post environmental health risks: Analysis based on a validated dynamic mathematical model. JOURNAL OF HAZARDOUS MATERIALS 2024; 473:134572. [PMID: 38772106 DOI: 10.1016/j.jhazmat.2024.134572] [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: 01/28/2024] [Revised: 04/30/2024] [Accepted: 05/08/2024] [Indexed: 05/23/2024]
Abstract
The outbreak of the COVID-19 pandemic led to a sharp increase in disposable surgical mask usage. Discarded masks can release microplastic and cause environmental pollution. Since masks have become a daily necessity for protection against virus infections, it is necessary to review the usage and disposal of masks during the pandemic for future management. In this study, we constructed a dynamic model by introducing related parameters to estimate daily mask usage in 214 countries from January 22, 2020 to July 31, 2022. And we validated the accuracy of our model by establishing a dataset based on published survey data. Our results show that the cumulative mask usage has reached 800 billion worldwide, and the microplastics released from discarded masks due to mismanagement account for 3.27% of global marine microplastic emissions in this period. Furthermore, we illustrated the response relationship between mask usage and the infection rates. We found a marginally significant negative correlation existing between the mean daily per capita mask usage and the rate of cumulative confirmed cases within the range of 25% to 50%. This indicates that if the rate reaches the specified threshold, the preventive effect of masks may become evident.
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Affiliation(s)
- Ying Zhang
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Fei Jiang
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Fengmin Li
- College of Environmental Science and Engineering, Ocean University of China, Qingdao 266100, China
| | - Shaoyong Lu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Zihao Liu
- School of information science and engineering, Shandong Normal University, Jinan 250358, China
| | - Yuwen Wang
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Yiming Chi
- College of Environmental Science and Engineering, Ocean University of China, Qingdao 266100, China
| | - Chenchen Jiang
- First Institute of Oceanography, Ministry of Natural Resources, Qingdao 266061, China
| | - Ling Zhang
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Qingfeng Chen
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Zhipeng He
- Shandong Freshwater Fisheries Research Institude, Jinan 250013, China
| | - Xiaoli Zhao
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jianmin Qiao
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Xiaoya Xu
- College of Geography and Environment, Shandong Normal University, Jinan 250358, China
| | - Kenneth Mei Yee Leung
- State Key Laboratory of Marine Pollution and Department of Chemistry, City University of Hong Kong, Hong Kong 999077, China
| | - Xiaohui Liu
- Key Laboratory of Marine Environment and Ecology, Ministry of Education and College of Environmental Science and Engineering, Ocean University of China, Qingdao 266100, China.
| | - Fengchang Wu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
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Greenhalgh T, MacIntyre CR, Baker MG, Bhattacharjee S, Chughtai AA, Fisman D, Kunasekaran M, Kvalsvig A, Lupton D, Oliver M, Tawfiq E, Ungrin M, Vipond J. Masks and respirators for prevention of respiratory infections: a state of the science review. Clin Microbiol Rev 2024; 37:e0012423. [PMID: 38775460 DOI: 10.1128/cmr.00124-23] [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] [Indexed: 06/14/2024] Open
Abstract
SUMMARYThis narrative review and meta-analysis summarizes a broad evidence base on the benefits-and also the practicalities, disbenefits, harms and personal, sociocultural and environmental impacts-of masks and masking. Our synthesis of evidence from over 100 published reviews and selected primary studies, including re-analyzing contested meta-analyses of key clinical trials, produced seven key findings. First, there is strong and consistent evidence for airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other respiratory pathogens. Second, masks are, if correctly and consistently worn, effective in reducing transmission of respiratory diseases and show a dose-response effect. Third, respirators are significantly more effective than medical or cloth masks. Fourth, mask mandates are, overall, effective in reducing community transmission of respiratory pathogens. Fifth, masks are important sociocultural symbols; non-adherence to masking is sometimes linked to political and ideological beliefs and to widely circulated mis- or disinformation. Sixth, while there is much evidence that masks are not generally harmful to the general population, masking may be relatively contraindicated in individuals with certain medical conditions, who may require exemption. Furthermore, certain groups (notably D/deaf people) are disadvantaged when others are masked. Finally, there are risks to the environment from single-use masks and respirators. We propose an agenda for future research, including improved characterization of the situations in which masking should be recommended or mandated; attention to comfort and acceptability; generalized and disability-focused communication support in settings where masks are worn; and development and testing of novel materials and designs for improved filtration, breathability, and environmental impact.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - C Raina MacIntyre
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Michael G Baker
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Shovon Bhattacharjee
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
- School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia
| | - Abrar A Chughtai
- School of Population Health, University of New South Wales, Sydney, Australia
| | - David Fisman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Amanda Kvalsvig
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Deborah Lupton
- Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia
| | - Matt Oliver
- Professional Standards Advocate, Edmonton, Canada
| | - Essa Tawfiq
- Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Ungrin
- Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Joe Vipond
- Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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3
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Lai J, Coleman KK, Tai SHS, German J, Hong F, Albert B, Esparza Y, Rastogi D, Srikakulapu A, Kalliomäki P, Schanz M, Smith AA, Sierra Maldonado I, Oertel M, Fadul N, Gold TL, McPhaul K, Ma T, Cowling BJ, Milton DK. Relative efficacy of masks and respirators as source control for viral aerosol shedding from people infected with SARS-CoV-2: a controlled human exhaled breath aerosol experimental study. EBioMedicine 2024; 104:105157. [PMID: 38821778 PMCID: PMC11245760 DOI: 10.1016/j.ebiom.2024.105157] [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: 12/11/2023] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Tight-fitting masks and respirators, in manikin studies, improved aerosol source control compared to loose-fitting masks. Whether this translates to humans is not known. METHODS We compared efficacy of masks (cloth and surgical) and respirators (KN95 and N95) as source control for SARS-CoV-2 viral load in exhaled breath of volunteers with COVID-19 using a controlled human experimental study. Volunteers (N = 44, 43% female) provided paired unmasked and masked breath samples allowing computation of source-control factors. FINDINGS All masks and respirators significantly reduced exhaled viral load, without fit tests or training. A duckbill N95 reduced exhaled viral load by 98% (95% CI: 97%-99%), and significantly outperformed a KN95 (p < 0.001) as well as cloth and surgical masks. Cloth masks outperformed a surgical mask (p = 0.027) and the tested KN95 (p = 0.014). INTERPRETATION These results suggest that N95 respirators could be the standard of care in nursing homes and healthcare settings when respiratory viral infections are prevalent in the community and healthcare-associated transmission risk is elevated. FUNDING Defense Advanced Research Projects Agency, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation, and The Flu Lab.
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Affiliation(s)
- Jianyu Lai
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Kristen K Coleman
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - S-H Sheldon Tai
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Jennifer German
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Filbert Hong
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Barbara Albert
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Yi Esparza
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Dewansh Rastogi
- Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, MD, USA
| | - Aditya Srikakulapu
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Petri Kalliomäki
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Maria Schanz
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Alycia A Smith
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Isabel Sierra Maldonado
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Molly Oertel
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Naja Fadul
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - T Louie Gold
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Kathleen McPhaul
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA
| | - Tianzhou Ma
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA
| | - Benjamin J Cowling
- World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Donald K Milton
- Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA.
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4
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Gilham EL, Raja AI, van Veldhoven K, Nicholls G, Sandys V, Atkinson B, Spencer A, Nicholls I, Cooke J, Bennett A, Morgan D, Keen C, Fletcher T, Pearce N, Manley P, Brickley EB, Chen Y. A SARS-CoV-2 outbreak in a public order and safety training facility in England, June 2021. Ann Work Expo Health 2024:wxae038. [PMID: 38785326 DOI: 10.1093/annweh/wxae038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The public order and safety (POS) sector remains susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks, as workplace attendance is typically compulsory and close physical contact is often needed. Here, we report on a SARS-CoV-2 outbreak with an attack rate of 39% (9/23), which occurred between 19 and 29 June 2021 among a cohort of new POS recruits participating in a mandatory 18-week training programme in England. METHODS The COVID-OUT (COVID-19 Outbreak investigation to Understand Transmission) study team undertook a multidisciplinary outbreak investigation, including viral surface sampling, workplace environmental assessment, participant viral and antibody testing, and questionnaires, at the two associated training facilities between 5 July and 24 August 2021. RESULTS Environmental factors, such as ventilation, were deemed inadequate in some areas of the workplace, with carbon dioxide (CO2) levels exceeding 1,500 ppm on multiple occasions within naturally ventilated classrooms. Activities during safety training required close contact, with some necessitating physical contact, physical exertion, and shouting. Furthermore, most participants reported having physical contact with colleagues (67%) and more than one close work contact daily (97%). CONCLUSIONS Our investigation suggests that site- and activity-specific factors likely contributed to the transmission risks within the POS trainee cohort. Potential interventions for mitigating SARS-CoV-2 transmission in this POS training context could include implementing regular rapid lateral flow testing, optimizing natural ventilation, using portable air cleaning devices in classrooms, and expanding use of well-fitted FFP2/FFP3 respirators during activities where prolonged close physical contact is required.
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Affiliation(s)
- Ellie L Gilham
- Rapid Investigation Team, Field Services, UK Health Security Agency, Wellington House, Waterloo Road, London, United Kingdom
| | - Amber I Raja
- Health Equity Action Lab, Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom
| | - Karin van Veldhoven
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom
| | - Gillian Nicholls
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
| | - Vince Sandys
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
| | - Barry Atkinson
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Antony Spencer
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Ian Nicholls
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Joan Cooke
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
| | - Allan Bennett
- Research and Evaluation, UK Health Security Agency, Porton Down, Salisbury, United Kingdom
| | - Derek Morgan
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
| | - Chris Keen
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
| | - Tony Fletcher
- Chemical and Environmental Effects Department, UK Health Security Agency, Harwell Campus, Chilton, United Kingdom
| | - Neil Pearce
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom
| | - Petra Manley
- Rapid Investigation Team, Field Services, UK Health Security Agency, Wellington House, Waterloo Road, London, United Kingdom
| | - Elizabeth B Brickley
- Health Equity Action Lab, Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, United Kingdom
| | - Yiqun Chen
- Science Division, Health and Safety Executive, Harpur Hill, Buxton, United Kingdom
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5
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Puglia M, Ottani F, Morselli N, Pedrazzi S, Allesina G, Muscio A, Cossarizza A, Tartarini P. Airborne pathogens diffusion: A comparison between tracer gas and pigmented aerosols for indoor environment analysis. Heliyon 2024; 10:e26076. [PMID: 38404762 PMCID: PMC10884858 DOI: 10.1016/j.heliyon.2024.e26076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024] Open
Abstract
The evaluation of airborne pathogens diffusion is a crucial practice in preventing airborne diseases like COVID-19, especially in indoor environments. Through this transmission route, pathogens can be carried by droplets, droplet nuclei and aerosols and be conveyed over long distances. Therefore, understanding their diffusion is vital for prevention and curbing disease transmission. There are different techniques used for this purpose, and one of the most common is the utilization of tracer gas, however, it has limitations such as the difference in size between the gas molecules and the respiratory droplets, as well as its incapability to take into account evaporation. For this reason, a new method for evaluating the diffusion of respiratory droplets has been developed. This approach involves the use of an ultrasonic emitter to release and disperse pigmented aerosols, and a colorimeter for the following quantitative evaluation. A comparison with the tracer gas technique has been carried out, showing for the pigmented aerosols methodology a response that is dependent on different relative humidity conditions, while there is no clear difference in the dispersion of tracer gas at high or low humidity.
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Affiliation(s)
- Marco Puglia
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Filippo Ottani
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Nicolo’ Morselli
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Simone Pedrazzi
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Giulio Allesina
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Alberto Muscio
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
| | - Andrea Cossarizza
- Università di Modena e Reggio Emilia, Dipartimento di Scienze Mediche e Chirurgiche Materno Infantili e dell'Adulto, Via del Pozzo, 71, 41124, Modena, Italy
| | - Paolo Tartarini
- Università di Modena e Reggio Emilia, Dipartimento di Ingegneria “Enzo Ferrari”, Via Pietro Vivarelli, 10-41125, Modena, Italy
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Echternach M, Ava Hermann L, Gantner S, Tur B, Peters G, Westphalen C, Benthaus T, Köberlein M, Kuranova L, Döllinger M, Kniesburges S. The Effect of Singers' Masks on the Impulse Dispersion of Aerosols During Singing. J Voice 2024; 38:247.e1-247.e10. [PMID: 34610881 DOI: 10.1016/j.jvoice.2021.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND During the Covid-19 pandemic, singing activities were restricted due to several super-spreading events that have been observed during rehearsals and vocal performances. However, it has not been clarified how the aerosol dispersion, which has been assumed to be the leading transmission factor, could be reduced by masks which are specially designed for singers. MATERIAL AND METHODS Twelve professional singers (10 of the Bavarian Radio-Chorus and two freelancers, seven females and five males) were asked to sing the melody of the ode of joy of Beethoven's 9th symphony "Freude schöner Götterfunken, Tochter aus Elisium" in D-major without masks and afterwards with five different singers' masks, all distinctive in their material and proportions. Every task was conducted after inhaling the basic liquid from an e-cigarette. The aerosol dispersion was recorded by three high-definition video cameras during and after the task. The cloud was segmented and the dispersion was analyzed for all three spatial dimensions. Further, the subjects were asked to rate the practicability of wearing the tested masks during singing activities using a questionnaire. RESULTS Concerning the median distances of dispersion, all masks were able to decrease the impulse dispersion of the aerosols to the front. In contrast, the dispersion to the sides and to the top was increased. The evaluation revealed that most of the subjects would reject performing a concert with any of the masks. CONCLUSION Although, the results exhibit that the tested masks could be able to reduce the radius of aerosol expulsion for virus-laden aerosol particles, there are more improvements necessary to enable the practical implementations for professional singing.
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Affiliation(s)
- Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany.
| | - Laila Ava Hermann
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany
| | - Sophia Gantner
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany
| | - Bogac Tur
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Gregor Peters
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Caroline Westphalen
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany
| | - Tobias Benthaus
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany
| | - Marie Köberlein
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany
| | - Liudmila Kuranova
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, University Hospital, LMU Munich, Germany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stefan Kniesburges
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
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7
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Higashi H, Oyabu T, Nagano C, Kitamura H, Kawanami S, Saito M, Horie S. Measuring the effects of respiratory protective equipment and other protectors in preventing the scattering of vocalization droplets. INDUSTRIAL HEALTH 2023; 61:432-445. [PMID: 36631085 PMCID: PMC10731419 DOI: 10.2486/indhealth.2022-0180] [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: 10/08/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
This study was conducted to quantitatively examine the effects of respiratory protective equipment (respirators) and various other types of protectors in preventing the scattering of vocalization droplets. Each of 12 adult male volunteers was asked to vocalize intermittently for 1 min at a target intensity of approximately 100 dBA in an experimental room adjusted to a humidity of approximately 60-70%. The subjects vocalized while wearing respirators, other types of protectors, or no protectors at all. The droplet concentration in a particle size range of 0.3 to 10 μm was measured under each experimental condition, and the transmitted particle concentration and penetration were calculated. The concentration and penetration of particles transmitted from the respirators were lower than those transmitted from the other protectors examined. The probability of infection reduction through the use of the protectors was estimated from the data obtained on the effectiveness of the protectors in preventing the scattering of droplets. We concluded that there is no need for additional droplet scattering prevention in various work settings when appropriate respirators are used under optimal conditions.
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Affiliation(s)
- Hidenori Higashi
- Department of Environmental Health Engineering, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Takako Oyabu
- Department of Environmental Health Engineering, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Chikage Nagano
- Department of Health Policy and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
| | - Hiroko Kitamura
- Occupational Health Training Center, University of Occupational and Environmental Health, Japan
| | - Shoko Kawanami
- Occupational Health Training Center, University of Occupational and Environmental Health, Japan
| | - Mitsumasa Saito
- Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Seichi Horie
- Department of Health Policy and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
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8
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Grestyák Molnárné AK, Nagy M, Barabás Á, Nagy AC, Takács P, Sántha Á, Konečná M, Sedlák V, Babejová A, Mydlárová Blaščáková M, Poráčová J, Erdei Jávorné R. Self-rated health status and hygienic behaviour of pregnant women in Hungary during the pandemic. Cent Eur J Public Health 2023; 31:S40-S47. [PMID: 38272477 DOI: 10.21101/cejph.a7897] [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: 05/25/2023] [Accepted: 10/15/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The aim of our research was to investigate the self-rated health status, health behaviour and hygiene habits of pregnant women, and to explore the influencing factors during the pandemic. METHODS The sample included 1,200 pregnant women who gave birth in the most progressive institutions of the three examined counties in Hungary; 839 questionnaires were returned, based on which the willingness to answer can be said to be 69.9%. After data cleaning, 640 questionnaires were added to the database. Descriptive statistical analyses and correlation tests were performed, during which we used the Pearson's chi-square test and Fisher's exact test. RESULTS Socio-demographic factors show a significant correlation with the perceived state of health and the degree of responsibility for health, however, the existence of a chronic disease does not affect either the self-assessed state of health or hygienic behaviour. Factors influencing hygienic behaviour include residence, education, assessed income, and gestational age. We found no correlation between health status and hygienic attitude. CONCLUSIONS Our results draw attention to the fact that among pregnant women - especially pregnant women with low socioeconomic status - education about hygiene habits is of particular importance. Teamwork is needed in this area, which should start during the period of preparation for pregnancy, but at the latest in the early stages of pregnancy.
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Affiliation(s)
| | - Melinda Nagy
- Department of Biology, Faculty of Education, J. Selye University, Komarno, Slovak Republic
| | - Ágota Barabás
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, Nyiregyhaza, Hungary
| | - Attila Csaba Nagy
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Péter Takács
- Department of Health Informatics, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Ágnes Sántha
- Department of Applied Social Sciences, Faculty of Technical and Human Sciences, Sapientia Hungarian University of Transylvania, Targu Mures, Romania
| | - Mária Konečná
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Vincent Sedlák
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Andrea Babejová
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Marta Mydlárová Blaščáková
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Janka Poráčová
- Department of Biology, Faculty of Humanities and Natural Sciences, University of Presov, Presov, Slovak Republic
| | - Renáta Erdei Jávorné
- Department of Health Methodology and Prevention, Faculty of Health Sciences, University of Debrecen, Nyiregyhaza, Hungary
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Tangpaisarn T, Chaiyakot N, Saenpan K, Sriphrom S, Owattanapanich N, Kotruchin P, Phungoen P. Surgical mask-to-mouth ventilation as an alternative ventilation technique during CPR: A crossover randomized controlled trial. Am J Emerg Med 2023; 72:158-163. [PMID: 37536087 DOI: 10.1016/j.ajem.2023.07.046] [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: 03/19/2023] [Revised: 06/07/2023] [Accepted: 07/23/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION Chest compression with rescue breathing improves outcomes in cardiac arrest. However, the efficacy of rescue breathing through surgical masks has not been investigated. OBJECTIVE We aimed to compare the tidal volume generated by mouth-to-mouth ventilation (MMV) with that generated by surgical mask-to-mouth ventilation (SMV), mouth-to-surgical mask ventilation (MSV), and surgical mask-to-surgical mask ventilation (SSV) in a manikin. METHODS A crossover randomized controlled trial was conducted in 42 medical personnel volunteers randomly assigned to perform four ventilation techniques: MMV (no protective equipment), SMV (participant wearing a mask), MSV (manikin wearing a mask), and SSV, (both participant and manikin wearing a mask). The average tidal volume and the proportion of adequate ventilation, evaluated using a manikin, were compared across different ventilation methods. RESULTS The average tidal volume of MMV (828 ± 278 ml) was significantly higher than those of the MSV (648 ± 250 ml, P < 0.001) and SSV (466 ± 301 ml, P < 0.001), but not SMV (744 ± 288 ml, P = 0.054). Adequate ventilation was achieved in 144/168 (85.7%) cases in the MMV group, a proportion significantly higher than in the SMV (77.4%, P = 0.02), MSV (66.7%, P < 0.001) and SSV (39.3%, P < 0.001) groups. The willingness to perform SMV was higher than that to perform MMV. CONCLUSIONS MMV resulted in a superior average tidal volume when compared to both MSV and SSV. However, SMV achieved a comparable average tidal volume to MMV.
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Affiliation(s)
- Thanat Tangpaisarn
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Narubet Chaiyakot
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Konglar Saenpan
- CPR training unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Sumana Sriphrom
- CPR training unit, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Natthida Owattanapanich
- Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Praew Kotruchin
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
| | - Pariwat Phungoen
- Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
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10
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Le Sage V, Lowen AC, Lakdawala SS. Block the Spread: Barriers to Transmission of Influenza Viruses. Annu Rev Virol 2023; 10:347-370. [PMID: 37308086 DOI: 10.1146/annurev-virology-111821-115447] [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] [Indexed: 06/14/2023]
Abstract
Respiratory viruses, such as influenza viruses, cause significant morbidity and mortality worldwide through seasonal epidemics and sporadic pandemics. Influenza viruses transmit through multiple modes including contact (either direct or through a contaminated surface) and inhalation of expelled aerosols. Successful human to human transmission requires an infected donor who expels virus into the environment, a susceptible recipient, and persistence of the expelled virus within the environment. The relative efficiency of each mode can be altered by viral features, environmental parameters, donor and recipient host characteristics, and viral persistence. Interventions to mitigate transmission of influenza viruses can target any of these factors. In this review, we discuss many aspects of influenza virus transmission, including the systems to study it, as well as the impact of natural barriers and various nonpharmaceutical and pharmaceutical interventions.
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Affiliation(s)
- Valerie Le Sage
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Anice C Lowen
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA;
| | - Seema S Lakdawala
- Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA;
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11
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Potisk T, Remškar M, Pirker L, Filipič G, Mihelič I, Ješelnik M, Čoko U, Ravnik M. Single-Layer and Double-Layer Filtration Materials Based on Polyvinylidene Fluoride-Co-hexafluoropropylene Nanofibers Coated on Melamine Microfibers. ACS APPLIED NANO MATERIALS 2023; 6:15807-15819. [PMID: 37706065 PMCID: PMC10496027 DOI: 10.1021/acsanm.3c02592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 09/15/2023]
Abstract
In this work, we demonstrate selected optimization changes in the simple design of filtration masks to increase particle removal efficiency (PRE) and filter quality factor by combining experiments and numerical modeling. In particular, we focus on single-layer filters fabricated from uniform thickness fibers and double-layer filters consisting of a layer of highly permeable thick fibers as a support and a thin layer of filtering electrospun nanofibers. For single-layer filters, we demonstrate performance improvement in terms of the quality factor by optimizing the geometry of the composition. We show significantly better PRE performance for filters composed of micrometer-sized fibers covered by a thin layer of electrospun nanofibers. This work is motivated and carried out in collaboration with a targeted industrial development of selected melamine-based filter nano- and micromaterials.
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Affiliation(s)
- Tilen Potisk
- Laboratory
for Molecular Modeling, National Institute
of Chemistry, SI-1001 Ljubljana, Slovenia
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
| | - Maja Remškar
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
| | - Luka Pirker
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
- J. Heyrovsky
Institute of Physical Chemistry, Czech Academy
of Sciences, 182 23 Prague 8, Czech Republic
| | | | | | | | - Urban Čoko
- Laboratory
for Molecular Modeling, National Institute
of Chemistry, SI-1001 Ljubljana, Slovenia
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
| | - Miha Ravnik
- Faculty
of Mathematics and Physics, University of
Ljubljana, SI-1001 Ljubljana, Slovenia
- Jožef
Stefan Institute, SI-1000 Ljubljana, Slovenia
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12
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Kim HS, Lee H, Kang S, Kim WJ, Shin S. Diagnostic performance of respirators for collection and detection of SARS-CoV-2. Sci Rep 2023; 13:13277. [PMID: 37582958 PMCID: PMC10427661 DOI: 10.1038/s41598-023-39789-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: 04/04/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023] Open
Abstract
Respirators, called as face mask, have been used to protect the wearer from the outside harmful air environment and prevent any virus from being released to neighbors from potentially infected exhaled breath. The antiviral effectiveness of respirators has not only been researched scientifically, but has also become a global issue due to society's obligation to wear respirators. In this paper, we report the results of a study on the collection and detection of viruses contained in exhaled breath using respirators. The inner electrostatic filter was carefully selected for virus collection because it does not come in direct contact with either human skin or the external environment. In the study of a healthy control group, it was confirmed that a large amount of DNA and biomolecules such as exosomes were collected from the respirator exposed to exhalation, and the amount of collection increased in proportion to the wearing time. We conducted experiments using a total of 72 paired samples with nasopharyngeal swabs and respirator samples. Out of these samples, fifty tested positive for SARS-CoV-2 and twenty-two tested negative. The PCR results of the NPS and respirator samples showed a high level of agreement, with a positive percent agreement of ≥ 90% and a negative percent agreement of ≥ 99%. Furthermore, there was a notable level of concordance between RCA-flow tests and PCR when examining the respirator samples. These results suggest that this is a non-invasive, quick and easy method of collecting samples from subjects using a respirator, which can significantly reduce the hassle of waiting at airports or public places and concerns about cross-contamination. Furthermore, we expect miniaturized technologies to integrate PCR detection into respirators in the near future.
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Affiliation(s)
- Hwang-Soo Kim
- Department of Micro-nano System Engineering, Korea University, Seoul, 02841, Republic of Korea
| | - Hansol Lee
- Asia Pacific Influenza Institute, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Seonghui Kang
- Division of Infectious Diseases, Department of Internal Medicine, Konyang University Hospital, Daejeon, 35365, Republic of Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, 08308, Republic of Korea.
| | - Sehyun Shin
- Department of Micro-nano System Engineering, Korea University, Seoul, 02841, Republic of Korea.
- School of Mechanical Engineering, Korea University, Seoul, 02841, Republic of Korea.
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13
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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [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: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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14
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Wang S, Han C, Sang Z, Zhang X, Chen S, Wang H, Wang G, Xu Y, Lei X, Chen J. Hidden faces, altered perceptions: the impact of face masks on interpersonal perception. Front Psychol 2023; 14:1203442. [PMID: 37416539 PMCID: PMC10321351 DOI: 10.3389/fpsyg.2023.1203442] [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: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
The pandemic has made wearing masks commonplace, prompting researchers to investigate their effects on interpersonal perception. Findings indicate masks obstruct face identification and expression recognition, with lower face cues being most affected. When judging attractiveness, masks can enhance the appeal of less attractive faces, but reduce the appeal of more attractive faces. Trust and speech perception outcomes are inconclusive. Future studies could focus on individual differences in how masks influence our perception of others.
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Affiliation(s)
- Shuai Wang
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Chengyang Han
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
- Zhejiang Philosophy and Social Science Laboratory for Research in Early Development and Childcare, Hangzhou Normal University, Hangzhou, China
| | - Zihan Sang
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Xuhui Zhang
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Shitao Chen
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Haoran Wang
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Gang Wang
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Yiqian Xu
- Department of Psychology, College of Education, Hangzhou Normal University, Hangzhou, China
| | - Xue Lei
- School of Business Administration, Zhejiang University of Finance and Economics, Hangzhou, China
| | - Jixu Chen
- Chinese Education Modernization Research Institute of Hangzhou Normal University (Zhejiang Provincial Key Think Tank), Hangzhou, China
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15
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Kaul V, Chahal J, Schrarstzhaupt IN, Geduld H, Shen Y, Cecconi M, Siqueira AM, Markoski MM, Kawano-Dourado L. Lessons Learned from a Global Perspective of Coronavirus Disease-2019. Clin Chest Med 2023; 44:435-449. [PMID: 37085231 PMCID: PMC9684102 DOI: 10.1016/j.ccm.2022.11.020] [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] [Indexed: 11/25/2022]
Abstract
Coronavirus disease-2019 has impacted the world globally. Countries and health care organizations across the globe responded to this unprecedented public health crisis in a varied manner in terms of public health and social measures, vaccination development and rollout, the conduct of research, developments of therapeutics, sharing of information, and in how they continue to deal with the widespread aftermath. This article reviews the various elements of the global response to the pandemic, focusing on the lessons learned and strategies to consider during future pandemics.
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Affiliation(s)
- Viren Kaul
- Department of Pulmonary and Critical Care Medicine, Crouse Health/Upstate Medical University, 736 Irving Avenue, Syracuse, NY, 13210, USA
| | - Japjot Chahal
- Department of Pulmonary and Critical Care Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY, 13210, USA
| | - Isaac N Schrarstzhaupt
- Capixaba Institute of Health Education, Research and Innovation (ICEPi), Rua Duque de Caxias, 267 - Centro, Vitória/ES, 29010-120, Brazil
| | - Heike Geduld
- Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Room 5006 Clinical Building, Stellenbosch University Tygerberg Campus, Cape Town 7505, South Africa
| | - Yinzhong Shen
- Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, 2901 Caolang Road, Jinshan District, Shanghai, 201508, China
| | - Maurizio Cecconi
- Department of Anesthesia and Intensive Care, IRCCS Instituto Clinico Humanitas, Via Manzoni 56, Rozzano (Milano), Italy
| | - Andre M Siqueira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Avenida Brasil 4365, CEP 21040-900, Rio de Janeiro RJ Brazil
| | - Melissa M Markoski
- UFCSPA - Federal University of Health Sciences of Porto Alegre. Sarmento Leite, 245 - Centro Histórico, Porto Alegre - RS, 90050-170, Brazil
| | - Leticia Kawano-Dourado
- Hcor Research Institute, Hospital do Coracao, R. Des Eliseu Guilherme, 200, 8o andar, Sao Paulo, SP 04004-030, Brazil; Pulmonary Division, InCor, University of Sao Paulo.
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16
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Moschovis PP, Lombay J, Rooney J, Schenkel SR, Singh D, Rezaei SJ, Salo N, Gong A, Yonker LM, Shah J, Hayden D, Hibberd PL, Demokritou P, Kinane TB. The effect of activity and face masks on exhaled particles in children. Pediatr Investig 2023; 7:75-85. [PMID: 37324601 PMCID: PMC10262878 DOI: 10.1002/ped4.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/29/2023] [Indexed: 06/17/2023] Open
Abstract
Importance Despite the high burden of respiratory infections among children, the production of exhaled particles during common activities and the efficacy of face masks in children have not been sufficiently studied. Objective To determine the effect of type of activity and mask usage on exhaled particle production in children. Methods Healthy children were asked to perform activities that ranged in intensity (breathing quietly, speaking, singing, coughing, and sneezing) while wearing no mask, a cloth mask, or a surgical mask. The concentration and size of exhaled particles were assessed during each activity. Results Twenty-three children were enrolled in the study. Average exhaled particle concentration increased by intensity of activity, with the lowest particle concentration during tidal breathing (1.285 particles/cm3 [95% CI 0.943, 1.627]) and highest particle concentration during sneezing (5.183 particles/cm3 [95% CI 1.911, 8.455]). High-intensity activities were associated with an increase primarily in the respirable size (≤ 5 µm) particle fraction. Surgical and cloth masks were associated with lower average particle concentration compared to no mask (P = 0.026 for sneezing). Surgical masks outperformed cloth masks across all activities, especially within the respirable size fraction. In a multivariable linear regression model, we observed significant effect modification of activity by age and by mask type. Interpretation Similar to adults, children produce exhaled particles that vary in size and concentration across a range of activities. Production of respirable size fraction particles (≤ 5 µm), the dominant mode of transmission of many respiratory viruses, increases significantly with coughing and sneezing and is most effectively reduced by wearing surgical face masks.
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Affiliation(s)
- Peter P. Moschovis
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jesiel Lombay
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jennifer Rooney
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Sara R. Schenkel
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Dilpreet Singh
- Department of Environmental HealthHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Mechanical and Aerospace EngineeringRutgers University School of Public HealthNew BrunswickNew JerseyUSA
| | - Shawheen J. Rezaei
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Nora Salo
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Amanda Gong
- David Geffen School of Medicinethe University of California Los AngelesLos AngelesCaliforniaUSA
| | - Lael M. Yonker
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Jhill Shah
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Douglas Hayden
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Patricia L. Hibberd
- Department of Global HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Philip Demokritou
- Department of Environmental HealthHarvard T. H. Chan School of Public HealthBostonMassachusettsUSA
- Department of Mechanical and Aerospace EngineeringRutgers University School of Public HealthNew BrunswickNew JerseyUSA
| | - T. Bernard Kinane
- Department of PediatricsMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
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17
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Saccente-Kennedy B, Szczepanska A, Harrison J, Archer J, Watson NA, Orton CM, Costello D, Calder JD, Shah PL, Reid JP, Bzdek BR, Epstein R. Mitigation of Respirable Aerosol Particles from Speech and Language Therapy Exercises. J Voice 2023:S0892-1997(23)00124-8. [PMID: 37248120 DOI: 10.1016/j.jvoice.2023.04.001] [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: 03/16/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Phonation and speech are known sources of respirable aerosol in humans. Voice assessment and treatment manipulate all the subsystems of voice production, and previous work (Saccente-Kennedy et al., 2022) has demonstrated such activities can generate >10 times more aerosol than conversational speech and 30 times more aerosol than breathing. Aspects of voice therapy may therefore be considered aerosol generating procedures and pose a greater risk of potential airborne pathogen (eg, SARS-CoV-2) transmission than typical speech. Effective mitigation measures may be required to ensure safe service delivery for therapist and patient. OBJECTIVE To assess the effectiveness of mitigation measures in reducing detectable respirable aerosol produced by voice assessment/therapy. METHODS We recruited 15 healthy participants (8 cis-males, 7 cis-females), 9 of whom were voice-specialist speech-language pathologists. Optical Particle Sizers (OPS) (Model 3330, TSI) were used to measure the number concentration of respirable aerosol particles (0.3 µm-10 µm) generated during a selection of voice assessment/therapy tasks, both with and without mitigation measures in place. Measurements were performed in a laminar flow operating theatre, with near-zero background aerosol concentration, allowing us to quantify the number concentration of respiratory aerosol particles produced. Mitigation measures included the wearing of Type IIR fluid resistant surgical masks, wrapping the same masks around the end of straws, and the use of heat and moisture exchange microbiological filters (HMEFs) for a water resistance therapy (WRT) task. RESULTS All unmitigated therapy tasks produced more aerosol than unmasked breathing or speaking. Mitigation strategies reduced detectable aerosol from all tasks to a level significantly below, or no different to, that of unmasked breathing. Pooled filtration efficiencies determined that Type IIR surgical masks reduced detectable aerosol by 90%. Surgical masks wrapped around straws reduced detectable aerosol by 96%. HMEF filters were 100% effective in mitigating the aerosol from WRT, the exercise that generated more aerosol than any other task in the unmitigated condition. CONCLUSIONS Voice therapy and assessment causes the release of significant quantities of respirable aerosol. However, simple mitigation strategies can reduce emitted aerosol concentrations to levels comparable to unmasked breathing.
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Affiliation(s)
- Brian Saccente-Kennedy
- Department of Speech and Language Therapy (ENT), Royal National Ear, Nose and Throat and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Alicja Szczepanska
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, United Kingdom
| | - Joshua Harrison
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, United Kingdom
| | - Justice Archer
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, United Kingdom
| | - Natalie A Watson
- Department of Ear, Nose and Throat Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Christopher M Orton
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom; Department of Respiratory Medicine, Chelsea and Westminster Hospital, London, United Kingdom; National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, United Kingdom
| | - Declan Costello
- Ear, Nose and Throat Department, Wexham Park Hospital, United Kingdom
| | - James D Calder
- Department of Bioengineering, Imperial College London, United Kingdom; Fortius Clinic, Fitzhardinge St, London, United Kingdom
| | - Pallav L Shah
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom; Department of Respiratory Medicine, Chelsea and Westminster Hospital, London, United Kingdom; National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, United Kingdom
| | - Jonathan P Reid
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, United Kingdom
| | - Bryan R Bzdek
- School of Chemistry, University of Bristol, Cantock's Close, Bristol, United Kingdom
| | - Ruth Epstein
- Department of Speech and Language Therapy (ENT), Royal National Ear, Nose and Throat and Eastman Dental Hospitals, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
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18
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Allicock OM, Yolda-Carr D, Todd JA, Wyllie AL. Pooled RNA-extraction-free testing of saliva for the detection of SARS-CoV-2. Sci Rep 2023; 13:7426. [PMID: 37156888 PMCID: PMC10165292 DOI: 10.1038/s41598-023-34662-2] [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: 04/11/2022] [Accepted: 05/05/2023] [Indexed: 05/10/2023] Open
Abstract
The key to limiting SARS-CoV-2 spread is to identify virus-infected individuals (both symptomatic and asymptomatic) and isolate them from the general population. Hence, routine weekly testing for SARS-CoV-2 in all asymptomatic (capturing both infected and non-infected) individuals is considered critical in situations where a large number of individuals co-congregate such as schools, prisons, aged care facilities and industrial workplaces. Such testing is hampered by operational issues such as cost, test availability, access to healthcare workers and throughput. We developed the SalivaDirect RT-qPCR assay to increase access to SARS-CoV-2 testing via a low-cost, streamlined protocol using self-collected saliva. To expand the single sample testing protocol, we explored multiple extraction-free pooled saliva testing workflows prior to testing with the SalivaDirect RT-qPCR assay. A pool size of five, with or without heat inactivation at 65 °C for 15 min prior to testing resulted in a positive agreement of 98% and 89%, respectively, and an increased Ct value shift of 1.37 and 1.99 as compared to individual testing of the positive clinical saliva specimens. Applying this shift in Ct value to 316 individual, sequentially collected, SARS-CoV-2 positive saliva specimen results reported from six clinical laboratories using the original SalivaDirect assay, 100% of the samples would have been detected (Ct value < 45) had they been tested in the 1:5 pool strategy. The availability of multiple pooled testing workflows for laboratories can increase test turnaround time, permitting results in a more actionable time frame while minimizing testing costs and changes to laboratory operational flow.
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Affiliation(s)
- Orchid M Allicock
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Devyn Yolda-Carr
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA
| | - John A Todd
- SalivaDirect, Inc, New Haven, CT, 06510, USA
| | - Anne L Wyllie
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06510, USA.
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19
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Peng Y, Yao M. Quantitatively Visualizing Airborne Disease Transmission Risks of Different Exhalation Activities through CO 2 Imaging. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:6865-6875. [PMID: 37074044 PMCID: PMC10124748 DOI: 10.1021/acs.est.2c08503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
Aerosol transmission has played a leading role in COVID-19 pandemic. However, there is still a poor understanding about how it is transmitted. This work was designed to study the exhaled breath flow dynamics and transmission risks under different exhaling modes. Using an infrared photography device, exhaled flow characteristics of different breathing activities, such as deep breathing, dry coughing, and laughing, together with the roles of mouth and nose were characterized by imaging CO2 flow morphologies. Both mouth and nose played an important role in the disease transmission though in the downward direction for the nose. In contrast to the trajectory commonly modeled, the exhaled airflows appeared with turbulent entrainments and obvious irregular movements, particularly the exhalations involving mouth were directed horizontal and had a higher propagation capacity and transmission risk. While the cumulative risk was high for deep breathing, those transient ones from dry coughing, yawning, and laughing were also shown to be significant. Various protective measures including masks, canteen table shields, and wearable devices were visually demonstrated to be effective for altering the exhaled flow directions. This work is useful to understanding the risk of aerosol infection and guiding the formulation of its prevention and control strategies. Experimental data also provide important information for refining model boundary conditions.
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Affiliation(s)
- Yijiao Peng
- State Key Joint Laboratory of Environmental Simulation and
Pollution Control, College of Environmental Sciences and Engineering, Peking
University, Beijing 100871, China
| | - Maosheng Yao
- State Key Joint Laboratory of Environmental Simulation and
Pollution Control, College of Environmental Sciences and Engineering, Peking
University, Beijing 100871, China
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20
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Kisielinski K, Hirsch O, Wagner S, Wojtasik B, Funken S, Klosterhalfen B, Kanti Manna S, Prescher A, Sukul P, Sönnichsen A. Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation. Front Public Health 2023; 11:1125150. [PMID: 37089476 PMCID: PMC10116418 DOI: 10.3389/fpubh.2023.1125150] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p < 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01).DiscussionMasks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health.ConclusionFace mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.
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Affiliation(s)
- Kai Kisielinski
- Orthopaedic and Trauma Surgery, Clinical Medicine, Private Practice, Düsseldorf, Germany
- *Correspondence: Kai Kisielinski
| | - Oliver Hirsch
- Department of Psychology, Fachhochschule für Oekonomie und Management (FOM) University of Applied Sciences, Siegen, Germany
| | - Susanne Wagner
- Veterinary Medicine, Wagner Medical Science Liason (MSL) Management, Blankenfelde-Mahlow, Germany
| | - Barbara Wojtasik
- Department of Genetics and Biosystematics, Faculty of Biology, University of Gdańsk, Gdansk, Poland
| | - Stefan Funken
- Internal Medicine, Clinical Medicine, Private Practice, Moers, Germany
| | | | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, India
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), Rhine-Westphalia Technical University of Aachen, Aachen, Germany
| | - Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
- Pritam Sukul
| | - Andreas Sönnichsen
- Internal Medicine, Clinical Medicine, Private Practice, Gesundheit für Österreich e.V. (Health for Austria), Vienna, Austria
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21
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A review on indoor airborne transmission of COVID-19– modelling and mitigation approaches. JOURNAL OF BUILDING ENGINEERING 2023; 64:105599. [PMCID: PMC9699823 DOI: 10.1016/j.jobe.2022.105599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 06/09/2023]
Abstract
In the past few years, significant efforts have been made to investigate the transmission of COVID-19. This paper provides a review of the COVID-19 airborne transmission modeling and mitigation strategies. The simulation models here are classified into airborne transmission infectious risk models and numerical approaches for spatiotemporal airborne transmissions. Mathematical descriptions and assumptions on which these models have been based are discussed. Input data used in previous simulation studies to assess the dispersion of COVID-19 are extracted and reported. Moreover, measurements performed to study the COVID-19 airborne transmission within indoor environments are introduced to support validations for anticipated future modeling studies. Transmission mitigation strategies recommended in recent studies have been classified to include modifying occupancy and ventilation operations, using filters and air purifiers, installing ultraviolet (UV) air disinfection systems, and personal protection compliance, such as wearing masks and social distancing. The application of mitigation strategies to various building types, such as educational, office, public, residential, and hospital, is reviewed. Recommendations for future works are also discussed based on the current apparent knowledge gaps covering both modeling and mitigation approaches. Our findings show that different transmission mitigation measures were recommended for various indoor environments; however, there is no conclusive work reporting their combined effects on the level of mitigation that may be achieved. Moreover, further studies should be conducted to understand better the balance between approaches to mitigating the viral transmissions in buildings and building energy consumption.
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22
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Kisielinski K, Wagner S, Hirsch O, Klosterhalfen B, Prescher A. Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents - A scoping review. Heliyon 2023; 9:e14117. [PMID: 37057051 PMCID: PMC9981272 DOI: 10.1016/j.heliyon.2023.e14117] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth. Method As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use. Results Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety and impaired learning and memory. There is also data indicating testicular toxicity in adolescents at CO2 inhalation concentrations above 0.5%. Discussion There is a possible negative impact risk by imposing extended mask mandates especially for vulnerable subgroups. Circumstantial evidence exists that extended mask use may be related to current observations of stillbirths and to reduced verbal motor and overall cognitive performance in children born during the pandemic. A need exists to reconsider mask mandates.
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Affiliation(s)
- Kai Kisielinski
- Independent Researcher, Surgeon, Private Practice, 40212 Düsseldorf, Germany
| | - Susanne Wagner
- Non Clinical Expert, Veterinarian, Wagner MSL Management, 15831 Mahlow, Germany
| | - Oliver Hirsch
- Department of Psychology, FOM University of Applied Sciences, 57078 Siegen, Germany
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), 52074 Aachen, Germany
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23
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Singh P, Ali SW, Kale RD. Antimicrobial Nanomaterials as Advanced Coatings for Self-Sanitizing of Textile Clothing and Personal Protective Equipment. ACS OMEGA 2023; 8:8159-8171. [PMID: 36910928 PMCID: PMC9996805 DOI: 10.1021/acsomega.2c06343] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Controlling bioaerosols has become increasingly critical in affecting human health. Natural product treatment in the nano form is a potential method since it has lower toxicity than inorganic nanomaterials like silver nanoparticles. This research is important for the creation of a bioaerosol control system that is effective. Nanoparticles (NPs) are gradually being employed to use bacteria as a nonantibiotic substitute for treating bacterial infections. The present study looks at nanoparticles' antimicrobial properties, their method of action, their impact on drug-opposing bacteria, and the hazards connected with their operation as antimicrobial agents. The aspects that influence nanoparticle conduct in clinical settings, as well as their distinctive features and mode of action as antibacterial assistants, are thoroughly examined. Nanoparticles' action on bacterial cells is presently accepted by way of the introduction of oxidative stress induction, metal-ion release, and nonoxidative methods. Because many concurrent mechanisms of action against germs would necessitate multiple simultaneous gene modifications in the same bacterial cell for antibacterial protection to evolve, bacterial cells developing resistance to NPs is difficult. This review discusses the antimicrobial function of NPs against microbes and presents a comprehensive discussion of the bioaerosols: their origin, hazards, and their prevention. This state of the art method is dependent upon the use of personal protective gear against these bioaerosols. The benefit of the utmost significant categories of metal nanoparticles as antibacterial agents is given important consideration. The novelty of this review depends upon the antimicrobial properties of (a) silver (Ag), (b) zinc oxide (ZnO), and (c) copper oxide (CuO) nanoparticles. The value-added features of these nanoparticles are discussed, as well as their physicochemical characterization and pharmacokinetics, including the toxicological danger they pose to people. Lastly, the effective role of nanomaterials and their future in human wellness is discussed.
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Affiliation(s)
- Preeti Singh
- Fibers
& Textile Processing Technology, Institute
of Chemical Technology, Mumbai, India
- Department
of Textile and Fibre Engineering, Indian
Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
| | - S. Wazed Ali
- Department
of Textile and Fibre Engineering, Indian
Institute of Technology Delhi, Hauz Khas, New Delhi 110016, India
| | - Ravindra D. Kale
- Fibers
& Textile Processing Technology, Institute
of Chemical Technology, Mumbai, India
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24
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Berger S, Mattern M, Niessner J. Face mask performance related to potentially infectious aerosol particles, breathing mode and facial leakage. Int J Hyg Environ Health 2023; 248:114103. [PMID: 36525701 PMCID: PMC9748312 DOI: 10.1016/j.ijheh.2022.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/24/2022] [Accepted: 12/08/2022] [Indexed: 12/15/2022]
Abstract
During the COVID 19 pandemic, wearing certified Respiratory Protective Devices (RPDs) provided important means of protection against direct and indirect infections caused by virus-laden aerosols. Assessing the RPD performance associated with infection prevention in standardised certification tests, however, faces drawbacks, such as the representativeness of the test aerosols used, the protection of third parties during exhalation or the effect of facial leaks. To address these drawbacks, we designed a novel test bench to measure RPD performance, namely the number based total efficiency, size-segregated fractional filtration efficiency and net pressure loss, for 11 types of certified surgical masks and Filtering Face Pieces dependent on breathing mode and facial fit. To be representative for the context of potentially infectious particles, we use a test aerosol based on artificial saliva that is in its size distribution similar to exhaled aerosols. In inhalation mode excluding facial leaks, all investigated samples deposit by count more than 85% of artificial saliva particles, which suggests a high efficiency of certified RPD filter media related to these particles. In exhalation mode most RPDs tend to have similar efficiencies but lower pressure losses. This deviation tends to be significant primarily for the RPDs with thin filter layers like surgical masks or Filtering Face Pieces containing nanofibers and may depend on the RPDs shape. Both the filtration efficiency and pressure loss are strongly inter-dependent and significantly lower when RPDs are naturally fitted including facial leaks, leading to a wide efficiency range of approximately 30-85%. The results indicate a much greater influence of the facial fit than the filter material itself. Furthermore, RPDs tend be more effective in self-protection than in third-party protection, which is inversely correlated to pressure loss. Comparing different types of RPDs, the pressure loss partially differs at similar filtration efficiencies, which points out the influence of the material and the filter area on pressure loss.
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Affiliation(s)
- Simon Berger
- Institute of Flow in Additively Manufactured Porous Media (ISAPS), Heilbronn University of Applied Sciences, Max-Planck-Str. 39, 74081, Heilbronn, Germany.
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25
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Alsaad H, Schälte G, Schneeweiß M, Becher L, Pollack M, Gena AW, Schweiker M, Hartmann M, Voelker C, Rossaint R, Irrgang M. The Spread of Exhaled Air and Aerosols during Physical Exercise. J Clin Med 2023; 12:jcm12041300. [PMID: 36835835 PMCID: PMC9961458 DOI: 10.3390/jcm12041300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
Physical exercise demonstrates a special case of aerosol emission due to its associated elevated breathing rate. This can lead to a faster spread of airborne viruses and respiratory diseases. Therefore, this study investigates cross-infection risk during training. Twelve human subjects exercised on a cycle ergometer under three mask scenarios: no mask, surgical mask, and FFP2 mask. The emitted aerosols were measured in a grey room with a measurement setup equipped with an optical particle sensor. The spread of expired air was qualitatively and quantitatively assessed using schlieren imaging. Moreover, user satisfaction surveys were conducted to evaluate the comfort of wearing face masks during training. The results indicated that both surgical and FFP2 masks significantly reduced particles emission with a reduction efficiency of 87.1% and 91.3% of all particle sizes, respectively. However, compared to surgical masks, FFP2 masks provided a nearly tenfold greater reduction of the particle size range with long residence time in the air (0.3-0.5 μm). Furthermore, the investigated masks reduced exhalation spreading distances to less than 0.15 m and 0.1 m in the case of the surgical mask and FFP2 mask, respectively. User satisfaction solely differed with respect to perceived dyspnea between no mask and FFP2 mask conditions.
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Affiliation(s)
- Hayder Alsaad
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
- Correspondence: (H.A.); (M.I.)
| | - Gereon Schälte
- Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Mario Schneeweiß
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Lia Becher
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Moritz Pollack
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Amayu Wakoya Gena
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Marcel Schweiker
- Healthy Living Spaces Lab, Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - Maria Hartmann
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Conrad Voelker
- Department of Building Physics, Faculty of Civil Engineering, Bauhaus-University Weimar, 99423 Weimar, Germany
| | - Rolf Rossaint
- Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Matthias Irrgang
- Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, 52074 Aachen, Germany
- Correspondence: (H.A.); (M.I.)
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26
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Knobloch JK, Franke G, Knobloch MJ, Knobling B, Kampf G. Overview of tight fit and infection prevention benefits of respirators (filtering face pieces). J Hosp Infect 2023; 134:89-96. [PMID: 36738992 PMCID: PMC9894678 DOI: 10.1016/j.jhin.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 02/05/2023]
Abstract
Regulations for measures to protect against SARS-CoV-2 transmission vary widely around the world, with very strict regulations in Germany where respirators (filtering face piece FFP2 or comparable) are often mandatory. The efficiency of respirators, however, depends essentially on the tight facial fit avoiding the bypass of contaminated air via gaps between mask and wearer's face. The facial fit can be verified in a fit test. The aim of this review was to describe the quantitative fit test results depending on the respirator designs. A literature search revealed 29 suitable studies. Of all respirators with circumferential head straps, three-panel folded dome-shaped respirators showed the best fit (80.8% of 4625 fit tests passed), followed by rigid-dome-shaped respirators (72.4% of 8234 fit tests passed), duckbill-shaped respirators (31.6% of 2120 fit tests passed), and coffee-filter-shaped respirators (30.9% of 3392 fit tests passed). Respirators with ear loops showed very poor tight fit (3.6% of 222 fit tests passed). In four randomized control trials, single-use respirators were not shown to be superior to surgical masks for the prevention of laboratory-confirmed viral respiratory infections, even when adjusted with a fit test. Therefore, we consider the mandatory use of respirators to be disproportionate and not supported by evidence. Further evidence should be generated, in which scenarios respirators might provide an effective benefit as part of occupational health and safety. For situations with confirmed benefits, only high-quality disposable respirators with head straps or respiratory protective equipment of higher protective levels should be used.
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Affiliation(s)
- J K Knobloch
- Institute of Medical Microbiology, Virology, and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - G Franke
- Institute of Medical Microbiology, Virology, and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M J Knobloch
- University Medicine Göttingen, Göttingen, Germany
| | - B Knobling
- Institute of Medical Microbiology, Virology, and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Kampf
- University Medicine Greifswald, Greifswald, Germany
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27
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Calà F, Manfredi C, Battilocchi L, Frassineti L, Cantarella G. Speaking with mask in the COVID-19 era: Multiclass machine learning classification of acoustic and perceptual parameters. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:1204. [PMID: 36859154 DOI: 10.1121/10.0017244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The intensive use of personal protective equipment often requires increasing voice intensity, with possible development of voice disorders. This paper exploits machine learning approaches to investigate the impact of different types of masks on sustained vowels /a/, /i/, and /u/ and the sequence /a'jw/ inside a standardized sentence. Both objective acoustical parameters and subjective ratings were used for statistical analysis, multiple comparisons, and in multivariate machine learning classification experiments. Significant differences were found between mask+shield configuration and no-mask and between mask and mask+shield conditions. Power spectral density decreases with statistical significance above 1.5 kHz when wearing masks. Subjective ratings confirmed increasing discomfort from no-mask condition to protective masks and shield. Machine learning techniques proved that masks alter voice production: in a multiclass experiment, random forest (RF) models were able to distinguish amongst seven masks conditions with up to 94% validation accuracy, separating masked from unmasked conditions with up to 100% validation accuracy and detecting the shield presence with up to 86% validation accuracy. Moreover, an RF classifier allowed distinguishing male from female subject in masked conditions with 100% validation accuracy. Combining acoustic and perceptual analysis represents a robust approach to characterize masks configurations and quantify the corresponding level of discomfort.
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Affiliation(s)
- F Calà
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - C Manfredi
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - L Battilocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - L Frassineti
- Department of Information Engineering, Università degli Studi di Firenze, Firenze, Italy
| | - G Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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28
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Larsen PS, Heebøll J, Meyer KE. Measured Air Flow Leakage in Facemask Usage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2363. [PMID: 36767730 PMCID: PMC9915892 DOI: 10.3390/ijerph20032363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
The importance of wearing a facemask during a pandemic has been widely discussed, and a number of studies have been undertaken to provide evidence of a reduced infectious virus dose because of wearing facemasks. Here, one aspect that has received little attention is the fraction of breathing flow that is not filtered because it passes as leak flow between the mask and face. Its reduction would be beneficial in reducing the dose response. The results of the present study include the filter material pressure loss parameters, pressure distributions under masks, and the fraction of breathing flow leaked versus steady breathing flow in the range of 5 to 30 L min-1, for two commonly used facemasks mounted on mannequins, in the usual 'casual' way and in a 'tight' way by means of three different fitters placed over the mask to improve the seals. For the 'casual' mount, leaks were high: 83% to 99% for both masks at both exhalation and inhalation flows. For the 'tight' mount with different fitters, the masks showed different lower levels in the range of 18 to 66% of leakage, which, for exhalation, were nearly independent of flow rate, while for inhalation, were decreasing with increasing rates of respiration flows, probably because suction improved the sealing. In practice, masks are worn in a 'casual' mount, which would imply that nearly all contagious viruses found in aerosols small enough to follow air streams would be exhaled to and inhaled from the ambient air.
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Affiliation(s)
- Poul S. Larsen
- Department of Civil & Mechanical Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - John Heebøll
- Department of Management Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
| | - Knud Erik Meyer
- Department of Civil & Mechanical Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
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29
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Géczy A, Havellant G, Bátorfi R, Skwarek A, Dušek K, Bušek D, Illés B. Filtering Efficiency of Sustainable Textile Materials Applied in Personal Protective Face Mask Production during Pandemic. MATERIALS (BASEL, SWITZERLAND) 2023; 16:903. [PMID: 36769913 PMCID: PMC9917621 DOI: 10.3390/ma16030903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/19/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak increased demand for personal protective respirator masks. Textile masks based on cloth materials appeared to be a sustainable, comfortable, and cost-effective alternative available in global communities. In this study, we used laser-based particle counting for mask material qualification to determine the concentration filtering efficiency in general, everyday community use. The efficiencies of eleven different commercially available textile materials were measured in single-, double-, and triple-layer configurations according to their grammage, mesh (XY), and inter-yarn gap. It was found that in the single-layer configurations, most materials were well below the acceptable standards, with a wide variation in filtering efficiency, which ranged from 5% to ~50%. However, when testing the fabrics in two or three layers, the efficiency increased significantly, exceeding or approaching the standard for medical masks. Three layers of natural silk was able to produce a level of filtration efficiency of 84.68%. Two-layered natural silk achieved 70.98%, cotton twill achieved 75.6%, and satin-weave viscose achieved 69.77%. Further options can also be considered in cases where lower filtration is acceptable It was statistically shown that applying a second layer was more significant in terms of overall filtering than increasing the layer count to three. However, layer stacking limited the breathability. The paper presents measurement-based qualitative and quantitative recommendations for future textile applications in face mask manufacturing.
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Affiliation(s)
- Attila Géczy
- Department of Electronics Technology, Faculty of Electrical Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
- Department of Electrotechnology, Faculty of Electrical Engineering (K13113), Czech Technical University in Prague, Technická 2, 1902/2, Praha 6, Dejvice, 166 27 Prague, Czech Republic
| | - Gergő Havellant
- Department of Electronics Technology, Faculty of Electrical Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
| | - Réka Bátorfi
- Department of Electronics Technology, Faculty of Electrical Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
| | - Agata Skwarek
- Łukasiewicz Research Network-Institute of Microelectronics and Photonics, 30-701 Kraków, Poland
| | - Karel Dušek
- Department of Electrotechnology, Faculty of Electrical Engineering (K13113), Czech Technical University in Prague, Technická 2, 1902/2, Praha 6, Dejvice, 166 27 Prague, Czech Republic
| | - David Bušek
- Department of Electrotechnology, Faculty of Electrical Engineering (K13113), Czech Technical University in Prague, Technická 2, 1902/2, Praha 6, Dejvice, 166 27 Prague, Czech Republic
| | - Balázs Illés
- Department of Electronics Technology, Faculty of Electrical Engineering and Informatics, Budapest University of Technology and Economics, H-1111 Budapest, Hungary
- Department of Electrotechnology, Faculty of Electrical Engineering (K13113), Czech Technical University in Prague, Technická 2, 1902/2, Praha 6, Dejvice, 166 27 Prague, Czech Republic
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Gomes da Silva P, Gonçalves J, Torres Franco A, Rodriguez E, Diaz I, Orduña Domingo A, Garcinuño Pérez S, March Roselló GA, Dueñas Gutiérrez CJ, São José Nascimento M, Sousa SI, Garcia Encina P, Mesquita JR. Environmental Dissemination of SARS-CoV-2 in a University Hospital during the COVID-19 5th Wave Delta Variant Peak in Castile-León, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1574. [PMID: 36674328 PMCID: PMC9866319 DOI: 10.3390/ijerph20021574] [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: 12/26/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 06/17/2023]
Abstract
The dominant SARS-CoV-2 Delta variant (B.1.617.2) became the main circulating variant among countries by mid 2021. Attention was raised to the increased risk of airborne transmission, leading to nosocomial outbreaks even among vaccinated individuals. Considering the increased number of COVID-19 hospital admissions fueled by the spread of the variant, with Spain showing the highest COVID-19 rates in mainland Europe by July 2021, the aim of this study was to assess SARS-CoV-2 environmental contamination in different areas of a University Hospital in the region of Castile-León, Spain, during the peak of the 5th wave of COVID-19 in the country (July 2021). Air samples were collected from sixteen different areas of the Hospital using a Coriolis® μ air sampler. Surface samples were collected in these same areas using sterile flocked plastic swabs. RNA extraction followed by a one-step RT-qPCR were performed for detection of SARS-CoV-2 RNA. Of the 21 air samples, only one was positive for SARS-CoV-2 RNA, from the emergency waiting room. Of the 40 surface samples, 2 were positive for SARS-CoV-2 RNA, both from the microbiology laboratory. These results may be relevant for risk assessment of nosocomial infection within healthcare facilities, thus helping prevent and minimize healthcare staff's exposure to SARS-CoV-2, reinforcing the importance of always wearing appropriate and well-fit masks at all times and proper PPE when in contact with infected patients.
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Affiliation(s)
- Priscilla Gomes da Silva
- ICBAS—School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, 1800-412 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 1800-412 Porto, Portugal
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 1800-412 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 1800-412 Porto, Portugal
| | - José Gonçalves
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina S/N., 47011 Valladolid, Spain
- Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - Andrés Torres Franco
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina S/N., 47011 Valladolid, Spain
- Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - Elisa Rodriguez
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina S/N., 47011 Valladolid, Spain
- Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - Israel Diaz
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina S/N., 47011 Valladolid, Spain
- Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - Antonio Orduña Domingo
- Microbiology Service, Valladolid University Clinical Hospital (HCUV), Faculty of Medicine, University of Valladolid, 47011 Valladolid, Spain
| | | | | | - Carlos Jesús Dueñas Gutiérrez
- Internal Medicine, Infectious Diseases Section, Valladolid University Clinical Hospital (HCUV), 47011 Valladolid, Spain
| | | | - Sofia I.V. Sousa
- LEPABE—Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 1800-412 Porto, Portugal
- ALiCE—Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, 1800-412 Porto, Portugal
| | - Pedro Garcia Encina
- Institute of Sustainable Processes, Valladolid University, Dr. Mergelina S/N., 47011 Valladolid, Spain
- Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr. Mergelina s/n., 47011 Valladolid, Spain
| | - João R. Mesquita
- ICBAS—School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, 1800-412 Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 1800-412 Porto, Portugal
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31
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Kamatani M, Miyazaki Y, Kawahara JI. Occlusion of faces by sanitary masks improves facial attractiveness of other races. Front Psychol 2023; 13:953389. [PMID: 36710777 PMCID: PMC9878602 DOI: 10.3389/fpsyg.2022.953389] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/12/2022] [Indexed: 01/15/2023] Open
Abstract
Recent studies provide mixed results regarding whether the perception of facial attractiveness is increased or decreased by partial occlusion with a sanitary mask. One set of studies demonstrated that occluding the bottom half of a face increased facial attractiveness. This effect is thought to occur because the occluded area is interpolated by an average facial representation that is perceived as attractive. However, several groups of studies showed that partial occlusion can increase or decrease perceived attractiveness depending on the attractiveness of the original (unoccluded) face, due to regression to the mean. To reconcile this inconsistency, we propose that the occluded area is interpolated not by an average facial representation, but by a template of moderate attractiveness, shaped by the distribution of each viewer's experience. This hypothesis predicts an interaction between occlusion and the attractiveness of the original face so that occluded attractive faces are rated as less attractive, while occluded unattractive faces are rated as more attractive. To examine this hypothesis, the present study used attractiveness-rating tasks with mask-free versus masked faces in own-race and other-races categories. Viewers were familiar with own-race faces and unfamiliar with other-races faces. If moderate-attractiveness interpolation were the explanatory factor, the interaction between the occlusion and the attractiveness of the original face should be found only in the rating of own-race faces. Consistent with this hypothesis, the interaction between the occlusion and the attractiveness of the original faces was significant only for the own-race faces. Specifically, wearing a sanitary mask decreased the facial attractiveness of attractive faces in the own-race, while it increased the attractiveness regardless of the level of facial attractiveness in other-races. These findings suggest that the occluded area of own-race faces is interpolated by a facial template of moderate attractiveness. The other-races template could be developed using familiar exemplars such as celebrities. Thus, interpolation by such a template should result in elevated attractiveness relative to that by an own-race template. Accordingly, the apparent inconsistency in the literature regarding the effect of partial occlusion on physical attractiveness can be explained in terms of differences in the template involving interpolation of the occluded area.
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Affiliation(s)
- Miki Kamatani
- Faculty of Humanities and Human Sciences, Hokkaido University, Sapporo, Japan,*Correspondence: Miki Kamatani, ✉
| | - Yuki Miyazaki
- Department of Psychology, Fukuyama University, Hiroshima, Japan
| | - Jun I. Kawahara
- Faculty of Humanities and Human Sciences, Hokkaido University, Sapporo, Japan,Jun I. Kawahara, ✉
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32
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Nishandar SR, He Y, Princevac M, Edwards RD. Fate of Exhaled Droplets From Breathing and Coughing in Supermarket Checkouts and Passenger Cars. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302221148274. [PMID: 36644342 PMCID: PMC9834932 DOI: 10.1177/11786302221148274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The global pandemic of COVID-19 has highlighted the importance of understanding the role that exhaled droplets play in virus transmission in community settings. Computational Fluid Dynamics (CFD) enables systematic examination of roles the exhaled droplets play in the spread of SARS-CoV-2 in indoor environments. This analysis uses published exhaled droplet size distributions combined with terminal aerosol droplet size based on measured peak concentrations for SARS-CoV-2 RNA in aerosols to simulate exhaled droplet dispersion, evaporation, and deposition in a supermarket checkout area and rideshare car where close proximity with other individuals is common. Using air inlet velocity of 2 m/s in the passenger car and ASHRAE recommendations for ventilation and comfort in the supermarket, simulations demonstrate that exhaled droplets <20 μm that contain the majority of viral RNA evaporated leaving residual droplet nuclei that remain aerosolized in the air. Subsequently ~ 70% of these droplet nuclei deposited in the supermarket and the car with the reminder vented from the space. The maximum surface deposition of droplet nuclei/m2 for speaking and coughing were 2 and 819, 18 and 1387 for supermarket and car respectively. Approximately 15% of the total exhaled droplets (aerodynamic diameters 20-700 µm) were deposited on surfaces in close proximity to the individual. Due to the non-linear distribution of viral RNA across droplet sizes, however, these larger exhaled droplets that deposit on surfaces have low viral content. Maximum surface deposition of viral RNA was 70 and 1.7 × 103 virions/m2 for speaking and 2.3 × 104 and 9.3 × 104 virions/m2 for coughing in the supermarket and car respectively while the initial airborne concentration of viral RNA was 7 × 106 copies per ml. Integrating the droplet size distributions with viral load distributions, this study helps explain the apparent importance of inhalation exposures compared to surface contact observed in the pandemic.
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Affiliation(s)
- Sanika Ravindra Nishandar
- Department of Mechanical Engineering,
Bourns College of Engineering, University of California, Riverside, CA, USA
| | - Yucheng He
- Department of Mechanical Engineering,
Bourns College of Engineering, University of California, Riverside, CA, USA
| | - Marko Princevac
- Department of Mechanical Engineering,
Bourns College of Engineering, University of California, Riverside, CA, USA
| | - Rufus D Edwards
- Department of Epidemiology, Program in
Public Health, University of California Irvine, CA, USA
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33
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Tvrzová L, Hrubanová M, Benešovský P, Doubková H, Blahová A, Malčík P, Dufková P, Jarmičová P, Nasadil P. Bacterial filtration efficiency of medical face masks - Evaluation of the use of disposable plastic petri dishes in Andersen impactor. J Microbiol Methods 2023; 204:106655. [PMID: 36526041 DOI: 10.1016/j.mimet.2022.106655] [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: 11/04/2022] [Revised: 12/05/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022]
Abstract
Bacterial filtration efficiency is the main characteristic of medical face masks effectivity and quality. The testing method is given by European and US, respectively, standard. The method is based on the analysis of biological aerosol with the bacterium Staphylococcus aureus in Andersen cascade impactor. The Andersen impactor contains six stages simulating the different parts of the respiratory tract, from the upper part with the larger droplets to the lungs with the small aerosol particles of the submicron size. The particles are separated depending on the size and sediment on agar medium in Petri dishes filled in the impactor. The use of the glass Petri dishes is recommended for the Andersen impactor, but the most of laboratories prefer the disposable plastic dishes, actually. The evaluation of the use of plastic dishes in Andersen impactor for the determination of the bacterial filtration efficiency of the medical face masks is the aim of this study.
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Affiliation(s)
- Ludmila Tvrzová
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic.
| | | | - Petr Benešovský
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Hana Doubková
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Anna Blahová
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Pavel Malčík
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Petra Dufková
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Pavla Jarmičová
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
| | - Petr Nasadil
- Textile Testing Institute, Cejl 12, 602 00 Brno, Czech Republic
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34
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Feng Z, Xu B, Zhong L, Chen J, Deng J, Luo Z, Cao L, Tang Y, Li C, Jin R, Deng L, Shang Y, Wu Y, Zhao H, Feng Q, Chen X, Xu L, Xie Z. A multicentre study on the incidence of respiratory viruses in children with community-acquired pneumonia requiring hospitalization in the setting of the zero-COVID policy in China. Arch Virol 2023; 168:64. [PMID: 36639581 PMCID: PMC9839207 DOI: 10.1007/s00705-023-05698-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/05/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Stringent nonpharmaceutical interventions (NPIs) have been implemented worldwide to combat the COVID-19 pandemic, and the circulation and seasonality of common respiratory viruses have subsequently changed. There have been few multicentre studies or comparisons of the prevalence of respiratory viruses accounting for community-acquired pneumonia (CAP) in hospitalized children between the pre-COVID period and the period after community and school reopening in the setting of the zero-COVID policy. METHODS We included 1543 children with CAP who required hospitalization from November 1, 2020 to April 30, 2021 (period 1), and 629 children with the same conditions from November 1, 2018, to April 30, 2019 (period 2), in our study. All respiratory samples from these patients were screened for six respiratory viruses (respiratory syncytial virus [RSV], adenovirus [ADV], influenza A virus [Flu A], influenza B virus [Flu B], parainfluenza virus type 1 [PIV1], and parainfluenza virus type 3 [PIV3]) using a multiplex real-time PCR assay. RESULTS AND CONCLUSIONS The median ages of the enrolled patients at the time of diagnosis were 1.5 years and 1.0 years for period 1 and period 2, respectively. In period 1, viral pathogens were detected in 50.3% (776/1543) of the enrolled patients. The most frequently identified viral pathogen was RSV (35.9%, 554/1543), followed by PIV3 (9.6%, 148/1543), PIV1 (3.6%, 56/1543), ADV (3.4%, 52/1543), Flu A (1.0%, 16/1543), and Flu B (0.8%, 13/1543). The total detection rates of these six viruses in the peak season of CAP were at the pre-COVID level. The prevalence of Flu A decreased dramatically, and circulation activity was low compared to pre-COVID levels, while the incidence of PIV3 increased significantly. There were no significant differences in the detection rates of RSV, ADV, Flu B, and PIV1 between the two periods. Our results showed that respiratory viruses accounted for CAP in hospitalized children at pre-COVID levels as communities and schools reopened within the zero-COVID policy, although the prevalence aetiology spectrum varied.
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Affiliation(s)
- Ziheng Feng
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan-li-shi Road, Beijing, 100045 China ,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016 China
| | - Baoping Xu
- Department of Respiratory Diseases I, Beijing Children’s Hospital, Capital Medical University, National Clinical Research Center for Respiratory Diseases, National Center for Children’s Health, Beijing, China
| | - Lili Zhong
- Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Jing Chen
- Shenyang Children’s Hospital, Shenyang, China
| | - Jikui Deng
- Department of Infectious Diseases, Shenzhen Children’s Hospital, Shenzhen, China
| | - Zhengxiu Luo
- Department of Respiratory Medicine, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Lingfeng Cao
- Department of Clinical Laboratory, Children’s Hospital of Fudan University, Shanghai, China
| | - Yu Tang
- Department of Respiratory, Children’s Hospital Affiliated to Zhengzhou University, Zhengzhou, China
| | - Changchong Li
- The 2nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027 China
| | - Rong Jin
- Guiyang Women and Children Healthcare Hospital, Guiyang, China
| | - Li Deng
- Guangzhou Women and Children’s Medical Center, Guangzhou, China
| | - Yunxiao Shang
- Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Wu
- Department of Clinical Laboratory Medicine, National Children’s Medical Center, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hongwei Zhao
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan-li-shi Road, Beijing, 100045 China ,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016 China
| | - Qianyu Feng
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan-li-shi Road, Beijing, 100045 China ,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016 China
| | - Xiangpeng Chen
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, No. 56 Nan-li-shi Road, Beijing, 100045 China ,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016 China
| | - Lili Xu
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nan-li-shi Road, Beijing, 100045, China. .,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China.
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No. 56 Nan-li-shi Road, Beijing, 100045, China. .,Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, Beijing, 2019RU016, China.
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35
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Knobloch JK, Popp W, Exner M, Walger P, Kampf G. An FFP2 respirator mandate for healthcare workers to prevent transmission of SARS-CoV-2 lacks proportionality. J Hosp Infect 2022; 130:146-147. [PMID: 36150562 PMCID: PMC9487173 DOI: 10.1016/j.jhin.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 11/18/2022]
Affiliation(s)
- J K Knobloch
- Institute for Medical Microbiology, Virology and Hygiene, Department for Infection Prevention and Control, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Popp
- HyKoMed GmbH, Dortmund, Germany
| | - M Exner
- German Society of Hospital Hygiene, Berlin, Germany
| | - P Walger
- German Society of Hospital Hygiene, Berlin, Germany
| | - G Kampf
- University Medicine Greifswald, Greifswald, Germany.
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36
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Gutz SE, Rowe HP, Tilton-Bolowsky VE, Green JR. Speaking with a KN95 face mask: a within-subjects study on speaker adaptation and strategies to improve intelligibility. Cogn Res Princ Implic 2022; 7:73. [PMID: 35907167 PMCID: PMC9339031 DOI: 10.1186/s41235-022-00423-4] [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: 10/18/2021] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
Mask-wearing during the COVID-19 pandemic has prompted a growing interest in the functional impact of masks on speech and communication. Prior work has shown that masks dampen sound, impede visual communication cues, and reduce intelligibility. However, more work is needed to understand how speakers change their speech while wearing a mask and to identify strategies to overcome the impact of wearing a mask. Data were collected from 19 healthy adults during a single in-person session. We investigated the effects of wearing a KN95 mask on speech intelligibility, as judged by two speech-language pathologists, examined speech kinematics and acoustics associated with mask-wearing, and explored KN95 acoustic filtering. We then considered the efficacy of three speaking strategies to improve speech intelligibility: Loud, Clear, and Slow speech. To inform speaker strategy recommendations, we related findings to self-reported speaker effort. Results indicated that healthy speakers could compensate for the presence of a mask and achieve normal speech intelligibility. Additionally, we showed that speaking loudly or clearly—and, to a lesser extent, slowly—improved speech intelligibility. However, using these strategies may require increased physical and cognitive effort and should be used only when necessary. These results can inform recommendations for speakers wearing masks, particularly those with communication disorders (e.g., dysarthria) who may struggle to adapt to a mask but can respond to explicit instructions. Such recommendations may further help non-native speakers and those communicating in a noisy environment or with listeners with hearing loss.
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37
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Wagner J, Macher JM, Chen W, Kumagai K. Comparative Mask Protection against Inhaling Wildfire Smoke, Allergenic Bioaerosols, and Infectious Particles. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15555. [PMID: 36497628 PMCID: PMC9735667 DOI: 10.3390/ijerph192315555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
This work compares relative mask inhalation protection against a range of airborne particle sizes that the general public may encounter, including infectious particles, wildfire smoke and ash, and allergenic fungal and plant particles. Several mask types available to the public were modeled with respirable fraction deposition. Best-case collection efficiencies for cloth, surgical, and respirator masks were predicted to be lowest (0.3, 0.6, and 0.8, respectively) for particle types with dominant sub-micrometer modes (wildfire smoke and human-emitted bronchial particles). Conversely, all mask types were predicted to achieve good collection efficiency (up to ~1.0) for the largest-sized particle types, including pollen grains, some fungal spores, and wildfire ash. Polydisperse infectious particles were predicted to be captured by masks with efficiencies of 0.3-1.0 depending on the pathogen size distribution and the type of mask used. Viruses aerosolized orally are predicted to be captured efficiently by all mask types, while those aerosolized from bronchiolar or laryngeal-tracheal sites are captured with much lower efficiency by surgical and cloth masks. The predicted efficiencies changed very little when extrathoracic deposition was included (inhalable rather than respirable fraction) or when very large (100 µm) particles were neglected. Actual mask fit and usage will determine protection levels in practice, but the relative comparisons in this work can inform mask guidance for different inhalation hazards, including particles generated by yard work, wildfires, and infections.
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38
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Giedraitienė A, Ruzauskas M, Šiugždinienė R, Tučkutė S, Milcius D. Antimicrobial Properties of CuO Particles Deposited on a Medical Mask. MATERIALS (BASEL, SWITZERLAND) 2022; 15:7896. [PMID: 36431382 PMCID: PMC9693313 DOI: 10.3390/ma15227896] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/28/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Medical face masks help to reduce the transmission of pathogens, however, the number of infections caused by antimicrobial-resistant pathogens continues to increase. The aim of this study was to investigate the antimicrobial effect of an experimental medical mask layer coated with copper oxide using an environmentally friendly non-thermal physical vapour deposition approach. Pure CuO nanoparticles were successfully deposited on the middle layer of a face mask. The particles were distributed in different size clusters (starting from less than 100 nm dots going up to about 1 µm cluster-like structures). The CuO clusters did not form uniform films, which could negatively influence airflow during use of the mask. We investigated the antimicrobial properties of the experimental mask layer coated with CuO NPs using 17 clinical and zoonotic strains of gram-negative, gram-positive, spore-forming bacteria and yeasts, during direct and indirect contact with the mask surface. The effectiveness of the coated mask layer depended on the deposition duration of CuO. The optimal time for deposition was 30 min, which ensured a bactericidal effect for both gram-positive and gram-negative bacteria, including antimicrobial-resistant strains, using 150 W power. The CuO NPs had little or no effect on Candida spp. yeasts.
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Affiliation(s)
- Agnė Giedraitienė
- Institute of Microbiology and Virology, Faculty of Veterinary Medicine, Lithuanian University of Health Sciences, Mickeviciaus 9, 44307 Kaunas, Lithuania
| | - Modestas Ruzauskas
- Institute of Microbiology and Virology, Faculty of Veterinary Medicine, Lithuanian University of Health Sciences, Mickeviciaus 9, 44307 Kaunas, Lithuania
| | - Rita Šiugždinienė
- Institute of Microbiology and Virology, Faculty of Veterinary Medicine, Lithuanian University of Health Sciences, Mickeviciaus 9, 44307 Kaunas, Lithuania
| | - Simona Tučkutė
- Center for Hydrogen Energy Technologies, Lithuanian Energy Institute, 44403 Kaunas, Lithuania
| | - Darius Milcius
- Center for Hydrogen Energy Technologies, Lithuanian Energy Institute, 44403 Kaunas, Lithuania
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39
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Glänzel MH, Barbosa IM, Machado E, Prusch SK, Barbosa AR, Lemos LFC, Schuch FB, Lanferdini FJ. Facial mask acute effects on affective/psychological and exercise performance responses during exercise: A meta-analytical review. Front Physiol 2022; 13:994454. [PMID: 36406998 PMCID: PMC9667098 DOI: 10.3389/fphys.2022.994454] [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: 07/14/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Face masks are widely used during the COVID-19 pandemic as one of the protective measures against the viral infection risk. Some evidence suggests that face mask prolonged use can be uncomfortable, and discomfort can be exacerbated during exercise. However, the acute responses of mask-wearing during exercise on affective/psychological and exercise performance responses is still a topic of debate. Purpose: To perform a systematic review with meta-analysis of the acute effects of mask-wearing during exercise on affective/psychological and exercise performance responses in healthy adults of different/diverse training status. Methods: This review (CRD42021249569) was performed according to Cochrane's recommendations, with searches performed in electronic (PubMed, Web of Science, Embase, SportDiscus, and PsychInfo) and pre-print databases (MedRxiv, SportRxiv, PsyArXiv, and Preprint.Org). Syntheses of included studies' data were performed, and the RoB-2 tool was used to assess the studies' methodological quality. Assessed outcomes were affective/psychological (discomfort, stress and affective responses, fatigue, anxiety, dyspnea, and perceived exertion) and exercise performance time-to-exhaustion (TTE), maximal power output (POMAX), and muscle force production] parameters. Available data were pooled through meta-analyses. Results: Initially 4,587 studies were identified, 36 clinical trials (all crossover designs) were included. A total of 749 (39% women) healthy adults were evaluated across all studies. The face mask types found were clothing (CM), surgical (SM), FFP2/N95, and exhalation valved FFP2/N95, while the most common exercises were treadmill and cycle ergometer incremental tests, beyond outdoor running, resistance exercises and functional tests. Mask-wearing during exercise lead to increased overall discomfort (SMD: 0.87; 95% CI 0.25-1.5; p = 0.01; I2 = 0%), dyspnea (SMD: 0.40; 95% CI 0.09-0.71; p = 0.01; I2 = 68%), and perceived exertion (SMD: 0.38; 95% CI 0.18-0.58; p < 0.001; I2 = 46%); decreases on the TTE (SMD: -0.29; 95% CI -0.10 to -0.48; p < 0.001; I2 = 0%); without effects on POMAX and walking/running distance traveled (p > 0.05). Conclusion: Face mask wearing during exercise increases discomfort (large effect), dyspnea (moderate effect), and perceived exertion (small effect), and reduces the TTE (small effect), without effects on cycle ergometer POMAX and distance traveled in walking and running functional tests. However, some aspects may be dependent on the face mask type, such as dyspnea and perceived exertion. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249569], identifier [CRD42021249569].
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Affiliation(s)
- Marcelo Henrique Glänzel
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Biomechanics and Kinesiology Research Group, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,*Correspondence: Marcelo Henrique Glänzel, ; Fábio Juner Lanferdini,
| | - Igor Martins Barbosa
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Esthevan Machado
- Biomechanics and Kinesiology Research Group, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Samuel Klippel Prusch
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Graduate Program in Gerontology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Luiz Fernando Cuozzo Lemos
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,Graduate Program in Gerontology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Fábio Juner Lanferdini
- Biomechanics Laboratory, Federal University of Santa Maria, Santa Maria, RS, Brazil,*Correspondence: Marcelo Henrique Glänzel, ; Fábio Juner Lanferdini,
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Viala R, Creton M, Jousserand M, Soubrié T, Néchab J, Crenn V, Léglise J. Experimental and numerical investigation on aerosols emission in musical practice and efficiency of reduction means. JOURNAL OF AEROSOL SCIENCE 2022; 166:106051. [PMID: 36061037 PMCID: PMC9420034 DOI: 10.1016/j.jaerosci.2022.106051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 06/27/2022] [Accepted: 07/10/2022] [Indexed: 06/07/2023]
Abstract
Early in the CoViD-19 pandemic, musical practices, especially singing and playing wind instruments, have been pointed out as having a high risk disease transmission due to aerosol production. However, characterization of these emission sources was not consolidated. This study focuses on the generation of aerosols and potential reduction in the context of playing wind instruments and singing. Aerosol concentration reduction means are evaluated using aerosol measurements in clean room and Computational Fluid Dynamics. Measurements at the bell of a clarinet and in front of singers are performed with or without a protection (bell cover for clarinet and surgical mask for singers). Numerical results on clarinet suggest that most of the supermicron ( ≥ 1 μ m ) particles are trapped on the walls of the instruments, which act as a filter, depending on toneholes configurations (closed or opened) changing the frequency of sound produced. Experimental results are consistent since almost only submicron particles contribute to the measured number concentration during playing clarinet. First of all, the high inter and intra-individuals variability is highlighted, with high coefficients of variation. This study highlights the impact of fingerings on the generated particles and the efficiency of protections such as bell cover (from 3 to 100 times), depending on the played note and players. Results for singers show that surgical masks significantly reduce the aerosol concentration (from 8 to 170 times) in front of the mouth. The evolution of aerosol concentration is also correlated with sound intensity.
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Affiliation(s)
- Romain Viala
- Institut Technologique Européen des Métiers de la Musique, ITEMM, 71 Avenue Olivier Messiaen, 72000, Le Mans, France
- Laboratoire d'Acoustique de l'Université du Mans - LAUM CNRS 6613 - Le Mans Université, Avenue Olivier Messiaen, 72085 Le Mans Cedex 09, France
| | - Milena Creton
- Buffet Crampon, 5 rue Maurice Berteaux, 78711 Mantes-La-Ville, France
| | | | - Tristan Soubrié
- ANDHEO, Centre ONERA, 29 Avenue de la Division Leclerc, 92322 Châtillon, France
| | - Julien Néchab
- ANDHEO, Centre ONERA, 29 Avenue de la Division Leclerc, 92322 Châtillon, France
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Sybert M, Oakley CT, Christensen T, Bosco J, Schwarzkopf R, Slover J. Impact of COVID-19 Protocols on Primary and Revision Total Hip Arthroplasty. J Arthroplasty 2022; 37:2193-2198. [PMID: 35598760 PMCID: PMC9119172 DOI: 10.1016/j.arth.2022.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/04/2022] [Accepted: 05/16/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Surgical site infection (SSI) after total hip arthroplasty (THA) is associated with increased morbidity, mortality, and healthcare expenditures. Our institution intensified hygiene standards during the COVID-19 pandemic; hospital staff exercised greater hand hygiene, glove use, and mask compliance. We examined the effect of these factors on SSI rates for primary THA (pTHA) and revision THA (rTHA). METHODS A retrospective review was performed identifying THA from January 2019 to June 2021 at a single institution. Baseline characteristics and outcomes were compared before (January 2019 to February 2020) and during (May 2020 to June 2021) the COVID-19 pandemic and during the first (May 2020 to November 2020) and second (December 2020 to June 2021) periods of the pandemic. Cohorts were compared using the Chi-squared test and independent samples t-test. RESULTS A total of 2,682 pTHA (prepandemic: 1,549 [57.8%]; pandemic: 1,133 [42.2%]) and 402 rTHA (prepandemic: 216 [53.7%]; Pandemic: 186 [46.2%]) were included. For primary and revision cases, superficial and deep SSI rates were similar before and during COVID-19. During COVID-19, the incidence of all (-0.43%, P = .029) and deep (-0.36%, P = .049) SSIs decreased between the first and second periods for rTHA. pTHA patients had longer operative times (P < .001) and shorter length of stay (P = .006) during COVID-19. Revision cases had longer operative times (P = .004) and length of stay (P = .046). Both pTHA and rTHA were discharged to skilled nursing facilities less frequently during COVID-19. CONCLUSION During COVID-19, operative times were longer in both pTHA and rTHA and patients were less likely to be discharged to a skilled nursing facility. Although intensified hygienic standards may lower SSI rates, infection rates did not significantly differ after our hospital implemented personal protective guidelines and a mask mandate.
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Affiliation(s)
| | | | | | | | | | - James Slover
- Address correspondence to: James D. Slover, MD, MS, Division of Adult Reconstruction, Department of Orthopedic Surgery, NYU Langone Health 301 East 17th Street, New York, NY 10003
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Sussman RA, Golberstein E, Polosa R. Analytic modeling and risk assessment of aerial transmission of SARS-CoV-2 virus through vaping expirations in shared micro-environments. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:83020-83044. [PMID: 35754079 PMCID: PMC9244239 DOI: 10.1007/s11356-022-20499-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
It is well known that airborne transmission of COVID-19 in indoor spaces occurs through various respiratory activities: breathing, vocalizing, coughing, and sneezing. However, there is a complete lack of knowledge of its possible transmission through exhalations of e-cigarette aerosol (ECA), which is also a respiratory activity. E-cigarettes have become widely popular among smokers seeking a much safer way of nicotine consumption than smoking. Due to restrictive lockdown measures taken during the COVID-19 pandemic, many smokers and vapers (e-cigarette users) were confined to shared indoor spaces, making it necessary to assess the risk of SARS-CoV-2 virus aerial transmission through their exhalations. We summarize inferred knowledge of respiratory particles emission and transport through ECA, as well as a theoretical framework for explaining the visibility of exhaled ECA, which has safety implications and is absent in other respiratory activities (apart from smoking). We also summarize and briefly discuss the effects of new SARS-CoV-2 variants, vaccination rates, and environmental factors that may influence the spread of COVID-19. To estimate the risk of SARS-CoV-2 virus aerial transmission associated with vaping exhalations, we adapt a theoretical risk model that has been used to analyze the risks associated with other respiratory activities in shared indoor spaces. We consider home and restaurant scenarios, with natural and mechanical ventilation, with occupants wearing and not wearing face masks. We consider as "control case" or baseline risk scenario an indoor space (home and restaurant) where respiratory droplets and droplet nuclei are uniformly distributed and aerial contagion risk might originate exclusively from occupants exclusively rest breathing, assuming this to be the only (unavoidable) respiratory activity they all carry on. If an infected occupant uses an e-cigarette in a home or restaurant scenarios, bystanders not wearing face masks exposed to the resulting ECA expirations face a [Formula: see text] increase of risk of contagion with respect the control case. This relative added risk with respect to the control case becomes [Formula: see text] for high-intensity vaping, [Formula: see text], and over [Formula: see text] for speaking for various periods or coughing (all without vaping). Infectious emissions are significantly modified by mechanical ventilation, face mask usage, vaccination, and environmental factors, but given the lack of empiric evidence, we assume as a working hypothesis that all basic parameters of respiratory activities are equally (or roughly equally) affected by these factors. Hence, the relative risk percentages with respect to the control state should remain roughly the same under a wide range of varying conditions. By avoiding direct exposure to the visible exhaled vaping jet, wearers of commonly used face masks are well protected from respiratory droplets and droplet nuclei directly emitted by mask-less vapers. Compared to the control case of an already existing (unavoidable) risk from continuous breathing, vaping emissions in shared indoor spaces pose just a negligible additional risk of COVID-19 contagion. We consider that it is not necessary to take additional preventive measures beyond those already prescribed (1.5 m separation and wearing face masks) in order to protect bystanders from this contagion.
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Affiliation(s)
- Roberto A Sussman
- Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, 04510, Mexico City, Mexico
| | - Eliana Golberstein
- Myriad Pharmaceuticals Limited, Unit 3, 36 Greenpark Rd, Penrose, 1061, Auckland, New Zealand
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy.
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Hong J, Byun J, Choi JO, Shim D, Rha DW. The Effects of Wearing Facemasks during Vigorous Exercise in the Aspect of Cardiopulmonary Response, In-Mask Environment, and Subject Discomfort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114106. [PMID: 36360983 PMCID: PMC9656209 DOI: 10.3390/ijerph192114106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/16/2022] [Accepted: 10/25/2022] [Indexed: 06/01/2023]
Abstract
Non-pharmaceutical intervention such as wearing a mask during the pandemic of SARS-CoV-2 is one of the most important ways to prevent the spread of the virus. However, despite high effectiveness and easy to access, the biggest problem is 'discomfort'. The purpose of this study was to measure the changes of cardiopulmonary response and related factors affecting breathing discomfort when wearing a mask during vigorous exercise. Fifteen healthy male adults participated in this study. The experimental protocol consisted of three conditions: no mask; KF-94 mask; and sports mask. Each condition consisted of three stages: stage I, 2 m/s on even level; stage II, 2 m/s with 5° inclination; and stage III, 3 m/s on even level. Oxygen saturation (SaO2) and heart rate (HR), partial pressure of carbon dioxide (pCO2), energy expenditure index (EEI), in-mask temperature, humidity, and a five-point scale questionnaire to evaluate subjective discomfort were measured. The results show that there was a significantly higher discomfort score in mask conditions compared with no mask (p < 0.05) and only pCO2 change significantly related to subjective discomfort during exercise (p < 0.05). Moreover, the pCO2 washout was significantly disturbed when wearing a sports mask in stages 2 and 3, which was related to wearer subjective discomfort.
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Oakley CT, Sybert M, Arraut J, Bosco J, Schwarzkopf R, Slover JD. Impact of Coronavirus Disease-2019 Protocols on Primary and Revision Total Knee Arthroplasty. Surg Infect (Larchmt) 2022; 23:841-847. [DOI: 10.1089/sur.2022.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Christian T. Oakley
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
| | - Michael Sybert
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
| | - Jerry Arraut
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
| | - Joseph Bosco
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
| | - James D. Slover
- Department of Orthopedic Surgery, NYU Langone Health, New York, New York, USA
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Wu SX, Wu X. Stay-at-home and face mask policy intentions inconsistent with incidence and fatality during the US COVID-19 pandemic. Front Public Health 2022; 10:990400. [PMID: 36311571 PMCID: PMC9609417 DOI: 10.3389/fpubh.2022.990400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/08/2022] [Indexed: 01/26/2023] Open
Abstract
During the COVID-19 pandemic, many states imposed stay-at-home (SAH) and mandatory face mask (MFM) orders to supplement the United States CDC recommendations. The purpose of this study was to characterize the relationship between SAH and MFM approaches with the incidence and fatality of COVID-19 during the pandemic period until 23 August 2020 (about 171 days), the period with no vaccines or specific drugs that had passed the phase III clinical trials yet. States with SAH orders showed a potential 50-60% decrease in infection and fatality during the SAH period (about 45 days). After normalization to population density, there was a 44% significant increase in the fatality rate in no-SAH + no-MFM states when compared to SAH + MFM. However, many results in this study were inconsistent with the intent of public health strategies of SAH and MFM. There were similar incidence rates (1.41, 1.81, and 1.36%) and significant differences in fatality rates (3.40, 2.12, and 1.25%; p < 0.05) and mortality rates (51.43, 34.50, and 17.42 per 100,000 residents; p < 0.05) among SAH + MFM, SAH + no-MFM, and no-SAH + no-MFM states, respectively. There were no significant differences in total positive cases, average daily new cases, and average daily fatality when normalized with population density among the three groups. This study suggested potential decreases in infection and fatality with short-term SAH order. However, SAH and MFM orders from some states' policies probably had limited effects in lowering transmission and fatality among the general population. At the policy-making level, if contagious patients would not likely be placed in strict isolation and massive contact tracing would not be effective to implement, we presume that following the CDC's recommendations with close monitoring of healthcare capacity could be appropriate in helping mitigate the COVID-19 disaster while limiting collateral socioeconomic damages.
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Affiliation(s)
- Samuel X. Wu
- Department of Engineering, Rice University, Houston, TX, United States
| | - Xin Wu
- Department of Neuroscience and Experimental Therapeutics, Texas A&M Health Science Center School of Medicine, Bryan, TX, United States
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Poydenot F, Abdourahamane I, Caplain E, Der S, Haiech J, Jallon A, Khoutami I, Loucif A, Marinov E, Andreotti B. Risk assessment for long- and short-range airborne transmission of SARS-CoV-2, indoors and outdoors. PNAS NEXUS 2022; 1:pgac223. [PMID: 36712338 PMCID: PMC9802175 DOI: 10.1093/pnasnexus/pgac223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/30/2022] [Indexed: 11/17/2022]
Abstract
Preventive measures to reduce infection are needed to combat the COVID-19 pandemic and prepare for a possible endemic phase. Current prophylactic vaccines are highly effective to prevent disease but lose their ability to reduce viral transmission as viral evolution leads to increasing immune escape. Long-term proactive public health policies must therefore complement vaccination with available nonpharmaceutical interventions aiming to reduce the viral transmission risk in public spaces. Here, we revisit the quantitative assessment of airborne transmission risk, considering asymptotic limits that considerably simplify its expression. We show that the aerosol transmission risk is the product of three factors: a biological factor that depends on the viral strain, a hydrodynamical factor defined as the ratio of concentration in viral particles between inhaled and exhaled air, and a face mask filtering factor. The short-range contribution to the risk, present both indoors and outdoors, is related to the turbulent dispersion of exhaled aerosols by air drafts and by convection (indoors), or by the wind (outdoors). We show experimentally that airborne droplets and CO2 molecules present the same dispersion. As a consequence, the dilution factor, and therefore the risk, can be measured quantitatively using the CO2 concentration, regardless of the room volume, the flow rate of fresh air, and the occupancy. We show that the dispersion cone leads to a concentration in viral particles, and therefore a short-range transmission risk, inversely proportional to the squared distance to an infected person and to the flow velocity. The aerosolization criterion derived as an intermediate result, which compares the Stokes relaxation time to the Lagrangian time-scale, may find application for a broad class of aerosol-borne pathogens and pollutants.
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Affiliation(s)
- Florian Poydenot
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Ismael Abdourahamane
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Elsa Caplain
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Samuel Der
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Jacques Haiech
- Cogitamus Laboratory and CNRS UMR 7242 BSC, 300 Bd Sébastien Brant, CS 10413, 67412 Illkirch Cedex, France
| | - Antoine Jallon
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Inés Khoutami
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Amir Loucif
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
| | - Emil Marinov
- Laboratoire de Physique de l’Ecole Normale Supérieure (LPENS), CNRS UMR 8023, Ecole Normale Supérieure, Université PSL, Sorbonne Université, and Université Paris Cité, 24 rue Lhomond, 75005 Paris, France
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Liu C, Huang J, Chen S, Wang D, Zhang L, Liu X, Lian X. The impact of crowd gatherings on the spread of COVID-19. ENVIRONMENTAL RESEARCH 2022; 213:113604. [PMID: 35691382 PMCID: PMC9181815 DOI: 10.1016/j.envres.2022.113604] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Crowd gatherings are an important cause of COVID-19 outbreaks. However, how the scale, scene and other factors of gatherings affect the spread of the epidemic remains unclear. A total of 184 gathering events worldwide were collected to construct a database, and 99 of them with a clear gathering scale were used for statistical analysis of the impact of these factors on the disease incidence among the crowd in the study. The results showed that the impact of small-scale (less than 100 people) gathering events on the spread of COVID-19 in the city is also not to be underestimated due to their characteristics of more frequent occurrence and less detection and control. In our dataset, 22.22% of small-scale events have an incidence of more than 0.8. In contrast, the incidence of most large-scale events is less than 0.4. Gathering scenes such as "Meal" and "Family" occur in densely populated private or small public places have the highest incidence. We further designed a model of epidemic transmission triggered by crowd gathering events and simulated the impact of crowd gathering events on the overall epidemic situation in the city. The simulation results showed that the number of patients will be drastically reduced if the scale and the density of crowds gathering are halved. It indicated that crowd gatherings should be strictly controlled on a small scale. In addition, it showed that the model well reproduce the epidemic spread after crowd gathering events better than does the original SIER model and could be applied to epidemic prediction after sudden gathering events.
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Affiliation(s)
- Chuwei Liu
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Jianping Huang
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China.
| | - Siyu Chen
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Danfeng Wang
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Li Zhang
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Xiaoyue Liu
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
| | - Xinbo Lian
- Collaborative Innovation Center for Western Ecological Safety, College of Atmospheric Sciences, Lanzhou University, Lanzhou, 730000, China
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Schmitt J, Wang J. A critical review on the role of leakages in the facemask protection against SARS-CoV-2 infection with consideration of vaccination and virus variants. INDOOR AIR 2022; 32:e13127. [PMID: 36305058 PMCID: PMC9828278 DOI: 10.1111/ina.13127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/18/2022] [Accepted: 09/19/2022] [Indexed: 05/28/2023]
Abstract
The protection provided by facemasks has been extensively investigated since the beginning of the SARS-CoV-2 outbreak, focusing mostly on the filtration efficiency of filter media for filtering face pieces (FFP), surgical masks, and cloth masks. However, faceseal leakage is a major contributor to the number of potentially infectious airborne droplets entering the respiratory system of a susceptible individual. The identification of leaking spots and the quantification of leaking flows are crucial to estimate the protection provided by facemasks. This study presents a critical review on the measurement and calculation of facemask leakages and a quantitative analysis of their role in the risk of SARS-CoV-2 infection. It shows that the pairing between the mask dimensions and the wearer's face is essential to improve protection efficiency, especially for FFP2 masks, and summarizes the most common leaking spots at the interface between the mask and the wearer's face. Leakage is a crucial factor in the calculation of the protection provided by facemasks and outweighs the filtration performances. The fit factors measured among mask users were summarized for different types of face protection. The reviewed data were integrated into a computational model to compare the mitigation impact of facemasks with vaccination with consideration of new variants of SARS-CoV-2. Combining a high adoption rate of facemasks and a high vaccination rate is crucial to efficiently control the spread of highly infectious variants.
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Affiliation(s)
- Jean Schmitt
- Department of Civil, Environmental and Geomatic Engineering, ETH ZurichInstitute of Environmental EngineeringZurichSwitzerland
- Laboratory for Advanced Analytical Technologies, EmpaSwiss Federal Laboratories for Materials Science and TechnologyDubendorfSwitzerland
| | - Jing Wang
- Department of Civil, Environmental and Geomatic Engineering, ETH ZurichInstitute of Environmental EngineeringZurichSwitzerland
- Laboratory for Advanced Analytical Technologies, EmpaSwiss Federal Laboratories for Materials Science and TechnologyDubendorfSwitzerland
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Siebler L, Calandri M, Rathje T, Stergiaropoulos K. Experimental Methods of Investigating Airborne Indoor Virus-Transmissions Adapted to Several Ventilation Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11300. [PMID: 36141572 PMCID: PMC9517214 DOI: 10.3390/ijerph191811300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 08/31/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
This study introduces a principle that unifies two experimental methods for evaluating airborne indoor virus-transmissions adapted to several ventilation measures. A first-time comparison of mechanical/natural ventilation and air purification with regard to infection risks is enabled. Effortful computational fluid dynamics demand detailed boundary conditions for accurate calculations of indoor airflows, which are often unknown. Hence, a suitable, simple and generalized experimental set up for identifying the spatial and temporal infection risk for different ventilation measures is more qualified even with unknown boundary conditions. A trace gas method is suitable for mechanical and natural ventilation with outdoor air exchange. For an accurate assessment of air purifiers based on filtration, a surrogate particle method is appropriate. The release of a controlled rate of either trace gas or particles simulates an infectious person releasing virus material. Surrounding substance concentration measurements identify the neighborhood exposure. One key aspect of the study is to prove that the requirement of concordant results of both methods is fulfilled. This is the only way to ensure that the comparison of different ventilation measures described above is reliable. Two examples (a two-person office and a classroom) show how practical both methods are and how the principle is applicable for different types and sizes of rooms.
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Wang TK, Solano T, Shoele K. Bridge the gap: correlate face mask leakage and facial features with 3D morphable face models. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2022; 32:735-743. [PMID: 34741114 PMCID: PMC8570071 DOI: 10.1038/s41370-021-00399-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND Face masks have been proven to be effective in protecting the public against airborne transmitted diseases when fitted appropriately. However, for homemade cloth masks and surgical masks, the fit is often poor, allowing viruses to escape through the gap. OBJECTIVE This work aims to identify the correlation between the mask leakage, mask configurations, and individual's facial features. METHODS A novel locally morphing 3D face model, and a minimum-energy-based mask deployment model are used to systematically examine the mask fit for a large cohort of exemplars. RESULTS The results show that the mask size and tuck-in ratio, along with selective facial features, especially nose height and chin length, are key factors determining the leakage location and extent. A polynomial regression model is presented for mask fitness based on localized facial features. SIGNIFICANCE This study is a complete pipeline to test various masks on a wide range of faces with controlled modification of distinct regions of the face, which is difficult to achieve with human subjects, and provide knowledge on how the masks should be designed in the future. IMPACT STATEMENT The face mask "fit" affects the mask's efficacy in preventing airborne transmission. To date, research on the face mask fit has been conducted mainly using experiments on limited subjects. The limited sample size in experimental studies makes it hard to reach a statistical correlation between mask fit and facial features in a population. Here, we employ a novel framework that utilizes a morphable face model and mask's deployment simulation to test mask fit for many facial characteristics and mask designs. The proposed technique is an important step toward enabling personalized mask selection with maximum efficacy for society members.
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Affiliation(s)
- Tso-Kang Wang
- FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, USA
| | - Tomas Solano
- FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, USA
| | - Kourosh Shoele
- FAMU-FSU College of Engineering, Florida State University, Tallahassee, FL, USA.
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