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Coyle JP, Derk RC, Lindsley WG, Blachere FM, Boots T, Lemons AR, Martin SB, Mead KR, Fotta SA, Reynolds JS, McKinney WG, Sinsel EW, Beezhold DH, Noti JD. Efficacy of Ventilation, HEPA Air Cleaners, Universal Masking, and Physical Distancing for Reducing Exposure to Simulated Exhaled Aerosols in a Meeting Room. Viruses 2021; 13:2536. [PMID: 34960804 PMCID: PMC8707272 DOI: 10.3390/v13122536] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 12/12/2022] Open
Abstract
There is strong evidence associating the indoor environment with transmission of SARS-CoV-2, the virus that causes COVID-19. SARS-CoV-2 can spread by exposure to droplets and very fine aerosol particles from respiratory fluids that are released by infected persons. Layered mitigation strategies, including but not limited to maintaining physical distancing, adequate ventilation, universal masking, avoiding overcrowding, and vaccination, have shown to be effective in reducing the spread of SARS-CoV-2 within the indoor environment. Here, we examine the effect of mitigation strategies on reducing the risk of exposure to simulated respiratory aerosol particles within a classroom-style meeting room. To quantify exposure of uninfected individuals (Recipients), surrogate respiratory aerosol particles were generated by a breathing simulator with a headform (Source) that mimicked breath exhalations. Recipients, represented by three breathing simulators with manikin headforms, were placed in a meeting room and affixed with optical particle counters to measure 0.3-3 µm aerosol particles. Universal masking of all breathing simulators with a 3-ply cotton mask reduced aerosol exposure by 50% or more compared to scenarios with simulators unmasked. While evaluating the effect of Source placement, Recipients had the highest exposure at 0.9 m in a face-to-face orientation. Ventilation reduced exposure by approximately 5% per unit increase in air change per hour (ACH), irrespective of whether increases in ACH were by the HVAC system or portable HEPA air cleaners. The results demonstrate that mitigation strategies, such as universal masking and increasing ventilation, reduce personal exposure to respiratory aerosols within a meeting room. While universal masking remains a key component of a layered mitigation strategy of exposure reduction, increasing ventilation via system HVAC or portable HEPA air cleaners further reduces exposure.
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Affiliation(s)
- Jayme P. Coyle
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Raymond C. Derk
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - William G. Lindsley
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Francoise M. Blachere
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Theresa Boots
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Angela R. Lemons
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Stephen B. Martin
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA;
| | - Kenneth R. Mead
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA;
| | - Steven A. Fotta
- Facilities Management Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA;
| | - Jeffrey S. Reynolds
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Walter G. McKinney
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Erik W. Sinsel
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - Donald H. Beezhold
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
| | - John D. Noti
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA; (J.P.C.); (R.C.D.); (F.M.B.); (T.B.); (A.R.L.); (J.S.R.); (W.G.M.); (E.W.S.); (D.H.B.); (J.D.N.)
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