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Jonker L, Linde KJ, de Boer AR, Ding E, Zhang D, de Hoog MLA, Herfst S, Heederik DJJ, Fraaij PLA, Bluyssen PM, Wouters IM, Bruijning-Verhagen PCJL. SARS-CoV-2 incidence in secondary schools; the role of national and school-initiated COVID-19 measures. BMC Public Health 2023; 23:1243. [PMID: 37370045 DOI: 10.1186/s12889-023-16146-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION Our aim was to gain insight into the effect of COVID-19 measures on SARS-CoV-2 incidence in secondary schools and the association with classroom CO2 concentration and airborne contamination. METHODS Between October 2020-June 2021, 18 schools weekly reported SARS-CoV-2 incidence and completed surveys on school-initiated COVID-19 measures (e.g. improving hygiene or minimizing contacts). CO2 was measured in occupied classrooms twice, and SARS-CoV-2 air contamination longitudinally using electrostatic dust collectors (EDC) and analyzed using RT-qPCR. National COVID-19 policy measures varied during pre-lockdown, lockdown and post-lockdown periods. During the entire study, schools were recommended to improve ventilation. SARS-CoV-2 incidence rate ratios (IRR) were estimated by Generalized Estimating Equation (GEE) models. RESULTS During 18 weeks follow-up (range: 10-22) SARS-CoV-2 school-incidence decreased during national lockdown (adjusted IRR: 0.41, 95%CI: 0.21-0.80) and post-lockdown (IRR: 0.60, 0.39-0.93) compared to pre-lockdown. School-initiated COVID-19 measures had no additional effect. Pre-lockdown, IRRs per 10% increase in time CO2 exceeded 400, 550 and 800 ppm above outdoor level respectively, were 1.08 (1.00-1.16), 1.10 (1.02-1.19), and 1.08 (0.95-1.22). Post-lockdown, CO2-concentrations were considerably lower and not associated with SARS-CoV-2 incidence. No SARS-CoV-2 RNA was detected in any of the EDC samples. CONCLUSION During a period with low SARS-CoV-2 population immunity and increased attention to ventilation, with CO2 levels most of the time below acceptable thresholds, only the national policy during and post-lockdown of reduced class-occupancy, stringent quarantine, and contact testing reduced SARS-CoV-2 incidence in Dutch secondary schools. Widespread SARS-CoV-2 air contamination could not be demonstrated in schools under the prevailing conditions during the study.
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Affiliation(s)
- L Jonker
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - K J Linde
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - A R de Boer
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands.
| | - E Ding
- Faculty of Architecture and the Built Environment, Delft University of Technology, Julianalaan 134, 2628 BL, Delft, the Netherlands
| | - D Zhang
- Faculty of Architecture and the Built Environment, Delft University of Technology, Julianalaan 134, 2628 BL, Delft, the Netherlands
| | - M L A de Hoog
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - S Herfst
- Department of Viroscience, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, 3000 CA, Rotterdam, Netherlands
| | - D J J Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - P L A Fraaij
- Department of Viroscience, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, 3000 CA, Rotterdam, Netherlands
- Department of Pediatrics, Erasmus MC, Dr. Molewaterplein 50, 3015 GE, 3000 CA, Rotterdam, Netherlands
| | - P M Bluyssen
- Faculty of Architecture and the Built Environment, Delft University of Technology, Julianalaan 134, 2628 BL, Delft, the Netherlands
| | - I M Wouters
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, the Netherlands
| | - P C J L Bruijning-Verhagen
- Julius Center for Health Sciences and Primary Care, UMC Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
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Tang JW, Bahnfleth WP, Bluyssen PM, Buonanno G, Jimenez JL, Kurnitski J, Li Y, Miller S, Sekhar C, Morawska L, Marr LC, Melikov AK, Nazaroff WW, Nielsen PV, Tellier R, Wargocki P, Dancer SJ. Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). J Hosp Infect 2021; 110:89-96. [PMID: 33453351 PMCID: PMC7805396 DOI: 10.1016/j.jhin.2020.12.022] [Citation(s) in RCA: 179] [Impact Index Per Article: 59.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of ‘airborne’ whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six ‘myths’ are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.
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Affiliation(s)
- J W Tang
- Respiratory Sciences, University of Leicester, Leicester, UK
| | - W P Bahnfleth
- Department of Architectural Engineering, The Pennsylvania State University, State College, PA, USA
| | - P M Bluyssen
- Faculty of Architecture and the Built Environment, Delft University of Technology, Delft, The Netherlands
| | - G Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | - J L Jimenez
- Department of Chemistry and CIRES, University of Colorado, Boulder, CO, USA
| | - J Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Tallinn, Estonia
| | - Y Li
- Department of Mechanical Engineering, University of Hong Kong, Hong Kong, China
| | - S Miller
- Mechanical Engineering, University of Colorado, Boulder, CO, USA
| | - C Sekhar
- Department of Building, National University of Singapore, Singapore
| | - L Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - L C Marr
- Civil and Environmental Engineering, Virginia Tech, Blacksburg, VA, USA
| | - A K Melikov
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - W W Nazaroff
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - P V Nielsen
- Faculty of Engineering and Science, Department of Civil Engineering, Aalborg University, Aalborg, Denmark
| | - R Tellier
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - P Wargocki
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Kongens Lyngby, Denmark
| | - S J Dancer
- Department of Microbiology, NHS Lanarkshire, Glasgow, UK; School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
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Bluyssen PM, Roda C, Mandin C, Fossati S, Carrer P, de Kluizenaar Y, Mihucz VG, de Oliveira Fernandes E, Bartzis J. Self-reported health and comfort in 'modern' office buildings: first results from the European OFFICAIR study. Indoor Air 2016; 26:298-317. [PMID: 25727348 DOI: 10.1111/ina.12196] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 02/16/2015] [Indexed: 06/04/2023]
Abstract
In the European research project OFFICAIR, a procedure was developed to determine associations between characteristics of European offices and health and comfort of office workers, through a checklist and a self-administered questionnaire including environmental, physiological, psychological, and social aspects. This procedure was applied in 167 office buildings in eight European countries (Portugal, Spain, Italy, Greece, France, Hungary, the Netherlands, and Finland) during the winter of 2011-2012. About 26 735 survey invitation e-mails were sent, and 7441 office workers were included in the survey. Among respondents who rated an overall comfort less than 4 (23%), 'noise (other than from building systems)', air 'too dry', and temperature 'too variable' were the main complaints selected. An increase of perceived control over indoor climate was positively associated with the perceived indoor environment quality. Almost one-third of office workers suffered from dry eyes and headache in the last 4 weeks. Physical building characteristics were associated with occupants' overall satisfaction (acoustical solutions, mold growth, complaints procedure, cleaning activities) and health (number of occupants, lack of operable windows, presence of carpet and cleaning activities). OFFICAIR project provides a useful database to identify stressors related to indoor environmental quality and office worker's health.
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Affiliation(s)
- P M Bluyssen
- Section Climate Design, Department of Architectural Engineering & Technology, Faculty of Architecture and the Built Environment, Delft University of Technology, Delft, The Netherlands
| | - C Roda
- Section Climate Design, Department of Architectural Engineering & Technology, Faculty of Architecture and the Built Environment, Delft University of Technology, Delft, The Netherlands
| | - C Mandin
- CSTB (Scientific and Technical Centre for Building), Marne-la-Vallée, France
| | - S Fossati
- "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy
| | - P Carrer
- "L. Sacco" Department of Biomedical and Clinical Sciences, University of Milano, Milano, Italy
| | - Y de Kluizenaar
- Department of Urban Environment and Safety, TNO (The Netherlands Organization for Applied Scientific Research), Delft, The Netherlands
| | - V G Mihucz
- Cooperative Research Centre of Environmental Sciences, Eötvös Loránd University, Budapest, Hungary
| | | | - J Bartzis
- University of Western Macedonia, Kozani, Greece
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