A Critical Review on the Factors that Influence Opportunistic Premise Plumbing Pathogens: From Building Entry to Fixtures in Residences

Residential buildings provide unique conditions for opportunistic premise plumbing pathogen (OPPP) exposure via aerosolized water droplets produced by showerheads, faucets, and tubs. The objective of this review was to critically evaluate the existing literature that assessed the impact of potentially enhancing conditions to OPPP occurrence associated with residential plumbing and to point out knowledge gaps. Comprehensive studies on the topic were found to be lacking. Major knowledge gaps identified include the assessment of OPPP growth in the residential plumbing, from building entry to fixtures, and evaluation of the extent of the impact of typical residential plumbing design (e.g., trunk and branch and manifold), components (e.g., valves and fixtures), water heater types and temperature setting of operation, and common pipe materials (copper, PEX, and PVC/CPVC). In addition, impacts of the current plumbing code requirements on OPPP responses have not been assessed by any study and a lack of guidelines for OPPP risk management in residences was identified. Finally, the research required to expand knowledge on OPPP amplification in residences was discussed.

Role of ventilation on the transmission of viruses in buildings, from a single zone to a multizone approach

In a virus pandemic context, buildings ventilation has been recognized as a solution for preventing transmission of the virus in aerosolized form. The impact of the widespread recommendation of window opening and sealing door on ventilation circuits needs to be considered with a multizone approach. We modeled the airflow distribution in a building where people are isolating in a pandemic context, including one infected person. We analyzed the impact of opening the window and sealing the door in the quarantine room on exposures and probability of infection for occupants of the flat and of adjacent flats. In order to study the sensitivity of the results, we tested three ventilation systems: balanced, exhaust-only, and humidity-based demand-controlled, and several window- and door-opening strategies. When the door of the quarantine room is sealed, we observe that opening the window in the quarantine room always results in increased exposure and probability of infection for at least one other occupant, including in neighbors' apartments. When all internal doors are opened, we observe moderate impacts, with rather an increase of exposure of the occupants of the same apartments and of their probability of infection, and a decrease for the occupants located in other apartments. Based on the analysis on the airflows distribution in this case study, we conclude that sealing the internal door has more influence than opening the window of the quarantine room, whatever the ventilation system. We observe that this widespread recommendation to open the window of a quarantine room and to seal the door is based on the consideration of a single zone model. We illustrate the importance of moving from such a single zone approach to a multizone approach for quantifying ventilation and airing impacts in multizone buildings as residences in order to prevent epidemics of viruses such as SARS-CoV-2. It highlights the need of air leakage databases.

Indoor ozone: Concentrations and influencing factors

Because people spend most of their time indoors, much of their exposure to ozone occurs in buildings, which are partially protective against outdoor ozone. Measurements in approximately 2000 indoor environments (residences, schools, and offices) show a central tendency for average indoor ozone concentration of 4-6 ppb and an indoor to outdoor concentration ratio of about 25%. Considerable variability in this ratio exists among buildings, as influenced by seven building-associated factors: ozone removal in mechanical ventilation systems, ozone penetration through the building envelope, air-change rates, ozone loss rate on fixed indoor surfaces, ozone loss rate on human occupants, ozone loss by homogeneous reaction with nitrogen oxides, and ozone loss by reaction with gas-phase organics. Among these, the most important are air-change rates, ozone loss rate on fixed indoor surfaces, and, in densely occupied spaces, ozone loss rate on human occupants. Although most indoor ozone originates outdoors and enters with ventilation air, indoor emission sources can materially increase indoor ozone concentrations. Mitigation technologies to reduce indoor ozone concentrations are available or are being investigated. The most mature of these technologies, activated carbon filtration of mechanical ventilation supply air, shows a high modeled health-benefit to cost ratio when applied in densely occupied spaces.

Inter-Rater Reliability of the Mealtime Scan+

BACKGROUND AND OBJECTIVES

The Mealtime Scan (MTS) was developed to assess the dining environment in Long Term Care (LTC). MTS has been reviewed and updated to ensure its standardization and responsiveness to changes in the dining environment. The objectives of this paper are to provide an overview of the changes made in the new MTS+ tool and to describe its inter-rater reliability.

RESEARCH DESIGN AND METHODS

The observational and scoring methods used to evaluate the physical, social, and relational-centered dining environments in LTC homes were reviewed and updated into MTS+ and an overall quality of dining rating derived. Two trained assessors were evaluated for the inter-rater reliability. Nine dining rooms in three LTC homes at different meals were observed for a total of 45 observations. Interclass Correlation Coefficient (ICC) was used to assess reliability.

RESULTS

MTS+ demonstrated good reliability on the orientation cues, social environment, and relationship-centered activities (orientation cues ICC: 0.75, social ICC: 0.78, relational ICC: 0.78). However, the tool's reliability was poor for the physical environment, ICC: 0.48 and moderate for the overall rating of the quality of the dining environment, ICC: 0.67. Discussion and Implications: Although deemed more effective and practical for use in intervention studies, MTS+ has some limitations with respect to its reliability, particularly in assessing the physical environment. It is hypothesized that more extensive training of the assessors may lead to improvements in the reliability of MTS+. MTS+ can be used in intervention research when one assessor completes repeat observations of a dining area.

Evaluation of Sources and Patterns of Elemental Composition of PM2.5 at Three Low-Income Neighborhood Schools and Residences in Quito, Ecuador

Elemental characterization of fine particulate matter was undertaken at schools and residences in three low income neighborhoods in Quito, Ecuador. The three zones were located in the northern (Cotocollao), south central (El Camal), and south east (Los Chillos) neighborhoods and were classified as zones 1–3, respectively. Forty elements were quantified via ICP-MS analysis. Amongst the geogenic elements, the concentration of Si was the most abundant followed by S, Al, and Ca. Elements with predominantly anthropogenic sources such as Zn, V, and Ni were higher in zone 3 school followed by zone 2 and zone 1 schools. Enrichment factors were calculated to study the role of crustal sources in the elemental concentrations. Geogenic elements, except K, all had values <10 and anthropogenic elements such as Ni, V, Zn, Pb, As, Cr had >10. Principal Component Analysis suggested that Ni and V concentrations were strongly attributable to pet coke and heavy oil combustion. Strong associations between As and Pb could be attributed to traffic and other industrial emissions. Resuspended dust, soil erosion, vehicular emissions (tailpipe, brake and tire wear, and engine abrasion), pet coke, heavy oil combustion, and heavy industrial operations were major contributors to air pollution.

Staff Reactions Toward Lesbian, Gay, or Bisexual (LGB) People Living in Residential Aged Care Facilities (RACFs) Who Actively Disclose Their Sexual Orientation

Fifty-three staff members currently working in residential aged care facilities located in Barcelona, Spain, were asked about the way they would react if a resident told them that he or she felt sexually attracted and had maintained sexual relationships with another resident of the same gender. Acceptance of non-heterosexual sexual orientation was a frequent answer, and around one in four professionals stated that they would try helping the resident in question, by offering a private space or giving some emotional support. However, some reactions were not consistent with a respectful approach toward sexual diversity, as, for instance, informing the resident's family or advising the resident to keep his or her sexual orientation hidden. We highlight the importance of developing formal policies and offering formal training to staff in order to address the specific needs of older LGB people living in RACFs.

A critical review of naphthalene sources and exposures relevant to indoor and outdoor air

Both the recent classification of naphthalene as a possible human carcinogen and its ubiquitous presence motivate this critical review of naphthalene's sources and exposures. We evaluate the environmental literature on naphthalene published since 1990, drawing on nearly 150 studies that report emissions and concentrations in indoor, outdoor and personal air. While naphthalene is both a volatile organic compound and a polycyclic aromatic hydrocarbon, concentrations and exposures are poorly characterized relative to many other pollutants. Most airborne emissions result from combustion, and key sources include industry, open burning, tailpipe emissions, and cigarettes. The second largest source is off-gassing, specifically from naphthalene's use as a deodorizer, repellent and fumigant. In the U.S., naphthalene's use as a moth repellant has been reduced in favor of para-dichlorobenzene, but extensive use continues in mothballs, which appears responsible for some of the highest indoor exposures, along with off-label uses. Among the studies judged to be representative, average concentrations ranged from 0.18 to 1.7 microg m(-3) in non-smoker's homes, and from 0.02 to 0.31 microg m(-3) outdoors in urban areas. Personal exposures have been reported in only three European studies. Indoor sources are the major contributor to (non-occupational) exposure. While its central tendencies fall well below guideline levels relevant to acute health impacts, several studies have reported maximum concentrations exceeding 100 microg m(-3), far above guideline levels. Using current but draft estimates of cancer risks, naphthalene is a major environmental risk driver, with typical individual risk levels in the 10(-4) range, which is high and notable given that millions of individuals are exposed. Several factors influence indoor and outdoor concentrations, but the literature is inconsistent on their effects. Further investigation is needed to better characterize naphthalene's sources and exposures, especially for indoor and personal measurements.