Indirect health effects of relative humidity in indoor environments

Structural Colored Based Humidity Sensor Consisting of High Resolution 3D Printed Photonic Crystal Coated with Ultrathin Responsive Hydrogels

Today, humidity sensors have become an integral part of the daily lives. In particular, humidity sensors using an electronic measuring principle have become the standard. Although these sensors have proven to be a stable measurement method, they have some disadvantages, such as their long response time or the danger of using them in explosive environments. This work introduces photonic crystals as an alternative optical measurement approach. The novel technology of ultra-fast two-photon polymerisation printing is combined with a thin-film deposition process, namely iCVD. This allows to print large area high-precision 3D templates, which are subsequently coated with a humidity responsive hydrogel thin film (p(HEMA) of 20 nm.The limits of 2PP technology are being pushed allowing the production ofs table and periodic large-area 3D structures. The flexible customization of hydrogels for ambient conditions make them exceptionally promising for a wide range of sensing applications. Additionally, optical methods for measuring humidity seem to be an excellent alternative to overcome the limitations for current state of the art humidity sensors. The optical detection of changes in ambient air humidity is achieved by observing color changes of the printed structure within the visible wavelength range.

Quantitative evaluation of the impact of indoor relative humidity on deposition of aerosols generated during tooth grinding in a real-world clinical setting

OBJECTIVES

Exposure to aerosol particles generated from tooth grinding has a negative impact on the health of dental personnel. The aim of this study was to quantitatively analyze the impact of indoor relative humidity (IRH) on the deposition of these suspended particles in a well-controlled dental environment.

MATERIALS AND METHODS

In this study, a humidity control system was employed to effectively regulate and maintain indoor relative humidity (IRH). A novel computer-assisted numerical control system was developed to pre-treat the molar specimens, and accurately simulate clinical tooth grinding procedures. Each procedure was performed in triplicate, with an online real-time particle counter (ORPC; TR-8301, TongrenCo.) measuring aerosol production. All testing devices were controlled remotely. The data obtained were statistically analyzed using descriptive statistics and non-parametric tests (Kruskal-Wallis/ Dunn's post hoc test with Bonferroni correction, p < 0.05).

RESULTS

The findings showed that with increasing IRH, the maximum peak concentration of aerosol particles decreased by 397% from 6.51 × 107 particles/m3 at 30% to 1.64 × 107 particles/m3 at 80%. The Kruskal-Wallis test results indicated a statistically significant effect of IRH on the aerosol increment (p < 0.05).

CONCLUSIONS

Increasing the IRH level can effectively promote the deposition of aerosol particles, with a return to baseline within 15 min after reaching 60% or above.

CLINICAL RELEVANCE

Our study suggested that maintaining IRH above 70% during the cleaning process, allowing natural recovery to ambient humidity levels within 15 min after cleaning, and taking basic precautions, may lead to an adequate reduction in the possible health risks of aerosol contamination.

HiMIC-Monthly: A 1 km high-resolution atmospheric moisture index collection over China, 2003-2020

Near-surface atmospheric moisture is a key environmental and hydro-climatic variable that has significant implications for the natural and human systems. However, high-resolution moisture data are severely lacking for fine-scale studies. Here, we develop the first 1 km high spatial resolution dataset of monthly moisture index collection in China (HiMIC-Monthly) over a long period of 2003~2020. HiMIC-Monthly is generated by the light gradient boosting machine algorithm (LightGBM) based on observations at 2,419 weather stations and multiple covariates, including land surface temperature, vapor pressure, land cover, impervious surface proportion, population density, and topography. This collection includes six commonly used moisture indices, enabling fine-scale assessment of moisture conditions from different perspectives. Results show that the HiMIC-Monthly dataset has a good performance, with R2 values for all six moisture indices exceeding 0.96 and root mean square error and mean absolute error values within a reasonable range. The dataset exhibits high consistency with in situ observations over various spatial and temporal regimes, demonstrating broad applicability and strong reliability.

Quantitative risk assessment of COVID-19 aerosol transmission indoors: a mechanistic stochastic web application

An increasing body of literature suggests that aerosol inhalation plays a primary role in COVID-19 transmission, particularly in indoor settings. Mechanistic stochastic models can help public health professionals, engineers, and space planners understand the risk of aerosol transmission of COVID-19 to mitigate it. We developed such model and a user-friendly web application to meet the need of accessible risk assessment tools during the COVID-19 pandemic. We built our model based on the Wells-Riley model of respiratory disease transmission, using quanta emission rates obtained from COVID-19 outbreak investigations. In this report, three modelled scenarios were evaluated and compared to epidemiological studies looking at similar settings: classrooms, weddings, and heavy exercise sessions. We found that the risk of long-range aerosol transmission increased 309-332% when people were not wearing masks, and 424-488% when the room was poorly ventilated in addition to no masks being worn across the scenarios. Also, the risk of transmission could be reduced by ∼40-60% with ventilation rates of 5 ACH for 1-4 h exposure events, and ∼70% with ventilation rates of 10 ACH for 4 h exposure events. Relative humidity reduced the risk of infection (inducing viral inactivation) by a maximum of ∼40% in a 4 h exposure event at 70% RH compared to a dryer indoor environment with 25% RH. Our web application has been used by more than 1000 people in 52 countries as of September 1st, 2021. Future work is needed to obtain SARS-CoV-2 dose-response functions for more accurate risk estimates.

Fabrication and characterization of a flexible and disposable impedance-type humidity sensor based on polyaniline (PAni)

This work presents a highly sensitive, economical, flexible, and disposable humidity sensor developed with a facile fabrication process. The sensor was fabricated on cellulose paper using polyemaraldine salt, a form of polyaniline (PAni), via the drop coating method. A three-electrode configuration was employed to ensure high accuracy and precision. The PAni film was characterized using various techniques including ultraviolet-visible (UV-vis) absorption spectroscopy, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The humidity sensing properties were evaluated through electrochemical impedance spectroscopy (EIS) in a controlled environment. The sensor exhibits a linear response with R 2 = 0.990 for impedance over a wide range of (0%-97%) relative humidity (RH). Further, it displayed consistent responsiveness, a sensitivity of 1.1701 Ω/%RH, acceptable response (≤220 s)/recovery (≤150 s), excellent repeatability, low hysteresis (≤2.1%) and long-term stability at room temperature. The temperature dependence of the sensing material was also studied. Due to its unique features, cellulose paper was found to be an effective alternative to conventional sensor substrates according to several factors including compatibility with the PAni layer, flexibility and low cost. These unique characteristics make this sensor a promising option for use in specific healthcare monitoring, research activities, and industrial settings as a flexible and disposable humidity measurement tool.

Structural Phase Transformations Induced by Guest Molecules in a Nickel-Based 2D Square Lattice Coordination Network

Herein, we report the crystal structure and guest binding properties of a new two-dimensional (2D) square lattice (sql) topology coordination network, sql-(azpy)(pdia)-Ni, which is comprised of two linker ligands with diazene (azo) moieties, (E)-1,2-di(pyridin-4-yl)diazene(azpy) and (E)-5-(phenyldiazenyl)isophthallate(pdia). sql-(azpy)(pdia)-Ni underwent guest-induced switching between a closed (nonporous) β phase and several open (porous) α phases, but unlike the clay-like layer expansion to distinct phases previously reported in switching sql networks, a continuum of phases was formed. In effect, sql-(azpy)(pdia)-Ni exhibited elastic-like properties induced by adaptive guest binding. Single-crystal X-ray diffraction (SCXRD) studies of the α phases revealed that the structural transformations were enabled by the pendant phenyldiazenyl moiety on the pdia^2- ligand. This moiety functioned as a type of hinge to enable parallel slippage of layers and interlayer expansion for the following guests: N,N-dimethylformamide, water, dichloromethane, para-xylene, and ethylbenzene. The slippage angle (interplanar distances) ranged from 54.133° (4.442 Å) in the β phase to 69.497° (5.492 Å) in the ethylbenzene-included phase. Insight into the accompanying phase transformations was also gained from variable temperature powder XRD studies. Dynamic water vapor sorption studies revealed a stepped isotherm with little hysteresis that was reversible for at least 100 cycles. The isotherm step occurred at ca. 50% relative humidity (RH), the optimal RH value for humidity control.

Application of virtual product design to the development of HVAC solution for Incheon International Airport Modular COVID-19 testing center

Owing to the spread of COVID-19, the need for an inspection center that can quickly determine whether travelers using the airport are infected has emerged. For rapid determination, not only polymerase chain reaction tests but also antigen-antibody tests and on-site analysis systems are required. However, because it is time- and cost-intensive to construct a building that meets the standards for negative pressure facilities, modular negative pressure facilities are being installed as alternatives. Existing negative pressure facilities have problems such as increased energy consumption due to outdoor air load and condensation due to differences in indoor and outdoor temperatures and humidities caused by excessive external air inflow to achieve the target negative pressure and air change rate (ACH). In addition, owing to the installation of additional devices, additional construction is required to use them for other purposes in the future. To solve these problems, in this study, energy recovery ventilation (ERV) was employed to develop a heating, ventilation and air conditioning (HVAC) solution for the Incheon International Airport COVID-19 Testing Center. To shorten the development period, virtual product design (VPD) using computational fluid dynamics analysis-based design of experiments was performed. Owing to the application of VPD, the Incheon International Airport Modular COVID-19 Testing Center was completed in 2 weeks. The target pressure was measured in all spaces by applying the optimal conditions derived through VPD. In addition, owing to the application of ERV, the ACH of an airborne infectious isolation room exceeded the value suggested by international organizations.

Associations between indoor relative humidity and global COVID-19 outcomes

Globally, the spread and severity of COVID-19 have been distinctly non-uniform. Seasonality was suggested as a contributor to regional variability, but the relationship between weather and COVID-19 remains unclear and the focus of attention has been on outdoor conditions. Because humans spend most of their time indoors and because most transmission occurs indoors, we here, instead, investigate the hypothesis that indoor climate-particularly indoor relative humidity (RH)-may be the more relevant modulator of outbreaks. To study this association, we combined population-based COVID-19 statistics and meteorological measurements from 121 countries. We rigorously processed epidemiological data to reduce bias, then developed and experimentally validated a computational workflow to estimate indoor conditions based on outdoor weather data and standard indoor comfort conditions. Our comprehensive analysis shows robust and systematic relationships between regional outbreaks and indoor RH. In particular, we found intermediate RH (40-60%) to be robustly associated with better COVID-19 outbreak outcomes (versus RH < 40% or >60%). Together, these results suggest that indoor conditions, particularly indoor RH, modulate the spread and severity of COVID-19 outbreaks.

Detecting the Effect Size of Weather Conditions on Patient-Reported Outcome Measures (PROMs)

One of the next frontiers in medical research, particularly in orthopaedic surgery, is personalized treatment outcome prediction. In personalized medicine, treatment choices are adjusted for the patient based on the individual's and their disease's distinct features. A high-value and patient-centered health care system requires evaluating results that integrate the patient's viewpoint. Patient-reported outcome measures (PROMs) are widely used to shed light on patients' perceptions of their health status after an intervention by using validated questionnaires. The aim of this study is to examine whether meteorological or light (night vs. day) conditions affect PROM scores and hence indirectly affect health-related outcomes. We collected scores for PROMs from questionnaires completed by patients (N = 2326) who had undergone hip and knee interventions between June 2017 and May 2020 at the IRCCS Orthopaedic Institute Galeazzi (IOG), Milan, Italy. Nearest neighbour propensity score (PS) matching was applied to ensure the similarity of the groups tested under the different weather-related conditions. The exposure PS was derived through logistic regression. The data were analysed using statistical tests (Student's t-test and Mann-Whitney U test). According to Cohen's effect size, weather conditions may affect the scores for PROMs and, indirectly, health-related outcomes via influencing the relative humidity and weather-related conditions. The findings suggest avoiding PROMs' collection in certain conditions if the odds of outcome-based underperformance are to be minimized. This would ensure a balance between costs for PROMs' collection and data availability.

SARS-CoV-2 phase I transmission and mutability linked to the interplay of climatic variables: a global observation on the pandemic spread

The study aims to determine the impact of global meteorological parameters on SARS-COV-2, including population density and initiation of lockdown in twelve different countries. The daily trend of these parameters and COVID-19 variables from February 15th to April 25th, 2020, were considered. Asian countries show an increasing trend between infection rate and population density. A direct relationship between the time-lapse of the first infected case and the period of suspension of movement controls the transmissivity of COVID-19 in Asian countries. The increase in temperature has led to an increase in COVID-19 spread, while the decrease in humidity is consistent with the trend in daily deaths during the peak of the pandemic in European countries. Countries with 65°F temperature and 5 mm rainfall have a negative impact on COVID-19 spread. Lower oxygen availability in the atmosphere, fine droplets of submicron size together with infectious aerosols, and low wind speed have contributed to the increase in total cases and mortality in Germany and France. The onset of the D614G mutation and subsequent changes to D614 before March, later G614 in mid-March, and S943P, A831V, D839/Y/N/E in April were observed in Asian and European countries. The results of the correlation and factor analysis show that the COVID-19 cases and the climatic factors are significantly correlated with each other. The optimum meteorological conditions for the prevalence of G614 were identified. It was observed that the complex interaction of global meteorological factors and changes in the mutational form of CoV-2 phase I influenced the daily mortality rate along with other comorbid factors. The results of this study could help the public and policymakers to create awareness of the COVID-19 pandemic.

Associative evidence for the potential of humidification as a non-pharmaceutical intervention for influenza and SARS-CoV-2 transmission

BACKGROUND

Both influenza and SARS-CoV-2 viruses show a strong seasonal spreading in temperate regions. Several studies indicated that changes in indoor humidity could be one of the key factors explaining this.

OBJECTIVE

The purpose of this study is to quantify the association between relevant epidemiological metrics and humidity in both influenza and SARS-CoV-2 epidemic periods.

METHODS

The atmospheric dew point temperature serves as a proxy for indoor relative humidity. This study considered the weekly mortality rate in the Netherlands between 1995 and 2019 to determine the correlation between the dew point and the spread of influenza. During influenza epidemic periods in the Netherlands, governmental restrictions were absent; therefore, there is no need to control this confounder. During the SARS-CoV-2 pandemic, governmental restrictions strongly varied over time. To control this effect, periods with a relatively constant governmental intervention level were selected to analyze the reproduction rate. We also examine SARS-CoV-2 deaths in the nursing home setting, where health policy and social factors were less variable. Viral transmissibility was measured by computing the ratio between the estimated daily number of infectious persons in the Netherlands and the lagged mortality figures in the nursing homes.

RESULTS

For both influenza and SARS-CoV-2, a significant correlation was found between the dew point temperature and the aforementioned epidemiological metrics. The findings are consistent with the anticipated mechanisms related to droplet evaporation, stability of virus in the indoor environment, and impairment of the natural defenses of the respiratory tract in dry air.

SIGNIFICANCE

This information is helpful to understand the seasonal pattern of respiratory viruses and motivate further study to what extent it is possible to alter the seasonal pattern by actively intervening in the adverse role of low humidity during fall and winter in temperate regions.

IMPACT

A solid understanding and quantification of the role of humidity on the transmission of respiratory viruses is imperative for epidemiological modeling and the installation of non-pharmaceutical interventions. The results of this study indicate that improving the indoor humidity by humidifiers could be a promising technology for reducing the spread of both influenza and SARS-CoV-2 during winter and fall in the temperate zone. The identification of this potential should be seen as a strong motivation to invest in further prospective testing of this non-pharmaceutical intervention.

A single-film fiber optical sensor for simultaneous measurement of carbon dioxide and relative humidity

Colorimetric measurement is a versatile, low-cost method for bio-/chemical sensing and that has importance in biomedical applications. General carbon dioxide (CO₂) sensors based on colorimetric change of a pH indicator report only one parameter at a time and are cross-sensitive to relative humidity (RH). This work describes a novel optical fiber sensor with a thin film on the distal end of the fiber, combining colorimetric measurement and a white light Fabry-Pérot interferometer (FPI) for the simultaneous measurement of CO₂ and RH. The CO₂ sensitive dye ion-pair: thymol blue and tetramethylammonium hydroxide are encapsulated inside organically modified silica forming an extrinsic FPI cavity (refractive index of 1.501 ± 0.02 and thickness of 5.83 ± 0.09 μm). The sensor reversibly responds to 0-6% CO₂ and 0-90% RH with negligible cross-sensitivity and allows measurement of both parameters simultaneously. A sensitivity of ∼0.19 nm/%RH is obtained for RH measurement based on the wavelength shift of the FPI and there is a polynomial correlation between the average intensity of selected wavelengths and the concentration of CO₂. The applicability of the sensor is demonstrated by measuring the CO₂ and RH exhaled from human breath with a percent error of 3.1% and 2.2% respectively compared to a commercial datalogger. A simulation model is provided for the dye-encapsulated FPI sensor allowing simulation of spectra of sensors with different film thicknesses.

Evaluation of Children's Thermal Environment in Nursery School: Through the Questionnaire and Measurement of Wearable Sensors Approach

Due to psychological and physical differences, children are more vulnerable to the influence of the surrounding environment than adults. A nursery school in Japan was selected as the research object. The actual thermal environment of children aged 1 to 5 in the classroom was evaluated based on measured data in winter and summer. Through a questionnaire survey of nursery teachers, this paper analyzed and compared the relationship between teachers’ thermal adaptation behavior and children’s thermal sensation. Compared with the traditional fixed-points measurement method, a method of wearable sensors for children was proposed to measure the indoor temperature distribution. The traditional measurement results showed that 73% of classroom indoor temperatures and humidity do not meet the thermal comfort standard stipulated by the government. The method proposed in this paper indicates that: (1) nursery teachers’ thermal adaptation behavior may not be based on children’s thermal sensations; (2) solar radiation and weather context could lead to uneven indoor horizontal temperature distribution, hence, specific attention should be paid to the thermal environment when children move to the window side; and (3) the density of occupants causes the temperature around the human body to be relatively high. We suggest that teachers improve the thermal comfort of gathered children through thermal adaptive behaviors. The results of the study provide valuable information for nursery managers to formulate effective indoor thermal environment strategies from the perspective of children.

Decision-Making Processes of Residents in Preservation, Thermal Comfort, and Energy Efficiency in Heritage Buildings: A Pilot Study in Mexico City

With building construction representing one of the largest sectors responsible for the use of natural resources, retrofitting existing heritage buildings becomes a necessity, albeit a challenging one. The emergence of specific guidance on retrofitting heritage buildings has unveiled more than never the need to understand how residents negotiate, thermal comfort, energy efficiency, and heritage conservation decisions. The paper reports the complexity of the decision-making process of residents of heritage buildings in the Historic Centre of Mexico City regarding energy efficiency, intending to improve thermal comfort and reduce energy consumption while preserving heritage values. The study involved in-depth semi-structured interviews with users of heritage buildings that were thematically analysed, complemented by the monitoring of internal environmental conditions and system dynamics analysis. The results show that although the residents perceived the buildings’ temperature as poor, passive thermal comfort actions (e.g., wearing more clothes and closing windows) were preferred against invasive retrofitting solutions for thermal comfort due to residents’ resistance to a potential loss in the buildings’ values and the high cost of changes. The degree of change necessary for maintenance, renovation, and actions for improving the thermal comfort of a heritage building is related to values and to their preservation for future generations. The users’ changes were limited to small-scale interventions in floors and ceilings while avoiding touching what they consider essential to preserve and protect (i.e., social and cultural values). Integrating the user into the decision-making process would enhance the long-term continuity and sustainability of retrofitting policies and guidelines, thus avoiding losing heritage-built stock.

Portable ultrasonic humidifier exacerbates indoor bioaerosol risks by raising bacterial concentrations and fueling pathogenic genera

Portable ultrasonic humidifiers are frequently used in heating rooms to ease air dryness. However, it has also posed serious health concerns such as "humidifier fever" because the bioaerosol concentration and community in the humidified space may alter quickly before the occupants could even notice. We compared the microbial proliferation rates in the humidifiers' reservoirs filled with three commonly used water types and investigated the impacts of the ultrasonic humidifiers on the temporal concentration, size distribution, and community variations of indoor bacterial and fungal aerosols during two-week humidification. The concentration of indoor bacterial aerosols increased exponentially, concentrating in the respiratory size ranges (≤1.1 µm), and was proportional to the humidification level, which soon exceeded 1000 CFU/m³ in one week (at RH = 70%), while the fungal concentration always remained low (≤177 CFU/m³ ). The indoor bioaerosol community, significantly associated with the humidifier water, was substantially distorted after humidification and dominated by the pathogenic Pseudomonas spp. (40.50%), Brevundimonas spp. (3.02%), Acinetobacter spp. (0.98%) and Legionella spp. (0.69%). Our results show that ultrasonic humidification contaminates indoor air by raising bacterial concentrations and fueling the pathogenic genera. To minimize the exposure risks, occupants should avoid long-term and excessive humidification (RH ≥ 70%) and clean the ultrasonic humidifier weekly.

Humidification of indoor air for preventing or reducing dryness symptoms or upper respiratory infections in educational settings and at the workplace

BACKGROUND

Indoor exposure to dry air during heating periods has been associated with dryness and irritation symptoms of the upper respiratory airways and the skin. The irritated or damaged mucous membrane poses an important entry port for pathogens causing respiratory infections.

OBJECTIVES

To determine the effectiveness of interventions that increase indoor air humidity in order to reduce or prevent dryness symptoms of the eyes, the skin and the upper respiratory tract (URT) or URT infections, at work and in educational settings.

SEARCH METHODS

The last search for all databases was done in December 2020. We searched Ovid MEDLINE, Embase, CENTRAL (Cochrane Library), PsycINFO, Web of Science, Scopus and in the field of occupational safety and health: NIOSHTIC-2, HSELINE, CISDOC and the In-house database of the Division of Occupational and Environmental Medicine, University of Zurich. We also contacted experts, screened reference lists of included trials, relevant reviews and consulted the WHO International Clinical Trials Registry Platform (ICTRP).

SELECTION CRITERIA

We included controlled studies with a parallel group or cross-over design, quasi-randomised studies, controlled before-and-after and interrupted time-series studies on the effects of indoor air humidification in reducing or preventing dryness symptoms and upper respiratory tract infections as primary outcomes at workplace and in the educational setting. As secondary outcomes we considered perceived air quality, other adverse events, sick leave, task performance, productivity and attendance and costs of the intervention.

DATA COLLECTION AND ANALYSIS

Two review authors independently screened titles, abstracts and full texts for eligibility, extracted data and assessed the risks of bias of included studies. We synthesised the evidence for the primary outcomes 'dry eye', 'dry nose', 'dry skin', for the secondary outcome 'absenteeism', as well as for 'perception of stuffiness' as the harm-related measure. We assessed the certainty of evidence using the GRADE system.

MAIN RESULTS

We included 13 studies with at least 4551 participants, and extracted the data of 12 studies with at least 4447 participants. Seven studies targeted the occupational setting, with three studies comprising office workers and four hospital staff. Three of them were clustered cross-over studies with 846 participants (one cRCT), one parallel-group controlled trial (2395 participants) and three controlled before-and-after studies with 181 participants. Five studies, all CTs, with at least 1025 participants, addressing the educational setting, were reported between 1963 and 1975, and in 2018. In total, at least 3933 (88%) participants were included in the data analyses. Due to the lack of information, the results of the risk of bias assessment remained mainly unclear and the assessable risks of bias of included studies were considered as predominantly high. Primary outcomes in occupational setting:  We found that indoor air humidification at the workplace may have little to no effect on dryness symptoms of the eye and nose (URT). The only cRCT showed a significant decrease in dry eye symptoms among working adults (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.37 to 0.79) with a low certainty of the evidence. The only cluster non-randomised cross-over study showed a non-significant positive effect of humidification on dryness nose symptoms (OR 0.87, 95% CI 0.53 to 1.42) with a low certainty of evidence. We found that indoor air humidification at the workplace may have little and non-significant effect on dryness skin symptoms. The pooled results of two cluster non-RCTs showed a non-significant alleviation of skin dryness following indoor air humidification (OR 0.66, 95% CI 0.33 to 1.32) with a low certainty of evidence. Similarly, the pooled results of two before-after studies yielded no statistically significant result (OR 0.69, 95% CI 0.33 to 1.47) with very low certainty of evidence No studies reported on the outcome of upper respiratory tract infections. No studies conducted in educational settings investigated our primary outcomes. Secondary outcomes in occupational setting: Perceived stuffiness of the air was increased during the humidification in the two cross-over studies (OR 2.18, 95% CI 1.47 to 3.23); (OR 1.70, 95% CI 1.10 to 2.61) with low certainty of evidence. Secondary outcomes in educational setting: Based on different measures and settings of absenteeism, four of the six controlled studies found a reduction in absenteeism following indoor air humidification (OR 0.54, 95% CI 0.45 to 0.65; OR 0.38, 95% CI 0.15 to 0.96; proportion 4.63% versus 5.08%).

AUTHORS' CONCLUSIONS

Indoor air humidification at the workplace may have little to no effect on dryness symptoms of the eyes, the skin and the URT. Studies investigating illness-related absenteeism from work or school could only be summarised narratively, due to different outcome measures assessed. The evidence suggests that increasing humidification may reduce the absenteeism, but the evidence is very uncertain. Future RCTs involving larger sample sizes, assessing dryness symptoms more technically or rigorously defining absenteeism and controlling for potential confounders are therefore needed to determine whether increasing indoor air humidity can reduce or prevent dryness symptoms of the eyes, the skin, the URT or URT infections at work and in educational settings over time.

Estimating the magnitude and risk associated with heat exposure among Ghanaian mining workers

Many occupational settings located outdoors in direct sun, such as open cut mining, pose a health, safety, and productivity risk to workers because of their increased exposure to heat. This issue is exacerbated by climate change effects, the physical nature of the work, the requirement to work extended shifts and the need to wear protective clothing which restricts evaporative cooling. Though Ghana has a rapidly expanding mining sector with a large workforce, there appears to be no study that has assessed the magnitude and risk of heat exposure on mining workers and its potential impact on this workforce. Questionnaires and temperature data loggers were used to assess the risk and extent of heat exposure in the working and living environments of Ghanaian miners. The variation in heat exposure risk factors across workers' gender, education level, workload, work hours, physical work exertion and proximity to heat sources is significant (p<0.05). Mining workers are vulnerable to the hazards of heat exposure which can endanger their health and safety, productive capacity, social well-being, adaptive capacity and resilience. An evaluation of indoor and outdoor Wet Bulb Globe Temperature (WBGT) in the working and living environment showed that mining workers can be exposed to relatively high thermal load, thus raising their heat stress risk. Adequate adaptation policies and heat exposure management for workers are imperative to reduce heat stress risk, and improve productive capacity and the social health of mining workers.

High Water Adsorption MOFs with Optimized Pore-Nanospaces for Autonomous Indoor Humidity Control and Pollutants Removal

The indoor air quality is of prime importance for human daily life and health, for which the adsorbents like zeolites and silica-gels are widely used for air dehumidification and harmful gases capture. Herein, we develop a pore-nanospace post-engineering strategy to optimize the hydrophilicity, water-uptake capacity and air-purifying ability of metal-organic frameworks (MOFs) with long-term stability, offering an ideal candidate with autonomous multi-functionality of moisture control and pollutants sequestration. Through variant tuning of organic-linkers carrying hydrophobic and hydrophilic groups in the pore-nanospaces of prototypical UiO-67, a moderately hydrophilic MOF (UiO-67-4Me-NH₂ -38 %) with high thermal, hydrolytic and acid-base stability is screened out, featuring S-shaped water sorption isotherms exactly located in the recommended comfortable and healthy ranges of relative humidity for indoor ventilation (45 %-65 % RH) and adverse health effects minimization (40-60 % RH). Its exceptional attributes of water-uptake working capacity/efficiency, contaminants removal, recyclability and regeneration promise a great potential in confined indoor environment application.

Indoor air quality assessment in dwellings with different ventilation strategies in Nunavik and impacts on bacterial and fungal microbiota

Indoor air quality is a major issue for public health, particularly in northern communities. In this extreme environment, adequate ventilation is crucial to provide a healthier indoor environment, especially in airtight dwellings. The main objective of the study is to assess the impact of ventilation systems and their optimization on microbial communities in bioaerosols and dust in 54 dwellings in Nunavik. Dwellings with three ventilation strategies (without mechanical ventilators, with heat recovery ventilators, and with energy recovery ventilators) were investigated before and after optimization of the ventilation systems. Indoor environmental conditions (temperature, relative humidity) and microbiological parameters (total bacteria, Aspergillus/Penicillium, endotoxin, and microbial biodiversity) were measured. Dust samples were collected in closed face cassettes with a polycarbonate filter using a micro-vacuum while a volume of 20 m³ of bioaerosols were collected on filters using a SASS3100 (airflow of 300 L/min). In bioaerosols, the median number of copies was 4.01 × 10³ copies/m³ of air for total bacteria and 1.45 × 10¹ copies/m³ for Aspergillus/Penicillium. Median concentrations were 5.13 × 10⁴ copies/mg of dust, 5.07 × 10¹ copies/mg, 9.98 EU/mg for total bacteria, Aspergillus/Penicillium and endotoxin concentrations, respectively. The main microorganisms were associated with human occupancy such as skin-related bacteria or yeasts, regardless of the type of ventilation.

COVID-19: The impact in US high-rise office buildings energy efficiency

The COVID-19 pandemic, through stay-at-home orders, forced rapid changes to social human behavior and interrelations, targeting the work environments to protect workers and users. Rapidly, global organizations, US associations, and professionals stepped in to mitigate the virus's spread in buildings' living and work environments. The institutions proposed new HVAC settings without efficiency concerns, as improved flow rates and filtering for irradiation, humidity, and temperature. Current literature consensually predicted an increase in energy consumption due to new measures to control the SARS-CoV-2 spread. The research team assumed the effort of validating the prior published outcomes, applied to US standardized high-rise office buildings, as defined and set by the key entities in the field, by resorting to a methodology based on software energy analysis. The study compares a standard high-rise office building energy consumption, CO₂ emissions and operations costs in nine US climate zones - from 0 to 8, south to north latitudes, respectively -, assessed in the most populated cities, between the previous and post COVID-19 scenarios. The outcomes clarify the gathered knowledge, explaining that climate zones above mixed-humid type tend to increase relative energy use intensity by 21.72%, but below that threshold the zones decrease relative energy use intensity by 11.92%.

Health-Related Benefits of Different Indoor Plant Species in a School Setting

Humans spend more than 80% of their lives indoors resulting in an increased demand for high indoor air quality (IAQ). At the same time, indoor air tends to be at least twice as polluted as outdoor air, and health threats caused by long-term exposure to indoor air pollution are rising. Few experiments under real-life conditions have demonstrated positive effects of indoor plants on parameters related to IAQ, resulting in improved humidity and temperature, reduced particulate matter concentration and CO2 levels. Indoor living walls allow the presence of many plants—without taking up valuable floor area. This article presents the results of conducted measurements on four do-it-yourself green walls planted with different plant species that are typically used for vertical indoor greenery (golden pothos, Boston fern, spider plant and a combination of plants) in a school setting. Besides the parameters of air humidity and temperature, CO2, mold spore and particulate matter levels, influences on room acoustics were investigated. Based on a custom-developed evaluation matrix, the plants were compared with each other and a reference without plants. The results show that no species led to deterioration of IAQ. Golden pothos had the most substantial effect and delivered improvements in all examined parameters.

The Adverse Associations of Classrooms' Indoor Air Quality and Thermal Comfort Conditions on Students' Illness Related Absenteeism between Heating and Non-Heating Seasons-A Pilot Study

(1) The association of the indoor environmental conditions in classrooms with illness-related absenteeism (IRA) was not well investigated. In addition, studying the association between heating and non-heating seasons were very limited; (2) To fill this knowledge gap, a research team collected various indoor air quality (IAQ) and thermal comfort conditions (TC) of 85 elementary classrooms in two school districts from the Midwestern United States throughout an academic year; in total, 255 classroom visits were performed. A negative binomial regression model was implied to associate the classroom’s IAQ and TC with IRA, separating for heating and non-heating seasons; (3) During non-heating season, a 3% increase of IRA was estimated with 1,000,000-counts/L increase of particles that had a diameter less than 2.5 μm (PN2.5); during the heating season, a 3% increase of IRA were expected with 100 ppm increase of room averaged CO₂ concentration; and (4) These results suggested that the IAQ and TC factors could associated with IRA differently between heating and non-heating seasons.

Susceptibility of an Airborne Common Cold Virus to Relative Humidity

The viability of airborne respiratory viruses varies with ambient relative humidity (RH). Numerous contrasting reports spanning several viruses have failed to identify the mechanism underlying this dependence. We hypothesized that an "efflorescence/deliquescence divergent infectivity" (EDDI) model accurately predicts the RH-dependent survival of airborne human rhinovirus-16 (HRV-16). We measured the efflorescence and deliquescence RH (RH_E and RH_D, respectively) of aerosols nebulized from a protein-enriched saline carrier fluid simulating the human respiratory fluid and found the RH range of the aerosols' hygroscopic hysteresis zone (RH_E-D) to be 38-68%, which encompasses the preferred RH for indoor air (40-60%). The carrier fluid containing HRV-16 was nebulized into the sub-hysteresis zone (RH_<E) or super-hysteresis zone (RH_>D) air, to set the aerosols to the effloresced/solid or deliquesced/liquid state before transitioning the RH into the intermediate hysteresis zone. The surviving fractions (SFs) of the virus were then measured 15 min post nebulization. SFs were also measured for aerosols introduced directly into the RH_<E, RH_E-D, and RH_>D zones without transition. SFs for transitioned aerosols in the hysteresis zone were higher for effloresced (0.17 ± 0.02) than for deliquesced (0.005 ± 0.005) aerosols. SFs for nontransitioned aerosols in the RH_<E, RH_E-D, and RH_>D zones were 0.18 ± 0.06, 0.05 ± 0.02, and 0.20 ± 0.05, respectively, revealing a V-shaped SF/RH dependence. The EDDI model's prediction of enhanced survival in the hysteresis zone for effloresced carrier aerosols was confirmed.

Biometric Data as Real-Time Measure of Physiological Reactions to Environmental Stimuli in the Built Environment

The physiological and cognitive effects of environmental stimuli from the built environment on humans have been studied for more than a century, over short time frames in terms of comfort, and over long-time frames in terms of health and wellbeing. The strong interdependence of objective and subjective factors in these fields of study has traditionally involved the necessity to rely on a number of qualitative sources of information, as self-report variables, which however, raise criticisms concerning their reliability and precision. Recent advancements in sensing technology and data processing methodologies have strongly contributed towards a renewed interest in biometric data as a potential high-precision tool to study the physiological effects of selected stimuli on humans using more objective and real-time measures. Within this context, this review reports on a broader spectrum of available and advanced biosensing techniques used in the fields of building engineering, human physiology, neurology, and psychology. The interaction and interdependence between (i) indoor environmental parameters and (ii) biosignals identifying human physiological response to the environmental stressors are systematically explored. Online databases ScienceDirect, Scopus, MDPI and ResearchGate were scanned to gather all relevant publications in the last 20 years, identifying and listing tools and methods of biometric data collection, assessing the potentials and drawbacks of the most relevant techniques. The review aims to support the introduction of biomedical signals as a tool for understanding the physiological aspects of indoor comfort in the view of achieving an improved balance between human resilience and building resilience, addressing human indoor health as well as energetic and environmental building performance.

Occupants' Health and Their Living Conditions of Remote Indigenous Communities in New Zealand

The New Zealand Ministry of Health reported that respiratory disease affects 700,000 people, annually costs New Zealand NZ$7.05 billion, and is the third-highest cause of death. The hospitalisation rate for asthma of Māori communities is 2.0 higher than that of other ethnic groups, and hospitalisation rates for deprived homes are 2.3 times higher than those of the least deprived homes. Based on physical data and evidence, which were drawn from a mixed methodology that includes field studies of the indoor microclimate, dust-mite allergens, mould growth, and occupants' Respiratory Health Survey of a number of sample houses of Māori communities in Minginui, Te Whaiti, Murupara, and Rotorua of New Zealand, the study identifies unhealthy indoor thermal conditions, thresholds or ranges of indoor micro-climate related to different levels of dust-mite allergen and mould growth, the most common type of indoor mould, and correlations between dust-mite and mould and correlations. The study not only identified that the poor health of occupants is closely related to their inadequate living conditions, but also identifies the threshold of indoor micro-climates to maintain indoor allergens at the acceptable level, which can be used as a guideline to maintain or improve indoor health conditions for future housing development or retrofitted old housing.

Aluminum Metal-Organic Frameworks with Photocatalytic Antibacterial Activity for Autonomous Indoor Humidity Control

There is an increasing need to maintain the indoor humidity at a comfortable and healthy level without relying on high energy-consuming and potentially germ-infested air-conditioning systems. Water adsorbents exhibiting reversible moisture adsorption/desorption ability as well as sufficient antibacterial activity are highly expected to achieve humidity control in an autonomous and safe way. Metal-organic frameworks (MOFs) featuring high porosity and designability show potential in meeting these requirements in a singular platform. Given the low toxicity and the rich abundance of aluminum in nature, a family of isoreticular Al-terephthalate-based MOFs were systematically evaluated in terms of the static and kinetic water adsorption/desorption and the photocatalytic bacteria-killing behavior. In particular, CAU-1-OH exhibits a desired working range (40-60% RH), a high working capacity (0.41 g g^-1), an excellent cycle performance (500 cycles), and a high photocatalytic killing efficiency (99.94%) against Escherichia coli. As a proof of concept, the air filter prepared by coating CAU-1-OH on a commercial nonwoven fabric is capable of buffering against sudden humidity changes caused by the infiltration of outside air and effectively reducing the contamination of bioaerosol or particulate matter. The study significantly advanced the development of next-generation water adsorbents with antibacterial activity for residential humidity control.

Prediction Model for Airborne Microorganisms Using Particle Number Concentration as Surrogate Markers in Hospital Environment

Indoor microbiological air quality, including airborne bacteria and fungi, is associated with hospital-acquired infections (HAIs) and emerging as an environmental issue in hospital environment. Many studies have been carried out based on culture-based methods to evaluate bioaerosol level. However, conventional biomonitoring requires laborious process and specialists, and cannot provide data quickly. In order to assess the concentration of bioaerosol in real-time, particles were subdivided according to the aerodynamic diameter for surrogate measurement. Particle number concentration (PNC) and meteorological conditions selected by analyzing the correlation with bioaerosol were included in the prediction model, and the forecast accuracy of each model was evaluated by the mean absolute percentage error (MAPE). The prediction model for airborne bacteria demonstrated highly accurate prediction (R² = 0.804, MAPE = 8.5%) from PNC1-3, PNC3-5, and PNC5-10 as independent variables. Meanwhile, the fungal prediction model showed reasonable, but weak, prediction results (R² = 0.489, MAPE = 42.5%) with PNC3-5, PNC5-10, PNC > 10, and relative humidity. As a result of external verification, even when the model was applied in a similar hospital environment, the bioaerosol concentration could be sufficiently predicted. The prediction model constructed in this study can be used as a pre-assessment method for monitoring microbial contamination in indoor environments.

Bad Air Can Also Kill: Residential Indoor Air Quality and Pollutant Exposure Risk during the COVID-19 Crisis

During the first outbreak of the SARS-CoV-2 pandemic the population, focusing primarily on the risk of infection, was generally inattentive to the quality of indoor air. Spain, and the city of Madrid in particular, were among the world's coronavirus hotspots. The country's entire population was subject to a 24/7 lockdown for 45 days. This paper describes a comparative longitudinal survey of air quality in four types of housing in the city of Madrid before and during lockdown. The paper analysed indoor temperatures and variations in CO2, 2.5 μm particulate matter (PM2.5) and total volatile organic compound (TVOC) concentrations before and during lockdown. The mean daily outdoor PM2.5 concentration declined from 11.04 µg/m3 before to 7.10 µg/m3 during lockdown. Before lockdown the NO2 concentration values scored as 'very good' 46% of the time, compared to 90.9% during that period. Although the city's outdoor air quality improved, during lockdown the population's exposure to indoor pollutants was generally more acute and prolonged. Due primarily to concern over domestic energy savings, the lack of suitable ventilation and more intensive use of cleaning products and disinfectants during the covid-19 crisis, indoor pollutant levels were typically higher than compatible with healthy environments. Mean daily PM2.5 concentration rose by approximately 12% and mean TVOC concentration by 37% to 559%. The paper also puts forward a series of recommendations to improve indoor domestic environments in future pandemics and spells out urgent action to be taken around indoor air quality (IAQ) in the event of total or partial quarantining to protect residents from respiratory ailments and concomitantly enhanced susceptibility to SARS-CoV-2, as identified by international medical research.

Super hygroscopic nanofibrous membrane-based moisture pump for solar-driven indoor dehumidification

Desiccants play vital roles in dehumidification and atmospheric water harvesting; however, current desiccants have mediocre hygroscopicity, limited recyclability, and high energy consumption. Herein, we report a wood-inspired moisture pump based on electrospun nanofibrous membrane for solar-driven continuous indoor dehumidification. The developed moisture pump with multilayer wood-like cellular networks and interconnected open channels is composed of a desiccant layer and a photothermal layer. The desiccant layer exhibits an unprecedented moisture absorption capacity of 3.01 g g^-1 at 90% relative humidity (RH), fast moisture absorption and transport rates, enabling atmospheric water harvesting. The photothermal layer shows a high solar absorption of 93%, efficient solar thermal conversion, and good moisture permeability, thus promoting water evaporation. The moisture pump efficiently reduces the indoor relative humidity to a comfort level (40‒60% RH) under one-sun illumination. This work opens the way to develop new-generation, high-performance nanofibrous membrane-based desiccants for energy-efficient humidity control and atmospheric water harvesting.

Physiological and Behavior Monitoring Systems for Smart Healthcare Environments: A Review

Healthcare optimization has become increasingly important in the current era, where numerous challenges are posed by population ageing phenomena and the demand for higher quality of the healthcare services. The implementation of Internet of Things (IoT) in the healthcare ecosystem has been one of the best solutions to address these challenges and therefore to prevent and diagnose possible health impairments in people. The remote monitoring of environmental parameters and how they can cause or mediate any disease, and the monitoring of human daily activities and physiological parameters are among the vast applications of IoT in healthcare, which has brought extensive attention of academia and industry. Assisted and smart tailored environments are possible with the implementation of such technologies that bring personal healthcare to any individual, while living in their preferred environments. In this paper we address several requirements for the development of such environments, namely the deployment of physiological signs monitoring systems, daily activity recognition techniques, as well as indoor air quality monitoring solutions. The machine learning methods that are most used in the literature for activity recognition and body motion analysis are also referred. Furthermore, the importance of physical and cognitive training of the elderly population through the implementation of exergames and immersive environments is also addressed.

Airborne Influenza A Virus Exposure in an Elementary School

Influenza contributes significantly to childhood morbidity and mortality. Given the magnitude of the school-aged child population, a sizeable proportion of influenza virus transmission events are expected to occur within school settings. However, influenza virus activity in schools is not well-understood, likely due to our limited ability to accurately monitor for respiratory viruses without disrupting the school environment. In this study, we evaluated the use of a bioaerosol sampling method to noninvasively detect and quantify airborne influenza A virus (IAV) densities in a public elementary school. Air samples were collected from multiple locations in the school, two days per week, throughout an eight-week sampling period during influenza season. Real-time RT-PCR targeting the IAV M gene revealed detectable IAV on five occasions in densities ranging from 2.0 × 10⁻¹ to 1.9 × 10⁴. No significant differences in IAV densities were related to student presence/absence. The majority of IAV-associated particles were ≤4 μm in diameter, and theoretical calculations indicate infectious thresholds after minutes of exposure. Our study represents the first identification and quantification of airborne influenza virus in an elementary school, and the results suggest that airborne IAV has the potential to circulate in schools during influenza season, in large enough doses known to cause infection.

Wellbuilt for wellbeing: Controlling relative humidity in the workplace matters for our health

This study offers a new perspective on the role of relative humidity in strategies to improve the health and wellbeing of office workers. A lack of studies of sufficient participant size and diversity relating relative humidity (RH) to measured health outcomes has been a driving factor in relaxing thermal comfort standards for RH and removing a lower limit for dry air. We examined the association between RH and objectively measured stress responses, physical activity (PA), and sleep quality. A diverse group of office workers (n = 134) from four well-functioning federal buildings wore chest-mounted heart rate variability monitors for three consecutive days, while at the same time, RH and temperature (T) were measured in their workplaces. Those who spent the majority of their time at the office in conditions of 30%-60% RH experienced 25% less stress at the office than those who spent the majority of their time in drier conditions. Further, a correlational study of our stress response suggests optimal values for RH may exist within an even narrower range around 45%. Finally, we found an indirect effect of objectively measured poorer sleep quality, mediated by stress responses, for those outside this range.

A stochastic SIRS epidemic model with non-monotone incidence rate under regime-switching

In this paper, we propose and discuss a stochastic SIRS epidemic model with non-monotone incidence rate under regime-switching. First of all, we show that there is a unique positive solution, which is a prerequisite for analyzing the long-term behavior of the stochastic model. Then, a threshold dynamic determined by the basic reproduction number R 0 s is established: the disease can be eradicated almost surely if R 0 s < 1 and under mild extra conditions, whereas if R 0 s > 1 , the densities of the distributions of the solution can converge in L ¹ to an invariant density by using the Markov semigroups theory. Finally, based on realistic parameters obtained from previous literatures, numerical simulations have been performed to verify our analytical results.

Multisensor IoT Platform for Optimising IAQ Levels in Buildings through a Smart Ventilation System

Indoor Air Quality (IAQ) issues have a direct impact on the health and comfort of building occupants. In this paper, an experimental low-cost system has been developed to address IAQ issues by using a distributed internet of things platform to control and monitor the indoor environment in building spaces while adopting a data-driven approach. The system is based on several real-time sensor data to model the indoor air quality and accurately control the ventilation system through algorithms to maintain a comfortable level of IAQ by balancing indoor and outdoor pollutant concentrations using the Indoor Air Quality Index approach. This paper describes hardware and software details of the system as well as the algorithms, models, and control strategies of the proposed solution which can be integrated in detached ventilation systems. Furthermore, a mobile app has been developed to inform, in real time, different-expertise-user profiles showing indoor and outdoor IAQ conditions. The system is implemented in a small prototype box and early-validated with different test cases considering various pollutant concentrations, reaching a Technology Readiness Level (TRL) of 3–4.

Permeable Water-Resistant Heat Insulation Panel Based on Recycled Materials and Its Physical and Mechanical Properties

This paper deals with the development and characteristics of the properties of a permeable water-resistant heat insulation panel based on recycled materials. The insulation panel consists of a thermal insulation core of recycled soft polyurethane foam and winter wheat husk, a layer of geopolymer that gives the entire sandwich composite strength and fire resistance, and a nanofibrous membrane that permits water vapor permeability, but not water in liquid form. The observed properties are the thermal conductivity coefficient, volumetric heat capacity, fire resistance, resistance to long-term exposure of a water column, and the tensile strength perpendicular to the plane of the board. The results showed that while the addition of husk to the thermal insulation core does not significantly impair its thermal insulation properties, the tensile strength perpendicular to the plane of these boards was impaired by the addition of husk. The geopolymer layer increased the fire resistance of the panel for up to 13 min, and the implementation of the nanofibrous membrane resulted in a water flow of 154 cm² in the amount of 486 g of water per 24 h at a water column height of 0.8 m.

Colorful Wall-Bricks with Superhydrophobic Surfaces for Enhanced Smart Indoor Humidity Control

Humidity-control materials have attracted increasing attention because of energy savings and smart regulation of indoor comforts. The current research is a successive work to face challenges, such as poor performance, limitations for large-scale production, and surface contamination. Here, we report a smart humidity-control wall-brick manufactured from sepiolite using CaCl₂ as an additive. Low-temperature sintering generated a super hygroscopic interior structure, and further silane modification produced bricks with superhydrophobic surfaces. These superhydrophobic surfaces can promote the moisture storage and prevent the CaCl₂ solution from leaking even after the surface is wiped 100 times. Meanwhile, the superhydrophobic surfaces make the wall-bricks easy to clean; also, these materials possess antifouling and antifungal properties. The 24 h and saturated moisture adsorption-desorption contents reached 630 and 1700 g·m^-2, respectively. Furthermore, a test was performed using model houses in a real environment, which indicates that the wall-bricks can narrow the daily indoor humidity fluctuations by more than 20% in both wet and dry seasons. The white wall-brick can also be dyed with different colors and thus shows promise for applications in interior decorations of houses.

Geostatistical predictive modeling for asthma and chronic obstructive pulmonary disease using socioeconomic and environmental determinants

The spatial distribution of the prevalence of asthma and chronic obstructive pulmonary disease (COPD) remains under the influence of a wide array of environmental, climatic, and socioeconomic determinants. However, a large proportion of these influences remain unexplained. In completion, this study examined the spatial associations between asthma/COPD morbidity and their determinants using ordinary least squares (OLS) and geographically weighted regressions (GWR). Inpatient records collected from the secondary and tertiary care hospitals in Kandy from 2010 to 2014 were considered as the dependent variable. Potential risk factors (explanatory variables) were identified in four distinguished classes: 1) meteorological factors, (2) direct and indirect factors of air pollution, (3) socioeconomic factors, and (4) characteristics of the physical environment. All possible combinations of candidate explanatory variables were evaluated through an exploratory regression. A comparison between the regression models was also explored. The best OLS regression models revealed about 55% of asthma variation and 62% of COPD variation while GWR models yielded 78% and 74% of the variation of asthma and COPD occurrences respectively. Relative humidity, proximity to roads (0-200 m), road density, use of firewood as a source of fuel, and elevation play a vital role in predicting morbidity from asthma and COPD. Both local and global regression models are important in assessing spatial relationships of asthma and COPD. However, the local models exhibit a better prediction capability for assessing non-stationary relationships of asthma and COPD than global models. The geostatistical aspects used in this study may also provide insights for evaluating heterogeneous environmental risk factors in other epidemiological studies across different spatial settings.

Cost-Effectiveness of Multifaceted Built Environment Interventions for Reducing Transmission of Pathogenic Bacteria in Healthcare Facilities

OBJECTIVES

The objective of this study is to determine the optimal allocation of budgets for pairs of alterations that reduce pathogenic bacterial transmission. Three alterations of the built environment are examined: handwashing stations (HW), relative humidity control (RH), and negatively pressured treatment rooms (NP). These interventions were evaluated to minimize total cost of healthcare-associated infections (HAIs), including medical and litigation costs.

BACKGROUND

HAIs are largely preventable but are difficult to control because of their multiple mechanisms of transmission. Moreover, the costs of HAIs and resulting mortality are increasing with the latest estimates at US$9.8 billion annually.

METHOD

Using 6 years of longitudinal multidrug-resistant infection data, we simulated the transmission of pathogenic bacteria and the infection control efforts of the three alterations using Chamchod and Ruan's model. We determined the optimal budget allocations among the alterations by representing them under Karush-Kuhn-Tucker conditions for this nonlinear optimization problem.

RESULTS

We examined 24 scenarios using three virulence levels across three facility sizes with varying budget levels. We found that in general, most of the budget is allocated to the NP or RH alterations in each intervention. At lower budgets, however, it was necessary to use the lower cost alterations, HW or RH.

CONCLUSIONS

Mathematical optimization offers healthcare enterprise executives and engineers a tool to assist with the design of safer healthcare facilities within a fiscally constrained environment. Herein, models were developed for the optimal allocation of funds between HW, RH, and negatively pressured treatment rooms (NP) to best reduce HAIs. Specific strategies vary by facility size and virulence.

Making the Case for "Whole System" Approaches: Integrating Public Health and Housing

Housing conditions have been an enduring focus for public health activity throughout the modern public health era. However, the nature of the housing and health challenge has changed in response to an evolution in the understanding of the diverse factors influencing public health. Today, the traditional public health emphasis on the type and quality of housing merges with other wider determinants of health. These include the neighbourhood, community, and "place" where a house is located, but also the policies which make access to a healthy house possible and affordable for everyone. Encouragingly, these approaches to policy and action on housing have the potential to contribute to the "triple win" of health and well-being, equity, and environmental sustainability. However, more effective housing policies (and in public health in general) that adopt more systemic approaches to addressing the complex interactions between health, housing, and wider environment are needed. This paper illustrates some of the key components of the housing and health challenge in developed countries, and presents a conceptual model to co-ordinate activities that can deliver the "triple win." This is achieved by offering a perspective on how to navigate more effectively, inclusively and across sectors when identifying sustainable housing interventions.

The association between local meteorological changes and exacerbation of acute wheezing in Kandy, Sri Lanka

BACKGROUND

Severe wheezing is a common medical emergency. Past studies have demonstrated associations between exacerbation of wheezing and meteorological factors and atmospheric pollution. There are no past studies from Sri Lanka that analyzed correlation between daily multiple meteorological variables and exacerbation of wheezing.

OBJECTIVES

To determine the correlations between daily counts of patients nebulized at the Outpatient Department (OPD) of Teaching Hospital - Kandy (THK) and local meteorological variables, and to explore the utility of that information.

DESIGN

We considered daily counts of patients nebulized at the OPD of THK as an indicator of exacerbations of wheezing in the population catered to by this hospital. We determined the correlations between daily counts of patients nebulized at OPD and the following meteorological variables for four years: daily rainfall, minimum temperature, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours, daytime humidity, nighttime humidity, barometric pressure and visibility. We utilized wavelet time series method for data analysis.

RESULTS

All nine meteorological parameters studied were correlated with the daily counts of patients nebulized with average lag periods ranging from 5 to 15 days. Peaks of daily rainfall, maximum temperature, diurnal temperature range, difference between maximum temperature and the temperature at 1800 hours and daytime humidity were followed by peaks of counts of patients nebulized (positive correlations). Troughs of minimum temperature, nighttime humidity, barometric pressure and visibility were followed by peaks of patients nebulized (negative correlations).

CONCLUSIONS

The THK shall expect more patients with acute wheezing after extremes of weather. Minimum temperature has been consistently correlated with the exacerbation of respiratory symptoms in the past studies in other countries as well. Hence, prescribing the inhalation of more drugs on unusually cold days (prophylactically) may help prevent acute exacerbation of wheezing in patients on treatment for asthma and COPD.

Synergistic effects of temperature and humidity on the symptoms of COPD patients

This panel study investigates how temperature, humidity, and their interaction affect chronic obstructive pulmonary disease (COPD) patients' self-reported symptoms. One hundred and six COPD patients from Shanghai, China, were enrolled, and age, smoking status, St. George Respiratory Questionnaire (SGRQ) score, and lung function index were recorded at baseline. The participants were asked to record their indoor temperature, humidity, and symptoms on diary cards between January 2011 and June 2012. Altogether, 82 patients finished the study. There was a significant interactive effect between temperature and humidity (p < 0.0001) on COPD patients. When the indoor humidity was low, moderate, and high, the indoor temperature ORs were 0.969 (95% CI 0.922 to 1.017), 0.977 (0.962 to 0.999), and 0.920 (95% CI 0.908 to 0.933), respectively. Low temperature was a risk factor for COPD patients, and high humidity enhanced its risk on COPD. The indoor temperature should be kept at least on average at 18.2 °C, while the humidity should be less than 70%. This study demonstrates that temperature and humidity were associated with COPD patients' symptoms, and high humidity would enhance the risk of COPD due to low temperature.

Quick Estimation Model for the Concentration of Indoor Airborne Culturable Bacteria: An Application of Machine Learning

Indoor airborne culturable bacteria are sometimes harmful to human health. Therefore, a quick estimation of their concentration is particularly necessary. However, measuring the indoor microorganism concentration (e.g., bacteria) usually requires a large amount of time, economic cost, and manpower. In this paper, we aim to provide a quick solution: using knowledge-based machine learning to provide quick estimation of the concentration of indoor airborne culturable bacteria only with the inputs of several measurable indoor environmental indicators, including: indoor particulate matter (PM_2.5 and PM₁₀), temperature, relative humidity, and CO₂ concentration. Our results show that a general regression neural network (GRNN) model can sufficiently provide a quick and decent estimation based on the model training and testing using an experimental database with 249 data groups.

Exposure science in an age of rapidly changing climate: challenges and opportunities

Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science-Exposures in an Evolving Environment-brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct "consequential science"-doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health.

Concentrations and identification of culturable airborne fungi in underground stations of the Seoul metro

The purpose of this study was to measure the culturable airborne fungi (CAF) concentrations in the underground subway stations of Seoul, Korea at two time points. This study measured the CAF concentrations in enclosed environments at 16 underground stations of the Seoul Metro in 2006 and 2013 and investigated the effects of various environmental factors, including the presence of platform screen doors, temperature, relative humidity, and number of passengers. CAF concentrations at the stations in 2006 were significantly higher than that at the same stations in 2013 (p < 0.001). Furthermore, there was a significant correlation between CAF concentration and relative humidity (r = 0.311, p < 0.05). Geotrichum and Penicillium were the predominant genera. The CAF concentrations in stations with an operating supply air were significantly higher than that in stations with no supply air (p < 0.001). Therefore, it is recommended that special attention be given to stations with clean supplied air to improve the indoor air quality of these subway stations.

Person to person droplets transmission characteristics in unidirectional ventilated protective isolation room: The impact of initial droplet size

Person to person droplets/particles or contaminant cross transmission is an important issue in ventilated environment, especially in the unidirectional ventilated protective isolation room (UVPIR) where the patient's immune system is extremely low and easily infected. We simulated the dispersion process of the droplets with initial diameter of 100 μm, 10 μm and gaseous contaminant in unidirectional ventilated protective isolation room and studied the droplets dispersion and cross transmission with different sizes. The droplets with initial size of 100 μm settle out of the coughing jet quickly after coming out from mouth and cannot be carried by the coughing jet to the human thermal plume affecting (HTPA) zone of the susceptible manikin. Hence, the larger droplets disperse mainly in the HTPA zone of the source manikin, and the droplets cross transmission between source manikin and susceptible manikin is very small. The droplets with initial size of 10 μm and gaseous contaminant have similar dispersion but different removal process in the UVPIR. Part of the droplets with initial size of 10 μm and gaseous contaminant that are carried by the higher velocity coughing airflow can enter the HTPA zone of the susceptible manikin and disperse around it. The other part cannot spread to the susceptible manikin's HTPA zone and mainly spread in the source manikin's HTPA zone. The results from this study would be useful for UVPIR usage and operation in order to minimize the risk of cross infection.