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Chawla H, Anand P, Garg K, Bhagat N, Varmani SG, Bansal T, McBain AJ, Marwah RG. A comprehensive review of microbial contamination in the indoor environment: sources, sampling, health risks, and mitigation strategies. Front Public Health 2023; 11:1285393. [PMID: 38074709 PMCID: PMC10701447 DOI: 10.3389/fpubh.2023.1285393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/25/2023] [Indexed: 12/18/2023] Open
Abstract
The quality of the indoor environment significantly impacts human health and productivity, especially given the amount of time individuals spend indoors globally. While chemical pollutants have been a focus of indoor air quality research, microbial contaminants also have a significant bearing on indoor air quality. This review provides a comprehensive overview of microbial contamination in built environments, covering sources, sampling strategies, and analysis methods. Microbial contamination has various origins, including human occupants, pets, and the outdoor environment. Sampling strategies for indoor microbial contamination include air, surface, and dust sampling, and various analysis methods are used to assess microbial diversity and complexity in indoor environments. The review also discusses the health risks associated with microbial contaminants, including bacteria, fungi, and viruses, and their products in indoor air, highlighting the need for evidence-based studies that can relate to specific health conditions. The importance of indoor air quality is emphasized from the perspective of the COVID-19 pandemic. A section of the review highlights the knowledge gap related to microbiological burden in indoor environments in developing countries, using India as a representative example. Finally, potential mitigation strategies to improve microbiological indoor air quality are briefly reviewed.
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Affiliation(s)
- Hitikk Chawla
- Institute for Cell Biology and Neuroscience, Goethe University Frankfurt, Frankfurt, Germany
| | - Purnima Anand
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Kritika Garg
- Department of Biosciences and Bioengineering, Indian Institute of Technology Roorkee, Roorkee, India
| | - Neeru Bhagat
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Shivani G. Varmani
- Department of Biomedical Science, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
| | - Tanu Bansal
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Andrew J. McBain
- School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Ruchi Gulati Marwah
- Department of Microbiology, Bhaskaracharya College of Applied Sciences, University of Delhi, New Delhi, India
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Markandan K, Tiong YW, Sankaran R, Subramanian S, Markandan UD, Chaudhary V, Numan A, Khalid M, Walvekar R. Emergence of infectious diseases and role of advanced nanomaterials in point-of-care diagnostics: a review. Biotechnol Genet Eng Rev 2022:1-89. [PMID: 36243900 DOI: 10.1080/02648725.2022.2127070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.
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Affiliation(s)
- Kalaimani Markandan
- Temasek Laboratories, Nanyang Technological University, Nanyang Drive, Singapore
- Faculty of Engineering, Technology and Built Environment, UCSI University, Kuala Lumpur, Malaysia
| | - Yong Wei Tiong
- NUS Environmental Research Institute, National University of Singapore, Engineering Drive, Singapore
| | - Revathy Sankaran
- Graduate School, University of Nottingham Malaysia Campus, Semenyih, Selangor, Malaysia
| | - Sakthinathan Subramanian
- Department of Materials & Mineral Resources Engineering, National Taipei University of Technology (NTUT), Taipei, Taiwan
| | | | - Vishal Chaudhary
- Research Cell & Department of Physics, Bhagini Nivedita College, University of Delhi, New Delhi, India
| | - Arshid Numan
- Graphene & Advanced 2D Materials Research Group (GAMRG), School of Engineering and Technology, Sunway University, Petaling Jaya, Selangor, Malaysia
- Sunway Materials Smart Science & Engineering (SMS2E) Research Cluster School of Engineering and Technology, Sunway University, Selangor, Malaysia
| | - Mohammad Khalid
- Graphene & Advanced 2D Materials Research Group (GAMRG), School of Engineering and Technology, Sunway University, Petaling Jaya, Selangor, Malaysia
- Sunway Materials Smart Science & Engineering (SMS2E) Research Cluster School of Engineering and Technology, Sunway University, Selangor, Malaysia
| | - Rashmi Walvekar
- Department of Chemical Engineering, School of Energy and Chemical Engineering, Xiamen University Malaysia, Sepang, Selangor, Malaysia
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3
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Environmental air sampling for detection and quantification of Mycobacterium tuberculosis in clinical settings: Proof of concept. Infect Control Hosp Epidemiol 2022; 44:774-779. [DOI: 10.1017/ice.2022.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Objective:
Novel approaches are needed to understand and disrupt Mycobacterium tuberculosis transmission. In this proof-of-concept study, we investigated the use of environmental air samplings to detect and quantify M. tuberculosis in different clinic settings in a high-burden area.
Design:
Cross-sectional, environmental sampling.
Setting:
Primary-care clinic.
Methods:
A portable, high-flow dry filter unit (DFU) was used to draw air through polyester felt filters for 2 hours. Samples were collected in the waiting area and TB room of a primary care clinic. Controls included sterile filters placed directly into collection tubes at the DFU sampling site, and filter samplings performed outdoors. DNA was extracted from the filters, and droplet digital polymerase chain reaction (ddPCR) was used to quantify M. tuberculosis DNA copies. Carbon dioxide (CO2) data loggers captured CO2 concentrations in the sampled areas.
Results:
The median sampling time was 123 minutes (interquartile range [IQR], 121–126). A median of 121 (IQR, 35–243) M. tuberculosis DNA copies were obtained from 74 clinic samplings, compared to a median of 3 (IQR, 1–33; P < .001) obtained from 47 controls. At a threshold of 320 DNA copies, specificity was 100%, and 18% of clinic samples would be classified as positive.
Conclusions:
This proof-of-concept study suggests that the potential for airborne M. tuberculosis detection based on M. tuberculosis DNA copy yield to enable the identification of high-risk transmission locations. Further optimization of the M. tuberculosis extraction technique and ddPCR data analysis would improve detection and enable robust interpretation of these data.
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Liu S, Koupriyanov M, Paskaruk D, Fediuk G, Chen Q. Investigation of airborne particle exposure in an office with mixing and displacement ventilation. SUSTAINABLE CITIES AND SOCIETY 2022; 79:103718. [PMID: 35127341 PMCID: PMC8799404 DOI: 10.1016/j.scs.2022.103718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 05/07/2023]
Abstract
Effective ventilation could reduce COVID-19 infection in buildings. By using a computational fluid dynamics technique and advanced experimental measurement methods, this investigation studied the air velocity, air temperature, and particle number concentration in an office under a mixing ventilation (MV) system and a displacement ventilation (DV) system with different ventilation rates. The results show reasonably good agreement between the computed results and measured data. The air temperature and particle number concentration under the MV system were uniform, while the DV system generated a vertical stratification of the air temperature and particle number concentration. Because of the vertical stratification of the particle number concentration, the DV system provided better indoor air quality than the MV system. An increase in ventilation rate can reduce the particle concentration under the two systems. However, the improvement was not proportional to the ventilation rate. The increase in ventilation rate from 2 ACH to 4 ACH and 6 ACH for MV system reduced the particle concentration by 20% and 60%, respectively. While for the DV system, increasing the ventilation rate from 2 ACH to 4 ACH and 6 ACH reduced the particle concentration by only 10% and 40%, respectively. The ventilation effectiveness of the MV system was close to 1.0, but it was much higher for the DV system. Therefore, the DV system was better than the MV system.
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Affiliation(s)
- Sumei Liu
- Tianjin Key Laboratory of Indoor Air Environmental Quality Control, School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China
| | - Mike Koupriyanov
- Price Industries Limited, 638 Raleigh Street Winnipeg, MB R2K 3Z9, Canada
| | - Dale Paskaruk
- Price Industries Limited, 638 Raleigh Street Winnipeg, MB R2K 3Z9, Canada
| | - Graham Fediuk
- Price Industries Limited, 638 Raleigh Street Winnipeg, MB R2K 3Z9, Canada
| | - Qingyan Chen
- Department of Building Environment and Energy Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong
- School of Mechanical Engineering, Purdue University, West Lafayette, IN 47905, USA
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Fan Y, Chen J, Liu M, Xu X, Zhang Y, Yue P, Cao W, Ji Z, Su X, Wen S, Kong J, Zhou G, Li B, Dong Y, Liu A, Bao F. Application of Droplet Digital PCR to Detection of Mycobacterium tuberculosis and Mycobacterium leprae Infections: A Narrative Review. Infect Drug Resist 2022; 15:1067-1076. [PMID: 35313727 PMCID: PMC8934166 DOI: 10.2147/idr.s349607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/25/2022] [Indexed: 12/15/2022] Open
Abstract
Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (MTB) infection, which has seriously endangered human health for many years. With the emergence of multidrug-resistant and extensively drug-resistant MTB, the prevention and treatment of TB has become a pressing need. Early diagnosis, drug resistance monitoring, and control of disease transmission are critical aspects in the prevention and treatment of TB. However, the currently available diagnostic technologies and drug sensitivity tests are time consuming, and thus, it is difficult to achieve the goal of early diagnosis and detection drug sensitivity, which results in limited control of disease transmission. The development of molecular testing technology has gradually achieved the vision of rapid and accurate diagnosis of TB. Droplet digital PCR (ddPCR) is an excellent nucleic acid quantification method with high sensitivity and no need for a calibration curve. Herein, we review the application of ddPCR in TB diagnosis and drug resistance detection and transmission monitoring.
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Affiliation(s)
- Yuxin Fan
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Yunnan Province Key Laboratory of Children’s Major Diseases Research, The Affiliated Children Hospital, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Jingjing Chen
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Meixiao Liu
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Xin Xu
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Yu Zhang
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Yunnan Province Key Laboratory of Children’s Major Diseases Research, The Affiliated Children Hospital, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Peng Yue
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Wenjing Cao
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Zhenhua Ji
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Xuan Su
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Shiyuan Wen
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Yunnan Province Key Laboratory of Children’s Major Diseases Research, The Affiliated Children Hospital, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Jing Kong
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Guozhong Zhou
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Bingxue Li
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Yan Dong
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
| | - Aihua Liu
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Yunnan Province Key Laboratory of Children’s Major Diseases Research, The Affiliated Children Hospital, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Department of Biochemistry and Molecular Biology, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Correspondence: Aihua Liu; Fukai Bao, The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China, Email ;
| | - Fukai Bao
- The Institute for Tropical Medicine, Faculty of Basic Medical Sciences, Kunming Medical University, Kunming, 650500, People’s Republic of China
- Department of Microbiology and Immunology, Kunming Medical University, Kunming, 650030, People’s Republic of China
- Yunnan Province Key Laboratory of Children’s Major Diseases Research, The Affiliated Children Hospital, Kunming Medical University, Kunming, 650030, People’s Republic of China
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Zürcher K, Riou J, Morrow C, Ballif M, Koch A, Bertschinger S, Warner DF, Middelkoop K, Wood R, Egger M, Fenner L. Estimating Tuberculosis Transmission Risks in a Primary Care Clinic in South Africa: Modeling of Environmental and Clinical Data. J Infect Dis 2022; 225:1642-1652. [PMID: 35039860 PMCID: PMC9071349 DOI: 10.1093/infdis/jiab534] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/09/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Congregate settings, such as healthcare clinics, may play an essential role in Mycobacterium tuberculosis (Mtb) transmission. Using patient and environmental data, we studied transmission at a primary care clinic in South Africa. METHODS We collected patient movements, cough frequency, and clinical data, and measured indoor carbon dioxide (CO2) levels, relative humidity, and Mtb genomes in the air. We used negative binomial regression model to investigate associations. RESULTS We analyzed 978 unique patients who contributed 14 795 data points. The median patient age was 33 (interquartile range [IQR], 26-41) years, and 757 (77.4%) were female. Overall, median CO2 levels were 564 (IQR 495-646) parts per million and were highest in the morning. Median number of coughs per day was 466 (IQR, 368-503), and overall median Mtb DNA copies/μL/day was 4.2 (IQR, 1.2-9.5). We found an increased presence of Mtb DNA in the air of 32% (95% credible interval, 7%-63%) per 100 additional young adults (aged 15-29 years) and 1% (0-2%) more Mtb DNA per 10% increase of relative humidity. Estimated cumulative transmission risks for patients attending the clinic monthly for at least 1 hour range between 9% and 29%. CONCLUSIONS We identified young adults and relative humidity as potentially important factors for transmission risks in healthcare clinics. Our approach should be used to detect transmission and evaluate infection control interventions.
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Affiliation(s)
- Kathrin Zürcher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Julien Riou
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Carl Morrow
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa,Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, University of Cape Town, Cape Town, South Africa
| | - Marie Ballif
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Anastasia Koch
- South African Medical Research Council/National Health Laboratory Service/University of Cape Town Molecular Mycobacteriology Research Unit and Department of Science and Innovation/National Research Foundation Centre of Excellence for Biomedical TB Research, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Simon Bertschinger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland,Institute for Medical Informatics, Bern University of Applied Sciences, Bern, Switzerland
| | - Digby F Warner
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa,South African Medical Research Council/National Health Laboratory Service/University of Cape Town Molecular Mycobacteriology Research Unit and Department of Science and Innovation/National Research Foundation Centre of Excellence for Biomedical TB Research, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Keren Middelkoop
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa,Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, University of Cape Town, Cape Town, South Africa
| | - Robin Wood
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa,Desmond Tutu HIV Centre, Department of Medicine, University of Cape Town, University of Cape Town, Cape Town, South Africa
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland,Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa,Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland,Correspondence: Lukas Fenner, MD, MSc, Institute of Social and Preventive Medicine, University of Bern (ISPM), Mittelstrasse 43, 3012 Bern, Switzerland ()
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Motamedi H, Shirzadi M, Tominaga Y, Mirzaei PA. CFD modeling of airborne pathogen transmission of COVID-19 in confined spaces under different ventilation strategies. SUSTAINABLE CITIES AND SOCIETY 2022; 76:103397. [PMID: 34631393 PMCID: PMC8487408 DOI: 10.1016/j.scs.2021.103397] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 05/18/2023]
Abstract
Airborne transmission is an important route of spread of viral diseases (e.g., COVID-19) inside the confined spaces. In this respect, computational fluid dynamics (CFD) emerged as a reliable and fast tool to understand the complex flow patterns in such spaces. Most of the recent studies, nonetheless, focused on the spatial distribution of airborne pathogens to identify the infection probability without considering the exposure time. This research proposes a framework to evaluate the infection probability related to both spatial and temporal parameters. A validated Eulerian-Lagrangian CFD model of exhaled droplets is first developed and then evaluated with an office case study impacted by different ventilation strategies (i.e., cross- (CV), single- (SV), mechanical- (MV) and no-ventilation (NV)). CFD results were analyzed in a bespoke code to calculate the tempo-spatial distribution of accumulated airborne pathogens. Furthermore, two indices of local and general infection risks were used to evaluate the infection probability of the ventilation scenarios. The results suggest that SV has the highest infection probability while SV and NO result in higher dispersions of airborne pathogens inside the room. Eventually, the time history of indices reveals that the efficiency of CV and MV can be poor in certain regions of the room.
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Affiliation(s)
- Hamid Motamedi
- Department of Mechanical Engineering, Tarbiat Modares University, Iran
| | - Mohammadreza Shirzadi
- Wind and Fluid Engineering Research Center, Niigata Institute of Technology, Kashiwazaki, Japan
- Fine Particle Technology Laboratory, Graduate School of Advanced Science and Engineering, Hiroshima University, Higashi-Hiroshima, 739-8527, Hiroshima, Japan
| | - Yoshihide Tominaga
- Wind and Fluid Engineering Research Center, Niigata Institute of Technology, Kashiwazaki, Japan
| | - Parham A Mirzaei
- Architecture & Built Environment Department, University of Nottingham, University Park, Nottingham NG2RD, United Kingdom
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Dai YZ, Chen YJ, Zhang CY. A Simulation Analyzing Approach to Estimating the Probability of Airborne Infection Risks in Railway Station Platform Coupling with the Wells-Riley Model and Pathfinder Model. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6066109. [PMID: 34970425 PMCID: PMC8714328 DOI: 10.1155/2021/6066109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022]
Abstract
Railway station platforms present a particular challenge, especially during a train departure or arrival where some passengers may have potential conditions that make them vulnerable to airborne infections due to the high density and close proximity of passengers. This study presented a simulation analyzing approach to estimating the probability of airborne infection risks in station platform spaces coupling with the Wells-Riley model and Pathfinder model. We examine the impact of overcrowded area of the station platform on infection rates under various traces of evacuation. The result of the potential risk for three modes is discussed, and the results of the standard model under the same parameter setting are optimised. Next, the impact of the ventilated volume based on uneven distribution of individuals and the exposure time based on evacuation on the infection risk in platform spaces are studied. The relationship between platform spaces overcrowding and the infection risk provided further insights to observe the supporting information.
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Affiliation(s)
- Yi-Zheng Dai
- School of Architecture, Southeast University, Nanjing, China
| | - Yan-Jiao Chen
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen-Yang Zhang
- School of Architecture, Southeast University, Nanjing, China
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Izhar MD, Butar MB, Hidayati F, Ruwayda R. Predictors and health-related quality of life with short form-36 for multidrug-resistant tuberculosis patients in Jambi, Indonesia: A case-control study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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10
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Matuka DO, Duba T, Ngcobo Z, Made F, Muleba L, Nthoke T, Singh TS. Occupational Risk of Airborne Mycobacterium tuberculosis Exposure: A Situational Analysis in a Three-Tier Public Healthcare System in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910130. [PMID: 34639431 PMCID: PMC8508202 DOI: 10.3390/ijerph181910130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022]
Abstract
This study aimed to detect airborne Mycobacterium tuberculosis (MTB) at nine public health facilities in three provinces of South Africa and determine possible risk factors that may contribute to airborne transmission. Personal samples (n = 264) and stationary samples (n = 327) were collected from perceived high-risk areas in district, primary health clinics (PHCs) and TB facilities. Quantitative real-time (RT) polymerase chain reaction (PCR) was used for TB analysis. Walkabout observations and work practices through the infection prevention and control (IPC) questionnaire were documented. Statistical analysis was carried out using Stata version 15.2 software. Airborne MTB was detected in 2.2% of samples (13/572), and 97.8% were negative. District hospitals and Western Cape province had the most TB-positive samples and identified risk areas included medical wards, casualty, and TB wards. MTB-positive samples were not detected in PHCs and during the summer season. All facilities reported training healthcare workers (HCWs) on TB IPC. The risk factors for airborne MTB included province, type of facility, area or section, season, lack of UVGI, and ineffective ventilation. Environmental monitoring, PCR, IPC questionnaire, and walkabout observations can estimate the risk of TB transmission in various settings. These findings can be used to inform management and staff to improve the TB IPC programmes.
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Affiliation(s)
- Dikeledi O. Matuka
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Thabang Duba
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Zethembiso Ngcobo
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Felix Made
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Lufuno Muleba
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Tebogo Nthoke
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
| | - Tanusha S. Singh
- National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg 2000, South Africa; (D.O.M.); (T.D.); (Z.N.); (F.M.); (L.M.); (T.N.)
- Department of Clinical Microbiology and Infectious Disease, School of Pathology, University of the Witwatersrand, Johannesburg 2000, South Africa
- Department of Environmental Health, School of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa
- Correspondence:
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Mukherjee S, Boral S, Siddiqi H, Mishra A, Meikap BC. Present cum future of SARS-CoV-2 virus and its associated control of virus-laden air pollutants leading to potential environmental threat - A global review. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:104973. [PMID: 33462561 PMCID: PMC7805399 DOI: 10.1016/j.jece.2020.104973] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/06/2020] [Accepted: 12/20/2020] [Indexed: 05/05/2023]
Abstract
The world is presently infected by the biological fever of COVID-19 caused by SARS-CoV-2 virus. The present study is mainly related to the airborne transmission of novel coronavirus through airway. Similarly, our mother planet is suffering from drastic effects of air pollution. There are sufficient probabilities or evidences proven for contagious virus transmission through polluted airborne-pathway in formed aerosol molecules. The pathways and sources of spread are detailed along with the best possible green control technologies or ideas to hinder further transmission. The combined effects of such root causes and unwanted outcomes are similar in nature leading to acute cardiac arrest of our planet. To maintain environmental sustainability, the prior future of such emerging unknown biological hazardous air emissions is to be thoroughly researched. So it is high time to deal with the future of hazardous air pollution and work on its preventive measures. The lifetime of such an airborne virus continues for several hours, thus imposing severe threat even during post-lockdown phase. The world waits eagerly for the development of successful vaccination or medication but the possible outcome is quite uncertain in terms of equivalent economy distribution and biomedical availability. Thus, risk assessments are to be carried out even during the post-vaccination period with proper environmental surveillance and monitoring. The skilled techniques of disinfection, sanitization, and other viable wayouts are to be modified with time, place, and prevailing climatic conditions, handling the pandemic efficiently. A healthy atmosphere makes the earth a better place to dwell, ensuring its future lifecycle.
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Key Words
- 2019-nCoV, 2019 novel coronavirus
- ACE2, angiotensin-converting enzyme 2
- ALRI, Acute Lower Respiratory Infections
- ANN, artificial neural network
- API, air pollution index
- ASTM, American Society for Testing and Materials
- Aerosol or particulate matter
- Airborne virus
- BCG, Bacillus Calmette Guérin
- COCOREC, Collaborative Study COVID Recurrence
- COPD, Chronic Obstructive Pulmonary Disorder
- COVID-19, coronavirus disease, 2019
- CSG, Coronavirus Study Group
- CoV, Coronavirus
- Dispersion
- EPA, Environmental Protection Agency
- FCVS, filtered containment venting systems
- HEME, High-Efficiency Mist Eliminator
- ICTV, International Committee on Taxonomy of Viruses
- IHD, Ischemic Heart Disease
- ISO, International organization of Standardization
- IoT, Internet of Things
- MERS-CoV, Middle-East Respiratory Syndrome coronavirus
- NAAQS, National Ambient Air Quality Standard
- NFKB, nuclear factor kappa-light-chain-enhancer of activated B cells
- NRF2, nuclear factor erythroid 2-related factor 2
- Novel coronavirus
- PM, particulate matter
- Pathways of transmission
- Prevention and control measures
- ROS, reactive oxygen species
- SARS-CoV-2
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- USEPA, United States Environmental Protection Agency
- UVGI, Ultraviolet Germicidal Irradiation
- VOC, volatile organic compound
- WHO, World Health Organization
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Affiliation(s)
- Subhrajit Mukherjee
- Department of Chemical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Soumendu Boral
- School of Bioscience, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Hammad Siddiqi
- Department of Chemical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Asmita Mishra
- Department of Chemical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
| | - Bhim Charan Meikap
- Department of Chemical Engineering, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India
- Department of Chemical Engineering, School of Engineering, Howard College Campus, University of Kwazulu-Natal (UKZN), King George V Avenue, Durban 4041, South Africa
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12
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Morawska L, Tang JW, Bahnfleth W, Bluyssen PM, Boerstra A, Buonanno G, Cao J, Dancer S, Floto A, Franchimon F, Haworth C, Hogeling J, Isaxon C, Jimenez JL, Kurnitski J, Li Y, Loomans M, Marks G, Marr LC, Mazzarella L, Melikov AK, Miller S, Milton DK, Nazaroff W, Nielsen PV, Noakes C, Peccia J, Querol X, Sekhar C, Seppänen O, Tanabe SI, Tellier R, Tham KW, Wargocki P, Wierzbicka A, Yao M. How can airborne transmission of COVID-19 indoors be minimised? ENVIRONMENT INTERNATIONAL 2020; 142:105832. [PMID: 32521345 PMCID: PMC7250761 DOI: 10.1016/j.envint.2020.105832] [Citation(s) in RCA: 544] [Impact Index Per Article: 136.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 05/17/2023]
Abstract
During the rapid rise in COVID-19 illnesses and deaths globally, and notwithstanding recommended precautions, questions are voiced about routes of transmission for this pandemic disease. Inhaling small airborne droplets is probable as a third route of infection, in addition to more widely recognized transmission via larger respiratory droplets and direct contact with infected people or contaminated surfaces. While uncertainties remain regarding the relative contributions of the different transmission pathways, we argue that existing evidence is sufficiently strong to warrant engineering controls targeting airborne transmission as part of an overall strategy to limit infection risk indoors. Appropriate building engineering controls include sufficient and effective ventilation, possibly enhanced by particle filtration and air disinfection, avoiding air recirculation and avoiding overcrowding. Often, such measures can be easily implemented and without much cost, but if only they are recognised as significant in contributing to infection control goals. We believe that the use of engineering controls in public buildings, including hospitals, shops, offices, schools, kindergartens, libraries, restaurants, cruise ships, elevators, conference rooms or public transport, in parallel with effective application of other controls (including isolation and quarantine, social distancing and hand hygiene), would be an additional important measure globally to reduce the likelihood of transmission and thereby protect healthcare workers, patients and the general public.
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Affiliation(s)
- Lidia Morawska
- International Laboratory for Air Quality and Heath (ILAQH), WHO Collaborating Centre for Air Quality and Health, School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Julian W Tang
- Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - William Bahnfleth
- Department of Architectural Engineering, The Pennsylvania State University, USA
| | - Philomena M Bluyssen
- Faculty of Architecture and the Built Environment, Delft University of Technology, the Netherlands
| | - Atze Boerstra
- REHVA (Federation of European Heating, Ventilation and Air Conditioning Associations), BBA Binnenmilieu, the Netherlands
| | - Giorgio Buonanno
- Department if Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Cassino, Italy
| | - Junji Cao
- Key Lab of Aerosol Chemistry and Physics Chinese Academy of Sciences, Xi'an, Beijing, China
| | - Stephanie Dancer
- Edinburgh Napier University and NHS Lanarkshire, Scotland, United Kingdom
| | - Andres Floto
- Department of Medicine, University of Cambridge, United Kingdom
| | | | - Charles Haworth
- Cambridge Centre for Lung Infection, Royal Papworth Hospital and Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jaap Hogeling
- International Standards at ISSO, ISSO International Project, the Netherlands
| | | | - Jose L Jimenez
- Department of Chemistry, and Cooperative Institute for Research in Environmental Sciences (CIRES) University of Colorado, Boulder, USA
| | - Jarek Kurnitski
- REHVA Technology and Research Committee, Tallinn University of Technology, Estonia
| | - Yuguo Li
- Department of Mechancal Engineering, Hong Kong University, University of Hong Kong, Pokfulam, Hong Kong, China
| | - Marcel Loomans
- Department of the Built Environment, Eindhoven University of Technology (TU/e), the Netherlands
| | - Guy Marks
- Centre for Air quality Research and evaluation (CAR), University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | | | | | - Arsen Krikor Melikov
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Denmark
| | - Shelly Miller
- Mechanical Engineering, University of Colorado, Boulder, USA
| | - Donald K Milton
- Environmental Health, School of Public Health, University of Maryland, USA
| | - William Nazaroff
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Peter V Nielsen
- Faculty of Engineering and Science, Department of Civil Engineering, Aalborg University, Denmark
| | - Catherine Noakes
- School of Civil Engineering, University of Leeds, United Kingdom
| | | | - Xavier Querol
- Institute of Environmental Assessment and Water Research, Department of Geosciences, Spanish National Research Council, Barcelona, Spain
| | - Chandra Sekhar
- Department of Building, National University of Singapore, Singapore
| | | | | | | | - Kwok Wai Tham
- Department of Building, National University of Singapore, Singapore
| | - Pawel Wargocki
- International Centre for Indoor Environment and Energy, Department of Civil Engineering, Technical University of Denmark, Denmark
| | | | - Maosheng Yao
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
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Zürcher K, Morrow C, Riou J, Ballif M, Koch AS, Bertschinger S, Liu X, Sharma M, Middelkoop K, Warner D, Wood R, Egger M, Fenner L. Novel approach to estimate tuberculosis transmission in primary care clinics in sub-Saharan Africa: protocol of a prospective study. BMJ Open 2020; 10:e036214. [PMID: 32847906 PMCID: PMC7451471 DOI: 10.1136/bmjopen-2019-036214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Tuberculosis (TB) transmission is difficult to measure, and its drivers are not well understood. The effectiveness of infection control measures at healthcare clinics and the most appropriate intervention strategies to interrupt transmission are unclear. We propose a novel approach using clinical, environmental and position-tracking data to study the risk of TB transmission at primary care clinics in TB and HIV high burden settings in sub-Saharan Africa. METHODS AND ANALYSIS We describe a novel and rapid study design to assess risk factors for airborne TB transmission at primary care clinics in high-burden settings. The study protocol combines a range of different measurements. We will collect anonymous data on the number of patients, waiting times and patient movements using video sensors. Also, we will collect acoustic sound recordings to determine the frequency and intensity of coughing. Environmental data will include indoor carbon dioxide levels (CO2 in parts per million) and relative humidity. We will also extract routinely collected clinical data from the clinic records. The number of Mycobacterium tuberculosis particles in the air will be ascertained from dried filter units using highly sensitive digital droplet PCR. We will calculate rebreathed air volume based on people density and CO2 levels and develop a mathematical model to estimate the risk of TB transmission. The mathematical model can then be used to estimate the effect of possible interventions such as separating patient flows or improving ventilation in reducing transmission. The feasibility of our approach was recently demonstrated in a pilot study in a primary care clinic in Cape Town, South Africa. ETHICS AND DISSEMINATION The study was approved by the University of Cape Town (HREC/REF no. 228/2019), the City of Cape Town (ID-8139) and the Ethics Committee of the Canton Bern (2019-02131), Switzerland. The results will be disseminated in international peer-reviewed journals.
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Affiliation(s)
- Kathrin Zürcher
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Carl Morrow
- Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine and the Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Julien Riou
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Marie Ballif
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Anastasia Sideris Koch
- Institute of Infectious Disease and Molecular Medicine and the Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
- Molecular Mycobacteriology Research Unit, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Simon Bertschinger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Medical Informatics, Berne University of Applied Sciences, Bern, Switzerland
| | - Xin Liu
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, Washington, USA
| | - Manuja Sharma
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, Washington, USA
| | - Keren Middelkoop
- Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine and the Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Digby Warner
- Institute of Infectious Disease and Molecular Medicine and the Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
- Molecular Mycobacteriology Research Unit, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Robin Wood
- Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine and the Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Centre for Infectious Disease Epidemiology & Research, School of Public Health & Family Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lukas Fenner
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
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Bizzoca ME, Campisi G, Lo Muzio L. Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3793. [PMID: 32471083 PMCID: PMC7312076 DOI: 10.3390/ijerph17113793] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 12/22/2022]
Abstract
The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: "dentist" OR "oral health" AND "COVID-19" OR "SARS-CoV-2" OR "coronavirus-19". After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks.
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Affiliation(s)
- Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy;
| | - Giuseppina Campisi
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, 90121 Palermo, Italy;
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy;
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), 66100 Chieti, Italy
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