1
|
Zhang Y, Shankar SN, Vass WB, Lednicky JA, Fan ZH, Agdas D, Makuch R, Wu CY. Air Change Rate and SARS-CoV-2 Exposure in Hospitals and Residences: A Meta-Analysis. Aerosol Sci Technol 2024; 58:217-243. [PMID: 38764553 PMCID: PMC11101186 DOI: 10.1080/02786826.2024.2312178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/16/2024] [Indexed: 05/21/2024]
Abstract
As SARS-CoV-2 swept across the globe, increased ventilation and implementation of air cleaning were emphasized by the US CDC and WHO as important strategies to reduce the risk of inhalation exposure to the virus. To assess whether higher ventilation and air cleaning rates lead to lower exposure risk to SARS-CoV-2, 1274 manuscripts published between April 2020 and September 2022 were screened using key words "airborne SARS-CoV-2 or "SARS-CoV-2 aerosol". Ninety-three studies involved air sampling at locations with known sources (hospitals and residences) were selected and associated data were compiled. Two metrics were used to assess exposure risk: SARS-CoV-2 concentration and SARS-CoV-2 detection rate in air samples. Locations were categorized by type (hospital or residence) and proximity to the sampling location housing the isolated/quarantined patient (primary or secondary). The results showed that hospital wards had lower airborne virus concentrations than residential isolation rooms. A negative correlation was found between airborne virus concentrations in primary-occupancy areas and air changes per hour (ACH). In hospital settings, sample positivity rates were significantly reduced in secondary-occupancy areas compared to primary-occupancy areas, but they were similar across sampling locations in residential settings. ACH and sample positivity rates were negatively correlated, though the effect was diminished when ACH values exceeded 8. While limitations associated with diverse sampling protocols exist, data considered by this meta-analysis support the notion that higher ACH may reduce exposure risks to the virus in ambient air.
Collapse
Affiliation(s)
- Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Mechanical Engineering, University of British Columbia, Vancouver, British Columnia, Canada
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Environmental & Public Health Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Z. Hugh Fan
- Mechanical and Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Duzgun Agdas
- Engineering School of Sustainable Infrastructure & Environment, University of Florida, Gainesville, Florida, USA
| | - Robert Makuch
- Department of Biostatistics, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA
| |
Collapse
|
2
|
Zambrana W, Boehm AB. Occurrence of Human Viruses on Fomites in the Environment: A Systematic Review and Meta-analysis. ACS Environ Au 2023; 3:277-294. [PMID: 37743950 PMCID: PMC10515712 DOI: 10.1021/acsenvironau.3c00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 09/26/2023]
Abstract
Documenting the occurrence of viruses on fomites is crucial in determining the significance of fomite-mediated transmission and the potential use of fomites for environmental disease surveillance. We conducted a systematic review and meta-analysis to compile information on the occurrence of human viruses on fomites in the environment; we identified 134 peer-reviewed papers. We compiled sampling and measurement methods, results, quality control information, and whether virus data were compared with community health data from the papers. We conducted univariate and multivariate analyses to investigate if presence of virus on fomites was associated with virus type (enveloped, nonenveloped), sampling location (healthcare setting, nonhealthcare temporary setting, nonhealthcare nontemporary setting), and area of fomite swabbed (<50, 50-100, >100 cm2). Across 275 data sets from the 134 papers, there was the most data available for Coronaviridae and from fomites at hospitals. Positivity rates, defined as the percent positive fomite samples, were low (median = 6%). Data were available on viruses from 16 different viral families, but data on viruses from 9 families had few (n < 5) data sets. Many human virus families were not identified in this review (11 families). Less than 15% of the data sets reported virus concentrations in externally valid units (viruses per area of surface), and 16% provided a quantitative comparison between virus and health data. Virus type and area swabbed were significant predictors of virus presence on fomites, and the positivity rate of data sets collected from healthcare settings and nonhealthcare nontemporary settings (e.g., individual housing) were significantly higher than those collected in nonhealthcare temporary settings (e.g., restaurants). Data from this review indicates that viruses may be present on fomites, that fomite-mediated virus transmission may occur, and that fomites may provide information on circulation of infectious diseases in the community. However, more quantitative data on diverse viruses are needed, and method reporting needs significant improvements.
Collapse
Affiliation(s)
- Winnie Zambrana
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| | - Alexandria B. Boehm
- Department
of Civil & Environmental Engineering, Stanford University, 473 Via Ortega, Stanford, California 94305, United States
| |
Collapse
|
3
|
Sah GP, Kovalick G, Chopyk J, Kuo P, Huang L, Ghatbale P, Das P, Realegeno S, Knight R, Gilbert JA, Pride DT. Characterization of SARS-CoV-2 Distribution and Microbial Succession in a Clinical Microbiology Testing Facility during the SARS-CoV-2 Pandemic. Microbiol Spectr 2023; 11:e0450922. [PMID: 36916973 PMCID: PMC10100919 DOI: 10.1128/spectrum.04509-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/11/2023] [Indexed: 03/15/2023] Open
Abstract
The exchange of microbes between humans and the built environment is a dynamic process that has significant impact on health. Most studies exploring the microbiome of the built environment have been predicated on improving our understanding of pathogen emergence, persistence, and transmission. Previous studies have demonstrated that SARS-CoV-2 presence significantly correlates with the proportional abundance of specific bacteria on surfaces in the built environment. However, in these studies, SARS-CoV-2 originated from infected patients. Here, we perform a similar assessment for a clinical microbiology lab while staff were handling SARS-CoV-2 infected samples. The goal of this study was to understand the distribution and dynamics of microbial population on various surfaces within different sections of a clinical microbiology lab during a short period of 2020 Coronavirus disease (COVID-19) pandemic. We sampled floors, benches, and sinks in 3 sections (bacteriology, molecular microbiology, and COVID) of an active clinical microbiology lab over a 3-month period. Although floor samples harbored SARS-CoV-2, it was rarely identified on other surfaces, and bacterial diversity was significantly greater on floors than sinks and benches. The floors were primarily colonized by bacteria common to natural environments (e.g., soils), and benchtops harbored a greater proportion of human-associated microbes, including Staphylococcus and Streptococcus. Finally, we show that the microbial composition of these surfaces did not change over time and remained stable. Despite finding viruses on the floors, no lab-acquired infections were reported during the study period, which suggests that lab safety protocols and sanitation practices were sufficient to prevent pathogen exposures. IMPORTANCE For decades, diagnostic clinical laboratories have been an integral part of the health care systems that perform diagnostic tests on patient's specimens in bulk on a regular basis. Understanding their microbiota should assist in designing and implementing disinfection, and cleaning regime in more effective way. To our knowledge, there is a lack of information on the composition and dynamics of microbiota in the clinical laboratory environments, and, through this study, we have tried to fill that gap. This study has wider implications as understanding the makeup of microbes on various surfaces within clinical laboratories could help identify any pathogenic bacterial taxa that could have colonized these surfaces, and might act as a potential source of laboratory-acquired infections. Mapping the microbial community within these built environments may also be critical in assessing the reliability of laboratory safety and sanitation practices to lower any potential risk of exposures to health care workers.
Collapse
Affiliation(s)
- Govind Prasad Sah
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Grace Kovalick
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Jessica Chopyk
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Peiting Kuo
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Lina Huang
- Department of Medicine, University of California San Diego, San Diego, California, USA
| | - Pooja Ghatbale
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Promi Das
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
| | - Susan Realegeno
- Department of Pathology, University of California San Diego, San Diego, California, USA
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
- Department of Bioengineering, University of California San Diego, San Diego, California, USA
- Department of Computer Science & Engineering, University of California San Diego, San Diego, California, USA
| | - Jack A. Gilbert
- Department of Pediatrics, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
- Scripps Institution of Oceanography and Department of Pediatrics, University of California San Diego, San Diego, California, USA
| | - David T. Pride
- Department of Pathology, University of California San Diego, San Diego, California, USA
- Department of Medicine, University of California San Diego, San Diego, California, USA
- Center for Microbiome Innovation, University of California San Diego, San Diego, California, USA
| |
Collapse
|
4
|
Danielli Bastos de Sousa F. The impact of plastic during the COVID-19 pandemic: The point of view of the environmental science literature. Mater Today Proc 2023; 80:1448-1455. [PMID: 36743883 PMCID: PMC9889263 DOI: 10.1016/j.matpr.2023.01.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/15/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023]
Abstract
COVID-19 is the official name of the disease provoked by a coronavirus called SARS-CoV-2. Since the advent of the first cases of the new coronavirus, our society has been completely changed. Due to the changes, new environmental challenges were imposed, principally due to the considerable growth in using plastic materials in packages and personal protective equipment such as face masks. The impact of plastic during the COVID-19 pandemic was discussed in the present work from the point of view of the environmental science area. Bibliometric analysis and mapping were performed based on Scopus database search results. Emphasis was placed on analyzing the authors' keywords of the publications. The main concern of the research area concerning the use of plastic during the COVID-19 pandemic is the pollution of water bodies by plastic.
Collapse
Affiliation(s)
- Fabiula Danielli Bastos de Sousa
- Technology Development Center, Universidade Federal de Pelotas, Rua Gomes Carneiro, 1, 96010-610, Pelotas, RS, Brazil,Center of Engineering, Modeling and Applied Social Science, Universidade Federal do ABC, Avenida dos Estados, 5001, 09210-580, Santo André, SP, Brazil,Corresponding author
| |
Collapse
|
5
|
Ragull S, Núñez-gómez A, Aretxalde MC, Zabala N, Párraga-niño N, Sabrià M. Low risk of environmental contagion by SARS-CoV-2 in non-sanitary spaces. Enfermedades infecciosas y microbiologia clinica (English ed ) 2022. [PMID: 36167639 PMCID: PMC9482839 DOI: 10.1016/j.eimce.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/19/2022] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
Objective To study the presence of SARS-CoV-2 on surfaces (high, medium and low contact) and airs in non-sanitary spaces with high public influx to evaluate the risk of environmental contagion. Methods Surfaces and airs were analysed by RT-qPCR to detect the presence of SARS-CoV-2. Results 394 surfaces and air samples were obtained from spaces with high public influx such as offices, shopping centres and nursing homes. The virus was not detected in any of the samples analysed. Conclusion Although we cannot emphatically conclude that there is no risk of environmental 27 infection by SARS-CoV-2 in non-sanitary spaces, we can affirm that the risk is almost non- existent.
Collapse
|
6
|
Silva PG, Branco PTBS, Soares RRG, Mesquita JR, Sousa SIV. SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity. Indoor Air 2022; 32:e13083. [PMID: 36040285 PMCID: PMC9538005 DOI: 10.1111/ina.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
This systematic review aims to present an overview of the current aerosol sampling methods (and equipment) being used to investigate the presence of SARS-CoV-2 in the air, along with the main parameters reported in the studies that are essential to analyze the advantages and disadvantages of each method and perspectives for future research regarding this mode of transmission. A systematic literature review was performed on PubMed/MEDLINE, Web of Science, and Scopus to assess the current air sampling methodologies being applied to SARS-CoV-2. Most of the studies took place in indoor environments and healthcare settings and included air and environmental sampling. The collection mechanisms used were impinger, cyclone, impactor, filters, water-based condensation, and passive sampling. Most of the reviewed studies used RT-PCR to test the presence of SARS-CoV-2 RNA in the collected samples. SARS-CoV-2 RNA was detected with all collection mechanisms. From the studies detecting the presence of SARS-CoV-2 RNA, fourteen assessed infectivity. Five studies detected viable viruses using impactor, water-based condensation, and cyclone collection mechanisms. There is a need for a standardized protocol for sampling SARS-CoV-2 in air, which should also account for other influencing parameters, including air exchange ratio in the room sampled, relative humidity, temperature, and lighting conditions.
Collapse
Affiliation(s)
- Priscilla G Silva
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro T B S Branco
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ruben R G Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Solna, Sweden
- Division of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
| | - João R Mesquita
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| |
Collapse
|
7
|
Nagle S, Tandjaoui-Lambiotte Y, Boubaya M, Gerber A, Alloui C, Bloch-Queyrat C, Carbonnelle E, Brichler S, Cohen Y, Zahar JR, Delagrèverie H. Environmental SARS-CoV-2 contamination in hospital rooms of patients with acute COVID-19. J Hosp Infect 2022; 126:116-122. [PMID: 35569577 PMCID: PMC9098885 DOI: 10.1016/j.jhin.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/19/2022]
Abstract
Objective Data on the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remain conflicting. Airborne transmission is still debated. However, hospital risk control requires better understanding of the different modes of transmission. This study aimed to evaluate the frequency of, and factors associated with, environmental air and surface contamination in the rooms of patients with coronavirus disease 2019 in the acute phase of the disease. Methods Sixty-five consecutive patients were included in this study. For each patient, seven room surfaces, air 1 m and 3 m from the patient's head, the inner surface of the patient's mask, and the outer surface of healthcare workers' (HCW) masks were sampled. Environmental contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA on surfaces, air and masks. A viral isolation test was performed on Vero cells for samples with an RT-qPCR cycle threshold (Ct) ≤37. Results SARS-CoV-2 RNA was detected by RT-qPCR in 34%, 12%, 50% and 10% of surface, air, patient mask and HCW mask samples, respectively. Infectious virus was isolated in culture from two samples among the 85 positive samples with Ct ≤37. On multi-variate analysis, only a positive result for SARS-CoV-2 RT-qPCR for patients' face masks was found to be significantly associated with surface contamination (odds ratio 5.79, 95% confidence interval 1.31–25.67; P=0.025). Conclusion This study found that surface contamination by SARS-CoV-2 was more common than air and mask contamination. However, viable virus was rare. The inner surface of a patient's mask could be used as a marker to identify those at higher risk of contamination.
Collapse
|
8
|
Myers NT, Laumbach RJ, Black KG, Ohman‐Strickland P, Alimokhtari S, Legard A, De Resende A, Calderón L, Lu FT, Mainelis G, Kipen HM. Portable air cleaners and residential exposure to SARS-CoV-2 aerosols: A real-world study. Indoor Air 2022; 32:e13029. [PMID: 35481935 PMCID: PMC9111720 DOI: 10.1111/ina.13029] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 05/04/2023]
Abstract
Individuals with COVID-19 who do not require hospitalization are instructed to self-isolate in their residences. Due to high secondary infection rates in household members, there is a need to understand airborne transmission of SARS-CoV-2 within residences. We report the first naturalistic intervention study suggesting a reduction of such transmission risk using portable air cleaners (PACs) with HEPA filters. Seventeen individuals with newly diagnosed COVID-19 infection completed this single-blind, crossover, randomized study. Total and size-fractionated aerosol samples were collected simultaneously in the self-isolation room with the PAC (primary) and another room (secondary) for two consecutive 24-h periods, one period with HEPA filtration and the other with the filter removed (sham). Seven out of sixteen (44%) air samples in primary rooms were positive for SARS-CoV-2 RNA during the sham period. With the PAC operated at its lowest setting (clean air delivery rate [CADR] = 263 cfm) to minimize noise, positive aerosol samples decreased to four out of sixteen residences (25%; p = 0.229). A slight decrease in positive aerosol samples was also observed in the secondary room. As the world confronts both new variants and limited vaccination rates, our study supports this practical intervention to reduce the presence of viral aerosols in a real-world setting.
Collapse
Affiliation(s)
- Nirmala T. Myers
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Robert J. Laumbach
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| | - Kathleen G. Black
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Pamela Ohman‐Strickland
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthRutgers UniversityPiscatawayNew JerseyUSA
| | - Shahnaz Alimokhtari
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Alicia Legard
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Adriana De Resende
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Leonardo Calderón
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Frederic T. Lu
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Gediminas Mainelis
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Howard M. Kipen
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| |
Collapse
|
9
|
Abstract
Understanding the contribution of routes of transmission, particularly the role of fomites in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) transmission is important in developing and implementing successful public health infection prevention and control measures.This article will look at case reports, laboratory findings, animal studies, environmental factors, the need for disinfection, and differences in settings, as they relate to SARS-CoV-2 transmission.
Collapse
Affiliation(s)
- Peter Katona
- UCLA School of Medicine Dept. of Infectious Diseases and UCLA School of Public Health
| | | | | |
Collapse
|
10
|
Dinoi A, Feltracco M, Chirizzi D, Trabucco S, Conte M, Gregoris E, Barbaro E, La Bella G, Ciccarese G, Belosi F, La Salandra G, Gambaro A, Contini D. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. Sci Total Environ 2022; 809:151137. [PMID: 34699823 PMCID: PMC8539199 DOI: 10.1016/j.scitotenv.2021.151137] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 05/03/2023]
Abstract
Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.
Collapse
Affiliation(s)
- Adelaide Dinoi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy
| | - Matteo Feltracco
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniela Chirizzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Sara Trabucco
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Marianna Conte
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy; Laboratory for Observations and Analyses of Earth and Climate, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy
| | - Elena Gregoris
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Elena Barbaro
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Giuseppina Ciccarese
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Franco Belosi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Andrea Gambaro
- Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniele Contini
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy.
| |
Collapse
|
11
|
Ragull S, Núñez-Gómez A, Aretxalde MC, Zabala N, Párraga-Niño N, Sabrià M. [Low risk of environmental contagion by SARS-CoV-2 in non-sanitary spaces]. Enferm Infecc Microbiol Clin 2022. [PMID: 35153355 DOI: 10.1016/j.eimc.2022.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
Objetivo Estudiar la presencia de SARS-CoV-2 en superficies (alto, medio y bajo contacto) y aires de espacios no sanitarios pero de elevada afluencia de público para evaluar el riesgo de contagio ambiental. Método Se ha realizado el análisis de las superficies y de los aires por RT-qPCR para detectar la presencia de SARS-CoV-2. Resultados Se obtuvieron 394 superficies y 23 muestras de aire de espacios de alta afluencia de personas, como oficinas, centros comerciales y residencias de ancianos. El virus no fue detectado en ninguna de las muestras analizadas. Conclusión Aunque no podemos concluir rotundamente que no existe un riesgo de infección ambiental por SARS-CoV-2 en espacios no sanitarios, sí podemos afirmar que el riesgo es casi nulo.
Collapse
|
12
|
Owen L, Shivkumar M, Cross RBM, Laird K. Porous surfaces: stability and recovery of coronaviruses. Interface Focus 2022; 12:20210039. [PMID: 34956608 PMCID: PMC8662390 DOI: 10.1098/rsfs.2021.0039] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/03/2021] [Indexed: 12/12/2022] Open
Abstract
The role of indirect contact in the transmission of SARS-CoV-2 is not clear. SARS-CoV-2 persists on dry surfaces for hours to days; published studies have largely focused on hard surfaces with less research being conducted on different porous surfaces, such as textiles. Understanding the potential risks of indirect transmission of COVID-19 is useful for settings where there is close contact with textiles, including healthcare, manufacturing and retail environments. This article aims to review current research on porous surfaces in relation to their potential as fomites of coronaviruses compared to non-porous surfaces. Current methodologies for assessing the stability and recovery of coronaviruses from surfaces are also explored. Coronaviruses are often less stable on porous surfaces than non-porous surfaces, for example, SARS-CoV-2 persists for 0.5 h-5 days on paper and 3-21 days on plastic; however, stability is dependent on the type of surface. In particular, the surface properties of textiles differ widely depending on their construction, leading to variation in the stability of coronaviruses, with longer persistence on more hydrophobic materials such as polyester (1-3 days) compared to highly absorbent cotton (2 h-4 days). These findings should be considered where there is close contact with potentially contaminated textiles.
Collapse
Affiliation(s)
- Lucy Owen
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| | - Maitreyi Shivkumar
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| | - Richard B. M. Cross
- Emerging Technologies Research Centre, School of Engineering and Sustainable Development, De Montfort University, Leicester LE1 9BH, UK
| | - Katie Laird
- Infectious Disease Research Group, The Leicester School of Pharmacy, De Montfort University, Leicester LE1 9BH, UK
| |
Collapse
|
13
|
Schumacher YO, Tabben M, Chamari K, Dzendrowskyj P, Bahr R, Hassoun K, Abbassi AK, Bensaad M, Al Barghouthi B, Alishaq M, Fadel RAA, Jeremijenko AM. Environmental surface contamination with SARS-CoV-2 in professional football clubs. SCI MED FOOTBALL 2022; 5:8-12. [PMID: 35077321 DOI: 10.1080/24733938.2021.1941227] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: We assessed SARS-CoV-2 contamination of random surfaces in football training facilities in an environment with a high prevalence of infections.Methods: In six clubs of the Qatar Stars League, surfaces of random locations (high-touch areas, ventilation systems, toilets, cleaning tools, freezers, pantries) in routinely cleaned training facilities, locker rooms, medical and administrative areas were swabbed for SARS-CoV-2. The swabs were screened for the presence of viral RNA using a SARS-CoV-2 qPCR Probe Assay.Results: None of the 103 swabs reached a cycle threshold (cT) value ≤30 (strong viral presence, suggestive of potential surface transmission). Four samples showed cT values >30 and <35 (low quantity of virus) and 16 swabs returned a cT value ≥35 and <40 (inactive virus remnants). The remaining 83 samples were negative (cT value ≥40). Most samples with viral or viral remnant presence originated from high-touch areas.Conclusion: We did not find evidence for potential surface transmission in football club facilities when routine cleaning procedures are in place despite the presence of infected subjects.
Collapse
Affiliation(s)
| | | | - Karim Chamari
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Roald Bahr
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Khalid Hassoun
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | | | - Meryem Bensaad
- Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - Bayan Al Barghouthi
- Genomics Laboratory, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar
| | - Moza Alishaq
- Department of Medicine, Staff Medical Services & Occupational Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Andrew M Jeremijenko
- Department of Medicine, Staff Medical Services & Occupational Medicine, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
14
|
Lucas TC, Moura CRF, Monteiro RA, da Silva Baracho V, Rodrigues CM, Rocha KLS, da Cruz Ferreira PH, Silva TJ, Rocha-Vieira E, de Oliveira DB. Detection of SARS-CoV-2 genome on inanimate surfaces in COVID-19 intensive care units and emergency care cohort. Braz J Microbiol 2022. [PMID: 34993920 DOI: 10.1007/s42770-021-00674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/24/2021] [Indexed: 01/02/2023] Open
Abstract
Introduction Understanding the different transmission routes of SARS-CoV-2 is crucial in planning effective interventions in healthcare institutions. This study aimed to evaluate the presence of SARS-Cov-2 genome on inanimate surfaces in COVID-19 intensive care unit and emergency care cohorts. Methods This is a prospective cross-sectional study. Samples of the environmental surface of objects and furniture were collected between July 15 and October 15, 2020, at COVID-19 intensive and emergency care units. The presence of SARS-CoV-2 genome was determined by quantitative RT-qPCR. The positivity rate for SARS-Cov-2 genome is presented as the arithmetic mean of the sum of the values obtained in each collection. Values of 1.0, 0.5, and 0.0 were assigned for positive, indeterminate, and negative events, respectively. Results In the intensive care unit, 86% of samples collected at the stethoscope and bed rail surfaces were positive. In the emergency care unit, 43% of bathroom tap, bed rails, and bedside table samples were positive. SARS-CoV-2 genome was not detected at the computer mouse and keyboard. At the emergency care unit, 14.3% of the samples from the collection room armchair were positive. Conclusions SARS-CoV-2 genome can be found at the environmental surface of objects and furniture at COVID-19 care units. They can represent a potential source of indirect transmission pathway for COVID-19, especially within health service institutions.
Collapse
|
15
|
Gonçalves J, da Silva PG, Reis L, Nascimento MSJ, Koritnik T, Paragi M, Mesquita JR. Surface contamination with SARS-CoV-2: A systematic review. Sci Total Environ 2021; 798:149231. [PMID: 34325141 PMCID: PMC8302502 DOI: 10.1016/j.scitotenv.2021.149231] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 05/17/2023]
Abstract
Little is known about contaminated surfaces as a route of transmission for SARS-CoV- 2 and a systematic review is missing and urgently needed to provide guidelines for future research studies. As such, the aim of the present study was to review the current scientific knowledge and to summarize the existing studies in which SARS-CoV-2 has been detected in inanimate surfaces. This systematic review includes studies since the emergence of SARS-CoV-2, available in PubMed/MEDLINE and Scopus. Duplicate publications were removed, and exclusion criteria was applied to eliminate unrelated studies, resulting in 37 eligible publications. The present study provides the first overview of SARS-CoV-2 detection in surfaces. The highest detection rates occurred in hospitals and healthcare facilities with COVID-19 patients. Contamination with SARS-CoV-2 on surfaces was detected in a wide range of facilities and surfaces. There is a lack of studies performing viability testing for SARS-CoV-2 recovered from surfaces, and consequently it is not yet possible to assess the potential for transmission via surfaces.
Collapse
Affiliation(s)
- José Gonçalves
- Department for Public Health Microbiology Ljubljana, Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia; Institute of Sustainable Processes, University of Valladolid, Valladolid, Spain.
| | - Priscilla Gomes da Silva
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal; Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, Porto, Portugal; LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Luís Reis
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | | | - Tom Koritnik
- Department for Public Health Microbiology Ljubljana, Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia
| | - Metka Paragi
- Department for Public Health Microbiology Ljubljana, Centre for Medical Microbiology, National Laboratory of Health, Environment and Food, Ljubljana, Slovenia
| | - João R Mesquita
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal; Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, Porto, Portugal
| |
Collapse
|
16
|
Dziedzinska R, Kralik P, Šerý O. Occurrence of SARS-CoV-2 in Indoor Environments With Increased Circulation and Gathering of People. Front Public Health 2021; 9:787841. [PMID: 34881222 PMCID: PMC8648259 DOI: 10.3389/fpubh.2021.787841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/28/2021] [Indexed: 12/18/2022] Open
Abstract
At the time of sampling (2020/2021), the number of new cases of SARS-CoV-2-positive individuals in the Czech Republic significantly exceeded the numbers in neighboring countries and in the EU. In terms of the number of deaths, the country ranked near the top of the list. Legislative orders required wearing masks indoors, disinfecting surfaces in public places, and limiting the number of people per sales area in commercial spaces. Due to an situation, most schools and shops were closed. The entire country anticipated a total lockdown. To assess the risk to public health regarding SARS-CoV-2 transmission, air and surfaces were sampled in two public places: a post office and a shopping center. Samples were also collected at the COVID-19 unit at the local hospital. Neither air nor surface samples were positive for SARS-CoV-2 virus particles in the post office or shopping center. Positive results were found in the hospital ward, with floors being the most and highest contaminated surface. Based on our results, we believe that public places do not pose a risk in relation to SARS-CoV-2 transmission, especially when epidemiological measures to reduce transmission are followed, such as wearing masks, using disinfectant or limiting the number of customers per retail establishment.
Collapse
Affiliation(s)
- Radka Dziedzinska
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Liběchov, Czechia
- Elisabeth Research Institute, Brno, Czechia
| | - Petr Kralik
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Liběchov, Czechia
- Elisabeth Research Institute, Brno, Czechia
| | - Omar Šerý
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Liběchov, Czechia
- Elisabeth Research Institute, Brno, Czechia
- Laboratory of DNA Diagnostics, Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czechia
| |
Collapse
|
17
|
Arunwuttipong A, Jangtawee P, Vchirawongkwin V, Kangwansupamonkon W, Asavanant K, Ekgasit S. Public Buses Decontamination by Automated Hydrogen Peroxide Aerosolization System. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND: Public transportation has been linked to an increase in the risk of coronavirus disease 2019 transmission. The effective decontamination system using aerosolized hydrogen peroxide can mitigate the transmission risk from using public transportation.
AIM: The aim of this study was to develop and validate an effective decontamination system for public transport.
METHODS: The experimental research was performed in 13 inter-city public buses. The aerosol generator with ultrasonic atomizer was used in the experiment. The validation process for disinfection was conducted using both a chemical indicator (CI) and spore discs biological indicator (inoculated with 106 Geobacillus stearothermophilus enclosed in glassine envelopes). The CIs and biological indicators were marked by number and placed in nine locations on each bus. The decontamination cycle was developed by analyzed of various aerosolized and decomposition period. Both concentrations of hydrogen peroxide, 5% and 7%, were used for comparison.
RESULTS: In an aerosolized period, both concentrations of hydrogen peroxide at 30 min were effective for sporicidal 6-log reductions. The decontamination cycle totaled 100 min, based on a 70 min average decomposition time.
CONCLUSIONS: The automated hydrogen peroxide aerosolized system is a highly effective and safe method of decontaminating public buses.
Collapse
|
18
|
Mourmouris P, Tzelves L, Roidi C, Fotsali A. COVID-19 transmission: a rapid systematic review of current knowledge. Osong Public Health Res Perspect 2021; 12:54-63. [PMID: 33979995 PMCID: PMC8102883 DOI: 10.24171/j.phrp.2021.12.2.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/21/2021] [Indexed: 12/12/2022] Open
Abstract
Objective The objective of this study was to identify the potential and definite sources of transmission of coronavirus disease 2019 (COVID-19). Methods Due to time constraints and the acute nature of the pandemic, we searched only PubMed/Medline from inception until January 28, 2021. We analyzed the level of evidence and risk of bias in each category and made suggestions accordingly. Results The virus was traced from its potential origin via possible ways of transmission to the last host. Symptomatic human-to-human transmission remains the driver of the epidemic, but asymptomatic transmission can potentially contribute in a substantial manner. Feces and fomites have both been found to contain viable virus; even though transmission through these routes has not been documented, their contribution cannot be ruled out. Finally, transmission from pregnant women to their children has been found to be low (up to 3%). Conclusion Even though robust outcomes cannot be easily assessed, medical personnel must maintain awareness of the main routes of transmission (via droplets and aerosols from even asymptomatic patients). This is the first attempt to systematically review the existing knowledge to produce a paper with a potentially significant clinical impact.
Collapse
Affiliation(s)
- Panagiotis Mourmouris
- Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lazaros Tzelves
- Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christiana Roidi
- Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Fotsali
- Second Department of Urology, Athens Medical School, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|