Fit evaluation of NIOSH approved N95 filtering facepiece respirators with various skin protectants: A pilot study

Widespread disease outbreaks can result in prolonged wear times of National Institute for Occupational Safety and Health Approved N95 filtering facepiece respirators by healthcare personnel. Prolonged wear times of these devices can cause the development of various adverse facial skin conditions. Healthcare personnel have been reported to apply "skin protectants" to the face to reduce the pressure and friction of respirators. Because tight-fitting respirators rely on a good face seal to protect the wearer, it is important to understand if the fit is affected when skin protectants are used. This laboratory pilot study included 10 volunteers who performed quantitative fit tests to evaluate respirator fit while wearing skin protectants. Three N95 filtering facepiece respirator models and three skin protectants were evaluated. Three replicate fit tests were performed for each combination of subject, skin protectant (including a control condition of no protectant), and respirator model. Fit Factor (FF) was affected differently by the combination of the protectant type and respirator model. The main effects of the protectant type and respirator model were both significant (p < 0.001); additionally, their interaction was significant (p = 0.02), indicating FF is affected by the combined effects of the protectant type and respirator model. Compared to the control condition, using a bandage-type or surgical tape skin protectant decreased the odds of passing the fit test. Using a barrier cream skin protectant also decreased the odds of passing the fit test across all models compared to the control condition; however, the probability of passing a fit test was not statistically significantly different from the control condition (p = 0.174). These results imply that all three skin protectants reduced mean fit factors for all N95 filtering facepiece respirator models tested. The bandage-type and surgical tape skin protectants both reduced fit factors and passing rates to a greater degree than the barrier cream. Respirator users should follow respirator manufacturers' guidance on the use of skin protectants. If a skin protectant is to be worn with a tight-fitting respirator, the fit of the respirator should be evaluated with the skin protectant applied before use in the workplace.

Assessing the Fit of N95 Filtering Facepiece Respirators Fitted with an Ear Loop Strap System: A Pilot Study

Throughout the COVID-19 pandemic, hundreds of millions of people worldwide have become new users of respiratory protective devices. Facemasks and KN95 respirators utilizing an ear loop straps system (ELSS) have recently become popular among occupational and non-occupational populations. Part of this popularity is due to the ease of wearability as compared with traditional devices utilizing two headbands, one worn over the head and the other behind the neck-a universal strap system used in NIOSH-certified N95 filtering facepiece respirators (FFRs). Some users convert the two-strap configuration to an adjustable ELSS. The first objective of this pilot study was to quantitatively characterize how such a conversion impacts the respirator fit. Additionally, a novel faceseal (NFS) technology, which has been previously demonstrated to enhance the fit of N95 FFRs, was deployed to modify the ELSS-converted N95 FFRs. The second objective of this study was to quantify the fit improvement that results from adding the NFS to the ELSS. The study was conducted by performing the Occupational Safety and Health Administration (OSHA)-approved quantitative fit testing (QNFT) on 16 human subjects featuring different facial shapes and dimensions. Three models of cup-shaped N95 FFRs were tested in three versions: the standard version with manufacturer's strap system, the ELSS-converted, and the ELSS-converted version modified by adding the NFS. QNFT demonstrated that the fit of an N95 FFR featuring the traditional/standard headbands strap system is negatively impacted when this system is converted to an ELSS. The fit of an ELSS-converted respirator can be significantly improved by the addition of the NFS. We found that the FFR model and the strap system version are significant factors affecting the QNFT-determined respirator fit factor (FF), as well as the OSHA QNFT pass rate (FF ≥100). The findings suggest that the current NFS, if further improved, has a potential for developing a 'universally fitting' ELSS-equipped N95 FFR that can be used by the general public, the vast majority of whom do not have access to OSHA fit requirements.

Technical note: Impact of face covering on aerosol transport patterns during coughing and sneezing

COVID-19 is spread via different routes, including virus-laden airborne particles generated by human respiratory activities. In addition to large droplets, coughing and sneezing produce a lot of small aerosol particles. While face coverings are believed to reduce the aerosol transmission, information about their outward effectiveness is limited. Here, we determined the aerosol concentration patterns around a coughing and sneezing manikin and established spatial zones representing specific elevations of the aerosol concentration relative to the background. Real-time measurements of sub-micrometer aerosol particles were performed in the vicinity of the manikin. The tests were carried out without any face covering and with three different types of face covers: a safety faceshield, low-efficiency facemask and high-efficiency surgical mask. With no face covering, the simulated coughing and sneezing created a powerful forward-propagating fine aerosol flow. At 6 ft forward from the manikin head, the aerosol concentration was still 20-fold above the background. Adding a face covering reconfigured the forward-directed aerosol transmission pattern. The tested face coverings were found capable of mitigating the risk of coronavirus transmission; their effectiveness is dependent on the protective device. The outward leakage associated with a specific face covering was shown to be a major determinant of the exposure level for a person standing or seating next to or behind the coughing or sneezing "spreader" in a bus/train/aircraft/auditorium setting. Along with reports recently published in the literature, the study findings help assess the infectious dose and ultimately health risk for persons located within a 6-ft radius around the "spreader."

Homemade facemasks: particle filtration, breathability, fit, and other performance characteristics

Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.

Coronavirus Disease 2019 Patients in Earlier Stages Exhaled Millions of Severe Acute Respiratory Syndrome Coronavirus 2 Per Hour

Exhaled breath samples had the highest positive rate (26.9%, n=52), followed by surface swabs (5.4%, n=242), and air samples (3.8%, n=26). COVID-19 patients recruited in Beijing exhaled millions of SARS-CoV-2 RNA copies into the air per hour. Exhaled breath emission may play an important role in the COVID-19 transmission.

Evaluation of AccuFIT 9000: A Novel Apparatus for Quantitative Fit Testing of Particulate Respirators

Various strategies developed for protecting frontline workers and the general public from the novel coronavirus, SARS-CoV-2, largely rely on respiratory protective devices (RPDs), especially considering recent evidence about the aerosol transmission route of COVID-19. Performance of an RPD primarily depends on how well the protective device fits the wearer. Therefore, quantitative fit testing of particulate respirators is crucial for achieving the intended protection level. Millions of fit tests are conducted every year using a US OSHA-accepted standard protocol involving a PortaCount^® (TSI Inc., Shoreview, MN, USA) which measures a respirator fit factor. Recently, several alternative fit testing instruments have been developed and introduced to the market. Among them is an AccuFIT 9000 (Kanomax-Japan Inc., Suita-city, Osaka, Japan), which, like the PortaCount^®, utilizes the condensation particle counting principle, but features an advanced saturation chamber design allowing for a longer residence time and greater flow stability. It is also claimed to have a more cost-efficient assembly than its predecessors. In this study, the novel AccuFIT apparatus was extensively evaluated against the PortaCount^® (the reference instrument) using the traditional standard fit testing protocol and following the American National Standards Institute (ANSI) standard (Z88.10-2010 Annex A2). The evaluation was performed with three types of respirators, N95 filtering facepiece respirator (FFR), P100 FFR, and half-mask elastomeric facepiece, of different models and manufacturers donned on 25 subjects. The comparative testing and analysis showed that the AccuFIT 9000 is capable of identifying an inadequate fit of the tested respirators with a sensitivity 0.95 and specificity of 0.97, which meets the ANSI requirement of ≥0.95. The other ANSI requirements/recommendations were also met. It was concluded that the novel fit testing apparatus demonstrated an acceptable performance and, thus, can be successfully deployed for the quantitative respirator fit testing.

Breath-, air- and surface-borne SARS-CoV-2 in hospitals

The COVID-19 pandemic has brought an unprecedented crisis to the global health sector. When discharging COVID-19 patients in accordance with throat or nasal swab protocols using RT-PCR, the potential risk of reintroducing the infection source to humans and the environment must be resolved. Here, 14 patients including 10 COVID-19 subjects were recruited; exhaled breath condensate (EBC), air samples and surface swabs were collected and analyzed for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) in four hospitals with applied natural ventilation and disinfection practices in Wuhan. Here we discovered that 22.2% of COVID-19 patients (n = 9), who were ready for hospital discharge based on current guidelines, had SARS-CoV-2 in their exhaled breath (~105 RNA copies/m3). Although fewer surface swabs (3.1%, n = 318) tested positive, medical equipment such as face shield frequently contacted/used by healthcare workers and the work shift floor were contaminated by SARS-CoV-2 (3-8 viruses/cm2). Three of the air samples (n = 44) including those collected using a robot-assisted sampler were detected positive by a digital PCR with a concentration level of 9-219 viruses/m3. RT-PCR diagnosis using throat swab specimens had a failure rate of more than 22% in safely discharging COVID-19 patients who were otherwise still exhaling the SARS-CoV-2 by a rate of estimated ~1400 RNA copies per minute into the air. Direct surface contact might not represent a major transmission route, and lower positive rate of air sample (6.8%) was likely due to natural ventilation (1.6-3.3 m/s) and regular disinfection practices. While there is a critical need for strengthening hospital discharge standards in preventing re-emergence of COVID-19 spread, use of breath sample as a supplement specimen could further guard the hospital discharge to ensure the safety of the public and minimize the pandemic re-emergence risk.

Eficacia de la mascarilla facial con filtro de partículas N95 y de la mascarilla quirúrgica durante la respiración humana: dos vías para la penetración de partículas

RESUMENEl nivel de protección ofrecido por las mascarillas con filtro de partículas y las mascarillas se establece considerando el porcentaje de partículas ambientales que penetran dentro del dispositivo de protección. Existen dos vías de penetración: (1) la infiltración a través del sellado facial de la mascarilla y (2) a través del medio filtrante. El objetivo principal de este estudio fue diferenciar el aporte proveniente de cada una de estas dos vías para partículas cuyo tamaño oscila entre 0.03-1 μm en condiciones de respiración reales. Así, mientras se realizaban pruebas de ajuste convencionales, se evaluaron una mascarilla respiratoria autofiltrante N95 y una mascarilla quirúrgica usada comúnmente en entornos de atención médica en 25 sujetos (número coincidente con el último panel de pruebas de ajuste del Instituto Nacional de Seguridad y Salud Laborales). Asimismo, ambas mascarillas fueron evaluadas empleando maniquíes de respiración que imitaban de forma precisa los patrones de respiración registrados previamente en los sujetos evaluados. Posteriormente, se compararon los datos de penetración obtenidos en las evaluaciones realizadas con sujetos humanos y con maniquíes para determinar los diferentes tamaños de partículas, así como los patrones de respiración. Así se determinaron 5,250 valores de penetración específicos correspondientes al ejercicio y el tamaño de las partículas. Para cada valor se calcularon la tasa de infiltración a través del sellado facial de la mascarilla y la tasa de infiltración a través del filtro, con la finalidad de cuantificar los aportes relativos realizados por cada vía de penetración. El número de partículas que penetra mediante infiltración del sellado facial de la mascarilla autofiltrante/mascarilla quirúrgica probadas excedió ampliamente el número de aquellas que lo hacen a través del filtro. Para la mascarilla autofiltrante N95, el exceso fue (en promedio) de un orden de magnitud y se incrementó notablemente al aumentar el tamaño de las partículas (p < 0.001): ∼7 veces mayor para 0,04 μm, ∼10 veces para 0.1 μm y ∼20 veces para 1 μm. En el caso de la mascarilla quirúrgica, la tasa de infiltración a través del sellado facial de la misma con respecto al filtro osciló entre 4.8 y 5.8 y no se vio significativamente afectada por el tamaño de las partículas para la fracción del submicrómetro evaluado. El movimiento facial/corporal tuvo un efecto pronunciado en el aporte relativo de las dos vías de penetración. La intensidad de la respiración y las dimensiones faciales mostraron alguna influencia (aunque limitada). Considerando que la mayoría de las partículas que penetraron ingresaron a través del sellado facial, al desarrollar la mascarilla autofiltrante/mascarilla quirúrgica la prioridad debería ser realizar una adecuación que permitiera eliminar o minimizar la infiltración a través del sellado facial y no mejorar la eficiencia del medio de filtro.

¿Cómo afecta la frecuencia respiratoria el desempeño de una mascarilla respiratoria autofiltrante N95 y de una mascarilla quirúrgica contra sustitutos de partículas virales?

ResumenLa frecuencia respiratoria (respiraciones/min) difiere entre los individuos y dependiendo de los niveles de actividad física. Las partículas ingresan a las mascarillas respiratorias mediante dos vías principales de penetración: infiltración a través del sellado facial y penetración a través de filtros. Sin embargo, se desconoce la forma en que la frecuencia respiratoria afecta el desempeño general de las mascarillas autofiltrantes N95 (filtering facepiece respirators, FFR) y las mascarillas quirúrgicas (MQ) contra partículas virales y otras partículas submicrómicas de importancia para la salud. En un maniquí de respiración a cuatro flujos inspiratorios medios (FIM) (15, 30, 55 y 85 L/min) y cinco frecuencias respiratorias (10, 15, 20, 25 y 30 respiraciones/min) se probaron una FFR y una MQ. En los dispositivos de protección respiratoria probados se determinaron la penetración a través del filtro (P_filtro) y la infiltración total hacia el interior (ITI) de partículas de aerosol de cloruro de sodio (NaCl) en tamaños que oscilaban entre 20 y 500 nm. Asimismo, se calcularon las proporciones de penetración de la "infiltración a través del sellado facial con respecto al filtro" (ISFF). Tanto el FIM como la frecuencia respiratoria mostraron efectos significativos (p < 0.05) en el P_filtro y la ITI. El aumento de la frecuencia respiratoria incrementó la ITI para las FFR N95 mientras que en las MQ no se observaron tendencias claras. El aumento del FIM incrementó la P_filtro y disminuyó la ITI, lo que dio lugar a una disminución de la proporción de la ISFF. La mayoría de las proporciones de la ISFF fueron >1, lo que sugiere que la infiltración a través del sellado facial fue la vía primaria de penetración de partículas a diversas frecuencias respiratorias. La frecuencia respiratoria es otro factor (además del FIM) que puede afectar significativamente el desempeño de las FFR N95: las frecuencias respiratorias más altas aumentan la ITI. En el caso de las MQ probadas no se observó ninguna tendencia consistente de aumento o disminución de la ITI relacionada con el FIM o la frecuencia respiratoria. Para ampliar potencialmente estos hallazgos más allá del maniquí/sistema respiratorio utilizado, se necesitan estudios futuros orientados a comprender plenamente el mecanismo que hace que la frecuencia respiratoria afecte el desempeño de los dispositivos de protección respiratoria en los sujetos humanos.

New respirator performance monitor (RePM) for powered air-purifying respirators

Powered air-purifying respirators (PAPRs) that offer protection from particulates are deployed in different workplace environments. Usage of PAPRs by healthcare workers is rapidly increasing; these respirators are often considered the best option in healthcare settings, particularly during public health emergency situations, such as outbreaks of pandemic diseases. At the same time, lack of user training and certain vigorous work activities may lead to a decrease in a respirator's performance. There is a critical need for real-time performance monitoring of respiratory protective devices, including PAPRs. In this effort, a new robust and low-cost real-time performance monitor (RePM) capable of evaluating the protection offered by a PAPR against aerosol particles at a workplace was developed. The new device was evaluated on a manikin and on human subjects against a pair of condensation nuclei counters (P-Trak) used as the reference protection measurement system. The outcome was expressed as a manikin-based protection factor (mPF) and a Simulated Workplace Protection Factor (SWPF) determined while testing on subjects. For the manikin-based testing, the data points collected by the two methods were plotted against each other; a near-perfect correlation was observed with a correlation coefficient of 0.997. This high correlation is particularly remarkable since RePM and condensation particle counter (CPC) measure in different particle size ranges. The data variability increased with increasing mPF. The evaluation on human subjects demonstrated that RePM prototype provided an excellent Sensitivity (96.3% measured on human subjects at a response time of 60 sec) and a Specificity of 100%. The device is believed to be the first of its kind to quantitatively monitor PAPR performance while the wearer is working; it is small, lightweight, and does not interfere with job functions.

Autoclave sterilization and ethanol treatment of re-used surgical masks and N95 respirators during COVID-19: impact on their performance and integrity

Background

An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and re-use as a standard of care, while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it “as a crisis capacity strategy”. However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks.

Aim

We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals.

Methods

The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037–3.2 μm to represent aerosolized single viruses, their agglomerates, bacteria and larger particle carriers.

Findings

The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving.

Conclusion

Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study.

Estimated dermal exposure to nebulized pharmaceuticals for a simulated home healthcare worker scenario

The duties of home healthcare workers are extensive. One important task that is frequently performed by home healthcare workers is administration of nebulized medications, which may lead to significant dermal exposure. In this simulation study conducted in an aerosol exposure chamber, we administered a surrogate of nebulizer-delivered medications (dispersed sodium chloride, NaCl) to a patient mannequin. We measured the amount of NaCl deposited on the exposed surface of the home healthcare worker mannequin, which represented the exposed skin of a home healthcare worker. Factors such as distance and position of the home healthcare worker, room airflow rate and patient's inspiratory rate were varied to determine their effects on dermal exposure. There was a 2.78% reduction in dermal deposition for every centimeter the home healthcare worker moved away from the patient. Increasing the room's air exchange rate by one air change per hour increased dermal deposition by about 2.93%, possibly due to a decrease in near field particle settling. For every 10-degrees of arc the home healthcare worker is positioned from the left side of the patient toward the right and thus moving into the ventilation airflow direction, dermal deposition increased by about 4.61%. An increase in the patient's inspiratory rate from 15-30 L/min resulted in an average of 14.06% reduction in dermal deposition for the home healthcare worker, reflecting a relative increase in the aerosol fraction inhaled by the patient. The findings of this study elucidate the interactions among factors that contribute to dermal exposure to aerosolized pharmaceuticals administered by home healthcare workers. The results presented in this paper will help develop recommendations on mitigating the health risks related to dermal exposure of home healthcare workers.

Inactivation of bacterial and fungal spores by UV irradiation and gaseous iodine treatment applied to air handling filters

Exposure to viable bacterial and fungal spores re-aerosolized from air handling filters may create a major health risk. Assessing and controlling this exposure have been of interest to the bio-defense and indoor air quality communities. Methods are being developed for inactivating stress-resistant viable microorganisms collected on ventilation filters. Here we investigated the inactivation of spores of Bacillus thuringiensis var. kurstaki (Btk), a recognized simulant for B. antracis, and Aspergillus fumigatus, a common opportunistic pathogen used as an indicator for indoor air quality. The viability change was measured on filters treated with ultraviolet (UV) irradiation and gaseous iodine. The spores were collected on high-efficiency particulate air (HEPA) and non-HEPA filters, both flattened for testing purposes to represent "surface" filters. A mixed cellulose ester (MCE) membrane filter was also tested as a reference. Additionally, a commercial HEPA unit with a deep-bed (non-flattened) filter was tested. Combined treatments of Btk spores with UV and iodine on MCE filter produced a synergistic inactivation effect. No similar synergy was observed for A. fumigatus. For spores collected on an MCE filter, the inactivation effect was about an order of magnitude greater for Btk compared to A. fumigatus. The filter type was found to be an important factor affecting the inactivation of Btk spores while it was not as influential for A. fumigatus. Overall, the combined effect of UV irradiation and gaseous iodine on viable bacterial and fungal spores collected on flat filters was found to be potent. The benefit of either simultaneous or sequential treatment was much lower for Btk spores embedded inside the deep-bed (non-flattened) HEPA filter, but for A. fumigatus the inactivation on flattened and non-flattened HEPA filters was comparable. For both species, applying UV first and gaseous iodine second produced significantly higher inactivation than when applying them simultaneously or in an opposite sequence.

Evaluation of total and inhalable samplers for the collection of carbon nanotube and carbon nanofiber aerosols

A growing number of carbon nanotubes and nanofibers (CNT/F) exposure and epidemiologic studies have utilized 25-mm and 37-mm open-faced cassettes (OFC) to assess the inhalable aerosol fraction. It has been previously established that the 37-mm OFC under-samples particles greater than 20 μm in diameter, but the size-selective characteristics of the 25-mm OFC have not yet been fully evaluated. This article describes an experimental study conducted to determine if the 25- and 37-mm OFCs performed with relative equivalence to a reference inhalable aerosol sampler when challenged with CNT/F particles. Side-by-side paired samples were collected within a small Venturi chamber using a 25-mm styrene OFC, 37-mm styrene OFC, 25-mm aluminum OFC, and Button Inhalable Aerosol Sampler. Three types of CNT/F materials and an Arizona road dust were used as challenge aerosols for the various sampler configurations. Repeated experiments were conducted for each sampler configuration and material. The OFC samplers operated at flow rates of 2 and 5 liters per minute. Results showed that the 25-mm OFC performed comparably to the Button Sampler when challenged with CNT/F aerosols, which was demonstrated in five of the six experimental scenarios with an average error of 20%. Overall, the results of this study indicate that the sampling efficiency of the 25- and 37-mm OFCs adequately followed the ISO/ACGIH/CEN inhalable sampling convention when challenged with CNT/F aerosols. Past exposure and epidemiologic studies that used these OFC samplers can directly compare their results to studies that have used other validated inhalable aerosol samplers.

Combining sensor-based measurement and modeling of PM2.5 and black carbon in assessing exposure to indoor aerosols

Accurate, cost-effective methods are needed for rapid assessment of traffic-related air pollution (TRAP). Typically, real-time data of particulate matter (PM) from portable sensors have been adjusted using data from reference methods such as gravimetric measurement to improve accuracy. The objective of this study was to create a correction factor or linear regression model for the real-time measurements of the RTI's Micro Personal Exposure Monitor (MicroPEM^™) and AethLab's microAeth® black carbon (AE51) sensor to generate accurate real-time data for PM_2.5 (PM_2.5RT) and black carbon (BC_RT) in Cincinnati metropolitan homes. The two sensors and an SKC PM_2.5 Personal Modular impactor were collocated in 44 indoor sampling events for 2 days in residences near major roadways. The reference filter-based analyses conducted by a laboratory included particle mass (SKC PM_2.5 and MicroPEM^™ PM_2.5) and black carbon (SKC BC); these methods are more accurate than real-time sensors but are also more cumbersome and costly. For PM_2.5, the average correction factor, a ratio of gravimetric to real-time, for the MicroPEM^™ PM_2.5 and SKC PM_2.5 utilizing the PM_2.5RT and was 0.94 and 0.83, respectively, with a coefficient of variation (CV) of 84% and 52%, respectively; the corresponding linear regression model had a CV of 54% and 25%. For BC, the average correction factor utilizing the BC_RT and SKC BC was 0.74 with a CV of 36% with the associated linear regression model producing a CV of 56%. The results from this study will help ensure that the real-time exposure monitors are capable of detecting an estimated PM_2.5 after an appropriate statistical model is applied.

Indoor particulate matter and lung function in children

People generally spend more time indoors than outdoors resulting in a higher proportion of exposure to particulate matter (PM) occurring indoors. Consequently, indoor PM levels, in contrast to outdoor PM levels, may have a stronger relationship with lung function. To test this hypothesis, indoor and outdoor PM_2.5 and fungal spore data were simultaneously collected from the homes of forty-four asthmatic children aged 10-16 years. An optical absorption technique was utilized on the collected PM_2.5 mass to obtain concentrations of black carbon (BC) and ultraviolet light absorbing particulate matter, (UVPM; a marker of light absorbing PM_2.5 emitted from smoldering organics). Enrolled children completed spirometry after environmental measurements were made. Given the high correlation between PM_2.5, BC, and UVPM, principal component analysis was used to obtain uncorrelated summaries of the measured PM. Separate linear mixed-effect models were developed to estimate the association between principal components of the PM variables and spirometry values, as well as the uncorrelated original PM variables and spirometry values. A one-unit increase in the first principal component variable representing indoor PM (predominantly composed of UVPM and PM_2.5) was associated with 4.1% decrease (99% CI = -6.9, -1.4) in FEV₁/FVC ratio. 11.3 μg/m³ increase in indoor UVPM was associated with 6.4% and 14.7% decrease (99% CI = -10.4, -2.4 and 99% CI = -26.3, -2.9, respectively) in percent predicted FEV₁/FVC ratio and FEF_25-75 respectively. Additionally, 17.7 μg/m³ increase in indoor PM_2.5 was associated with 6.1% and 12.9% decrease (99% CI = -10.2, -1.9 and 99% CI = -24.9, -1.0, respectively) in percent predicted FEV₁/FVC ratio and FEF_25-75, respectively. Outdoor PM, indoor BC, and indoor fungal spores were not significantly associated with lung function. The results indicate that indoor PM is more strongly associated with lung function in children with asthma as compared with outdoor PM.

Predicting Indoor Concentrations of Black Carbon in Residential Environments

Black carbon (BC) is a descriptive term that refers to light-absorbing particulate matter (PM) produced by incomplete combustion and is often used as a surrogate for traffic-related air pollution. Exposure to BC has been linked to adverse health effects. Penetration of ambient BC is typically the primary source of indoor BC in the developed world. Other sources of indoor BC include biomass and kerosene stoves, lit candles, and charring food during cooking. Home characteristics can influence the levels of indoor BC. As people spend most of their time indoors, human exposure to BC can be associated to a large extent with indoor environments. At the same time, due to the cost of environmental monitoring, it is often not feasible to directly measure BC inside multiple individual homes in large-scale population-based studies. Thus, a predictive model for indoor BC is needed to support risk assessment in public health. In this study, home characteristics and occupant activities that potentially modify indoor levels of BC were documented in 23 homes, and indoor and outdoor BC concentrations were measured twice. The homes were located in the Cincinnati-Kentucky-Indiana tristate region and measurements occurred from September 2015 through August 2017. A linear mixed-effect model was developed to predict BC concentration in residential environments. The measured outdoor BC concentrations and the documented home characteristics were utilized as predictors of indoor BC concentrations. After the model was developed, a leave-one-out cross-validation algorithm was deployed to assess the predictive accuracy of the output. The following home characteristics and occupant activities significantly modified the concentration of indoor BC: outdoor BC, lit candles and electrostatic or high efficiency particulate air (HEPA) filters in heating, ventilation and air conditioning (HVAC) systems. Predicted indoor BC concentrations explained 78% of the variability in the measured indoor BC concentrations. The data show that outdoor BC combined with home characteristics can be used to predict indoor BC levels with reasonable accuracy.

Assessing the accuracy of commercially available gas sensors for the measurement of ambient ozone and nitrogen dioxide

The objective of the National Institute for Occupational Safety and Health (NIOSH) accuracy criterion is to ensure that measurements from monitoring devices are within ±25% of the true concentration of the analyte with 95% certainty. To determine whether NO2 and O3 sensors meet this criterion, three commercially available units (Cairclip O3/NO2, Aeroqual NO2, and Aeroqual O3 sensors) were co-located three times with validated instruments (NOx chemiluminescence [NO2mon] and photometric O3 analyzers [O3mon]) at an outdoor monitoring station. As cofactors of sensor performance such as temperature (T) and relative humidity (RH) potentially influence the response of NO2 and O3 sensors, corrections for cofactors were made by using T, RH, and the sensor measurements to predict measurements made by NO2mon and O3mon during the first co-location period (training dataset). The developed models were tested in the merged data obtained from the second and third co-location periods (testing dataset). In the training and testing datasets, the mean NO2 as measured by NO2mon was 4.6 ppb (range = 0.4-35 ppb) and 9.4 ppb (range = 1-37 ppb), respectively. The mean O3 in the training and testing datasets as measured by O3mon was 38.8 ppb (range = 1-65 ppb) and 35.7 ppb (range = 1-61 ppb), respectively. None of the sensor measurements in the training dataset were within the NIOSH accuracy criterion (mean error ≥25%). After correcting for cofactors of sensor performance, the accuracy of the Cairclip O3/NO2 and the Aeroqual O3 sensors considerably improved when tested with the testing dataset (mean error = -1% and 14%, respectively). However, the Aeroqual NO2 sensor had an error that was not within ±25%. Raw measurements from the tested sensors may be unsuitable for assessing workers' exposure to NO2 and O3. Corrections for cofactors of Cairclip O3/NO2 and Aeroqual O3 sensor performance are required for more accurate occupational exposure assessment.

Effectiveness of a portable air cleaner in removing aerosol particles in homes close to highways

Outdoor traffic-related airborne particles can infiltrate a building and adversely affect the indoor air quality. Limited information is available on the effectiveness of high efficiency particulate air (HEPA) filtration of traffic-related particles. Here, we investigated the effectiveness of portable HEPA air cleaners in reducing indoor concentrations of traffic-related and other aerosols, including black carbon (BC), PM2.5 , ultraviolet absorbing particulate matter (UVPM) (a marker of tobacco smoke), and fungal spores. This intervention study consisted of a placebo-controlled cross-over design, in which a HEPA cleaner and a placebo "dummy" were placed in homes for 4-weeks each, with 48-hour air sampling conducted prior to and during the end of each treatment period. The concentrations measured for BC, PM2.5 , UVPM, and fungal spores were significantly reduced following HEPA filtration, but not following the dummy period. The indoor fraction of BC/PM2.5 was significantly reduced due to the HEPA cleaner, indicating that black carbon was particularly impacted by HEPA filtration. This study demonstrates that HEPA air purification can result in a significant reduction of traffic-related and other aerosols in diverse residential settings.

Performance of a novel real-time respirator seal integrity monitor on firefighters: Simulated workplace pilot study

Millions of workers, including firefighters, use respiratory protective device. The key aspect in assuring the intended protection level of a respirator is its fit. However, even if the respirator originally fits well, the faceseal may be breached during its use. Until now, there have been no practically viable, inexpensive means to monitor the performance of a respirator during actual use. A novel Respirator Seal Integrity Monitor (ReSIM) was developed and recently evaluated on manikins by our team. The objective of this study was to evaluate the ReSIM effectiveness on respirator-wearing firefighters exposed to aerosols while performing simulated routine operational activities. Initially, 15 subjects were recruited for the study. Following a preliminary investigation that resulted in modifications in the ReSIM prototype and testing protocol, a subset of nine firefighters was chosen for a full-scale evaluation. The testing was conducted in a 24.3-m³ exposure chamber using NaCl as the challenge aerosol. Controlled faceseal leaks were established by opening a solenoid valve for 10, 15, or 20 sec. Leaks were also established as the tested firefighter slightly repositioned the respirator on his/her face. During the testing, the ReSIM measured particles inside a full-face elastomeric respirator with a 72.7% leak detection sensitivity (probability of correct leak identification) and an 84.2% specificity (probability of correct identification of the intervals which are absent of any leak). After adjusting for false negatives and persistent false positives, sensitivity and specificity increased to 83.6% and 92.2%, respectively. The factors causing minor limitations in leak detection sensitivity and specificity can be attributed to variability among subjects, moisture's effect on the particle sensor, and some in-mask sampling bias. In conclusion, the ReSIM can promptly detect the breach in a respirator faceseal with high sensitivity and specificity. Due to its capability to alert the wearer of possible overexposure to hazardous aerosols, the ReSIM concept has a remarkable potential to be applied in various working environments, where respirators are used.

Laboratory Evaluation of a Novel Real-Time Respirator Seal Integrity Monitor

Background

A low-cost real-time Respirator Seal Integrity Monitor (ReSIM) was recently developed to monitor a respirator's actual performance at a workplace. The objective of this study was to evaluate the capability of the new ReSIM prototype in manikin-based laboratory experiments to rapidly detect induced leakage of a half-mask elastomeric respirator.

Methods

Two phases of testing were conducted in this study. First, the accuracy of ReSIM measuring an aerosol concentration was assessed by comparing the outputs of ReSIM against a reference optical aerosol spectrometer (OAS) in a flow-through set-up. Second, the capability to detect a leak was tested using a manikin-based set-up to simulate leaks into a functional respirator.

Results

The regression curve of ReSIM versus OAS had an R2 of 0.936, indicating its high accuracy within the targeted particle size range of 0.5-2 µm. The ReSIM provided a leak detection sensitivity (probability of correctly identifying intervals with the true leak) of 98.4% when challenged with a combustion aerosol, compared to 71.8% when challenged with a NaCl aerosol. Its specificity (probability of identifying intervals without a leak) was 99.8% after adjusting for persistent false positives for both types of challenge aerosol.

Conclusion

The ReSIM prototype not only can estimate the particle concentration with high accuracy but also can rapidly detect respirator faceseal leakage in real time with sufficient sensitivity and specificity. In addition, it can trigger an alarm when the faceseal integrity is compromised.

Exposure assessments for a cross-sectional epidemiologic study of US carbon nanotube and nanofiber workers

BACKGROUND

Recent animal studies have suggested the potential for wide-ranging health effects resulting from exposure to carbon nanotubes and nanofibers (CNT/F). To date, no studies in the US have directly examined the relationship between occupational exposure and potential human health effects.

OBJECTIVES

Our goal was to measure CNT/F exposures among US workers with representative job types, from non-exposed to highly exposed, for an epidemiologic study relating exposure to early biologic effects.

METHODS

108 participants were enrolled from 12 facilities across the US. Personal, full-shift exposures were assessed based on the mass of elemental carbon (EC) at the respirable and inhalable aerosol particle size fractions, along with quantitatively characterizing CNT/F and estimating particle size via transmission electron microscopy (TEM). Additionally, sputum and dermal samples were collected and analyzed to determine internal exposures and exposures to the hands/wrists.

RESULTS

The mean exposure to EC was 1.00 μg/m³ at the respirable size fraction and 6.22 μg/m³ at the inhalable fraction. Analysis by TEM found a mean exposure of 0.1275 CNT/F structures/cm³, generally to agglomerated materials between 2 and 10 μm. Internal exposures to CNT/F via sputum analysis were confirmed in 18% of participants while ∼70% had positive dermal exposures.

CONCLUSIONS

We demonstrated the occurrence of a broad range of exposures to CNT/F within 12 facilities across the US. Analysis of collected sputum indicated internal exposures are currently occurring within the workplace. This is an important first step in determining if exposures in the workforce have any acute or lasting health effects.

Surgical Smoke Simulation Study: Physical Characterization and Respiratory Protection

Exposure of operating room (OR) personnel to surgical smoke, a unique aerosol generated from the common use of electrocautery during surgical procedures, is an increasing health risk concern. The main objective of this simulation study was to characterize the surgical smoke exposure in terms of the particle number concentration and size distribution in a human breathing zone. Additionally, the performance of respiratory protective devices designed for ORs was examined using two commercially available N95 facepiece filtering respirators (FFRs) as well as the same FFRs modified with new faceseal technology. The tests were conducted in an OR-simulating exposure chamber with the surgical smoke generated by electrocautery equipment applied to animal tissue and measured in the breathing zone with four aerosol spectrometers. The simulated workplace protection factor of each tested respirator was determined for ten subjects by measuring the total aerosol concentrations inside and outside of a respirator. The peak of the particle size distribution was in a range of 60-150 nm. The concentration of particles generated during the simulated surgical procedure significantly exceeded the background concentration under all tested air exchange conditions. The data suggest that wearing N95 filtering facepiece respirators significantly decreased the human exposure to surgical smoke. The new faceseal technology provided significantly higher respiratory protection than the commercial N95 FFRs.

Performance of two respiratory protective devices used by home-attending health care workers (a pilot study)

OBJECTIVES

This pilot study aimed at determining the Workplace Protection Factor (WPF) for respiratory protective devices widely used by health care workers to reduce exposure to potentially hazardous aerosols when attending patients in their homes. Two devices were tested, an N95 filtering facepiece respirator (FFR) and a surgical mask (SM).

METHODS

Three home-attending health care workers were recruited, medically cleared and fit tested. At the workplace, the aerosol concentrations outside (C_out) and inside (C_in) of the tested respiratory protective device worn by a subject were measured using two simultaneously operating P-Trak condensation particle counters within the particle size range of approximately 20-1,000 nm. Real-time and integrated (time-weighted average, TWA) values of WPF = C_out/C_in were determined.

RESULTS

This pilot study demonstrated that the WPF of the tested N95 FFR consistently exceeded that of the SM. The WPF_TWA(C) values calculated for the entire test time (based on the TWA aerosol concentration values) ranged from 29 to 40 and 2 to 9, respectively. In all cases, the N95 FFR provided protection above the Occupational Safety and Health Administration's (OSHA) assigned protection factor of 10, whereas the SM often offered little or essentially no protection against the measured sub-micrometer aerosol particles. For both devices, the protection level was found to depend on activity. For example, the WPF_TWA(C) for one subject wearing the N95 FFR was 56 during normal activity but fell almost 70% during tracheal suctioning. It is explicable considering that different procedures implemented by health care workers in homes generate particles of different sizes and require different body movements; both factors are anticipated to affect the WPF.

CONCLUSIONS

Wearing an N95-certified respirator helps significantly reduce the aerosol inhalation exposure of home-attending health care workers. An SM offers much lower protection. The WPF depends on several factors, including, but not limited to, the health care worker's activity and/or body movements; the WPF varies from one worker to another.

Evaluation of personal inhalable aerosol samplers with different filters for use during anthrax responses

Risk of inhalation exposure to viable Bacillus anthracis (B. anthracis) spores has primarily been assessed using short-term, stationary sampling methods which may not accurately characterize the concentration of inhalable-sized spores reaching a person's breathing zone. While a variety of aerosol sampling methods have been utilized during previous anthrax responses, no consensus has yet been established for personal air sampling. The goal of this study was to determine the best sampler-filter combination(s) for the collection and extraction of B. anthracis spores. The study was designed to (1) evaluate the performance of four filter types (one mixed cellulose ester, MCE (pore size = 3 µm), two polytetrafluoroethylene, PTFE (1 and 3 µm), and one polycarbonate, PC (3 µm)); and (2) evaluate the best performing filters in two commercially available inhalable aerosol samplers (IOM and Button). Bacillus thuringiensis kurstaki [Bt(k)], a simulant for B. anthracis, served as the aerosol challenge. The filters were assessed based on criteria such as ability to maintain low pressure drop over an extended sampling period, filter integrity under various environmental conditions, spore collection and extraction efficiencies, ease of loading and unloading the filters into the samplers, cost, and availability. Three of the four tested collection filters-except MCE-were found suitable for efficient collection and recovery of Bt(k) spores sampled from dry and humid as well as dusty and clean air environments for up to 8 hr. The PC (3 µm) filter was identified as the best performing filter in this study. The PTFE (3 µm) demonstrated a comparable performance, but it is more expensive. Slightly higher concentrations were measured with the IOM inhalable sampler which is the preferred sampler's performance criterion when detecting a highly pathogenic agent with no established "safe" inhalation exposure level. Additional studies are needed to address the effects of environmental conditions and spore concentration. The data obtained in this investigation are crucial for future efforts on the development and optimization of a method for assessing inhalation exposure to B. anthracis.

Performance of N95 FFRs Against Combustion and NaCl Aerosols in Dry and Moderately Humid Air: Manikin-based Study

OBJECTIVES

The first objective of this study was to evaluate the penetration of particles generated from combustion of plastic through National Institute for Occupational Safety and Health (NIOSH)-certified N95 filtering facepiece respirators (FFRs) using a manikin-based protocol and compare the data to the penetration of NaCl particles. The second objective was to investigate the effect of relative humidity (RH) on the filtration performance of N95 FFRs.

METHODS

Two NIOSH-certified N95 FFRs (A and B) were fully sealed on a manikin headform and challenged with particles generated by combustion of plastic and NaCl particles. The tests were performed using two cyclic flows [with mean inspiratory flow (MIF) rates = 30 and 85 l min(-1), representing human breathing under low and moderate workload conditions] and two RH levels (≈20 and ≈80%, representing dry and moderately humid air). The total and size-specific particle concentrations inside (C in) and outside (C out) of the respirators were measured with a condensation particle counter and an aerosol size spectrometer. The penetration values (C in/C out) were calculated after each test.

RESULTS

The challenge aerosol, RH, MIF rate, and respirator type had significant (P < 0.05) effects on the performance of the manikin-sealed FFR. Its efficiency significantly decreased when the FFR was tested with plastic combustion particles compared to NaCl aerosols. For example, at RH ≈80% and MIF = 85 l min(-1), as much as 7.03 and 8.61% of combustion particles penetrated N95 respirators A and B, respectively. The plastic combustion particles and gaseous compounds generated by combustion likely degraded the electric charges on fibers, which increased the particle penetration. Increasing breathing flow rate or humidity increased the penetration (reduced the respirator efficiency) for all tested aerosols. The effect of particle size on the penetration varied depending on the challenge aerosol and respirator type. It was observed that the peak of the size distribution of combustion particles almost coincided with their most penetrating particle size, which was not the case for NaCl particles. This finding was utilized for the data interpretation.

CONCLUSIONS

N95 FFRs have lower filter efficiency when challenged with contaminant particles generated by combustion, particularly when used under high humidity conditions compared to NaCl particles.

Indoor air quality in green-renovated vs. non-green low-income homes of children living in a temperate region of US (Ohio)

Green eco-friendly housing includes approaches to reduce indoor air pollutant sources and to increase energy efficiency. Although sealing/tightening buildings can save energy and reduce the penetration of outdoor pollutants, an adverse outcome can be increased buildup of pollutants with indoor sources. The objective of this study was to determine the differences in the indoor air quality (IAQ) between green and non-green homes in low-income housing complexes. In one housing complex, apartments were renovated using green principles (n=28). Home visits were conducted immediately after the renovation, and subsequently at 6 months and at 12 months following the renovation. Of these homes, eight homes had pre-renovation home visits; this allowed pre- and post-renovation comparisons within the same homes. Parallel visits were conducted in non-green (control) apartments (n=14) in a nearby low-income housing complex. The IAQ assessments included PM2.5, black carbon, ultrafine particles, sulfur, total volatile organic compounds (VOCs), formaldehyde, and air exchange rate. Data were analyzed using linear mixed-effects models. None of the indoor pollutant concentrations were significantly different between green and non-green homes. However, we found differences when comparing the concentrations before and after renovation. Measured immediately after renovation, indoor black carbon concentrations were significantly lower averaging 682 ng/m(3) in post-renovation vs. 2364 ng/m(3) in pre-renovation home visits (p=0.01). In contrast, formaldehyde concentrations were significantly higher in post-renovated (0.03 ppm) than in pre-renovated homes (0.01 ppm) (p=0.004). Questionnaire data showed that opening of windows occurred less frequently in homes immediately post-renovation compared to pre-renovation; this factor likely affected the levels of indoor black carbon (from outdoor sources) and formaldehyde (from indoor sources) more than the renovation status itself. To reduce IAQ problems and potentially improve health, careful selection of indoor building materials and ensuring sufficient ventilation are important for green building designs.

Culturability of Bacillus spores on aerosol collection filters exposed to airborne combustion products of Al, Mg, and B·Ti

Destruction of bioweapon facilities due to explosion or fire could aerosolize highly pathogenic microorganisms. The post-event air quality assessment is conducted through air sampling. A bioaerosol sample (often collected on a filter for further culture-based analysis) also contains combustion products, which may influence the microbial culturability and, thus, impact the outcome. We have examined the interaction between spores deposited on collection filters using two simulants of Bacillus anthracis [B. thuringiensis (Bt) and B. atrophaeus (referred to as BG)] and incoming combustion products of Al as well as Mg and B·Ti (common ingredient of metalized explosives). Spores extracted from Teflon, polycarbonate, mixed cellulose ester (MCE), and gelatin filters (most common filter media for bioaerosol sampling), which were exposed to combustion products during a short-term sampling, were analyzed by cultivation. Surprisingly, we observed that aluminum combustion products enhanced the culturability of Bt (but not BG) spores on Teflon filters increasing the culturable count by more than an order of magnitude. Testing polycarbonate and MCE filter materials also revealed a moderate increase of culturability although gelatin did not. No effect was observed with either of the two species interacting on either filter media with products originated by combustion of Mg and B·Ti. Sample contamination, spore agglomeration, effect of a filter material on the spore survival, changes in the spore wall ultrastructure and germination, as well as other factors were explored to interpret the findings. The study raises a question about the reliability of certain filter materials for collecting airborne bio-threat agents in combustion environments.

Performance of Facepiece Respirators and Surgical Masks Against Surgical Smoke: Simulated Workplace Protection Factor Study

Objective:

Surgical smoke generated during electrocautery contains toxins which may cause adverse health effects to operating room (OR) personnel. The objective of this study was to investigate the performance of surgical masks (SMs), which are routinely used in ORs, more efficient N95 surgical mask respirator (SMRs) and N100 filtering facepiece respirator (FFRs), against surgical smoke.

Methods:

Ten subjects were recruited to perform surgical dissections on animal tissue in a simulated OR chamber, using a standard electrocautery device, generating surgical smoke. Six respiratory protective devices (RPDs) were tested: two SMs, two SMRs, and two N100 FFRs [including a newly developed faceseal (FS) prototype]. Fit testing was conducted before the experiment. Each subject was then exposed to the surgical smoke while wearing an RPD under the tests. Concentrations inside (C_in) and outside (C_out) of the RPD were measured by a particle size spectrometer. The simulated workplace protection factor (SWPF) was determined by the ratio of C_out and C_in for each RPD-wearing subject.

Results:

For the SMs, the geometric means of SWPF_total (based on the total aerosol concentration) were 1.49 and 1.76, indicating minimal protection. The SWPF_total values of the SMRs and N100 FFRs were significantly higher than those of the SMs: for the two SMRs, the SWPF_total were 208 and 263; for the two N100s, the SWPF_total values were 1,089 and 2,199. No significant difference was observed between either the two SMs or the two SMRs. The SWPF_total for the novel FS prototype N100 FFR was significantly higher than the conventional N100 FFR. The correlation between SWPF_total and fit factor (FF) determined for two N95 SMRs was not significant.

Conclusions:

SMs do not provide measurable protection against surgical smoke. SMRs offer considerably improved protection versus SMs, while the N100 FFRs showed significant improvement over the SMRs. The FS prototype offered a higher level of protection than the standard N100 FFR, due to a tighter seal. While we acknowledge that conventional N100 FFRs (equipped with exhalation valves) are not practical for human OR use, the results obtained with the FS prototype demonstrate the potential of the new FS technology for implementation on various types of respirators.

Performance of an improperly sized and stretched-out loose-fitting powered air-purifying respirator: Manikin-based study

The objective of this study was to investigate the protection level offered by a Powered Air-Purifying Respirator (PAPR) equipped with an improperly sized or stretched-out loose-fitting facepiece using constant and cyclic flow conditions. Improperly sized PAPR facepieces of two models as well as a stretched-out facepiece were tested. These facepieces were examined in two versions: with and without exhaust holes. Loose-fitting facepieces (size "large") were donned on a small manikin headform and challenged with sodium chloride (NaCl) aerosol particles in an exposure chamber. Four cyclic flows with mean inspiratory flows (MIFs) of 30, 55, 85, and 135 L/min were applied using an electromechanical Breathing Recording and Simulation System (BRSS). The manikin Fit Factor (mFF) was determined as the ratio of aerosol concentrations outside (Cout) to inside (Cin) of the facepiece, measured with a P-Trak condensation particle counter (CPC). Results showed that the mFF decreased exponentially with increasing MIF. The mFF values of the stretched-out facepiece were significantly lower than those obtained for the undamaged ones. Facepiece type and MIF were found to significantly affect the performance of the loose-fitting PAPR. The effect of the exhaust holes was less pronounced and depended on the facepiece type. It was concluded that an improperly sized facepiece might potentially offer relatively low protection (mFF < 250) at high to strenuous workloads. The testing was also performed at a constant inhalation flow to explore the mechanism of the particle-facepiece interaction. Results obtained with cyclic flow pattern were consistent with the data generated when testing the loose-fitting PAPR under constant flow conditions. The time-weighted average values of mFF calculated from the measurements conducted under the constant flow regime were capable of predicting the protection under cyclic flow regime. The findings suggest that program administrators need to equip employees with properly sized facepieces and remove stretched-out ones from workplace. Manufacturers should emphasize the importance of proper sizing with their user instructions.

Timing and Duration of Traffic-related Air Pollution Exposure and the Risk for Childhood Wheeze and Asthma

RATIONALE

The timing and duration of traffic-related air pollution (TRAP) exposure may be important for childhood wheezing and asthma development.

OBJECTIVES

We examined the relationship between TRAP exposure and longitudinal wheezing phenotypes and asthma at age 7 years.

METHODS

Children completed clinical examinations annually from age 1 year through age 4 years and age 7 years. Parental-reported wheezing was assessed at each age, and longitudinal wheezing phenotypes (early-transient, late-onset, persistent) and asthma were defined at age 7 years. Participants' time-weighted exposure to TRAP, from birth through age 7 years, was estimated using a land-use regression model. The relationship between TRAP exposure and wheezing phenotypes and asthma was examined.

MEASUREMENTS AND MAIN RESULTS

High TRAP exposure at birth was significantly associated with both transient and persistent wheezing phenotypes (adjusted odds ratio [aOR] = 1.64; 95% confidence interval [CI], 1.04-2.57 and aOR = 2.31; 95% CI, 1.28-4.15, respectively); exposure from birth to age 1 year and age 1 to 2 years was also associated with persistent wheeze. Only children with high average TRAP exposure from birth through age 7 years were at significantly increased risk for asthma (aOR = 1.71; 95% CI, 1.01-2.88).

CONCLUSIONS

Early-life exposure to TRAP is associated with increased risk for persistent wheezing, but only long-term exposure to high levels of TRAP throughout childhood was associated with asthma development.

MS2 virus inactivation by atmospheric-pressure cold plasma using different gas carriers and power levels

In this study, airborne MS2 bacteriophages were exposed for subsecond time intervals to atmospheric-pressure cold plasma (APCP) produced using different power levels (20, 24, and 28 W) and gas carriers (ambient air, Ar-O2 [2%, vol/vol], and He-O2 [2%, vol/vol]). In addition, waterborne MS2 viruses were directly subjected to the APCP treatment for up to 3 min. MS2 viruses with and without the APCP exposure were examined by scanning electron microscopy (SEM), reverse transcription-PCR (RT-PCR), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Viral inactivation was shown to exhibit linear relationships with the APCP generation power and exposure time (R(2) > 0.95 for all energy levels tested) up to 95% inactivation (1.3-log reduction) after a subsecond airborne exposure at 28 W; about the same inactivation level was achieved for waterborne viruses with an exposure time of less than 1 min. A larger amount of reactive oxygen species (ROS), such as atomic oxygen, in APCP was detected for a higher generation power with Ar-O2 and He-O2 gas carriers. SEM images, SDS-PAGE, and agarose gel analysis of exposed waterborne viruses showed various levels of damage to both surface proteins and their related RNA genes after the APCP exposure, thus leading to the loss of their viability and infectivity.

Protection of firefighters against combustion aerosol particles: simulated workplace protection factor of a half-mask respirator (pilot study)

The present pilot study investigated the penetration of ultrafine particles originated by combustion of different materials into elastomeric half-mask respirators equipped with two P100 filters. We determined the Simulated Workplace Protection Factor (SWPF) for 11 firefighters wearing elastomeric half-mask respirators and performing activities simulating those conducted during fire overhaul operations. The tests were performed in a controlled laboratory setting. A newly-developed battery-operated Portable Aerosol Mobility Spectrometer (PAMS) was used to measure size-resolved aerosol particle concentrations outside (C(out)) and inside (Cin) of an air-purifying respirator donned on a firefighter, and the SWPF was calculated as C(out)/C(in). Based on the total aerosol concentration, the "total" SWPF ranged from 4,222 (minimum) to 35,534 (maximum) with values falling primarily in a range from 11,171 (25 percentile) to 26,604 (75 percentile) and a median value being ≈15,000. This is consistent with the recently reported fit factor (FF) data base.((1)) The size-resolved SWPF data revealed a dependency on the particle size. It was concluded that a portable device such as PAMS can be used on firefighters during overhaul operations (as well as on other workers wearing elastomeric half-mask respirators) to monitor the aerosol concentrations in real time and ultimately help prevent overexposure.

Penetration of Combustion Aerosol Particles Through Filters of NIOSH-Certified Filtering Facepiece Respirators (FFRs)

Filtering facepiece respirators (FFRs) are commonly worn by first responders, first receivers, and other exposed groups to protect against exposure to airborne particles, including those originated by combustion. Most of these FFRs are NIOSH-certified (e.g., N95-type) based on the performance testing of their filters against charge-equilibrated aerosol challenges, e.g., NaCl. However, it has not been examined if the filtration data obtained with the NaCl-challenged FFR filters adequately represent the protection against real aerosol hazards such as combustion particles. A filter sample of N95 FFR mounted on a specially designed holder was challenged with NaCl particles and three combustion aerosols generated in a test chamber by burning wood, paper, and plastic. The concentrations upstream (Cup) and downstream (Cdown) of the filter were measured with a TSI P-Trak condensation particle counter and a Grimm Nanocheck particle spectrometer. Penetration was determined as (Cdown/Cup) ×100%. Four test conditions were chosen to represent inhalation flows of 15, 30, 55, and 85 L/min. Results showed that the penetration values of combustion particles were significantly higher than those of the "model" NaCl particles (p < 0.05), raising a concern about applicability of the N95 filters performance obtained with the NaCl aerosol challenge to protection against combustion particles. Aerosol type, inhalation flow rate and particle size were significant (p < 0.05) factors affecting the performance of the N95 FFR filter. In contrast to N95 filters, the penetration of combustion particles through R95 and P95 FFR filters (were tested in addition to N95) were not significantly higher than that obtained with NaCl particles. The findings were attributed to several effects, including the degradation of an N95 filter due to hydrophobic organic components generated into the air by combustion. Their interaction with fibers is anticipated to be similar to those involving "oily" particles. The findings of this study suggest that the efficiency of N95 respirator filters obtained with the NaCl aerosol challenge may not accurately predict (and rather overestimate) the filter efficiency against combustion particles.

Glyphosate-rich air samples induce IL-33, TSLP and generate IL-13 dependent airway inflammation

Several low weight molecules have often been implicated in the induction of occupational asthma. Glyphosate, a small molecule herbicide, is widely used in the world. There is a controversy regarding a role of glyphosate in developing asthma and rhinitis among farmers, the mechanism of which is unexplored. The aim of this study was to explore the mechanisms of glyphosate induced pulmonary pathology by utilizing murine models and real environmental samples. C57BL/6, TLR4-/-, and IL-13-/- mice inhaled extracts of glyphosate-rich air samples collected on farms during spraying of herbicides or inhaled different doses of glyphosate and ovalbumin. The cellular response, humoral response, and lung function of exposed mice were evaluated. Exposure to glyphosate-rich air samples as well as glyphosate alone to the lungs increased: eosinophil and neutrophil counts, mast cell degranulation, and production of IL-33, TSLP, IL-13, and IL-5. In contrast, in vivo systemic IL-4 production was not increased. Co-administration of ovalbumin with glyphosate did not substantially change the inflammatory immune response. However, IL-13-deficiency resulted in diminished inflammatory response but did not have a significant effect on airway resistance upon methacholine challenge after 7 or 21 days of glyphosate exposure. Glyphosate-rich farm air samples as well as glyphosate alone were found to induce pulmonary IL-13-dependent inflammation and promote Th2 type cytokines, but not IL-4 for glyphosate alone. This study, for the first time, provides evidence for the mechanism of glyphosate-induced occupational lung disease.

Dustborne and airborne Gram-positive and Gram-negative bacteria in high versus low ERMI homes

The study aimed at investigating Gram-positive and Gram-negative bacteria in moldy and non-moldy homes, as defined by the home's Environmental Relative Moldiness Index (ERMI) value. The ERMI values were determined from floor dust samples in 2010 and 2011 and homes were classified into low (<5) and high (>5) ERMI groups based on the average ERMI values as well as 2011 ERMI values. Dust and air samples were collected from the homes in 2011 and all samples were analyzed for Gram-positive and Gram-negative bacteria using QPCR assays, endotoxin by the LAL assay, and N-acetyl-muramic acid using HPLC. In addition, air samples were analyzed for culturable bacteria. When average ERMI values were considered, the concentration and load of Gram-positive bacteria determined with QPCR in house dust, but not air, were significantly greater in high ERMI homes than in low ERMI homes. Furthermore, the concentration of endotoxin, but not muramic acid, in the dust was significantly greater in high ERMI than in low ERMI homes. In contrast, when ERMI values of 2011 were considered, Gram-negative bacteria determined with QPCR in air, endotoxin in air, and muramic acid in dust were significantly greater in high ERMI homes. The results suggest that both short-term and long-term mold contamination in homes could be linked with the bacterial concentrations in house dust, however, only the current mold status was associated with bacterial concentrations in air. Although correlations were found between endotoxin and Gram-negative bacteria as well as between muramic acid and Gram-positive bacteria in the entire data set, diverging associations were observed between the different measures of bacteria and the home moldiness. It is likely that concentrations of cells obtained by QPCR and concentrations of cell wall components are not equivalent and represent too broad categories to understand the bacterial composition and sources of the home microbiota.

How does breathing frequency affect the performance of an N95 filtering facepiece respirator and a surgical mask against surrogates of viral particles?

Breathing frequency (breaths/min) differs among individuals and levels of physical activity. Particles enter respirators through two principle penetration pathways: faceseal leakage and filter penetration. However, it is unknown how breathing frequency affects the overall performance of N95 filtering facepiece respirators (FFRs) and surgical masks (SMs) against viral particles, as well as other health-relevant submicrometer particles. A FFR and SM were tested on a breathing manikin at four mean inspiratory flows (MIFs) (15, 30, 55, and 85 L/min) and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). Filter penetration (Pfilter) and total inward leakage (TIL) were determined for the tested respiratory protection devices against sodium chloride (NaCl) aerosol particles in the size range of 20 to 500 nm. "Faceseal leakage-to-filter" (FLTF) penetration ratios were calculated. Both MIF and breathing frequency showed significant effects (p < 0.05) on Pfilter and TIL. Increasing breathing frequency increased TIL for the N95 FFR whereas no clear trends were observed for the SM. Increasing MIF increased Pfilter and decreased TIL resulting in decreasing FLTF ratio. Most of FLTF ratios were >1, suggesting that the faceseal leakage was the primary particle penetration pathway at various breathing frequencies. Breathing frequency is another factor (besides MIF) that can significantly affect the performance of N95 FFRs, with higher breathing frequencies increasing TIL. No consistent trend of increase or decrease of TIL with either MIF or breathing frequency was observed for the tested SM. To potentially extend these findings beyond the manikin/breathing system used, future studies are needed to fully understand the mechanism causing the breathing frequency effect on the performance of respiratory protection devices on human subjects.

Effects of breathing frequency and flow rate on the total inward leakage of an elastomeric half-mask donned on an advanced manikin headform

OBJECTIVES

The objective of this study was to investigate the effects of breathing frequency and flow rate on the total inward leakage (TIL) of an elastomeric half-mask donned on an advanced manikin headform and challenged with combustion aerosols.

METHODS

An elastomeric half-mask respirator equipped with P100 filters was donned on an advanced manikin headform covered with life-like soft skin and challenged with aerosols originated by burning three materials: wood, paper, and plastic (polyethylene). TIL was determined as the ratio of aerosol concentrations inside (C in) and outside (C out) of the respirator (C in/C out) measured with a nanoparticle spectrometer operating in the particle size range of 20-200nm. The testing was performed under three cyclic breathing flows [mean inspiratory flow (MIF) of 30, 55, and 85 l/min] and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). A completely randomized factorial study design was chosen with four replicates for each combination of breathing flow rate and frequency.

RESULTS

Particle size, MIF, and combustion material had significant (P < 0.001) effects on TIL regardless of breathing frequency. Increasing breathing flow decreased TIL. Testing with plastic aerosol produced higher mean TIL values than wood and paper aerosols. The effect of the breathing frequency was complex. When analyzed using all combustion aerosols and MIFs (pooled data), breathing frequency did not significantly (P = 0.08) affect TIL. However, once the data were stratified according to combustion aerosol and MIF, the effect of breathing frequency became significant (P < 0.05) for all MIFs challenged with wood and paper combustion aerosols, and for MIF = 30 l/min only when challenged with plastic combustion aerosol.

CONCLUSIONS

The effect of breathing frequency on TIL is less significant than the effects of combustion aerosol and breathing flow rate for the tested elastomeric half-mask respirator. The greatest TIL occurred when challenged with plastic aerosol at 30 l/min and at a breathing frequency of 30 breaths/min.

The impact of an anti-idling campaign on outdoor air quality at four urban schools

Idling school buses may increase concentrations of air pollutants including fine particulate matter (PM2.5) and elemental carbon (EC) near schools. Efforts to reduce vehicle idling near schools have rarely included air sampling to objectively assess changes in concentrations of air pollutants. The objective was to determine the impact of an anti-idling campaign on outdoor air quality at four schools with varying exposure to bus and automobile traffic. Outdoor air sampling for PM2.5, EC and particle number concentration (PNC) was conducted at four schools for five days before and after an anti-idling campaign. Sampling began before the morning arrival of buses and concluded after their afternoon departure. Sampling was simultaneously conducted at four corresponding community sites. Differences in PM2.5, EC, and PNC measured at school and community sites for each sampling day were calculated before and after the campaign. Before the campaign, the average outdoor concentration of PM2.5 during the school day at three of the four schools exceeded community background levels and the difference was greatest (4.11 μg m(-3), p < 0.01) at the school with the most buses (n = 39). The largest difference in EC between school and community sites was also observed at the school with the greatest number of buses (0.40 μg m(-3), p < 0.01). Following the anti-idling campaign, the average difference in PM2.5 at the school with the most buses decreased from 4.11 μg m(-3) to 0.99 μg m(-3) (p < 0.05). Similarly, at this school, the difference in the EC level decreased from 0.40 μg m(-3) to 0.15 μg m(-3) and PNC decreased from 11,560 to 1690 particles per cm(3) (p < 0.05). The outdoor concentrations of pollutants at schools with fewer buses (n = 5-11) were not significantly reduced. The concentration of air pollutants near schools may significantly exceed community background levels, particularly in the presence of idling school buses. Anti-idling campaigns are effective in reducing PM2.5, EC and PNC at schools with significant amounts of buses and passenger cars.

Effect of Particle Size on the Performance of an N95 Filtering Facepiece Respirator and a Surgical Mask at Various Breathing Conditions

The effect of aerosol particle size on the performance of an N95 filtering facepiece respirator (FFR) and a surgical mask (SM) was evaluated under different breathing conditions, including breathing frequency and mean inspiratory flow (MIF) rate. The FFR and SM were sealed on a manikin headform and challenged with charge-equilibrated NaCl aerosol. Filter penetration (Pfilter) was determined as the ratio of aerosol concentrations inside and outside the FFR/SM size-selectively (28 channels) within a range of 20 to 500 nm. In addition, the same models of the FFR and SM were donned, but not sealed, on an advanced manikin headform covered with skin-like material. Total inward leakage (TIL), which represents the total particle penetration, was measured under conditions identical to the filter penetration experiment. Testing was conducted at four mean MIFs (15, 30, 55 and 85 L/min) combined with five breathing frequencies (10, 15, 20, 25 and 30 breaths/min). The results show that SM produced much higher Pfilter and TIL values, and thus provide little protection against aerosols in the size range tested. Pfilter was significantly affected by particle size and breathing flow rate (p <0.05) for the tested FFR and SM. Surprisingly, for both devices, Pfilter as a function of the particle size exhibited more than one peak under all tested breathing conditions. The effect of breathing frequency on Pfilter was generally less pronounced, especially for lower MIFs. For the FFR and SM, TIL increased with increasing particle size up to about 50 nm; for particles above 50 nm, the total penetration was not significantly affected by particle size and breathing frequency; however, the effect of MIF remained significant.

Family and home characteristics correlate with mold in homes

Previously, we demonstrated that infants residing in homes with higher Environmental Relative Moldiness Index were at greater risk for developing asthma by age seven. The purpose of this analysis was to identify the family and home characteristics associated with higher moldiness index values in infants' homes at age one. Univariate linear regression of each characteristic determined that family factors associated with moldiness index were race and income. Home characteristics associated with the moldiness index values were: air conditioning, carpet, age of the home, season of home assessment, and house dust mite allergen. Parental history of asthma, use of dehumidifier, visible mold, dog and cat allergen levels were not associated with moldiness index. Results of multiple linear regression showed that older homes had 2.9 units higher moldiness index (95% confidence interval [CI]=0.4, 5.4), whereas homes with central air conditioning had 2.5 units lower moldiness index (95% CI=-4.7, -0.4). In addition, higher dust mite allergen levels and carpeting were positively and negatively associated with higher moldiness index, respectively. Because older homes and lack of air conditioning were also correlated with race and lower income, whereas carpeting was associated with newer homes, the multivariate analyses suggests that lower overall socioeconomic position is associated with higher moldiness index values. This may lead to increased asthma risk in homes inhabited by susceptible, vulnerable population subgroups. Further, age of the home was a surrogate of income, race and carpeting in our population; thus the use of these factors should carefully be evaluated in future studies.

Laboratory evaluation of the particle size effect on the performance of an elastomeric half-mask respirator against ultrafine combustion particles

OBJECTIVES

This study quantified the particle size effect on the performance of elastomeric half-mask respirators, which are widely used by firefighters and first responders exposed to combustion aerosols.

METHODS

One type of elastomeric half-mask respirator equipped with two P-100 filters was donned on a breathing manikin while challenged with three combustion aerosols (originated by burning wood, paper, and plastic). Testing was conducted with respirators that were fully sealed, partially sealed (nose area only), or unsealed to the face of a breathing manikin to simulate different faceseal leakages. Three cyclic flows with mean inspiratory flow (MIF) rates of 30, 85, and 135 L/min were tested for each combination of sealing condition and combustion material. Additional testing was performed with plastic combustion particles at other cyclic and constant flows. Particle penetration was determined by measuring particle number concentrations inside and outside the respirator with size ranges from 20 to 200 nm.

RESULTS

Breathing flow rate, particle size, and combustion material all had significant effects on the performance of the respirator. For the partially sealed and unsealed respirators, the penetration through the faceseal leakage reached maximum at particle sizes >100 nm when challenged with plastic aerosol, whereas no clear peaks were observed for wood and paper aerosols. The particles aerosolized by burning plastic penetrated more readily into the unsealed half-mask than those aerosolized by the combustion of wood and paper. The difference may be attributed to the fact that plastic combustion particles differ from wood and paper particles by physical characteristics such as charge, shape, and density. For the partially sealed respirator, the highest penetration values were obtained at MIF = 85 L/min. The unsealed respirator had approximately 10-fold greater penetration than the one partially sealed around the bridge of the nose, which indicates that the nose area was the primary leak site.

Manikin-based performance evaluation of elastomeric respirators against combustion particles

This study investigated the effects of faceseal leakage, breathing flow, and combustion material on the overall (non-size-selective) penetration of combustion particles into P-100 half and full facepiece elastomeric respirators used by firefighters. Respirators were tested on a breathing manikin exposed to aerosols produced by combustion of three materials (wood, paper, and plastic) in a room-size exposure chamber. Testing was performed using a single constant flow (inspiratory flow rate = 30 L/min) and three cyclic flows (mean inspiratory flow rates = 30, 85, and 135 L/min). Four sealing conditions (unsealed, nose-only sealed, nose and chin sealed, and fully sealed) were examined to evaluate the respirator faceseal leakage. Total aerosol concentration was measured inside (C(in)) and outside (C(out)) the respirator using a condensation particle counter. The total penetration through the respirator was determined as a ratio of the two (P = C(in) / C(out)). Faceseal leakage, breathing flow type and rate, and combustion material were all significant factors affecting the performance of the half mask and full facepiece respirators. The efficiency of P-100 respirator filters met the NIOSH certification criteria (penetration ≤0.03%); it was not significantly influenced by the challenge aerosol and flow type, which supports the current NIOSH testing procedure using a single challenge aerosol and a constant airflow. However, contrary to the NIOSH total inward leakage (TIL) test protocol assuming that the result is independent on the type of the tested aerosol, this study revealed that the challenge aerosol significantly affects the particle penetration through unsealed and partially sealed half mask respirators. Increasing leak size increased total particle penetration. The findings point to some limitations of the existing TIL test in predicting protection levels offered by half mask elastomeric respirators.

Penetration of fiber versus spherical particles through filter media and faceseal leakage of N95 filtering facepiece respirators with cyclic flow

This study investigated differences in penetration between fibers and spherical particles through faceseal leakage of an N95 filtering facepiece respirator. Three cyclic breathing flows were generated corresponding to mean inspiratory flow rates (MIF) of 15, 30, and 85 L/min. Fibers had a mean diameter of 1 μm and a median length of 4.9 μm (calculated aerodynamic diameter, d(ae) = 1.73 μm). Monodisperse polystyrene spheres with a mean physical diameter of 1.01 μm (PSI) and 1.54 μm (PSII) were used for comparison (calculated d(ae) = 1.05 and 1.58 μm, respectively). Two optical particle counters simultaneously determined concentrations inside and outside the respirator. Geometric means (GMs) for filter penetration of the fibers were 0.06, 0.09, and 0.08% at MIF of 15, 30, and 85 L/min, respectively. Corresponding values for PSI were 0.07, 0.12, and 0.12%. GMs for faceseal penetration of fibers were 0.40, 0.14, and 0.09% at MIF of 15, 30, and 85 L/min, respectively. Corresponding values for PSI were 0.96, 0.41, and 0.17%. Faceseal penetration decreased with increased breathing rate for both types of particles (p ≤ 0.001). GMs of filter and faceseal penetration of PSII at an MIF of 30 L/min were 0.14% and 0.36%, respectively. Filter penetration and faceseal penetration of fibers were significantly lower than those of PSI (p < 0.001) and PSII (p < 0.003). This confirmed that higher penetration of PSI was not due to slightly smaller aerodynamic diameter, indicating that the shape of fibers rather than their calculated mean aerodynamic diameter is a prevailing factor on deposition mechanisms through the tested respirator. In conclusion, faceseal penetration of fibers and spherical particles decreased with increasing breathing rate, which can be explained by increased capture by impaction. Spherical particles had 2.0-2.8 times higher penetration through faceseal leaks and 1.1-1.5 higher penetration through filter media than fibers, which can be attributed to differences in interception losses.

Exploring a novel ultrafine particle counter for utilization in respiratory protection studies

In this study, a novel portable ultrafine particle counter developed at the University of Cincinnati was tested against a conventional condensation particle counter (CPC, TSI Inc.) for evaluating the efficiency of respiratory protection devices. The experiments were conducted with elastomeric respirators donned on a breathing manikin using combustion particles as challenge aerosols. A favorable agreement between the two data sets on the particle penetration efficiency was observed (slope ≈ 1.16, R² ≈ 0.99; paired t-test: p-value = 0.91), suggesting that the new counter produced meaningful data comparable to a conventional CPC instrument.

Infant origins of childhood asthma associated with specific molds

BACKGROUND

The specific cause or causes of asthma development must be identified to prevent this disease.

OBJECTIVE

Our hypothesis was that specific mold exposures are associated with childhood asthma development.

METHODS

Infants were identified from birth certificates. Dust samples were collected from 289 homes when the infants were 8 months of age. Samples were analyzed for concentrations of 36 molds that comprise the Environmental Relative Moldiness Index (ERMI) and endotoxin, house dust mite, cat, dog, and cockroach allergens. Children were evaluated at age 7 years for asthma based on reported symptoms and objective measures of lung function. Host, environmental exposure, and home characteristics evaluated included a history of parental asthma, race, sex, upper and lower respiratory tract symptoms, season of birth, family income, cigarette smoke exposure, air conditioning, use of a dehumidifier, presence of carpeting, age of home, and visible mold at age 1 year and child's positive skin prick test response to aeroallergens and molds at age 7 years.

RESULTS

Asthma was diagnosed in 24% of the children at age 7 years. A statistically significant increase in asthma risk at age 7 years was associated with high ERMI values in the child's home in infancy (adjusted relative risk for a 10-unit increase in ERMI value, 1.8; 95% CI, 1.5-2.2). The summation of levels of 3 mold species, Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile, was significantly associated with asthma (adjusted relative risk, 2.2; 95% CI, 1.8-2.7).

CONCLUSION

In this birth cohort study exposure during infancy to 3 mold species common to water-damaged buildings was associated with childhood asthma at age 7 years.

Inactivation of aerosolized Bacillus atrophaeus (BG) endospores and MS2 viruses by combustion of reactive materials

Accidental release of biological agents from a bioweapon facility may contaminate large areas, possibly causing disastrous environmental consequences. To address this issue, novel halogen-containing reactive materials are being designed with the added capability to inactivate viable airborne microorganisms. This study determined the efficiency of combustion products of such materials to inactivate aerosolized bacteria and viruses. Spores of Bacillus atrophaeus and MS2 viruses dispersed in dry air were exposed for subsecond time intervals to hydrocarbon flames seeded with different reactive powders so that bioaerosol particles interacted with the combustion products in a controlled high-temperature environment. The experiments were designed to quantify differences in the biocidal effects of different reactive material powders including Al and Mg, a B•Ti nanocomposite, an 8Al•MoO(3) nanothermite, and a novel Al•I(2) nanocomposite. Compared to pure hydrocarbon flame, powder-seeded flame (with no iodine) produced about an order of magnitude greater inactivation of bacterial spores. The iodine-containing material increased the spore inactivation by additional 2 orders of magnitude. The aerosolized MS2 viruses (generally not as stress-resistant as spores) were fully inactivated when exposed to combustion of either the iodinated or noniodinated powders. Overall, the study suggests a great biocidal potential of combustion products generated by novel iodine-containing nanocomposite materials.

Influence of home characteristics on airborne and dustborne endotoxin and β-D-glucan

The aim of this study was to assess the associations between airborne and dustborne microbial contaminants (endotoxin and β-D-glucan) and estimate the effects of home characteristics on exposure levels of these microbial contaminants. Endotoxin and β-D-glucan concentrations in airborne inhalable particles, airborne PM1 (<1 μm) and vacuumed dust from 184 residential homes were determined using specific Limulus amebocyte assays. Home characteristics were recorded by visual inspection and questionnaires. Linear regression and correlation analyses were performed. Inhalable endotoxin correlated with dust endotoxin (r = 0.34, p < 0.001) and PM1 endotoxin (r = 0.33, p < 0.001). Inhalable β-D-glucan correlated with dust β-D-glucan (r = 0.18, p < 0.01), but not with PM1 β-D-glucan. Significant correlation was also found between PM1 and dust concentrations for endotoxin (r = 0.26, p < 0.001), but not for β-D-glucan. Multivariate regression analyses showed only one significant association between airborne contaminants and environmental characteristics: inhalable β-D-glucan was positively associated with relative humidity with an effect size (change in the dependent variable corresponding to a unit increase in the independent variable) of 2.32 and p < 0.05. In contrast, several associations were found between dust concentrations and environmental characteristics. Dust endotoxin was positively associated with temperature (2.87, p < 0.01) and number of inhabitants (2.76, p < 0.01), whereas dust β-D-glucan was inversely associated with the presence of dogs (-2.24, p < 0.05) and carpet (-3.05, p < 0.01) in the home. In conclusion, dustborne contaminants were more strongly affected by home characteristics than airborne contaminants. Furthermore, even though statistically significant, the correlations between airborne and dustborne contaminants were weak. This indicates that airborne concentrations cannot be reliably predicted based on dustborne concentrations.

Comparison of workplace protection factors for different biological contaminants

This study compared workplace protection factors (WPFs) for five different contaminants (endotoxin, fungal spores, (1→3)-β-D-glucan, total particle mass, and total particle number) provided by an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR). We previously reported size-selective WPFs for total particle numbers for the ER and FFR, whereas the current article is focused on WPFs for bioaerosols and total particle mass. Farm workers (n = 25) wore the ER and FFR while performing activities at eight locations representing horse farms, pig barns, and grain handling facilities. For the determination of WPFs, particles were collected on filters simultaneously inside and outside the respirator during the first and last 15 min of a 60-min experiment. One field blank per subject was collected without actual sampling. A reporting limit (RL) was established for each contaminant based on geometric means (GMs) of the field blanks as the lowest possible measurable values. Depending on the contaminant type, 38-48% of data points were below the RL. Therefore, a censored regression model was used to estimate WPFs (WPF(censored)). The WPF(censored) provided by the two types of respirators were not significantly different. In contrast, significant differences were found in the WPF(censored) for different types of contaminants. GMs WPFs(censored) for the two types of respirators combined were 154, 29, 18, 19, and 176 for endotoxin, fungal spore count, (1→3)-β-D-glucan, total particle mass, and total particle number, respectively. The WPF(censored) was more strongly associated with concentrations measured outside the respirator for endotoxin, fungal spores, and total particle mass except for total particle number. However, when only data points with outside concentrations higher than 176×RL were included, the WPFs increased, and the association between the outside concentrations and the WPFs became weaker. Results indicate that difference in WPFs observed between different contaminants may be attributed to differences in the sensitivity of analytical methods to detect low inside concentrations, rather than the nature of particles (biological or non-biological).

Chemical compositions and source identification of PM₂.₅ aerosols for estimation of a diesel source surrogate

Exposure to traffic-related pollution during childhood has been associated with asthma exacerbation, and asthma incidence. The objective of the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) is to determine if the development of allergic and respiratory disease is associated with exposure to diesel engine exhaust particles. A detailed receptor model analyses was undertaken by applying positive matrix factorization (PMF) and UNMIX receptor models to two PM₂.₅ data sets: one consisting of two carbon fractions and the other of eight temperature-resolved carbon fractions. Based on the source profiles resolved from the analyses, markers of traffic-related air pollution were estimated: the elemental carbon attributed to traffic (ECAT) and elemental carbon attributed to diesel vehicle emission (ECAD). Application of UNMIX to the two data sets generated four source factors: combustion related sulfate, traffic, metal processing and soil/crustal. The PMF application generated six source factors derived from analyzing two carbon fractions and seven factors from temperature-resolved eight carbon fractions. The source factors (with source contribution estimates by mass concentrations in parentheses) are: combustion sulfate (46.8%), vegetative burning (15.8%), secondary sulfate (12.9%), diesel vehicle emission (10.9%), metal processing (7.5%), gasoline vehicle emission (5.6%) and soil/crustal (0.7%). Diesel and gasoline vehicle emission sources were separated using eight temperature-resolved organic and elemental carbon fractions. Application of PMF to both datasets also differentiated the sulfate rich source from the vegetative burning source, which are combined in a single factor by UNMIX modeling. Calculated ECAT and ECAD values at different locations indicated that traffic source impacts depend on factors such as traffic volumes, meteorological parameters, and the mode of vehicle operation apart from the proximity of the sites to highways. The difference in ECAT and ECAD, however, was less than one standard deviation. Thus, a cost benefit consideration should be used when deciding on the benefits of an eight or two carbon approach.