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      Modeling Clothing as a Vector for Transporting Airborne Particles and Pathogens across Indoor Microenvironments

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          Abstract

          Evidence suggests that human exposure to airborne particles and associated contaminants, including respiratory pathogens, can persist beyond a single microenvironment. By accumulating such contaminants from air, clothing may function as a transport vector and source of “secondary exposure”. To investigate this function, a novel microenvironmental exposure modeling framework (ABICAM) was developed. This framework was applied to a para-occupational exposure scenario involving the deposition of viable SARS-CoV-2 in respiratory particles (0.5–20 μm) from a primary source onto clothing in a nonhealthcare setting and subsequent resuspension and secondary exposure in a car and home. Variability was assessed through Monte Carlo simulations. The total volume of infectious particles on the occupant’s clothing immediately after work was 4800 μm 3 (5th–95th percentiles: 870–32 000 μm 3). This value was 61% (5–95%: 17–300%) of the occupant’s primary inhalation exposure in the workplace while unmasked. By arrival at the occupant’s home after a car commute, relatively rapid viral inactivation on cotton clothing had reduced the infectious volume on clothing by 80% (5–95%: 26–99%). Secondary inhalation exposure (after work) was low in the absence of close proximity and physical contact with contaminated clothing. In comparison, the average primary inhalation exposure in the workplace was higher by about 2–3 orders of magnitude. It remains theoretically possible that resuspension and physical contact with contaminated clothing can occasionally transmit SARS-CoV-2 between humans.

          Abstract

          SARS-CoV-2 could, but is unlikely to, be spread by resuspension from contaminated cotton clothing in a nonhealthcare setting.

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          Most cited references79

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          Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015

          Summary Background Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to global disease burden. We explored spatial and temporal trends in mortality and burden of disease attributable to ambient air pollution from 1990 to 2015 at global, regional, and country levels. Methods We estimated global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2·5 μm (PM2·5) and ozone at an approximate 11 km × 11 km resolution with satellite-based estimates, chemical transport models, and ground-level measurements. Using integrated exposure–response functions for each cause of death, we estimated the relative risk of mortality from ischaemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, lung cancer, and lower respiratory infections from epidemiological studies using non-linear exposure–response functions spanning the global range of exposure. Findings Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7 million to 4·8 million) deaths and 103·1 million (90·8 million 115·1 million) disability-adjusted life-years (DALYs) in 2015, representing 7·6% of total global deaths and 4·2% of global DALYs, 59% of these in east and south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95% UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8 million) DALYs from chronic obstructive pulmonary disease in 2015. Interpretation Ambient air pollution contributed substantially to the global burden of disease in 2015, which increased over the past 25 years, due to population ageing, changes in non-communicable disease rates, and increasing air pollution in low-income and middle-income countries. Modest reductions in burden will occur in the most polluted countries unless PM2·5 values are decreased substantially, but there is potential for substantial health benefits from exposure reduction. Funding Bill & Melinda Gates Foundation and Health Effects Institute.
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            The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.

            Because human activities impact the timing, location, and degree of pollutant exposure, they play a key role in explaining exposure variation. This fact has motivated the collection of activity pattern data for their specific use in exposure assessments. The largest of these recent efforts is the National Human Activity Pattern Survey (NHAPS), a 2-year probability-based telephone survey (n=9386) of exposure-related human activities in the United States (U.S.) sponsored by the U.S. Environmental Protection Agency (EPA). The primary purpose of NHAPS was to provide comprehensive and current exposure information over broad geographical and temporal scales, particularly for use in probabilistic population exposure models. NHAPS was conducted on a virtually daily basis from late September 1992 through September 1994 by the University of Maryland's Survey Research Center using a computer-assisted telephone interview instrument (CATI) to collect 24-h retrospective diaries and answers to a number of personal and exposure-related questions from each respondent. The resulting diary records contain beginning and ending times for each distinct combination of location and activity occurring on the diary day (i.e., each microenvironment). Between 340 and 1713 respondents of all ages were interviewed in each of the 10 EPA regions across the 48 contiguous states. Interviews were completed in 63% of the households contacted. NHAPS respondents reported spending an average of 87% of their time in enclosed buildings and about 6% of their time in enclosed vehicles. These proportions are fairly constant across the various regions of the U.S. and Canada and for the California population between the late 1980s, when the California Air Resources Board (CARB) sponsored a state-wide activity pattern study, and the mid-1990s, when NHAPS was conducted. However, the number of people exposed to environmental tobacco smoke (ETS) in California seems to have decreased over the same time period, where exposure is determined by the reported time spent with a smoker. In both California and the entire nation, the most time spent exposed to ETS was reported to take place in residential locations.
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              Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals

              The ongoing outbreak of coronavirus disease 2019 (COVID-19) has spread rapidly on a global scale. Although it is clear that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted through human respiratory droplets and direct contact, the potential for aerosol transmission is poorly understood1-3. Here we investigated the aerodynamic nature of SARS-CoV-2 by measuring viral RNA in aerosols in different areas of two Wuhan hospitals during the outbreak of COVID-19 in February and March 2020. The concentration of SARS-CoV-2 RNA in aerosols that was detected in isolation wards and ventilated patient rooms was very low, but it was higher in the toilet areas used by the patients. Levels of airborne SARS-CoV-2 RNA in the most public areas was undetectable, except in two areas that were prone to crowding; this increase was possibly due to individuals infected with SARS-CoV-2 in the crowd. We found that some medical staff areas initially had high concentrations of viral RNA with aerosol size distributions that showed peaks in the submicrometre and/or supermicrometre regions; however, these levels were reduced to undetectable levels after implementation of rigorous sanitization procedures. Although we have not established the infectivity of the virus detected in these hospital areas, we propose that SARS-CoV-2 may have the potential to be transmitted through aerosols. Our results indicate that room ventilation, open space, sanitization of protective apparel, and proper use and disinfection of toilet areas can effectively limit the concentration of SARS-CoV-2 RNA in aerosols. Future work should explore the infectivity of aerosolized virus.
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                Author and article information

                Journal
                Environ Sci Technol
                Environ Sci Technol
                es
                esthag
                Environmental Science & Technology
                American Chemical Society
                0013-936X
                1520-5851
                11 April 2022
                03 May 2022
                : 56
                : 9
                : 5641-5652
                Affiliations
                []Department of Earth Sciences, University of Toronto , Toronto, Ontario M5S 3B1, Canada
                []Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency , Durham, North Carolina 27711, United States
                [§ ]Department of Civil and Mineral Engineering, University of Toronto , Toronto, Ontario M5S 1A4, Canada
                []Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario M5T 3M7, Canada
                []Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto , 1 King’s College Circle, Toronto, Ontario M5S 1A8, Canada
                [# ]School of the Environment, University of Toronto , Toronto, Ontario M5S 3E8, Canada
                Author notes
                [* ]Email: miriam.diamond@ 123456utoronto.ca . Phone: 1 (416) 978-1586. Department of Earth Sciences, School of the Environment, University of Toronto, 22 Ursula Franklin Street, Toronto, Ontario M5S 3B1, Canada.
                Author information
                https://orcid.org/0000-0002-8076-9703
                https://orcid.org/0000-0002-9650-3483
                https://orcid.org/0000-0001-5904-169X
                https://orcid.org/0000-0001-6296-6431
                Article
                10.1021/acs.est.1c08342
                9069698
                35404579
                908e9e8e-4b61-4c55-8af8-1765efa147b8
                © 2022 The Authors. Published by American Chemical Society

                Permits non-commercial access and re-use, provided that author attribution and integrity are maintained; but does not permit creation of adaptations or other derivative works ( https://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 08 December 2021
                : 21 March 2022
                : 19 March 2022
                Funding
                Funded by: Natural Sciences and Engineering Research Council of Canada, doi 10.13039/501100000038;
                Award ID: RGPIN-2017-06654
                Funded by: University of Toronto, doi 10.13039/501100003579;
                Award ID: NA
                Categories
                Article
                Custom metadata
                es1c08342
                es1c08342

                General environmental science
                sars-cov-2,virus,covid-19,aerosol,droplet,para-occupational human exposure,particle resuspension,clothing,microenvironment,near-field exposure

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