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Quantitative Microbial Risk Assessment for Airborne Transmission of SARS-CoV-2 via Breathing, Speaking, Singing, Coughing, and Sneezing.

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Title: Quantitative Microbial Risk Assessment for Airborne Transmission of SARS-CoV-2 via Breathing, Speaking, Singing, Coughing, and Sneezing.
Authors: Schijven, Jack1,2 jack.schijven@rivm.nl, Vermeulen, Lucie C.1, Swart, Arno1, Meijer, Adam1, Duizer, Erwin1, de Roda Husman, Ana Maria1,3
Source: Environmental Health Perspectives. Apr2021, Vol. 129 Issue 4, p047002-1-047002-10. 10p. 1 Diagram, 2 Charts, 3 Graphs.
Subject Terms: *Aerosols, *Indoor air pollution, *Infectious disease transmission, *Bacterial growth, *Ventilation, RNA analysis, Air microbiology, Mucus, Reverse transcriptase polymerase chain reaction, COVID-19, Singing, Sneezing, Time, Viral load, Inhalation injuries, Quantitative research, Risk assessment, Cough, Descriptive statistics, Microbiological techniques, Research funding, Particles, Respiration, Social distancing, Polymerase chain reaction, Speech, Analytical chemistry, Disease risk factors
Abstract: BACKGROUND: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. OBJECTIVES: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. METHODS: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented. RESULTS: The expelled volume of aerosols was highest for a sneeze, followed by a cough, singing, speaking, and breathing. After 20 min of exposure, at 107 RNA copies/mL in mucus, all mean illness risks were largely estimated to be below 0.001, except for the "high" sneeze scenario. At virus concentrations above 108 RNA copies/mL, and after 2 h of exposure, in the high and "low" sneeze scenarios, the high cough scenario and the singing scenario, risks exceeded 0.01 and may become very high, whereas the low coughing scenario, the high and low speaking scenarios and the breathing scenario remained below 0.1. After 2 h of exposure, singing became the second highest risk scenario. One air exchange per hour reduced risk of illness by about a factor of 2. Six air exchanges per hour reduced risks of illness by a factor of 8–13 for the sneeze and cough scenarios and by a factor of 4–9 for the other scenarios. DISCUSSION: The large variation in the volume of expelled aerosols is discussed. The model calculations indicated that SARS-CoV-2 transmission via aerosols outside of the 1:5-m social distancing norm can occur. Virus concentrations in aerosols and/or the amount of expelled aerosol droplets need to be high for substantial transmission via this route. AirCoV2 is made available as interactive computational tool. [ABSTRACT FROM AUTHOR]
Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Quantitative Microbial Risk Assessment for Airborne Transmission of SARS-CoV-2 via Breathing, Speaking, Singing, Coughing, and Sneezing.
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  Data: <searchLink fieldCode="AR" term="%22Schijven%2C+Jack%22">Schijven, Jack</searchLink><relatesTo>1,2</relatesTo><i> jack.schijven@rivm.nl</i><br /><searchLink fieldCode="AR" term="%22Vermeulen%2C+Lucie+C%2E%22">Vermeulen, Lucie C.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Swart%2C+Arno%22">Swart, Arno</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Meijer%2C+Adam%22">Meijer, Adam</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Duizer%2C+Erwin%22">Duizer, Erwin</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22de+Roda+Husman%2C+Ana+Maria%22">de Roda Husman, Ana Maria</searchLink><relatesTo>1,3</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Environmental+Health+Perspectives%22">Environmental Health Perspectives</searchLink>. Apr2021, Vol. 129 Issue 4, p047002-1-047002-10. 10p. 1 Diagram, 2 Charts, 3 Graphs.
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  Data: *<searchLink fieldCode="DE" term="%22Aerosols%22">Aerosols</searchLink><br />*<searchLink fieldCode="DE" term="%22Indoor+air+pollution%22">Indoor air pollution</searchLink><br />*<searchLink fieldCode="DE" term="%22Infectious+disease+transmission%22">Infectious disease transmission</searchLink><br />*<searchLink fieldCode="DE" term="%22Bacterial+growth%22">Bacterial growth</searchLink><br />*<searchLink fieldCode="DE" term="%22Ventilation%22">Ventilation</searchLink><br /><searchLink fieldCode="DE" term="%22RNA+analysis%22">RNA analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Air+microbiology%22">Air microbiology</searchLink><br /><searchLink fieldCode="DE" term="%22Mucus%22">Mucus</searchLink><br /><searchLink fieldCode="DE" term="%22Reverse+transcriptase+polymerase+chain+reaction%22">Reverse transcriptase polymerase chain reaction</searchLink><br /><searchLink fieldCode="DE" term="%22COVID-19%22">COVID-19</searchLink><br /><searchLink fieldCode="DE" term="%22Singing%22">Singing</searchLink><br /><searchLink fieldCode="DE" term="%22Sneezing%22">Sneezing</searchLink><br /><searchLink fieldCode="DE" term="%22Time%22">Time</searchLink><br /><searchLink fieldCode="DE" term="%22Viral+load%22">Viral load</searchLink><br /><searchLink fieldCode="DE" term="%22Inhalation+injuries%22">Inhalation injuries</searchLink><br /><searchLink fieldCode="DE" term="%22Quantitative+research%22">Quantitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Cough%22">Cough</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Microbiological+techniques%22">Microbiological techniques</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Particles%22">Particles</searchLink><br /><searchLink fieldCode="DE" term="%22Respiration%22">Respiration</searchLink><br /><searchLink fieldCode="DE" term="%22Social+distancing%22">Social distancing</searchLink><br /><searchLink fieldCode="DE" term="%22Polymerase+chain+reaction%22">Polymerase chain reaction</searchLink><br /><searchLink fieldCode="DE" term="%22Speech%22">Speech</searchLink><br /><searchLink fieldCode="DE" term="%22Analytical+chemistry%22">Analytical chemistry</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: BACKGROUND: Evidence for indoor airborne transmission of SARS-CoV-2 is accumulating. OBJECTIVES: We assessed of the risk of illness due to airborne SARS-CoV-2 particles from breathing, speaking, singing, coughing, and sneezing in indoor environments. METHODS: A risk assessment model, AirCoV2, for exposure to SARS-CoV-2 particles in aerosol droplets was developed. Previously published data on droplets expelled by breathing, speaking, singing, coughing, and sneezing by an infected person were used as inputs. Scenarios encompassed virus concentration, exposure time, and ventilation. Newly collected data of virus RNA copies in mucus from patients are presented. RESULTS: The expelled volume of aerosols was highest for a sneeze, followed by a cough, singing, speaking, and breathing. After 20 min of exposure, at 107 RNA copies/mL in mucus, all mean illness risks were largely estimated to be below 0.001, except for the "high" sneeze scenario. At virus concentrations above 108 RNA copies/mL, and after 2 h of exposure, in the high and "low" sneeze scenarios, the high cough scenario and the singing scenario, risks exceeded 0.01 and may become very high, whereas the low coughing scenario, the high and low speaking scenarios and the breathing scenario remained below 0.1. After 2 h of exposure, singing became the second highest risk scenario. One air exchange per hour reduced risk of illness by about a factor of 2. Six air exchanges per hour reduced risks of illness by a factor of 8–13 for the sneeze and cough scenarios and by a factor of 4–9 for the other scenarios. DISCUSSION: The large variation in the volume of expelled aerosols is discussed. The model calculations indicated that SARS-CoV-2 transmission via aerosols outside of the 1:5-m social distancing norm can occur. Virus concentrations in aerosols and/or the amount of expelled aerosol droplets need to be high for substantial transmission via this route. AirCoV2 is made available as interactive computational tool. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1289/EHP7886
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 10
        StartPage: 047002-1
    Subjects:
      – SubjectFull: Aerosols
        Type: general
      – SubjectFull: Indoor air pollution
        Type: general
      – SubjectFull: Infectious disease transmission
        Type: general
      – SubjectFull: Bacterial growth
        Type: general
      – SubjectFull: Ventilation
        Type: general
      – SubjectFull: RNA analysis
        Type: general
      – SubjectFull: Air microbiology
        Type: general
      – SubjectFull: Mucus
        Type: general
      – SubjectFull: Reverse transcriptase polymerase chain reaction
        Type: general
      – SubjectFull: COVID-19
        Type: general
      – SubjectFull: Singing
        Type: general
      – SubjectFull: Sneezing
        Type: general
      – SubjectFull: Time
        Type: general
      – SubjectFull: Viral load
        Type: general
      – SubjectFull: Inhalation injuries
        Type: general
      – SubjectFull: Quantitative research
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      – SubjectFull: Risk assessment
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Microbiological techniques
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      – SubjectFull: Research funding
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      – SubjectFull: Particles
        Type: general
      – SubjectFull: Respiration
        Type: general
      – SubjectFull: Social distancing
        Type: general
      – SubjectFull: Polymerase chain reaction
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      – SubjectFull: Speech
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      – SubjectFull: Analytical chemistry
        Type: general
      – SubjectFull: Disease risk factors
        Type: general
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      – TitleFull: Quantitative Microbial Risk Assessment for Airborne Transmission of SARS-CoV-2 via Breathing, Speaking, Singing, Coughing, and Sneezing.
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              Text: Apr2021
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