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Experimental study on the control effect of different ventilation systems on fine particles in a simulated hospital ward.

ABSTRACT: In recent years, a large number of respiratory infectious diseases (especially COVID-19) have broken out worldwide. Respiratory infectious viruses may be released in the air, resulting in cross-infection between patients and medical workers. Indoor ventilation systems can be adjusted to affect fine particles containing viruses. This study was aimed at performing a series of experiments to evaluate the ventilation performance and assess the exposure of healthcare workers (HW) to virus-laden particles released by patients in a confined experimental chamber. In a typical ward setting, four categories (top supply and exhaust, side supply and exhaust) were evaluated, encompassing 16 different air distribution patterns. The maximum reduction in the cumulative exposure level for HW was 70.8% in ventilation strategy D (upper diffusers on the sidewall supply and lower diffusers on the same sidewall return). The minimum value of the cumulative exposure level for a patient close to the source of the contamination pertained to Strategy E (upper diffusers on the sidewall supply and lower diffusers on the opposite sidewall return). Lateral ventilation strategies can provide significant guidance for ward operation to minimizing the airborne virus contamination. This study can provide a reference for sustainable buildings to construct a healthy indoor environment.

SUBMITTER: Kong X

PROVIDER: S-EPMC8222082 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionThe rising prevalence of rapid response teams has led to a demand for risk-stratification tools that can estimate a ward patient's risk of clinical deterioration and subsequent need for intensive care unit (ICU) admission. Finding such a risk-stratification tool is crucial for maximizing the utility of rapid response teams. This study compares the ability of nine risk prediction scores in detecting clinical deterioration among non-ICU ward patients. We also measured each score serially to characterize how these scores changed with time.MethodsIn a retrospective nested case-control study, we calculated nine well-validated prediction scores for 328 cases and 328 matched controls. Our cohort included non-ICU ward patients admitted to the hospital with a diagnosis of infection, and cases were patients in this cohort who experienced clinical deterioration, defined as requiring a critical care consult, ICU admission, or death. We then compared each prediction score's ability, over the course of 72 hours, to discriminate between cases and controls.ResultsAt 0 to 12 hours before clinical deterioration, seven of the nine scores performed with acceptable discrimination: Sequential Organ Failure Assessment (SOFA) score area under the curve of 0.78, Predisposition/Infection/Response/Organ Dysfunction Score of 0.76, VitalPac Early Warning Score of 0.75, Simple Clinical Score of 0.74, Mortality in Emergency Department Sepsis of 0.74, Modified Early Warning Score of 0.73, Simplified Acute Physiology Score II of 0.73, Acute Physiology and Chronic Health Evaluation II of 0.72, and Rapid Emergency Medicine Score of 0.67. By measuring scores over time, it was found that average SOFA scores of cases increased as early as 24 to 48 hours prior to deterioration (P = 0.01). Finally, a clinical prediction rule which also accounted for the change in SOFA score was constructed and found to perform with a sensitivity of 75% and a specificity of 72%, and this performance is better than that of any SOFA scoring model based on a single set of physiologic variables.ConclusionsICU- and emergency room-based prediction scores can also be used to prognosticate risk of clinical deterioration for non-ICU ward patients. In addition, scoring models that take advantage of a score's change over time may have increased prognostic value over models that use only a single set of physiologic measurements.

Project description:BackgroundA few studies have reported associations between traffic-related air pollution exposure at schools and cognitive development. The role of PM components or sources other than traffic on cognitive development has been little explored.ObjectivesWe aimed to explore the role of PM sources in school air on cognitive development.MethodsA cohort of 2,618 schoolchildren (average age, 8.5 years) belonging to 39 schools in Barcelona (Spain) was followed up for a year. Children completed computerized tests assessing working memory, superior working memory, and inattentiveness during four visits. Particulate matter ? 2.5 ?m (PM2.5) was measured during two 1-week campaigns in each school, both outdoors and in the classroom. Source apportionment resulted in nine sources: mineral, organic/textile/chalk, traffic, secondary sulfate and organics, secondary nitrate, road dust, metallurgy, sea spray, and heavy oil combustion. Differences in cognitive growth trajectories were assessed with mixed models with age-by-source interaction terms.ResultsAn interquartile range increase in indoor traffic-related PM2.5 was associated with reductions in cognitive growth equivalent to 22% (95% CI: 2%, 42%) of the annual change in working memory, 30% (95% CI: 6%, 54%) of the annual change in superior working memory, and 11% (95% CI: 0%, 22%) of the annual change in the inattentiveness scale. None of the other PM2.5 sources was associated with adverse effects on cognitive development.ConclusionsTraffic was the only source of fine particles associated with a reduction in cognitive development. Reducing air pollution from traffic at primary schools may result in beneficial effects on cognition.CitationBasagaña X, Esnaola M, Rivas I, Amato F, Alvarez-Pedrerol M, Forns J, López-Vicente M, Pujol J, Nieuwenhuijsen M, Querol X, Sunyer J. 2016. Neurodevelopmental deceleration by urban fine particles from different emission sources: a longitudinal observational study. Environ Health Perspect 124:1630-1636;?http://dx.doi.org/10.1289/EHP209.

Project description:BackgroundAfrican houses are frequently too hot and uncomfortable to use a bed net at night. Indoor thermal comfort is often evaluated by measuring temperature and humidity, ignoring ventilation. This study explored ways to measure ventilation in single-roomed rural Gambian houses during the malaria transmission season and evaluated building designs that could increase airflow at night and help keep the occupants comfortable.MethodsTwo identical mud-walled houses were constructed with a metal roof, three doors and closed eaves. Experiment 1 compared five methods for measuring ventilation in a building: (1) using a blower door, (2) increasing carbon dioxide (CO2) levels indoors using an artificial source of CO2 and then measuring the rate of gas decay, (3) using a similar approach with a natural source of CO2, (4) measuring the rise of CO2 when people enter a building and (5) using hot-wire anemometers. Experiment 2 used CO2 data loggers to compare ventilation in a reference metal-roofed house with closed eaves and badly-fitting doors with a similar house with (1) thatched roof and open eaves, (2) eaves tubes, (3) screened doors and (4) screened doors and windows.ResultsIn experiment 1, CO2 data loggers placed indoors in two identical houses showed similar changes in airflow (p > 0.05) for all three methods recording either decreasing or increasing CO2. Blower doors were unable to measure airflow in houses with open eaves or screened windows and the anemometers broke down under field conditions. In experiment 2, open eaves in thatched houses, screened doors alone, and screened doors and windows increased indoor ventilation compared to the reference metal-roofed house with closed eaves and badly fitting doors (p < 0.05). Eaves tubes did not increase ventilation in comparison to the reference house.ConclusionCO2 data loggers proved to be a simple and efficient method for measuring ventilation in rural houses at night. Ventilation of metal-roofed houses can be improved by adding two screened doors and windows on opposite walls. Improved ventilation will result in increased thermal comfort making it more likely that people will sleep under a bed net.

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Experimental study on the control effect of different ventilation systems on fine particles in a simulated hospital ward.

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