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Fungi are among the most diverse and ecologically important kingdoms in life. However, the distributional ranges of fungi remain largely unknown as do the ecological mechanisms that shape their distributions1,2. To provide an integrated view of the spatial and seasonal dynamics of fungi, we implemented a globally distributed standardized aerial sampling of fungal spores3. The vast majority of operational taxonomic units were detected within only one climatic zone, and the spatiotemporal patterns of species richness and community composition were mostly explained by annual mean air temperature. Tropical regions hosted the highest fungal diversity except for lichenized, ericoid mycorrhizal and ectomycorrhizal fungi, which reached their peak diversity in temperate regions. The sensitivity in climatic responses was associated with phylogenetic relatedness, suggesting that large-scale distributions of some fungal groups are partially constrained by their ancestral niche. There was a strong phylogenetic signal in seasonal sensitivity, suggesting that some groups of fungi have retained their ancestral trait of sporulating for only a short period. Overall, our results show that the hyperdiverse kingdom of fungi follows globally highly predictable spatial and temporal dynamics, with seasonality in both species richness and community composition increasing with latitude. Our study reports patterns resembling those described for other major groups of organisms, thus making a major contribution to the long-standing debate on whether organisms with a microbial lifestyle follow the global biodiversity paradigms known for macroorganisms4,5.

Novel methods for sampling and characterizing biodiversity hold great promise for re-evaluating patterns of life across the planet. The sampling of airborne spores with a cyclone sampler, and the sequencing of their DNA, have been suggested as an efficient and well-calibrated tool for surveying fungal diversity across various environments. Here we present data originating from the Global Spore Sampling Project, comprising 2,768 samples collected during two years at 47 outdoor locations across the world. Each sample represents fungal DNA extracted from 24 m3 of air. We applied a conservative bioinformatics pipeline that filtered out sequences that did not show strong evidence of representing a fungal species. The pipeline yielded 27,954 species-level operational taxonomic units (OTUs). Each OTU is accompanied by a probabilistic taxonomic classification, validated through comparison with expert evaluations. To examine the potential of the data for ecological analyses, we partitioned the variation in species distributions into spatial and seasonal components, showing a strong effect of the annual mean temperature on community composition.

Background: Surgical site infection (SSI) is a major problem following total hip arthroplasty (THA). This study investigated the impact of a standard intraoperative routine where the surgical team wears full-body exhaust suits (space suits) within a laminar airflow (LAF)-ventilated operating room (OR) on environmental contamination. Our primary objective was to identify potential modifiable intraoperative factors that could be better controlled to minimize SSI risk. Methods: We implemented an approach involving simultaneous and continuous air sampling throughout actual primary cementless THA procedures. This method concurrently monitored both airborne particle and microbial contamination levels from the time the patient entered the OR for surgery until extubation. Results: Airborne particulate and microbial contamination significantly increased during the first and second patient repositionings (postural changes) when the surgical team was not wearing space suits. However, their concentration exhibited inconsistent changes during the core surgical procedures, between incision and suturing, when the surgeons wore space suits. The microbial biosensor detected zero median microbes from draping to suturing. In contrast, the particle counter indicated a significant level of airborne particles during head resection and cup press-fitting, suggesting these procedures might generate more non-viable particles. Conclusions: This study identified a significant portion of airborne particles during the core surgical procedures as non-viable, suggesting that monitoring solely for particle counts might not suffice to estimate SSI risk. Our findings strongly support the use of space suits for surgeons to minimize intraoperative microbial contamination within LAF-ventilated ORs. Therefore, minimizing unnecessary traffic and movement of unsterile personnel is crucial. Additionally, since our data suggest increased contamination during patient repositioning, effectively controlling contamination during the first postural change plays a key role in maintaining low microbial contamination levels throughout the surgery. The use of sterile gowns during this initial maneuver might further reduce SSIs. Further research is warranted to investigate the impact of sterile attire on SSIs. [ABSTRACT FROM AUTHOR]

Background: Data on the prevalence of sick building syndrome (SBS) and its components in medical staff working at the Semnan University of Medical Sciences are limited. Objectives: The present study investigated the prevalence of SBS and its related factors in the medical staff in Semnan, Iran. Methods: A cross-sectional study was done on 300 medical staff in Kausar Hospital in Semnan, Iran, in 2020. A standard questionnaire was used to obtain information about SBS and indoor air quality. In order to measure environmental factors, random sampling was taken from different parts of the hospital, including building inspection, dust samples, and indoor and outdoor air measurements. The condition of physical factors, including temperature, humidity, and ventilation, was checked using relevant devices. The NIOSH 0800 method was used to measure the biological status of the working spaces in terms of fungal and bacterial contamination. Data analyses were performed using SPSS 26. Results: The mean age of the participants was 32.23 ± 5.34 years, of whom 81% were women. The prevalence of SBS was 65%, with the highest prevalence in the emergency ward (18%), followed by internal (16%), intensive care unit (13%), and cardiac care unit (12%). Sleep disorder (65%), tiredness (59%), feeling heavy (47%), headache (46%) and stress (45%) were the most common components of the SBS. There was a statistically significant relationship between the presence of harmful environmental factors, including noise, static electricity, unpleasant smell, and infection, and the prevalence of SBS (all P-values < 0.05). Conclusions: Considering the high prevalence of SBS in hospital employees, re-engineering the hospital environment and improving the air quality and ventilation systems may be useful in preventing SBS. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the effectiveness of various cleaning methods in reducing airborne endotoxin and microbial aerosols during oral cleaning procedures. Method: Forty patients undergoing oral cleaning procedures were randomly assigned to one of four groups (n = 10 per group). Group A received strong suction alone; Group B received strong suction combined with an air disinfection machine; Group C received strong suction combined with a dental electric suction machine; Group D received strong suction in conjunction with both an air disinfection machine and a dental electric suction machine. Airborne aerosol concentrations were assessed at four-time points: before treatment, 30 min into treatment, immediately after treatment, and 60 min after treatment ended. Samples were collected at distances of 20 cm, 60 cm, and 1 m from the patient's oral cavity using the natural sedimentation method. T-test was used to evaluate the difference among tested groups. Results: Airborne endotoxins and microbial aerosols levels increased significantly during treatment, with the highest levels observed at 20 cm from the patient's mouth. During treatment, groups with additional cleaning methods (Groups B, C, and D) exhibited higher levels of airborne endotoxins and microbial aerosols compared to Group A (strong suction alone). However, post-treatment analysis revealed that Group D demonstrated the lowest level of airborne endotoxins and microbial aerosols, while Group A exhibited the highest. Conclusions: Implementing effective aerosol management strategies can significantly reduce aerosol dispersion in the oral clinical environment. Continuous monitoring aerosol concentrations and the application of appropriate control measures are essential for minimizing infection risks for both patients and healthcare providers during oral cleaning procedures. [ABSTRACT FROM AUTHOR]

Global and South African populations continue to increase exponentially, with large flows of persons into urban centres. Urban air quality and bioaerosol are therefore becoming an increasingly important consideration in the face of a growing burden of allergic respiratory diseases. More than 20% of South Africans have asthma, with morbidity being disproportionately high compared to high-income countries (HICs). Air pollutants (particularly particulate matter and ozone), pollen and fungal spores are known triggers and exacerbating factors in asthma and, alarmingly, the levels of air pollutants remain high in hotspot areas despite robust air-quality legislation in South Africa. The concern is that genetically and environmentally vulnerable children in low- and middle-income countries (LMICs) such as South Africa will have asthma triggered and exacerbated disproportionately by poor air quality. Urban green areas are increasingly being recognised by many stakeholders as important possible mitigation tools. However, multiple factors must be considered for having an optimal green space design. In this review, we bring together experts across the fields of health, air quality and aerobiology to outline the intersection between asthma and air quality and/or aerobiology in South Africa. We highlight the importance of careful multidisciplinary green space design as a possible healing tonic. We conclude that detailed studies combining air quality, pollen dispersal and health issues are needed to derive more precise exposure--response functions of the green spaces in South Africa and other LMICs. [ABSTRACT FROM AUTHOR]

Basal Stem Rot (BSR), caused by Ganoderma spp., is one of the most important emerging diseases of oil palm in Colombia and is so far restricted to only two producing areas in the country. However, despite the controls established to prevent its spread to new areas, containment has not been possible. This study aimed to understand BSR's propagation mechanisms and related environmental conditions by measuring Ganoderma basidiospores' concentrations at various heights using four 7-day Burkard volumetric samplers in a heavily affected plantation. Meteorological data, including solar radiation, temperature, humidity, precipitation, and wind speed, were also recorded. Analysis revealed higher basidiospore concentrations below 4 m, peaking at 02:00 h, with increased levels towards the study's end. Spore concentrations were not directly influenced by temperature, humidity, or precipitation, but showed higher releases during drier periods. A significant correlation was found between wind speed and spore concentration, particularly below 1.5 m/s, though higher speeds might aid long-distance pathogen spread. This study highlights the complexity of BSR propagation and the need for continued monitoring and research to manage its impact on Colombia's oil palm industry. [ABSTRACT FROM AUTHOR]

Antibiotic resistance, a significant public health hazard, is predicted to cause 10 million deaths worldwide by 2050. The study aimed to identify culturable bioaerosols in the indoor air of dental units in Lahore and assess their antibiotic resistance. Air samples were collected from 10 dental unit locations at different distances, with average concentrations of fungi and bacteria falling within intermediate ranges, per the Global Index of Microbial Contamination (GIMC/m3) index. The study found higher antibiotic-resistant strains in hospital dental units, particularly during winter. The most vigorous strain, S.aureus-NAJIH18, exhibited 70% resistance to ceftazidime. The research highlights the importance of quantifying microbial pollutants for evaluating their source and complexity. It suggests proactive mitigation techniques, such as focused cleaning and air filtration, to improve indoor air quality can mitigate the spread of antibiotic-resistant strains. These insights offer hope in combating the growing public health threat of antibiotic resistance. [ABSTRACT FROM AUTHOR]

The effective identification of bacterial and fungal isolates is essential for microbiological monitoring in environments like speleotherapeutic caves. This study compares MALDI-TOF MS and the OmniLog ID System, two high-throughput culture-based identification methods. MALDI-TOF MS identified 80.0% of bacterial isolates to the species level, while the OmniLog ID System identified 92.9%. However, species-level matches between the methods were only 48.8%, revealing considerable discrepancies. For discrepant results, MALDI-TOF MS matched molecular identification at the genus level in 90.5% of cases, while the OmniLog ID System matched only in 28.6%, demonstrating MALDI-TOF MS's superiority. The OmniLog ID System had difficulties identifying genera from the order Micrococcales. Fungal identification success with MALDI-TOF MS was 30.6% at the species level, potentially improvable with a customised spectral library, compared to the OmniLog ID System's 16.7%. Metagenomic approaches detected around 100 times more microbial taxa than culture-based methods, highlighting human-associated microorganisms, especially Staphylococcus spp. In addition to Staphylococcus spp. and Micrococcus spp. as indicators of cave anthropisation, metagenomics revealed another indicator, Cutibacterium acnes. This study advocates a multi-method approach combining MALDI-TOF MS, the OmniLog ID System, culture-based, and metagenomic analyses for comprehensive microbial identification. Metagenomic sampling on nitrocellulose filters provided superior read quality and microbial representation over liquid sampling, making it preferable for cave air sample collection. [ABSTRACT FROM AUTHOR]

Lamiaceae is a botanical family rich in aromatic species that are in high demand such as basil, lavender, mint, oregano, sage, and thyme. It has great economical, ecological, ethnobotanical, and floristic importance. The aim of this work is to provide an updated view on the aerobiology of species from the family Lamiaceae, with an emphasis on novelties and emerging applications. From the aerobiology point of view, the greatest interest in this botanical family is related to the volatile organic compounds emitted by the plants and, to a much lesser extent, their pollen. Research has shown that the major volatile organic compounds emitted by the plants from this botanical family are monoterpenes and sesquiterpenes. The most important monoterpenes reported across studies include α-pinene, β-pinene, 1,8-cineole, menthol, limonene, and γ-terpinene. Most reports tend to cover species from the subfamily Nepetoideae. Volatile oils are produced by glandular trichomes found on aerial organs. Based on general morphology, two main types are found in the family Lamiaceae, namely peltate and capitate trichomes. As a result of pollinator-mediated transfer of pollen, Lamiaceae species present a reduced number of stamens and quantity of pollen. This might explain the low probability of pollen presence in the air from these species. A preliminary synopsis of the experimental evidence presented in this work suggests that the interplay of the organic particles and molecules released by these plants and their environment could be leveraged for beneficial outcomes in agriculture and landscaping. Emerging reports propose their use for intercropping to ensure the success of fructification, increased yield of entomophilous crops, as well as in sensory gardens due to the therapeutic effect of volatiles. [ABSTRACT FROM AUTHOR]

A total of 17 Legionnaires' disease cases were identified in an outbreak in a western town in New York. The cases had symptom onset dates ranging from August 1, 2019, to July 1, 2021. Staff from the New York State Department of Health and Chemung County Health Department employed numerous environmental investigation techniques. Environmental health program staff collected 74 environmental samples, including samples from cooling towers, residences, and a wastewater treatment plant. Wind direction was analyzed to determine the potential for the dispersion of aerosolized Legionella. In total, five cases were found to be genetically related by whole genome sequencing. Further testing revealed that isolates recovered from a cooling tower at an industrial facility were genetically related to four of the 2019 cases. Excessive iron was found in the tower and might have suppressed the oxidizing biocide residual and interfered with the evaluation of routine culture and other testing methods. In 2021, clinical and environmental samples from a private hot tub were found to be genetically related to the four matching cases and cooling tower samples recovered in 2019. [ABSTRACT FROM AUTHOR]

BACKGROUND: In response to the COVID-19 pandemic, new evidence-based strategies have emerged for reducing transmission of respiratory infections through management of indoor air. OBJECTIVES: This paper reviews critical advances that could reduce the burden of disease from inhaled pathogens and describes challenges in their implementation. DISCUSSION: Proven strategies include assuring sufficient ventilation, air cleaning by filtration, and air disinfection by germicidal ultraviolet (UV) light. Layered intervention strategies are needed to maximize risk reduction. Case studies demonstrate how to implement these tools while also revealing barriers to implementation. Future needs include standards designed with infection resilience and equity in mind, buildings optimized for infection resilience among other drivers, new approaches and technologies to improve ventilation, scientific consensus on the amount of ventilation needed to achieve a desired level of risk, methods for evaluating new air-cleaning technologies, studies of their long-term health effects, workforce training on ventilation systems, easier access to federal funds, demonstration projects in schools, and communication with the public about the importance of indoor air quality and actions people can take to improve it [ABSTRACT FROM AUTHOR]

Objectives We examined factors contributing to the transmission of an acute respiratory virus within multi-use facilities, focusing on an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a movie theater in the Republic of Korea. Methods This retrospective cohort study involved a descriptive analysis of 48 confirmed cases. Logistic regression was applied to a cohort of 80 theater attendees to identify risk factors for infection. The infection source and transmission route were determined through gene sequencing data analysis. Results Of the 48 confirmed cases, 35 were theater attendees (72.9%), 10 were family members of attendees (20.8%), 2 were friends (4.2%), and 1 was an employee (2.1%). Among the 80 individuals who attended the 3rd to 5th screenings of the day, 35 became infected, representing a 43.8% attack rate. Specifically, 28 of the 33 third-screening attendees developed confirmed SARS-CoV-2, constituting an 84.8% attack rate. Furthermore, 11 of the 12 cases epidemiologically linked to the theater outbreak were clustered monophyletically within the AY.69 lineage. At the time of the screening, 35 individuals (72.9%) had received 2 vaccine doses. However, vaccination status did not significantly influence infection risk. Multivariate analysis revealed that close contacts had a 15.9-fold higher risk of infection (95% confidence interval, 4.37–78.39) than casual contacts. Conclusion SARS-CoV-2 transmission occurred within the theater, and extended into the community, via a moviegoer who attended the 3rd screening during the viral incubation period after contracting the virus from a family member. This study emphasizes the importance of adequate ventilation in theaters.

Air contains large number of microorganisms including bacteria and fungi and their estimation is important as an index of cleanliness for any particular environment. Ability of a microorganism to produce biosurfactant is an indicator of its hydrocarbon degradation capability. The air microflora of five different offices at the faculty of Life Sciences in the University of Ilorin was examined by exposing plates on nutrient agar and potato dextrose agar at different locations in the offices. The bacterial load obtained ranged from 20,445 to 24,849 cfu/m³ whiles the fungal load ranged from 5,269 to 10,144 cfu/m³ . A total of 6 bacterial and 10 fungal species were isolated at varying frequency of distribution. The bacteria isolated were Pseudomonas aeruginosa, Micrococcus varians, Staphylococcus epidermidis, Bacillus circulans, Staphylococcus aureus and Bacillus subtilis. The most predominant bacterial isolate was Staphylococcus aureus while the least was, Bacillus circulans. The fungi isolated were Aspergillus niger, Penicillum chrysogenum, Cladosporium herbarum, Aspergillus nidulans, Mucor mucedo, Geotrichum candidum, Fusarium oxysporum and Rhizopus stolonifer. The predominant fungal isolate was Aspergillus niger while Fusarium oxysporum was the least predominant. The highest emulsification index was observed in Pseudomonas aureginosa with an E24% of 50% using crude oil as its carbon source. Pseudomonas aeruginosa and Bacillus Bacillus subtilis showed promise oof biosurfactant production and hence petroleum biodegradation. This will be explored further in our next study. Most of the microorganisms are opportunistic pathogens especially in immunocompromised individuals. Therefore, proper air sanitation is advised in offices to prevent infection. [ABSTRACT FROM AUTHOR]

Introduction: Guidelines for Airborne Infection Control in Health Care Settings were published in the 2010 to reduce Airborne Infections in health service providers and visitors to health facilities. Objectives: To evaluate healthcare facilities regarding implementation of Guidelines for Airborne Infection Control in Health Care Settings. Methods: An analytic, cross- sectional, health care facility-based study in the district Solan of Himachal Pradesh. A total 53 health care facilities from both public and private sectors were assessed and compared. Results: The implementation of these guidelines was unsatisfactory. Government health care facilities were better implementing the guidelines, compared to the private sector. Conclusion: The guidelines are over a decade old and implementation is not optimal. Efforts and emphasis are required to be put into implementation of these guidelines in health care facilities. An update of policy with stringent penalties are advocated for better compliance in the private sector. [ABSTRACT FROM AUTHOR]

Air quality in a cancer facility is integral to the success of patient treatment. The organization must be committed to providing a patient care environment free of physical and biological hazards that result from construction and demolition activities. This project intended to safely demolish a derelict building in Texas while minimizing air quality risks and impacts to nearby hospitals and a proximal cancer hospital. Two of the neighboring facilities were less than 18 feet (5.5 m) away from the demolition location. Adjacent facilities included inpatient and outpatient cancer treatment clinics, a large data center, a pediatric hospital complex, and a heart institute. Plans to minimize infection risks and dust for respective facilities were designed before implosion and remained in place until total debris removal. Risk assessments of nearby buildings were completed to determine the appropriate precautions and physical barriers needed. Culturable and non-culturable fungal air samples were collected during implosion to verify the management of outside contaminants. Additionally, continuous particulate and routine sampling for culturable and non-culturable fungi were performed for approximately 7 months after the project demolition. Air sampling results from 32 internal areas indicated that most areas remained at pre-implosion background levels. Areas that experienced elevated particle counts were cleaned and resampled, and baseline values returned to pre-implosion levels within 12 hr. Fungal air sampling results were acceptable based on predetermined infection control guidelines. The building was successfully demolished via implosion with no injuries and minimal damage to nearby facilities. The team learned that an integrated approach to project management that includes all stakeholders is essential to success. Contingency planning should account for all variables; no assumptions should be made. Staffing plans should be reviewed to ensure the sampling strategy developed can be implemented appropriately. [ABSTRACT FROM AUTHOR]

This cross-sectional study aims to obtain knowledge about workers' exposure to airborne dust, bacterial and fungal species, endotoxin, biofilm formation, and hydrogen sulfide (H2S) in drilling waste treatment plants. In total, 408 full-shift personal samples, 66 work areas, 40 drilling waste, and reference (outdoor air and seawater) samples were analyzed. Some workers were exposed to high levels of endotoxin (207 EU/m3), bacteria (3.8 × 104 colony forming units (CFU)/m3 and 9.8 × 104 DNA copies/m3), or fungi (1.4 × 107 CFU/m3 and 3,600 copies/m3). The exposure levels to endotoxin, bacteria, and peaks of H2S were dependent on the treatment technique. All types of drilling waste contained large concentrations of bacteria compared to the seawater references. Elevated concentrations of airborne bacteria were found close to drilling waste basins. In total, 116, 146, and 112 different bacterial species were found in workers' exposure, work areas, and the drilling waste, respectively. An overlap in bacterial species found in the drilling waste and air (personal and work area) samples was found. Of the bacterial species found, 49 are classified as human pathogens such as Escherichia coli , Enterobacter cloacae , and Klebsiella oxytoca. In total, 44 fungal species were found in the working environment, and 6 of these are classified as human pathogens such as Aspergillus fumigatus. In conclusion, across the drilling waste treatment plants, human pathogens were present in the drilling waste, and workers' exposure was affected by the drilling waste treated at the plants with elevated exposure to endotoxin and bacteria. Elevated exposure was related to working as apprentices or chemical engineers, and working with cleaning, or slop water, and working in the daytime. [ABSTRACT FROM AUTHOR]

Objectives There is growing interest in the role of airborne mycotoxins in occupational environments, however, their impact on human health still remains poorly investigated. This review aims to provide a comprehensive analysis of the existing literature on the occurrence of inhalable mycotoxins in working environments to investigate which sectors and tasks are at greater risk of exposure. Methods We have performed a systematic search in the PubMed, Scopus and Web of Science databases from 2010 to date, without limitation of geographic location. Results Database searches yielded 350 articles. After the removal of duplicates and applying our inclusion and exclusion criteria, 31 papers remained. Results show that the most exposed workers are those engaged in activities related to animal care and management and, in particular, in feeding tasks, while harvester cleaning seems to be the activity with the highest levels of exposure in agriculture. In healthcare settings mycotoxin concentrations are low but HVAC systems can be a source of contamination and this reinforces the relevance of further studies in this sector. The most common scenario is the exposure to multiple mycotoxins with variable concentrations depending on the working environment, the products handled or the tasks performed by workers. Some authors emphasize the importance of multi-approach sampling and analysis protocols to achieve an accurate and more realistic risk characterization. Conclusions Results brought forward by this review can be utilized by health and safety professionals to recognize activities in which workers may be potentially exposed to airborne mycotoxins and thus undertake suitable preventive and protective measures. [ABSTRACT FROM AUTHOR]

Poor indoor air quality in healthcare settings has been tied with the increase in hospital-acquired infections. Thus, this systematic review was conducted to assess the levels and compositions of bacteria in indoor hospital air in the Middle East and North Africa (MENA) region. We examined results provided by different search engines published between 2000 and 2021. Our data showed that most studies were conducted in Iran (80.9%) with a bacterial concentration mean of 172.9 CFU/m3. Comparing sensitive and non-sensitive areas of hospitals, no significant difference was detected in the mean bacterial concentration. The most investigated sensitive hospital areas were operating rooms and intensive care units with mean indoor bacterial concentrations of 180.3 CFU/m3 and 204.6 CFU/m3, respectively. Staphylococcaceae, Enterobacteriaceae, Pseudomonadaceae, and Bacillaceae were commonly identified bacterial families. In conclusion, the mean concentrations of the airborne bacteria were within the acceptable limit compared to WHO standards (300 CFU/m3) for the air in areas occupied by immunosuppressed people. [ABSTRACT FROM AUTHOR]

Background: Laminar airflow (LAF) technologies minimize infectious microorganisms to enhance air quality and surgical site infections (SSIs). LAF lowers SSIs in some clinical studies but not others. This study analyzes laminar airflow ventilation's capacity to reduce orthopaedic surgery-related SSIs. Methods: The PRISMA-compliant keywords were utilized to conduct a search for pertinent articles in various databases including PubMed, MEDLINE, CENTRAL, Web of Sciences, and the Cochrane databases. Observational studies, including retrospective, prospective, and cohort designs, satisfy the PICOS criteria for research methodology. The assessment of quality was conducted utilizing the Robvis software, while the meta-analysis was performed using the RevMan application. The study's results were assessed based on effect sizes of odds ratio (OR) and risk ratio (RR). Results: From 2000 to 2022, 10 randomized controlled clinical trials with 10,06,587 orthopaedic surgery patients met the inclusion criteria. The primary outcomes were: (1) Risk of SSI, (2) Bacterial count in sampled air and (3) Reduction in SSIs. The overall pooled OR of all included studies was 1.70 (95% CI 1.10–2.64), and the overall pooled RR was 1.27 (95% CI 1.02–1.59) with p < 0.05. LAF is ineffective at preventing SSIs in orthopaedic procedures due to its high-risk ratio and odds ratio. Conclusions: The present meta-analysis has determined that the implementation of LAF systems does not result in a significant reduction in the incidence of surgical site infections (SSIs), bacterial count in the air, or SSIs occurrence in orthopaedic operating rooms. Consequently, the installation of said equipment in operating rooms has been found to be both expensive and inefficient. [ABSTRACT FROM AUTHOR]

Airborne fungi are dispersed through the air. The aim of this study was to determine the prevalence of airborne fungi in Brazil and understand the relationship between fungal growth and respiratory diseases and infections. We conducted an integrative literature review of studies conducted in Brazil based on searches of the PubMed, MEDLINE-BIREME, SciELO, and LILACS databases for full-text articles published between 2000 and 2022. The searches returned 147 studies, of which only 25 met the inclusion criteria. The most prevalent genera of airborne fungi in Brazil are Aspergillus, Penicillium, Cladosporium, Curvularia, and Fusarium. The studies were conducted in the states of Maranhão, Ceará, Piauí, Sergipe, Mato Grosso, Pernambuco, Rio Grande do Sul, Santa Catarina, Rio de Janeiro, São Paulo, and Minas Gerais. The findings also show the relationship between fungi and meteorological factors and seasonality, the sensitivity of atopic individuals to fungi, and the main nosocomial mycoses reported in the literature. This work demonstrates the importance of maintaining good microbiological air quality to prevent potential airborne diseases. [ABSTRACT FROM AUTHOR]

Knowledge about person-to-person transmission of SARS-CoV-2 is reviewed, emphasizing three components: emission of virus-containing particles and drops from infectious persons; transport and fate of such emissions indoors; and inhalation of viral particles by susceptible persons. Emissions are usefully clustered into three groups: small particles (diameter 0.1-5 µm), large particles (5-100 µm), and ballistic drops (>100 µm). Speaking generates particles and drops across the size spectrum. Small particles are removed from indoor air at room scale by ventilation, filtration, and deposition; large particles mainly deposit onto indoor surfaces. Proximate exposure enhancements are associated with large particles with contributions from ballistic drops. Masking and social distancing are effective in mitigating transmission from proximate exposures. At room scale, masking, ventilation, and filtration can contribute to limit exposures. Important information gaps prevent a quantitative reconciliation of the high overall global spread of COVID-19 with known transmission pathways. Available information supports several findings with moderate-to-high confidence: transmission occurs predominantly indoors; inhalation of airborne particles (up to 50 µm in diameter) contributes substantially to viral spread; transmission occurs in near proximity and at room scale; speaking is a major source of airborne SARS-CoV-2 virus; and emissions can occur without strong illness symptoms.

The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs.

ObjectiveTo characterize respiratory emissions produced during labor and vaginal delivery vis-à-vis the potential for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).MethodsObservational study of three women who tested negative for SARS-CoV-2 and had uncomplicated vaginal deliveries. Using background-oriented schlieren imaging, we evaluated the propagation of respiratory emissions produced during the labor course and delivery. The primary outcome was the speed and propagation of breath over time, calculated through processed images collected throughout labor and delivery.ResultsIn early labor with regular breathing, the speed of the breath was 1.37 meters/s (range 1.20-1.55 meters/s). The breath appeared to propagate faster with a cough during early labor at a speed of 1.69 meters/s (range 1.22-2.27 meters/s). During the second stage of labor with Valsalva and forced expiration, the propagation speed was 1.79 meters/s (range 1.71-1.86 meters/s).ConclusionLabor and vaginal delivery increase the propagation of respiratory emissions that may increase risk of respiratory transmission of SARS-CoV-2.

The COVID-19 pandemic has revealed critical knowledge gaps in our understanding of and a need to update the traditional view of transmission pathways for respiratory viruses. The long-standing definitions of droplet and airborne transmission do not account for the mechanisms by which virus-laden respiratory droplets and aerosols travel through the air and lead to infection. In this Review, we discuss current evidence regarding the transmission of respiratory viruses by aerosols-how they are generated, transported, and deposited, as well as the factors affecting the relative contributions of droplet-spray deposition versus aerosol inhalation as modes of transmission. Improved understanding of aerosol transmission brought about by studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires a reevaluation of the major transmission pathways for other respiratory viruses, which will allow better-informed controls to reduce airborne transmission.

Objectives: Serious COVID-19 nosocomial infection has demonstrated a need to design our health services in a different manner. Triggered by the current crisis and the interest in rapid deployable hospital, this article discusses how hospital building layouts can be improved to streamline the patient pathways and thus to reduce the risk of hospital-related infections. Another objective of this work is to explore the possibility to develop flexible and scalable hospital building layouts through modular construction. This enables hospitals to better cope with different future demands and thereby enhance the resilience of the healthcare facilities. Background: During the first wave of COVID-19, approximate one-seventh to one-fifth COVID-19 patients and majority of infected healthcare workers acquired the disease in NHS hospitals. Similar issues emerged during the Crimean War (1853–1856) when more soldiers died from infectious diseases rather than of battlefield casualties in Scutari Hospital. This led to an important collaborative work between Florence Nightingale, who looked into this problem statistically, and Isambard Kingdom Brunel, who designed the rapid deployment Renkioi Hospital which yielded a death rate 90% lower than that in Scutari Hospital. While contemporary medical research and practice have moved beyond Nightingale's concept of contagion, challenges of optimizing hospital building layouts to support healing and effectively combat nosocomial infections still pose elusive problems that require further investigation. Methods: Through case study investigations, this article evaluates the risk of nosocomial infections of airborne transmissions under different building layouts, and this provides essential data for infection control in the new-build or refurbished healthcare projects. Results: Improved hospital layout can be achieved through reconfiguration of rooms and concourse. Design interventions through evidence-based infection risk analysis can reduce congestion and provide extra separation and compartmentalization which will contribute the reduced nosocomial infection rate. Conclusions: A resilient hospital shall be able to cope with unexpected circumstances and be flexible to change when new challenges arise, without compromising the safety and well-being of frontline medical staff and other patients. Such an organizational resilience depends on not only flexible clinical protocols but also flexible hospital building layouts. The latter allows hospitals to get better prepared for rapidly changing patient expectations, medical advances, and extreme weather events. The reconfigurability of an existing healthcare facility can be further enhanced through modular construction, standardization of building components, and additional space considered. [ABSTRACT FROM AUTHOR]

Aim: Establish the influence of the terminal or nonterminal position of High Efficiency Particulate Air (HEPA) filters in the Heating, Ventilation, and Air Conditioning (HVAC) system on the presence of airborne fungi in controlled environment rooms. Background: Fungal infections are an important cause of morbidity and mortality in hospitalized patients. Methods: This study was realized from 2010 to 2017, in rooms with terminal and nonterminal HEPA filters, in eight Spanish hospitals. In rooms with terminal HEPA filters, 2,053 and 2,049 samples were recollected, and in rooms with nonterminal HEPA filters, 430 and 428 samples were recollected in the air discharge outlet (Point 1) and in the center of the room (Point 2), respectively. Temperature, relative humidity, air changes per hour, and differential pressure were recollected. Results: Multivariable analysis showed higher odds ratio (OR) of airborne fungi presence when HEPA filters were in nonterminal position (OR : 6.78; 95% CI [3.77, 12.20]) in Point 1 and (OR : 4.43; 95% CI [2.65, 7.40]) in Point 2. Other parameters influenced airborne fungi presence, such as temperature (OR : 1.23; 95% CI [1.06, 1.41]) in Point 2 differential pressure (OR : 0.86; 95% CI [0.84, 0.90]) and (OR : 0.88; 95% CI [0.86, 0.91]) in Points 1 and 2, respectively. Conclusions: HEPA filter in terminal position of the HVAC system reduces the presence of airborne fungi. To decrease the presence of airborne fungi, adequate maintenance of the environmental and design parameters is necessary in addition to the terminal position of the HEPA filter. [ABSTRACT FROM AUTHOR]

Methicillin-resistant strains of Staphylococcus aureus (MRSA) are resistant to most β-lactam antibiotics. Pigs are an important reservoir of livestock-associated MRSA (LA-MRSA), which is genetically distinct from both hospital and community-acquired MRSA. Occupational exposure to pigs on farms can lead to LA-MRSA carriage by workers. There is a growing body of research on MRSA found in the farm environment, the airborne route of transmission, and its implication on human health. This study aims to directly compare two sampling methods used to measure airborne MRSA in the farm environment; passive dust sampling with electrostatic dust fall collectors (EDCs), and active inhalable dust sampling using stationary air pumps with Gesamtstaubprobenahme (GSP) sampling heads containing Teflon filters. Paired dust samples using EDCs and GSP samplers, totaling 87 samples, were taken from 7 Dutch pig farms, in multiple compartments housing pigs of varying ages. Total nucleic acids of both types of dust samples were extracted and targets indicating MRSA (femA, nuc, mecA) and total bacterial count (16S rRNA) were quantified using quantitative real-time PCRs. MRSA could be measured from all GSP samples and in 94% of the EDCs, additionally MRSA was present on every farm sampled. There was a strong positive relationship between the paired MRSA levels found in EDCs and those measured on filters (Normalized by 16S rRNA; Pearson's correlation coefficient r = 0.94, Not Normalized; Pearson's correlation coefficient r = 0.84). This study suggests that EDCs can be used as an affordable and easily standardized method for quantifying airborne MRSA levels in the pig farm setting. [ABSTRACT FROM AUTHOR]

Backgrounds: Dental procedures involving drilling and grinding can produce a significant amount of suspended aerosol particles (PM) and bioaerosols. This study aims to analyze the size and concentration of aerosol particles generated during drilling and to investigate the effectiveness of two air exchange systems, namely forceful suction (FS) and air disinfection machines (DM), in removing PM. Methods: For this study, 100 extracted permanent teeth were collected and divided into three groups: without suction (n = 50), suction with forceful suction (n = 25), and suction with air disinfection machines (n = 25). The removal rate of suspended aerosol particles was analyzed using particle counters and air data multimeter. Results: When drilling and grinding were performed without vacuum, 0.75% of the aerosol particles generated were PM2.5-10, 78.25% of total suspended aerosol particles (TSP) were PM2.5, and 98.68% of TSP were PM1. The nanoanalyzer measurements revealed that the aerodynamic diameter of most aerosol particles was below 60 nm, with an average particle diameter of 52.61 nm and an average concentration of 2.6*1011 ultrafine aerosol particles. The air change per hour (ACH) was significantly lower in the air disinfection machines group compared to the forceful suction group. Additionally, the number of aerosol particles and mass concentration was significantly lower in the air disinfection machines group compared to the forceful suction group in terms of PM2.5 levels. However, the forceful suction group also reduced the mass concentration in PM10 level than the air disinfection machines group. Conclusion: In conclusion, the air exchange system can reduce the aerosol particles generated during drilling and grinding. Comparing the two air exchange systems, it was found that the air disinfection machines group reduces the number of aerosol particles and mass concentration in PM2.5 levels, while the forceful suction group reduces the mass concentration in PM10 level. [ABSTRACT FROM AUTHOR]

Global and South African populations continue to increase exponentially, with large flows of persons into urban centres. Urban air quality and bioaerosol are therefore becoming an increasingly important consideration in the face of a growing burden of allergic respiratory diseases. More than 20% of South Africans have asthma, with morbidity being disproportionately high compared to high-income countries (HICs). Air pollutants (particularly particulate matter and ozone), pollen and fungal spores are known triggers and exacerbating factors in asthma and, alarmingly, the levels of air pollutants remain high in hotspot areas despite robust air-quality legislation in South Africa. The concern is that genetically and environmentally vulnerable children in low- and middle-income countries (LMICs) such as South Africa will have asthma triggered and exacerbated disproportionately by poor air quality. Urban green areas are increasingly being recognised by many stakeholders as important possible mitigation tools. However, multiple factors must be considered for having an optimal green space design. In this review, we bring together experts across the fields of health, air quality and aerobiology to outline the intersection between asthma and air quality and/or aerobiology in South Africa. We highlight the importance of careful multidisciplinary green space design as a possible healing tonic. We conclude that detailed studies combining air quality, pollen dispersal and health issues are needed to derive more precise exposure-response functions of the green spaces in South Africa and other LMICs. [ABSTRACT FROM AUTHOR]

Objectives: Air pollutants in dentistry offices may cause problems for the health of staff and patients. Accordingly, the present study was performed to the assessment of bacterial bioaerosols and particulate matter (PM) characteristics in the indoor air of dentistry clinics. Methods: The sampling points were restoration, endodontics, and prosthesis wards. The PM specimens were taken using Grimm Dust Monitor and the microbial specimens were taken using QuickTake 30. Results: The maximum and minimum PM10 concentration across the different measure wards occurred as 70.31 and 30.32 μg/m3 in the Ketabchi Clinic restoration and its endodontics ward, respectively. The total number of bioaerosols was 2079. Gram‑positive Staphylococcus spp.(872), Gram‑positive Micrococcus spp.(706), and Gram‑negative Bacillus spp.(501) were present in the indoor air. The results showed a significant relationship for PM1 and PM2.5 in each sampling site. Conclusion: The low PM and bacterial bioaerosols contamination can be due to the coincidence with coronavirus pandemic, as during this period, health and hygienic protocols have been strictly observed. [ABSTRACT FROM AUTHOR]

Introduction: Data on the use of remote spirometry are limited in the pediatric population. We sought to assess the feasibility and accuracy of a digital turbine spirometer, Medical International Research (MIR) Spirobank Smart (MIR, New Berlin, WI, USA), compared with a pneumotachography spirometer, Pneumotrac (Vitalograph Inc., Lenexa, KS, USA), in field-based clinical research. Methods: This is a cross-sectional study of a subgroup of school-aged participants enrolled in the Air quality, Environment, and Respiratory Outcomes in Bronchopulmonary Dysplasia (BPD) study, who performed same-day paired coached baseline spirometry measurements from the Pneumotrac and MIR devices. Proportion of successful tests was estimated for each device and compared using McNemar's test. Correlation between devices forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) was analyzed by Lin's concordance correlation, and Bland–Altman plots were generated. Results: Twenty-one participants with history of BPD completed home spirometry maneuvers on both devices. The mean age of participants was 8.7 years. The mean FEV1 and FVC measurement was 81% predicted and 90.4% predicted, respectively. The proportion of acceptable tests appeared higher using Pneumotrac (81%) than when using MIR (67%), although without evidence of discordance (P = 0.317). Among subjects with successful tests on both devices, Lin's concordance correlation demonstrated moderate agreement (FEV1r = 0.955, 95% confidence interval [CI]: 0.87–0.98; FVC r = 0.971, CI: 0.91–0.99). The mean difference in FEV1 between Pneumotrac and MIR was 0.079 L (95% limits of agreement were −0.141 to 0.298 L) and FVC was 0.075 L (95% limits of agreement were −0.171 to 0.322 L). These were relatively small and without evidence of systematic or volume-dependent bias. Conclusions: Utilizing turbine spirometers may be a promising and feasible way to perform pulmonary function testing for field research in children. [ABSTRACT FROM AUTHOR]

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Building ventilation systems must get much better

The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of 'airborne' whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six 'myths' are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.

The reconstruction of bacterial and archaeal genomes from shotgun metagenomes has enabled insights into the ecology and evolution of environmental and host-associated microbiomes. Here we applied this approach to >10,000 metagenomes collected from diverse habitats covering all of Earth's continents and oceans, including metagenomes from human and animal hosts, engineered environments, and natural and agricultural soils, to capture extant microbial, metabolic and functional potential. This comprehensive catalog includes 52,515 metagenome-assembled genomes representing 12,556 novel candidate species-level operational taxonomic units spanning 135 phyla. The catalog expands the known phylogenetic diversity of bacteria and archaea by 44% and is broadly available for streamlined comparative analyses, interactive exploration, metabolic modeling and bulk download. We demonstrate the utility of this collection for understanding secondary-metabolite biosynthetic potential and for resolving thousands of new host linkages to uncultivated viruses. This resource underscores the value of genome-centric approaches for revealing genomic properties of uncultivated microorganisms that affect ecosystem processes.

The coronavirus disease 2019 (COVID-19) pandemic has caused untold disruption throughout the world. Understanding the mechanisms for transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is key to preventing further spread, but there is confusion over the meaning of 'airborne' whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago which has generated mythological beliefs that obscure current thinking. This article collates and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six 'myths' are presented, explained and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to produce this review to consolidate the evidence for airborne transmission mechanisms, and offer justification for modern strategies for prevention and control of COVID-19 in health care and the community.

BackgroundIdentifying the extent of environmental contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection control and prevention. The extent of environmental contamination has not been fully investigated in the context of severe coronavirus disease (COVID-19) patients.AimTo investigate environmental SARS-CoV-2 contamination in the isolation rooms of severe COVID-19 patients requiring mechanical ventilation or high-flow oxygen therapy.MethodsEnvironmental swab samples and air samples were collected from the isolation rooms of three COVID-19 patients with severe pneumonia. Patients 1 and 2 received mechanical ventilation with a closed suction system, while patient 3 received high-flow oxygen therapy and non-invasive ventilation. Real-time reverse transcription-polymerase chain reaction (rRT-PCR) was used to detect SARS-CoV-2; viral cultures were performed for samples not negative on rRT-PCR.FindingsOf the 48 swab samples collected in the rooms of patients 1 and 2, only samples from the outside surfaces of the endotracheal tubes tested positive for SARS-CoV-2 by rRT-PCR. However, in patient 3's room, 13 of the 28 environmental samples (fomites, fixed structures, and ventilation exit on the ceiling) showed positive results. Air samples were negative for SARS-CoV-2. Viable viruses were identified on the surface of the endotracheal tube of patient 1 and seven sites in patient 3's room.ConclusionEnvironmental contamination of SARS-CoV-2 may be a route of viral transmission. However, it might be minimized when patients receive mechanical ventilation with a closed suction system. These findings can provide evidence for guidelines for the safe use of personal protective equipment.

Background: Using a rotary instrument or ultrasonic instrument for tooth preparation is a basic operation in the dental clinic that can produce a significant number of droplets and aerosols. The dental droplet and aerosol can lead to the transfer of harmful germs. The goal of this study was to analyze the properties of microbiological aerosol created by droplets and aerosol generated by three common tooth-preparation instruments. Methods: Streptococcus mutans UA159 was used as the biological tracer to visualize the droplets and aerosols. The passive sampling method was used to map the three-dimensional spatial distribution and the six-stage Andersen microbial sampler (AMS) was used as the active sampling method to catch aerosol particles at a specific time. Results: The aerosol concentration is related to instruments, three-dimensional spatial distribution, and dissipation time. Most aerosols were generated by air turbines. More microorganisms are concentrated at the 1.5 m plane. The majority of the post dental procedure contamination was detected within the 0–10-min period and it decreased rapidly within 30 min. Conclusion: This study is conducive to the proposal and improvement of relevant infection control measures in dental procedures and provides a basis for the assessment of measures, reducing the risk of nosocomial infection. [ABSTRACT FROM AUTHOR]

This study aimed to measure the levels of airborne radon Rn and bioaerosols – culturable airborne bacteria (CAB) and culturable airborne fungi (CAF)—in South Korea's residential environments, considering living conditions such as the number of ventilations, number of windows, floors, temperature, and relative humidity.. The range of Rn levels was 0.43–7.439 pCi/L with a median of 0.70 pCi/L. The CAB levels were 239–488 colony-forming unit (CFU)/m3 with a median of 309 CFU/m3, and CAF levels were 174–366 CFU/m3 with a median of 233 CFU/m3. Thus, this study found that semi-basement residential indoor environments negatively affected Rn and bioaerosol levels, and living in such residences resulted in high health condition scores on the bad side. Given the correlation between airborne Rn and bioaerosol levels, further large-scale studies are needed to identify more reliable and representative of research. [ABSTRACT FROM AUTHOR]

Wheat blast, caused by the ascomycetous fungus Pyricularia oryzae Triticum lineage (PoTl), is mainly controlled by fungicide use, but resistance to the main fungicide groups—sterol demethylase (DMI), quinone outside (QoI), and succinate dehydrogenase inhibitors (SDHI)—has been reported in Brazil. In order to rationalize fungicide inputs (e.g., choice, timing, dose-rate, spray number, and mixing/alternation) for managing wheat blast, we describe a new monitoring tool, enabling the quantitative measurement of pathogen's inoculum levels and detection of fungicide resistance alleles. Wheat blast airborne spores (aerosol populations) were monitored at Londrina in Paraná State, a major wheat cropping region in Brazil, using an automated high-volume cyclone coupled with a lab-based quantitative real-time PCR (qPCR) assay. The objectives of our study were as follows: (1) to monitor the amount of PoTl airborne conidia during 2019–2021 based on DNA detection, (2) to reveal the prevalence of QoI resistant (QoI-R) cytochrome b alleles in aerosol populations of wheat blast, and (3) to determine the impact of weather on the dynamics of wheat blast aerosol populations and spread of QoI resistant alleles. PoTl inoculum was consistently detected in aerosols during the wheat cropping seasons from 2019 to 2021, but amounts varied significantly between seasons, with highest amounts detected in 2019. High peaks of PoTl DNA were also continuously detected during the off-season in 2020 and 2021. The prevalence of QoI resistant (QoI-R) cytochrome b G143A alleles in aerosol populations was also determined for a subset of 10 PoTl positive DNA samples with frequencies varying between 10 and 91% using a combination of PCR-amplification and SNP detection pyrosequencing. Statistically significant but low correlations were found between the levels of pathogen and the weather variables. In conclusion, for wheat blast, this system provided prior detection of airborne spore levels of the pathogen and of the prevalence of fungicide resistance alleles. [ABSTRACT FROM AUTHOR]

Background: Poor ventilation in healthcare settings is a concern for airborne infections, particularly in light of the potential for coronavirus disease 2019 (COVID-19) transmission. This study aimed to assess the implementation status of airborne infection control (AIC) measures in primary and secondary public healthcare facilities (HCFs) and to explore the facilitating factors and barriers in the implementation of AIC measures. Methods: A mixed-methods approach was adopted, which includes a cross-sectional descriptive study using a checklist to collect data on the implementation of AIC measures in 22 primary and two secondary public HCFs in Puducherry, South India, between October 2020 and February 2021. Further, key informant interviews (KIIs) were conducted among medical officers (MOs). The qualitative data were manually analyzed, and transcripts created from handwritten notes and audio recordings were deductively evaluated. Results: Of the twenty-four health facilities visited, 54.2% had infection control (IC) committees. Annual IC training was held for housekeeping staff, MOs, nurses, and laboratory technicians in 23 (95.8%), 21 (87.5%), 20 (83.4%), and 14 (58.4%) facilities, respectively. Respiratory symptomatic patients were counseled on cough etiquettes in 22 (91.6%) facilities. Adequate cross-ventilation was present in outpatient departments in 16 (66.6%) institutions. N95 masks and face shields were provided in 21 (87.5%) facilities. Training through the KAYAKALP program and the presence of a separate sputum collection area were facilitators of IC, while lack of patient adherence and delays in fund release were found as barriers. Conclusion: Overall, the AIC measures were well-implemented, but improvements are needed in infrastructure development for patient segregation in outpatient departments and dedicated AIC training for all healthcare personnel. [ABSTRACT FROM AUTHOR]

The sooty bark disease (SBD) is an emerging disease affecting sycamore maple trees (Acer pseudoplatanus) in Europe. Cryptostroma corticale, the causal agent, putatively native to eastern North America, can be also pathogenic for humans causing pneumonitis. It was first detected in 1945 in Europe, with markedly increasing reports since 2000. Pathogen development appears to be linked to heat waves and drought episodes. Here, we analyse the conditions of the SBD emergence in Europe based on a three-decadal timeseries data set. We also assess the suitability of aerobiological samples using a species-specific quantitative PCR assay to inform the epidemiology of C. corticale, through a regional study in France comparing twoyear aerobiological and epidemiological data, and a continental study including 12 air samplers from six countries (Czechia, France, Italy, Portugal, Sweden and Switzerland). We found that an accumulated water deficit in spring and summer lower than -132 mm correlates with SBD outbreaks. Our results suggest that C. corticale is an efficient airborne pathogen which can disperse its conidia as far as 310 km from the site of the closest disease outbreak. Aerobiology of C. corticale followed the SBD distribution in Europe. Pathogen detection was high in countries within the host native area and with longer disease presence, such as France, Switzerland and Czech Republic, and sporadic in Italy, where the pathogen was reported just once. The pathogen was absent in samples from Portugal and Sweden, where the disease has not been reported yet. We conclude that aerobiological surveillance can inform the spatial distribution of the SBD, and contribute to early detection in pathogen-free countries. [ABSTRACT FROM AUTHOR]

During the rapid rise in COVID-19 illnesses and deaths globally, and notwithstanding recommended precautions, questions are voiced about routes of transmission for this pandemic disease. Inhaling small airborne droplets is probable as a third route of infection, in addition to more widely recognized transmission via larger respiratory droplets and direct contact with infected people or contaminated surfaces. While uncertainties remain regarding the relative contributions of the different transmission pathways, we argue that existing evidence is sufficiently strong to warrant engineering controls targeting airborne transmission as part of an overall strategy to limit infection risk indoors. Appropriate building engineering controls include sufficient and effective ventilation, possibly enhanced by particle filtration and air disinfection, avoiding air recirculation and avoiding overcrowding. Often, such measures can be easily implemented and without much cost, but if only they are recognised as significant in contributing to infection control goals. We believe that the use of engineering controls in public buildings, including hospitals, shops, offices, schools, kindergartens, libraries, restaurants, cruise ships, elevators, conference rooms or public transport, in parallel with effective application of other controls (including isolation and quarantine, social distancing and hand hygiene), would be an additional important measure globally to reduce the likelihood of transmission and thereby protect healthcare workers, patients and the general public.

Over a 2-year period, drag swabs of orchard soil surface and air, soil, and almond leaf samples were collected in an almond orchard adjacent to (35 m from the first row of trees) and downwind from a poultry operation and in two almond orchards (controls) that were surrounded by other orchards. Samples were evaluated for aerobic plate count, generic Escherichia coli, other coliforms, the presence of Salmonella, bacterial community structure (analyzed through sequencing of the 16S rRNA gene), and amounts of dry solids (dust) on leaf surfaces on trees 0, 60, and 120 m into each orchard. E. coli was isolated from 41 of 206 (20%) and 1 of 207 (0.48%) air samples in the almond-poultry and control orchards, respectively. Salmonella was not isolated from any of the 529 samples evaluated. On average, the amount of dry solids on leaves collected from trees closest to the poultry operation was more than 2-fold greater than from trees 120 m into the orchard or from any of the trees in the control orchards. Members of the family Staphylococcaceae-often associated with poultry-were, on average, significantly (P

Exposure to outside air microorganisms especially fungi has been linked with illness such as allergic respiratory symptoms, rhinitis, asthma, and infection such as mycosis. Airborne fungal composition was sampled from five locations in Lagos State, Nigeria, between May 2014 and April 2016. Fungi spores were collected using the sedimentation plate method with the Petri dishes of dichloran-glycerol 18 (DG-18) and potato dextrose agar (PDA) media. Fungi sporulated faster on DG-18 agar plate as compared with PDA. The abundances of fungal spores collected monthly at the locations varied. The most abundant spores came from the fungi were Aspergillus niger (14.47%), Aspergillus sydowii (10.37%), and Aspergillus flavus (7.93%). Additional species were present in the collections including Ascomycetes: Penicillium funiculosum (5.49%), Neurospora crassa (5.32%), Penicillium oxalicum (4.71%), Penicillium pinophilum (2.88%), Fusarium verticillioides (3.05%), Penicillium simplicissimum (1.83%), Aphaderanum sp. (0.22%), Curvularia sp. (0.22%), Aspergillus oryzae (0.22%), and Paecilomyces sp. (0.61%) and the Mucoromycotina Zygomycetes: Rhizopus oryzae (4.10%) and Mucor sp. (3.44%). Fungal concentrations were significantly higher (P ≤ 0.05) during the rainy season compared with the dry season. Aspergillus and Penicillium were the most predominant airborne fungal genera while Mucor, Alternaria, and Cladosporium were some of the least observed. Generally, abundance of fungi was significantly high during the wet season in all the studied locations.

Previously, we demonstrated a strong correlation between the amplitude of human speech and the emission rate of micron-scale expiratory aerosol particles, which are believed to play a role in respiratory disease transmission. To further those findings, here we systematically investigate the effect of different 'phones' (the basic sound units of speech) on the emission of particles from the human respiratory tract during speech. We measured the respiratory particle emission rates of 56 healthy human volunteers voicing specific phones, both in isolation and in the context of a standard spoken text. We found that certain phones are associated with significantly higher particle production; for example, the vowel /i/ ("need," "sea") produces more particles than /ɑ/ ("saw," "hot") or /u/ ("blue," "mood"), while disyllabic words including voiced plosive consonants (e.g., /d/, /b/, /g/) yield more particles than words with voiceless fricatives (e.g., /s/, /h/, /f/). These trends for discrete phones and words were corroborated by the time-resolved particle emission rates as volunteers read aloud from a standard text passage that incorporates a broad range of the phones present in spoken English. Our measurements showed that particle emission rates were positively correlated with the vowel content of a phrase; conversely, particle emission decreased during phrases with a high fraction of voiceless fricatives. Our particle emission data is broadly consistent with prior measurements of the egressive airflow rate associated with the vocalization of various phones that differ in voicing and articulation. These results suggest that airborne transmission of respiratory pathogens via speech aerosol particles could be modulated by specific phonetic characteristics of the language spoken by a given human population, along with other, more frequently considered epidemiological variables.

The lettuce downy mildew pathogen, Bremia lactucae, is an obligate oomycete that causes extensive produce losses. Initial chlorotic symptoms that severely reduce the market value of the produce are followed by the appearance of white, downy sporulation on the abaxial side of the leaves. These spores become airborne and disseminate the pathogen. Controlling lettuce downy mildew has relied on repeated fungicide applications to prevent outbreaks. However, in addition to direct economic costs, heterogeneity and rapid adaptation of this pathogen to repeatedly applied fungicides has led to the development of fungicide-insensitivity in the pathogen. We deployed a quantitative PCR assay-based detection method using a species-specific DNA target for B. lactucae coupled with a spore trap system to measure airborne B. lactucae spore loads within three commercial fields that each contained experimental plots, designated EXP1 to EXP3. Based upon these measurements, when the spore load in the air reached a critical level (8.548 sporangia per m3 air), we advised whether or not to apply fungicides on a weekly basis within EXP1 to EXP3. This approach saved three sprays in EXP1, and one spray each in EXP2 and EXP3 without a significant increase in disease incidence. The reduction in fungicide applications to manage downy mildew can decrease lettuce production costs while slowing the development of fungicide resistance in B. lactucae by eliminating unnecessary fungicide applications.