Search

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.

Buildings represent habitats for microorganisms that can have direct or indirect effects on the quality of our living spaces, health, and well-being. Over the last ten years, new research has employed sophisticated tools, including DNA sequencing-based approaches, to study microbes found in buildings and the overall built environment. These investigations have catalyzed new insights into and questions about the microbes that surround us in our daily lives. The emergence of the “microbiology of the built environment” field has required bridging disciplines, including microbiology, ecology, building science, architecture, and engineering. Early insights have included a fuller characterization of sources of microbes within buildings, important processes that structure the distributions and abundances of microbes, and a greater appreciation of the role that occupants can have on indoor microbiology. This ongoing work has also demonstrated that traditional culture- and microscopy-based approaches for studying microbiology vastly underestimate the types and quantity of microbes present in environmental samples. We offer ten questions that highlight important lessons learned regarding the microbiology of buildings and suggest future areas of investigation.

Black carbon (BC) was characterized by three complementary techniques - incandescence (single particle soot photometer, SP2, at Parque Morelos), light absorption (cavity ringdown spectrometer with integrating nephelometer, CRDS-Neph, at Parque Morelos and Aethalometers at seven locations), and volatility (volatility tandem differential mobility analyzer, V-TDMA) during the Cal-Mex 2010 campaign. SP2, CRDS-Neph, and Aethalometer measurements characterized the BC mass, and SP2 and V-TDMA measurements also quantified BC-containing particle number, from which mass-mean BC diameters were calculated. Onaverage, the mass concentrations measured in Tijuana (1.8±2.6μgm-3 at Parque Morelos and 2.6μgm-3 in other regions of Tijuana) were higher than in San Diego or the international border crossing (0.5±0.6μgm-3). The observed BC mass concentrations were attributable to nighttime urban burning activities and diesel vehicles, both from the local (Baja California) and transported (Southern California) diesel vehicle fleets. Comparisons of the SP2 and co-located Aethalometers indicated that the two methods measured similar variations in BC mass concentrations (correlation coefficients greater than 0.85), and the mass concentrations were similar for the BC particles identified from nighttime urban burning sources. When the BC source changed to diesel vehicle emissions, the SP2 mass concentrations were lower than the Aethalometer mass concentrations by about 50%, likely indicating a change in the mass absorption efficiency and quantification by the Aethalometers. At Parque Morelos there were up to three different-sized modes of BC mass in particles: one mode below 100nm, one near 100nm, and another between 200 and 300nm. The mode between 200 and 300nm was associated with urban burning activities that influenced the site during evening hours. When backtrajectories indicated that airmasses came from the south to the Parque Morelos site, BC mass in particles was also larger (mass median diameter of 170nm rather than 155nm), consistent with the higher fraction of older diesel vehicles in the Tijuana fleet compared to the vehicles found in southern California. © 2013 Elsevier Ltd.

SARS-CoV-2 is predominantly transmitted through aerosols (ie, airborne transmission); however, the US Centers for Disease Control and Prevention continue to recommend the use of contact precautions (a gown and gloves) for the care of patients with COVID-19. Infection-prevention guidelines should reflect the current science and eliminate this wasteful practice., Competing Interests: Potential conflicts of interest . The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Sustained community spread of influenza viruses relies on efficient person-to-person transmission. Current experimental transmission systems do not mimic environmental conditions (e.g., air exchange rates, flow patterns), host behaviors, or exposure durations relevant to real-world settings. Therefore, results from these traditional systems may not be representative of influenza virus transmission in humans. To address this pitfall, we developed a close-range transmission setup that implements a play-based scenario and used it to investigate the impact of ventilation rates on transmission. In this setup, four immunologically naive recipient ferrets were exposed to a donor ferret infected with a genetically barcoded 2009 H1N1 virus (H1N1pdm09) for 4 h. The ferrets interacted in a shared space that included toys, similar to a childcare setting. Transmission efficiency was assessed under low and high ventilation, with air exchange rates of ~1.3 h -1 and 23 h -1 , respectively. Transmission efficiencies observed in three independent replicate studies were similar between ventilation conditions. The presence of infectious virus or viral RNA on surfaces and in air throughout the exposure area was also not impacted by the ventilation rate. While high viral genetic diversity in donor ferret nasal washes was maintained during infection, recipient ferret nasal washes displayed low diversity, revealing a narrow transmission bottleneck regardless of ventilation rate. Examining the frequency and duration of ferret physical touches revealed no link between these interactions and a successful transmission event. Our findings indicate that exposures characterized by frequent, close-range interactions and the presence of fomites can overcome the benefits of increased ventilation., Competing Interests: Competing interests statement:The authors declare no competing interest.

The inactivation of viruses in aerosol particles (aerosols) and droplets depends on many factors, but the precise mechanisms of inactivation are not known. The system involves complex physical and biochemical interactions. We reviewed the literature to establish current knowledge about these mechanisms and identify knowledge gaps. We identified 168 relevant papers and grouped results by the following factors: virus type and structure, aerosol or droplet size, temperature, relative humidity (RH) and evaporation, chemical composition of the aerosol or droplet, pH and atmospheric composition. These factors influence the dynamic microenvironment surrounding a virion and thus may affect its inactivation. Results indicate that viruses experience biphasic decay as the carrier aerosols or droplets undergo evaporation and equilibrate with the surrounding air, and their final physical state (liquid, semi-solid or solid) depends on RH. Virus stability, RH and temperature are interrelated, but the effects of RH are multifaceted and still not completely understood. Studies on the impact of pH and atmospheric composition on virus stability have raised new questions that require further exploration. The frequent practice of studying virus inactivation in large droplets and culture media may limit our understanding of inactivation mechanisms that are relevant for transmission, so we encourage the use of particles of physiologically relevant size and composition in future research.

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. https://doi.org/10.1289/EHP13878.

If some countries lead by example, standards may increasingly become normalized.

This study introduces a novel surface-enhanced Raman spectroscopy (SERS)-based lateral flow test (LFT) dipstick that integrates digital analysis for highly sensitive and rapid viral quantification. The SERS-LFT dipsticks, incorporating gold-silver core-shell nanoparticle probes, enable pixel-based digital analysis of large-area SERS scans. Such an approach enables ultralow-level detection of viruses that readily distinguishes positive signals from background noise at the pixel level. The developed digital SERS-LFTs demonstrate limits of detection (LODs) of 180 fg for SARS-CoV-2 spike protein, 120 fg for nucleocapsid protein, and 7 plaque forming units for intact virus, all within <30 min. Importantly, digital SERS-LFT methods maintain their robustness and their LODs in the presence of indoor dust, thus underscoring their potential for accurate and reliable virus diagnosis and quantification in real-world environmental settings.

Surveillance of airborne viruses in crowded indoor spaces is crucial for managing outbreaks, as highlighted by the SARS-CoV-2 pandemic. However, the rapid and on-site detection of fast-mutating viruses, such as SARS-CoV-2, in complex environmental backgrounds remains challenging. Our study introduces a machine learning (ML)-driven surface-enhanced Raman spectroscopy (SERS) approach for detecting viruses within environmental dust matrices. By decomposing intact virions into individual structural components via a Raman-background-free lysis protocol and concentrating them into nanogap SERS hotspots, we significantly enhance the SERS signal intensity and fingerprint information density from viral structural components. Utilizing Principal Component Analysis (PCA), we establish a robust connection between the SERS data of these structural components and their biological sequences, laying a solid foundation for virus detection through SERS. Furthermore, we demonstrate reliable quantitative detection of SARS-CoV-2 using identified SARS-CoV-2 peaks at concentrations down to 10 2  pfu/ml through Gaussian Process Regression (GPR) and a digital SERS methodology. Finally, applying a Principal Component Analysis-Linear Discriminant Analysis (PCA-LDA) algorithm, we identify SARS-CoV-2, influenza A virus, and Zika virus within an environmental dust background with over 86% accuracy. Therefore, our ML-driven SERS approach holds promise for rapid environmental virus monitoring to manage future outbreaks., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Expulsions of virus-laden aerosols or droplets from the oral and nasal cavities of an infected host are an important source of onward respiratory virus transmission. However, the presence of infectious influenza virus in the oral cavity during infection has not been widely considered, and thus, little work has explored the environmental persistence of influenza virus in oral cavity expulsions. Using the ferret model, we detected infectious virus in the nasal and oral cavities, suggesting that the virus can be expelled into the environment from both anatomical sites. We also assessed the stability of two influenza A viruses (H1N1 and H3N2) in droplets of human saliva or respiratory mucus over a range of relative humidities. We observed that influenza virus infectivity decays rapidly in saliva droplets at intermediate relative humidity, while viruses in airway surface liquid droplets retain infectivity. Virus inactivation was not associated with bulk protein content, salt content, or droplet drying time. Instead, we found that saliva droplets exhibited distinct inactivation kinetics during the wet and dry phases at intermediate relative humidity, and droplet residue morphology may lead to the elevated first-order inactivation rate observed during the dry phase. Additionally, distinct differences in crystalline structure and nanobead localization were observed between saliva and airway surface liquid droplets. Together, our work demonstrates that different respiratory fluids exhibit unique virus persistence profiles and suggests that influenza viruses expelled from the oral cavity may contribute to virus transmission in low- and high-humidity environments.IMPORTANCEDetermining how long viruses persist in the environment is important for mitigating transmission risk. Expelled infectious droplets and aerosols are composed of respiratory fluids, including saliva and complex mucus mixtures, but how well influenza viruses survive in such fluids is largely unknown. Here, we find that infectious influenza virus is present in the oral cavity of infected ferrets, suggesting that saliva-containing expulsions can play a role in onward transmission. Additionally, influenza virus in droplets composed of saliva degrades more rapidly than virus within respiratory mucus. Droplet composition impacts the crystalline structure and virus localization in dried droplets. These results suggest that viruses from distinct sites in the respiratory tract could have variable persistence in the environment, which will impact viral transmission fitness., Competing Interests: The authors declare no conflict of interest.

Cyanobacterial harmful algal blooms (cHABs) have the potential to adversely affect public health through the production of toxins such as microcystins, which consist of numerous molecularly distinct congeners. Microcystins have been observed in the atmosphere after emission from freshwater lakes, but little is known about the health effects of inhaling microcystins and the factors contributing to microcystin aerosolization. This study quantified total microcystin concentrations in water and aerosol samples collected around Grand Lake St. Marys (GLSM), Ohio. Microcystin concentrations in water samples collected on the same day ranged from 13 to 23 μg/L, dominated by the d-Asp 3 -MC-RR congener. In particulate matter <2.5 μm (PM 2.5 ), microcystin concentrations up to 156 pg/m 3 were detected; the microcystins were composed primarily of d-Asp 3 -MC-RR, with additional congeners (d-Asp 3 -MC-HtyR and d-Asp 3 -MC-LR) observed in a sample collected prior to a storm event. The PM size fraction containing the highest aerosolized MC concentration ranged from 0.44 to 2.5 μm. Analysis of total bacteria by qPCR targeting 16S rDNA revealed concentrations up to 9.4 × 10 4 gc/m 3 in aerosol samples (≤3 μm), while a marker specific to cyanobacteria was not detected in any aerosol samples. Concentrations of aerosolized microcystins varied even when concentrations in water were relatively constant, demonstrating the importance of meteorological conditions (wind speed and direction) and aerosol generation mechanism(s) (wave breaking, spillway, and aeration systems) when evaluating inhalation exposure to microcystins and subsequent impacts on human health.

Respiratory viruses can be transmitted by multiple modes, including contaminated surfaces, commonly referred to as fomites. Efficient fomite transmission requires that a virus remain infectious on a given surface material over a wide range of environmental conditions, including different relative humidities. Prior work examining the stability of influenza viruses on surfaces has relied upon virus grown in media or eggs, which does not mimic the composition of virus-containing droplets expelled from the human respiratory tract. In this study, we examined the stability of the 2009 pandemic H1N1 (H1N1pdm09) virus on a variety of nonporous surface materials at four different humidities. Importantly, we used virus grown in primary human bronchial epithelial cell (HBE) cultures from different donors to recapitulate the physiological microenvironment of expelled viruses. We observed rapid inactivation of H1N1pdm09 on copper under all experimental conditions. In contrast to copper, viruses were stable on polystyrene plastic, stainless steel, aluminum, and glass, at multiple relative humidities, but greater decay on acrylonitrile butadiene styrene (ABS) plastic was observed at short time points. However, the half-lives of viruses at 23% relative humidity were similar among noncopper surfaces and ranged from 4.5 to 5.9 h. Assessment of H1N1pdm09 longevity on nonporous surfaces revealed that virus persistence was governed more by differences among HBE culture donors than by surface material. Our findings highlight the potential role of an individual's respiratory fluid on viral persistence and could help explain heterogeneity in transmission dynamics. IMPORTANCE Seasonal epidemics and sporadic pandemics of influenza cause a large public health burden. Although influenza viruses disseminate through the environment in respiratory secretions expelled from infected individuals, they can also be transmitted by contaminated surfaces where virus-laden expulsions can be deposited. Understanding virus stability on surfaces within the indoor environment is critical to assessing influenza transmission risk. We found that influenza virus stability is affected by the host respiratory secretion in which the virus is expelled, the surface material on which the droplet lands, and the ambient relative humidity of the environment. Influenza viruses can remain infectious on many common surfaces for prolonged periods, with half-lives of 4.5 to 5.9 h. These data imply that influenza viruses are persistent in indoor environments in biologically relevant matrices. Decontamination and engineering controls should be used to mitigate influenza virus transmission., Competing Interests: The authors declare a conflict of interest. This work was funded by the National Institutes of Health (NIH) CEIRS (HHSN272201400007C) and New Innovator Award to L.C.M. (1-DP2-A1112243), the American Lung Association Biomedical Research Grant (RG-575688), the Tsinghua Education Foundation of North America, and the China Scholarship Council (CSC). Work by D.H.M. and J.O.L.-S. was supported by the UCLA AIDS Institute and Charity Treks, and National Science Foundation (NSF) Grants DEB-1557022 and DEB-2245631.

The potential for masks to act as fomites in the transmission of SARS-CoV-2 has been suggested but not demonstrated experimentally or observationally. In this study, we aerosolized a suspension of SARS-CoV-2 in saliva and used a vacuum pump to pull the aerosol through six different types of masks. After 1 h at 28 °C and 80% RH, SARS-CoV-2 infectivity was not detectable on an N95 and surgical mask, was reduced by 0.7 log 10 on a nylon/spandex mask, and was unchanged on a polyester mask and two different cotton masks when recovered by elution in a buffer. SARS-CoV-2 RNA remained stable for 1 h on all masks. We pressed artificial skin against the contaminated masks and detected the transfer of viral RNA but no infectious virus to the skin. The potential for masks contaminated with SARS-CoV-2 in aerosols to act as fomites appears to be less than indicated by studies involving SARS-CoV-2 in very large droplets.

Growing concerns about environmental conditions, public health, and disease diagnostics have led to the rapid development of portable sampling techniques to characterize trace-level volatile organic compounds (VOCs) from various sources. A MEMS-based micropreconcentrator (μPC) is one such approach that drastically reduces the size, weight, and power constraints offering greater sampling flexibility in many applications. However, the adoption of μPCs on a commercial scale is hindered by a lack of thermal desorption units (TDUs) that easily integrate μPCs with gas chromatography (GC) systems equipped with a flame ionization detector (FID) or a mass spectrometer (MS). Here, we report a highly versatile μPC-based, single-stage autosampler-injection unit for traditional, portable, and micro-GCs. The system uses μPCs packaged in 3D-printed swappable cartridges and is based on a highly modular interfacing architecture that allows easy-to-remove, gas-tight fluidic, and detachable electrical connections (FEMI). This study describes the FEMI architecture and demonstrates the FEMI-Autosampler (FEMI-AS) prototype (9.5 cm × 10 cm x 20 cm, ≈500 gms). The system was integrated with GC-FID, and the performance was investigated using synthetic gas samples and ambient air. The results were contrasted with the sorbent tube sampling technique using TD-GC-MS. FEMI-AS could generate sharp injection plugs (≈240 ms) and detect analytes with concentrations <15 ppb within 20 s and <100 ppt within 20 min of sampling time. With more than 30 detected trace-level compounds from ambient air, the demonstrated FEMI-AS, and the FEMI architecture significantly accelerate the adoption of μPCs on a broader scale., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

This is an account that should be heard of an important struggle: the struggle of a large group of experts who came together at the beginning of the COVID-19 pandemic to warn the world about the risk of airborne transmission and the consequences of ignoring it. We alerted the World Health Organization about the potential significance of the airborne transmission of SARS-CoV-2 and the urgent need to control it, but our concerns were dismissed. Here we describe how this happened and the consequences. We hope that by reporting this story we can raise awareness of the importance of interdisciplinary collaboration and the need to be open to new evidence, and to prevent it from happening again. Acknowledgement of an issue, and the emergence of new evidence related to it, is the first necessary step towards finding effective mitigation solutions., Competing Interests: Potential conflicts of interest. J. H. reports an unpaid position as secretary/treasurer of BOD of IEQ-GA. F. F. reports an SBIR grant from Franchimon ICM, informal shares and co-founder stock from BlueCanary and iventionair, consulting fees for professional papers and reports from Franchimon ICM, payment for lectures from TVVL (Member Association for HVAC), and payment for webinars from the Dutch Green Building Council. A. B. reports a position at Delft University of Technology and consultancy with a company specialized in indoor environmental quality. J. L. J. reports grants or contracts from NASA, US National Science Fund, and Balvi Filantropic Fund; payment for lectures at Peking University; and unpaid roles on the committee for Testing of Air Cleaning Devices of ASTM and Aireamos volunteer group on ventilation solutions for the Spanish-speaking world. Y. L. reports a collaborative research grant and 3 general research grants from the Hong Kong Research Grants Council (RGC), a grant from the Health and Medical Research Fund (HMRF), and grants or contracts from P&G Singapore. Marcel G.L.C. Loomans reports grants or contracts from TVVL, RVO government program TNO for P3Venti project, a grant from TKI NL Health Holland for the CLAIRE project, and a grant from NOW for the MIST project (all paid to the author's institution); M. G. L. C. L. also serves as an ISIAQ.nl board member, and is a member of Impulgroep TVVL (Dutch Association of Building Services Engineers), Kennisgroep VCCN (Dutch Association on Contaminant Control), and WHO, for which they sit on the Environment and Engineering Control Expert Advisory Panel (ECAP) for COVID-19. L. C. M. reports a contract with the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH) Department of Health and Human Services (HHSN272201400007C); grants or contracts from the Flu Lab and Wellcome Leap (all paid to the author's institution); consulting fees paid to the author from MITRE Corporation, Freedman Consulting, and The New York Times; payment or honoraria paid to the author from the University of Toronto, University of Hong Kong, Queensland University of Technology, and Virginia Tech Carilion School of Medicine; support for meetings and/or travel from MITRE Corporation and the International Society for Influenza and Other Respiratory Viruses. G. M. reports their role as president of the International Union Against TB & Lung Disease. D. K. M. reports the following grants or contracts—US NIAID U19 AI 162130, for Evaluating Modes of Influenza Transmission (EMIT-2) using Innovative Technologies and Designs in Controlled Environments; US NIAID contract number 75N93021C00014, for the Centers of Excellence for Influenza Research and Response, for Wearable Micro Air Cleaner for Protection of Workers’ Health during Prolonged Use (US NSF Project 75D30121C10610); US NIAID AI148689, A Phase 3, Randomized, Stratified, Observer-Blind, Placebo-Controlled Study to Evaluate the Efficacy, Safety, and Immunogenicity of mRNA-1273 SARS-CoV-2 Vaccine in Adults Aged 18 Years and Older; US NIAID F3038571, Implementing Vaccine and Treatment Evaluation Unit (VTEU) clinical site protocols (CoVPN 3004 Novavax Supplement); US NIAID R21 AI161501, Elucidating Airborne SARS-CoV-2 Infectivity at Single Aerosol Resolution; US National Institute of Environmental Health Sciences (NIEHS) R01 ES034303, Research Employing Environmental Systems and Occupational Health Policy Analyses to Interrupt the Impact of Structural Racism on Agricultural Workers and Their Respiratory Health (RESPIRAR); Bill & Melinda Gates Foundation INVO022295, COVID-19: Quantifying viral RNA in exhaled breath; US NIAID 025806864609, COVID-19 Surveillance and Exhaled Breath Aerosol Assessment Study; US National Science Foundation (NSF) CMMI2034755, EAGER: Protecting University Communities from COVID-19 with Model-Based Risk Management; US NSF 2030502, COVID: Collaborative Research: RAPID: Understanding and Facilitating Remote Triage and Rehabilitation During Pandemics via Visual Based Patient Physiology Sensing, WMATA Bus Air Cleaning Effectiveness with Novel Air Cleaning Systems, College Band Directors National Association Aerosol Generation from Playing Band Instruments and Risk of Infectious Disease Transmission; US Centers for Disease Control and Prevention (CDC) COVID-19: Real-World Tests of Face Coverings as Source Control for COVID-19 and US DARPA, BARDA Contagious Phenotypes of Acute Respiratory Infection: Identification, Characterization, and Biomarkers. D. K. M. also reports payment or honoraria for the American Conference of Governmental Hygienists from the American Dental Association, support for meetings and/or travel from the Flu Lab, and receipt of UVC fixtures from Aeromed, Inc, and FarUV, Inc. C. N. reports the following grants or contracts paid to their institution: Class-ACT (Co-Investigator [CoI]), 2021–22, DHSC-funded project on air cleaning interventions in schools; Far UV projects (CoI), 2021 DHSC funding, 2022 NHS Scotland Assure funding collaboration led by St Andrews with Leeds, Dundee, Ninewells Hospital, Colombia University; PROTECT National Core Study on Transmission (CoI, theme lead), 2020–2023, £21 M program led by HSE; CONTACT (CoI), 2020–2023, NIHR, £1.6 M, Breathing City: Future Urban Ventilation Network (Principal Investigator [PI]), 2020–2023, UKRI SPF Clean Air Programme Network, £500 K; TRACK: Transport Risk Assessment for COVID Knowledge (PI), 2020–2023; EPSRC, £3.4. Multi-partner project with Universities of Manchester, Cambridge, Newcastle, Imperial, UKHSA, Dstl, Department for Transport and multiple transport stakeholders, CECAM, Engineering and Physical Sciences Research Council (EPSRC) £950 K funding to support a new bioaerosol chamber (2021–2025); Centre for Doctoral Training in Fluid Dynamics (Co-Director, PI Prof P. Jimack), 2019–2027, EPSRC, £4.2 M; Cross-faculty programme to train 50 PhD students over 8 years; and EPSRC National Fellowships in Fluid Dynamics coordination hub (CoI), 2022–2025. C. N. also reports honoraria for Royal Institution Christmas Lecture; payment from BBC Life Scientific; accommodation and registration fees for Indoor Air June 2022, Kuopio, Finland, and BOHS annual conference, June 2022, Belfast; travel expenses for the International Symposium on Stratified Fluid, August 2022; travel and registration fees for IHEEM annual conference (October 2022). C. N. served as co-chair for SAGE Environment and Modelling Group (April 2020–May 2022) and participated in multiple UK government advisory groups during COVID, serves as Chair for HSE Science Quality Assurance Group, is a member of the UKRI SPF clean air programme steering board, a member of the WHO Environment and Engineering Control Expert Advisory Panel (ECAP) on ventilation and WHO European High Level Expert Group on COVID-19 leading the ventilation subgroup, and as a Member of the Royal Academy of Engineering COVID-19 Working Group on Infection Resilient Buildings and co-author of reports in July 2021 and May/June 2022. C. N. also received 3 Aranet CO2 sensors from Naltic Industrials. S. M. reports a leadership role as the Vice President for the Academy of Fellows, International Society for Indoor Air Quality and Climate, and on the Aerosol Science and Technology Journal advisory board (both of which are unpaid positions). W. B. reports an unpaid role as chair of the ASHRAE Epidemic Task Force. P. M. B. serves in a leadership or fiduciary role on the KNAW Commission and the Pandemic Disaster Preparedness Centre (both unpaid positions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)

Purpose of Review: The coronavirus disease 2019 pandemic has had a wide-ranging and profound impact on how we think about the transmission of respiratory viruses This review outlines the basis on which we should consider all respiratory viruses as aerosol-transmissible infections, in order to improve our control of these pathogens in both healthcare and community settings., Recent Findings: We present recent studies to support the aerosol transmission of severe acute respiratory syndrome coronavirus 2, and some older studies to demonstrate the aerosol transmissibility of other, more familiar seasonal respiratory viruses., Summary: Current knowledge on how these respiratory viruses are transmitted, and the way we control their spread, is changing. We need to embrace these changes to improve the care of patients in hospitals and care homes including others who are vulnerable to severe disease in community settings., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Efficient spread of respiratory viruses requires the virus to maintain infectivity in the environment. Environmental stability of viruses can be influenced by many factors, including temperature and humidity. Our study measured the impact of initial droplet volume (50, 5, and 1 μL) and relative humidity (RH; 40%, 65%, and 85%) on the stability of influenza A virus, bacteriophage Phi6 (a common surrogate for enveloped viruses), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) under a limited set of conditions. Our data suggest that the drying time required for the droplets to reach quasi-equilibrium (i.e., a plateau in mass) varied with RH and initial droplet volume. The macroscale physical characteristics of the droplets at quasi-equilibrium varied with RH but not with the initial droplet volume. Virus decay rates differed between the wet phase, while the droplets were still evaporating, and the dry phase. For Phi6, decay was faster in the wet phase than in the dry phase under most conditions. For H1N1pdm09, decay rates between the two phases were distinct and initial droplet volume had an effect on virus viability within 2 h. Importantly, we observed differences in virus decay characteristics by droplet size and virus. In general, influenza virus and SARS-CoV-2 decayed similarly, whereas Phi6 decayed more rapidly under certain conditions. Overall, this study suggests that virus decay in media is related to the extent of droplet evaporation, which is controlled by RH. Importantly, accurate assessment of transmission risk requires the use of physiologically relevant droplet volumes and careful consideration of the use of surrogates. IMPORTANCE During the COVID-19 pandemic, policy decisions were being driven by virus stability experiments with SARS-CoV-2 in different droplet volumes under various humidity conditions. Our study, the first of its kind, provides a model for the decay of multiple enveloped RNA viruses in cell culture medium deposited in 50-, 5-, and 1-μL droplets at 40%, 65%, and 85% RH over time. The results of our study indicate that determination of half-lives for emerging pathogens in large droplets may overestimate transmission risk for contaminated surfaces, as observed during the COVID-19 pandemic. Our study implicates the need for the use of physiologically relevant droplet sizes with use of relevant surrogates in addition to what is already known about the importance of physiologically relevant media for risk assessment of future emerging pathogens.

Nontuberculous mycobacteria (NTM) are frequently present in municipal drinking water and building plumbing, and some are believed to cause respiratory tract infections through inhalation of NTM-containing aerosols generated during showering. However, the present understanding of NTM transfer from water to air is insufficient to develop NTM risk mitigation strategies. This study aimed to characterize the contribution of shower water to the abundance of viable NTM in indoor air. Shower water and indoor air samples were collected, and 16S rRNA and rpoB genes were sequenced. The sequencing results showed that running the shower impacted the bacterial community structure and NTM species composition in indoor air by transferring certain bacteria from water to air. A mass balance model combined with NTM quantification results revealed that on average 1/132 and 1/254 of NTM cells in water were transferred to air during 1 hour of showering using a rain and massage showerhead, respectively. A large fraction of the bacteria transferred from water to air were membrane-damaged, i.e. they had compromised membranes based on analysis by live/dead staining and flow cytometry. However, the damaged NTM in air were recoverable as shown by growth in a culture medium mimicking the respiratory secretions of people with cystic fibrosis, implying a potential infection risk by NTM introduced to indoor air during shower running. Among the recovered NTM, Mycobacterium mucogenicum was the dominant species as determined by rpoB gene sequencing. Overall, this study lays the groundwork for future pathogen risk management and public health protection in the built environment., (© The Author(s) 2022. Published by Oxford University Press on behalf of National Academy of Sciences.)

A considerable body of research exists outlining ecological impacts of surface coal mining, but less work has explicitly focused on human health, and few studies have examined potential links between health and surface coal mining at fine spatial scales. In particular, relationships between individual birth outcomes and exposure to air contaminants from coal mining activities has received little attention. Central Appalachia (portions of Virginia, West Virginia, Kentucky, and Tennessee, USA), our study area, has a history of resource extraction, and epidemiologic research notes that the region experiences a greater level of adverse health outcomes compared to the rest of the country that are not fully explained by socioeconomic and behavioral factors. The purpose of this study is to examine associations between surface mining and birth outcomes at four spatial scales: individual, Census tract, county, and across county-sized grid cells. Notably, this study is among the first to examine these associations at the individual scale, providing a more direct measure of exposure and outcome. Airsheds were constructed for surface mines using an atmospheric trajectory model. We then implemented linear (birthweight) and logistic (preterm birth [PTB]) regression models to examine associations between airsheds and birth outcomes, which were geocoded to home address for individual analyses and then aggregated for areal unit analyses, while controlling for a number of demographic variables. This study found that surface mining airsheds are significantly associated with PTB and decreased birthweight at all four spatial scales, suggesting that surface coal mining activities impact birth outcomes via airborne contaminants., Competing Interests: The authors declare no conflicts of interest relevant to this study., (© 2022 The Authors. GeoHealth published by Wiley Periodicals LLC on behalf of American Geophysical Union.)

The question of whether SARS-CoV-2 is mainly transmitted by droplets or aerosols has been highly controversial. We sought to explain this controversy through a historical analysis of transmission research in other diseases. For most of human history, the dominant paradigm was that many diseases were carried by the air, often over long distances and in a phantasmagorical way. This miasmatic paradigm was challenged in the mid to late 19th century with the rise of germ theory, and as diseases such as cholera, puerperal fever, and malaria were found to actually transmit in other ways. Motivated by his views on the importance of contact/droplet infection, and the resistance he encountered from the remaining influence of miasma theory, prominent public health official Charles Chapin in 1910 helped initiate a successful paradigm shift, deeming airborne transmission most unlikely. This new paradigm became dominant. However, the lack of understanding of aerosols led to systematic errors in the interpretation of research evidence on transmission pathways. For the next five decades, airborne transmission was considered of negligible or minor importance for all major respiratory diseases, until a demonstration of airborne transmission of tuberculosis (which had been mistakenly thought to be transmitted by droplets) in 1962. The contact/droplet paradigm remained dominant, and only a few diseases were widely accepted as airborne before COVID-19: those that were clearly transmitted to people not in the same room. The acceleration of interdisciplinary research inspired by the COVID-19 pandemic has shown that airborne transmission is a major mode of transmission for this disease, and is likely to be significant for many respiratory infectious diseases., (© 2022 The Authors. Indoor Air published by John Wiley & Sons Ltd.)

Technological advances in a variety of scientific disciplines are being applied in the life sciences leading to an increase in the number scientists who see themselves or are classed as being multidisciplinary. Although their diverse skills are celebrated and needed to understand the immense complexity of life, being a multidisciplinary researcher can pose unique challenges. We asked multidisciplinary researchers and the director of an institute that fosters multidisciplinary research for their thoughts on what they see as the challenges or obstacles that multidisciplinary scientists can often face., (Copyright © 2022 Elsevier Inc. All rights reserved.)

We conducted a critical review to establish what is known about the sources, characteristics, and dissemination of ARGs in the atmosphere. We identified 52 papers that reported direct measurements of bacterial ARGs in air samples and met other inclusion criteria. The settings of the studies fell into the following categories: urban, rural, hospital, industrial, wastewater treatment plants (WWTPs), composting and landfill sites, and indoor environments. Certain genes were commonly studied and generally abundant: sul1 , intI1 , β-lactam ARGs, and tetracycline ARGs. Abundances of total ARGs varied by season and setting, with air in urban areas having higher ARG abundance than rural areas during the summer and vice versa during the winter. There was greater consistency in the types and abundances of ARGs throughout the seasons in urban areas. Human activity within indoor environments was also linked to increased ARG content (abundance, diversity, and concentration) in the air. Several studies found that human exposure to ARGs through inhalation was comparable to exposure through drinking water or ingesting soil. Detection of ARGs in air is a developing field, and differences in sampling and analysis methods reflect the many possible approaches to studying ARGs in air and make direct comparisons between studies difficult. Methodologies need to be standardized to facilitate identification of the dominant ARGs in the air, determine their major sources, and quantify the role of atmospheric transport in dissemination of ARGs in the environment. With such knowledge we can develop better policies and guidelines to limit the spread of antimicrobial resistance.

Responses to the early (February-July 2020) COVID-19 pandemic varied widely, globally. Reasons for this are multiple but likely relate to the healthcare and financial resources then available, and the degree of trust in, and economic support provided by, national governments. Cultural factors also affected how different populations reacted to the various pandemic restrictions, like masking, social distancing and self-isolation or self-quarantine. The degree of compliance with these measures depended on how much individuals valued their needs and liberties over those of their society. Thus, several themes may be relevant when comparing pandemic responses across different regions. East and Southeast Asian populations tended to be more collectivist and self-sacrificing, responding quickly to early signs of the pandemic and readily complied with most restrictions to control its spread. Australasian, Eastern European, Scandinavian, some Middle Eastern, African and South American countries also responded promptly by imposing restrictions of varying severity, due to concerns for their wider society, including for some, the fragility of their healthcare systems. Western European and North American countries, with well-resourced healthcare systems, initially reacted more slowly, partly in an effort to maintain their economies but also to delay imposing pandemic restrictions that limited the personal freedoms of their citizens., (© 2022 The Authors.)

The phase state of respiratory aerosols and droplets has been linked to the humidity-dependent survival of pathogens such as SARS-CoV-2. To inform strategies to mitigate the spread of infectious disease, it is thus necessary to understand the humidity-dependent phase changes associated with the particles in which pathogens are suspended. Here, we study phase changes of levitated aerosols and droplets composed of model respiratory compounds (salt and protein) and growth media (organic-inorganic mixtures commonly used in studies of pathogen survival) with decreasing relative humidity (RH). Efflorescence was suppressed in many particle compositions and thus unlikely to fully account for the humidity-dependent survival of viruses. Rather, we identify organic-based, semisolid phase states that form under equilibrium conditions at intermediate RH (45 to 80%). A higher-protein content causes particles to exist in a semisolid state under a wider range of RH conditions. Diffusion and, thus, disinfection kinetics are expected to be inhibited in these semisolid states. These observations suggest that organic-based, semisolid states are an important consideration to account for the recovery of virus viability at low RH observed in previous studies. We propose a mechanism in which the semisolid phase shields pathogens from inactivation by hindering the diffusion of solutes. This suggests that the exogenous lifetime of pathogens will depend, in part, on the organic composition of the carrier respiratory particle and thus its origin in the respiratory tract. Furthermore, this work highlights the importance of accounting for spatial heterogeneities and time-dependent changes in the properties of aerosols and droplets undergoing evaporation in studies of pathogen viability., Competing Interests: The authors declare no competing interest., (Copyright © 2022 the Author(s). Published by PNAS.)

Some infectious diseases, including COVID-19, can undergo airborne transmission. This may happen at close proximity, but as time indoors increases, infections can occur in shared room air despite distancing. We propose two indicators of infection risk for this situation, that is, relative risk parameter ( H r ) and risk parameter ( H ). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and aerosol-removal rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend that is consistent with airborne infection and enable recommendations to minimize transmission risk. Transmission in typical prepandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, influenza, and tuberculosis were also assessed. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at higher risk parameter values. Because both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on masking, ventilation and aerosol-removal rates, number of occupants, and duration of exposure, to investigate airborne transmission.

We examine airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) potential using a source-to-dose framework beginning with generation of virus-containing droplets and aerosols and ending with virus deposition in the respiratory tract of susceptible individuals. By addressing 4 critical questions, we identify both gaps in addressing 4 critical questions with answers having policy implications., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Current infection-control guidelines subscribe to a contact/droplet/airborne paradigm that is based on outdated understanding. Here, we propose to modify and align existing guidelines with a more accurate description of the different transmission routes. This will improve the effectiveness of control measures as more transmissible variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerge., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)

Competing Interests: The authors declare no competing interest.

The incidence of several respiratory viral infections has been shown to be related to climate. Because humans spend most of their time indoors, measures of indoor climate, rather than outdoor climate, may be better predictors of disease incidence and transmission. Therefore, understanding the relationship between indoor and outdoor climate will help illuminate their influence on the seasonality of diseases caused by respiratory viruses. Indoor-outdoor relationships between temperature and humidity have been documented in temperate regions, but little information is available for tropical regions, where seasonal patterns of respiratory viral diseases differ. We have examined indoor-outdoor correlations of temperature, relative humidity (RH), and absolute humidity (AH) over a 1-year period in each of seven tropical cities. Across all cities, the average monthly indoor temperature was 25 ± 3°C (mean ± standard deviation) with a range of 20-30°C. The average monthly indoor RH was 66 ± 9% with a range of 50-78%, and the average monthly indoor AH was 15 ± 3 g/m 3 with a range of 10-23 g/m 3 . Indoor AH and RH were linearly correlated with outdoor AH when the air conditioning (AC) was off, suggesting that outdoor AH may be a good proxy of indoor humidity in the absence of AC. All indoor measurements were more strongly correlated with outdoor measurements as distance from the equator increased. Such correlations were weaker during the wet season, especially when AC was in operation. These correlations will provide insight for assessing the seasonality of respiratory viral infections using outdoor climate data, which is more widely available than indoor data, even though transmission of these diseases mainly occurs indoors., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Respiratory viruses such as SARS-CoV-2 are transmitted in respiratory droplets and aerosol particles, which are released during talking, breathing, coughing, and sneezing. Noncontact transmission of SARS-CoV-2 has been demonstrated, suggesting transmission via virus carried through the air. Here, we demonstrate that golden Syrian hamsters produce infectious SARS-CoV-2 in aerosol particles prior to and concurrent with the onset of mild clinical signs of disease. The average emission rate in this study was 25 infectious virions/hour on days 1 and 2 postinoculation, with average viral RNA levels 200-fold higher than infectious virus in aerosol particles. The majority of virus was contained within particles <5 μm in size. Thus, we provide direct evidence that, in hamsters, SARS-CoV-2 is an airborne virus. IMPORTANCE SARS-CoV-2 is a respiratory virus and has been isolated from the air near COVID-19 patients. Here, using a hamster model of infection, we demonstrate that SARS-CoV-2 is emitted in aerosol particles prior to and concurrent with the onset of mild disease. Virus is contained primarily within aerosol particles <5 μm in size, which can remain airborne and be inhaled. These findings indicate that SARS-CoV-2 is an airborne virus and support the use of ventilation to reduce SARS-CoV-2 transmission.

The COVID-19 pandemic has exposed major gaps in our understanding of the transmission of viruses through the air. These gaps slowed recognition of airborne transmission of the disease, contributed to muddled public health policies and impeded clear messaging on how best to slow transmission of COVID-19. In particular, current recommendations have been based on four tenets: (i) respiratory disease transmission routes can be viewed mostly in a binary manner of 'droplets' versus 'aerosols'; (ii) this dichotomy depends on droplet size alone; (iii) the cut-off size between these routes of transmission is 5 µm; and (iv) there is a dichotomy in the distance at which transmission by each route is relevant. Yet, a relationship between these assertions is not supported by current scientific knowledge. Here, we revisit the historical foundation of these notions, and how they became entangled from the 1800s to today, with a complex interplay among various fields of science and medicine. This journey into the past highlights potential solutions for better collaboration and integration of scientific results into practice for building a more resilient society with more sound, far-sighted and effective public health policies., (© 2021 The Authors.)

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., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Possible links between the transmission of COVID-19 and meteorology have been investigated by comparing positive cases across geographical regions or seasons. Little is known, however, about the degree to which environmental conditions modulate the daily dynamics of COVID-19 spread at a given location. One reason for this is that individual waves of the disease typically rise and decay too sharply, making it hard to isolate the contribution of meteorological cycles. To overcome this shortage, we here present a case study of the first wave of the outbreak in the city of Buenos Aires, which had a slow evolution of the caseload extending along most of 2020. We found that humidity plays a prominent role in modulating the variation of COVID-19 positive cases through a negative-slope linear relationship, with an optimal lag of 9 days between the meteorological observation and the positive case report. This relationship is specific to winter months, when relative humidity predicts up to half of the variance in positive case count. Our results provide a tool to anticipate possible local surges in COVID-19 cases after events of low humidity. More generally, they add to accumulating evidence pointing to dry air as a facilitator of COVID-19 transmission.

Ambient temperature and humidity strongly affect inactivation rates of enveloped viruses, but a mechanistic, quantitative theory of these effects has been elusive. We measure the stability of SARS-CoV-2 on an inert surface at nine temperature and humidity conditions and develop a mechanistic model to explain and predict how temperature and humidity alter virus inactivation. We find SARS-CoV-2 survives longest at low temperatures and extreme relative humidities (RH); median estimated virus half-life is >24 hr at 10°C and 40% RH, but ∼1.5 hr at 27°C and 65% RH. Our mechanistic model uses fundamental chemistry to explain why inactivation rate increases with increased temperature and shows a U-shaped dependence on RH. The model accurately predicts existing measurements of five different human coronaviruses, suggesting that shared mechanisms may affect stability for many viruses. The results indicate scenarios of high transmission risk, point to mitigation strategies, and advance the mechanistic study of virus transmission., Competing Interests: DM, KY, AG, FR, QH, TB, RF, MM, NV, PV, LM, VM, JL No competing interests declared

The COVID-19 pandemic has disrupted the supply chain for personal protective equipment (PPE) for medical professionals, including N95-type respiratory protective masks. To address this shortage, many have looked to the agility and accessibility of additive manufacturing (AM) systems to provide a democratized, decentralized solution to producing respirators with equivalent protection for last-resort measures. However, there are concerns about the viability and safety in deploying this localized download, print, and wear strategy due to a lack of commensurate quality assurance processes. Many open-source respirator designs for AM indicate that they do not provide N95-equivalent protection (filtering 95% of SARS-CoV-2 particles) because they have either not passed aerosol generation tests or not been tested. Few studies have quantified particle transmission through respirator designs outside of the filter medium. This is concerning because several polymer-based AM processes produce porous parts, and inherent process variation between printers and materials also threaten the integrity of tolerances and seals within the printed respirator assembly. No study has isolated these failure mechanisms specifically for respirators. The goal of this paper is to measure particle transmission through printed respirators of different designs, materials, and AM processes. The authors compare the performance of printed respirators to N95 respirators and cloth masks. Respirators in this study printed using desktop- and industrial-scale fused filament fabrication processes and industrial-scale powder bed fusion processes were not sufficiently reliable for widespread distribution and local production of N95-type respiratory protection. Even while assuming a perfect seal between the respirator and the user's face, although a few respirators provided >90% efficiency at the 100-300 nm particle range, almost all printed respirators provided <60% filtration efficiency. Post-processing procedures including cleaning, sealing surfaces, and reinforcing the filter cap seal generally improved performance, but the printed respirators showed similar performance to various cloth masks. The authors further explore the process-driven aspects leading to low filtration efficiency. Although the design/printer/material combination dictates the AM respirator performance, the identified failure modes originate from system-level constraints and are therefore generalizable across multiple AM processes. Quantifying the limitations of AM in producing N95-type respiratory protective masks advances understanding of AM systems toward the development of better part and machine designs to meet the needs of reliable, functional, end-use parts., Competing Interests: The authors report no declarations of interest., (© 2021 The Society of Manufacturing Engineers. Published by Elsevier Ltd. All rights reserved.)

Increases in the salt concentration of freshwater result in detrimental impacts on water quality and ecosystem biodiversity. Biodiversity effects include freshwater microbiota, as increasing salinity can induce shifts in the structure of native freshwater bacterial communities, which could disturb their role in mediating basal ecosystem services. Moreover, salinity affects the wave breaking and bubble-bursting mechanisms via which water-to-air dispersal of bacteria occurs. Given this dual effect of freshwater salinity on waterborne bacterial communities and their aerosolization mechanism, further effects on aerosolized bacterial diversity and abundance are anticipated. Cumulative salt additions in the freshwater-euhaline continuum (0-35 g/kg) were administered to a freshwater sample aerosolized inside a breaking wave analogue tank. Waterborne and corresponding airborne bacteria were sampled at each salinity treatment and later analyzed for diversity and abundance. Results demonstrated that the airborne bacterial community was significantly different (PERMANOVA; F 1,22 = 155.1, r 2 = 0.38, p < 0.001) from the waterborne community. The relative aerosolization factor ( r -AF), defined as the air-to-water relative abundance ratio, revealed that different bacterial families exhibited either an enhanced ( r -AF ≫ 1), neutral ( r -AF ∼ 1), or diminished ( r -AF ≪ 1) transfer to the aerosol phase throughout the salinization gradient. Going from freshwater to euhaline conditions, aerosolized bacterial abundance exhibited a nonmonotonic response with a maximum peak at lower oligohaline conditions (0.5-1 g/kg), a decline at higher oligohaline conditions (5 g/kg), and a moderate increase at polyhaline-euhaline conditions (15-35 g/kg). Our results demonstrate that increases in freshwater salinity are likely to influence the abundance and diversity of aerosolized bacteria. These shifts in aerosolized bacterial communities might have broader implications on public health by increasing exposure to airborne pathogens via inhalation. Impacts on regional climate, related to changes in biological ice-nucleating particles (INPs) emission from freshwater, are also expected.

The emergence of next generation sequencing (NGS) is revolutionizing the potential to address complex microbiological challenges in the water industry. NGS technologies can provide holistic insight into microbial communities and their functional capacities in water and wastewater systems, thus eliminating the need to develop a new assay for each target organism or gene. However, several barriers have hampered wide-scale adoption of NGS by the water industry, including cost, need for specialized expertise and equipment, challenges with data analysis and interpretation, lack of standardized methods, and the rapid pace of development of new technologies. In this critical review, we provide an overview of the current state of the science of NGS technologies as they apply to water, wastewater, and recycled water. In addition, a systematic literature review was conducted in which we identified over 600 peer-reviewed journal articles on this topic and summarized their contributions to six key areas relevant to the water and wastewater fields: taxonomic classification and pathogen detection, functional and catabolic gene characterization, antimicrobial resistance (AMR) profiling, bacterial toxicity characterization, Cyanobacteria and harmful algal bloom identification, and virus characterization. For each application, we have presented key trends, noteworthy advancements, and proposed future directions. Finally, key needs to advance NGS technologies for broader application in water and wastewater fields are assessed., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Elsevier Ltd. All rights reserved.)