The predictions of infection risk of indoor airborne transmission of diseases in high-rise hospitals: Tracer gas simulation

The spread of diseases from infected patients within hospitals is resulting in many human casualties. If a virus were to be transmitted through uncontrolled air movement within a hospital and were then to infect other patients or healthy visitors, it would be impossible to contain the spread of the disease. The purpose of this paper is to apply reliable boundary conditions based on previous studies in order to analyze the airflow pattern caused by the stack effect in high-rise hospitals. An analysis was carried out on the vertical airborne transmission of viruses according to the location of the infected patients. The horizontal airborne transmission based on the characteristics of the supply air diffuser and return air grille was also analyzed by using the multi-zone airflow simulation and tracer gas (CFD) simulation. In addition, this paper explored solutions to prevent the spread of airborne pathogenic bacteria by analyzing various alternatives of HVAC systems and basic data on ventilation system planning for high-rise hospitals.     

Principles and applications of probability-based inverse modeling method for finding indoor airborne contaminant sources

Building indoor air quality (IAQ) has received growing attentions lately because of the extended time people spend indoors and the increasing reports of health problems related to poor indoor environments. Recent alarms to potential terrorist attacks with airborne chemical and biological agents (CBA) have further highlighted the research needs on building vulnerability and protection. To maintain a healthful and safe indoor environment, it is crucial to identify contaminant source locations, strengths, and release histories. Accurate and prompt identification of contaminant sources can ensure that the contaminant sources can be quickly removed and contaminated spaces can be effectively isolated and cleaned. This paper introduces a probability concept based prediction method—the adjoint probability method-that can track potential indoor airborne contaminant sources with limited sensor outputs. The paper describes the principles of the method and presents the general modeling algorithm and procedure that can be implemented with current computational fluid dynamics (CFD) or multi-zone airflow models. The study demonstrates the application of the method for identifying airborne pollutant source locations in two realistic indoor environments with few sensor measurement outputs. The numerical simulations verify the feasibility and accuracy of the method for indoor pollutant tracking applications, which forms a good foundation for developing an intelligent and integrated indoor environment management system that can promptly respond to indoor pollution episodes with effective detection, analysis, and control.     

Prompt tracking of indoor airborne contaminant source location with probability-based inverse multi-zone modeling

Indoor air quality (IAQ) has a significant influence on occupants' comfort, health, productivity, and safety. Existing studies show that the primary causes of many IAQ problems are various airborne contaminants that either are generated indoors or penetrate into indoor environments with passive or active airflows. Accurate and prompt identification of contaminant sources can help determinate appropriate IAQ control solutions, such as, eliminating contaminant sources, isolating and cleaning contaminated spaces. This study develops a fast and effective inverse modeling method for identifying indoor contaminant source characteristics. The paper describes the principles of the probability-based adjoint inverse modeling method and formulates a multi-zone model based inverse prediction algorithm that can rapidly track contaminant source location with known source release time in a building with many compartments. The paper details the inverse modeling procedure with modification of an existing multi-zone airflow and contaminant transport simulation program. The application of the method has been demonstrated with two case studies: contaminant releases in a multi-compartment residential house and in a complex institutional building. The numerical experiments tested the source identification capability of the program for various contaminant sensing scenarios. The investigation verifies the effectiveness and accuracy of the developed method for indoor contaminant source tracking, which will be further explored to identify more complicated indoor contamination episodes.     

Removal of contaminants released from room surfaces by displacement and mixing ventilation: modeling and validation

This paper presents the experimental and numerical modeling of contaminant dispersion in a full-scale environmental chamber with different room air distribution systems. For the experimental modeling, an area source with uniform emissions of a hypothetical contaminant (SF6) from the entire floor surface is designed and constructed. Two different types of ventilation are studied: displacement and mixing ventilation. A computer model for predicting the contaminant dispersion in indoor spaces was validated with experimental data. The validated model is used to study the effects of airflow and the area-source location on contaminant dispersion. Results show that the global airflow pattern has a strong impact on the distribution of the contaminants. In general, the personal exposure could be estimated by analyzing the relative source positions in the airflow pattern. Accordingly, the location of an exhaust diffuser may not greatly affect the airflow pattern, but can significantly affect the exposure level in the room. PRACTICAL IMPLICATIONS: When designing ventilation in addition to bringing fresh air to occupants, it is important to consider the removal of contaminants released in the off-gassing of building materials. Typical indoor off-gassing examples are emissions of volatile organic compounds from building enclosure surfaces such as flooring and painted walls. In this study, we conducted experimental and numerical modeling of different area sources in a mock-up office setup, with displacement or mixing ventilation. Displacement ventilation was as successful as mixing ventilation in removing the contaminant source from the floor area. Actually, the most important consideration in the removal of these contaminants is the relative position of the area source to the main airflow pattern and the occupied zone.     

SARS-CoV-2, other respiratory viruses and bacteria in aerosols: Report from Kuwait's hospitals

The role of airborne particles in the spread of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is well explored. The novel coronavirus can survive in aerosol for extended periods, and its interaction with other viral communities can cause additional virulence and infectivity. This baseline study reports concentrations of SARS-CoV-2, other respiratory viruses, and pathogenic bacteria in the indoor air from three major hospitals (Sheikh Jaber, Mubarak Al-Kabeer, and Al-Amiri) in Kuwait dealing with coronavirus disease 2019 (COVID-19) patients. The indoor aerosol samples showed 12–99 copies of SARS-CoV-2 per m³ of air. Two non-SARS-coronavirus (strain HKU1 and NL63), respiratory syncytial virus (RSV), and human bocavirus, human rhinoviruses, Influenza B (FluB), and human enteroviruses were also detected in COVID-positive areas of Mubarak Al Kabeer hospital (MKH). Pathogenic bacteria such as Mycoplasma pneumonia, Streptococcus pneumonia and, Haemophilus influenza were also found in the hospital aerosols. Our results suggest that the existing interventions such as social distancing, use of masks, hand hygiene, surface sanitization, and avoidance of crowded indoor spaces are adequate to prevent the spread of SARS-CoV-2 in enclosed areas. However, increased ventilation can significantly reduce the concentration of SARS-CoV-2 in indoor aerosols. The synergistic or inhibitory effects of other respiratory pathogens in the spread, severity, and complexity of SARS-CoV-2 need further investigation.     

A methodology for estimating airborne virus exposures in indoor environments using the spatial distribution of expiratory aerosols and virus viability characteristics

This study investigated the feasibility of using the spatial distribution of expiratory aerosols and the viability functions of airborne viruses to estimate exposures to airborne viruses in an indoor environment under imperfectly mixed condition. A method adopting this approach was tested in an air-conditioned hospital ward. Artificial coughs were produced by aerosolizing a simulated respiratory fluid containing a known concentration of benign bacteriophage. The bacteriophage exposures estimated on the basis of the spatial aerosol distributions and its viability function were in reasonable agreement with those measured directly by biological air sampling and culturing. The ventilation flow and coughing orientation were found to play significant roles in aerosol transport, leading to different spatial distribution patterns in bacteriophage exposure. Bacteriophage exposures decreased with lateral distance from the infector when the infector coughed vertically upward. In contrast, exposures were constant or even increased with distance in the case of lateral coughing. The possibility of incorporating the proposed exposure estimation into a dose-response model for infection risk assessment was discussed. The study has also demonstrated the potential application of viability functions of airborne viral pathogens in exposure assessment and infection risk analysis, which are often unavailable in literature for some important communicable diseases. PRACTICAL IMPLICATIONS: The proposed method makes use of the viability function of the virus and the spatial distribution of the expiratory aerosols for virus exposure estimation. Spatial differences in aerosol distribution and its influences on virus exposure in an air space can be determined. Variations in infectious dose with carrier aerosol size could also be considered. The proposed method may serve as a tool for further investigation of ventilation design and infection control in clinical or other indoor environments.     

Novel measurement system for respiratory aerosols and droplets in indoor environments

The SARS-CoV-2 pandemic has created a great demand for a better understanding of the spread of viruses in indoor environments. A novel measurement system consisting of one portable aerosol-emitting mannequin (emitter) and a number of portable aerosol-absorbing mannequins (recipients) was developed that can measure the spread of aerosols and droplets that potentially contain infectious viruses. The emission of the virus from a human is simulated by using tracer particles solved in water. The recipients inhale the aerosols and droplets and quantify the level of solved tracer particles in their artificial lungs simultaneously over time. The mobile system can be arranged in a large variety of spreading scenarios in indoor environments and allows for quantification of the infection probability due to airborne virus spreading. This study shows the accuracy of the new measurement system and its ability to compare aerosol reduction measures such as regular ventilation or the use of a room air purifier.     

Natural ventilation for reducing airborne infection in hospitals

High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled.     

The effect of source motion on contaminant distribution in the cleanrooms

In the recent decades, cleanrooms have found growing applications in broad range of industries such as pharmacy and microelectronics. Concerns about negative effects of the contaminant exposure on the human health and product quality motivate many researchers towards understanding of the airflow and contaminant distribution though these environments. With an improvement in computational capacity of the computers, computational fluid dynamics (CFD) technique has become a powerful tool to study the engineering problems including indoor air quality (IAQ). In this research, indoor airflow in a full-scale cleanroom is investigated numerically using Eulerian-Eulerian approach. To evaluate the ventilation system effectiveness, a new index, called final efficiency, is introduced which takes all aspects of the problem into account. The results show that the contaminant source motion and its path have a great influence on the contaminant dispersion through the room. Based on the results, the contaminant distribution indexes, e.g. final efficiency and spreading radius, are improved when the source motion path is in the dominant direction of the ventilation airflow. Consequently, the efficiency of an air distribution system which provides a directional airflow pattern shows the least source path dependency. This study and its results may be useful to gain better understanding of the source motion effects on the indoor air quality (IAQ) and to design more effective ventilation systems.     

气流组织对空调房间空气环境影响的数值模拟

针时相同室内条件、不同气流组织形式下的各种模型,运用暖通空调专用数值模拟软件Airpark,对室内速度场、温度场进行了数值模拟计算.并应用模拟结果分析不同气流组织形式下的空气品质和人体热舒适,为空调室内的气流组织形式优化设计及舒适性提供了研究依据.     

Performance of ventilation system in a non-standard operating room

The ventilation system of a hospital operating room is to provide a comfortable and healthy environment for the patient and the surgical team. Thermal comfort can be achieved by controlling the temperature, the humidity, and the air movement. A healthy environment can be achieved by minimizing the risk of contamination through appropriate filtration and air distribution scheme. The design and construction of operating rooms in Hong Kong, including the upgrading of the older ones, have been based on the UK Health Building Notes and Health Technical Memoranda. Observations and field measurements in a case study found that the airflow and some design features were not fully complied with the specified requirements. A CFD analysis supported by field measurements was made to simulate the temperature distribution, airflow pattern and the contaminant dispersion. The study placed an emphasis on the health risk of the airborne bacteria released from the surgical team on the patient, and vice versa.     

辨识室内空气污染源的反问题建模

当发生室内空气污染事故时,获知污染源释放的位置与强度等信息至关重要.利用污染物传感器提供的信息来推断室内空气污染源的研究属于反问题建模.反问题属于病态问题,因而必须采取一些特定的策略才能让反问题获得求解.本文总结了国内外有关应用反问题建模来辨识室内空气污染源的研究进展,以及反问题建模在传热、水污染以及大气污染等领域内的研究概况.辨识室内空气污染源的研究方法可归纳为四类,即分析法、优化法、概率法以及直接求解法.直接求解法不需要使用过多的假设,而且能够较好平衡计算效率以及计算精度,因而比较适于室内环境中污染源的辨识.     

Identifying decaying contaminant source location in building HVAC system using the adjoint probability method

Building heating, ventilation and air-conditioning (HVAC) system can be potential contaminant emission source. Released contaminants from the mechanical system are transported through the HVAC system and thus impact indoor air quality (IAQ). Effective control and improvement measures require accurate identification and prompt removal of contaminant sources from the HVAC system so as to eliminate the unfavourable influence on the IAQ. This paper studies the application of the adjoint probability method for identifying a dynamic (decaying) contaminant source in building HVAC system. A limited number of contaminant sensors are used to detect contaminant concentration variations at certain locations of the HVAC ductwork. Using the sensor inputs, the research is able to trace back and find the source location. A multi-zone airflow model, CONTAM, is employed to obtain a steady state airflow field for the studied building with detailed duct network, upon which the adjoint probability based inverse tracking method is applied. The study reveals that the adjoint probability method can effectively identify the decaying contaminant source location in building HVAC system with few properly located contaminant concentration sensors.     

Multi-zone modeling of probable SARS virus transmission by airflow between flats in Block E, Amoy Gardens

More than 300 residents of a private high-rise housing estate were infected with severe acute respiratory syndrome within a short period during the 2003 epidemic in Hong Kong. The outbreak occurred after the identified index patient visited a flat on a middle floor in Block E of the Amoy Gardens estate on two nights. Approximately 45% of the subsequently infected people resided in Block E, while the other 55% of infected cases mainly resided in six other blocks close to Block E. The distribution of the infected flats in Block E conformed to a non-uniform spatial pattern. Probable environmental causes for airborne transmission associated with the air movements between flats in Block E are identified. The well-established multi-zone airflow modeling method was used to analyze the virus-laden bio-aerosol dispersion between flats through door and window leakage areas in Block E under six different scenarios. The distribution of infection risk in Block E matched with the virus concentrations in flats predicted with the use of multi-zone modeling. Our study shows the importance of ventilation design in high-rise residential apartments. PRACTICAL IMPLICATIONS: The present study on the Amoy Gardens outbreak presented a scenario in which crowded living spaces might lead to infection disasters. There is a need to improve the current sanitary drainage design and maintenance standards to avoid any leakage of foul gas into the indoor environments. Our study revealed the need for a review of indoor air quality and ventilation design in buildings including offices, homes and hotels. The study has implications to public health in, for example, the control of other airborne respiratory infectious diseases such as influenza, and in bio-terror safety in buildings.     

Experimental verification of tracking algorithm for dynamically-releasing single indoor contaminant

Identifying contaminant sources in a precise and rapid manner is critical to indoor air quality (IAQ) management as disclosed source information can facilitate proper and effective IAQ controls in environments with airborne infection, fire smoke and chemical pollutant release etc. Probability-based inverse modeling method was shown feasible for locating single instantaneous source in IAQ events. To tackle more realistic sources of continuous release, this paper advances the method to identify continuously releasing single contaminant source. The study formulates a suite of inverse modeling algorithms that can promptly locate dynamic source with known release time for IAQ events. Two field experiments are employed to verify the prediction: one in a multi-room apartment and the other in a hospital ward which was involved in a SARS outbreak in Hong Kong in 2003. The developed algorithms promptly and accurately identify the source locations in both cases.     

Modeling Indoor Air Exposure from Short-Term Point Source Releases

Abstract We have developed a simplified analytical indoor air model that describes the concentrations as a function of position and time in a room following a short-term release of airborne particles or gases. The indoor dispersion model considers the two main physical processes of (1) point-source dispersion with reflection from all walls and (2) the general concentration decay in a room due to room ventilation and surface deposition of pollutants. Comparison of model predictions with experimental indoor measurements conducted by other researchers showed excellent agreement. This model should prove useful for human-health risk estimations in which the inhalation dose resulting from an indoor, short-term release of a contaminant needs to be calculated.     

轻钢结构住宅体系节能系统的研究

基于冷弯薄壁轻型钢结构住宅构造特征研发了一种具有呼吸功能的节能环保双层空气循环系统,运用Fluent、Airpak软件三维数值模拟探讨该系统对室内热环境的影响机理。考察空气循环系统各个组件在运行过程中速度场、温度场、PPD-PMV分布等各项指标特性及影响因素,据此对室内气流组织及空气品质进行评价。研究表明,空气缓冲层能为内、外空气层提供良好空气源;外空气层利用烟囱效应能动态地隔绝室内外热量;整个双层空气循环系统能够在较低能耗的前提下,改善室内热环境,为室内居住者24 h提供新鲜空气,达到节能环保的目的。     

CFD boundary conditions for contaminant dispersion,heat transfer and airflow simulations around human occupants in indoor environments

Indoor computational fluid dynamics (CFD) simulations can predict contaminant dispersion around human occupants and provide valuable information in resolving indoor air quality or homeland security problems. The accuracy of CFD simulations strongly depends on the appropriate setting of boundary conditions and numerical simulation parameters. The present study explores influence of the following three key boundary condition settings on the simulation accuracy: (1) contaminant source area size, (2) convective/radiative heat fluxes, and (3) shape/size of human simulators. For each of the boundary conditions, numerical simulations were validated with experimental data obtained in two different environmental chambers. In CFD simulations, a small release area of a contaminant point source causes locally high concentration gradients that require a very fine local grid system. This fine grid system can slow down the simulations substantially. The convergence speed of calculation is greatly increased by the source area enlargement. This method will not influence the simulation accuracy of passive point source within well-predicted airflow field. However, for active point source located within complicated airflow filed, such an enlargement should be carried out cautiously because simulation inaccuracy might be introduced. For setting thermal boundary conditions, convection to radiation heat flux ratio is critical for accurate CFD computations of temperature profiles around human simulators. The recommended convection to radiation (C:R) ratio is 30:70 for human simulators. Finally, simplified human simulators can provide accurate temperature profiles within the whole domain of interest. However, velocity and contaminant concentration simulations require further work in establishing the influence of simplifications on the simulation accuracy in the vicinity of the human simulator.     

复合空调室内气态污染物对流输运模拟

利用CFD数值模拟方法分析了复合窗式空调系统对建筑室内气态污染物输运过程的影响.采用雷诺应力模型(RSM)描述了室内空气和污染物对流输运过程,并详细探讨了复合窗式空调系统的送风速度、新风比、净化效率和室内热源强度等对室内气态污染物对流输运过程的影响.计算结果表明,提高送风速度、新风比以及净化效率都能有效降低室内气态污染物平均浓度.值得注意的是,当送风速度超过0.75 m/s后,室内气态污染物浓度水平维持恒定;空调系统即使按全新风模式运行,也不能彻底排除室内污染物.     

Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review

There have been few recent studies demonstrating a definitive association between the transmission of airborne infections and the ventilation of buildings. The severe acute respiratory syndrome (SARS) epidemic in 2003 and current concerns about the risk of an avian influenza (H5N1) pandemic, have made a review of this area timely. We searched the major literature databases between 1960 and 2005, and then screened titles and abstracts, and finally selected 40 original studies based on a set of criteria. We established a review panel comprising medical and engineering experts in the fields of microbiology, medicine, epidemiology, indoor air quality, building ventilation, etc. Most panel members had experience with research into the 2003 SARS epidemic. The panel systematically assessed 40 original studies through both individual assessment and a 2-day face-to-face consensus meeting. Ten of 40 studies reviewed were considered to be conclusive with regard to the association between building ventilation and the transmission of airborne infection. There is strong and sufficient evidence to demonstrate the association between ventilation, air movements in buildings and the transmission/spread of infectious diseases such as measles, tuberculosis, chickenpox, influenza, smallpox and SARS. There is insufficient data to specify and quantify the minimum ventilation requirements in hospitals, schools, offices, homes and isolation rooms in relation to spread of infectious diseases via the airborne route. PRACTICAL IMPLICATION: The strong and sufficient evidence of the association between ventilation, the control of airflow direction in buildings, and the transmission and spread of infectious diseases supports the use of negatively pressurized isolation rooms for patients with these diseases in hospitals, in addition to the use of other engineering control methods. However, the lack of sufficient data on the specification and quantification of the minimum ventilation requirements in hospitals, schools and offices in relation to the spread of airborne infectious diseases, suggest the existence of a knowledge gap. Our study reveals a strong need for a multidisciplinary study in investigating disease outbreaks, and the impact of indoor air environments on the spread of airborne infectious diseases.