Exposition to airborne SARS-CoV-2 in household and hospitals settings as studied by a vacuum cleaner as a high-powered air sampler
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Abstract
Background
We aimed to study the presence of SARS-CoV-2 in air surrounding infected healthcare workers (HCW) in their homes versus infected patients who were undergoing potential aerosol-generating medical procedures (AGMP). We also studied the effect of different face masks worn bij infected persons on spread of SARS-CoV-2 into the air.
Methods
We developed a high-volume air sampler method that uses a household vacuum cleaner with a surgical mask serving as a sample filter. SARS-CoV-2 RNA was harvested from these sample filters and analyzed on the presence of RNA by polymerase chain reaction. We acquired air samples in close aproximity of HCWs wearing different facemasks. Also, we obtained free air samples away from the infected HCWs and samples near intensive care unit (ICU) patients undergoing AGMP. Fog experiments were performed to visualize the airflow around our air sampler.
Results
Aerosols were visibly suctioned into the vacuum cleaner when there was no face mask, whereas wearing a face mask resulted in a delayed and reduced flow of aerosols into the vacuum cleaner. The face masks that were worn by the HCWs were positive in 54-83% of cases. The proportion of positive air samples was higher in household settings of recently infected HCWs (29/41; 70.7%) compared to ICU settings (4/17; 23.5%) (p<0.01).
Conclusion
This high-volume air sampler method was able to detect SARS-CoV-2 RNA in air samples. Air samples in the household environment of recently infected HCWs more frequently contained SARS-CoV-2 in comparison to those obtained in patient rooms during potential AGMP.
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SciScore for 10.1101/2021.07.16.21260337: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The Institutional Review Board of the Franciscus Gasthuis and Vlietland Hospital in Rotterdam approved the study protocol and ethical approval was obtained (IRB protocol number 2020-092).
Consent: Written informed consent was obtained from the HCWs during the household visits.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Statistical analysis: All data were analyzed using Microsoft Excel and R version 3.3.2 (R Foundation for Statistical Computing). Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)Results from OddPub: We did not detect open data. We …
SciScore for 10.1101/2021.07.16.21260337: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: The Institutional Review Board of the Franciscus Gasthuis and Vlietland Hospital in Rotterdam approved the study protocol and ethical approval was obtained (IRB protocol number 2020-092).
Consent: Written informed consent was obtained from the HCWs during the household visits.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources Statistical analysis: All data were analyzed using Microsoft Excel and R version 3.3.2 (R Foundation for Statistical Computing). Microsoft Excelsuggested: (Microsoft Excel, RRID:SCR_016137)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are several study limitations to consider. First, the primary aim was to measure the protective effects of different types of face masks worn by infected persons to prevent further spread. In retrospect, our approach failed to address this research question due to our sampling setting with poor ventilation resulting in many positive air samples due to circulating virus RNA. Therefore, our findings should not be interpreted as a failure in the protective effects of face masks. Importantly, SARS-CoV-2 was also detected on the masks worn by the infected persons and thus these masks limited the exposition of the virus to the environment. Second, all our observations were carried out prior to the emergence of variants of concern, such as the United Kingdom, South African, and Brazilian P1 SARS-CoV-2 variants in the Netherlands. We cannot exclude that different results would have been obtained due to more transmittable variants. Third, our experimental findings in adequately ventilated ICU rooms of COVID-19 patients with low proportions of positive air samples during AGMP require confirmation in a larger cohort that should also include different oxygen therapy. In conclusion, the presented vacuum cleaner based air sampling followed by RT-qPCR is simple to perform, does not require expensive materials, and is an effective method to detect SARS-CoV-2 in the air. Although airborne transmission of SARS-CoV-2 has not yet been widely accepted, it should be considered as an importan...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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