title: A methodology for estimating airborne virus exposures in indoor environments using the spatial distribution of expiratory aerosols and virus viability characteristics.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Mechanical Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China.
authors.forename: G N
authors.initials: GN
authors.lastname: Sze To
authors.forename: M P
authors.initials: MP
authors.lastname: Wan
authors.forename: C Y H
authors.initials: CY
authors.lastname: Chao
authors.forename: F
authors.initials: F
authors.lastname: Wei
authors.forename: S C T
authors.initials: SC
authors.lastname: Yu
authors.forename: J K C
authors.initials: JK
authors.lastname: Kwan
mesh_terms: D000336:Aerosols / Q000032:analysis*; D000389:Air Conditioning; D016902:Air Pollution, Indoor / Q000032:analysis*; D001435:Bacteriophages / Q000302:isolation & purification* / Q000502:physiology*; D004196:Disease Outbreaks / Q000517:prevention & control; D004784:Environmental Monitoring / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D017053:Infection Control; D008284:Maintenance and Engineering, Hospital; D010316:Particle Size; D018570:Risk Assessment; D014691:Ventilation; D014779:Virus Replication / Q000502:physiology
chemical_list: D000336:Aerosols