On the airborne transmission of SARS-CoV-2 and relationship with indoor conditions at a hospital

Zeynab Baboli; Niloofar Neisi; Ali Akbar Babaei; Mehdi Ahmadi; Armin Sorooshian; Yaser Tahmasebi Birgani; Gholamreza Goudarzi

doi:10.1016/j.atmosenv.2021.118563

On the airborne transmission of SARS-CoV-2 and relationship with indoor conditions at a hospital

Atmos Environ (1994). 2021 Sep 15:261:118563. doi: 10.1016/j.atmosenv.2021.118563. Epub 2021 Jun 21.

Authors

Zeynab Baboli^{1

2}, Niloofar Neisi³, Ali Akbar Babaei^{4

5}, Mehdi Ahmadi^{4

5}, Armin Sorooshian^{6

7}, Yaser Tahmasebi Birgani^{4

5}, Gholamreza Goudarzi^{2

4

5}

Affiliations

¹ Student Research Committee, Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
² Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
³ Clinical Sciences Research Institute, Alimentary Tract Research Center, Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁴ Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁵ Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
⁶ Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, USA.
⁷ Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, USA.

Abstract

The limited knowledge about the mechanism of SARS-CoV-2 transmission is a current challenge on a global scale. Among possible transmission routes, air transfer of the virus is thought to be prominent. To investigate this further, measurements were conducted at Razi hospital in Ahvaz, Iran, which was selected to treat COVID-19 severe cases in the Khuzestan province. Passive and active sampling methods were employed and compared with regard to their efficiency for collection of airborne SARS-COV-2 virus particles. Fifty one indoor air samples were collected in two areas, with distances of less than or equal to 1 m (patient room) and more than 3 m away (hallway and nurse station) from patient beds. A simulation method was used to obtain the virus load released by a regularly breathing or coughing individual including a range of microdroplet emissions. Using real-time reverse transcription polymerase chain reaction (RT-PCR), 11.76% (N = 6) of all indoor air samples (N = 51) collected in the COVID-19 ward tested positive for SARS-CoV-2 virus, including 4 cases in patient rooms and 2 cases in the hallway. Also, 5 of the 6 positive cases were confirmed using active sampling methods with only 1 based on passive sampling. The results support airborne transmission of SARS-CoV-2 bioaerosols in indoor air. Multivariate analysis showed that among 15 parameters studied, the highest correlations with PCR results were obtained for temperature, relative humidity, PM levels, and presence of an air cleaner.

Keywords: Aerosols; Airborne; Indoor air quality; RT-PCR; SARS-CoV-2.