Air Quality Monitoring During High-Level Biocontainment Ground Transport: Observations From Two Operational Exercises

Disaster Med Public Health Prep. 2022 Aug;16(4):1482-1489. doi: 10.1017/dmp.2021.156. Epub 2021 Jun 28.

Abstract

Objective: Stretcher transport isolators provide mobile, high-level biocontainment outside the hospital for patients with highly infectious diseases, such as Ebola virus disease. Air quality within this confined space may pose human health risks.

Methods: Ambient air temperature, relative humidity, and CO2 concentration were monitored within an isolator during 2 operational exercises with healthy volunteers, including a ground transport exercise of approximately 257 miles. In addition, failure of the blower unit providing ambient air to the isolator was simulated. A simple compartmental model was developed to predict CO2 and H2O concentrations within the isolator.

Results: In both exercises, CO2 and H2O concentrations were elevated inside the isolator, reaching steady-state values of 4434 ± 1013 ppm CO2 and 22 ± 2 mbar H2O in the first exercise and 3038 ± 269 ppm CO2 and 20 ± 1 mbar H2O in the second exercise. When blower failure was simulated, CO2 concentration exceeded 10 000 ppm within 8 minutes. A simple compartmental model predicted CO2 and H2O concentrations by accounting for human emissions and blower air exchange.

Conclusions: Attention to air quality within stretcher transport isolators (including adequate ventilation to prevent accumulation of CO2 and other bioeffluents) is needed to optimize patient safety.

Keywords: Ebola virus disease; air quality; biocontainment; emergency medical services; transport isolator.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Air Pollution*
  • Carbon Dioxide* / analysis
  • Humans
  • Temperature
  • Ventilation

Substances

  • Carbon Dioxide