Respiratory aerosol particle emission and simulated infection risk is greater during indoor endurance than resistance exercise

Proc Natl Acad Sci U S A. 2023 Feb 28;120(9):e2220882120. doi: 10.1073/pnas.2220882120. Epub 2023 Feb 21.

Abstract

Pathogens such as severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), influenza, and rhinoviruses are transmitted by airborne aerosol respiratory particles that are exhaled by infectious subjects. We have previously reported that the emission of aerosol particles increases on average 132-fold from rest to maximal endurance exercise. The aims of this study are to first measure aerosol particle emission during an isokinetic resistance exercise at 80% of the maximal voluntary contraction until exhaustion, second to compare aerosol particle emission during a typical spinning class session versus a three-set resistance training session. Finally, we then used this data to calculate the risk of infection during endurance and resistance exercise sessions with different mitigation strategies. During a set of isokinetic resistance exercise, aerosol particle emission increased 10-fold from 5,400 ± 1,200 particles/min at rest to 59,000 ± 69,900 particles/min during a set of resistance exercise. We found that aerosol particle emission per minute is on average 4.9-times lower during a resistance training session than during a spinning class. Using this data, we determined that the simulated infection risk increase during an endurance exercise session was sixfold higher than during a resistance exercise session when assuming one infected participant in the class. Collectively, this data helps to select mitigation measures for indoor resistance and endurance exercise classes at times where the risk of aerosol-transmitted infectious disease with severe outcomes is high.

Keywords: SARS-CoV-2; aerosol particle emission; exercise; infection risk; pathogen transmission.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / prevention & control
  • Exercise
  • Humans
  • Resistance Training*
  • Respiratory Aerosols and Droplets
  • SARS-CoV-2