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4. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents

Author

IRAS OH Epidemiology Microbial Agents, Faculteit Diergeneeskunde, Linde, Kimberly J, Wouters, Inge M, Kluytmans, Jan A J W, Kluytmans-van den Bergh, Marjolein F Q, Pas, Suzan D, Koopmans, Marion P G, GeurtsvanKessel, Corine H, Meier, Melanie, Meijer, Patrick, Raben, Ceder R, Spithoven, Jack, Tersteeg-Zijderveld, Monique H G, COCON Consortium, Heederik, Dick J J, Dohmen, Wietske, IRAS OH Epidemiology Microbial Agents, Faculteit Diergeneeskunde, Linde, Kimberly J, Wouters, Inge M, Kluytmans, Jan A J W, Kluytmans-van den Bergh, Marjolein F Q, Pas, Suzan D, Koopmans, Marion P G, GeurtsvanKessel, Corine H, Meier, Melanie, Meijer, Patrick, Raben, Ceder R, Spithoven, Jack, Tersteeg-Zijderveld, Monique H G, COCON Consortium, Heederik, Dick J J, and Dohmen, Wietske

Published
2023

5. Ventilation and thermal conditions in secondary schools in the Netherlands: Effects of COVID-19 pandemic control and prevention measures

Author

IRAS OH Epidemiology Microbial Agents, Ding, Er, Zhang, Dadi, Hamida, Amneh, García-Sánchez, Clara, Jonker, Lotte, de Boer, Annemarijn R, Bruijning, Patricia C J L, Linde, Kimberly J, Wouters, Inge M, Bluyssen, Philomena M, IRAS OH Epidemiology Microbial Agents, Ding, Er, Zhang, Dadi, Hamida, Amneh, García-Sánchez, Clara, Jonker, Lotte, de Boer, Annemarijn R, Bruijning, Patricia C J L, Linde, Kimberly J, Wouters, Inge M, and Bluyssen, Philomena M

Published
2023

6. Ventilation and thermal conditions in secondary schools in the Netherlands: Effects of COVID-19 pandemic control and prevention measures

Author

Ding, Er (author), Zhang, D. (author), Hamida, A.B. (author), Garcia Sanchez, C. (author), Jonker, Lotte (author), de Boer, Annemarijn R. (author), Bruijning, Patricia C.J.L. (author), Linde, Kimberly J. (author), Wouters, Inge M. (author), Bluyssen, P.M. (author), Ding, Er (author), Zhang, D. (author), Hamida, A.B. (author), Garcia Sanchez, C. (author), Jonker, Lotte (author), de Boer, Annemarijn R. (author), Bruijning, Patricia C.J.L. (author), Linde, Kimberly J. (author), Wouters, Inge M. (author), and Bluyssen, P.M. (author)

Abstract

During the COVID-19 pandemic, the importance of ventilation was widely stressed and new protocols of ventilation were implemented in school buildings worldwide. In the Netherlands, schools were recommended to keep the windows and doors open, and after a national lockdown more stringent measures such as reduction of occupancy were introduced. In this study, the actual effects of such measures on ventilation and thermal conditions were investigated in 31 classrooms of 11 Dutch secondary schools, by monitoring the indoor and outdoorCO2 concentration and air temperature, both before and after the lockdown. Ventilation rates were calculated using the steady-state method. Pre-lockdown, with an average occupancy of 17 students, in 42% of the classrooms the CO2 concentration exceeded the upper limit of the Dutch national guidelines (800 ppm above outdoors),while 13% had a ventilation rate per person (VRp) lower than the minimum requirement (6 l/s/p). Post lockdown, the indoor CO2 concentration decreased significantly while for ventilation rates significant increase was only found in VRp, mainly caused by the decrease in occupancy (average 10 students). The total ventilation rate per classrooms, mainly induced by opening windows and doors, did not change significantly. Meanwhile, according to the Dutch national guidelines, thermal conditions in the classrooms were not satisfying, both pre and post-lockdown. While opening windows and doors cannot achieve the required indoor environmental quality at all times, reducing occupancy might not be feasible for immediate implementation. Hence, more controllable and flexible ways for improving indoor air quality and thermal comfort in classrooms are needed., Indoor Environment, Urban Data Science

Published
2023
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7. SARS‑CoV‑2 incidence in secondary schools: the role of national and school‑initiated COVID‑19 measures

Author

Jonker, Lotte (author), Linde, Kimberly J. (author), de Boer, Annemarijn R. (author), Ding, Er (author), Zhang, D. (author), de Hoog, M.L.A. (author), Herfst, Sander (author), Heederik, Dick (author), Bluyssen, P.M. (author), Jonker, Lotte (author), Linde, Kimberly J. (author), de Boer, Annemarijn R. (author), Ding, Er (author), Zhang, D. (author), de Hoog, M.L.A. (author), Herfst, Sander (author), Heederik, Dick (author), and Bluyssen, P.M. (author)

Abstract

Introduction: Our aim was to gain insight into the effect of COVID-19 measures on SARS-CoV-2 incidence in secondary schools and the association with classroom CO 2 concentration and airborne contamination. Methods: Between October 2020—June 2021, 18 schools weekly reported SARS-CoV-2 incidence and completed surveys on school-initiated COVID-19 measures (e.g. improving hygiene or minimizing contacts). CO 2 was measured in occupied classrooms twice, and SARS-CoV-2 air contamination longitudinally using electrostatic dust collectors (EDC) and analyzed using RT-qPCR. National COVID-19 policy measures varied during pre-lockdown, lockdown and post-lockdown periods. During the entire study, schools were recommended to improve ventilation. SARS-CoV-2 incidence rate ratios (IRR) were estimated by Generalized Estimating Equation (GEE) models. Results: During 18 weeks follow-up (range: 10–22) SARS-CoV-2 school-incidence decreased during national lockdown (adjusted IRR: 0.41, 95%CI: 0.21–0.80) and post-lockdown (IRR: 0.60, 0.39–0.93) compared to pre-lockdown. School-initiated COVID-19 measures had no additional effect. Pre-lockdown, IRRs per 10% increase in time CO 2 exceeded 400, 550 and 800 ppm above outdoor level respectively, were 1.08 (1.00–1.16), 1.10 (1.02–1.19), and 1.08 (0.95–1.22). Post-lockdown, CO 2-concentrations were considerably lower and not associated with SARS-CoV-2 incidence. No SARS-CoV-2 RNA was detected in any of the EDC samples. Conclusion: During a period with low SARS-CoV-2 population immunity and increased attention to ventilation, with CO 2 levels most of the time below acceptable thresholds, only the national policy during and post-lockdown of reduced class-occupancy, stringent quarantine, and contact testing reduced SARS-CoV-2 incidence in Dutch secondary schools. Widespread SARS-CoV-2 air contamination could not be demonstrated in schools under the prevailing conditions during the study., Environmental & Climate Design

Published
2023
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8. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents

Author

Linde, Kimberly J, Wouters, Inge M, Kluytmans, Jan A J W, Kluytmans-van den Bergh, Marjolein F Q, Pas, Suzan D, Koopmans, Marion P G, GeurtsvanKessel, Corine H, Meier, Melanie, Meijer, Patrick, Raben, Ceder R, Spithoven, Jack, Tersteeg-Zijderveld, Monique H G, COCON Consortium, Heederik, Dick J J, Dohmen, Wietske, IRAS OH Epidemiology Microbial Agents, and Faculteit Diergeneeskunde

Subjects
Medicine(all), nursing home, SARS-CoV-2, surface, air levels
Abstract

There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10); 1-4 μm 50% (5/10)

Published
2023

9. SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

Author

Jonker, Lotte, primary, Linde, Kimberly J, additional, de Hoog, Marieke LA, additional, Sprado, Robin, additional, Huisman, Robin, additional, Molenkamp, Richard, additional, Oude Munnink, Bas B, additional, Dohmen, Wietske, additional, Heederik, Dick JJ, additional, Eggink, Dirk, additional, Welkers, Matthijs RA, additional, Vennema, Harry, additional, Koopmans, Marion PG, additional, Fraaij, Pieter LA, additional, Wouters, Inge M, additional, and Bruijning-Verhagen, Patricia CJL, additional

Published
2022
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10. SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020: silent circulation

Author

IRAS OH Epidemiology Microbial Agents, Faculteit Diergeneeskunde, Jonker, Lotte, Linde, Kimberly J, de Hoog, Marieke L A, Sprado, Robin, Huisman, Robin C, Molenkamp, Richard, Oude Munnink, Bas B, Dohmen, Wietske, Heederik, Dick J J, Eggink, Dirk, Welkers, Matthijs R A, Vennema, Harry, Fraaij, Pieter L A, Koopmans, Marion P G, Wouters, Inge M, Bruijning-Verhagen, Patricia C J L, IRAS OH Epidemiology Microbial Agents, Faculteit Diergeneeskunde, Jonker, Lotte, Linde, Kimberly J, de Hoog, Marieke L A, Sprado, Robin, Huisman, Robin C, Molenkamp, Richard, Oude Munnink, Bas B, Dohmen, Wietske, Heederik, Dick J J, Eggink, Dirk, Welkers, Matthijs R A, Vennema, Harry, Fraaij, Pieter L A, Koopmans, Marion P G, Wouters, Inge M, and Bruijning-Verhagen, Patricia C J L

Published
2022

11. SARS-CoV-2 outbreaks in secondary school settings in the Netherlands during fall 2020; silent circulation

Author

Epi Infectieziekten Team 1, Child Health, Infection & Immunity, JC onderzoeksprogramma Methodologie, JC onderzoeksprogramma Infectieziekten, Jonker, Lotte, Linde, Kimberly J., de Hoog, Marieke L.A., Sprado, Robin, Huisman, Robin C., Molenkamp, Richard, Oude Munnink, Bas B., Dohmen, Wietske, Heederik, Dick J.J., Eggink, Dirk, Welkers, Matthijs R.A., Vennema, Harry, Fraaij, Pieter L.A., Koopmans, Marion P.G., Wouters, Inge M., Bruijning-Verhagen, Patricia C.J.L., Epi Infectieziekten Team 1, Child Health, Infection & Immunity, JC onderzoeksprogramma Methodologie, JC onderzoeksprogramma Infectieziekten, Jonker, Lotte, Linde, Kimberly J., de Hoog, Marieke L.A., Sprado, Robin, Huisman, Robin C., Molenkamp, Richard, Oude Munnink, Bas B., Dohmen, Wietske, Heederik, Dick J.J., Eggink, Dirk, Welkers, Matthijs R.A., Vennema, Harry, Fraaij, Pieter L.A., Koopmans, Marion P.G., Wouters, Inge M., and Bruijning-Verhagen, Patricia C.J.L.

Published
2022

12. SARS-CoV-2 Incidence in Secondary Schools; the Role of National and School-Initiated COVID-19 Measures and Indoor Air Quality

Author

Jonker, Lotte, primary, Linde, Kimberly J., additional, de Boer, Annemarijn Rachel, additional, Ding, Erica, additional, Zhang, Dadi, additional, de Hoog, Marieke L. A., additional, Herfst, Sander, additional, Heederik, Dick J. J., additional, Fraaij, Pieter L. A., additional, Bluyssen, Philomena, additional, Wouters, Inge M., additional, and Bruijning-Verhagen, Patricia, additional

Published
2022
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13. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents.

Author

Linde KJ, Wouters IM, Kluytmans JAJW, Kluytmans-van den Bergh MFQ, Pas SD, GeurtsvanKessel CH, Koopmans MPG, Meier M, Meijer P, Raben CR, Spithoven J, Tersteeg-Zijderveld MHG, Heederik DJJ, and Dohmen W

Subjects
Humans, SARS-CoV-2, RNA, Viral, Nursing Homes, COVID-19 epidemiology, Occupational Exposure
Abstract

There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10); 1-4 μm 50% (5/10); <1 μm 20% (2/10)] (Fischer exact test P = 0.076). The highest proportion of RNA-positive air samples on room level was found with a filtration-based sampler 80% (8/10) and the cyclone-based sampler 70% (7/10), and impingement-based sampler 50% (5/10). SARS-CoV-2 RNA was detected in 10 out of 12 (83%) passive air samples in patient rooms. Both high-touch and low-touch surfaces contained SARS-CoV-2 genome in rooms of residents with positive OPS [high 38% (21/55); low 50% (22/44)]. In one active air sample, infectious virus in vitro was detected. In conclusion, SARS-CoV-2 is frequently detected in air and on surfaces in the immediate surroundings of room-isolated COVID-19 patients, providing evidence of environmental contamination. The environmental contamination of SARS-CoV-2 and infectious aerosols confirm the potential for transmission via air up to several meters., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Published
2023
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