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德黑兰医院重症监护病房医护人员的严重急性呼吸综合征冠状病毒2颗粒职业暴露。

Occupational exposure of health care personnel to SARS-CoV-2 particles in the intensive care unit of Tehran hospital.

作者信息

Yarahmadi R, Bokharaei-Salim F, Soleimani-Alyar S, Moridi P, Moradi-Moghaddam O, Niakan-Lahiji M, Darvishi M-M, Golmahammadi S, Mousavi S A J, Ebrahimi H, Ashtarinezad A, Farshad A-A, Jonidi-Jafari A, Kiani S J, Garshasbi S, Mehrzadi S

机构信息

Air Pollution Research Center, Department of Occupational Health, Iran University of Medical Sciences, Tehran, Iran.

Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Environ Sci Technol (Tehran). 2021;18(12):3739-3746. doi: 10.1007/s13762-020-03095-z. Epub 2021 Feb 2.

Abstract

The outbreak of SARS-CoV-2 (COVID-19) has attracted much attention to study its possible presence and airborne transmission. The possibility of COVID-19 airborne transmission in indoor environments is debatable. The present study examined the concentration of viral RNA-containing particles produced directly or indirectly by breathing or coughing of confirmed COVID-19 patients or by carriers without symptoms. Some studies do not accept this method of transmission (COVID-19 airborne transmission). The present study aimed to measure the possible exposure of health care personnel to SARS-CoV-2 particles that may have been suspended in the air to respond to the hypothesis of COVID-19 airborne transmission. Airborne particle sampling was performed using impingement method based on NIOSH (chapter BA) and ASHRAE. Selection of sampling sections was in line with the WHO guidelines. The samples were analyzed using RT-PCR technique. Based on the given results, airborne particles of COVID-19 may present in the air and affect the health of hospital personnel. In fact, the analysis of gene expression in ambient conditions and thereby aerosol transmission of SARS-CoV-2 through air is possible and may lead to occupational exposure of health care personnel. Furthermore, it was found that airborne emission of COVID-19 through the breathing zone of patients, particularly in ICU wards with confirmed cases of COVID-19, may be higher than in other ICU wards. Also, the demonstrated results showed that there is a possibility of reaerosolization (reintroduction) of previously airborne SARS-CoV-2 particles into the atmosphere due to health care personnel frequently walking between different wards and stations of ICU.

摘要

严重急性呼吸综合征冠状病毒2(SARS-CoV-2,即新冠病毒)的爆发引发了人们对其可能存在及空气传播的广泛关注。新冠病毒在室内环境中通过空气传播的可能性存在争议。本研究检测了确诊的新冠患者或无症状携带者呼吸或咳嗽直接或间接产生的含病毒RNA颗粒的浓度。一些研究并不认可这种传播方式(新冠病毒空气传播)。本研究旨在测量医护人员可能暴露于空气中悬浮的SARS-CoV-2颗粒的情况,以回应新冠病毒空气传播的假设。基于美国国家职业安全与健康研究所(NIOSH,第BA章)和美国采暖、制冷与空调工程师协会(ASHRAE)的标准,采用撞击法进行空气颗粒采样。采样区域的选择符合世界卫生组织的指导方针。使用逆转录聚合酶链反应(RT-PCR)技术对样本进行分析。根据给出的结果,新冠病毒的空气颗粒可能存在于空气中,并影响医院工作人员的健康。事实上,分析环境条件下的基因表达以及由此SARS-CoV-2通过空气进行气溶胶传播是可能的,且可能导致医护人员的职业暴露。此外,研究发现,新冠病毒通过患者呼吸区域的空气排放,尤其是在有确诊新冠病例的重症监护病房,可能高于其他重症监护病房。而且,已证实的结果表明,由于医护人员频繁在重症监护病房的不同病房和站点之间走动,先前空气中的SARS-CoV-2颗粒有可能再次气溶胶化(重新进入)大气。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6e4/7850955/6f5283498bcf/13762_2020_3095_Fig1_HTML.jpg

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