Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control.
Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control.
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DOI：
10.1186/s12199-020-00904-2
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发表时间：
2020-11-03
影响因子：
4.7
通讯作者：
Hayashi M
中科院分区：
文献类型：
--
作者：
Azuma K;Yanagi U;Kagi N;Kim H;Ogata M;Hayashi M
严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）是2019年12月出现的一种新的人畜共患病原体，导致2019冠状病毒病（COVID-19）。这种感染可以通过无症状、症状前和有症状的携带者传播。SARS-CoV-2主要通过在封闭空间，特别是建筑物中的人与人密切接触期间的呼吸道飞沫传播。本文总结了SARS-CoV-2传播的环境因素，包括防止SARS-CoV-2在建筑环境中传播的策略。SARS-CoV-2可以在污染物表面持续存在至少3天，具体取决于条件。如果SARS-CoV-2被有意雾化，它至少在几个小时内是稳定的。SARS-CoV-2在阳光照射下的表面上迅速灭活。如一些聚集性病例所示，在密闭、拥挤和通风不良的室内环境中，通过较小的气溶胶颗粒进行的密切接触气溶胶传播可能与呼吸道飞沫和接触传播相结合。尽管气溶胶传播影响的证据有限且仍存在不确定性，但由于COVID-19已对公共卫生、社区和社会经济造成严重的全球性损害，因此需要基于预防方法采取充分的预防措施来控制室内环境质量。日本的COVID-19专家小组重点关注“3C”，即“通风不良的封闭空间”、“人多拥挤的空间”和“密切接触”。此外，日本厚生劳动省一直建议根据《建筑物卫生维护法》的现行标准，在所有封闭空间内进行充分通风，作为防止COVID-19传播的初步政治行动之一。然而，室内环境质量控制的具体标准尚未得到推荐，关于SARS-CoV-2在封闭室内空间中的感染动力学和传播模式仍存在许多科学不确定性。室内环境质量控制尤其是通风的效果和作用还需要进一步研究和评价。
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new zoonotic agent that emerged in December 2019, causes coronavirus disease 2019 (COVID-19). This infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. SARS-CoV-2 spreads primarily via respiratory droplets during close person-to-person contact in a closed space, especially a building. This article summarizes the environmental factors involved in SARS-CoV-2 transmission, including a strategy to prevent SARS-CoV-2 transmission in a building environment. SARS-CoV-2 can persist on surfaces of fomites for at least 3 days depending on the conditions. If SARS-CoV-2 is aerosolized intentionally, it is stable for at least several hours. SARS-CoV-2 is inactivated rapidly on surfaces with sunlight. Close-contact aerosol transmission through smaller aerosolized particles is likely to be combined with respiratory droplets and contact transmission in a confined, crowded, and poorly ventilated indoor environment, as suggested by some cluster cases. Although evidence of the effect of aerosol transmission is limited and uncertainty remains, adequate preventive measures to control indoor environmental quality are required, based on a precautionary approach, because COVID-19 has caused serious global damages to public health, community, and the social economy. The expert panel for COVID-19 in Japan has focused on the “3 Cs,” namely, “closed spaces with poor ventilation,” “crowded spaces with many people,” and “close contact.” In addition, the Ministry of Health, Labour and Welfare of Japan has been recommending adequate ventilation in all closed spaces in accordance with the existing standards of the Law for Maintenance of Sanitation in Buildings as one of the initial political actions to prevent the spread of COVID-19. However, specific standards for indoor environmental quality control have not been recommended and many scientific uncertainties remain regarding the infection dynamics and mode of SARS-CoV-2 transmission in closed indoor spaces. Further research and evaluation are required regarding the effect and role of indoor environmental quality control, especially ventilation.
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