Occupational Inhalation Exposure to Infectious Respiratory Virus Aerosols in Medical Facilities

项目摘要 准确评估医护人员对空气传播致病性病毒的个人暴露 现有的生物气溶胶采样器阻碍了这项工作， 空气传播的病毒，并保持其活力，或不适合个人采样。的目标 这项拟议的工作是为了更准确地评估个人接触造成的不同 空气传播传染性病毒的传播方式。要做到这一点， 国家职业安全与健康研究所（NIOSH）生物气溶胶采样器将成为 个人采样器的选择，以便它可以有效地收集空气中含有病毒的颗粒， 它们的颗粒大小，并保持其生存能力的信息，以进行接触风险评估。 本提案的两个具体目标是：（1）根据金校准NIOSH采样器- 活病毒气溶胶采样器（VIVAS）的标准参考。VIVAS高效地 收集空气传播的活病毒，但对于个人采样来说太大太重。校准 将使用实验室产生的呼吸道病毒气溶胶进行，以获得以下校正因子： 使用NIOSH采样器测定活病毒气溶胶浓度。(2)评估个人 使用经校准的NIOSH采样器对医护人员暴露于空气中的病毒进行检测。领域 在学生保健中心（SHCC）对位于同一地点的NIOSH采样器和VIVAS进行测试， 在真实环境中证实实验室生成的校正因子。采样将 使用经校准的NIOSH采样器进行，以评估 接待员，医疗保健提供者和医疗助理在SHCC在流感季节。 通过不同阶段收集的大小分级的含病毒颗粒的结果显示， NIOSH采样器将揭示不同传输模式的相对重要性， 空气传播的病毒个人与固定样本的配对比较将揭示， 固定抽样可以代替个人抽样。从拟议方案中学到的知识 研究将有助于制定行政政策和工程控制， 卫生保健工作者避免意外暴露于空气传播的传染性病毒。这项建议 响应NIOSH 2019-23财年战略计划设定的两个目标，这两个目标最能代表 美国劳动力面临的健康和安全问题：目标3 -减少职业传染病 目标5 -减少职业性呼吸道疾病。具体而言，目标3.3 -传染性 活动目标3.3.1 -开展基础/病原学研究， 了解流感的空气生物学和在医疗机构中的传播。

PROJECT SUMMARY Accurate assessment of healthcare workers’ personal exposure to airborne pathogenic viruses is hampered by existing bioaerosol samplers, which are either inefficient in sampling infectious airborne viruses and maintaining their viability, or not suitable for personal sampling. The goal of this proposed work is to more accurately assess personal exposure resulting from different transmission modes of airborne infectious viruses. This will be accomplished by empowering the National Institute for Occupational Safety and Health (NIOSH) bioaerosol sampler to be the personal sampler of choice so that it can efficiently collect airborne virus-containing particles by their particle size and maintain their viability information for exposure risk assessment. The two specific aims of this proposal are to: (1) Calibrate the NIOSH sampler against the gold- standard reference of Viable Virus Aerosol Sampler (VIVAS). The VIVAS is highly efficient in collecting viable airborne viruses, but too large and heavy for personal sampling. The calibration will be conducted using lab-generated respiratory virus aerosols to obtain correction factors for determining viable virus aerosol concentrations using the NIOSH sampler. (2) Evaluate personal exposures of healthcare workers to airborne viruses using the calibrated NIOSH sampler. Field tests of co-located NIOSH sampler and the VIVAS at a student health care center (SHCC) will corroborate the lab-generated correction factors in a real-world environment. Sampling will then be conducted using the calibrated NIOSH sampler to assess the personal exposures of the receptionist, healthcare providers, and medical assistants at the SHCC during flu season. Results of the size-fractionated virus-containing particles collected by different stages of the NIOSH sampler will bring to light the relative importance of the different transmission modes of airborne viruses. Paired comparisons of the personal vs. stationary samplings will reveal if stationary sampling can substitute for personal sampling. Knowledge learned from the proposed study will allow setting of administrative polices and engineering control that better protect healthcare workers from undesired exposure to airborne infectious viruses. This proposal responds to two goals set by NIOSH’s Strategic Plans for FY 2019-23 that best represent the health and safety issues facing the U.S. workforce: Goal 3 - reduce occupational infectious disease, and Goal 5 - reduce occupational respiratory disease. Specifically, Goal 3.3 - infectious disease transmission, and Activity Goal 3.3.1 - conduct basic/ etiologic research to better understand influenza aerobiology and transmission in healthcare settings.