Testing Interventions to Human-Generated Occupational Airborne Infections

测试对人为职业空气传播感染的干预措施

• 批准号: 7472395
• 负责人: Edward A. Nardell
• 金额: $ 26.37万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7472395
• 关键词: Testing; Interventions; Human; Generated; Occupational

DESCRIPTION (provided by applicant): Most currently recommended interventions to control airborne infection have never been rigorously tested against human-generated infectious aerosols, in part because of an inability to quantitatively air sample for most airborne pathogens under real life conditions. We plan to study patients with infectious multi-drug resistant tuberculosis (MDR-TB) as a prototype airborne infection in a unique Airborne Infections Research (AIR) facility in South Africa designed to efficiently test the efficacy of infection control interventions through the use of quantitative guinea pig air sampling. Guinea pigs in one of two identical chambers are exposed on alternate days to the exhaust air from three 2-bed rooms and the common area of the AIR patient suite. The infection control intervention is applied in the patient rooms on alternate days. Guinea pig exposure chamber A receive air from the patient rooms only when the intervention is operative, while exposure chamber B receives air from the patient rooms only under control conditions. The difference in the infection rate of guinea pigs in the two chambers, as determined by tuberculin skin testing, is a measure of the efficacy of the intervention. The HYPOTHESES to be tested are that two rapid response interventions (face masks on infectious persons and portable room air cleaning machines), and one pre-planned preventive interventions (upper room UV air disinfection) can effectively reduce the risk of person to person airborne transmission. SPECIFIC AIMS: (1) To determine if surgical masks on infectious individuals are at least 50% effective in reducing transmission. (2) To determine if commercial portable air disinfection units are at least 75% effective. We aim to establish a relationship between clean air delivery rate and room air disinfection, independent of the specific device used. We will test both a conventional HEPA filter unit and novel low-maintenance electrostatic air decontamination technology developed for use in outer space. (3) To determine if upper room UVGI is at least 75% effective, and whether room air mixing and low humidity are critical efficacy factors. SIGNIFICANCE: Influenza, SARS, smallpox, and MDR-TB are among the emerging infectious airborne treats to workers. MDR-TB patients and quantitative guinea pig air sampling in the AIR facility provide a unique model for the efficient testing under conditions of controlled infectious source strength (the alternate day strategy), environment (the AIR facility), and host susceptibility (the guinea pigs), of both conventional and novel infection control interventions to protect workers and other building occupants. Test results obtained with MDR-TB may be applicable to other infections that are completely or partially airborne.

描述（由申请人提供）：目前，大多数建议控制空气传播感染的干预措施从未对人类产生的感染性气溶胶进行严格测试，部分原因是在现实生活中，大多数机载病原体都无法定量空气样本。我们计划研究南非独特的空气传播感染研究（AIR）在南非的独特的空中感染中具有传染性多药抗性结核病（MDR-TB）的患者，旨在通过使用定量的豚鼠空气采样来有效地测试感染控制干预措施的功效。两个相同腔室之一的豚鼠在替代日期暴露于三个2张床房间和空气患者套房的公共区域的排气空气中。感染控制干预措施在替代日期应用于患者室。豚鼠暴露室A仅在干预措施时才从病房接收空气，而暴露室B仅在控制条件下从患者室接收空气。通过结核蛋白皮肤测试确定，两个腔室中豚鼠感染率的差异是衡量干预措施的功效。要测试的假设是两种快速反应干预措施（感染者和便携式房间空气清洁机的面罩）以及一种预先计划的预防性干预措施（上房间紫外线空气消毒）可以有效地降低人对空中传播的人的风险。具体目的：（1）确定传染病患者的手术口罩是否至少有效地减少传播有效。 （2）确定商业便携式空气消毒单位是否至少有效75％。我们旨在建立清洁的空气输送率与房间空气消毒之间的关系，而与所使用的特定设备无关。我们将同时测试一个常规的HEPA滤清器和新型的低维护静电空气去污技术，以便在外层空间使用。 （3）确定UVGI上层房间是否至少有效75％，以及房间空气混合和低湿度是否是关键功效因素。意义：流感，SARS，天花和MDR-TB是新兴的传染性空中零食。空气设施中的MDR-TB患者和定量豚鼠空气采样为受控感染源强度（替代日策略），环境（空气设施）和宿主易感性（豚鼠）的有效测试提供了独特的模型，该模型既可以保护工人和新的居民和其他建筑居住者和其他建筑居民。用MDR-TB获得的测试结果可能适用于其他完全或部分空气传播的感染。