Quantification of shared air: a social and environmental determinant of airborne disease transmission

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dc.contributor.authorWood, Robinen_ZA
dc.contributor.authorMorrow, Carlen_ZA
dc.contributor.authorGinsberg, Samuelen_ZA
dc.contributor.authorPiccoli, Elizabethen_ZA
dc.contributor.authorKalil, Darrylen_ZA
dc.contributor.authorSassi, Angelinaen_ZA
dc.contributor.authorWalensky, Rochelle Pen_ZA
dc.contributor.authorAndrews, Jason Ren_ZA
dc.date.accessioned2015-11-23T12:31:10Z
dc.date.available2015-11-23T12:31:10Z
dc.date.issued2014en_ZA
dc.description.abstractBACKGROUND: Tuberculosis is endemic in Cape Town, South Africa where a majority of the population become tuberculosis infected before adulthood. While social contact patterns impacting tuberculosis and other respiratory disease spread have been studied, the environmental determinants driving airborne transmission have not been quantified. METHODS: Indoor carbon dioxide levels above outdoor levels reflect the balance of exhaled breath by room occupants and ventilation. We developed a portable monitor to continuously sample carbon dioxide levels, which were combined with social contact diary records to estimate daily rebreathed litres. A pilot study established the practicality of monitor use up to 48-hours. We then estimated the daily volumes of air rebreathed by adolescents living in a crowded township. RESULTS: One hundred eight daily records were obtained from 63 adolescents aged between 12- and 20-years. Forty-five lived in wooden shacks and 18 in brick-built homes with a median household of 4 members (range 2-9). Mean daily volume of rebreathed air was 120.6 (standard error: 8.0) litres/day, with location contributions from household (48%), school (44%), visited households (4%), transport (0.5%) and other locations (3.4%). Independent predictors of daily rebreathed volumes included household type (p = 0.002), number of household occupants (p = 0.021), number of sleeping space occupants (p = 0.022) and winter season (p<0.001). CONCLUSIONS: We demonstrated the practical measurement of carbon dioxide levels to which individuals are exposed in a sequence of non-steady state indoor environments. A novel metric of rebreathed air volume reflects social and environmental factors associated with airborne infection and can identify locations with high transmission potential.en_ZA
dc.identifier.apacitationWood, R., Morrow, C., Ginsberg, S., Piccoli, E., Kalil, D., Sassi, A., ... Andrews, J. R. (2014). Quantification of shared air: a social and environmental determinant of airborne disease transmission. <i>PLoS One</i>, http://hdl.handle.net/11427/15307en_ZA
dc.identifier.chicagocitationWood, Robin, Carl Morrow, Samuel Ginsberg, Elizabeth Piccoli, Darryl Kalil, Angelina Sassi, Rochelle P Walensky, and Jason R Andrews "Quantification of shared air: a social and environmental determinant of airborne disease transmission." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/15307en_ZA
dc.identifier.citationWood, R., Morrow, C., Ginsberg, S., Piccoli, E., Kalil, D., Sassi, A., ... & Andrews, J. R. (2013). Quantification of shared air: a social and environmental determinant of airborne disease transmission. PloS one, 9(9), e106622. doi:10.1371/journal.pone.0106622en_ZA
dc.identifier.ris TY - Journal Article AU - Wood, Robin AU - Morrow, Carl AU - Ginsberg, Samuel AU - Piccoli, Elizabeth AU - Kalil, Darryl AU - Sassi, Angelina AU - Walensky, Rochelle P AU - Andrews, Jason R AB - BACKGROUND: Tuberculosis is endemic in Cape Town, South Africa where a majority of the population become tuberculosis infected before adulthood. While social contact patterns impacting tuberculosis and other respiratory disease spread have been studied, the environmental determinants driving airborne transmission have not been quantified. METHODS: Indoor carbon dioxide levels above outdoor levels reflect the balance of exhaled breath by room occupants and ventilation. We developed a portable monitor to continuously sample carbon dioxide levels, which were combined with social contact diary records to estimate daily rebreathed litres. A pilot study established the practicality of monitor use up to 48-hours. We then estimated the daily volumes of air rebreathed by adolescents living in a crowded township. RESULTS: One hundred eight daily records were obtained from 63 adolescents aged between 12- and 20-years. Forty-five lived in wooden shacks and 18 in brick-built homes with a median household of 4 members (range 2-9). Mean daily volume of rebreathed air was 120.6 (standard error: 8.0) litres/day, with location contributions from household (48%), school (44%), visited households (4%), transport (0.5%) and other locations (3.4%). Independent predictors of daily rebreathed volumes included household type (p = 0.002), number of household occupants (p = 0.021), number of sleeping space occupants (p = 0.022) and winter season (p<0.001). CONCLUSIONS: We demonstrated the practical measurement of carbon dioxide levels to which individuals are exposed in a sequence of non-steady state indoor environments. A novel metric of rebreathed air volume reflects social and environmental factors associated with airborne infection and can identify locations with high transmission potential. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0106622 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Quantification of shared air: a social and environmental determinant of airborne disease transmission TI - Quantification of shared air: a social and environmental determinant of airborne disease transmission UR - http://hdl.handle.net/11427/15307 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/15307
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0106622
dc.identifier.vancouvercitationWood R, Morrow C, Ginsberg S, Piccoli E, Kalil D, Sassi A, et al. Quantification of shared air: a social and environmental determinant of airborne disease transmission. PLoS One. 2014; http://hdl.handle.net/11427/15307.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2014 Wood et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherCarbon dioxideen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherAdolescentsen_ZA
dc.subject.otherRespiratory infectionsen_ZA
dc.subject.otherInfectious disease epidemiologyen_ZA
dc.subject.otherPilot studiesen_ZA
dc.subject.otherMycobacterium tuberculosisen_ZA
dc.subject.otherGlobal positioning systemen_ZA
dc.titleQuantification of shared air: a social and environmental determinant of airborne disease transmissionen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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