Air cleaners and respiratory infections in schools. A modeling study using epidemiological, environmental, and molecular data
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Authors
Banholzer, Nicolas
Jent, Philipp
Bittel, Pascal
Zürcher, Kathrin
Furrer, Lavinia
Bertschinger, Simon
Ramette, Alban
Egger, Matthias
Hascher, Tina
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Publication date
30.12.2023
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01A - Journal article
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Open Forum Infectious Diseases
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Oxford University Press
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Abstract
AbstractBackgroundUsing a multiple-measurement approach, we examined the real-world effectiveness of portable HEPA-air filtration devices (air cleaners) in a school setting.MethodsWe collected environmental (CO2, particle concentrations), epidemiological (absences related to respiratory infections), audio (coughing), and molecular data (bioaerosol and saliva samples) over seven weeks during winter 2022/2023 in two Swiss secondary school classes. Using a cross-over study design, we compared particle concentrations, coughing, and the risk of infection with vs without air cleaners.ResultsAll 38 students (age 13−15 years) participated. With air cleaners, mean particle con-centration decreased by 77% (95% credible interval 63%−86%). There were no differences in CO2levels. Absences related to respiratory infections were 22 without vs 13 with air cleaners. Bayesian modeling suggested a reduced risk of infection, with a posterior probability of 91% and a relative risk of 0.73 (95% credible interval 0.44−1.18). Coughing also tended to be less frequent (posterior probability 93%). Molecular analysis detected mainly non-SARS-CoV-2 viruses in saliva (50/448 positive), but not in bioaerosols (2/105 positive) or HEPA-filters (4/160). The detection rate was similar with vs without air cleaners. Spatiotemporal analysis of positive saliva samples identified several likely transmissions.ConclusionsAir cleaners improved air quality, showed a potential benefit in reducing respiratory infections, and were associated with less coughing. Airborne detection of non-SARS-CoV-2 viruses was rare, suggesting that these viruses may be more difficult to detect in the air. Future studies should examine the importance of close contact and long-range transmission, and the cost-effectiveness of using air cleaners.
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610 - Medizin und Gesundheit
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2328-8957
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English
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Yes
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Published
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BANHOLZER, Nicolas, Philipp JENT, Pascal BITTEL, Kathrin ZÜRCHER, Lavinia FURRER, Simon BERTSCHINGER, Ernest WEINGARTNER, Alban RAMETTE, Matthias EGGER, Tina HASCHER und Lukas FENNER, 2023. Air cleaners and respiratory infections in schools. A modeling study using epidemiological, environmental, and molecular data. Open Forum Infectious Diseases. 30 Dezember 2023. DOI 10.1101/2023.12.29.23300635. Verfügbar unter: https://irf.fhnw.ch/handle/11654/46626