Flow dynamics and characterization of a cough

Abstract Airborne disease transmission has always been a topic of wide interests in various fields for decades. Cough is found to be one of the prime sources of airborne diseases as it has high velocity and large quantity of droplets. To understand and characterize the flow dynamics of a cough can help to control the airborne disease transmission. This study has measured flow dynamics of coughs with human subjects. The flow rate variation of a cough with time can be represented as a combination of gamma‐probability‐distribution functions. The variables needed to define the gamma‐probability‐distribution functions can be represented by some medical parameters. A robust multiple linear regression analysis indicated that these medical parameters can be obtained from the physiological details of a person. However, the jet direction and mouth opening area during a cough seemed not related to the physiological parameters of the human subjects. Combining the flow characteristics reported in this study with appropriate virus and droplet distribution information, the infectious source strength by coughing can be evaluated.

Practical Implications

There is a clear need for the scientific community to accurately predict and control the transmission of airborne diseases. Transportation of airborne viruses is often predicted using Computational Fluid Dynamics (CFD) simulations. CFD simulations are inexpensive but need accurate source boundary conditions for the precise prediction of disease transmission. Cough is found to be the prime source for generating infectious viruses. The present study was designed to develop an accurate source model to define thermo‐fluid boundary conditions for a cough. The model can aid in accurately predicting the disease transmission in various indoor environments, such as aircraft cabins, office spaces and hospitals.     

Airborne transmission between room occupants during short‐term events: Measurement and evaluation

This study experimentally examines and compares the dynamics and short‐term events of airborne cross‐infection in a full‐scale room ventilated by stratum, mixing and displacement air distributions. Two breathing thermal manikins were employed to simulate a standing infected person and a standing exposed person. Four influential factors were examined, including separation distance between manikins, air change per hour, positioning of the two manikinsand air distribution. Tracer gas technique was used to simulate the exhaled droplet nuclei from the infected person and fast tracer gas concentration meters (FCM41) were used to monitor the concentrations. Real‐time and average exposure indices were proposed to evaluate the dynamics of airborne exposure. The time‐averaged exposure index depends on the duration of exposure time and can be considerably different during short‐term events and under steady‐state conditions. The exposure risk during short‐term events may not always decrease with increasing separation distance. It changes over time and may not always increase with time. These findings imply that the control measures formulated on the basis of steady‐state conditions are not necessarily appropriate for short‐term events.     

Characterizing exhaled airflow from breathing and talking

Abstract The exhaled air of infected humans is one of the prime sources of contagious viruses. The exhaled air comes from respiratory events such as the coughing, sneezing, breathing and talking. Accurate information on the thermo‐fluid characteristics of the exhaled airflow can be important for prediction of infectious disease transmission. The present study developed a source model to provide the thermo‐fluid conditions of the exhaled air from the breathing and talking processes. The source model is a set of equations obtained from the measurements of the flow rate, flow direction, and area of mouth/nose opening with human subjects. It was found that the exhaled flow rate over time can be represented as a sinusoidal function for breathing and a constant for talking. The flow rates can be calculated by physiological parameters of a subject. The direction of the exhalation jet did not vary much between subjects and the area of mouth/nose opening could be regarded as a constant. Though the mouth/nose opening size varied among subjects, they were not correlated with the physiological parameters of the subjects. If combined with appropriate virus and droplet distribution information, the model can be used to describe the disease source due to breathing and talking.

Practical Implications

Accurate prediction of airborne disease transmission, and the infection prone zones, can aid in identifying and implementing the control strategies. With the recent advancements, Computational Fluid Dynamics (CFD) has become a powerful tool in predicting the disease transmission. Accurate prediction of the transmission by these CFD simulations requires information on sources and sinks of infectious viruses and models for dispersion of these viruses. The exhaled air of an infected human is one of the prime sources of disease viruses. In the present study, measurements of the flow were conducted on human subjects to develop models for the flow boundary conditions for the exhalation and inhalation during breathing and talking.     

Short‐range airborne transmission of expiratory droplets between two people

The occurrence of close proximity infection for many respiratory diseases is often cited as evidence of large droplet and/or close contact transmission. We explored interpersonal exposure of exhaled droplets and droplet nuclei of two standing thermal manikins as affected by distance, humidity, ventilation, and breathing mode. Under the specific set of conditions studied, we found a substantial increase in airborne exposure to droplet nuclei exhaled by the source manikin when a susceptible manikin is within about 1.5 m of the source manikin, referred to as the proximity effect. The threshold distance of about 1.5 m distinguishes the two basic transmission processes of droplets and droplet nuclei, that is, short‐range modes and the long‐range airborne route. The short‐range modes include both the conventional large droplet route and the newly defined short‐range airborne transmission. We thus reveal that transmission occurring in close proximity to the source patient includes both droplet‐borne (large droplet) and short‐range airborne routes, in addition to the direct deposition of large droplets on other body surfaces. The mechanisms of the droplet‐borne and short‐range airborne routes are different; their effective control methods also differ. Neither the current droplet precautions nor dilution ventilation prevents short‐range airborne transmission, so new control methods are needed.     

Inhalation of expiratory droplets in aircraft cabins

Airliner cabins have high occupant density and long exposure time, so the risk of airborne infection transmission could be high if one or more passengers are infected with an airborne infectious disease. The droplets exhaled by an infected passenger may contain infectious agents. This study developed a method to predict the amount of expiratory droplets inhaled by the passengers in an airliner cabin for any flight duration. The spatial and temporal distribution of expiratory droplets for the first 3 min after the exhalation from the index passenger was obtained using the computational fluid dynamics simulations. The perfectly mixed model was used for beyond 3 min after the exhalation. For multiple exhalations, the droplet concentration in a zone can be obtained by adding the droplet concentrations for all the exhalations until the current time with a time shift via the superposition method. These methods were used to determine the amount of droplets inhaled by the susceptible passengers over a 4-h flight under three common scenarios. The method, if coupled with information on the viability and the amount of infectious agent in the droplet, can aid in evaluating the infection risk. PRACTICAL IMPLICATIONS: The distribution of the infectious agents contained in the expiratory droplets of an infected occupant in an indoor environment is transient and non-uniform. The risk of infection can thus vary with time and space. The investigations developed methods to predict the spatial and temporal distribution of expiratory droplets, and the inhalation of these droplets in an aircraft cabin. The methods can be used in other indoor environments to assess the relative risk of infection in different zones, and suitable measures to control the spread of infection can be adopted. Appropriate treatment can be implemented for the zone identified as high-risk zones.     

Droplet fate in indoor environments,or can we prevent the spread of infection?

Abstract Abstract When considering how people are infected and what can be done to prevent the infections, answers from many disciplines are sought: microbiology, epidemiology, medicine, engineering, and physics. There are many pathways to infection spread, and among the most significant from the epidemiological point of view is airborne transport. Microorganisms can become airborne when droplets are generated during speech, coughing, sneezing, vomiting, or atomization of feces during sewage removal. The fate of the droplets is governed by the physical principles of transport, with droplet size being the most important factor affecting their dispersion, deposition on surfaces and determining the survival of microorganisms within the droplets. In addition, physical characteristics of the indoor environment as well as the design and operation of building ventilation systems are of critical importance. Do we understand the mechanisms of infection spread and can we quantify the droplet dynamics under various indoor conditions? Unfortunately no, as this aspect of infection spread has attracted surprisingly little scientific interest. However, investigations of numerous cases in which a large number of people were infected show how critical the physics of microorganism spread can be. This paper reviews the state of knowledge regarding mechanisms of droplet spread and solutions available to minimize the spread and prevent infections.     

Optimization of variables in air conditioning control systems: Applications of simulations integrating CFD analysis and response factor method

The integration of three-dimensional spatial distributions into building simulations is of significant interest, and computational fluid dynamics (CFD) analysis is widely employed in building design processes. For example, based on the experience of architects and engineers, CFD analyses are often conducted under steady boundary conditions to determine the degree of attainment of indoor environments. However, CFD analyses have large calculation costs and cannot be often used for simulations with unsteady boundary conditions such as energy simulations in the building design processes. Thus, we developed a method that calculates sensitivities from heat sources to an arbitrary point in an indoor environment and integrates them into simulations with unsteady boundary conditions. In the proposed method, CFD analysis is employed under steady boundary conditions to calculate the response factors, and the resulting sensitivities are integrated into simulations under unsteady boundary conditions. In the present study, the proposed method was applied to optimize the variables of an air conditioning control system. With our method, temperature changes at a sensor over time are calculated from the time series of air supply temperature. In total, 800 calculations were conducted, and the optimal variables that allow the temperature at the sensor to reach the target value quickly were obtained. Except for the time required to calculate the response factors, the optimization in the present study took only a few seconds. If only CFD analysis was used for the optimization, the calculations would take a year. Thus, calculating the sensitivities via CFD analysis and utilizing the results in simulations is a useful approach for solving optimization problems. Moreover, the proposed method is applicable to simulations that require three-dimensional spatial distributions to enhance the accuracy of the calculation such as energy simulations.     

Modeling the evaporation and dispersion of airborne sputum droplets expelled from a human cough

This study contributes a new model to simulate the evaporation and dispersion of sputum droplets from human coughs or sneezes. It is the first time different chemical components have been included in order to estimate the transport of sputum or similar biological droplets. This modified model demonstrates the ability to describe real-world phenomena that the widely used single droplet model lacks. Evaporation and dispersion of airborne sputum droplets originating from a human cough are simulated using this model combined with an initially buoyant turbulent jet. Constituents of sputum droplets such as NaCl, amino acids, carbohydrates, and lipids are included. Effects of these chemical components on evaporation rate, velocity, and temperature of droplets are investigated in detail. The results obtained for sputum droplets will provide a perspective of what conditions the viruses within a droplet might face upon being ejected from the mouth during a cough. Finally, computational fluid dynamics (CFD) and probability density function (PDF) techniques were used to complement the new model with a simulation of a cough jet and the dynamics of droplet nuclei in confined spaces. Numerical results indicate that a 10 microns sputum droplet will evaporate to become a droplet nucleus (3.5 microns) in 0.55 s at 0.8 or 80% RH, in 0.3 s at 0.5 or 50% RH, and in 0.25 s at 0.2 or 20% RH. The droplet temperature decreases rapidly from human body temperature to room temperature, which may affect the viability of any carried virus.     

Coupled simulations for naturally ventilated rooms between building simulation (BS) and computational fluid dynamics (CFD) for better prediction of indoor thermal environment

The coupling strategies for natural ventilation between building simulation (BS) and computational fluid dynamics (CFD) are discussed and coupling methodology for natural ventilation is highlighted. Two single-zone cases have been used to validate coupled simulations with full CFD simulations. The main discrepancy factors have also been analyzed. The comparison results suggest that for coupled simulations taking pressure from BS as inlet boundary conditions can provide more accurate results for indoor CFD simulation than taking velocity from BS as boundary conditions. The validation results indicate that coupled simulations can improve indoor thermal environment prediction for natural ventilation taking wind as the major force. With the aids of developed coupling program, coupled simulations between BS and CFD can effectively improve the speed and accuracy in predicting indoor thermal environment for natural ventilation studies.     

Experimental investigation of far-field human cough airflows from healthy and influenza-infected subjects

Seasonal influenza epidemics have been responsible for causing increased economic expenditures and many deaths worldwide. Evidence exists to support the claim that the virus can be spread through the air, but the relative significance of airborne transmission has not been well defined. Particle image velocimetry (PIV) and hot-wire anemometry (HWA) measurements were conducted at 1 m away from the mouth of human subjects to develop a model for cough flow behavior at greater distances from the mouth than were studied previously. Biological aerosol sampling was conducted to assess the risk of exposure to airborne viruses. Throughout the investigation, 77 experiments were conducted from 58 different subjects. From these subjects, 21 presented with influenza-like illness. Of these, 12 subjects had laboratory-confirmed respiratory infections. A model was developed for the cough centerline velocity magnitude time history. The experimental results were also used to validate computational fluid dynamics (CFD) models. The peak velocity observed at the cough jet center, averaged across all trials, was 1.2 m/s, and an average jet spread angle of θ = 24° was measured, similar to that of a steady free jet. No differences were observed in the velocity or turbulence characteristics between coughs from sick, convalescent, or healthy participants.     

Predicting transient particle transport in enclosed environments with the combined computational fluid dynamics and Markov chain method

To quickly obtain information about airborne infectious disease transmission in enclosed environments is critical in reducing the infection risk to the occupants. This study developed a combined computational fluid dynamics (CFD) and Markov chain method for quickly predicting transient particle transport in enclosed environments. The method first calculated a transition probability matrix using CFD simulations. Next, the Markov chain technique was applied to calculate the transient particle concentration distributions. This investigation used three cases, particle transport in an isothermal clean room, an office with an underfloor air distribution system, and the first‐class cabin of an MD‐82 airliner, to validate the combined CFD and Markov chain method. The general trends of the particle concentrations vs. time predicted by the Markov chain method agreed with the CFD simulations for these cases. The proposed Markov chain method can provide faster‐than‐real‐time information about particle transport in enclosed environments. Furthermore, for a fixed airflow field, when the source location is changed, the Markov chain method can be used to avoid recalculation of the particle transport equation and thus reduce computing costs.     

The predictions of infection risk of indoor airborne transmission of diseases in high-rise hospitals: Tracer gas simulation

The spread of diseases from infected patients within hospitals is resulting in many human casualties. If a virus were to be transmitted through uncontrolled air movement within a hospital and were then to infect other patients or healthy visitors, it would be impossible to contain the spread of the disease. The purpose of this paper is to apply reliable boundary conditions based on previous studies in order to analyze the airflow pattern caused by the stack effect in high-rise hospitals. An analysis was carried out on the vertical airborne transmission of viruses according to the location of the infected patients. The horizontal airborne transmission based on the characteristics of the supply air diffuser and return air grille was also analyzed by using the multi-zone airflow simulation and tracer gas (CFD) simulation. In addition, this paper explored solutions to prevent the spread of airborne pathogenic bacteria by analyzing various alternatives of HVAC systems and basic data on ventilation system planning for high-rise hospitals.     

Indoor cooling/heating load analysis based on coupled simulation of convection,radiation and HVAC control

A computational fluid dynamics (CFD) simulation for analyzing indoor cooling/heating load is presented in this study. It is coupled with a radiative heat transfer simulation and heating, ventilating, and air-conditioning (HVAC) controlling system in a room. This new method feeds back the outputs of the HVAC system control to the input boundary conditions of the CFD, and this method includes a human model to evaluate the thermal environment. It would be used to analyze the heating/cooling loads of different HVAC systems under the condition of the same human thermal sensation (e.g. PMV, operative temperature, etc.) even though the temperature and air-velocity distribution in the room are different from each other.To examine the performance of the new method, a cooling load and a thermal environment within a semi-enclosed space, which opens into an atrium space, is analyzed under the steady-state conditions during the summer season. This method is able to analyze the indoor cooling load with changes of target thermal environments of a room and/or changing clothing conditions of occupants considering the temperature and air-velocity distribution in the room. In this paper, two types of HVAC system are compared; i.e. radiation-panel system and all-air cooling system. The radiation-panel cooling system is found to be more energy efficient for cooling the semi-enclosed space. Changes of the level of thermal environment reduce cooling load effectively in case of the all-air cooling system while the radiation-panel system does not reduce cooling load even though the targeted thermal condition is relaxed. Energy saving effect is expected by easing the clothing conditions of occupants. In this study, the reducing effect of cooling load is quantitatively evaluated with clothing conditions also.     

Variability in expiratory trajectory angles during consonant production by one human subject and from a physical mouth model: Application to respiratory droplet emission

The COVID-19 pandemic has highlighted the need to improve understanding of droplet transport during expiratory emissions. While historical emphasis has been placed on violent events such as coughing and sneezing, the recognition of asymptomatic and presymptomatic spread has identified the need to consider other modalities, such as speaking. Accurate prediction of infection risk produced by speaking requires knowledge of both the droplet size distributions that are produced, as well as the expiratory flow fields that transport the droplets into the surroundings. This work demonstrates that the expiratory flow field produced by consonant productions is highly unsteady, exhibiting extremely broad inter- and intra-consonant variability, with mean ejection angles varying from ≈+30° to −30°. Furthermore, implementation of a physical mouth model to quantify the expiratory flow fields for fricative pronunciation of [f] and [θ] demonstrates that flow velocities at the lips are higher than previously predicted, reaching 20–30 m/s, and that the resultant trajectories are unstable. Because both large and small droplet transport are directly influenced by the magnitude and trajectory of the expirated air stream, these findings indicate that prior investigations of the flow dynamics during speech have largely underestimated the fluid penetration distances that can be achieved for particular consonant utterances.     

CFD boundary conditions for contaminant dispersion,heat transfer and airflow simulations around human occupants in indoor environments

Indoor computational fluid dynamics (CFD) simulations can predict contaminant dispersion around human occupants and provide valuable information in resolving indoor air quality or homeland security problems. The accuracy of CFD simulations strongly depends on the appropriate setting of boundary conditions and numerical simulation parameters. The present study explores influence of the following three key boundary condition settings on the simulation accuracy: (1) contaminant source area size, (2) convective/radiative heat fluxes, and (3) shape/size of human simulators. For each of the boundary conditions, numerical simulations were validated with experimental data obtained in two different environmental chambers. In CFD simulations, a small release area of a contaminant point source causes locally high concentration gradients that require a very fine local grid system. This fine grid system can slow down the simulations substantially. The convergence speed of calculation is greatly increased by the source area enlargement. This method will not influence the simulation accuracy of passive point source within well-predicted airflow field. However, for active point source located within complicated airflow filed, such an enlargement should be carried out cautiously because simulation inaccuracy might be introduced. For setting thermal boundary conditions, convection to radiation heat flux ratio is critical for accurate CFD computations of temperature profiles around human simulators. The recommended convection to radiation (C:R) ratio is 30:70 for human simulators. Finally, simplified human simulators can provide accurate temperature profiles within the whole domain of interest. However, velocity and contaminant concentration simulations require further work in establishing the influence of simplifications on the simulation accuracy in the vicinity of the human simulator.     

Microbial analyses of airborne dust collected from dormitory rooms predict the sex of occupants

We have long known that human occupants are a major source of microbes in the built environment, thus raising the question: How much can we learn about the occupants of a building by analyzing the microbial communities found in indoor air? We investigated bacterial and fungal diversity found in airborne dust collected onto heating, ventilation, and air‐conditioning (HVAC) air filters and settling plates from 91 rooms within a university dormitory. The sex of the room occupants had the most significant effect on the bacterial communities, while the room occupants had no significant effect on fungal communities. By examining the abundances of bacterial genera, we could predict the sex of room occupants with 79% accuracy, a finding that demonstrates the potential forensic applications of studying indoor air microbiology. We also identified which bacterial taxa were indicators of female and male rooms, and found that those taxa often identified as members of the vaginal microbiome were more common in female‐occupied rooms while taxa associated with human skin or the male urogenital microbiota were more common in male‐occupied rooms.     

Comparison of STAR-CCM+ and ANSYS Fluent for simulating indoor airflows

Suitable air distributions are essential for creating thermally comfortable and healthy conditions in indoor spaces. Computational fluid dynamics (CFD) is widely used to predict air distributions. This study systematically assessed the performance of the two most popular CFD programs, STAR-CCM+ and ANSYS Fluent, in predicting air distributions. The assessment used the same meshes and thermo-fluid boundary conditions for several types of airflow found in indoor spaces, and experimental data from the literature. The programs were compared in terms of grid-independent solutions; turbulent viscosity calculations; heat transfer coefficients as determined by wall functions; and complex flow with complicated boundary conditions. The two programs produced almost the same results with similar computing effort, although ANSYS Fluent seemed slightly better in some aspects.     

Evaporation and dispersion of respiratory droplets from coughing

Understanding how respiratory droplets become droplet nuclei and their dispersion is essential for understanding the mechanisms and control of disease transmission via droplet‐borne and airborne routes. A theoretical model was developed to estimate the size of droplet nuclei and their dispersion as a function of the ambient humidity and droplet composition. The model‐predicted dried droplet nuclei size was 32% of the original diameter, which agrees with the maximum residue size in the classic study by Duguid, 1946, Edinburg Med. J., 52 , 335 and the validation experiment in this study, but is smaller than the 50% size predicted by Nicas et al., 2005, J. Occup. Environ. Hyg., 2 , 143. The droplet nuclei size at a relative humidity of 90% (25°C) could be 30% larger than the size of the same droplet at a relative humidity of less than 67.3% (25°C). The trajectories of respiratory droplets in a cough jet are significantly affected by turbulence, which promotes the wide dispersion of droplets. We found that medium‐sized droplets (e.g., 60 μm) are more influenced by humidity than are smaller and larger droplets, while large droplets (≥100 μm), whose travel is less influenced by humidity, quickly settle out of the jet.     

Role of mechanical ventilation in the airborne transmission of infectious agents in buildings

Infectious disease outbreaks and epidemics such as those due to SARS, influenza, measles, tuberculosis, and Middle East respiratory syndrome coronavirus have raised concern about the airborne transmission of pathogens in indoor environments. Significant gaps in knowledge still exist regarding the role of mechanical ventilation in airborne pathogen transmission. This review, prepared by a multidisciplinary group of researchers, focuses on summarizing the strengths and limitations of epidemiologic studies that specifically addressed the association of at least one heating, ventilating and/or air‐conditioning (HVAC) system‐related parameter with airborne disease transmission in buildings. The purpose of this literature review was to assess the quality and quantity of available data and to identify research needs. This review suggests that there is a need for well‐designed observational and intervention studies in buildings with better HVAC system characterization and measurements of both airborne exposures and disease outcomes. Studies should also be designed so that they may be used in future quantitative meta‐analyses.     

Impact of airflow profile on indoor air quality—a tropical study

The validation of the concentration levels of indoor contaminants and the measurement of ventilation parameters with CFD simulation results often poses considerable difficulty due to the effect of several confounding factors. Whilst a building in dynamic operation with varying operating characteristics in terms of the air-conditioning system and the activities of the occupants renders the possibility of a continuous measurement of IAQ and ventilation data, it is almost impossible to simulate such dynamic changes in the CFD environment. It then becomes imperative that steady-state measurements in buildings be used as representative data for the purposes of CFD simulation. This paper reports the findings of a study, in which the simulation of airflow pattern in an office building in Singapore is based on the indoor environmental conditions and the corresponding ventilation parameters measured on a typical day. Boundary conditions are obtained through hood measurements to determine the airflow rate from each diffuser. The findings of this study clearly support the critical impact of airflow on pollutant pathways in the building as a result of air supply volume, arrangement of air inlet and outlet devices, space design and the presence of heat sources.