Cited by 449Infection Control and VentilationCOVID-19 epidemiological studiesCOVID-19 impact on air quality

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Quantitative assessment of the risk of airborne transmission of SARS-CoV-2 infection: Prospective and retrospective applications

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Buonanno, G., Morawska, L., Stabile, L.·2020·Environment International

DOI 10.1016/j.envint.2020.106112PMC PMC7474922

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Abstract

Airborne transmission is a recognized pathway of contagion; however, it is rarely quantitatively evaluated. The numerous outbreaks that have occurred during the SARS-CoV-2 pandemic are putting a demand on researchers to develop approaches capable of both predicting contagion in closed environments (predictive assessment) and analyzing previous infections (retrospective assessment). This study presents a novel approach for quantitative assessment of the individual infection risk of susceptible subjects exposed in indoor microenvironments in the presence of an asymptomatic infected SARS-CoV-2 subject. The application of a Monte Carlo method allowed the risk for an exposed healthy subject to be evaluated or, starting from an acceptable risk, the maximum exposure time. We applied the proposed approach to four distinct scenarios for a prospective assessment, highlighting that, in order to guarantee an acceptable risk of 10−3 for exposed subjects in naturally ventilated indoor environments, the exposure time could be well below one hour. Such maximum exposure time clearly depends on the viral load emission of the infected subject and on the exposure conditions; thus, longer exposure times were estimated for mechanically ventilated indoor environments and lower viral load emissions. The proposed approach was used for retrospective assessment of documented outbreaks in a restaurant in Guangzhou (China) and at a choir rehearsal in Mount Vernon (USA), showing that, in both cases, the high attack rate values can be justified only assuming the airborne transmission as the main route of contagion. Moreover, we show that such outbreaks are not caused by the rare presence of a superspreader, but can be likely explained by the co-existence of conditions, including emission and exposure parameters, leading to a highly probable event, which can be defined as a “superspreading event”.

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Authors: Buonanno, G., Morawska, L., & Stabile, L.
Affiliations: Queensland University of Technology (AU)
Università degli studi di Cassino e del Lazio Meridionale (IT)
Corresponding author: Stabile, L.
ORCID: Buonanno, G.
Morawska, L.
Stabile, L.
Venue: Environment International
Publisher: Elsevier BV
Published: 2020-12
Volume: 145
Pages: 106112
ISSN: 0160-4120 (ISSN-L)
DOI: 10.1016/j.envint.2020.106112
PMC: PMC7474922
OpenAlex: W3083235507
Cited by: 449
References: 46
Citations by year: 2026: 20 · 2025: 48 · 2024: 55 · 2023: 78 · 2022: 96 · 2021: 117 · 2020: 35
FWCI: 45.83
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: Environment International (publishedVersion, cc-by)
medRxiv (acceptedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Archivio Istituzionale della Ricerca - Università degli Studi di Cassino (submittedVersion)
Topics: Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
Keywords: SARS-CoV-2, airborne transmission, infection risk assessment, indoor microenvironments, asymptomatic infection, exposure time, superspreading events, superspreaders, outbreak investigation, Monte Carlo simulation, attack rate
MeSH terms: Betacoronavirus, COVID-19, SARS-CoV-2, Aerosols, China, Humans, Pneumonia, Viral, Prospective Studies, Retrospective Studies, Air Pollution, Indoor, Coronavirus, Coronavirus Infections, Risk Assessment, Pandemics

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Quantitative assessment of the risk of airborne transmission of SARS-CoV-2 infection: Prospective and retrospective applications

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