Cited by 623Infection Control and VentilationDental Research and COVID-19COVID-19 impact on air quality

Particle Sizes of Infectious Aerosols: Implications for Infection Control

Open access
Fennelly, Kevin P·2020·The Lancet Respiratory Medicine

Abstract

The global pandemic of COVID-19 has been associated with infections and deaths among health-care workers. This Viewpoint of infectious aerosols is intended to inform appropriate infection control measures to protect health-care workers. Studies of cough aerosols and of exhaled breath from patients with various respiratory infections have shown striking similarities in aerosol size distributions, with a predominance of pathogens in small particles (<5 μm). These are immediately respirable, suggesting the need for personal respiratory protection (respirators) for individuals in close proximity to patients with potentially virulent pathogens. There is no evidence that some pathogens are carried only in large droplets. Surgical masks might offer some respiratory protection from inhalation of infectious aerosols, but not as much as respirators. However, surgical masks worn by patients reduce exposures to infectious aerosols to health-care workers and other individuals. The variability of infectious aerosol production, with some so-called super-emitters producing much higher amounts of infectious aerosol than most, might help to explain the epidemiology of super-spreading. Airborne infection control measures are indicated for potentially lethal respiratory pathogens such as severe acute respiratory syndrome coronavirus 2.

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Crossref · 10.1016/s2213-2600(20)30323-4

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  • Both measured airborne bacteria size distributions in Figure 1 span approximately da = 1-10 μm.

    “Both measured airborne bacteria size distributions in Figure 1 [49,50] span approximately da = 1–10 µm”

    From Comparative Mask Protection against Inhaling Wildfire Smoke, Allergenic Bioaerosols, and Infectious Particles (2022) · cites this paper as [49]

    The Cough aerosol studies section identifies Figure 1 as showing measured particle-size distributions for two bacterial cough aerosols: tuberculosis and Pseudomonas aeruginosa. It reports that most particles in each were below 4.7 µm, but our copy does not give the plotted distributions’ endpoints, so the approximate 1–10 µm span cannot be verified. (LLM, conf=0.81)

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Research works printed but not linked: 2

  1. [6]CADTH Rapid Response Reports Respiratory precautions for protection from bioaerosols or infectious agents: a review of the clinical effectiveness and guidelines 2014 Canadian Agency for Drugs and Technologies in Health Ottawa 25411668
  2. [100]Santarpia JL Rivera DN Herrera V Aerosol and surface transmission potential of SARS-CoV-2 medRxiv 2020 https://doi.org/2020.03.23.20039446 published online June 3. (preprint).

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Authors
Fennelly, K. P.
Affiliations
National Institutes of Health (US)
Corresponding author
Fennelly, Kevin P
Venue
The Lancet Respiratory Medicine
Publisher
Elsevier BV
Published
2020-09
Volume
8
Issue
9
Pages
914-924
ISSN
2213-2600 (ISSN-L)
OpenAlex
W3044072752
Cited by
621
References
145
Citations by year
2026: 42 · 2025: 58 · 2024: 83 · 2023: 75 · 2022: 119 · 2021: 185 · 2020: 59
FWCI
15.48
Type
journal article
Language
en
Open access
Locations
  • The Lancet Respiratory Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • reponame:Expeditio Repositorio Institucional UJTL
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
  • Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
  • Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
Keywords
infectious aerosols, aerosol particle size, infection control, healthcare workers, COVID-19 pandemic, SARS-CoV-2, respiratory protection, respirators, surgical masks, cough aerosols, exhaled breath, super-emitters, superspreading, airborne transmission, respiratory pathogens
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Aerosols, Health Personnel, Humans, Particle Size, Pneumonia, Viral, Infection Control, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Inhalation Exposure, Pandemics

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