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Particle sizes of infectious aerosols: implications for infection control
Open accessAbstract
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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“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]
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Hu, L., Liu, Z., Yao, G., Shang, Z., Hu, C., Lu, L., Rong, R., Zhou, T., & Cai, D. (2026) · Journal of Hazardous Materials · doi:10.1016/j.jhazmat.2026.142353 · Cited by 1
Fan, Z., Yin, X., Ma, M., Du, B., Liu, Z., Xu, J., Liu, B., & Tong, Z. (2026) · Biosensors and Bioelectronics · doi:10.1016/j.bios.2026.118885 · Cited by 1
Analysis of aerosol production and aerosol dispersion during otologic surgery
Serrano, M. G., Santiago‐Sáez, A., Rodriguez, R. M., Salcedo, A. L., Perez-Botija, A. P., Sanzen-Baker, W. A., Martín, Á. F. G., García, J. A. G., & Moreno, M. C. I. (2021) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-021-07059-y · Cited by 1
Maingard, J. T., Montalverne, F. J., & Chandra, R. V. (2021) · Interventional Neuroradiology · doi:10.1177/15910199211035307 · Cited by 1
State of Poor Ventilation and Indoor Air Environment in Buildings
Hayashi, M. (2022) · Indoor Environment · doi:10.7879/siej.25.33 · Cited by 1
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Czerwiński, J., Mayer, A., Mayer, J., Burtscher, H., Lutz, T. W., Mayer, R., Rothen‐Rutishauser, B., Joachim Frey, A., Lämmle, C., Rüggeberg, T., et al. (2023) · Silniki Spalinowe/Combustion Engines · doi:10.19206/ce-168141 · Cited by 1
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Paradiso, M., Maccallini, L., Vericat, A., Romero, F., & Encinas, D. (2022) · International Conference on Computational Science and Computational Intelligence (CSCI) · doi:10.1109/csci58124.2022.00244 · Cited by 1
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Souza, V. O. D., de Souza, L. L., de Oliveira, R. C., & Freitas, S. R. S. (2023) · Educere · doi:10.25110/educere.v23i3.2023-010 · Cited by 1
Materials Delay Impact due to COVID-19 on Construction Projects
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Total outward leakage of face-worn products used by the general public for source control
Yang, W., Myers, W. R., Bergman, M., Fisher, E. M., Ryan, K. J., Vollmer, B., Portnoff, L., & Zhuang, Z. (2024) · American Journal of Infection Control · doi:10.1016/j.ajic.2024.09.020 · Cited by 1
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Yang, W., Myers, W. R., Bergman, M., Fisher, E. M., Ryan, K. J., Vollmer, B., Portnoff, L., & Zhuang, Z. (2024) · Aerosol Science and Technology · doi:10.1080/02786826.2024.2427282 · Cited by 2
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Pieris, S., Leung, R., Yarusevych, S. V., Peterson, S. D., & Duriseti, R. S. (2025) · Aerosol Science and Technology · doi:10.1080/02786826.2025.2453587 · Cited by 1
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Metadata
- Authors
- Fennelly, K. P.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Fennelly, Kevin P
- ORCID
- 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)
- PMC
- PMC7380927
- 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
- bronze
- doi.org
- 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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