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Showing papers by "Lidia Morawska published in 2021"


Journal ArticleDOI
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels.
Abstract: Summary Background Regularly updated data on stroke and its pathological types, including data on their incidence, prevalence, mortality, disability, risk factors, and epidemiological trends, are important for evidence-based stroke care planning and resource allocation. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) aims to provide a standardised and comprehensive measurement of these metrics at global, regional, and national levels. Methods We applied GBD 2019 analytical tools to calculate stroke incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and the population attributable fraction (PAF) of DALYs (with corresponding 95% uncertainty intervals [UIs]) associated with 19 risk factors, for 204 countries and territories from 1990 to 2019. These estimates were provided for ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and all strokes combined, and stratified by sex, age group, and World Bank country income level. Findings In 2019, there were 12·2 million (95% UI 11·0–13·6) incident cases of stroke, 101 million (93·2–111) prevalent cases of stroke, 143 million (133–153) DALYs due to stroke, and 6·55 million (6·00–7·02) deaths from stroke. Globally, stroke remained the second-leading cause of death (11·6% [10·8–12·2] of total deaths) and the third-leading cause of death and disability combined (5·7% [5·1–6·2] of total DALYs) in 2019. From 1990 to 2019, the absolute number of incident strokes increased by 70·0% (67·0–73·0), prevalent strokes increased by 85·0% (83·0–88·0), deaths from stroke increased by 43·0% (31·0–55·0), and DALYs due to stroke increased by 32·0% (22·0–42·0). During the same period, age-standardised rates of stroke incidence decreased by 17·0% (15·0–18·0), mortality decreased by 36·0% (31·0–42·0), prevalence decreased by 6·0% (5·0–7·0), and DALYs decreased by 36·0% (31·0–42·0). However, among people younger than 70 years, prevalence rates increased by 22·0% (21·0–24·0) and incidence rates increased by 15·0% (12·0–18·0). In 2019, the age-standardised stroke-related mortality rate was 3·6 (3·5–3·8) times higher in the World Bank low-income group than in the World Bank high-income group, and the age-standardised stroke-related DALY rate was 3·7 (3·5–3·9) times higher in the low-income group than the high-income group. Ischaemic stroke constituted 62·4% of all incident strokes in 2019 (7·63 million [6·57–8·96]), while intracerebral haemorrhage constituted 27·9% (3·41 million [2·97–3·91]) and subarachnoid haemorrhage constituted 9·7% (1·18 million [1·01–1·39]). In 2019, the five leading risk factors for stroke were high systolic blood pressure (contributing to 79·6 million [67·7–90·8] DALYs or 55·5% [48·2–62·0] of total stroke DALYs), high body-mass index (34·9 million [22·3–48·6] DALYs or 24·3% [15·7–33·2]), high fasting plasma glucose (28·9 million [19·8–41·5] DALYs or 20·2% [13·8–29·1]), ambient particulate matter pollution (28·7 million [23·4–33·4] DALYs or 20·1% [16·6–23·0]), and smoking (25·3 million [22·6–28·2] DALYs or 17·6% [16·4–19·0]). Interpretation The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years. The highest age-standardised stroke-related mortality and DALY rates were in the World Bank low-income group. The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index. Without urgent implementation of effective primary prevention strategies, the stroke burden will probably continue to grow across the world, particularly in low-income countries. Funding Bill & Melinda Gates Foundation.

1,473 citations


Journal ArticleDOI
TL;DR: It is explored how the risk of infection would vary with several influential factors: ventilation rate, duration of event, and deposition onto surfaces, to better understand the factors that promote superspreading events.
Abstract: During the 2020 COVID-19 pandemic, an outbreak occurred following attendance of a symptomatic index case at a weekly rehearsal on 10 March of the Skagit Valley Chorale (SVC). After that rehearsal, 53 members of the SVC among 61 in attendance were confirmed or strongly suspected to have contracted COVID-19 and two died. Transmission by the aerosol route is likely; it appears unlikely that either fomite or ballistic droplet transmission could explain a substantial fraction of the cases. It is vital to identify features of cases such as this to better understand the factors that promote superspreading events. Based on a conditional assumption that transmission during this outbreak was dominated by inhalation of respiratory aerosol generated by one index case, we use the available evidence to infer the emission rate of aerosol infectious quanta. We explore how the risk of infection would vary with several influential factors: ventilation rate, duration of event, and deposition onto surfaces. The results indicate a best-estimate emission rate of 970 ± 390 quanta/h. Infection risk would be reduced by a factor of two by increasing the aerosol loss rate to 5 h-1 and shortening the event duration from 2.5 to 1 h.

465 citations



Journal ArticleDOI
TL;DR: COVID-19 patients recruited in Beijing exhaled millions of SARS-CoV-2 RNA copies into the air per hour, and exhaled breath samples had the highest positive rate, suggesting breath emission may play an important role in the CO VID-19 transmission.
Abstract: Coronavirus disease 2019 (COVID-19) patients exhaled millions of severe acute respiratory syndrome coronavirus 2 RNA copies per hour, which plays an important role in COVID-19 transmission. Exhaled breath had a higher positive rate (26.9%, n = 52) than surface (5.4%, n = 242) and air (3.8%, n = 26) samples.

184 citations


Journal ArticleDOI
Katherine R. Paulson1, Aruna M Kamath1, Tahiya Alam1, Kelly Bienhoff1  +735 moreInstitutions (4)
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030, were presented in this paper.

176 citations


Journal ArticleDOI
14 May 2021-Science
TL;DR: In this paper, the authors suggest that the dramatic growth in our understanding of the mechanisms behind respiratory infection transmission should drive a paradigm shift in how we view and address the transmission of respiratory infections to protect present and future generations from unnecessary suffering and economic losses.
Abstract: There is great disparity in the way we think about and address different sources of environmental infection. Governments have for decades promulgated a large amount of legislation and invested heavily in food safety, sanitation, and drinking water for public health purposes. In contrast, airborne pathogens and respiratory infections, whether seasonal influenza or COVID-19, are ad-dressed fairly weakly, if at all, in terms of regulations, standards, and building design and operation, pertaining to the air we breathe. We suggest that the dramatic growth in our understanding of the mechanisms behind respiratory infection transmission should drive a paradigm shift in how we view and address the transmission of respiratory infections to protect present and future generations from unnecessary suffering and economic losses. It starts with a recognition that preventing respiratory infection, like reducing waterborne or food-borne disease, is a tractable problem. See Additional URL below for 'free to read' PDF reprint.

155 citations


Journal ArticleDOI
TL;DR: Modelling the probability of infection whilst travelling in buses under different scenarios indicates that forced ventilation greatly reduces the risk of infection, and best practice demands that regular vehicle disinfection in public transport worldwide needs to be rigorously ascertained to be effective at eliminating traces of the virus throughout the vehicle.

105 citations


Journal ArticleDOI
TL;DR: It is concluded that the influences of different GI options on air quality in street canyons depend on street canyon geometry, meteorological conditions and vegetation characteristics, and a need for further research, particularly on green walls and green screens, to substantiate their efficacy and investigate technical considerations.

95 citations


Journal ArticleDOI
TL;DR: While there is a critical need for strengthening hospital discharge standards in preventing re-emergence of COVID-19 spread, use of breath sample as a supplement specimen could further guard the hospital discharge to ensure the safety of the public and minimize the pandemic re- emergence risk.

69 citations


Journal ArticleDOI
TL;DR: In this paper, a mass balance approach is used to quantify the ability of both mechanical ventilation and ad-hoc airing procedures to mitigate airborne transmission risk in the classroom environment, and a feedback control strategy using CO2 concentrations to continuously monitor and adjust the airing procedure is proposed.

62 citations


Journal ArticleDOI
TL;DR: In this article, an integrated risk assessment is presented for SARS-CoV-2 close proximity exposure between a speaking infectious subject and a susceptible subject, based on a three-dimensional transient numerical model for the description of exhaled droplet spread once emitted by a speaking person, coupled with a recently proposed SARS CoV2 emission approach.

Journal ArticleDOI
TL;DR: In this paper, the authors provided global, regional, and national estimates of the burden of tracheal, bronchus, and lung cancer and larynx cancer and their attributable risks from 1990 to 2019.


Journal ArticleDOI
TL;DR: The potential role of air pollution in the spread and worsening of health impacts of COVID-19, and the influence of the pandemic on air pollution levels in Europe is explored in this paper.
Abstract: The potential role of air pollution in the spread and worsening of health impacts of COVID-19, and the influence of the pandemic on air pollution levels in Europe is explored. We outline the major lessons learned to chart a healthy post-pandemic course.

Journal ArticleDOI
TL;DR: Wang et al. as mentioned in this paper investigated the association between maternal exposure to ambient air pollution on congenital heart defects (CHD) and its subtypes and found that maternal exposure during the first trimester was associated with an increased odds of CHD.

Journal ArticleDOI
TL;DR: The authors of as discussed by the authors truly appreciate the funding provided by Nazarbayev University through the Collaborative Research Grant (grant number: 091019CRP2104), and they would like to acknowledge the resources provided by CART and EREC to conduct this research.
Abstract: The authors of this study truly appreciate the funding provided by Nazarbayev University through the Collaborative Research Grant (grant number: 091019CRP2104). MAT, MN, EA, and NE are the members of the Chemical and Aerosol Research Team (CART) and also the Environment and Resource Efficiency Cluster (EREC) at Nazarbayev University, and they would like to acknowledge the resources provided by CART and EREC to conduct this research. For India, except for Delhi, daily and hourly averaged air quality data were obtained from the Central Pollution Control Board (CPCB) CCR, OpenAQ or Air quality historical data platform, and location of stations were obtained from the OpenAQ website. CPCB is gratefully acknowledged for making the data available. Further, the CPCB data were consolidated and curated by Mr Prem Maheshwarkar, Earth and Environmental Sciences, IISER Bhopal whose contribution is also acknowledged. In Chile, the contributions made by Mr. Roberto Martinez, Head of the Planning and the Standards, Department of the Air Quality and Climate Change Division, Ministry for the Environment to provide data to this study, are greatly appreciated. In Brazil, CETESB (Environmental Company of the State of Sao Paulo) is acknowledged for its contribution to data preparation. In Cyprus, the authors would like to thank the Department of Labor Inspection of the Ministry of Environment of the Republic of Cyprus for providing the observational data for their monitoring network. For New Zealand, authors acknowledge the Environment Canterbury as the source for the Christchurch data. For Spain, Barcelona, the authors would like to thank "Department of Environmental Quality, Generalitat de Catalunya" as the data source. Turkish Ministry of Environment and Urbanization and Turkish State of Meteorological Services provided air quality and meteorological data, respectively, that are greatly appreciated. In the Netherlands, data were obtained from the National Institute for Public Health and the Environment (RIVM) and contained additional data from the GGD Amsterdam (provided by Dave de Jonge) and the DCMR Environmental Protection Agency (provided by Ed van der Gaag) and National Institute for Public Health and the Environment (RIVM) that are greatly appreciated. The authors would like to thank Tehran Air Quality Control Company for providing the data for the city of Tehran.

Journal ArticleDOI
TL;DR: In this paper, a new design method is proposed to calculate outdoor air ventilation rates to control respiratory infection risk in indoor spaces, which makes it possible to calculate the required ventilation rate at a given probability of infection and quanta emission rate.

Journal ArticleDOI
TL;DR: In this paper, the authors examined the trade-offs between in-car aerosol concentrations, ventilation and respiratory infection transmission under three ventilation settings: windows open (WO), windows closed with air-conditioning on ambient air mode (WC-AA), and windows closed closed with AC on recirculation (WCRC).

Journal ArticleDOI
23 Mar 2021
TL;DR: In every breath, humans take in particles that may be deposited on the respiratory tract and exhale particles that contain pathogens as mentioned in this paper, and they explain how physics advances are needed to understand these processes.
Abstract: In every breath, humans take in particles that may be deposited on the respiratory tract and exhale particles that may contain pathogens. Lidia Morawska and Giorgio Buonanno explain how physics advances are needed to understand these processes.

Journal ArticleDOI
TL;DR: In this paper, the authors assess the strength of a predictive estimation approach developed by the authors for SARS-CoV-2 and uses novel estimates to compare the contagiousness of respiratory pathogens.
Abstract: The infectious emission rate is a fundamental input parameter for airborne transmission risk assessment, but data are limited due to reliance on estimates from chance superspreading events. This study assesses the strength of a predictive estimation approach developed by the authors for SARS-CoV-2 and uses novel estimates to compare the contagiousness of respiratory pathogens. We applied the approach to SARS-CoV-1, SARS-CoV-2, MERS, measles virus, adenovirus, rhinovirus, coxsackievirus, seasonal influenza virus and Mycobacterium tuberculosis (TB) and compared quanta emission rate (ERq) estimates to literature values. We calculated infection risk in a prototypical classroom and barracks to assess the relative ability of ventilation to mitigate airborne transmission. Our median standing and speaking ERq estimate for SARS-CoV-2 (2.7 quanta h−1) is similar to active, untreated TB (3.1 quanta h−1), higher than seasonal influenza (0.17 quanta h−1), and lower than measles virus (15 quanta h−1). We calculated event reproduction numbers above 1 for SARS-CoV-2, measles virus, and untreated TB in both the classroom and barracks for an activity level of standing and speaking at low, medium and high ventilation rates of 2.3, 6.6 and 14 L per second per person (L s–1 p–1), respectively. Our predictive ERq estimates are consistent with the range of values reported over decades of research. In congregate settings, current ventilation standards are unlikely to control the spread of viruses with upper quartile ERq values above 10 quanta h−1, such as SARS-CoV-2, indicating the need for additional control measures.

Journal ArticleDOI
TL;DR: In this article, the authors measured mass concentrations of particulate matter with diameters ≤ 2.5 μm (PM2.5), ≤ 1.0 μm(PM1.0), and ≤ 0.5 µm (μm 0.1) and found significant associations of greater concentrations of PM in different size fractions within 5 days before blood collection with lower HDL-C and apolipoprotein A (ApoA1) levels, higher apoliprotein B (APoB) levels and lower ApoA1/ApoB ratios
Abstract: Existing evidence is scarce concerning the various effects of different PM sizes and chemical constituents on blood lipids. A panel study that involved 88 healthy college students with five repeated measurements (440 blood samples in total) was performed. We measured mass concentrations of particulate matter with diameters ≤ 2.5 μm (PM2.5), ≤1.0 μm (PM1.0), and ≤0.5 μm (PM0.5) as well as number concentrations of particulate matter with diameters ≤ 0.2 μm (PN0.2) and ≤0.1 μm (PN0.1). We applied linear mixed-effect models to assess the associations between short-term exposure to different PM size fractions and PM2.5 constituents and seven lipid metrics. We found significant associations of greater concentrations of PM in different size fractions within 5 days before blood collection with lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A (ApoA1) levels, higher apolipoprotein B (ApoB) levels, and lower ApoA1/ApoB ratios. Among the PM2.5 constituents, we observed that higher concentrations of tin and lead were significantly associated with decreased HDL-C levels, and higher concentrations of nickel were associated with higher HDL-C levels. Our results suggest that short-term exposure to PM in different sizes was deleteriously associated with blood lipids. Some constituents, especially metals, might be the major contributors to the detrimental effects.

Journal ArticleDOI
TL;DR: In this article, a network of 9 KOALA monitors measuring PM2.5 and carbon monoxide (CO), supported by one set of reference instruments and a meteorological station, were deployed for a 6 week period across a suburb hosting most of the Games activities.

Journal ArticleDOI
TL;DR: The emission factors of newly-generated ultrafine particles due to the use of different floor cleaning products under actual temperature and relative humidity conditions and ozone concentrations typical of the summer periods were evaluated.
Abstract: The new particle formation due to the use of cleaning products containing volatile organic compounds (VOCs) in indoor environments is well documented in the scientific literature. Indeed, the physical-chemical process occurring in particle nucleation due to VOC-ozone reactions was deepened as well as the effect of the main influencing parameters (ie, temperature, ozone). Nonetheless, proper quantification of the emission under actual meteo-climatic conditions and ozone concentrations is not available. To this end, in the present paper the emission factors of newly generated ultrafine particles due to the use of different floor cleaning products under actual temperature and relative humidity conditions and ozone concentrations typical of the summer periods were evaluated. Tests in a chamber and in an actual indoor environment were performed measuring continuously particle number concentrations and size distributions during cleaning activities. The tests revealed that a significant particle emission in the nucleation mode was present for half of the products under investigation with emission factors up to 1.1 × 1011 part./m2 (8.8 × 1010 part./mLproduct ), then leading to an overall particle emission comparable to other well-known indoor sources when cleaning wide surfaces.

Journal ArticleDOI
TL;DR: In this paper, the authors developed an indicator, ambient population-weighted average PM2.5 concentration per unit per capita CO2 emission (P M 2.5 /C O 2 ), to assess country-specific air pollution control efficacy (abbreviated as APCI).

Journal ArticleDOI
TL;DR: In this paper, the authors investigated the trends of number, frequency, and duration of pollution episodes and compared these with the baseline trend in air pollution, and showed that the factors contributing to these events are complex; however, longterm measures to abate emissions from all anthropogenic sources at all times is also the most efficient way to reduce the occurrence of severe air pollution events.

Posted Content
TL;DR: In this paper, the authors measured the saliva viral load of an infected subject located in a hospital room, as well as the airborne SARS-CoV-2 concentration in the room resulting from the person breathing and speaking.
Abstract: The question of how SARS-CoV-2 is transmitted remains surprisingly controversial today, especially with reference to airborne transmission. In fact, despite a large body of scientific evidence, health and regulatory authorities still require direct proof of this mode of transmission. To close this gap, we measured the saliva viral load of SARS-CoV-2 of an infected subject located in a hospital room, as well as the airborne SARS-CoV-2 concentration in the room resulting from the person breathing and speaking. As the next step, we simulated the same scenarios to estimate the concentration of RNA copies in the air through a novel predictive theoretical approach. Finally, we conducted a comparative analysis (i.e. a metrological compatibility analysis) of the differences between the experimental and theoretical results by estimating the uncertainties of these two approaches. Our results showed that for an infected subject's saliva load ranging between 2.4x106 and 5.5x106 RNA copies mL-1, the corresponding airborne SARS-CoV-2 concentration was not detectable when the person was breathing, but was 16.1 (with an uncertainty of 32.8) RNA copies m-3 when speaking. The application of the novel predictive estimation approach provided average concentrations of 3.2 (uncertainty range of 0.2-8.3) and 18.5 (uncertainty range of 4.5-43.0) RNA copies m-3 for breathing and speaking scenarios, respectively, thus confirming that for the breathing scenario, the airborne RNA concentration would be undetectable, being below the minimum detection threshold of the experimental apparatus (< 2 RNA copies m-3).

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TL;DR: In this paper, the authors quantified the concentrations of PM2.5 indoor and outdoor and assessed the influence of incense burning on indoor air quality at residential houses in Hanoi, Vietnam.

Journal ArticleDOI
TL;DR: In this article, the authors performed a Monte Carlo simulation using a social contact network and exponential dose-response model to quantify the close proximity reproduction number of both wild-type SARS-CoV-2 and the Delta variant.

Journal ArticleDOI
TL;DR: In this article, the levels of respiratory exposure of black carbon (BC) to commuters in Hanoi were measured using microAeth AE51 portable devices on motorcycles and in the cabins of cars and buses.

Journal ArticleDOI
TL;DR: It was evident that the contribution of the Cooking & Eating microenvironment to the total exposure was only 8%-14% for low- and middle-income populations, while significant contributions were estimated for Outdoor day and Transport microenvironments and the Sleeping & Resting microenvironment.