{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:45:31Z","timestamp":1747172731205,"version":"3.40.5"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1935789321001567_as1\"><jats:title>Objective:<\/jats:title><jats:p>Stretcher transport isolators provide mobile, high-level biocontainment outside the hospital for patients with highly infectious diseases, such as Ebola virus disease. Air quality within this confined space may pose human health risks.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789321001567_as2\"><jats:title>Methods:<\/jats:title><jats:p>Ambient air temperature, relative humidity, and CO<jats:sub>2<\/jats:sub> concentration were monitored within an isolator during 2 operational exercises with healthy volunteers, including a ground transport exercise of approximately 257 miles. In addition, failure of the blower unit providing ambient air to the isolator was simulated. A simple compartmental model was developed to predict CO<jats:sub>2<\/jats:sub> and H<jats:sub>2<\/jats:sub>O concentrations within the isolator.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789321001567_as3\"><jats:title>Results:<\/jats:title><jats:p>In both exercises, CO<jats:sub>2<\/jats:sub> and H<jats:sub>2<\/jats:sub>O concentrations were elevated inside the isolator, reaching steady-state values of 4434 \u00b1 1013 ppm CO<jats:sub>2<\/jats:sub> and 22 \u00b1 2 mbar H<jats:sub>2<\/jats:sub>O in the first exercise and 3038 \u00b1 269 ppm CO<jats:sub>2<\/jats:sub> and 20 \u00b1 1 mbar H<jats:sub>2<\/jats:sub>O in the second exercise. When blower failure was simulated, CO<jats:sub>2<\/jats:sub> concentration exceeded 10\u00a0000 ppm within 8 minutes. A simple compartmental model predicted CO<jats:sub>2<\/jats:sub> and H<jats:sub>2<\/jats:sub>O concentrations by accounting for human emissions and blower air exchange.<\/jats:p><\/jats:sec><jats:sec id=\"S1935789321001567_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>Attention to air quality within stretcher transport isolators (including adequate ventilation to prevent accumulation of CO<jats:sub>2<\/jats:sub> and other bioeffluents) is needed to optimize patient safety.<\/jats:p><\/jats:sec>","DOI":"10.1017\/dmp.2021.156","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T07:41:06Z","timestamp":1624866066000},"page":"1482-1489","source":"Crossref","is-referenced-by-count":1,"title":["Air Quality Monitoring During High-Level Biocontainment Ground Transport: Observations From Two Operational Exercises"],"prefix":"10.1017","volume":"16","author":[{"given":"Audrey","family":"Dang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent","family":"Williams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D.","family":"Warsing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-8730","authenticated-orcid":false,"given":"Michael","family":"Noone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander P.","family":"Isakov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David K.","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4652-2272","authenticated-orcid":false,"given":"Stephen Y.","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,6,28]]},"reference":[{"key":"S1935789321001567_ref14","unstructured":"14. US Department of Labor, Occupational Safety and Health Administration. Permissible exposure limits \u2013 annotated tables. Table Z-1. https:\/\/www.osha.gov\/dsg\/annotated-pels\/tablez-1.html#annotated_table_Z-1. Accessed July 22, 2020."},{"key":"S1935789321001567_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s40506-016-0096-2"},{"key":"S1935789321001567_ref20","doi-asserted-by":"publisher","DOI":"10.1186\/s12245-017-0142-y"},{"key":"S1935789321001567_ref11","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001395"},{"key":"S1935789321001567_ref22","unstructured":"22. American Society of Heating Refrigerating and Air-Conditioning Engineers. Table 7.1. Design parameters \u2013 hospital spaces. ANSI\/ASHRAE\/ASHE Addendum PTO ANSI\/ASHRAE\/ASHE Standard 170-2017. ANSI\/ASHRAE\/ASHE Standard 170-2017: Ventilation of health care facilities. 2017. https:\/\/www.ashrae.org\/file%20library\/technical%20resources\/standards%20and%20guidelines\/standards%20addenda\/170-2017\/170_2017_p_20200302.pdf. Accessed August 3, 2020."},{"key":"S1935789321001567_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2016-000623"},{"key":"S1935789321001567_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/2046-7648-2-4"},{"key":"S1935789321001567_ref1","doi-asserted-by":"crossref","first-page":"241","DOI":"10.3201\/eid0502.990208","article-title":"Air evacuation under high-level biosafety containment: the aeromedical isolation team","volume":"5","author":"Christopher","year":"1999","journal-title":"Emerg Infect Dis."},{"key":"S1935789321001567_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s12873-017-0121-x"},{"key":"S1935789321001567_ref9","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2003.056895"},{"key":"S1935789321001567_ref23","unstructured":"23. American Society of Heating Refrigerating and Air-Conditioning Engineers. Table\u00a06.2.2.1. Minimum ventilation rates in breathing zone. ANSI\/ASHRAE Addendum P to ANSI\/ASHRAE Standard 62.1-2013: ventilation for acceptable indoor air quality. 2015. https:\/\/www.ashrae.org\/file%20library\/technical%20resources\/standards%20and%20guidelines\/standards%20addenda\/62_1_2013_p_20150707.pdf. 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