Stephane Bilodeau 00:03

Good day, everyone. Welcome to the IBEC CLEAN Lessons Learned series, a live webinar session. No matter where you are joining us from, my name is Stephane Bilodeau. I’m the Chief Science Officer at the Integrated Bioscience and Built Environment Consortium (IBEC), an adjunct professor in bioengineering at McGill University in Montreal, and a fellow of Engineers Canada. As an independent contractor for UN agencies and other public and private organizations, I have worked on projects across Asia, Europe, America, and Africa. I’ve only yet to touch on projects in Australia. So I’ve worked on all continents, and coincidentally, we have great representation from Australia in our session today.

I strongly believe in collaborating because collaboration is key to bridging the gap between science and real-world applications, which is why I’m thrilled to be part of IBEC. The Integrated Bioscience and Built Environment Consortium, with “consortium” being a key word here. The next 90 minutes form part of the fourth installment of a six-part series on pathogens in buildings. It’s sponsored by the American Industrial Hygiene Association (AIHA) through technology brought to us by Firebrand Creative. So thanks to both of them.

A warm welcome to you all, and to our fellow members of AIHA. The series focuses on how we can operate our buildings differently, driven by our desire to decrease health risks, increase productivity and financial success of our organizations, and make buildings fit for everyone. You can find the earlier episodes on our website at www.weareibec.org/clean-past-events.

Today’s session is titled “Pioneering Health Through Improved Air Quality: Bridging the Gap Between Current Indoor Air Quality Assessments and Evolving Biosensing Technologies in Built Environments.” There’s a saying that we cannot improve what we don’t measure. Today we’ll talk about measurement. We are meeting from across the globe to dig deep into the role of indoor environmental monitoring in detecting hazardous microorganisms in our buildings. The advancement of indoor air quality monitoring technologies requires expertise from physicists, chemists, engineers, microbiologists, and many others. While approaches vary, the shared vision of reducing infection risks and ensuring safer indoor environments has brought all our contributors together today.

Our speakers and moderators have kindly presented questions already that they feel the panel will appropriately address. We will start with some questions posed by the Science Advisory Board advisors. You can also add yours on the go, so we encourage you to add your questions to the Q&A box that you’ll see on your screen. If we do not get to all our questions today, we will do our best to forward them to the panelists after the session is completed. Please make sure you say to whom you are addressing the questions. If you have any questions about the session’s running or technical issues, feel free to leave a comment to that effect in the Help box that you see on the bottom right of your screen. At the end, we will bring you up to speed with IBEC and our latest work and tell you how to engage with us now and in the future. So join me in this highly quantitative area, and let’s look forward to an exciting and inspiring session.

I just told you we have two co-moderators and we have five contributing speakers participating in our panel today. Erik Malstrom, Chief Executive Officer of Safe Traces from the USA and also a member of our Scientific Advisory Board, as well as Mitesh Kumar, Principal Environmental Health and Safety Consultant for WSP, the well-known engineering firm. He’s based in Singapore. Both will be moderating our session and together they will introduce our panelists and guide our discussions today. Erik will introduce Mr. Kumar later on in more detail, but let’s start with his own background. As mentioned, he is the CEO of Safe Traces in California. The company has developed a unique way to measure and verify viral pathogen behavior in a building under different infection mitigation scenarios through DNA-enabled diagnostic solutions. Mr. Malstrom is a combat veteran, former White House official, and founder and executive in a variety of businesses. He has earned a joint MBA and MPP from Harvard Business School and the Kennedy School and is a Rotary Ambassadorial Scholarship recipient at Macquarie University in Uganda. Erik is here to help us get perspectives from our team of incredible experts that will no doubt lead to lively and meaningful discussions. So, Erik, please introduce our first panelist and start our discussion.

Erick Malstrom  05:41

Great. Well, thank you so much, Stephane. Thank you so much to IBEC, to AIHA, to my co-moderator, panelists, and everyone who’s joined us today. I would like to start by introducing our first speaker, Dr. William Mills, ahead of him more thoroughly describing his work. Thanks so much for joining us today. We’re incredibly grateful.

Dr. Mills’ career has spanned almost 40 years in air monitoring with a strong focus on protecting people. Dr. Mills is a certified industrial hygienist, an AIHA fellow, and a chartered chemist. Dr. Mills is one of our leading experts in quantifying the level of contaminants a person is exposed to and describing the transport and fate of those contaminants in the environment. He has achieved this through developing real-time sensor technologies and by implementing controls to mitigate health risks.

Dr. Mills is a distinguished scholar with a background in chemistry and industrial hygiene, receiving his doctoral degree in Environmental and Occupational Health Sciences from the University of Illinois, Chicago. He now serves as an associate professor in the Department of Engineering Technology at Northern Illinois University in DeKalb. His diverse background includes skills attained across the US and Canada in mathematics, chemistry, and environmental engineering. He has presented numerous papers on remote sensing of environmental toxins, including PCBs and pesticides. His diverse professional activities traverse health and engineering professional bodies, including the AIHA, who are sponsoring our event today. Dr. Mills is also Chief Scientist and President of Mills Consulting Incorporated. He’s led the organization for 24 years and continues to work as a field worker, researcher, and educator across small and large commercial and public organizations.

And now, I’ll turn it over to Dr. Mills. Please take it away.

William Mills  07:35

Thank you for that introduction. And thank you for allowing me the opportunity to present here today. I am currently the vice-chair of the AIHA Real Time Detection Systems Committee. We’ve published a number of documents on the use of real-time detection systems, also called direct reading instrumentation. I was a co-author of the recent December 2022 document shown on the left here, establishing a process for setting real-time detection system alarms. We’ve covered that in several Synergist articles, and just showing you one on the right from March of 2023. In the white space down below is the direct link to that if people want to get hold of it. It’s about 80 pages long.

As part of that, a fie step process flow was developed. First of all, making a statement of purpose. Why are you doing what you’re doing? And what are you going to do with your objectives? There are devices that you’re going to use for the detection and determining your fitness for purpose. It could be a decision point, a reading level, whatever. And then what you’re going to do when it reaches that level or prior to reaching that level, and then finally, presenting that to the stakeholders. The question that I raise today, and I want to really talk about is, is fitness for purpose good enough? It’s an important concept in my research.

It’s very easy to spend a lot of money on instrumentation. I’ve gone more the opposite way, which is, how can we make the same decisions with low-cost sensors? Is a low-cost sensor good enough to make the correct decision or take action to, for example, identify poor ventilation areas, to identify areas in a building that are having undue exposure, so that you can either protect workers, maybe add some controls, and then check on how the controls are working? Or now that we have the ASHRAE 241—would we go into infection response mode, etc.?

There’s a large amount of discussion on this determination of fitness of purpose. What we propose is that you need to look at whether your work really needs the expensive measure. You need to understand a little bit about the technology being used and look into it, but it doesn’t necessarily has to be that expensive. We have a variety of low-cost environmental sensors, including aerosols, CO2, temperature, relative humidity, noise, and a light sensor.

In addition, we also had a lot of ESP32 boards, which are almost about the size of half your thumb. We had temperature and relative humidity sensors that we can put around in an array, and we also did a demonstration using just uncontrolled logic where we could, depending on what the sensors detect, have the HEPA filters firing up or increasing speed if needed. We could also control climate with an air conditioning and heating unit, and, in our pilot-scale system, trigger outdoor air makeup and that sort of thing. Using a variety of wired and wireless technologies, coding, and display of the data, at the end of the day, we came up with a set of criteria that follow that five-step process, and we have our decision points based on that.

The other issue that came up that I talked about is things such as the spatial and temporal resolution needed for where the sensors are. I would note that I think one of the things that’s been proving helpful is the use of Computational fluid Dynamics (CFD) modeling. Most of the major biological aerosol stuff that I am aware of tends to do more of grab sampling, so they’re not necessarily direct reading at the same time, but there will be some temporal resolution in there. That’s about all I want to do today. I’m open for questions afterward.

Erik Malstrom  15:06

All right, Dr. Mills, excellent. Great start, really valuable stuff. You raised a couple of points that I’m sure we’re going to get back to on the fitness for purpose. Now, I am going to hand it over to my co-moderator, Mitesh Kumar, who’s helping me today.

Just a brief introduction on Mr. Kumar. He’s joining us from Singapore, where, as mentioned, he works as the Principal EHS Consultant for global engineering giant WSP. Mr. Kumar is a lead auditor who has been heavily engaged in Indoor Air Quality (IAQ) assessments for over 10 years. He holds a degree in Life Sciences, a Master’s in Environmental Management, and an MBA. Most recently, Mitesh has expanded his interest into integrated digital delivery for smart facility management. He has diverse and numerous current or past licenses and certifications across consulting, indoor environment assessment, artificial intelligence, air pollution, and data analysis.

Mitesh’s expertise is highly valuable from his diverse practical experience in IAQ sampling, including biological sampling and detection. His active engagement in the industry has led Mitesh to establish and lead the Singapore chapter of the Global Indoor Air Quality Association since 2016. He has been part of the American Industrial Hygiene Association, who is sponsoring our event today.

Mitesh, handing it over to you.

 

Mitesh Kumar  16:43

Thank you, Erik. Thanks for that flattering introduction. It is indeed a great opportunity to be here and to bring a perspective from Singapore and Southeast Asia. Asia is particularly very active in the IAQ technology space, so I’m really excited to hear what our panelists have to say about it today.

I would like to turn our attention to Dr. Karen Dannemiller. Dr. Dannemiller is a multi-award-winning researcher and associate professor from Ohio University, where she runs an interdisciplinary and collaborative research group focused on chemical and microbial processes in the indoor environment. Following a degree in Chemical and Biochemical Engineering, she completed her doctoral studies at Yale University, integrating measurements of environmental fungal communities with health outcomes. This was followed by a master’s degree in Chemical and Environmental Engineering and an internship at the California Department of Public Health Indoor Air Quality Program.

Today, her focus is on integrating engineering with microbiology to meet emerging health challenges. Dr. Dannemiller researches the indoor environment in a way that connects changes in building conditions to health, specifically when those changes cause microbial populations to alter. By netting public health data to the measurements in the building, she has broken critical ground in understanding childhood asthma and how microbial populations change and move through buildings.

We hope to learn today from Dr. Dannemiller what matrices provided by our microbial communities can tell us about the health of our buildings, and how we can leverage those measurements to be safe in those environments. Over to Dr. Dannemiller.

 

Karen Dannemiller  18:44

Awesome. Thank you so much for having me, and thank you to the organizers for putting on this webinar. I’m really excited to be here. Today, I want to give an introduction of myself and talk about some of the work we’ve been doing to look for microbial indicators in indoor spaces, and how those might be associated with health outcomes.

Here at Ohio State, I direct the Indoor Environmental Quality Research Group, and we study the indoor microbiome and our chemistry on how factors in the indoor environment might influence those, and ultimately, how those might impact human exposure, human health, and things like childhood asthma. When I think about indoor spaces, I often ask the question, what makes a healthy indoor microbiome? You can think about things like the hygiene hypothesis, which sometimes I think of as the good guys hypothesis for microbes. This basically posits that some microbes, if you’re exposed to them early in life, might help prevent you from developing asthma or allergic sensitization. Then there’s also the bad guys hypothesis, which is that some detrimental taxa, if you’re exposed to these, might have a negative health effect.

One point I’d like everyone to take home today is that when we more fully understand the entire indoor microbiome, we can get a much better picture of who are the good guys, who are the bad guys, and who are the many neutral ones that might not have much impact on our health. My talk today is focused on the bad guys. Some of the microbes in our indoor spaces are clearly bad. We’re all familiar with the pandemic and what happened with that. I wanted to give an example of what can happen when we actually understand our indoor microbial communities to the extent that we can start to identify these bad guys and understand how they’re associated with health effects.

When the pandemic first started, we wanted to see how we could contribute to the ongoing efforts. We wanted to use our knowledge of indoor microbial communities to add another way to monitor for respiratory disease prevalence in buildings. Our goal was to see if we could find a mid-resolution option to understand viral prevalence rates in an area. On one end of the spectrum, we have wastewater monitoring, which is extremely effective at monitoring entire sewer shed levels to get an idea of COVID-19 rates. On the other end is individual testing, which gives high-resolution data, but nobody likes getting tested every week. We wanted to see if we could add a mid-resolution option to our toolbox to complement these other tools and better understand the microbes in our indoor spaces.

I want to be clear that when I’m talking about sampling in indoor environments, I’m not talking about infectivity. All the data I’m showing you is looking at viral RNA. If you think about the viral structure of SARS-CoV-2, you have this envelope on the outside, a protein capsid in the middle, and RNA inside. What I’m talking about is measuring this RNA, which doesn’t tell us anything about infectivity, which requires the envelope on the outside.

What we did was measure this virus in our buildings and indoor spaces. We went to the isolation rooms on campus in October and fall of 2020, where people were recovering from COVID-19, and took various environmental measurements. We did air samples, surface swabs, and bulk dust samples. We found that the highest viral concentration was in those bulk dust samples, as shown down here. The air samples were only 20-30% positive, surface swabs were 55% positive, but bulk floor dust was 89% positive at first pass, and we quickly got that up to 97% with improved analytical techniques. We’ve probably gotten even higher at this point.

We were able to quickly take this data and, by August of 2021, started measuring about 50 buildings a week on Ohio State’s campus and reporting that data back to the university to inform decisions on keeping everyone healthy and safe. We also showed that you can track variants by sequencing the virus out of the dust. This bar graph shows the variants present over time, with saliva data as dotted lines and dust data as bars. There’s a pretty good correlation between the variants in the dust and in people.

Overall, this is just one example of how understanding the microbes in our indoor spaces can help develop better tools for understanding and tracking respiratory diseases. This is a great additional tool in our toolkit, providing a mid-resolution measure between wastewater monitoring and individual testing.

I also want to plug the Indoor Air Conference this summer, from July 7-11 in Honolulu, Hawaii. If you can’t make it to Honolulu, there’s also a remote track option. This conference is endorsed by AIHA. I also want to acknowledge the great funding organizations and my fantastic group of students who work hard on this project every day.

 

Mitesh Kumar  25:04

I would like now to introduce Dr. Alex LeBeau. He is the owner and principal toxicologist of his organization called Exposure Assessment Consulting in Orlando, Florida. He earned a PhD in Toxicology and Risk Assessment from the University of South Florida College of Public Health. He’s a certified industrial hygienist with a career spanning over 17 years. He is skilled in understanding the challenges and opportunities around sampling and analysis of environmental sampling, having performed toxicological evaluations of chemical and biological agents in the environmental and occupational space. Additionally, he has conducted safety assessments for consumer products and can lead us on what we need to consider to assess levels of exposure risk when encountering potential human health risk drivers.

Dr. LeBeau also undertakes research as an Affiliate Associate Professor at the University of South Florida, where he has worked for over 11 years. His research has focused on childhood exposures to chemicals and metals from a variety of exposure points, and potential outcomes that may impact those early life exposures. Dr. LeBeau has been active in the American Industrial Hygiene Association (AIHA), where he has served in officer positions on the Indoor Environmental Quality Committee for the past five years and is ending his position as part of the IAQ Committee Chair next week. During this time, he co-authored a number of AIHA IAQ-sponsored documents, including COVID-19 and Legionella technical frameworks. He also serves as the AIHA liaison to the Association for Professionals in Infection Control and Epidemiology (APIC).

He serves as a subject matter expert in legal cases in areas that include exposure to both chemicals and biological agents. Additionally, he is a certified mold assessor for the state of Florida, giving him a comprehensive view of health risks associated with bioaerosols in our built environment. He is a member candidate for the ACGIH Bioaerosols Committee and is an author of the antimicrobial agent chapter in the recently released second edition of the Bioaerosol Assessment and Control reference book.

Dr. LeBeau, please furnish us with more details about your work and how you hope to learn and contribute to today’s session.

 

Alex LeBeau  28:09

Mitesh, I appreciate that introduction. There’s a lot in this space, so I don’t have any slides. I’m just going to talk to everyone. I know we’re discussing and focusing a lot on IAQ, indoor air quality. But what we’ve done at the AIHA in the IEQ Committee is to say there’s the indoor environment focus on indoor environmental quality. That’s where a lot of our focus has been at AIHA, dealing with exposures in the indoor environment from various sources. We look at the totality of the built environment and how it’s impacting the health of the people occupying that building.

One of the things we’ve understood is there’s not always going to be a one-size-fits-all scenario for what we’re doing in application. We can give guidance and understanding, such as discussing sensors and implementation, but every scenario will be unique and need particular addressing for that exposure scenario. When I deal with different types of exposures in the indoor environment, there are many ways beyond just the air that occupies the voids inside the building.

In previous work, I’ve done numerous indoor environmental quality assessments in various scenarios, both residential and industrial. I’ve also worked on risk assessments for different types of projects, whether site closures or the way they impact communities. We’ve identified that for different site receptors, like residential site receptors, we need to address particular facilities that release heavy metals into the environment. We need to understand how these heavy metals are getting into the indoor environment, how people are being impacted, and how they are being exposed. There may be settled dust containing lead within the buildings that we have to account for. So it’s not only the air that we look at but the environment itself.

Another area I focus on is water quality. I deal with a lot of waterborne pathogens like Legionella. We have to think about how the water impacts the air in those facilities and the totality of the indoor environment. Much of my career has been about being proactive. We’re trying to be proactive with everyone in the audience to help them understand why and how we’re doing things. Most of my work has been on the reactive side, helping to educate people about problems and solutions. It’s important to help people understand why the work they’re doing is necessary.

We look at the totality of the indoor environment because it takes many people to address these issues. It takes building owners, operators, and people in the trenches to understand why their work is essential. Accurate data recording, whether from remote sensors or direct reading instruments, is crucial because someone will analyze that data. Conveying the importance of this work to people has been a significant part of my career.

Some of the work we’ve done includes addressing different environments and scenarios. There’s not a one-size-fits-all solution. Last year, we had an article in the Synergist about correctional institutions, addressing risks and protecting employees, the population, and vendors. Next week, at AIHA Connect in Ohio, I am moderating a panel between industrial hygienists and infection preventionists from a healthcare scenario. It’s essential to understand how people work together and synergize to achieve our common goal of protecting human health within the indoor built environment.

 

Mitesh Kumar  33:00

That is great. Thanks, Alex. I would now like to hand back to Eric to introduce our remaining panelist.

 

Erik Malstrom  33:08

Now, we’ve got another great one coming up. I’d like to introduce Dr. Krystall Pollitt. An accomplished researcher, Dr. Pollitt is an Associate Professor of Epidemiology at the Yale School of Public Health. She also holds an appointment in Chemical and Environmental Engineering at the Yale School of Engineering and Applied Sciences.

She obtained her doctoral degree in Environmental Toxicology from King’s College London in 2012, subsequent to a Bachelor and Master’s degree in Chemical Engineering from the University of Toronto. Her research explores the influence of environmental pollutants on health. Her research group has pioneered wearable technologies to comprehensively evaluate personal exposure to chemical and biological contaminants in the air. One of these technologies was the Fresh Air Clip, which was developed as a low-cost tool to measure an individual’s exposure to airborne SARS-CoV-2. Dr. Pollitt has studied the effects of air pollutants on pulmonary and cardiovascular diseases, as well as chronic conditions.

Dr. Pollitt was recently awarded the Joan M. Daisley Outstanding Young Scientist Award by the International Society of Exposure Science, as well as the Early Career Researchers Award from Yale University. Welcome, Dr. Pollitt. Over to you.

 

Krystal Pollitt  35:06

Thanks so much for this introduction. I’ve really enjoyed hearing about the work of the previous speakers. As shared, my work is focused on understanding the impact of environmental factors on health. To better understand this, I have developed wearable technology to assess individual-level exposure because we know that one person’s exposure can differ significantly from another’s, and much of these exposures come from our indoor environments.

With my training in air pollution and atmospheric chemistry, I have shifted my focus to better understanding air quality within indoor spaces. Using air as an amazing matrix that collects contaminants from various sources, we can better understand the environmental factors that ultimately impact health. We have developed wearable tools, one of which looks like this—a small clip that can be worn on the collar to comprehensively measure environmental contaminants. These contaminants can be chemicals in the form of particles or gas-phase constituents, as well as airborne respiratory viruses.

We have demonstrated the use of these technologies with over 2,000 people internationally, ranging from those living across the United States to individuals on almost every continent worldwide, in both rural and urban locations, and across different age groups. This has allowed us to gather significant data on the various sources of exposure and what these exposures mean for health.

These technologies work by detecting hundreds of different chemicals using high-resolution mass spectrometry and PCR techniques to evaluate biological contaminants on the devices. This information has provided insights into the factors within indoor environments that contribute to our exposures. Additionally, it allows us to test the effectiveness of different interventions and develop actionable solutions to ultimately prevent exposures and create healthier indoor environments.

 

Erik Malstrom  37:47

Great, all right, excellent, very interesting work, and thank you for that. Now, I am going to introduce our next panelist. I am welcoming Dr. Corey Boles to the panel now.

Dr. Corey Boles is a Senior Risk Assessment Scientist at Insight Exposure and Risk Sciences Group. He specializes in human health risk assessment and consults with a wide range of industry groups in the US and abroad on chemical and microbial exposure concerns among workers and consumers. Dr. Boles was awarded his PhD in Occupational and Environmental Health with a focus on industrial hygiene from the University of Iowa College of Public Health, where he optimized sampling and analytical techniques for the quantification of aerosolized norovirus. In addition, he received his BS in Molecular Biology from East Carolina University.

He has conducted numerous human health risk assessments related to microbial exposures and has published extensively on microbial risk assessments and their intersection with traditional and novel human health risk assessment frameworks. He’s an active member of the American Industrial Hygiene Association and the Inspire Safety and Environmental Microbiology Committee. He was an active member of AIHA’s Back to Work Safely Task Force, providing guidance documents during the COVID-19 pandemic. We’re honored to have him as a contributing member of the IBEC Scientific Advisory Board, where he has supported the development of guidance documents for those wanting to mitigate their risks from airborne infectious diseases.

Additionally, he has delivered lectures on microbial risk assessments in the workplace to graduate students at the University of Cincinnati and the University of Iowa. Dr. Boles is also currently studying for an MBA from Wake Forest University. Welcome, Dr. Boles. Please jump in and tell us more about your interests and participation in our discussion today.

 

Corey Boles  40:03

Thanks, Erik. I appreciate the wonderful introduction. I’m honored to be a part of this tremendous and well-established panel today to discuss this very important topic. Given the multifaceted nature of my job as a consultant, where I help various industry groups navigate this exact topic and adjacent topics, there will be aspects I talk about that link back to presentations from all the other panelists. This is not a coincidence but a necessity.

As Alex mentioned, my current job requires me to be at the intersection of industry groups, academic research teams, and guidance-setting groups. I’d like to add more about my background and provide additional context regarding my experience and current work in this area, which will shed light on my interest and involvement in this panel’s subject.

I had the opportunity to become involved in human health risk assessment and fundamental microbiology research early in my career while working with Dr. Rachel Roper at the Brody School of Medicine in a clinical virology lab. One of our primary goals was to investigate the human immune system’s response following exposure to biological agents, particularly poxviruses like smallpox. This early experience taught me that while general immune responses and pathways are similar among all of us, there is also tremendous variability between individuals.

This variability or uncertainty is important to understand when making risk management decisions, including implementing controls and monitoring due to differences in assumptions in risk assessments and subsequent decisions. Whether discussing occupational, residential, patient, or general populations in the built environment, these differences are reflected across the differing approaches set by regulatory and governmental agencies, depending on the population they research or regulate, like OSHA, NIOSH, EPA, and FDA, as well as their counterparts abroad.

When relying on risk assessments for specific populations, such as occupational versus residential, it’s crucial to understand how uncertainties and variability are addressed because they impact risk management and control decisions. This is relevant when discussing how to manage risks associated with exposures to chemicals and biological agents. It often comes up when setting health-based exposure limits for biological agents or discussing indirect methods for monitoring bioburden in a space or setting alarm thresholds.

For example, if we are monitoring certain volatile organic compounds as an indirect method for biological burden, are the alarm thresholds set based on corresponding bioburden levels or the toxicological effects of the VOC exposure? These are the questions industry groups face daily, and they seek support to navigate through these technologies.

During my PhD, I focused on developing and optimizing sampling methods for aerosolized norovirus. I also worked with a team optimizing and evaluating bioaerosol sampling techniques for a range of biological agents in various settings, including healthcare, animal housing, and even the cruise ship industry. This experience highlighted the limitations and challenges of deploying sampling and monitoring across diverse industries and the lack of a one-size-fits-all solution.

This background has informed my work with various industry groups, governmental, and academic partners. As a consultant specializing in human health risk assessment, particularly in aerosol science and microbial exposures, I have conducted occupational microbial risk assessments for numerous sectors, including healthcare, agriculture, pharmaceutical, medical device manufacturing, construction, laboratory, and advanced manufacturing. These problems are not unique to any one sector but may be exacerbated in certain sectors.

I have also worked with companies to assess potential microbial contamination of consumer products and food, navigating challenges like determining whether an FDA voluntary recall is necessary. More recently, I’ve worked with manufacturers and sellers of antimicrobial products to ensure human health is considered, tested, and marketed based on science.

My job often involves helping industry groups identify and assess monitoring and control options, especially since the pandemic has increased the number of available options. Many industry partners are overwhelmed and confused about which avenue to pursue. My focus has been on addressing issues raised or exacerbated by the pandemic and implementing microbial risk management protocols.

As part of Insight Exposure and Risk Sciences Group, I collaborate closely with academic institutions, governmental groups, and industry partners to advance knowledge of health risks to workers and communities through science innovation, particularly in biological sciences. One exciting research area is the impact of the working life exposome—chemical and biological exposures during work—on the worker microbiome. This research is still in its infancy but is crucial for understanding the onset of certain diseases later in life.

I hope this provides additional context about my background and current work and how it informs our discussion on biosensing. I’m looking forward to the questions posed by the panel.

 

Erik Malstrom  48:39

All right, great, Corey. Thank you, and thanks to everyone. You’ve given us a lot to think about and discuss. Corey, while you’re still here, I’m going to kick off our Q&A portion with a seemingly simple and basic question, but one that becomes quite complicated: What metrics matter? When we’re talking about pathogens and indoor air quality, and going back to the initial quote by Stephane that we can’t manage what we can’t measure, what are we measuring?

At the end of the day, we need something to measure. Should we be measuring the contaminants themselves, which is more akin to what the safety community does? Should we be measuring the controls, like a facilities person ensuring a certain air change rate or a certain pressurization? Should we be measuring both? And are these two categories, if we need to do both, coherent right now?

 

Corey Boles  49:55

Yeah, that’s an excellent question. I’d say it depends, like a lot of other questions. In my experience, it’s a matter of both, but it’s a culmination of many other things you’re monitoring. It’s not just a single pathogen or a single indicator of potential bioburden and microbial load in a built environment. I’ll provide a summary of my current understanding of the science and how I’ve worked with clients. Based on what we’ve heard so far, I’m sure there’s a lot of other important experience from our panel members they can add to this.

First off, I’m not aware of any single metric that captures infection risk in a particular built environment. Monitoring various gases and vapors can be useful as indicators of overall ventilation, which can inform the possibility of risk. For example, ASHRAE 241 relies heavily on ventilation flow rate as a measure to reduce the risk of transmission. There are other classic indicators, like humidity, CO2, and carbon monoxide, but each has shortcomings. You don’t simply monitor one in isolation; it’s usually a combination, and they are heavily dependent on flexible and fluid factors in the built environment, making them hard to pinpoint.

A wide number of microbial volatile organic compounds (VOCs) and semi-volatiles have been assessed as indicators of microbial bioburden. The most extensive research I’m aware of in this area was by IRSST out of Canada. They conducted a feasibility study in 2017 to determine if microbial VOCs could be used as biomarkers, specifically in the occupational environment for mold. They identified 548 microbial VOCs emitted from various mold species and narrowed that down to 20 key microbial VOCs for further analysis, representing alcohols, esters, ketones, and more. They are following up with an applicability study to test these in the real world and link human health occupational exposure to microbial VOCs and controls in the built environment. However, the links between microbial VOCs, indoor bioburden, and human health are still relatively weak, and more research is needed.

Monitoring indicators to detect and estimate biological agents, including the toxins themselves with very low infectious doses, can be challenging. Dr. Pollitt has done a great job with her passive sampler device for SARS-CoV-2, but given low concentrations required to elicit infections of certain other pathogens with extremely low infectious doses, it may be unlikely to detect enough indicators. So, it’s a combination of all the above, and some apply in certain situations while others don’t.

With ventilation tracking specifically, air changes per hour have been heavily used to monitor ventilation and link that back to potential risks. There is recent evidence suggesting that airflow path may be more appropriate. How does the biological agent travel from the source to the ventilation filtration and subsequent exhausts? This would require a significant rethinking of ventilation systems and their distribution in the built environment, but it provides an exciting avenue for research.

Sorry for the non-answer, but that’s the best that I’m aware of.

 

Erik Malstrom  54:12

No, it’s great. Does anyone want to hop in? I see a lot of heads nodding. It seems like this is something that other panelists may have thoughts on. So before I go on to the next question, let me briefly open it up. Does anyone else want to comment on the question of metrics and what you think is useful when considering what we actually do in the building to control and mitigate the risk?

Alex LeBeau  54:37

Sure, I’ll have a quick comment. Earlier, I mentioned we deal a lot with Legionella and Legionnaires’ disease. One of the things the AIHA IEQ community recently addressed in the second edition of the Legionella guideline book is how to handle Legionella problems. One of the key aspects we discuss is the direct indication of whether Legionella is present by testing for it. We’re not talking about air but about something that could potentially become airborne in an aerosolized form.

Part of a facility’s water management plan involves identifying whether Legionella is present in the water. Additionally, there are other metrics we look for in the water itself, such as disinfectant levels like chlorine or monochloramine and the overall water quality that impacts the risk and presence of Legionella and the biofilm that may harbor it.

So, depending on the scenario, while we may not be focusing solely on ventilation or another single factor, we do directly quantify the levels of Legionella at different points within the water system. This approach considers the quality of the water, which could end up as a bioaerosol within the built environment.

 

Erik Malstrom  56:02

Great. Okay, great comments and a great addition there. All right, so the next question is going to go to William. You kicked us off talking about the rise of low-cost sensor technologies and brought up the concept of fitness for purpose and “good enough.” I’m going to take your question in a slightly different direction, which is about low-cost sensor technologies for various IAQ contaminants. Given that this discussion is focused on pathogens, I’d say we’re not there yet on low-cost sensors specifically for pathogens. However, many low-cost technologies for other contaminants are being applied as proxies, like CO2, particulate levels, and other contaminants that are more easily and inexpensively measured.

But thinking about the pathogen case, what is “good enough”? Are we good enough now?

 

William Mills  57:03

I don’t think that for direct pathogens, we’re good enough right now. However, what we’ve been able to show with our work, and what many others have demonstrated, is that a low-cost sensor may be good enough to identify an area of risk. It may be good enough to show that a condition has changed. For example, in the building I’m in right now versus next door, it was very clear which room had just a wall-mounted air conditioner and boiler heat versus those with active HVAC systems. With a low-cost sensor, you can see it right away. CO2 levels were rising to 1500 parts per million with 12 people in a classroom. While this isn’t directly measuring biological contaminants, it certainly identifies areas where the potential for transmission is increased.

During COVID, even when people were wearing masks in a large lecture hall, we could see an increase in PM 2.5. Although most people were just wearing surgical masks, and the increase wasn’t large, the sensors still responded to what we believe were respiratory aerosols. This could help identify high-risk areas.

Additionally, low-cost temperature and relative humidity sensors can identify areas at high risk for mold and even COVID. For example, meatpacking plants, with their specific conditions, were ideal for preserving COVID. Low-cost sensors, when used properly, can help identify areas where more thorough or expensive testing is warranted.

The military and homeland defense sectors have likely made the most progress with biological contaminants, developing some impressive instruments, but these are also very expensive.

 

Erik Malstrom  59:27

Okay, great. I’m going to turn it over to Mitesh.

 

Mitesh Kumar  59:32

Thank you, Erik. So, I would like to come back to Dr. Dannemiller. After your insightful introduction to your work, I do have one question that comes to mind. What are some ways that transmission may differ for different pathogens, such as viruses, bacteria, or fungal agents of infection? And are there any other risks from microorganisms that we should be aware of when managing our buildings?

 

Karen Dannemiller  1:00:05

That’s a great question. Thank you so much. In the case of what I was talking about in my presentation, we weren’t actually measuring direct transmission of SARS-CoV-2; we were measuring viral RNA. We did another study on viral surrogates, specifically bacteriophages (viruses that infect bacteria only), which were safe to use in our lab. We found differences in the viability of these viruses on dust particles and carpeted surfaces between enveloped and non-enveloped viruses.

Enveloped viruses have a fragile outer envelope necessary for infectivity, which breaks down quickly in the environment. Non-enveloped viruses, which lack this outer envelope and have a hardy protein capsid, can persist on surfaces much longer. Our study and others have shown this repeatedly.

Regarding aerosolized viral transmission, there’s limited research, but one small study looked at this in the context of particulate matter. People are familiar with transmission via respiratory droplets. The persistence of viruses on surfaces can vary based on viral structure.

We also need to consider other microorganisms like bacteria and fungi. For instance, with mold, current quantitative measurement methods aren’t as effective as subjective measures like seeing or smelling mold. If you see a wall covered in mold, you know it’s a problem and needs to be addressed, regardless of measurement.

It’s important to consider both microbiological and chemical contaminants in indoor environments, making it a complex issue. Often, if you know there’s a problem, measurement isn’t necessary; you just need to address it. The US Department of Housing and Urban Development’s eight principles of healthy housing are a good guide, emphasizing keeping environments dry and clean to maintain health.

 

Mitesh Kumar  1:03:06

Thank you, Dr. Dannemiller. That was quite an insightful answer. I’m now going to turn to Alex. Alex, you seem to be at the cutting edge of development in the exposure arena. Can I please ask you where you see the current trend of exposure science and thought leadership as we traverse through this IAQ landscape?

 

Alex LeBeau  1:03:30

Sure, and I appreciate that question. I think what we’re doing now, today with this talk and this gathering of experts, is one way we’re facilitating thought leadership. Over the past years, the American Industrial Hygiene Association (AIHA) has identified where thought leadership should be, especially with efforts like the Back to Work Safely initiative. The IAQ committee focused on getting buildings disinfected and reopened after closures, among other things.

It’s important to understand that we, as exposure scientists, have the knowledge, skills, training, and education to provide guidance on these types of exposures. It’s critical that we are at the forefront of this. There’s a lot happening now that is enhancing collaborative efforts between organizations. Originally, many organizations were very siloed in their efforts. Moving forward, there’s a desire for more collaboration. For example, AIHA wants to work with other organizations like ASHRAE to understand and leverage synergies with other groups. I mentioned earlier our efforts with AIHA and APIC to facilitate these relationships because we have the expertise, experience, and know what to look for and measure.

It’s also critical to have the education and knowledge to say what we should and shouldn’t be doing. If we don’t take the lead, someone else will, and that person may not provide the correct information. It’s much more difficult to correct bad information than to be proactive and provide good information from the start.

With different states wanting to pass IAQ laws for buildings, and the push from the EPA looking at indoor air quality and indoor environmental quality, we, as exposure scientists, need to be at the forefront. We should be meeting with legislators if they’re thinking about enacting laws about indoor air quality to ensure they receive guidance from the right experts, rather than someone else who may not have the proper expertise.

 

Erik Malstrom  1:06:48

All right, great points. And, you know, the partnerships across organizations are also crucial. This issue is inherently very complex, interdisciplinary, and cross-disciplinary, often involving communities that don’t have an amazing history of speaking the same language or coordinating effectively. However, it seems like things are moving forward.

 

Alex LeBeau  1:07:12

No, I completely agree. What we’ve found out, and what we’re moving towards, is more synergy despite speaking different languages. For instance, if I talk about aerosols from an industrial hygiene perspective, infection preventionists may think differently about sizes and ranges and what they need to do to protect themselves in a patient care environment. So, it’s about guiding us towards a common language so we all understand and are on the same page. Thank you for pointing that out.

 

Erik Malstrom  1:07:44

Okay, well, moving on to Krystal. Your work with wearables is fascinating. You’re using an approach that looks at the chemical signatures of things in the air. How do you think this is relevant or applicable to assessing and detecting infectious diseases and agents in the air? Thinking more broadly, how can this be useful for understanding what’s happening in the environment, and how can we mitigate the risk?

 

Krystal Pollitt  1:08:21

This is a great question. It has been touched upon previously, particularly with Corey’s response. To get at what you’re asking specifically, it really involves looking at the intersections between so many different types of exposures. This relates to the emerging concept of the exposome, where we aim to comprehensively measure the totality of our exposures over time. This includes chemical signatures, biological agents, and other physical and ecological factors. This whole exposure ensemble, if you will, and the different features of these influences, can tell us where we might have vulnerabilities that may present themselves, such as in the case of infectious agents.

From all the different chemical compounds we measure indoors, it’s clear that it’s much more than just looking at criteria pollutants or those measurable with commonly available low-cost sensors. We’re looking at hundreds of different compounds with nuanced chemical signatures that we find to be associated with many health-related risk factors, including developmental and neurological effects, and endocrine disruptors. These factors could potentially play a role in increased vulnerability for certain populations when it comes to infectious agents.

 

Erik Malstrom  1:09:56

Great. Yeah, it’s fascinating. In some ways, what you and several others are doing on the exposure side with these advanced technologies ultimately has to be translated into something that a facility manager or a building automation system can digest and act upon. It’s a very big challenge, but great work. So I’m going to turn it over to Mitesh for the next question.

 

Mitesh Kumar  1:10:32

Thanks, Erik. Okay, so thank you all for very much for giving us this energetic and informative responses. Just before we address audience questions, we have few questions for you all as well. I would like to ask the big question, or which is on everybody’s mind. So what should be the measuring to reduce our risk from exposure to biological agents? And how should we measure them? And can I address these questions to Corey, William, and then to Alex?

 

Corey Boles  1:11:04

Yeah, I guess that is the big million-dollar question. So I think that’s an appropriate question coming right off Krystal’s response. This can get very complicated very quickly, and it links back to some of the things Alex and Karen were talking about earlier, like testing for specific pathogens.

In my belief, given the complex nature and ongoing research, you almost need to focus more on maintaining a suitable built environment from the standpoint of cleanliness, fresh air, and good ventilation. This approach is employed by the EPA, CDC, and ASHRAE. From the context of infection risk and potential pathogens, much of the problem can be solved by addressing and diminishing the environment in such a way that it doesn’t promote or foster microbial growth and increased bioburden within that built environment.

Of course, there are unique situations like Alex mentioned with Legionella and other specific scenarios, but the primary focus in my mind should be on maintaining a clean environment. As Karen pointed out, visual indicators like seeing and smelling any odors can be significant. There’s no need to go in and test right away if you notice these signs. Additionally, it’s crucial to monitor adequate ventilation and define what “adequate ventilation” means for your environment. Design appropriate testing when the scenario calls for it.

Alex, I’ll turn it over to you.

 

Alex LeBeau  1:12:43

Well, I appreciate that. As I said earlier, and Corey just touched on, it is going to depend on the scenario. Every scenario is going to be different. Even if you have buildings that look very similar, you may have different contractors designing HVAC systems differently. You have to look at the building in totality to understand what your risk mitigation suggestions should be for that scenario.

As for biological agents and what you’re measuring, one thing to consider in these scenarios is the secondary products of mold or bacteria, such as mycotoxins or endotoxins. These don’t have set thresholds but are potential human health drivers. If you’re mitigating in a certain way that introduces other potential human health risk factors, you have to account for those. For example, during remediation, you need containment to ensure the contaminant doesn’t spread elsewhere.

When considering mitigation steps or scenarios, ventilation is crucial but context-dependent. For instance, in areas prone to wildfires, introducing outdoor air might bring in particulates. You have to consider each scenario uniquely to avoid introducing new risks while trying to mitigate existing ones.

Every scenario must be evaluated on its own. For example, if an area is affected by wildfires, you might need to shut off outdoor dampers to prevent particulate intrusion. The system must be fluid and adaptable, depending on the number of people in the environment and other factors.

Dr. Mills, I’ll turn it over to you.

 

William Mills  1:15:05

Alright, thanks very much. I concur with the two prior speakers. One thing I would add is the advantage of monitoring typical building ventilation and environmental parameters. I’ve talked extensively about temperature, relative humidity, and CO2, which are now very easy to measure with low-cost sensors. These measurements can provide information on changes in the environment, differences between seasons, and how the HVAC system is operating.

I would also point out that a lot of work I do with schools highlights that many systems are not operating as designed. A 2019 GAO report found that about 50% of schools in the US were not operating as designed, and some designs are 50 years old. In Chicago public schools, during early COVID work, we found almost the exact same number of systems not functioning as intended.

Monitoring, in this case, could be as simple as noise monitoring to detect anomalies, or measuring pressure drops across filter banks. In several schools and universities, I found HEPA or MERV 13 filter banks with one or two filters out, causing air to bypass the filters. A simple delta P measurement across the filters would have indicated something was amiss. I’ll end with that.

 

Erik Malstrom  1:16:47

Okay, great. My next question is going to go to Karen and Krystall. Both of you have technologies and approaches for monitoring and assessing complex biological and chemical agents. As your technologies and approaches start going out into the real world, there are challenges in educating buildings and the people operating them on how to think about these issues. Additionally, there’s the question of what to do with the data—when is there a problem that triggers an action, and how to handle the overwhelming amount of data to find the needle in the haystack.

How would you advise or how do you think about putting your technologies into the real world and addressing these challenges?

 

Karen Dannemiller  1:17:48

Yeah, I think that’s a really excellent question. When we think about indoor spaces and the chemicals and microbes present, we can measure hundreds of chemicals and thousands of microbes, which can be extremely overwhelming. On my first slide, I mentioned that we have what we can think of as some good guys and bad guys, but most of them are just there and not necessarily impacting our health.

For example, in a study we did measuring compounds from damp building materials, we found that the majority of high concentration VOCs were coming from the materials themselves, not from microbial growth. The smelly compounds, like sulfur-containing ones, were from the microbes, but they were in much lower concentrations. It’s what we pick up as people, but it creates a complex picture that we need to understand.

Firstly, we need to understand a baseline—every building has its own unique microbial community. Then we can start to understand when things go wrong, whether it’s the presence of pathogens or concerns about mold. Generally, maintaining the right conditions, such as appropriate relative humidity and avoiding water leaks, can prevent issues. Others have mentioned these fundamental conditions too.

We’re still in relatively early stages of fully understanding these complex systems with hundreds of chemicals and thousands of microbes.

 

Krystall Pollitt  1:19:42

To follow up on that, I agree with Karen. When dealing with our datasets, we have thousands of compounds we could potentially report back, but doing so in a meaningful way without raising undue alarms is crucial. We focus on those compounds we can quantify with the highest confidence and that have a known potential health impact.

Much of the time, when we do our in-depth chemical analysis, we pair it with databases that can inform us about predicted or experimental toxicities. We use databases from the EPA, primarily the CompTox Chemicals Dashboard, which has information on 1.2 million compounds, many of which also include health information. This is our first point of scan where we can curate the exposures we are detecting and report back those with the most meaningful impact.

We always pair this with actionable solutions. Many are related to ventilation-based approaches, but also insights from consumer product use or materials that people can proactively manage at an individual level to prevent exposure.

 

Erik Malstrom  1:21:11

Great, great points. Thank you both. So now, I’m going to direct a question to Alex about risk communications. Just briefly, to set this up, I feel like this area is generally pretty poor. It always feels like a game of defense, with things not being proactively or clearly communicated to the general public. When something goes wrong or there’s a concern, the response is very reactive. Additionally, even among technical experts, there’s often confusion. When communicating with the general public, it becomes very hard to clearly convey information.

Real-world examples include a parent asking their school or school district if the air and ventilation are safe, or a family member in a nursing or senior living facility wanting to know about air quality. These are two examples I have personal experience with, and I often receive very unsatisfying, unclear answers.

What is your take on risk communications? How can this be done better? What do you think the state of current risk communications is, and how do you think it can be improved for the general public?

 

Alex LeBeau  1:22:31

Eric, you stole my thunder! No, I completely agree with you. I’m not speaking for anyone else here, but I think many people may echo these sentiments, especially those of us with experience in risk assessment. One of the key components of risk assessment is risk communication. We can assess the risk, quantify it qualitatively or quantitatively, and identify the risk, but communicating that effectively to stakeholders is crucial.

There are many different types of stakeholders: regulators, facility owners or operators, and the general public. Each group requires a different approach. Among professionals, we use technical terms and jargon, but with regulators, we might use language that aligns with their regulatory framework. When communicating with the general public, we need to simplify our language and concepts.

I believe we did a poor job of communicating risk during COVID. This area will need introspection over the next five to ten years to identify where we went wrong and how we can correct our approach to risk communication. Talking in high-level terms often goes over people’s heads, and they may not care or understand.

During COVID, I saw other professionals, including medical professionals, miscommunicating the effectiveness of personal protective equipment by inappropriately applying equations for determining material effectiveness. This miscommunication and misunderstanding of technical knowledge led to confusion and misinformation.

In emergency response, we have to go out and speak to people in the community, help them feel at ease, and make them understand the risk in terms they can relate to. For example, every year at my kids’ elementary school, they have a “teach-in” where parents explain their jobs. I relate my work to elementary kids using simple, silly examples they can understand.

Our job in risk communication is to use language and concepts familiar to the audience. We need a course correction in how we communicate risk, addressing past mistakes and improving our approach.

I’m interested to hear what others have to say about this.

 

Erik Malstrom  1:26:31

Please jump in anyone. William, go ahead.

 

William Mills  1:26:36

I echo everything that Alex said. That’s also why step five in the alarm-setting process is specifically called communicating to stakeholders. I think we recognize the importance of this, and as a profession, myself included, we can still do better. I look forward to learning more in the future about improving risk communication.

 

Mitesh Kumar  1:27:11

Thank you, William. I have another question. How should we communicate and share the limitations of our current testing technologies, especially when individuals enter a building and see a digital display showing good levels of carbon dioxide, carbon monoxide, and particulate matter? Would anyone like to take this question?

 

William Mills  1:27:36

I’ve been pretty involved in that. If anyone attended the ASHRAE conference in January, you might have seen some examples. There are a number of monitoring technologies out there now where they don’t actually show the numbers first. Instead, they use color ranges. I think that is a more effective initial way of communicating information to people. The red, green, yellow type of approach seems to work well. I won’t mention any specific vendors, but we’ve done work with digital displays and found that people respond more to the color indicators than the actual numbers.

 

Mitesh Kumar  1:28:26

Thank you, William. Thank you very much, everyone. This has been so informative. We have a large number of questions from the audience, as I can see. So, Erik, I will now share them with you.

 

Erik Malstrom  1:28:48

Great, and I’m just looking at the time here. We’re one minute away from the scheduled end time. Stephane, do we want to run longer, or do we want to wrap up? Because we could go either way. There are a lot of great comments here, and I’d like to call out a couple.

Ralph Froelich, thanks so much for your comments throughout. You mentioned that building managers need to evaluate whether their building represents a hazard for occupants and need a list of the most important factors to measure that can give an indication of habitability and the lack of agents that can cause fatal diseases. This gets back to the concept of parameters—what are you actually measuring?

Several of you have talked about this, but for someone who has nothing in place right now, where should they start? If you want to implement something like this, where do you begin? Maybe I’ll turn this over to Alex since you’re out working with folks in the field. If you’re taking someone from square one, how do you start?

 

Alex LeBeau  1:30:46

We’ve talked about the parameters a lot, Erik, so I won’t dive back into that. For resources, I’d say there’s some good documentation from the EPA, NIOSH, and even OSHA around what building managers can use. These resources are great starting points because you’ll see a lot of trends across all those documents, including the ones Karen already shared.

These would be good starting points for a building manager. Typically, the ones that are more like pamphlets or flyers are written in the form of risk communication, as Alex was talking about. They’re designed so building managers and practitioners can easily digest the instructions.

 

Erik Malstrom  1:31:38

And just to call out, Karen mentioned this before, but there’s a link in the chat to the principles of a healthy home, provided by the Department of Housing and Urban Development (HUD). That’s great for the residential building stock, and commercial buildings are a little bit different.

 

Karen Dannemiller  1:31:55

Yeah, I’ll agree with that too. That’s probably a really great starting place to at least get an overview of what you should be considering.

 

Erik Malstrom  1:32:05

There’s another question that could probably be another webinar by itself: the word “safe.” I’ve found this word to be loaded, and folks in academia and industry often don’t use it because it’s relative to many things. Ultimately, all the complexity needs to be distilled down to pass/fail, a letter grade, a traffic light, or something both digestible and actionable.

Does anyone want to comment on “safe”? You hear words like “adequate” in code, which gives you a baseline level of design for any building. How do we think about “safe” and that word? Is it a bad word? Any reactions to that?

 

Corey Boles  1:33:06

I don’t think it’s a bad word. I think it goes right back to risk communication and defining what we mean by all these terms. Anecdotally, one of my professors at Iowa had a definition for “safe.” He said we measure how safe something is by actually measuring how unsafe it is, and that’s usually how we characterize it.

 

Alex LeBeau  1:33:32

Usually, you know, it’s this classic hazard versus risk kind of viewpoint. If you look at this from a qualitative standpoint, are you looking at high risk, medium risk, or low risk? And what does low risk mean? Is low risk acceptable for your scenario? Low risk might be acceptable in one scenario but not in another. You have to consider what you’re talking about in terms of safe and safety and whether it’s a risk driver or a risky scenario you’re facing. As you said, this could be the topic for a whole different webinar.

 

Erick Malstrom  1:34:10

All right, I’m going to begin the wrap-up here and give each of you a lightning round final question: What capabilities should we be prioritizing for the prevention of the next pandemic? But I’ll lower the stakes a bit to say, even just seasonal surges of pathogens. What’s number one on your list that could really move the needle this winter or the next time something really bad happens? I’ll cold call people. Karen, what do you think?

 

Karen Dannemiller  1:34:52

Yeah, absolutely. I think it’s really important to have a comprehensive approach with different tools to meet the need. It’s crucial to be able to adjust our actions depending on the risk at any given time. For example, people aren’t as concerned about influenza over the summer because it’s a lower risk, but we might need to increase monitoring and ventilation as we get into flu season.

It’s important to think about how to use different tools, how to improve ventilation in different cases, and when to move towards masking. Understanding the thresholds for these actions is key. Many people have been talking about these measures as a continuum rather than a simple red, yellow, or green. We use that for communication to help people understand, but it’s about understanding when to step up and use different frameworks to address the current situation.

 

Erik Malstrom  1:35:51

Great. Thank you. All right, William.

 

William Mills  1:36:02

I think one of the biggest changes that’s been helpful is wastewater monitoring. It provides valuable information about what’s happening in the community. I’ve looked closely at the work being done at NIU, and we could track positive testing almost a week in advance. Incorporating that sort of data into how we look at indoor air, and considering the relationship with water, as Alex mentioned, presents opportunities. As Karen said, knowing when to start using masks and other measures could be informed by this data, allowing us to act sooner when necessary.

 

Erik Malstrom  1:36:49

Great point. Krystal.

 

Krystal Pollitt  1:36:57

I’ll raise another metric that I found to be very informative—the simplicity of indoor CO2 monitoring. It’s a great indicator for people to have value associated with, whether they prefer quantitative measurements or categorical risk levels within spaces. This metric holds up well because CO2 monitors are small and relative, and I see this as a path forward.

 

Alex LeBeau  1:37:39

I think this goes somewhat back to risk communication. We all got caught off guard. To mitigate or prevent the next pandemic or any issues, we need to be prepared. One of the things we’re working on at AIHA, through the IAQ committee, is upgrading and updating our guidance documents to be more applicable beyond COVID. Get ready, have contingency plans, seasonal plans, and atypical plans to prepare your facilities or buildings.

When these situations arise, be ready for them with an action plan that you’ve already thought through. Sit down with professionals or read the guidance and get that down on paper. There was a lot of scrambling and figuring things out in the moment, and it goes back to risk communication. If we effectively communicate the risk and help people understand it, they can develop plans to get ready for their facilities. It can be something very simple or, depending on the type of facility, very complex. Prepare yourself now to be ready for anything or almost anything that could happen in the future.

 

Erik Malstrom  1:38:52

Thanks, Alex. Corey.

 

Corey Boles  1:38:56

Yeah, these are all great responses. This is making it difficult to be the last one following this up. But I would say for me, the strongest arsenal we have, particularly in the workplace and the general population, is education and empowerment of individuals to understand risk, define “safe,” and know the protocols and plans.

It’s great to have all these plans, accurate risk communication, and multiple tools, but if we’re not accurately educating the general population and workforce on what these aspects mean, how to employ them, and why things are fluid, we’ll run into the same obstacles and issues experienced during the COVID-19 pandemic. Items like this Lessons Learned series and other educational formats are hugely empowering and need to be integrated into workplaces, schools, and other settings, addressing these topics in a much more direct manner.

 

Erik Malstrom  1:40:10

Great, okay. Well, Stephane, do we want to begin to wrap up?

 

Stephane Bilodeau  1:40:19

Yes, we can definitely go to the closure the session. Do you want to say some last words before?

 

Erik Malstrom  1:40:28

I’ll say something, and then I’ll turn it over to Mitesh. Thank you so much to our panelists. Great discussion, really insightful comments from all of you. Thank you for your contributions to this field. The work and research you’re doing are all very exciting. It’s been a pleasure. Thank you. And I’ll turn it over to Mitesh.

 

Mitesh Kumar  1:40:51

Thanks, Erik. And likewise, thank you to the panelists. This was one of my first sessions as a moderator, and it was great to have such an insightful discussion. Thank you.

 

Stephane Bilodeau  1:41:05

Closing this wonderful event, I first want to greatly thank our outstanding and insightful speakers: William, Karen, Alex, Krystal, and Corey. A big thank you as well to our generous and sharp moderators, Erik and Mitesh. Another big thank you to both of you.

Secondly, I want to thank all the participants for taking the time to join us and exchange ideas during the session. With your contributions, we help to extend a vibrant and inclusive scientific community that provides meaningful experiences and knowledge, benefiting everyone involved.

We welcome you all to join us as members. You can find all the necessary links on our website. You’ve seen the link for past events in the chat. I would also like to add this link to meet our Science Advisory Board, where you can see the great and outstanding people on our board.

So I’ll wrap up here. Thank you for being part of our community. We look forward to welcoming you to our upcoming events and initiatives, where you can connect with like-minded individuals and explore science, a wide range of solutions, activities, and opportunities as you’ve seen today. Have a great rest of the day. Thank you.