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Characterization of Aerosol Generation During Various Intensities of Exercise #MMPMID33957100
Chest 2021[Oct]; 160 (4): 1377-1387 PMID33957100show ga
BACKGROUND: Characterization of aerosol generation during exercise can inform the development of safety recommendations in the face of COVID-19. RESEARCH QUESTION: Does exercise at various intensities produce aerosols in significant quantities? STUDY DESIGN AND METHODS: In this experimental study, subjects were eight healthy volunteers (six men, two women) who were 20 to 63 years old. The 20-minute test protocol of 5 minutes rest, four 3-minute stages of exercise at 25%, 50%, 75%, and 100% of age-predicted heart rate reserve, and 3 minutes active recovery was performed in a clean, controlled environment. Aerosols were measured by four particle counters that were place to surround the subject. RESULTS: Age averaged 41 +/- 14 years. Peak heart rate was 173 +/- 17 beat/min (97% predicted); peak maximal oxygen uptake was 33.9 +/- 7.5 mL/kg/min; and peak respiratory exchange ratio was 1.22 +/- 0.10. Maximal ventilation averaged 120 +/- 23 L/min, while cumulative ventilation reached 990 +/- 192 L. Concentrations increased exponentially from start to 20 minutes (geometric mean +/- geometric SD particles/liter): Fluke >0.3 mum = 66 +/- 1.8 --> 1605 +/- 3.8; 0.3-1.0 mum = 35 +/- 2.2 --> 1095 +/- 4.6; Fluke 1.0-5.0 mum = 21 +/- 2.0 --> 358 +/- 2.3; P-Trak anterior = 637 +/- 2.3 --> 5148 +/- 3.0; P-Trak side = 708 +/- 2.7 --> 6844 +/- 2.7; P-Track back = 519 +/- 3.1 --> 5853 +/- 2.8. All increases were significant at a probability value of <.05. Exercise at or above 50% of predicted heart rate reserve showed statistically significant increases in aerosol concentration. INTERPRETATION: Our data suggest exercise testing is an aerosol-generating procedure and, by extension, other activities that involve exercise intensities at or above 50% of predicted heart rate reserve. Results can guide recommendations for safety of exercise testing and other indoor exercise activities.