A Probabilistic Transmission Model to Assess Infection Risk from Mycobacterium Tuberculosis in Commercial Passenger Trains
Journal
Risk Analysis
Journal Volume
31
Journal Issue
6
Pages
930-939
Date Issued
2011
Author(s)
Abstract
The objective of this article is to characterize the risk of infection from airborne Mycobacterium tuberculosis bacilli exposure in commercial passenger trains based on a risk-based probabilistic transmission modeling. We investigated the tuberculosis (TB) infection risks among commercial passengers by inhaled aerosol M. tuberculosis bacilli and quantify the patterns of TB transmission in Taiwan High Speed Rail (THSR). A deterministic Wells-Riley mathematical model was used to account for the probability of infection risk from M. tuberculosis bacilli by linking the cough-generated aerosol M. tuberculosis bacilli concentration and particle size distribution. We found that (i) the quantum generation rate of TB was estimated with a lognormal distribution of geometric mean (GM) of 54.29 and geometric standard deviation (GSD) of 3.05 quantum/h at particle size ? 5 μm and (ii) the basic reproduction numbers (R0) were estimated to be 0.69 (0.06-6.79), 2.82 (0.32-20.97), and 2.31 (0.25-17.69) for business, standard, and nonreserved cabins, respectively. The results indicate that commercial passengers taking standard and nonreserved cabins had higher transmission risk than those in business cabins based on conservatism. Our results also reveal that even a brief exposure, as in the bronchoscopy cases, can also result in a transmission when the quantum generation rate is high. This study could contribute to a better understanding of the dynamics of TB transmission in commercial passenger trains by assessing the relationship between TB infectiousness, passenger mobility, and key model parameters such as seat occupancy, ventilation rate, and exposure duration. ? 2010 Society for Risk Analysis.
Subjects
Airborne transmission; Modeling; Passenger trains; Probabilistic risk assessment; Tuberculosis
SDGs
Other Subjects
Airborne Mycobacterium tuberculosis; Airborne transmission; Basic reproduction number; Generation rate; Geometric mean; Geometric standard deviations; Key models; Log-normal distribution; M. tuberculosis; Mycobacterium tuberculosis; Passenger train; Probabilistic Risk Assessment; Risk-based; Taiwan high speed rails; Transmission model; Tuberculosis; Ventilation rate; Atmospheric aerosols; Bacilli; Disease control; Endoscopy; Mathematical models; Particle size analysis; Probability distributions; Railroad transportation; Risk assessment; aerosol composition; atmospheric pollution; disease transmission; health risk; high-speed train; numerical model; particle size; pollution exposure; probability; risk assessment; tuberculosis; ventilation; aerosol; article; disease transmission; environmental exposure; human; isolation and purification; microbiology; Mycobacterium tuberculosis; probability; railway; Taiwan; theoretical model; tuberculosis; Aerosols; Environmental Exposure; Humans; Models, Theoretical; Mycobacterium tuberculosis; Probability; Railroads; Taiwan; Tuberculosis; Taiwan; Bacilli (class); Mycobacterium tuberculosis
Type
journal article