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We all agree we want our clients to feel better when they leave our practice than they did when they arrived. Making sure we stay well is a part of keeping them well too. That's why all eyes, especially during this time of COVID-19, are on ways we can prevent infections from spreading in our workplaces. A big part of that is paying attention to the quality of the air we breathe when we are at work and sharing indoor spaces with people we don't live with. For those of us working in close-contact wellness professions, here are some things to consider for achieving the best air quality in the treatment space. HOW VIRUSES TRAVEL It is important to understand that the virus we are most concerned about now is transmitted through airborne droplets and aerosols that an infected person emits when they sneeze, cough, speak, or breathe. Viruses in aerosol form are about the same size as smoke and vapor particles. Imagine you are in your home, in a bedroom 30 feet away from the kitchen. Suddenly, you perk up—you can smell that someone has made coffee. Your olfactory receptors sense it because the vapor particles have traveled in aerosol form all the way through the air to your room, even under the door and through the vents. You open the door and are blasted with the scent of that delicious joe, and you are lured to the kitchen. The closer you get, the more your lungs fill with that rich, roasted aroma, and you can almost taste it in your mouth. Now, here's the rub—viruses travel the same way, only you can't smell them. The closer you are to them, and the worse the ventilation, the more you will be sharing air and breathing in second-hand aerosols that may be laden with a virus. 1 We also know viruses can travel great distances and linger, which may cause us harm. 2 Some experts say the 6-foot rule about social distancing is inadequate, and new evidence shows we should be asking for at least twice that distance. As researchers have demonstrated, an unprotected sneeze can extend 23–26 feet in its combined trajectory and velocity. 3 Knowing this, you may feel like throwing up your hands and admitting defeat, resolving to never leave your home again. However, addressing the problem can be as easy as upgrading filters, checking a few gauges, doing some math, flicking a switch, and opening a window or two. CHECK YOUR HVAC SYSTEM First, assess your overall indoor environment. Most modern buildings have heating, ventilation, and air conditioning (HVAC) systems, so check to see how well those systems are functioning. HVAC filters are designed to filter pollutants or contaminants out of the air that passes through them. This filtration can help reduce airborne contaminants, including particles containing viruses. The Environmental Protection Agency (EPA) recommends upgrading HVAC filters as appropriate for your specific building and HVAC system, making sure they are of the highest efficiency possible for your system, and are securely fitted and sealed. HVAC filters are given a minimum efficiency reporting value (MERV ) that indicates the size of particulates they can remove; the higher the MERV rating, the smaller the particulates they filter. The EPA recommends using filters with a MERV-13 rating or higher, but to consult your HVAC manual or an HVAC professional before making changes to the filters used in your BY JULIE TUDOR L i s te n to T h e A B M P Po d c a s t a t a b m m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 59 home or office systems, as demands may differ depending on your space. 4 The EPA also reminds us that an HVAC filter upgrade is but one element of a larger plan to protect you and your clients, and should be used along with other best practices. HEPA FILTRATION TO CLEAN THE AIR Like filters, air cleaners also help reduce particles containing viruses, and may be useful when used along with source control and ventilation. However, it is not a substitute for either method. Source control involves removing or decreasing pollutants such as smoke, chemical vapors, or infectious particles. The use of air cleaners alone cannot ensure adequate air quality, particularly where significant pollutant sources are present and ventilation is insufficient. 5 Portable air cleaners, also known as air purifiers, may be particularly helpful when additional ventilation with outdoor air is not possible without compromising indoor comfort. High efficiency particulate air (HEPA) filters were developed during the 1940s to improve gas masks and protect people from radiation particles. They were further innovated in the 1950s and 1960s for use in aerospace and NASA technology, and adapted for use in laboratory and health- care settings. They are rated to filter 99.97 percent of microparticles with a diameter of 0.3 microns or larger, but can actually capture nanoparticles that are only 0.1 microns wide. That means they are capable of trapping the SARS- CoV-2 virus and its variants because those particles are 0.125 microns in diameter. The reasoning behind this has to do with how the blown microfibers that make up the HEPA filter overlay into a dense, fuzzy, electrostatic web. Also, the

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