ArticleProceedings of the National Academy of Sciences of the United States of America2022
Aerosol particle emission increases exponentially above moderate exercise intensity resulting in superemission during maximal exercise.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Severe acute respiratory syndrome coronavirus-2 shedding in exhaled material: a systematic review.Epidemiology and infection · 2025Pooled it
- Host factors associated with respiratory particle emission and virus presence within respiratory particles: a systematic review.Frontiers in microbiology · 2025Pooled it
- The Risk of SARS-CoV-2 Transmission in Community Indoor Settings: A Systematic Review and Meta-analysis.The Journal of infectious diseases · 2024Pooled it
- Aerosol emission rates from breathing, speaking, and speaking with a surgical mask.Frontiers in public health · 2026Article
- A Virus Aerosol Chamber Study: The Impact of UVA, UVC, and HEnvironment & health (Washington, D.C.) · 2025Article
- Association between social activities and risk of COVID-19 in a cohort of healthcare personnel.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Functional areas shape indoor microbial structure and potential risks in university dormitories.Frontiers in microbiology · 2025Article
- Modelling indoor airborne transmission combining architectural design and people movement using the VIRIS simulator and web app.Scientific reports · 2024Article
- An Outbreak of Respiratory Viral Infections in a Professional Ice Hockey Team.Influenza and other respiratory viruses · 2024Article
- Contraction of Respiratory Viral Infection During air Travel: An Under-Recognized Health Risk for Athletes.Sports medicine - open · 2024Article
- Resolving the Loss of Intermediate-Size Speech Aerosols in Funnel-Guided Particle Counting Measurement.Atmosphere · 2024Article
- Indices of airway resistance and reactance from impulse oscillometry correlate with aerosol particle emission in different age groups.Scientific reports · 2024Article
- Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review.Frontiers in public health · 2024Review
- Peak risk of SARS-CoV-2 infection within 5 s of face-to-face encounters: an observational/retrospective study.Scientific reports · 2023Observational
- Lung aerosol particle emission increases with age at rest and during exercise.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Association of Physical Activity With SARS-CoV-2 Infection and Severe Clinical Outcomes Among Patients in South Korea.JAMA network open · 2023Article
- Indoor air surveillance and factors associated with respiratory pathogen detection in community settings in Belgium.Nature communications · 2023Article
- Respiratory aerosol particle emission and simulated infection risk is greater during indoor endurance than resistance exercise.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- The Spread of Exhaled Air and Aerosols during Physical Exercise.Journal of clinical medicine · 2023Article
- T-cell-derived TNF-α and a cluster of immunological parameters from plasma allow a separation between SARS-CoV-2 convalescent versus vaccinated elite athletes.Frontiers in physiology · 2023Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Many airborne pathogens such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are transmitted indoors via aerosol particles. During exercise, pulmonary ventilation can increase over 10-fold, and therefore, exercisers will exhale a greater volume of aerosol-containing air. However, we currently do not know how exercise affects the concentration of aerosol particles in exhaled air and the overall emission of aerosol particles. Consequently, we developed a method to measure in parallel the concentration of aerosol particles in expired air, pulmonary ventilation, and aerosol particle emission at rest and during a graded exercise test to exhaustion. We used this method to test eight women and eight men in a descriptive study. We found that the aerosol particle concentration in expired air increased significantly from 56 ± 53 particles/liter at rest to 633 ± 422 particles/liter at maximal intensity. Aerosol particle emission per subject increased significantly by a factor of 132 from 580 ± 489 particles/min at rest to a super emission of 76,200 ± 48,000 particles/min during maximal exercise. There were no sex differences in aerosol particle emission, but endurance-training subjects emitted significantly more aerosol particles during maximal exercise than untrained subjects. Overall, aerosol particle emission increased moderately up to an exercise intensity of ∼2 W/kg and exponentially thereafter. Together, these data might partly explain superspreader events especially during high-intensity group exercise indoors and suggest that strong infection prevention measures are needed especially during exercise at an intensity that exceeds ∼2 W/kg. Investigations of influencing factors like airway and whole-body hydration status during exercise on aerosol particle generation are needed.
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