Enni Sanmark

University of Helsinki

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Lotta‐Maria Oksanen

University of Helsinki

Ahmed Geneid

Helsinki University Hospital

Nina S. Atanasova

University of Helsinki

Lasse Lehtonen

Helsinki University Hospital

Veli‐Jukka Anttila

Helsinki University Hospital

Noora Rantanen

Finnish Society of Sciences and Letters

Antti Hyvärinen

Finnish Meteorological Institute

Svetlana Sofieva

Finnish Meteorological Institute

Sirpa Laitinen

Finnish Institute of Occupational Health

Sampo Oksanen

Aalto University

Cooperative Institutions

University of Helsinki

Helsinki University Hospital

Tampere University

Hospital District of Helsinki and Uusimaa

Finnish Institute for Health and Welfare

Finnish Meteorological Institute

Institute for Molecular Medicine Finland

Tampere University Hospital

Karolinska Institutet

Helsinki Institute of Physics

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Aetiology of peritonsillar abscess - role of minor salivary glands

Enni Sanmark

Peritonsillar Abscess

Etiology

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Laulaminen on todennäköisesti puhumista vaarallisempaa korona-aikana

Suomen lääkärilehti (2021)

Lotta‐Maria Oksanen Enni Sanmark Anna Tuhkuri Veli‐Jukka Anttila Ahmed Geneid

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A machine learning approach to predict resilience and sickness absence in the healthcare workforce during the COVID-19 pandemic

Scientific Reports (2022)

Johannes Lieslehto Noora Rantanen Lotta‐Maria Oksanen Sampo Oksanen Anne S. Kivimäki

Abstract During the COVID-19 pandemic, healthcare workers (HCWs) have faced unprecedented workloads and personal health risks leading to mental disorders and surges in sickness absence. Previous work has shown that interindividual differences in psychological resilience might explain why only some individuals are vulnerable to these consequences. However, no prognostic tools to predict individual HCW resilience during the pandemic have been developed. We deployed machine learning (ML) to predict psychological resilience during the pandemic. The models were trained in HCWs of the largest Finnish hospital, Helsinki University Hospital (HUS, N = 487), with a six-month follow-up, and prognostic generalizability was evaluated in two independent HCW validation samples (Social and Health Services in Kymenlaakso: Kymsote, N = 77 and the City of Helsinki, N = 322) with similar follow-ups never used for training the models. Using the most predictive items to predict future psychological resilience resulted in a balanced accuracy (BAC) of 72.7–74.3% in the HUS sample. Similar performances (BAC = 67–77%) were observed in the two independent validation samples. The models' predictions translated to a high probability of sickness absence during the pandemic. Our results provide the first evidence that ML techniques could be harnessed for the early detection of COVID-19-related distress among HCWs, thereby providing an avenue for potential targeted interventions.

Pandemic

Resilience

2019-20 coronavirus outbreak

Coronavirus Infections

10.1038/s41598-022-12107-6

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Effect of Vocalization on Human Aerosol Dynamics: Whispering Produces More Aerosols than Speaking

Journal of Voice (2024)

Enni Sanmark Anna Tuhkuri-Matvejeff Ahmed Geneid Lotta‐Maria Oksanen Paavo Alku

Sound pressure and exhaled flow have been identified as important factors associated with higher particle emissions. The aim of this study was to assess how different vocalizations affect the particle generation independently from other factors.

Dynamics

10.1016/j.jvoice.2024.07.028

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Should we avoid colleagues in leisure time during the coronavirus disease 2019 (COVID-19) pandemic?

Infection Control and Hospital Epidemiology (2020)

Lotta‐Maria Oksanen Enni Sanmark Sampo Oksanen Veli‐Jukka Anttila Jussi J. Paterno

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Pandemic

2019-20 coronavirus outbreak

Content (measure theory)

Coronavirus

10.1017/ice.2020.1320

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Safe use of PHI6 IN the experimental studies

Heliyon (2023)

Enni Sanmark Joel Kuula Sirpa Laitinen Lotta‐Maria Oksanen Dennis H. Bamford

Surrogate viruses theoretically provide an opportunity to study the viral spread in an indoor environment, a highly needed understanding during the pandemic, in a safe manner to humans and the environment. However, the safety of surrogate viruses for humans as an aerosol at high concentrations has not been established. In this study, Phi6 surrogate was aerosolized at high concentration (Particulate matter2.5: ∼1018 μg m-3) in the studied indoor space. Participants were closely followed for any symptoms. We measured the bacterial endotoxin concentration of the virus solution used for aerosolization as well as the concentration in the room air containing the aerosolized viruses. In addition, we measured how the bacterial endotoxin concentration of the sample was affected by different traditional virus purification procedures. Despite the purification, bacterial endotoxin concentration of the Phi6 was high (350 EU/ml in solution used for aerosols) with both (two) purification protocols. Bacterial endotoxins were also detected in aerosolized form, but below the occupational exposure limit of 90 EU/m3. Despite these concerns, no symptoms were observed in exposed humans when they were using personal protective equipment. In the future, purification protocols should be developed to reduce associated bacterial endotoxin levels in enveloped bacterial virus specimens to ensure even safer research use of surrogate viruses.

10.1016/j.heliyon.2023.e13565

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Aerosol generation during general anesthesia is comparable to coughing: An observational clinical study

Acta Anaesthesiologica Scandinavica (2021)

Lotta‐Maria Oksanen Enni Sanmark Svetlana Sofieva Noora Rantanen Mari Lahelma

Intubation, laryngoscopy, and extubation are considered highly aerosol-generating procedures, and additional safety protocols are used during COVID-19 pandemic in these procedures. However, previous studies are mainly experimental and have neither analyzed staff exposure to aerosol generation in the real-life operating room environment nor compared the exposure to aerosol concentrations generated during normal patient care. To assess operational staff exposure to potentially infectious particle generation during general anesthesia, we measured particle concentration and size distribution with patients undergoing surgery with Optical Particle Sizer.

10.1111/aas.14022

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The effect of room air cleaners on infection control in day care centres

Indoor Environments (2024)

Ville Vartiainen Johanna Hela Anni Luoto Petra Nikuri Enni Sanmark

The aim of this study was to assess the effectiveness of air cleaning in reducing the risk of respiratory infection in two day care centres using a simple and robust calculation model. Additionally, we aimed to identify potential hotspots for infections in indoor setting and focus countermeasures accordingly. Initial results from an interventional clinical study are provided as proof-of-concept for the model. We constructed a mathematical model to assess the number of persons at risk for airborne infection transmission in day care. Utilizing the model, we used portable air cleaners in two day care units (A and B, number of children participating in the study n = 43) and compared infection incidents between the two intervention units to the rest of the units in city of Helsinki (n = 607). The intervention buildings had mechanical supply and exhaust air ventilation. The risk modelling suggests that the use of air cleaners reduced the expected number of persons at infection transmission risk significantly. At day care centre A the average reduction was 60% (range 52% - 88%) and at day care centre B 53% (range 14% - 59%). During the approximately six month study period, we observed a significant difference in the days absent from day care due to infections between the intervention and reference day care units. On average, the parents were absent from work due to child's illness in reference day care centers for 5.53 days and 3.77 days in intervention day care centers during the study period (p=0.009). In relative terms the reduction was approximately 32%. Our study offers compelling evidence to support increasing non-infectious air flow rates in daycare centers during periods requiring infection risk management. This can be implemented with portable air cleaners as an effective and cost-efficient strategy for mitigating the spread of respiratory infections among children. The clinical results support the findings suggested by the theoretical model. -Air cleaning seems to be an effective way to reduce infection risk in day cares -Identification of infection risk hotspot will help in desgining the preventive methods Portable air cleaners offer an affordable and versatile solution also in buildings where existing ventilation is insufficient for infection risk management"

10.1016/j.indenv.2024.100007

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Minor salivary gland infection as origin of peritonsillitis – novel theory and preliminary results

Acta Oto-Laryngologica (2022)

Nelli Vanhapiha Enni Sanmark Karin Blomgren Johanna Wikstén

Peritonsillitis (PT) is defined as cellulitis in peritonsillar tissue without pus. The pathogenesis of peritonsillar infections is controversial.To explore whether minor salivary glands are involved in the development of PT and to identify clinical findings that predict the evolution of PT to peritonsillar abscess (PTA).We included 146 adult patients treated for acute tonsillitis (AT; n = 54), PT (n = 34), or PTA (n = 58) at the Helsinki University Hospital. The treating physician recorded tonsillar, oropharyngeal, and dental findings. We analysed serum C-reactive protein (S-CRP) and amylase (S-Amyl). For PTA, pus samples were analysed; for AT and PT, throat cultures were collected. Patients with PT or PTA (PT/PTA; n = 92) were classified into groups with or without tonsillar exudate or hyperaemia (tonsillar findings).The PT group without tonsillar findings had lower S-CRP than the PT group with tonsillar findings (p=.0275). The PT/PTA group without tonsillar findings had higher S-Amyl than the PT/PTA group with tonsillar findings (p=.0278). Three out of 34 (8.8%) patients with PT returned to the emergency department; 1 (2.9%) developed PTA.Elevated S-Amyl in the PT/PTA group without tonsillar findings suggests that minor salivary glands are sometimes involved in the development of peritonsillar infections.

Peritonsillar Abscess

Throat

Acute Tonsillitis

Tonsil

10.1080/00016489.2022.2026003

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SARS-CoV-2 air and surface contamination on a COVID-19 ward and at home

Research Square (Research Square) (2021)

Lotta‐Maria Oksanen Jenni Virtanen Enni Sanmark Noora Rantanen Vinaya Venkat

Abstract SARS-CoV-2 has been detected both in air and on surfaces, but questions remain about the patient-specific and environmental factors affecting virus transmission to the environment. Additionally, more detailed information on viral findings in air is needed. This cross-sectional study presents results from 259 air and 252 surface samples from the surroundings of 23 hospitalized and eight home-treated COVID-19 patients between July 2020 and March 2021 and compares the results between the measured environments and patient factors. The proportions of PCR-positive air and surface samples showed statistical similarity in hospital and in the home. In four cases, positive environmental samples were detected even after the patients had developed a neutralizing IgG response. SARS-CoV-2 RNA was detected in the following particle sizes: 0.65–4.7 µm, >7 µm, >10 µm, and <100 µm. Appropriate infection control against airborne and surface transmission routes is needed in both environments, even after antibody production has begun.

2019-20 coronavirus outbreak

Airborne Transmission

10.21203/rs.3.rs-1002547/v2

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