Background: Although several COVID-19 outbreaks have occurred in older adult care facilities throughout Japan, no field studies focusing on airborne infections within these settings have been reported. Countermeasures against airborne infection not only consider the air change rate (ACR) in a room but also the airflow in and between rooms. However, a specific method has not yet been established by Japanese public health centers or infectious disease–related organizations. Objective: In April 2021, 59 COVID-19 cases were reported in an older adult care facility in Miyagi, Japan, and airborne transmission was suspected. The objective of this study was to simultaneously reproduce the ACR and aerosol advection in this facility using the carbon dioxide (CO2) tracer gas method to elucidate the specific location and cause of the outbreak. These findings will guide our recommendations to the facility to prevent recurrence. Methods: In August 2021, CO2 sensors were placed in 5 rooms where airborne infection was suspected, and the CO2 concentration was intentionally increased using dry ice, which was subsequently removed. The ACR was then estimated by applying the Seidel equation to the time-series changes in the CO2 concentration due to ventilation. By installing multiple sensors outside the room, advection outside the room was monitored simultaneously. Aerosol advection was verified using computer simulations. Although the windows were closed at the time of the outbreak, we conducted experiments under open-window conditions to quantify the effects of window opening. Results: The ACR values at the time of the outbreak were estimated to be 2.0 to 6.8 h−1 in the rooms of the facility. A low-cost intervention of opening windows improved the ventilation frequency by a factor of 2.2 to 5.7. Ventilation depended significantly on the window-opening conditions (P values ranging from .001 to .03 for all rooms). Aerosol advection was detected from the private room to the day room in agreement with the simulation results. Considering that the individual who initiated the infection was in the private room on the day of infection, and several residents, who later became secondarily infected, were gathered in the day room, it was postulated that the infectious aerosol was transmitted by this air current. Conclusions: The present results suggest that secondary infections can occur owing to aerosol advection driven by large-scale flow, even when the building design adheres to the ventilation guidelines established in Japan. Moreover, the CO2 tracer gas method facilitates the visualization of areas at a high risk of airborne infection and demonstrates the effectiveness of window opening, which contributes to improved facility operations and recurrence prevention.

Promoting subjective well-being is a crucial challenge in aging societies. In 2022, we launched a community-based intervention trial (the Chofu-Digital-Choju Movement). This initiative centered on fostering in-person and online social connections to enhance the subjective well-being of older adults. This paper describes the study design and baseline survey. This quasi-experimental study involved community-dwelling older adults aged 65–84 years in Chofu City, Tokyo, Japan. A self-administered questionnaire was distributed to 3742 residents (1681 men and 2061 women), and a baseline survey was conducted in January 2022. We assessed subjective well-being (primary outcome); psychosocial, physical, and dietary factors; and the use of information and communication technology variables (secondary outcomes) among the participants. After the intervention involving online classes, community hubs, and community events, a 2-year follow-up survey will be conducted to evaluate the effects of the intervention, comparing the intervention group (participants) with the control group (non-participants). We received 2503 questionnaires (66.9% response rate); of these, the analysis included 2343 questionnaires (62.6% valid response rate; mean age, 74.4 (standard deviation, 5.4) years; 43.7% male). The mean subjective well-being score was 7.2 (standard deviation, 1.9). This study will contribute to the development of a prototype subjective well-being strategy for older adults.

A coronavirus disease 2019 (COVID-19) cluster emerged in a manufacturing factory in early August 2021. In November 2021, we conducted a ventilation survey using the tracer gas method. Firstly, we reproduce the situation at the time of cluster emergence and examined whether the ventilation in the office was in a condition that increased the risk of aerosol transmission. Secondly, we verified the effectiveness of the factory’s own countermeasure implemented immediately after the August cluster outbreak. Furthermore, we verified the effectiveness of several additional improvement measures on the factory’s own countermeasures already installed in August. Under the conditions of the cluster emergence, the air changes per hour (ACH) value was 0.73 ACH on average. The ACH value was less than 2 ACH recommended by the Ministry of Health, Labour, and Welfare, suggesting an increased risk of aerosol transmission. The factory’s own countermeasures taken immediately in August were found to be effective, as the ACH value increased to 3.41 ACH on average. Moreover, it was confirmed that additional improvement measures on the factory’s own countermeasures increased the ACH value to 8.33 ACH on average. In order to prevent the re-emergence of COVID-19 clusters due to aerosol infection in the office, it was found that while continuing the factory’s own countermeasure, additional improvement measures should also be added depending on the number of workers in the room. In a company, it is important that workers themselves continue to take infection control measures autonomously, and confirming the effectiveness of the measures will help maintain workers’ motivation. We believe it is helpful that external researchers in multiple fields and internal personnel in charge of the health and safety department and occupational health work together to confirm the effectiveness of conducted measures, such as in this case.

There is growing global concern regarding the detrimental health impacts of PM_2.5 emissions from traditional stoves that utilize polluting fuels. Conventional methods for estimating daily personal PM_2.5 exposure involve personal air samplers and measuring devices placed in a waist pouch, but these instruments are cumbersome and inconvenient. To address this issue, we developed a novel neck-mounted PM_2.5 monitoring device (Pocket PM_2.5 Logger) that is compact, lightweight, and can operate continuously for 1 week without recharging. Twelve participants who utilized charcoal, firewood, or propane gas for cooking in rural regions of Rwanda wore the Pocket PM_2.5 Logger continuously for 1 week, and time-series variations in personal PM_2.5 exposure were recorded at 5-min intervals. Individual daily exposure concentrations during cooking differed significantly among users of the different fuel types, and PM_2.5 exposure was at least 2.6 and 3.4 times higher for charcoal and firewood users, respectively, than for propane gas users. Therefore, switching from biomass fuels to propane gas would reduce daily individual exposure by at least one-third. An analysis of cooking times showed that the median cooking time per meal was 30 min; however, half the participants cooked for 1.5 h per meal, and one-third cooked for over 4.5 h per meal. Reducing these extremely long cooking times would reduce exposure with all fuel types. The Pocket PM_2.5 Logger facilitates the comprehensive assessment of personal PM_2.5 exposure dynamics and is beneficial for the development of intervention strategies targeting household air pollution.

Background/Objectives: Internet use positively impacts mental health in older adults, with health literacy (HL) playing a key role. While social networks may complement individual HL, the role of neighborhood relationships in this association, particularly by gender, remains unclear. This study examined how the association between HL and Internet use among older adults was modified by neighborhood relationships. Methods: Using baseline data from the Chofu–Digital–Choju project, a cross-sectional analysis was conducted on 1955 community-dwelling adults aged 65–84 (889 men and 1066 women). HL was assessed using the Communicative and Critical Health Literacy scale and dichotomized at four points. Neighborhood relationships were categorized as high (visiting/chatting with neighbors) or low (exchanging greetings/no relationship). Gender-stratified logistic regression analyses were performed with Internet use as the dependent variable, with HL, neighborhood relationships, and their interaction as independent variables. Results: Internet user proportion was 55.6% for men and 41.8% for women. HL was positively associated with Internet use in both genders, though patterns differed. Among men, the HL–Internet use association was consistent (OR = 3.09; 95% CI: 2.25–4.24) regardless of neighborhood relationship levels. For women, this association was significantly modified (interaction OR = 0.46, 95% CI: 0.24–0.87). Women with low HL but strong neighborhood relationships showed increased odds of Internet use (OR = 2.08, 95% CI: 1.32–3.26). Conclusions: Gender-specific patterns in HL and neighborhood relationships influence Internet use among older adults. Neighborhood relationships may compensate for low HL in women, underscoring the need for gender-sensitive strategies to promote digital HL.

We experimentally investigated indoor air ventilation using the CO ₂ tracer technique to verify the infection cluster of SARS-CoV-2 that erupted at an office space. Multi-placed observations revealed extremely low air change rates (0.1/h) at the site. The local infection clusters were observed several meters away from a door that is the only ventilation in the office, which suggests a negative effect of plastic sheeting shielding. The thermo-fluid simulation showed that the plastic sheet blocked the airflow and trapped the exhaled air in each partition cell. As risk suppression methods, improving air ventilation by opening windows and using fans were verified, and significant improvements (10–28/h) were observed for each partition cells.