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Updated: Sep 12, 2025
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Published on: March 17, 2023
Engineering Infection Controls to Reduce Indoor Transmission of Respiratory Infections : A Scoping Review
Amiran Baduashvili1, Lewis Radonovich2, Louis Leslie3
1Division of Hospital Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado (A.B., C.B., B.F., J.W.).
Background:
Engineering infection controls include a wide range of interventions used indoors to reduce occupants' exposure to respiratory pathogens.
Purpose:
To identify and describe primary studies evaluating the effects of engineering infection control interventions designed to reduce the spread of respiratory infections transmitted through indoor air.
Data Sources:
MEDLINE, Embase, Global Health, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Environmental Science Collection from database inception to 12 December 2023.
Study Selection:
English-language primary research articles evaluating engineering infection control interventions.
Data Extraction:
Publication information, population characteristics, intervention details, and all relevant outcomes were abstracted by a reviewer and verified by a second, senior reviewer.
Data Synthesis:
A total of 672 studies published between 1929 and 2024 were identified. Most (n = 606) evaluated environmental samples only, 57 included human participants, and 9 included sentinel animal subjects. About half of the studies included at least 1 intervention classified as pathogen inactivation (n = 405), with fewer involving pathogen removal (n = 200) or air exchange or dilution (n = 143). Across all studies, about half (n = 332) measured the quantity of viable nonpathogenic organisms from air samples, followed by the quantity of nonbiological particulates (n = 197) or viable pathogenic organisms (n = 149). Harms, such as toxic byproducts, were rarely measured.
Limitation:
Exclusion of non-English-language publications and gray literature.
Conclusion:
There is substantial heterogeneity in the available evidence. Gaps in evidence include studies measuring efficacy outcomes that are highly relevant for human infection transmission or harms. Refinements in classification of interventions and outcomes could strengthen reporting of these evaluations.
Primary Funding Source:
National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention. (Registered on Open Science Framework [https://osf.io/5zmhd]).
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