Mitigating airborne infection risks in public transportation: A systematic review

Airborne infections pose significant challenges to public transportation systems which can result in significant decline in ridership levels and financial stress for operators. This systematic review presents a comprehensive overview of measures and strategies employed by ground public transportation agencies to protect passengers and staff while ensuring the uninterrupted operation. This study also conducted a bibliometric analysis to provide insights into key topics, publication patterns, and major contributors in the field of airborne transmission research in public transportation. We have included studies published from January 2003 to June 2024, which reported measures and recommendations for managing public transportation to reduce virus transmission. Of the 2848 initially identified studies, 69 met our eligibility criteria. Our review identified four key strategies to prevent virus transmission in public transportation, including air quality improvement, cleaning, mask-wearing, and social distancing in vehicles and stations. While social distancing poses a significant challenge to public transportation, the integration of crowd management techniques and technology-driven information dissemination can provide effective strategies for managing capacity. The adoption of technology-driven solutions, such as efficient filtration systems, automated mask detection mechanisms, ultraviolet disinfection devices, and real-time passenger information, is required to implement these strategies effectively. Transportation agencies can utilize an airborne infection risk calculator during pandemics and beyond to assess and mitigate the risk of airborne transmission in various modes of transportation. Lessons from the Covid-19 pandemic underscored the need for developing advanced technologies to enhance passenger and staff safety in public transportation vehicles and stations.