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Background: While increasing the ventilation rate is an important measure toremove inhalable virus-laden respiratory particles and lower the risk ofinfection, direct validation in schools with population-based studies is farfrom definitive.  Methods: We investigated the strength of association between ventilation andSARS-CoV-2 transmission reported among the students of Italy's Marche region inmore than 10,000 classrooms, of which 316 were equipped with mechanicalventilation. We used ordinary and logistic regression models to explore therelative risk associated with the exposure of students in classrooms.  Findings: For classrooms equipped with mechanical ventilation systems, therelative risk of infection decreased with the increase in ventilation:ventilation ranging from 10 to 14 L s-1 student-1 reduced the likelihood ofinfection for students by 80% compared with a classroom with only naturalventilation. From the regression analysis, as confirmed by the predictivetheoretical approach, we obtained a relative risk reduction in the range12%-15% for each additional unit of ventilation rate per person.  Interpretation: We need high ventilation rates (> 10 L s$^{-1}$student$^{-1}$) to protect students in classrooms from airborne transmission;this is higher than the rate needed to ensure indoor air quality. The excellentagreement between the results from the retrospective cohort study and theoutcomes of the predictive theoretical approach makes it possible to assess therisk of airborne transmission for any indoor environment.

Increasing ventilation reduces SARS-CoV-2 airborne transmission in schools: a retrospective cohort study in Italy's Marche region