Effect of the implosion and demolition of a hospital building on the concentration of fungi in the air

Abstract

Building renovations increase the concentration of Aspergillus conidia in the air. In 2010, one wing of the hospital building was imploded due to structural problems. To evaluate the impact of building implosion on the concentration of fungi in the air, the demolition was performed in two phases: mechanical demolition of 30 m of the building, followed by implosion of the wing. Patients at high risk for aspergillosis were placed in protected wards. Air sampling was performed during mechanical demolition, on the day of implosion and after implosion. Total and specific fungal concentrations were compared in the different areas and periods of sampling, using the anova test. The incidence of IA in the year before and after implosion was calculated. The mean concentration of Aspergillus increased during mechanical demolition and on the day of implosion. However, in the most protected areas, there was no significant difference in the concentration of fungi. The incidence of invasive aspergillosis (cases per 1000 admissions) was 0.9 in the 12 months before, 0.4 during, and 0.5 in the 12 months after mechanical demolition (P > 0.05). Continuous monitoring of the quality of air and effective infection control measures are important to minimize the impact of building demolition.

What’s New in Prevention of Invasive Fungal Diseases during Hospital Construction and Renovation Work: An Overview

“…Different preventive measures were applied in the studies published in the seven-year period from 2015 to 2022. Procedures intended to decrease and control dust contamination included: increased cleaning of surfaces and air conducts [ 29 , 33 , 40 ]; closing or sealing of windows of rooms with at-risk patients [ 29 , 31 , 33 ]; plastic barriers between inpatient-care areas and construction areas to prevent dust from entering [ 32 , 40 ]; adhesive carpets for collecting dust at the entry ways of the unit [ 31 ]; lock chambers between hospitalization units and building sites with temporary rigid plastic walls [ 31 ]; permanent humidification (moistening of construction debris) of the location of demolition by constant blasting of water (water jets) during demolition [ 29 , 31 ]; covering of rubble containers and quickly removing [ 31 ]. …”

“…permanent humidification (moistening of construction debris) of the location of demolition by constant blasting of water (water jets) during demolition [ 29 , 31 ];…”

“…Pedestrian traffic for healthcare workers, patients, construction workers, and visitors was limited and redirected to avoid construction areas and limit the entrance of contaminated particles [ 29 , 31 , 33 ]. For immunosuppressed patients, N95 masks were recommended when going near construction work areas [ 33 ].…”

“…Patients were divided into risk groups and placed in the more protected environment if they were classified in the higher risk groups (patients with acute leukemia and recipients of hematopoietic cell transplantation (HCT)) [ 29 ]. For them, the use of rooms equipped with high-efficiency particulate air filtration (HEPA) and positive pressure was applied.…”

Qualidade do ar em reformas hospitalares. A dissipação de fungos e aerodispersoides causada por canteiros de obras dentro de hospitais.

“…A demolição do edifício foi realizada em duas fases: demolição mecânica e implosão. A amostragem de ar foi realizada durante o período de demolição mecânica, no dia da implosão e após a implosão, sendo que, também foram utilizados dados de amostragens de períodos anteriores à demolição, os quais utilizaram os mesmos procedimentos de análise e cultivo(BARREIROS et al, 2015). Porém, surtos de fungos e infecções em circunstâncias especiais ainda continuam ocorrendo em ambientes de saúde, especialmente em pacientes com neoplasias hematológicas e aqueles que são equipes de controle de infecção e a engenharia hospitalar.…”