Indoor Air Quality in Inpatient Environments: A Systematic Review on Factors that Influence Chemical Pollution in Inpatient Wards

Abstract

Introduction. Indoor air quality is one the main issues in which governments are focusing. In healing spaces, several research studies are reporting a growing number of data analysis and research works in order to guarantee and prevent health of users and workers. Currently the main investigations are about biological and physical risks; otherwise chemical ones are less investigated. Several countries are carrying out indoor air quality monitoring in those professional workplaces in which chemicals are used but also in some typically indoor (generic) spaces for the building hygiene assessment. The indoor air is affected by several factors that currently are analyzed punctually, without a whole scenario of all the variable performances. The authors have done a systematic review on the current state of the art and knowledge related to chemical pollution in healing spaces and the emerging strategies, supported by scientific literature, for healthy inpatient rooms and their indoor air. Methodology. The systematic review has been done through the analysis of papers from SCOPUS, DOAJ, and PubMed databases. The survey sample considered 483 scientific articles, between 1989 and 2017, and starting the systematic reading and analysis of the abstracts, only 187 scientific papers were selected, and only 96 were accessible. Discussion. Since scientific literature reports very different outputs and results, the resulting work from the survey is divided into specific fields of interest related to construction and finishing materials, installations, components, ventilation systems, processes, etc. Starting from the systematic reading, the paper classifies the factors of indoor air in four macroareas: outdoor air and microclimatic factors (temperature, relative humidity, air velocity, air change, etc.); management activities (management and maintenance activities, ventilation systems, HVAC, cleaning and disinfectant activities, etc.); design factors (room dimensions, furniture, finishing materials, etc.); and human presence and medical activities (users’ presence, their health status, and medical activities carried out in inpatient rooms). Conclusion. The systematic review gives rise to a broad scenario on the existing knowledge regarding the indoor air pollution, design, and management strategies for healthy spaces and several emerging topics. Although the aim of the investigation is strictly related to chemical pollution, several considerations from the biological point of view have been listed. The systematic review, supported by the existing scientific literature, becomes a starting point for considering the importance of the topic and to stimulate the knowledge around this field of interest for improving studies, analysis, and simulations.

Assessment of Indoor Air Quality and Users Perception of a Renovated Office Building in Manchester

“…Spores of mold pathogens such as Penicillium and Aspergillus are numerous in indoor air and pose a hazard, especially among individuals with underlying health challenges. Other studies [24][25][26][28][29][30] have previously established a strong association between mold presence in buildings and reported respiratory symptoms among occupants. In addition, microbial volatile organic compounds (MVOCs) associated with mold have being a subject of concern in indoor environments [31][32][33].…”

“…In a given indoor environment, a concentration of TVOCs could vary and depend on the presence or absence of emission sources, and exposure to TVOCs can result in both acute and chronic health effects. Earlier studies have affirmed that pollutant loads in indoor environments are associated with a number of factors that include intensity of air exchange, emissions from various indoor and outdoor sources, temperature and humidity, ventilation systems, atmospheric air quality in the vicinity, external emission sources and so on [22][23][24]. At high concentrations, many of these TVOCs are potent narcotics and can depress the central nervous system [5,25], and exposure to these compounds can lead to irritation of the eyes and respiratory tracts, in addition to causing sensitization reactions involving the eyes, skin and lungs.…”

The Relevance of Indoor Air Quality in Hospital Settings: From an Exclusively Biological Issue to a Global Approach in the Italian Context

“…), the presence of patients, healthcare users, temporary visitors, volunteers, activities carried out by healthcare staff and not, and hygienic conditions of the environments depending on the health status, the type or risk of patients or, in general, of the daily flows (i.e., presence of microbial and fungal communities with a capacity for persistence, variability of concentration, and diversity in healthcare environments, which can generate an extension of the length of hospitalization stay, additional diagnostic and/or therapeutic interventions and additional costs, etc.) [38,39].…”

“…The aims and scope are to provide the procedures and tools necessary to strengthen, optimize, and improve interventions for the prevention, protection, and promotion of the health of users in healthcare environments that represent one of the priority objectives of the NHS's strategy in the prevention programs, with monitoring activities within the healing spaces [38,53].…”

The Dose of Fungal Aerosol Inhaled by Workers in a Waste-Sorting Plant in Poland: A Case Study

“…Air contamination is responsible for three million early deaths globally each year, and it is the fifth top risk factor for mortality worldwide [1,2]. Indoor air is a complex and dynamic phenomenon in which physical factors and various type of pollutants can affect the health condition of occupants [3]. A wide range of health effects are associated with exposure (EX) to biological contaminants in work environments.…”