Abstract

Background: The complex hospital environment requires special attentionto ensure healthful indoor air quality (IAQ) to protect patients and healthcare workers against hospital-acquired(nosocomial) infections and occupational diseases. The aim here is to recommend effective guidelinesfor the control and management of hospital IAQ. Material/Methods: The authors have done an extensiveliterature review and conducted comprehensive IAQ assessments in nine hospitals. It is noted that theIAQ measurements are not presented in this paper because of confidentiality. However, the IAQ analysiswas studied carefully in the development of the recommendations given in this paper. Results: The airbornechemical and microbiological contaminants of concern for hospitals have been identified and the majoremission sources, monitoring methods, and exposure limits have been well documented and are reviewedhere. Proper engineering system designs and operations are also reviewed, with recommendations for effectivedilution and removal of the contaminants. The control and mitigation measures cover mechanical ventilation,filtration, differential pressure control, directional airflow control, local exhaust ventilation, andultraviolet germicidal irradiation (UVGI) disinfection. Their applications in critical environments,such as operating theatres, isolation rooms, and other typical units, such as outpatient departmentsand laboratories, are also considered. Conclusions: Effective IAQ monitoring methods and mitigation measuressuitable for the hospital environment have been identified. Accordingly, strategies for the implementationof a hospital indoor air quality management system are recommended. Healthcare workers, hospital engineers,and administrative staff can use the above as guidelines to manage and run their hospitals with healthfulindoor air quality.

Keywords: Air Movements, Air Microbiology, Air Pollution, Air Pollution, Indoor - prevention & control, Environment, Controlled, Environmental Monitoring, Facility Design and Construction, Filtration, Guidelines as Topic, Hospital Administrators, Hospitals - standards, Infection Control - methods, Review Literature as Topic, Ventilation