Aerial dispersion of pathogens is recognized as a potential transmission route for hospital acquired infections; however, little is known about the link between healthcare worker (HCW) contacts’ with contaminated surfaces, the transmission of infections and hospital room design. We combine computational fluid dynamics (CFD) simulations of bioaerosol deposition with a validated probabilistic HCW–surface contact model to estimate the relative quantity of pathogens accrued on hands during six types of care procedures in two room types. Results demonstrate that care type is most influential (P < 0.001), followed by the number of surface contacts (P < 0.001) and the distribution of surface pathogens (P = 0.05). Highest hand contamination was predicted during Personal care despite the highest levels of hand hygiene. Ventilation rates of 6 ac/h vs. 4 ac/h showed only minor reductions in predicted hand colonization. Pathogens accrued on hands decreased monotonically after patient care in single rooms due to the physical barrier of bioaerosol transmission between rooms and subsequent hand sanitation. Conversely, contamination was predicted to increase during contact with patients in four‐bed rooms due to spatial spread of pathogens. Location of the infectious patient with respect to ventilation played a key role in determining pathogen loadings (P = 0.05).
The high world-wide prevalence of tuberculosis (TB) and the increase in multi-drug resistant strains (MDRTB) have prompted increased interest in engineering control solutions such as ventilation system design and the use of ultraviolet germicidal irradiation (UVGI). This study considers the contribution of the ventilation airflow to the transmission of TB, and uses computational fluid dynamics (CFD) simulations to examine how changes in the design of a ward, in Hospital Nacional Dos de Mayo, Lima, Peru may reduce the transmission of TB from patients to health-care workers, visitors and other patients. The results of this study were used to advise the architects and engineers in the remodelling of the ward.
Passive air sampling provides quantitative data analogous to that obtained from surfaces. Settle plates could serve as a proxy for routine environmental screening to determine the infection risk in ICU.
Homes satisfy our most basic needs for shelter and should be designed to provide a comfortable and safe environment. However, provision of housing is constrained through cost and legislation encompassing appearance, structure, materials, provision of services and energy performance. Most of the time these align to human needs, but there are conflicts, particularly with respect to energy and ventilation and their influence on health. In a bid to reduce energy and carbon emissions, the building sector is delivering increasingly airtight homes that aim to reduce uncontrolled ventilation losses 1. There are concerns that without improved designed ventilation provision this strategy may lead to a range of unintended consequences including impacts on occupant health 2. Ventilation affects exposure to a number of elements that are known to influence health, including chemicals, moisture, temperature and microorganisms. There is evidence that poor ventilation may be linked with poor physical and mental health in a number of non-domestic building types 3 , but whilst the literature points to detrimental effects in housing 2,4 , this remains seriously under investigated. In particular, there are currently gaps in knowledge about the range and diversity of microorganisms in the domestic environment, particularly in the context of modern airtight homes 5. People spend a great deal of time in their homes, especially those at the extremes of age, and therefore the indoor microbiome could impact upon human health in ways not yet understood 6. Recent research into the real world performance of buildings has begun to reveal significant performance gaps in environmental conditions, especially poor rates of ventilation, particularly in bedrooms 7. This has led to studies that have examined the consequences of increasing airtightness of modern construction, lack of ventilation, occupant interaction with ventilation, and increasing use of mechanical ventilation 8,9 .
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.