Effects of indoor environmental parameters related to building heating, ventilation, and air conditioning systems on patients' medical outcomes: A review of scientific research on hospital buildings

Abstract

The indoor environment of a mechanically ventilated hospital building controls infection rates as well as influences patients’ healing processes and overall medical outcomes. This review covers the scientific research that has assessed patients’ medical outcomes concerning at least one indoor environmental parameter related to building heating, ventilation, and air conditioning (HVAC) systems, such as indoor air temperature, relative humidity, and indoor air ventilation parameters. Research related to the naturally ventilated hospital buildings was outside the scope of this review article. After 1998, a total of 899 papers were identified that fit the inclusion criteria of this study. Of these, 176 papers have been included in this review to understand the relationship between the health outcomes of a patient and the indoor environment of a mechanically ventilated hospital building. The purpose of this literature review was to summarize how indoor environmental parameters related to mechanical ventilation systems of a hospital building are impacting patients. This review suggests that there is a need for future interdisciplinary collaborative research to quantify the optimum range for HVAC parameters considering airborne exposures and patients’ positive medical outcomes.

Challenges faced in establishing a dedicated 250 bed COVID-19 intensive care unit in a temporary structure

“…Climate control is also an essential part of critical care, and wide variations in the ICU indoor environment have been demonstrated to adversely affect patient outcomes [ [11] , [12] , [13] ]. With all health care professionals donning full complement personal protective equipment (PPE), a reasonably cool environment is vital.…”

Impact of a New Portable Air Purification Technology Device in the Pediatric Hospital Setting – A Pre-post Assessment Study

“…While it is known that the indoor air environment plays a critical role in the health of patients in hospitals and buildings, more stringent air quality standards and standardized monitoring protocols in the hospital setting are needed [1]. Previous studies with portable air purification in the hospital setting have shown the potential to reduce potentially infectious bacteria and mold and have stressed the importance of patients breathing clean air in their local environment [13][14][15].…”

“…The quality of the air within the hospital can significantly impact the health of individuals within this space [1]. Specifically, the air provides a vehicle for the spread of bacteria, viruses, 1 2 3 4 fungi, and other airborne toxins and can contribute to potentially lethal hospital-acquired infections [2][3][4].…”

“…Specifically, the air provides a vehicle for the spread of bacteria, viruses, 1 2 3 4 fungi, and other airborne toxins and can contribute to potentially lethal hospital-acquired infections [2][3][4]. Hospitals predominantly rely on high minimum efficiency reporting value (MERV) rated filters to maintain air filtration through the central heating, ventilation, air conditioning (HVAC) system [1,5]. Despite the use of these filters, airborne-related infections continue to be a problem within the hospital setting [6].…”

Modeling Hospital Energy and Economic Costs for COVID-19 Infection Control Interventions

“…Hospital facilities have unique requirements compared to other buildings given that patient outcomes (patient pain levels, lengths of stay, infection rates, patient recovery rates, patient mortality rates) as well as staff outcomes (such as overall workplace safety, infection control metrics, stress levels, and staff sense of well-being), are intricately connected to the built environment of the hospital itself [6][7]. Additionally, indoor air quality and HVAC parameters can impact patient outcomes [7]. Air flow and thermal control can directly relate to patient comfort and recovery and hospital patient satisfaction metrics [8].…”