Indoor hospital air and the impact of ventilation on bioaerosols: a systematic review

Stockwell, Rebecca E; Ballard, Emma; O’Rourke, Peter; Knibbs, Luke D.; Morawska, Lidia; Bell, Scott C.

doi:10.1016/j.jhin.2019.06.016

Cited by 124 publications

(105 citation statements)

References 67 publications

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“…For example, Legionellae bacteria can grow in building water systems and become aerosolized by aeration systems and water sprays, while the flushing of toilets can aerosolize bacteria contained in feces such as Clostridium difficile (Best, Sandoe and Wilcox 2012; Springston and Yocavitch 2017). Indoor bioaerosol sampling for bacteria is often performed because of health concerns from exposure, particularly in locations such as healthcare facilities where the risks of disease transmission are heightened (Stockwell et al 2019).…”

Section: Indoor Bacteriamentioning

confidence: 99%

Field sampling of indoor bioaerosols

Cox

Mbareche

Lindsley

et al. 2019

Aerosol Science and Technology

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Because bioaerosols are related to adverse health effects in exposed humans and indoor environments represent a unique framework of exposure, concerns about indoor bioaerosols have risen over recent years. One of the major issues in indoor bioaerosol research is the lack of standardization in the methodology, from air sampling strategies and sample treatment to the analytical methods applied. The main characteristics to consider in the choice of indoor sampling methods for bioaerosols are the sampler performance, the representativeness of the sampling, and the concordance with the analytical methods to be used. The selection of bioaerosol collection methods is directly dependent on the analytical methods, which are chosen to answer specific questions raised while designing a study for exposure assessment. In this review, the authors present current practices in the analytical methods and the sampling strategies, with specificity for each type of microbe (fungi, bacteria, archaea and viruses). In addition, common problems and errors to be avoided are discussed. Based on this work, recommendations are made for future efforts towards the development of viable bioaerosol samplers, standards for bioaerosol exposure limits, and making association studies to optimize the use of the big data provided by highthroughput sequencing methods.

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Section: Indoor Bacteriamentioning

confidence: 99%

Field sampling of indoor bioaerosols

Cox

Mbareche

Lindsley

et al. 2019

Aerosol Science and Technology

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“…However, this fact did not cause any significant differences in temperature and microbial growth. Different observations were made by Stockwell et al (2019), who recorded significantly higher bioaerosol concentrations (201 CFU m -3 ) in areas with natural ventilation as compared to areas with mechanical ventilation (20 CFU m -3 ) in hospitals. The results indicated that the smaller cubic capacity of a facility may contribute to a higher concentration of airborne bacteria.…”

Section: The Impact Of Selected Factors On the Concentration Of Micromentioning

confidence: 88%

Microbiological air quality in pharmacies and an antibiotic resistance profile of staphylococci species

2020

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The air in public facilities contains microorganisms which may cause a wide variety of clinical syndromes in humans. This is particularly important in primary healthcare units, where patients with reduced immunity and staff are directly exposed to microbial pathogens. Air samples were collected from dispensing areas (customer areas) of five pharmacies using MAS-100 air sampler. The concentration of particular groups of microorganisms was determined with the use of selective media. The taxonomic analysis of mannitol-positive bacteria was conducted using the BIOLOG Ò method, based on metabolic characteristics of analyzed strains. The isolated molds were identified based on their macroscopic and microscopic features according to available keys. The antimicrobial susceptibility of identified staphylococci was tested using the disk diffusion method in accordance with The European Committee on Antimicrobial Susceptibility Testing recommendations. The highest average concentrations of heterotrophic bacteria and staphylococci were recorded in two hospital pharmacies. The highest average concentrations of molds were recorded in the pharmacies located in shopping centers. Taxonomic analysis indicated that Cladosporium and Penicillium spp. predominated among the isolated molds while Staphylococcus haemolyticus and Staphylococcus aureus, among mannitol-positive bacteria. Antibiograms showed that the majority of Staphylococcus strains (68.2%) were resistant to erythromycin. There was a statistically significant correlation between the concentration of investigated bacteria and the season of the year as well as the size and location of the pharmacies. The results demonstrate that there is a range of factors affecting air quality in public spaces and emphasize the fact that pharmacies can be a source of potentially pathogenic, drug-resistant bacteria.

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“…Pasquarella et al demonstrated that 80 CFU/m 3 could be reached during operational conditions [29], and Vonci et al demonstrated that 50 CFU/m 3 could be recorded in operating theatres equipped with turbulent flow ventilation at 15 air changes per hour [44]. In a recent revision, Stockwell et al reported a microbial air contamination of 20 CFU/m 3 in hospital areas equipped with conventional mechanical ventilation systems [45].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Surgical Staff Behavior on Air Quality in a Conventionally Ventilated Operating Theatre during a Simulated Arthroplasty: A Case Study at the University Hospital of Parma

Pasquarella

Balocco

Colucci

et al. 2020

IJERPH

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Surgical staff behavior in operating theatres is one of the factors associated with indoor air quality and surgical site infection risk. The aim of this study was to apply an approach including microbiological, particle, and microclimate parameters during two simulated surgical hip arthroplasties to evaluate the influence of staff behavior on indoor air quality. During the first hip arthroplasty, the surgical team behaved correctly, but in the second operation, behavioral recommendations were not respected. Microbiological contamination was evaluated by active and passive methods. The air velocity, humidity, temperature, and CO2 concentration were also monitored. The highest levels of microbial and particle contamination, as well as the highest variation in the microclimate parameter, were recorded during the surgical operation where the surgical team behaved “incorrectly”. Turbulent air flow ventilation systems appeared more efficient than in the past and very low air microbial contamination was reached when behavior was correct. Therefore, adherence to behavioral recommendations in operating theatres is essential to not undermine the effectiveness of the heating, ventilation, and air conditioning systems and employed resources.

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Indoor hospital air and the impact of ventilation on bioaerosols: a systematic review

Cited by 124 publications

References 67 publications

Field sampling of indoor bioaerosols

Field sampling of indoor bioaerosols

Microbiological air quality in pharmacies and an antibiotic resistance profile of staphylococci species

The Influence of Surgical Staff Behavior on Air Quality in a Conventionally Ventilated Operating Theatre during a Simulated Arthroplasty: A Case Study at the University Hospital of Parma

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