Long-term surveillance of air quality in medical center operating rooms

Wan, Gwo-Hwa; Chung, Feng-Fang; Tang, Chin-Sheng

doi:10.1016/j.ajic.2010.07.006

Cited by 96 publications

(83 citation statements)

References 27 publications

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“…More information on both PM10 and PM2.5 comes from Asian countries ( Table 2). Two studies performed in Taiwan reported similar concentration ranges of PM10 (Wan et al 2011) and PM2.5 (Hsu et al 2012) to those in Portugal. In India and China, observed PM2.5 and PM10 in hospital environments were much higher than in Portugal (three to four times; Verma and Taneja 2011;Wang et al 2006a, b).…”

Section: Pm Concentrationsmentioning

confidence: 72%

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Slezáková

Morais

Pereira

2013

Environ Sci Pollut Res

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Hospitals are considered as a special and important type of indoor public place where air quality has significant impacts on potential health outcomes. Information on indoor air quality of these environments, concerning exposures to partic-ulate matter (PM) and related toxicity, is limited though. This work aims to evaluate risks associated with inhalation exposure to ten toxic metals and chlorine (As, Ni, Cr, Cd, Pb, Mn, Se, Ba, Al, Si, and Cl) in coarse (PM2.5-10) and fine (PM2.5) particles in a Portuguese hospital in comparison with studies representative of other countries. Samples were collected during 1 month in one urban hospital; elemental PM characterization was determined by proton-induced X-ray emission. Noncarcinogenic and carcinogenic risks were assessed according to the methodology provided by the United States Environmental Protection Agency (USEPA; Region III Risk-Based Concentration Table) for three different age categories of hospital personnel (adults, >20, and <65 years) and patients (considering nine different age groups, i.e., children of 1-3 years to seniors of >65 years). The estimated noncarcinogenic risks due to occupational inhalation exposure to PM2.5-bound metals ranged from 5.88×10−6 for Se (adults, 55-64 years) to 9.35×10 −1 for As (adults, 20-24 years) with total noncarcinogenic risks (sum of all metals) above the safe level for all three age categories. As and Cl (the latter due to its high abundances) were the most important contributors (approximately 90 %) to noncarcinogenic risks. For PM2.5-10, noncarcinogenic risks of all metals were acceptable to all age groups. Concerning carcinogenic risks, for Ni and Pb, they were negligible (<1×10 −6 ) in both PM fractions for all age groups of hospital personnel; potential risks were observed for As and Cr with values in PM2.5 exceeding (up to 62 and 5 times, respectively) USEPA guideline across all age groups; for PM2.5-10, increased excess risks of As and Cr were observed particularly for long-term exposures (adults, 55-64 years). Total carcinogenic risks highly (up to 67 times) exceeded the recommended level for all age groups, thus clearly showing that occupational exposure to metals in fine particles pose significant risks. If the extensive working hours of hospital medical staff were considered, the respective noncarcinogenic and carcinogenic risks were increased, the latter for PM2.5 exceeding the USEPA cumulative guideline of 10 . For adult patients, the estimated noncarcinogenic and carcinogenic risks were approximately three times higher than for personnel, with particular concerns observed for children and adolescents.

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Section: Pm Concentrationsmentioning

confidence: 72%

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Slezáková

Morais

Pereira

2013

Environ Sci Pollut Res

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“…A number of studies have indicated that indoor air pollutants with chemical (Lu et al, 2006;Chen et al, 2009) and biological (Ortiz et al, 2009;Wan et al, 2011;Napoli et al, 2012) natures pose potential hazards to patients, medical staffs, and visitors in hospitals. Sophisticated simulations through computational fluid dynamics for indoor air contamination and control design have also been developed (Panagopoulos et al, 2011;Cao et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Airborne and Surface-Bound Microbial Contamination in Two Intensive Care Units of a Medical Center in Central Taiwan

Huang

Shi

Chen

et al. 2013

Aerosol Air Qual. Res.

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Samples of airborne and surface-bound microbial contamination were taken in two intensive care units of a large-scale medical center. Microbial analyses included total bacterial and fungal loads, as well as the four bacterial species of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii. Among the 114 surface samples taken from seven designated surface locations of room and equipment for each patient, P. aeruginosa was the most frequently detected (19.3%) and most abundant (mean count: 4.18 cfu/plate) bacterium, whereas the respirator represented the most heavily contaminated surface location in both total pathogenic bacteria colony counts (272 cfu) and frequency of positive detection (38.2%). P. aeruginosa also represented the most frequently detected (39.1%, n = 46) and abundant (11.52 ± 17.16 cfu/m 3 ) bacterium in the air samples (n = 46), and was the only bacterium exhibiting a positive correlation of the mean counts between air and surface samples. The data analysis results further suggested a higher value of relative risk among the infected patients in the presence of the pathogens as compared to those in the absence of them, although the evidence of a of correlation for the individual bacterial species between the environmental samples and infected patients was inconclusive. This study also found that the mean airborne counts and the detection frequencies of these bacteria after patient visitation periods were higher than those before visitation, and that the installation of local air ionizers did not lead to any discernible differences in total bacterial and fungal concentrations.

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“…The ability of ACH to remove hazardous substances below those of exposure standards was highlighted by Scott, Beswick, and Wakefield (2004) using 20 ACH. Other studies have identified the removal of particulate matter and surgical smoke at rates greater than 15 ACH (Scaltriti et al, 2007;Wan, Chung, & Tang, 2011). Scott et al (2004) noted that previous studies might have detected chemical substances because the ACH rates were lower than 20 during testing.…”

Section: Control Of Independent Variablesmentioning

confidence: 99%

“…All gas levels were below maximum exposure limits Wan, et al 2011 Indoor air quality was measured in 8 ORs with ACH of 15 (n=7) and ACH of 23 (n=1).…”

Section: Cautery Co2 Lasermentioning

confidence: 99%

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

Mellor

Hutchinson²

2013

Workplace Health Saf

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Long-term surveillance of air quality in medical center operating rooms

Cited by 96 publications

References 27 publications

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Trace metals in size-fractionated particulate matter in a Portuguese hospital: exposure risks assessment and comparisons with other countries

Airborne and Surface-Bound Microbial Contamination in Two Intensive Care Units of a Medical Center in Central Taiwan

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

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