scholarly journals Assessment of bioaerosols in tuberculosis high-risk areas of health care facilities in central Thailand

2019 ◽  
Vol 12 (2) ◽  
pp. 55-63
Author(s):  
Jarmmaree Sornboot ◽  
Wichai Aekplakorn ◽  
Pongrama Ramasoota ◽  
Surat Bualert ◽  
Somying Tumwasorn ◽  
...  

AbstractBackgroundLong-term surveillance of airborne bioaerosols in health care facilities is required to protect the health of patients and health care workers. Feasible methods to measure airborne bioaerosol concentrations and determine associated environmental factors may help to avoid nosocomial tuberculosis (TB).ObjectivesTo describe the concentrations and size of airborne bioaerosols and to identify the potential contributors to indoor airborne bioaerosols in TB high-risk areas in health care facilities.MethodsWe conducted a cross-sectional study in 7 large health care facilities located in Bangkok and nearby in central Thailand using a 6-stage Andersen cascade impactor to collect viable airborne bioaerosols that were quantified using culture techniques. Environmental parameters were determined using a tracer gas technique with an indoor air quality meter. Other potential factors were assessed using a questionnaire.ResultsThe mean indoor airborne bacterial and fungal concentrations were 596.1 and 521.2 colony-forming units (cfu)/m3, respectively, and the mean outdoor airborne bacterial and fungal concentrations were 496.5 and 650.1 cfu/m3, respectively. The majority of airborne bioaerosols were in respirable sizes. The indoor-to-outdoor ratios were 1.2 for bacteria and 0.8 for fungi. Air change rate was inversely correlated with indoor airborne bioaerosol concentrations, whereas emergency department central-type air conditioners and relative humidity were positively correlated with the indoor airborne bioaerosol concentrations (P < 0.05).ConclusionsHigh indoor bioaerosol concentrations found in the health care facilities suggest that it is imperative to improve the indoor air quality. Improved air change rate and avoiding use of central-type air-conditioning systems may reduce bioaerosol concentrations.

Facilities ◽  
2019 ◽  
Vol 37 (9/10) ◽  
pp. 600-623 ◽  
Author(s):  
Marco Gola ◽  
Gaetano Settimo ◽  
Stefano Capolongo

Purpose Several countries have carried out air quality monitoring in professional workplaces where chemicals are used. Health-care spaces have been less investigated. This paper aims to define a protocol, as developed by a research group, for inpatient rooms to understand the state of the art and to suggest design and management strategies for improving process quality. Design/methodology/approach Starting from the ISO-16000 standard and guidelines for monitoring activities, a protocol is defined for a one year investigation, with passive samplers. Through data analysis of the investigations and analysis of the cleaning and finishing products, heating, ventilation and air conditioning and maintenance activities, etc., it is possible to highlight the potential influences of chemical pollution. Findings A methodology is defined for understanding the chemical pollution and the possible factors related to construction materials, cleaning products and maintenance activities. Research limitations/implications The paper analyzes only a limited number of case studies because the monitoring activity is still in progress. Practical implications The investigation offers a starting point for a wide tool for the definition of design, maintenance and management strategies in health-care facilities. Social implications The research project, aimed at improving the knowledge of indoor air quality (IAQ) in inpatient rooms, is a starting point for a supporting tool for future regulations concerning health-care facilities. Originality/value IAQ is an issue on which many governments are focusing. Several health-care researchers have reported studies that aim at improving users’ health. Most investigations are about biological and physical risks, but chemical risks have been less studied. The paper suggests some design and management strategies for inpatient room.


2020 ◽  
Vol 18 (3) ◽  
pp. 247-257
Author(s):  
Ehsan Mousavi ◽  
Vivek Sharma ◽  
Dhaval Gajjar ◽  
Shervin Shoai Naini

Purpose The purpose of this study is to evaluate the effectiveness of the control cubes for dust control in health-care facilities. Research shows that more than 80% of pathogenic agents in hospitals are spread into the air, where they either remain airborne or deposit on the surface. At the same time, renovation and repair activities, including regular maintenance, are a necessity in active health-care facilities and a multitude of studies have documented their impact on indoor air quality. The dust that is generated by construction activities may potentially carry pathogenic agents, varying from coarse particles (≤10 µm, PM10) to fine particles (≤2.5 µm, PM2.5), including airborne bacteria, and fungal spores linked to high patient mortality in immune-compromised patients. Design/methodology/approach This study measures the impact and effectiveness of one such preventative measure, namely, the control cube (CC), on air quality during renovation and repair. CC is a temporary structure, typically made from stainless steel, around the local repair zone to minimize the spread of dust and potential microorganisms. The current paper presents a comparative analysis to identify the effectiveness of a CC equipped with the high-efficiency particulate filtration (HEPA) filter in a hospital setting by simulating construction renovation and repair work. Findings A baseline was established to measure the effectiveness of CCs and the impact of negative pressure on the indoor air quality in a hospital during simulated renovation work. Results showed that CCs are very effective in minimizing the spread of dust due to construction activities in the hospital. However, it is imperative to ensure that the air inside the CC is cleaned via filtration. Originality/value CCs are very effective, and this paper investigates the best approach for facility managers to implement this strategy.


Author(s):  
Harry Zhuang ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock ◽  
Fred Shaw

  Objectives: Nosocomial infection has always been a significant topic in the field of public health. The disinfection procedures involved in health care facilities are extremely important to prevent potential transmission of diseases. Therefore, this study was performed to compare the disinfection efficacy between three different disinfection methods (Accel wipes, Hubscrub industrial washer, and Steam vapor) on three pieces of non-critical medical equipment: wheelchairs, mattresses and bath chairs. Methods: The method used to evaluate the disinfection efficacy compared the reduction of contaminants count in the relative light unit using ATP monitoring methods. 30 samples of each of the three types of medical equipment were swabbed pre-disinfection and post-disinfection using the three disinfection methods. The recorded reduction number was then converted using log transformation. Statistical analysis was conducted using NCSS to assess differences between the disinfection methods. Results: The mean log-reduction of disinfection for Accel wipes, Hubscrub, and steam vapor were 1.067, 1.490, and 1.485 respectively. Steam vapor and Hubscrub displayed statistically significantly better disinfection efficacy compared to Accel wipes in terms of log reduction (overall p=0.000002). Conclusion: Hubscrub and steam vapor are better disinfectants compared to Accel wipes in terms of mean log reduction values; however, all three disinfection methods demonstrated effectiveness when cleaning and disinfecting non-critical medical equipment. For critical medical equipment, steam vapor and Hubscrub industrial washing are effective while Accel wipes do not meet the standards of high-level disinfection. As a result, combination usages of all three disinfection methods are recommended at health care facilities based on the categories of the medical equipment.  


2021 ◽  
Author(s):  
Andreas van Arkel ◽  
Ina Willemsen ◽  
Jan Kluytmans

Abstract Background:The objective of this study was to determine the correlation between adenosine triphosphate (ATP) measurements and microbial contamination using a standardized method. Methods: ATP measurements and aerobic colony counts (ACC’s) were conducted on 10 pre-defined fomites in a hospital and nursing home setting. Per fomite two ATP measurements and two agar plate measurements were conducted, each measurement was conducted on a 25 cm2 surface. Both measurements were compared and analyzed for correlation. Results: In total 200 paired measurements were conducted, 200 ATP measurements and 200 ACC’s. The mean of all ATP measurements tested on the same surface was calculated, as was for all 200 ACC’s. There was a strong correlation between the mean of two ATP measurements on two different sites on the same fomite (R=0.800, p<0.001) as well as between two ACC measurements on the same fomite (R=0.667, p<0.001). A much weaker correlation was found between RLU values and ACC’s (R=0.244, p<0.001). Conclusions: Reproducibility of ATP measurements and ACC’s on the same fomite was good. However, the correlation between RLU values and ACC’s on hospital surfaces was much lower. This may be explained by the wide variety of biological material that is measured with ATP, of which the bacterial load is only one of many components. ATP measurement can be used to give a quantifiable outcome for the rating of cleanliness in health care facilities, however the results cannot be translated into the level of microbial contamination.


2020 ◽  
Vol 32 (6-7) ◽  
pp. 357-359
Author(s):  
Wen-Nan Huang ◽  
Mao-Song Zhuang ◽  
Tsun-Jen Cheng ◽  
Shih-Huai Hsiao

Reducing nosocomial transmission within health care facilities is important, but the number of negative-pressure airborne infection isolation rooms for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is limited. It is a daunting challenge to cope with a surge of suspected infectious patients in hospitals. We installed air exhaust fans on the windows to change the pressure direction within the wards rapidly. The best location for the fans was 90 cm from the floor and 90 cm from the edge of bed whether the indoor air conditioners were on or off. The noise level should be <60 dB(A) as per government regulations. General wards can be transformed into makeshift negative-pressure rooms easily and effectively within 24 hours, which is really the simple, fast, and effective way for the transformation being applied.


2006 ◽  
Vol 25 (5) ◽  
pp. 261-266 ◽  
Author(s):  
M B Forrester

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was 5 / 5 years (48%), 6 / 19 years (8%), and 20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritis (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable.


2021 ◽  
Vol 8 (3) ◽  
pp. 150-154
Author(s):  
Szymon Wit ◽  
Paweł Więch ◽  
Marta Kłęk ◽  
Marek Muster ◽  
Grzegorz Kucaba

Aim: The aim of the study was to evaluate the effectiveness of supraglottic airways management by paramedics using selected methods in simulated conditions. Material and methods: The study included a group of 115 professionally active paramedics working in various health care facilities in the Podkarpackie Province. Each subject was asked to open the airways using a laryngeal mask airway (LMA) and a disposable laryngeal tube (LT-D) in simulated conditions. The study assessed the effectiveness of the airway opening taking into account: average tidal volume of a single breath in ml, average minute tidal volume in ml, time of insertion in seconds, the need for a second attempt, pressure on incisors in N. The obtained results were statistically analysed, p<0.05 was considered statistically significant. The calculations were performed with the SPSS 20 software. results: The study showed that the time of inserting of LT-D is the same as the time of LMA (LT-D: 25.95s ± 7.89s vs. LMA: 24.78s ± 8.32s; p>0.05). The mean tidal volume of a single breath was significantly higher with the LMA com-pared to LT-D (LMA 633.24 ml vs. LT-D 579.68 ml, p<0.05). During LMA insertion, the pressure on incisors of 11.41N ± 6.22N was used, while in case of LT-D this pressure amounted to 13.15N ± 3.68N. Every fourth examined paramedic had problems with correct insertion of LT-D tube in accordance with the adopted algorithm. Conclusions: The supralottic LMA and LT-D tools seem to be an effective and safe alternative of the airway management in case of life emergency


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