Indoor air quality is important in hospitals where patients spend significant time. Poor indoor air quality can be caused by several factors like the building layout and HVAC system. Common indoor pollutants in hospitals include sensitizing agents, irritants, toxins, and infectious aerosols from patients. Exposure limits exist for various compounds to protect health, such as limits for formaldehyde, glutaraldehyde, and anesthetic gases.

1. INDOOR AIR QUALITY IN HOSPITALS

2. WHAT IS IAQ? Indoor Air Quality refers to the nature of conditioned (Heat/Cool) air that circulates throughout the space/area where we work and live i.e. the air we breathe during most of our lives. IAQ, refers not only to comfort, which is affected by temperature, humidity and odours but also to harmful biological contaminants and chemicals present in the conditioned space.

3. Why IAQ? Indoor air can be up to 10 times more polluted than outdoor air. Most people spend up to 90% of their time indoors and many spend most of their working hours in an office environment. Poor air quality in office buildings can result in loss of productivity, absenteeism and medical problems.

4. Effects of poor IAQ Poor indoor air quality can lead to a number of physical symptoms and complaints Headaches,Fatigue,Shortness of breath, Sinus congestion,Coughs,Sneezing,Eye, nose, and throat irritation,Skin irritation,Dizziness,Nausea,asthma,lung cancer,Legionnaire’s Disease Categorized as SBS BRI

5. Factors affecting IAQ A number of factors can affect the indoor air quality of a building or facility, including: The physical layout of the building The building’s heating, ventilation, and air conditioning (HVAC)system The outdoor climate The people who occupy the building Contaminants inside and outside the building

6. Indoor air pollutants,sources&health effects

9. Common exposers in hospitals Sensitizing and Allergenic Agents histamines glutaraldehyde, formaldehyde, latex allergen, hexachlorophene, and psyllium laxatives Irritants Methylmethacrylate

10. Direct Toxins, Mutagens, and Teratogens Anesthetic agents Infectious Aerosols source patients having infectious diseases such as tuberculosis, chicken pox, measles (Rubeola), and German measles (Rubella) can be spread easily in the air

11. Exposure limits Compounds Exposure limits Halogenated TLV (NIOSH): anaesthetic agents 8-h TWA: 2 ppm without concomitant N2O exposure 0.5 ppm with concomitant N2O exposure Nitrous oxide TLV for hospital environments (NIOSH): 8-h TWA: 25 ppm (40 mg/m3) Formaldehyde 8-h TWA: 0.75 ppm (0.94 mg/m3) 15-min STEL: 2 ppm (2.5 mg/m3) Glutaraldehyde TLV:0.2 ppm (0.82 mg/m3) (ceiling level) Ethylene oxide 8-h TWA: 1 ppm 15-min STEL: 5 ppm Action level 8-h TWA: 0.5 ppm

12. Halothane 50 ppm ACGIH 8-h TLV-TWA 2 ppm NIOSH 60-min REL-C Enflurane 75 ppm ACGIH 8-h TLV-TWA 2 ppm NIOSH 60-min REL-C Methoxyflurane 2 ppm NIOSH 15-min REL-C carbon dioxide 1000 ppm ASHRAE Std 62-1989 8-h TLV-TWA 5000- 9000 ACGIH 15min TLV-TWA carbon monoxide 9 ppm ASHRAE Std 62-1989 8-h TLV-TWA 25 ppm ACGIH 8-h TLV-TWA Nitrogen dioxide 3 ppm or 5.6 mg/m (8-hr) ASHRAE Sulpur dioxide 2 ppm or 5.2 mg/m (8-hr) ASHRAE

13. Thermal comfort conditions