Perceived indoor air quality, air-related symptoms and ventilation in Finnish hospitals.

OBJECTIVES: Good ventilation is more important in hospitals than in many other buildings. The objective of this study was to evaluate the effect of the condition, performance and modernity of ventilation systems on the perceived indoor air quality (IAQ) and the indoor air-related symptoms of hospital personnel. MATERIALS AND METHODS: An inspection and evaluation graded on a 1 to 3 scale of the condition, performance, and modernity of the ventilation systems was carried out in ten central hospitals in Finland. The perceived IAQ and the related symptoms were collected by means of an indoor air questionnaire survey among the workers in these hospitals. RESULTS: The condition, performance and modernity of the ventilation systems were good in 40% of the hospitals included in the research and poor in another 40% of them. In hospitals where the majority of the ventilation systems were assessed to be good, the prevalence of the indoor air-related complaints and symptoms was lower than in hospitals where the majority of the ventilation systems were assessed as needing extensive repairs. CONCLUSIONS: The condition and performance of the ventilation systems in hospitals had a significant impact on the perceived IAQ and the symptoms observed among the employees in Finnish hospitals. Therefore, it is important that hospital ventilation systems are maintained properly and regularly. Furthermore, they should be renovated, at the latest when their technical lifespan expires.

Indoor air problems in hospitals: a challenge for occupational health.

Indoor air problems, caused by moisture damage and limited ventilation, have been detected in Finnish hospital buildings. A recent survey found that hospital personnel experience indoor air-related symptoms more often than office workers. The aim of this study was to assess the role, capabilities, and methods of hospital occupational health professionals in handling indoor air problems. Data were generated through semi-structured interviews. Representatives of occupational health, occupational safety, and infection control were interviewed in seven central hospitals. The data were analyzed using qualitative methods. According to interviewed professionals, indoor air problems are difficult to tackle. The evaluation of health risks and risk communication were considered particularly difficult. A uniform action model for resolving indoor air problems should be created. An interprofessional indoor air group to handle indoor air problems should be created in all hospitals.

Low tumor necrosis factor alpha levels and neutrophil counts in nasal lavage after mold exposure.

BACKGROUND: The results of allergy tests against molds usually remain negative in patients with upper respiratory tract and conjunctival symptoms after microbial exposure in a water-damaged building. Most mold-exposed persons report nasal irritation. Immune mechanisms of the nasal symptoms have not been fully elucidated. OBJECTIVE: To investigate local inflammatory responses after mold exposure in the upper respiratory tract and the feasibility of nasal lavage in diagnosing work-related exposure. METHODS: Altogether, 26 mold-exposed and 20 nonexposed workers from the same hospital were selected for the present study. The work premises of the exposed workers had detectable moisture and microbial problems. All exposed workers and their nonexposed controls underwent clinical examination, laboratory tests to detect allergy to molds, and nasal lavage. Inflammatory cells and proinflammatory cytokines were measured in the nasal lavage fluid. Nasal lavages were performed again 6 months after a thorough renovation of the building. RESULTS: In the nasal lavage, the neutrophil count and the level of tumor necrosis factor alpha in the exposed employees were lower, whereas the macrophage and epithelial cell counts were higher than in the control group. After the renovation, no difference was found in inflammatory response between the study group and the control group. The mean concentration of serum IgG to Stachybotrys chartarum was higher in the exposed workers. CONCLUSIONS: These results suggest that exposure to toxin-producing microbial growth in a water-damaged building caused immunosuppression in nasal mucosa, leading to a decrease in neutrophil counts and tumor necrosis factor alpha levels. Nasal lavage is a suitable method for examining inflammatory responses in work-related mold exposure.