Detection and Measurement of Unhealthy, Environment-Derived Aerosol Materials in an Emergency Department.

OBJECTIVE: To measure unhealthy aerosol materials in an Emergency Department (ED) and identify their sources for mitigation efforts. BACKGROUND: Based on pilot findings of elevated ED particulate matter (PM) levels, investigators hypothesized that unhealthy aerosol materials derive from exogenous (vehicular) sources at ambulance receiving entrances. METHODS: The Aerosol Environmental Toxicity in Healthcare-related Exposure and Risk program was conducted as an observational study. Calibrated sensors monitored PM and toxic gases at Ambulance Triage Exterior (ATE), Ambulance Triage Desk (ATD), and control Public Triage Desk (PTD) on a 3/3/3-day cycle. Cassette sampling characterized PM; meteorological and ambulance traffic data were logged. Descriptive and multiple linear regression analyses assessed for interactions between aerosol material levels, location, temporal variables, ambulance activity, and meteorological factors. RESULTS: Sensors acquired 93,682 PM0.3, 90,250 PM2.5, and 93,768 PM5 measurements over 366 days to generate a data set representing at least 85.6% of planned measurements. PM0.3, PM2.5, and PM5 mean counts were lowest in PTD; 56%, 224%, and 223% higher in ATD; and 996%, 200%, and 63% higher in ATE, respectively (all p < .001). Qualitative analyses showed similar PM compositions in ATD and ATE. On multiple linear regression analysis, PM0.3 counts correlated primarily with location; PM2.5 and PM5 counts correlated most strongly with location and ambulance presence. PM < 2.5 and toxic gas concentrations at ATD and PTD patient care areas did not exceed hazard levels; PM0.3 counts did not have formal safety thresholds for comparison. CONCLUSIONS: Higher levels of PM were linked with ED ambulance areas, although their health impact is unclear.

Water quality and quantity assessment of pervious pavements performance in experimental car park areas.

Pervious pavements have become one of the most used sustainable urban drainage system (SUDS) techniques in car parks. This research paper presents the results of monitoring water quality from several experimental car park areas designed and constructed in Spain with bays made of interlocking concrete block pavement, porous asphalt, polymer-modified porous concrete and reinforced grass with plastic and concrete cells. Moreover, two different sub-base materials were used (limestone aggregates and basic oxygen furnace slag). This study therefore encompasses the majority of the materials used as permeable surfaces and sub-base layers all over the world. Effluent from the test bays was monitored for dissolved oxygen, pH, electric conductivity, total suspended solids, turbidity and total petroleum hydrocarbons in order to analyze the behaviour shown by each combination of surface and sub-base materials. In addition, permeability tests were undertaken in all car parks using the 'Laboratorio Caminos Santander' permeameter and the Cantabrian Portable Infiltrometer. All results are presented together with the influence of surface and sub-base materials on water quality indicators using bivariate correlation statistical analysis at a confidence level of 95%. The polymer-modified porous concrete surface course in combination with limestone aggregate sub-base presented the best performance.

Measuring hygiene and health perfomance of buildings: a multidimensional approach.

This paper proposes an innovative and transparent methodology to support the "ASL Milano" (Local Health Agency) in the hygiene and health evaluation of construction projects, in order to highlight their positive and negative performance beyond the requirements imposed by the current laws and regulations regarding buildings' hygiene performance, which are too old and therefore unsuitable to ascertain the real quality of indoor environments. The compliance with laws or regulations, mostly out of date, and the assessment of performance involving only a part of the current emerging needs and problems, in fact, should be considered as a necessary, although not a sufficient step, to ensure high quality indoors. Consequently, it is necessary to identify and test an assessment tool which could provide an effective and flexible support for the development of hygiene and health statements regarding projects at building scale (new construction, conversion of the existing, rehabilitation, extension, change of use, etc). The assessment tool suggested by this paper is tailored for the metropolitan area of the city of Milan, but its evaluation framework could be developed and applied to other contexts.

Taking a strategic approach to campus parking.

Building a new parking facility in a campus setting - such as a hospital or medical center - is not an easy assignment. By taking a strategic planning approach, according to the author, campus planners can meet the needs of most of their constituents for convenient, easily accessible and safe parking.

Challenges in healthcare parking and the role of parking master planning.

By considering parking and campus access within the larger master-planning context of your healthcare campus, you can assure that overall institutional goals and objectives are successfully supported, the author says.

Recruiting nurses: the problem is the process.

With competition increasing for scarce personnel resources, recruitment and retention processes must be efficient and effective. The author reports the results of an extensive study of recruitment processes and systems in acute care hospitals throughout the United States and the major recruitment factors that lead to job choice decisions by staff nurses.

Maximizing use of lighting, cameras in hospital parking areas.

Next to emergency rooms, a hospital's parking areas poses the greatest risk of crime and violence for staff, patients, and visitors. Critical to securing such areas (and creating an improved perception of safety) are the employment of lighting and the use of surveillance cameras. In this report, we'll give details of how one hospital used a lighting survey to trigger improvements in its parking security setup and we'll present tips from a leading camera manufacturer on the most effective use of cameras in conjunction with lighting in parking areas.