Article Abstract

The potential risk of sick building syndrome of the emergency department areas in a medical center in Taiwan

Authors: Pang-Yen Chen, Lu-Chih Kung, Weide Tsai, Ding-Kuo Chien, Wen-Han Chang


Background: Indoor air pollution is a constant problem in the current society, especially in the emergency department (ED). Dirty and polluted air in hospitals will reduce work efficiency of healthcare staff and could ultimately cause diseases and illness; some serious acute respiratory diseases are liable to become epidemics in the hospital. A solution to organize the medical working environment and prevent the underlying threat of nosocomial infection is becoming an increasingly important issue; therefore, a research project is designed to study the air quality in the ED of a medical center in Taiwan.
Methods: Air quality measuring instruments were used three times a day for a non-continuous monitoring in the ED of the Taipei Mackay Memorial Hospital, including temperature, oxygen, carbon dioxide, ozone, total volatile organic compounds, suspended particulates (PM10) with a particle size of 10 microns or less, and formaldehyde. The emergency areas were classified into four types according to whether medical procedures were performed or not, is there confined space or not. The data collected from different ER zones were analyzed and compared.
Results: The results showed that the oxygen concentration was higher than that of the general environment (20.9%) in all areas of the ED, while carbon dioxide concentration (CO2) is also higher. The oxygen concentration of most places in ER exceeded 30%. The CO2 concentration of each unit exceeds 700 ppm, especially in the internal and surgical ED, as well as the negative pressure isolation room, for which the value was close to 800 ppm (P<0.05). A higher formaldehyde value (>0.12 ppm) was detected in the nursing station the observation room and the research office. The highest concentration of ozone was also detected in the nursing station the observation room. As for the suspended particles (PM10) having a particle diameter of 10 µm or less, the level of each zone was quite low. There was a much lower concentration of volatile organic substances (VOCs) in the triage station, research office as well as corridors; while all other areas have exceeded 150 ppb.
Conclusions: Our research indicates that the current emergency environment could be harmful to healthcare staff, and poor air quality in the ER is observed especially during busy hours, in older buildings, at intensive medical disposal areas and also in confined spaces. Some confined medical treatment spaces were prone to higher carbon dioxide (CO2) concentrations that may cause fatigue and decrease of work efficiency. Therefore, improvement of air quality in ER and maintenance of emergency environment at the ideal air condition is significantly important. The ventilation of outdoor airflow and filtration of particles of the air conditioning systems should be thoughtfully planned as early as when designing an ER construction in order to avoid “sick building syndrome (SBS)”. That said, a healthier working environment to the ER staffs could ultimately bring more effective work and promote better medical quality.