Buying an air purifier for hospitals

Hospitals are places where people come for treatment and recovery. As such, these institutions should be safe havens for health and cleanliness. Unfortunately, this is not always the case. Hospital-inquired infections (HAIs), also known as ‘nosocomial infections’, are rising by 0.06% per year on a global scale¹. These are infections contracted by patients whilst in a hospital setting. Many of these infections are spread via airborne viruses, emphasising the societal need of addressing the topic of poor indoor air quality (IAQ) in hospitals. How does a hospital’s indoor air quality (IAQ) impact patient well-being? Can an air purifier for hospitals help to reduce the number of pathogens spread by patients and particle pollution? Read on to learn more.

Major causes of poor air quality inside hospitals

Hospitals and other healthcare facilities suffer from two main types of indoor air pollution: chemical and biological. Since these institutions operate on a full-time basis, there is a constant influx of indoor air pollution that never has the opportunity to dissipate.

Chemical pollution

In hospitals, the use of sterilising, disinfecting, and cleaning products releases a host of volatile organic compounds (VOCs) that have negative health risks. Some of these may include gases and particles like formaldehyde and benzene (two known carcinogens), ethylene oxides, alcohols, carbon monoxide and dioxide, radon, and glutaraldehyde^2,3. Furthermore, gases like nitrous oxide that are used for anaesthetic purposes and other medical procedures contribute to poor indoor air quality.

Studies have established that analysing and monitoring chemical pollution in hospitals are often given less attention than biological pollution. Concentration of VOCs in indoor spaces is often 2 to 5 times higher than outdoor spaces, sometimes reaching up to 1000 times higher just after using a product that emits VOCs4. Exposure to VOCs and particle pollutants can lead to both short-term and long-term health risks ranging from:

• Short-term: headaches, dizziness, eye and throat irritation, loss of coordination
• Long-term: nervous system, liver, and/or kidney damage; formaldehyde and benzene are carcinogenic³

Additionally, it is common for hospital buildings themselves to emit harmful air pollutants, causing occupants to experience Sick Building Syndrome. In order to emphasise energy efficiency, newer buildings have an airtight design. Once pollutants enter, they cannot escape, causing a build-up in pollutant concentrations. Materials used in construction like paints, solvents, adhesives, and even new furniture and other furnishings all release dangerous pollutants like VOCs (especially formaldehyde) into the interior of a building for up to two years!

Older hospital buildings have their own set of problems with contributing to poor indoor air quality. Outdated ductwork may mean improper filtration of air that is drawn in from outside. Chemical pollutants like VOCs and other types of air pollutants like dust and dust mites, dirt, pollen, and even airborne pathogens are able to circulate through vents, gaining access to vulnerable patients and staff.

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Biological pollution

Naturally, biological pollution is the type of indoor pollution most commonly associated with a hospital environment. Based on systematic review on 55 hospitals in 14 different countries around the world, the World Health Organization (WHO) reports that 8.7% of patients receiving treatment in hospital had HAIs. Prevalence of HAIs was estimated at 5% in Europe and North America but was highest (upwards of 40%) in some African, Latin American, and Asian countries¹.

When a patient coughs or sneezes, aerosols may be released into the air or spread onto hospital surfaces. These aerosols may land on materials like bedpans, silverware, bedding, and furniture. Coughing and sneezing may propel aerosols up to 60 metres (200 feet)⁹! This makes it easy for bacteria and viruses to circulate throughout the rest of the hospital, potentially infecting other patients and staff. The most common HAIs are respiratory tract infections (pneumonia), surgical site infections, sepsis, Clostridium difficile infections (CDIs), and urinary tract infections⁵.

HAIs and biological pollution can be spread in multiple ways:

• Poor hospital IAQ that spreads airborne pathogens
• Poor personal hygiene of hospital staff
• Poor hospital health standards
• Lack of compliance to established hospital health and safety guidelines⁶

With the proliferation of the SARS-CoV-2 virus during the COVID-19 pandemic, the importance of combatting airborne illness in hospitals has been put in the limelight. One study goes as far as to claim that ‘reasonable air quality control in hospital facilities is not only vital for infection prevention considering patients with weakened immune systems, it is also central toward ensuring healthcare workers' optimal health, productivity and well-being’^7,8.

Poor ventilation

Hospitals and healthcare facilities are generally fragile environments. The goal is to keep vulnerable patients safe by keeping out outside contaminants wherever possible. With closed environments often comes lack of sufficient ventilation which causes severe problems for a hospital’s indoor air quality. Ventilation is crucial in controlling levels of indoor air pollution. It can even reduce pathogen transmission risk between patient rooms and within NHS institutions.

Coronavirus transmission in hospitals and the COVID-19 pandemic as a whole have put things into perspective. They have proven that greater attention must be paid by hospitals and other medical institutions in ensuring proper ventilation and maintenance of ventilation systems. This may include installing more specialised ventilation systems designed for healthcare buildings, an option that is usually costly but necessary for NHS institutions. When used in combination with medical-grade air purifiers installed in patient rooms and other high-transmission locations around a hospital, bacterial and viral transmission may be significantly reduced.

Outdoor factors contributing to poor hospital IAQ

Certain outdoor factors may contribute to poor air quality in a hospital environment. Firstly, levels of outdoor air pollution play an important role in indoor air pollution concentrations. Hospitals and healthcare facilities located in urban or industrial environments are impacted most by outdoor air pollution. In these areas, high levels of vehicle exhaust, pollution from construction sites, power plants, and smog are all sources of fine particle pollution (particulate matter). Patients may track particles from outdoors into hospitals on their clothes, on their skin, and in their hair. These fine particles may also enter hospitals via HVAC systems.

Rural environments equally have their share of particle contributions to poor indoor air quality in hospitals. Rural environments experience high levels of allergens, like pollen and road dust, and pesticides used on nearby agricultural lands.

Climate conditions like humidity and temperature may further aggravate poor indoor air quality in both urban and rural locations.

Occupational factors

Certain hospital-specific pollutants may pose dangers to NHS staff and patients alike. Mercury is one of those pollutants.

When a device containing mercury is broken, if proper measures are not taken to handle or store the broken device, mercury will be emitted into the indoor air. Without sufficient ventilation, toxic vapours may contaminate a hospital’s breathing air. Once mercury gains access to the body via inhalation, it can make its way to the bloodstream.

Mercury is a neurotoxin, and health risks depend upon many different factors including:

• The dose and type of mercury to which the person was exposed
• The age of the person
• The duration of exposure
• The route of exposure (inhalation, dermal, ingestion)

When mercury is airborne, inhalation can lead to negative effects on the nervous, immune, and systems as well as damage to the liver and kidneys. Behavioural and neurological effects are commonly observed, and foetuses are the most at-risk¹⁰.

Furthermore, staff members who are responsible for cleaning may experience high levels of exposure to VOCs, endangering their health. The presence of cleaning products in patient rooms may also impact the health of patients.

How does an air purifier for hospitals work?

Air purifiers, also known as ‘air sterilisers’ or ‘air cleaners’, are powerful yet simple machines. They pull in polluted air containing toxic gases and particles from your indoor space, treat the air using one or more air filtration technologies, then release the purified air back into your space.

Air cleaners available on today’s market vary greatly in the options they offer and their price. Some are designed to combat specific types of pollutants, whereas others have a wider spectrum of action.

The benefits of an air purifier for hospitals

Installing air purifiers and investing in better IAQ in a hospital is a great way to protect recovering patients and hard-working staff.

Prevent an outbreak

As a result of the COVID-19 pandemic, the use of air purifiers in hospitals has risen significantly. Multiple studies have thus focused their efforts on understanding to which degree these devices help reduce pathogen transmission. As we have learned from the coronavirus pandemic, airborne pathogens like COVID-19 are transmitted through aerosol droplets and microdroplets. Exposure to these bacteria and viruses in hospitals or patient rooms occurs when an infected individual talks, coughs, sneezes, sings, or even breathes or exhales with their mouth open. Social distancing can sometimes pose challenges in hospitals when doctors need to be close to their patients. Pathogen transmission rates are highest in indoor spaces without proper ventilation that are occupied by many people, making a hospital the perfect breeding ground.

A 2023 study found that the correct use of a portable air cleaner (PAC) can reduce the half-lives of aerosols by 82%, thus serving as an excellent form of infection control. Furthermore, the study found that concentration levels of aerosols were at least 46% lower than environments without air cleaners. A portable air purifier can lead to ‘significant reductions in the level of aerosol concentration’, consequently reducing droplet-based airborne diseases and pathogens¹¹.

Another 2021 study had even more promising results. It found that the use of two portable air cleaners in a single patient room found that within 5.5 minutes, 99% of aerosols were removed from the air¹².

It is important to note that air sterilisers should not be used as a replacement for sufficient ventilation. In order to continue to support improved indoor air quality (IAQ) and infection control in a hospital, a combination of an air purifier for hospital use and ventilation is always recommended.

Reassure staff and patients

Studies have even shown that when patients know they are breathing cleaner air, it may aid in their recovery.  A ‘healthy psychology’ and a reduction in stress can encourage earlier surgery recovery, improve the short- and long-term outcomes of chronic diseases and infections¹³.

The same can be said for members of hospital staff. When staff members feel that their employer is investing in their health by installing air purifiers in a hospital, they will feel empowered to put in more quality work. Furthermore, studies have linked the presence of indoor air pollution in the workplace with decreased concentration and productivity and increased fatigue. By improving indoor air quality in a hospital, staff may benefit from a 25% increase in productivity¹⁴.

Reduce hospital spending

A 2012 study out of California found that patients and staff are not the only ones to benefit from the installation of air purification devices in hospitals and other healthcare facilities. In fact, by focusing efforts on improving overall air quality, a hospital can significantly reduce its spending on air pollution-related equipment and patient care.

The economic costs of air pollution-related illness, especially emergency care for patients with asthma and respiratory and cardiovascular diseases, have grown dramatically in the past several decades. One hospital that took part in the study, Riverside Community Hospital in California, found that had federal standards been met for indoor and outdoor PM2.5 levels from 2005 to 2007, 329 air pollution-related hospital admissions and ER visits could have been prevented. These hospital admissions and ER visits equated to a total of over $2 million (£1.6 million or €1.8 million). Another hospital, St. Agnes Medical Center, had similar findings during this timeframe with 384 air pollution-related hospital admissions/ER visits totalling nearly $3 million (£2.3 million or €2.7 million)¹⁵.

Knowing that our indoor spaces are 2 to 5 times more polluted than outdoor spaces, investing in improved indoor air quality in hospitals can lead to noteworthy savings.

How to choose an air purifier for hospitals?