Health Risk Assessment of Indoor Air Quality Exposure Among Healthcare Workers in a Community Hospital, Khon Kaen Province
Article Sidebar
Main Article Content
Abstract
This study is a cross-sectional descriptive research aimed at evaluating indoor air quality and health risks in 11 hospital areas. Ten parameters were analyzed temperature, relative humidity, air movement, carbon dioxide, carbon monoxide, particulate matter (PM2.5 and PM10), formaldehyde, total bacteria, and total fungi. Data were collected using indoor air quality monitoring instruments and questionnaires from 159 hospital staff. Descriptive statistics, including frequency, percentage, mean, standard deviation, and median, were analyzed using STATA 10.0. The study covered 11 areas, comprising 4 inpatient wards (74 participants), 1 outpatient ward (15 participants), 3 procedure rooms (40 participants), and 3 laboratories (30 participants). Four parameters exceeded standard levels temperature (25.85 ± 2.29°C), relative humidity (62.79 ± 8.69%), PM2.5 (38.91 ± 15.71 µg/m³), and PM10 (53.3 ± 19.49 µg/m³). Although formaldehyde levels (3.41 ± 1.48 μg/m³) were below the 8-hour exposure standard, prolonged exposure (over 10 years) increases cancer risk, especially in laboratories with the highest formaldehyde levels (1.111 x 10-6). This risk is greater in laboratories compared to other departments. Outpatient wards showed elevated temperature and particulate matter, increasing the risk of respiratory diseases. The study highlights the potential long-term health impacts of indoor air quality issues on hospital staff. Regular indoor air quality assessments and health risk evaluations are essential to implement preventive measures and maintain workplace safety for hospital staff.
Article Details
References
United States Environmental Protection Agency. The inside story: A guide to indoor air quality. Washington DC: EPA , 1995. Available at https://laws.anamai.moph.go.th/th/practices/ 211864 , accessed on Nov 23, 2022.
WHO. Health risk assessment of air pollution. Denmark: WHO Regional Office for Europe, 2016. 40 p.
WHO. Household air pollution. Available at https://www.who.int/news-room/fact-sheets/detail/household-air-pollution-and health?gclid=EAIaIQobChMIyKyvzcu5gQMVSkUrCh39a AIjEAAYASAAEgJDIvD_BwE, accessed on Sep 20, 2022.
Ibrahim F, Samsudin EZ, Ishak AR, et al. The relationship between occupant behaviour and indoor air quality in Malaysian hospital outpatient departments: A multistage cross-sectional study. Heliyon 2024; 10: 1-19.
Phung D, Hien TT, Linh HN, et al. Air pollution and risk of respiratory and cardiovascular hospitalizations in the most populous city in Vietnam. Sci Total Environ 2016; 557-558: 322-30
Salam ZHA, Karlin RB, Ling ML, et al. The impact of portable high-efficiency particulate air filters on the incidence of invasive aspergillosis in a large acute tertiary-care hospital. Am J Infect Control 2010; 38: e1-7.
Rahayu EP, Saam Z, Sukendi S, et al. The factors of affect indoor air quality inpatient at private hospital, Pekanbaru, Indonesia. Open Access Maced J Med Sci 2019; 7(13): 2208-12.
Boonyayothin V, Luengsrisakul T. Ventilation system for control the hospital indoor air quality. RTA Med J 2018; 71: 51-61.
Tawee V. Indoor air pollution threats. Technical Articles of the Society of Heating, Refrigerating and Air-Conditioning Engineers of Thailand, 2008. 22 p.
U.S. Environmental Protection Agency. Introduction to Indoor Air Quality. Available at https://www.epa.gov/indoor-air-qualityiaq/introduction-indoor-air-quality, accessed on May 16, 2023.
National Environment Agency. Updated guidance on improving ventilation and indoor air quality in buildings for a healthy indoor environment. Available at https://www.nea.gov.sg/our-services/public-cleanliness/environmental-cleaning-guidelines/advisories/guidance-on-improving-ventilation-and-indoor-air-quality-in-buildings-for-a-healthy-indoor-environment, accessed on Sep 20, 2022.
Department of Health, Ministry of Public Health, Thailand. Indoor air quality standards. Available at https://laws.anamai.moph.go.th/ th/practices/211864, accessed on Nov 23, 2022.
Manorat N, Sinthunansakul N. A study of microbial contamination and indoor air quality in tertiary hospitals. J Thai Med Assoc 2019; 9(2): 232-42.
Tangwiwat C, Tultrairat S, Panomyong K. (2023). Prevalence and factors associated with sick building syndrome in medical personnel. J Dis Control 2023; 49(2): 430-440.
Kannirun M, Surawattanasakul V, Rattananupong T, et al. Prevalence and association of indoor environmental factors and sick building syndrome among workers of Army Medical Department headquarter, Bangkok. J Royal Thai Army Nurses 2022; 23(3): 197-205.
Natthapong L. (2005). The prevalence rate and associated factors of sick building syndrome among health care workers in hospitals with inadequate ventilation. 2005. 121 p.
Pantip T, Monthira T, Jira K. Indoor air quality in hospitals: A case study of a community hospital in Nakhon Si Thammarat Province. J Public Health 2019; 28(2): 325–33.
Occupational and Environmental Disease Bureau. Indoor air quality monitoring manual for border entry points, 2018.88 p.
Singapore Standard Council. Code of practice for indoor air quality for air-conditioned buildings. Singapore: Enterprise Singapore, 2021.30 p.
Office of Superfund Remediation and Technology Innovation. Risk assessment guidance for superfund volume I: human health evaluation manual (Part F, supplemental guidance for inhalation risk assessment) Washington: U.S. Environmental Protection Agency; 1970. Available at https://www. epa.gov/sites/production/files/2015-09/documents/partf_200901_final.pdf, accessed on Nov 23, 2022.
Kimbell JS, Overton JH, Subramaniam RP, et al. Dosimetry modeling of inhaled formaldehyde: Binning nasal flux predictions for quantitative risk assessment. Toxicol Sci 2001; 64(1): 111–21.
Integrated Risk Information System. (2024). IRIS toxicological review of formaldehyde (inhalation): CASRN 50-00-0. Washington, DC: U.S. Environmental Protection Agency, 2024. 10 p.
Department of Health, Ministry of Public Health, Thailand. Indoor air quality standards. Available at https://laws.anamai.moph.go.th/ th/practices/211864, accessed on Feb 14, 2023.
Occupational Safety and Health Administration (OSHA). Formaldehyde standard: 29 CFR 1910.1048. Washington (DC): US Department of Labor. Available at https://www.osha.gov, accessed on May 20, 2024.
Ashely K, Connor P, editors. NIOSH manual of analytical method 5th ed. Washington: The National Institute for Occupational Safety and Health (NIOSH); 1970. Available at https:// www.cdc.gov/niosh/nmam/default.html, accessed on May 20, 2024.
Chaiklieng S, Tongsantia U, Autrup HN. Risk assessment of inhalation exposure to formaldehyde among workers in medical laboratories. Asia-Pacific J Sci Technol 2021; 26(4): 1-8
Thongchom T, On-si N, Puongphan C, et al. Health Risks from Indoor PM10 and Effects of Sick Building Syndrome in Office Workers. Thai J Public Health 2021; 51(2):170-80.
Fustinoni S, Campo L, Spinazzè A, et al. Exposure and management of the health risk for the use of formaldehyde and xylene in a
large pathology laboratory. Ann Work Exposures Health 2021; 65(7): 805-18.
Chatchanan P. The Prevalence and factors associated with sick building syndrome in care workers: A case study in a hospital in Saraburi Province, 2023. 196 p.
Zhang J, Smith KR. Indoor air pollution: A global health concern. Br Med Bull 2003; 68: 209-25.
Zain SM, Azmi WN, Veloo Y, et al. Formaldehyde exposure, health symptoms, and risk assessment among hospital workers in Malaysia. J Environ Prot Sci 2019; 10(6): 861-79.
Promtes K, Kaewboonchoo O, Harncharoen K, et al. Cancer risk assessment of inhalation formaldehyde exposure among medical students during anatomy laboratory. Thai J Toxicol 2020; 29 (1-2): 8-22.
Rovira J, Roig N, Nadal M, et al. Human health risks of formaldehyde indoor levels: An issue of concern. J Environ Sci Health, Part A: Toxic/Hazardous Substances and Environmental Engineering 2016; 51(4): 357-63.
Department of Health. Manual for conducting indoor air quality assessment for building operators. Nonthaburi: Bureau of Environmental Health, Department of Health, Ministry of Public Health, 2016: 71 p.