Проблемы идентификации опасности для здоровья человека при химическом загрязнении воздушной среды помещений медицинских стационаров

Abstract

Use of various physical and chemical research techniques, including chromato-mass-spectrometry, made it possible to identify and quantify more than 40 organic compounds in air inside healthcare organizations, including saturated, unsaturated, cyclic, and aromatic hydrocarbons; terpenes, alcohols, aldehydes, esters, ketones, halogen-containing compounds, and organic acids. Levels of ethanol, dichloromethane, carbon tetrachloride, ethyl acetate, propyl acetate, acetone, terpene hydrocarbons, and acetic acid made the main contribution to the total content of all identified compounds. Most detected substances were present in concentrations not exceeding hygienic standards, except for chloroform and iodoform, the levels of which were up to 2 times higher than average daily MPL in intensive care wards and a bronchoscopy room. Organic acids and chlorinated organic compounds were found in elevated concentrations compared with insides of non-medical public buildings. Among the wide list of identified substances, hygienic standards have not been established for more than 70% of compounds and it is not possible to give a hygienic assessment of hazards or safety of their presence in air inside healthcare facilities. Despite that, the information obtained in this study is extremely useful for accomplishing an important stage in health risk analysis, which is identification of hazards for health of patients and healthcare workers posed by chemical air pollution inside healthcare organizations when using the risk analysis methodology. In this study, we assessed effects produced by operations of UV recirculator irradiators for air disinfection on its chemical composition inside healthcare institutions. The assessment showed that when such devices worked in the presence of patients and staff, there was an increase in the amount of pollutants in air and their total concentration grew from two to more than four times. When analyzing risks for health of staff and patients, hazard identification within risk-based control of chemical air pollution in the hospital environment should include monitoring of formaldehyde, styrene, ammonia, ethanol, isopropanol, chloroform, dichloroethane, acetic acid along with identification of a wide range of volatile organic compounds; it should also cover ammonia as one of the priority pollutants occurring in the environment from human excretory products.