Abstract
BackgroundIn the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. The toilet flushing of patient fecal waste may be a source of bioaerosols. To date, no study has investigated bioaerosol concentrations from flushing fecal wastes during patient care.MethodsParticle and bioaerosol concentrations were measured in hospital bathrooms across three sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle and bioaerosol concentrations were measured with a particle counter bioaerosol sampler both before after a toilet flushing event at distances of 0.15, 0.5, and 1 m from the toilet for 5, 10, 15 min.ResultsParticle concentrations measured before and after the flush were found to be significantly different (0.3–10 μm). Bioaerosol concentrations when flushing fecal waste were found to be significantly greater than background concentrations (p-value = 0.005). However, the bioaerosol concentrations were not different across time (p-value = 0.977) or distance (p-value = 0.911) from the toilet, suggesting that aerosols generated may remain for longer than 30 min post flush. Toilets produce aerosol particles when flushed, with the majority of the particles being 0.3 μm in diameter. The particles aerosolized include microorganisms remaining from previous use or from fecal wastes. Differences in bioaerosol concentrations across conditions also suggest that toilet flushing is a source of bioaerosols that may result in transmission of pathogenic microorganisms.ConclusionsThis study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet during routine patient care. Future studies are needed targeting pathogens associated with gastrointestinal illness and evaluating aerosol exposure reduction interventions.
Highlights
In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually
Background concentrations of bioaerosols and particles were determined from bathrooms where toilets were not flushed and designated as “no waste no flush.”
The results of our study are significant, as no previous study has measured bioaerosol concentrations in normal hospital bathrooms without flushing, or bioaerosols generated from flushing unmanipulated loose human waste in a hospital setting during active patient care
Summary
In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. No study has investigated bioaerosol concentrations from flushing fecal wastes during patient care. In the United States (US), 1.7 million people contract an infectious disease from a hospital-based patient care setting [i.e., healthcare associated infection (HAI)], annually [1]. These HAIs increase morbidity, mortality with costs estimates from 4.5 to 29 billion US dollars, annually and are underreported [2, 3]. The isolation of microorganisms from hospital surfaces after contamination suggests that infections occur among individuals after being admitted [11–14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
