Current approaches for preventing environment-associated contamination in healthcare facilities: a systematic literature review by open access database

Abstract

This article presents a Systematic Literature Review (SLR) whose objective is to identify aspects related to the built environment of Emergency Rooms (ERs) and healthcare facilities that interfere with infection by respiratory diseases. The SLR presented is a relevant part of ongoing research dedicated to discussing the built environment’s role on contamination, considering the COVID-19 pandemic scenario and the ER of the University Hospital of the University of São Paulo (USP), sited in São Paulo city, Brazil, as a case study. The results of this SLR showed that the main aspects discussed in the selected articles are: Heating, Ventilation, and Air Conditioning (HVAC) systems; disinfection and hygiene; layout and spatial organisation; air curtain and air purification; natural ventilation; door opening; and surface material. As major findings, the importance of properly designed mechanical ventilation systems and of the parameters’ control for the maintenance of Indoor Air Quality (IAQ) are highlighted. In addition, the existence of isolation rooms; periodic assessments based on guides and protocols; self-sanitising materials surfaces; and environmental design strategies are presented, together with the development of technologies, often incorporated into hospital furniture. Thus, as contribution, the article highlights the importance of the association of several measures related to the performance of the built environment to minimise respiratory infections in healthcare environments. As a limit of this research, only open access articles and reviews from 2017 to 2021 were considered, so that the article reveals trends in this field of study, not covering the entirety of content.