Abstract
Adequate management of indoor air quality (IAQ) in healthcare units has relevant impacts on sustainability performance due to its effects on patient safety, occupational health and safety, and energy consumptions. This study sought to identify improvement opportunities on IAQ management by collecting and analyzing experimental data of selected parameters in three healthcare units in Portugal: Two general hospitals and one primary healthcare center. Indoor air temperature, relative humidity, CO2, bacteria, and fungi concentrations were measured in summer and winter campaigns in June/July 2017 and in January/March 2018. Results show that the exclusive use of natural ventilation is not adequate when the affluence of users is high, but the analyzed parameters revealed acceptable results under low occupation intensity conditions. Results also show that keeping low indoor air relative humidity has a significant impact in reducing fungi concentration and that there is a significant correlation at the 0.05 level between indoor air CO2 concentration and bacterial loads. Therefore, as opportunities to improve sustainability, IAQ management in healthcare facilities should consider natural ventilation as a complement to mechanical ventilation systems and should focus on adequate control of indoor air relative humidity and CO2 concentration to reduce the risk of airborne infections.
Highlights
Sustainable healthcare systems need to balance economic, social, and ecological interests, in a comprehensive approach and with a long-term focus [1]
The results obtained in this study show that there are improvement opportunities for sustainability management on the scope of indoor air quality (IAQ) monitoring and control in healthcare facilities
Natural ventilation mechanisms are cost-effective solutions to control IAQ, and the results of the sampling campaigns in the health center HC under normal working conditions show its effectiveness for the parameters analyzed in this study
Summary
Sustainable healthcare systems need to balance economic, social, and ecological interests, in a comprehensive approach and with a long-term focus [1]. Healthcare sustainability management faces the challenge of providing high quality healthcare services with limited financial resources, attending the needs and expectations of patients and healthcare professionals, and minimizing negative environmental impacts [1,2]. Sustainability management programs, with their corresponding control systems, are nowadays common practice in many healthcare facilities, with recognized positive effects on performance [2,4]. The comparison of different healthcare organizations practices is a relevant benchmarking tool to search for improvement opportunities regarding the environmental and societal quality of the service provided while enhancing adequate economic and financial performances [2,3]. It is widely recognized that healthcare facilities are major energy consumers [3,4,5,6,7] and, according to Carnero [2], European hospitals are responsible for 5% of the CO2 emissions of the European
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