Guide to indoor air quality monitoring for healthcare facilities

The importance of indoor air quality in healthcare facilities

Air quality is a measure used to indicate the cleanliness of the air in any given environment, focusing on identifying potentially harmful agents that could impact the health of humans. The WHO considers air pollution the world’s largest single environmental health risk, with the negative impacts of contaminated air posing elevated risks in hospital environments.

Data suggests that indoor pollutant levels can be 5 – 10 times greater than outdoor levels due to factors like ventilation, building envelope design, furnishings and hygiene. This means patients and staff who spend most of their days inside healthcare facilities could be exposed to elevated airborne pollutants if no protective measures are developed.

Hospital air quality monitoring systems are particularly important in high-risk environments like operating rooms, recovery rooms, maternity wards and similar areas where vulnerable patients are located to help staff identify and address contaminants reliably and effectively.

The challenges of maintaining good air quality in hospitals

Maintaining clean air in any indoor environment can be challenging, with multiple factors like poor ventilation, the use of cleaning chemicals, the presence of certain furnishings and the simple act of breathing all known to influence the spread of potentially harmful contaminants.

However, hospitals and healthcare facilities can be exposed to numerous additional airborne contaminants associated with the profession. A recent study published by the National Library of Medicine details several specific contaminants that can impact hospital air quality:

• Carbon monoxide
• Volatile Organic Compounds (VOCs)
• Nitrous oxide
• Glutaraldehyde
• Formaldehyde

Below are more detailed examples of processes and infrastructural considerations that can make it hard for staff to meet hospital air quality standards like ANSI/ASHRAE Standard 62.1, a rule that sets minimum requirements for ventilation and IAQ in healthcare facilities.

Cleaning requirements

Healthcare professionals must follow strict guidelines outlined by the CDC, OSHA and the EPA (among others) when cleaning and disinfecting equipment and patient care areas. This means most hospitals will be thoroughly cleaned multiple times in a typical day.

Many commonly used cleaning products and detergents, including those considered ​“green,” have been shown to emit VOCs that can be harmful to humans. VOCs can cause:

• Breathing difficulties
• Irritation of the eyes, nose and throat
• Nausea and headaches
• Reproductive and developmental toxicity
• Damage to the nervous system

How often surfaces and equipment are cleaned can also lead to increased moisture and humidity in hospital air, influencing mold growth.

HVAC installations

HVAC installations help to ensure hospital air is constantly refreshed and filtered throughout the facility, reducing the build-up of harmful contaminants. However, research indicates that improperly installed and maintained HVAC systems can contribute to the spread of airborne infections, which may go unnoticed if no hospital air quality monitoring systems are in place.

Improper maintenance of HVAC systems can also lead to the formation of mold spores and bacteria inside air filters, as well as dust and particulate matter being drawn into the hospital from outdoors. Ensuring all ventilation ducts and hospital air filters are frequently maintained and cleaned can help reduce risk factors, supported by real-time IAQ monitoring systems.

Patient health status

The health status of patients being cared for can also impact hospital air quality monitoring. If an area is experiencing an outbreak of an infectious disease, such as influenza, COVID-19 or MRSA, extra provisions must be taken to mitigate contamination.

While additional cleaning and disinfection procedures will help to limit exposure, effectively addressing airborne contaminants can be difficult. In this case, hospital IAQ monitoring systems can aid healthcare workers in actively reducing the spread of infections.

Materials and furnishings

Some materials and furnishings commonly found in hospitals can emit particulate matter and VOCs, contributing to poor air quality. For example, polymer materials found in blood bags and infusion bags have been shown to release VOCs and phthalates in enclosed spaces.

Materials found in hospital furniture and finishing materials like paints can also contain VOCs such as methylene, chloride, benzene and formaldehyde, the inhalation of which can cause health effects like nose/​throat irritation and even breathing difficulties at high concentrations.

Vaping and smoking

Some hospitals face issues with patients, visitors and even staff vaping or smoking indoors. Lifelong smokers who are unable to leave the hospital may attempt to circumvent smoking bans by choosing to vape in private or less-frequented rooms. If left unaddressed, this can lead to significant fines for the breaching of smoking bans and various serious health risks.

Cigarettes and e‑cigarettes release multiple harmful chemicals like formaldehyde, benzene, propylene glycol and carbon monoxide into the air, which can be incredibly detrimental to the health of vulnerable patients and healthcare staff. The use of hospital air quality monitoring technologies helps administrators to both address and deter smoking in healthcare facilities.

What are hospital IAQ monitoring systems?

IAQ monitoring systems provide real-time information about the air quality in any area. IAQ sensors can be installed in various locations and programmed to continuously analyze air samples in search of potentially harmful particulate matter, humidity levels, temperatures and other similar stimuli. They can also provide detailed alerts and reports to help admins address issues.

With IAQ monitors, hospital administrators and facility managers can assess air quality metrics across the site to better understand potential threats. Staff can program IAQ monitoring systems to instantly warn them of high concentrations of target stimuli, with integrations enabling the development of automated responses to specific risks.

What can indoor air quality monitors for healthcare facilities detect?

IAQ monitoring systems can detect a wide range of airborne pathogens, particulate matter and chemicals, with sensors designed to detect various stimuli. Hospital air quality monitoring systems will generally be designed to accurately monitor stimuli like:

• Anesthetic gas: Waste Anesthetic Gasses (WAGs) like isoflurane, halothane and nitrous oxide can collect in operating rooms and treatment facilities. Excess exposure to WAGs can cause miscarriages, congenital disabilities, cancer and liver and kidney disease.
• Disinfection substances: Sterilizing and disinfection agents used to clean hospital equipment commonly contain potentially harmful chemicals like glutaraldehyde and formaldehyde, both of which can cause throat and lung irritation at elevated levels.
• VOCs: VOCs can emit from numerous sources, including antiseptic solutions, anesthetic agents and cleaning products. Research suggests that over-exposure to VOCs has led to an elevated risk for work-related asthma.
• Carbon dioxide: Carbon dioxide is often used in surgical procedures to provide respiratory stimulation after administering anesthesia. Over-exposure to CO2 can cause dizziness, drowsiness and even unconsciousness within a few minutes.
• Humidity: Industry standards like ASHRAE Standard 170- 2008 Table 7.1 state that a maximum relative humidity of 60% must be maintained in healthcare facilities. IAQ monitoring systems can be used to warn stakeholders of rushing humidity levels.
• Banned substances: Hospital air quality monitoring sensors can be used to detect vape aerosols, nicotine and THC to help ensure sites maintain compliance with smoking bans and to protect patients from the negative health impacts of smoking.

Benefits of monitoring IAQ for healthcare facilities 

Bespoke IAQ monitoring systems for healthcare facilities give hospital staff a more holistic view of potential environmental threats. Implementing these systems can bring about several significant benefits to improve the lives of patients and staff.

Improved air quality

Hospital air quality monitoring systems help to improve air safety by providing continuous protection against pollutants and contaminants. Thresholds can be set for different types of contaminants in different areas, with alerts programmed to instantly warn staff if levels begin to rise unexpectedly. This line of defense helps ensure hospital air remains safe to breathe.

Reduced risk of infections

Air pollution is directly linked to the transmission of pathogens and respiratory illnesses. By developing systems to monitor air quality and instantly address rising levels of contaminants, hospital administrators can reduce the risk of respiratory infections causing harm to patients.

Regulatory compliance

Hospital administrators are expected to maintain compliance with industry standards such as ANSI/ASHRAE Standard 62.1 and ASHRAE Standard 170- 2008 Table 7.1, as well as the National Ambient Air Quality Standards (NAAQS). These regulations define safe thresholds for contaminants and humidity that hospitals must be able to prove they meet consistently.

Green building certifications

Institutions that use IAQ monitoring systems to track carbon dioxide levels and general air quality metrics can benefit from incentives such as green building certifications. Examples include the LEED system and the Green Building Initiative, which can assist staff in creating energy and cost-efficient facilities primed to receive social and governance benefits.

Health risk prevention

Hospital air quality monitoring systems also provide general protection against health risks associated with common and specific contaminants. Custom alerts and responses can be programmed to ensure carbon dioxide levels, VOCs, surgical smoke and humidity do not surpass safe thresholds to mitigate the risk of patients experiencing adverse health effects.

Choosing the best indoor air quality monitor for healthcare facilities

When considering which hardware and software solutions to include in a bespoke hospital air quality monitoring system, administrators must understand which key features will provide the greatest benefits. Factors such as useability, scalability, integration and cost must be carefully considered.

Sensor accuracy

Hospital air quality regulations like ASHRAE Standard 62.1 and the 2014 FGI Guidelines shed some light on the size of particulate matter that hospital administrators are expected to be aware of, with particles as small as 0.02 microns needing to be filtered from the air.

IAQ monitoring sensors for healthcare facilities must also be able to detect tiny variations in the concentration of potentially harmful gasses and VOCs to ensure responsive measures are implemented before adverse effects become apparent. This means the sensitivity and consistent accuracy of hospital IAQ monitoring sensors must be considered a top priority. 

Detection capabilities

Effective IAQ monitoring in healthcare environments is about much more than measuring the levels of common pollutants, meaning a reliable and compliant hospital air quality monitoring solution will be capable of monitoring a much wider range of stimuli than a typical air sensor.

To maintain compliance with strict regulations imposed on healthcare facilities, and to ensure staff and patients are reliably protected from the harmful effects of industry-specific contaminants, hospital IAQ monitoring solutions must be able to detect unique stimuli like:

• Anesthetic gasses
• Surgical smoke
• VOCs like sevoflurane, isoflurane, chlorine and formaldehyde
• Nitrous oxide 
• Carbon dioxide 

Analytics and reporting

Simply detecting potentially harmful pollutants and contaminants will typically not be enough to ensure hospital air quality remains consistently safe. Admins must be provided with analytical reports detailing average air quality metrics and information about contamination events to maintain regulatory compliance and address the cause of contamination events.

IAQ monitoring sensors installed throughout the hospital should be connected to a wider management system, with software tools used to perform real-time analytics processes and create detailed reports. These systems should be intuitive and easy to use, with notifications programmed to alert admins and staff if thresholds are exceeded at any time.

Integration possibilities

Hospital air quality monitoring systems can provide additional protections and help workers respond to incidents promptly when leveraging integrations with wider systems. For example, IAQ monitoring sensors may be linked to HVAC systems, with ventilation tools programmed to automatically engage in response to levels of contaminants surpassing a safe threshold.

IAQ monitoring sensors may also be connected to security devices like hospital access control and alarm systems to instantly warn residents of incidents and restrict access to contaminated areas. Additionally, integrations with different types of CCTV cameras may be developed to ensure footage of contamination incidents is recorded and flagged for later use.

Cost and scalability

Indoor air quality monitors for healthcare facilities can cost a significant amount of money per unit, however, choosing the most expensive option isn’t always the best choice. Factors like sensitivity, detection capabilities and operability should be prioritized to ensure that proposed tools provide adequate protection, as reliable systems often become cost-effective over time.

Alongside cost factors, admins must consider future upgrades and additions to IAQ monitoring systems, with some systems being scaled easily by enabling new sensors to be added to existing management tools.

Improving indoor air quality in hospitals with HALO Sensors

HALO Smart Sensors provide a complete solution for identifying various air quality issues in hospitals and healthcare facilities. These cutting-edge sensors enable hospital staff to proactively address potential concerns by tracking the following environmental factors:

• Temperature
• Humidity
• Air pressure
• Light levels
• Volatile organic compounds (VOCs)
• Particulates (PM1, PM2.5 and PM10)
• Ammonia (NH3), nitrogen dioxide (NO2), carbon monoxide (CO) and carbon dioxide (CO2)

HALO Smart Sensors continuously monitor air quality, delivering actionable insights to support healthier indoor environments for patients, visitors and staff. They integrate effortlessly into a hospital’s existing security systems, enabling quick responses to any air quality concerns.

In addition to air quality monitoring, HALO Smart Sensors also detect vaping, smoke and sound anomalies, providing an extra layer of security while preserving privacy. This makes HALO Smart Sensors a comprehensive solution for healthcare facilities, addressing both air quality and broader behavioral and safety challenges.

Implementing indoor air quality monitors in healthcare facilities

Administrators must ensure all components are installed and configured appropriately to ensure that hospital air quality monitoring systems work effectively. 

Identify high-risk areas

While maintaining safe air quality across the entire hospital is important, some areas face elevated contamination risks. As part of a complete hospital security assessment, prioritize installing IAQ monitoring sensors in rooms where sources of contamination are more likely to be of issue, including:

• Airborne Infection Isolation (AII) rooms: It’s imperative that the air cycled through these spaces is closely monitored for signs of contaminants and pollutants.
• Operating theaters: Operating theaters must be sterile to ensure the safety of every patient. IAQ monitoring sensors help staff identify contaminants and ensure no anesthetic gasses or disinfection agents in the room exceed safe thresholds.
• Protective Environment (PE) rooms: Patients in PE rooms have compromised immune systems and face elevated risks from contaminants and pollutants. IAQ sensors in these spaces can alert staff to issues and trigger automated responses.

Position sensors intelligently

Hospital air quality monitoring sensors must be positioned carefully to ensure appropriate coverage. Sensors should be installed at head height and in keeping with the room’s natural airflow to improve the likelihood of contaminants passing through the device. Provisions should also be made for maintenance with sensors positioned to provide access as required.

Program automations and alerts

The best indoor air quality monitors for healthcare facilities are designed with automation in mind. Admins should develop custom alerts for different incidents, with SMS and email notifications sent to staff warning of air quality events. Integrations with wider systems should also be explored, such as HVAC systems engaging in response to triggered sensors.

Conclusion

IAQ monitoring is of utmost importance in healthcare environments, helping staff to protect patients from exposure to potentially harmful contaminants and airborne illnesses. IAQ monitoring also aids administrators in complying with strict regulations regarding air quality in healthcare facilities, which can lead to significant operational and legal issues.

By choosing to develop and implement hospital air quality monitoring systems, healthcare professionals can improve their abilities to identify and address potential air quality issues. Custom alerts and automated responses can be programmed to mitigate risk factors and facilitate a safer environment where the spread of airborne contaminants is minimized.