Airborne bacteria concentrations and related factors at university laboratories, hospital diagnostic laboratories and a biowaste site

Distribution and the trend of airborne particles and bio-aerosol concentration in pediatric intensive care units with different ventilation setting at two hospitals in Riyadh, Saudi Arabia

OBJECTIVE

To examine the distribution and the trend of airborne particles and bio-aerosol concentration in pediatric intensive care units (PICUs) in two tertiary care hospitals with different ventilation setting.

METHODS

Hospitals A but not B is provided with a central HEPA filter. PICUs in both hospitals were categorized into protective environment (PE) with room HEPA filter, semi-protective environment (SPE) with portable air-purifier, and non-protective environment (NPE) with neither system. Fine particles (≤ 2.5 µm) and coarse particles (≤ 10.0 µm) were obtained using optical particle counter (Lighthouse Handheld 3016) and total bacterial (TBC) and fungal (TFC) counts were obtained using Andersen air sampler.

RESULTS

Hospital B had significantly higher levels of fine and coarse particles (in all room), TBC (in PE), but not TFC compared with matched rooms in hospital A. In hospital B, the levels of fine particles, coarse particles, and TBC were lowest in SPE (p < 0.001, p = 0.004, and p = 0.006, respectively) while TFC was lowest in NPE (p = 0.014). Airborne particles, TBC, and TFC had variable trends with some of the indoor peaks follow outdoor peaks. Gram-positive bacteria (69 %) were the predominant bacteria in hospital A while bacterial flora (70 %) were the predominant bacteria in hospital B (p < 0.001 for each).

CONCLUSIONS

The levels of airborne contaminants and microbial counts in PICUs are significantly affected by the ventilation system and to less extent by outdoor levels. The results indicated that advanced filtration system and central HEPA filters play a significant role in the reduction of indoor fine particulates and TBC.

Inhalable and Respirable Particulate and Endotoxin Exposures in Kentucky Equine Farms

Adverse respiratory health effects in the agricultural industry have been linked to particulate endotoxin exposure. However, whether the endotoxin concentration is significantly correlated to the size of the particle remains an open question. To date, limited research has been conducted to assess particulate endotoxin exposures in the agricultural industry in general or the equine industry in particular. A task-based exposure assessment was conducted to characterize the endotoxin levels of inhalable and respirable particles on four Kentucky farms during the summer season. We conducted personal sampling of respirable and inhalable particles (n = 75) across all four farms and particulate endotoxin (n = 58) on two of them. Simultaneously, we collected real-time area samples across all four farms by task - horse care, filing hooves, cleaning stalls, cleaning barns, cleaning dry lots, and cleaning trucks. The endotoxin concentration of inhalable particles (geometric mean: 50.2-1,024 EU/m³) was ~50 times higher than that of respirable particles (geometric mean: 1.72-19.0 EU/m³). Horse care generated the lowest endotoxin concentrations for both particle sizes, while cleaning tasks tended to produce higher concentrations. There was no significant correlation between the endotoxin and particle concentrations for each size fraction based on tasks by farm (R² = 0.069 for inhalable; 0.214 for respirable). The equine workers in this study were exposed to higher endotoxin concentrations than workers in other industries, such as the swine industry. Providing exposure control guidelines and recommendations to the equine industry is necessary to reduce long-term endotoxin exposure and to prevent adverse respiratory symptoms.

Investigating the effect of several factors on concentrations of bioaerosols in a well-ventilated hospital environment

This study characterized and quantified the bacterial and fungal bioaerosols in nine wards of the Razavi Hospital (Mashhad, Iran) that is equipped with an advanced heating, ventilating, and air conditioning (HVAC) system including HEPA filters for air cleaning. In this study, 432 samples were taken from the indoor air of multiple hospital wards during the morning and afternoon shifts during summer and autumn. The particle number concentrations with sizes of > 0.3, > 0.5, > 1, > 2, > 5, and > 10 μm were measured using a 6-channel handheld particle counter. A greater diversity of bioaerosol types were observed during the morning shifts and during summer. The microbial load was not affected significantly by the temperature, relative humidity, working shift, season, and number of visitors, indicating the effectiveness of a well-designed ventilation system to eliminate site-specific variations. For microbial number concentrations, a significant correlation was only observed between the number of particles with a diameter of > 10 μm and the airborne microbial loading. Thus, passive sampling may not properly reflect the actual concentrations of smaller bioaerosols. In conclusion, HEPA filters in the HVAC system successfully decreased the bioaerosol concentrations in the hospital environment. Additionally, we recommend that active sampling be used in cases where a well-functioning HVAC system exists.

Evaluation of PM10, CO2, airborne bacteria, TVOCs, and formaldehyde in facilities for susceptible populations in South Korea

Poor indoor air quality can have adverse effects on human health, especially in susceptible populations; however, few studies have measured multiple pollutants in facilities for susceptible populations at a national scale in South Korea. Therefore, we measured the concentrations of indoor pollutants (fine particulate matter (PM₁₀), CO₂, airborne bacteria (AB), total volatile organic compounds (TVOCs), and formaldehyde) to determine their possible relation to other indoor environmental factors and characteristics of facilities with susceptible populations, such as hospitals, geriatric hospitals, elderly care facilities, and postnatal care centers throughout South Korea. Indoor pollutants were sampled at 82 indoor facilities, including 62 facilities for susceptible populations. Spearman's correlation, Kruskal-Wallis, and Mann-Whitney analyses were used to examine the relationship among and differences between pollutants at indoor facilities and indoor/outdoor differences in PM₁₀ concentration. There were significant correlations between indoor temperature and AB concentration (r = 0.37, p < 0.01), TVOCs, and formaldehyde (r = 0.264, p < 0.01). Indoor PM₁₀ concentrations were higher than outdoor concentrations at all facilities for susceptible populations (p < 0.01). CO₂ might be a good indicator for predicting indoor pollutants when categorized into two levels (≤750 ppm and >750 ppm). The hazard quotient of formaldehyde was higher than the acceptable level of 1 for children under the age of eight in postnatal care centers, indicative of unsafe levels. Therefore, more depth study for exposure characteristics of formaldehyde and indoor air quality (IAQ) in postnatal care facilities as a national scale is needed for finding the children exposure levels.

Bacterial Contamination and Disinfection Status of Laryngoscopes Stored in Emergency Crash Carts

Objectives

To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts.

Methods

One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ²-test and Fisher exact test.

Results

One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (p<0.05).

Conclusions

Protocols and policies must be reviewed to standardize procedures to clean and disinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced.

Seasonality in airborne bacterial, fungal, and (1→3)-β-D-glucan concentrations in two indoor laboratory animal rooms

AIMS

The purpose of this study was to assess the temporal changes in the concentrations of bioaerosols in a laboratory mouse room (LMR) and laboratory rabbit room (LRR), and to determine environmental factors associated with the culturable bacteria, fungi and (1→3)-β-D-glucan concentrations.

METHOD

The concentrations of culturable airborne bacteria, fungi and (1→3)-β-D-glucan in the LMR and LRR were sampled once a month from March 2011 to February 2012. A single-stage viable cascade impactor was used to sample bacteria and fungi, while a two-stage cyclone bioaerosol sampler was used to collect airborne (1→3)-β-D-glucan.

RESULTS

The culturable bacterial concentrations in the LMR showed a gradual increase during the summer. The culturable fungal concentrations showed similar seasonal patterns of change in the LMR and LRR with a noticeable increase during the summer. The (1→3)-β-D-glucan concentrations were highest during the warmer spring and summer months. Relative humidity (RH) was the environmental factor most associated with the concentrations of culturable bacteria and fungi. The overall airborne microbe concentrations were significantly higher in the LRR than in the LMR.

CONCLUSIONS

Airborne microbe concentrations in the LMR and LRR varied greatly depending on season, and these changes were affected by environmental factors.

Concentrations and identification of culturable airborne fungi in underground stations of the Seoul metro

The purpose of this study was to measure the culturable airborne fungi (CAF) concentrations in the underground subway stations of Seoul, Korea at two time points. This study measured the CAF concentrations in enclosed environments at 16 underground stations of the Seoul Metro in 2006 and 2013 and investigated the effects of various environmental factors, including the presence of platform screen doors, temperature, relative humidity, and number of passengers. CAF concentrations at the stations in 2006 were significantly higher than that at the same stations in 2013 (p < 0.001). Furthermore, there was a significant correlation between CAF concentration and relative humidity (r = 0.311, p < 0.05). Geotrichum and Penicillium were the predominant genera. The CAF concentrations in stations with an operating supply air were significantly higher than that in stations with no supply air (p < 0.001). Therefore, it is recommended that special attention be given to stations with clean supplied air to improve the indoor air quality of these subway stations.

Analysis of variation in total airborne bacteria concentration to assess the performance of biological safety cabinets in microbial laboratories

Background

The purpose of this study was to compare the concentration of total airborne bacteria (TAB) in biosafety cabinets (BSCs) at universities and hospital microbial laboratories to assess the performance of BSCs.

Methods

TAB was determined by using the single-stage Anderson sampler (BioStage Viable Cascade Impactor). The samples were obtained three times (with the BSC turned off and the shield open; with the BSC turned off and the shield closed; and with the BSC tuned on and operating) from the areas in front of 11 BSCs.

Results

TAB concentrations of accredited and nonaccredited BSCs were determined. No significant differences were observed in the TAB concentrations of the accredited BSCs and the nonaccredited BSCs for the areas outside the BSCs in the laboratories (p > 0.05). TAB concentrations for the BSCs sampled with the shield open and the instrument turned off showed differences based on the sampling site outside the BSC in each laboratory.

Conclusion

These results imply that TAB concentration is not altered by the performance of the BSCs or TAB itself and/or concentration of TAB outside the BSC is not a good index of BSC performance.

Characterization of the monthly variation in (1 → 3)-β-D-glucan concentrations in university laboratories

We characterize the monthly variation in (1 → 3)-β-D-glucan concentration measured over the course of 1 year, and we evaluate the characteristics of size selection using a two-stage cyclone sampler. The (1 → 3)-β-D-glucan concentrations were measured in four bio-related laboratories. A total of 156 samples were collected using a new two-stage cyclone sampler. Analysis of (1 → 3)-β-D-glucan was performed using the kinetic Limulus amebocyte lysate assay. The study showed that airborne (1 → 3)-β-D-glucan concentrations were significantly higher in laboratory D (mean ± SD 1,105 ± 1,893 pg/m(3)) and in the spring (5,458 pg/m(3)). The highest concentration of (1 → 3)-β-D-glucan occurred in the spring, particularly in May.