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Mizuno M, Abe K, Kakimoto T, Yano K, Ota Y, Tomita K, Kagi N, Sekiya I. Volatile organic compounds and ionic substances contamination in cell processing facilities during rest period; a preliminary assessment of exposure to cell processing operators. Regen Ther 2023; 24:211-218. [PMID: 37519908 PMCID: PMC10371781 DOI: 10.1016/j.reth.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Cell processing operators (CPOs) use a variety of disinfectants that vaporize in the workspace environment. These disinfectants can induce allergic reactions in CPOs, due to their long working hours at cell processing facilities (CPFs). Ionic substances such as CH3COO- generated from peracetic acid, nitrogen oxides (NOx) and sulfur oxides (SOx) from outdoor environment are also known to pollute air. Therefore, our objective was to assess the air quality in CPFs and detect volatile organic compounds (VOCs) from disinfectants and building materials, and airborne ionic substances from outdoor air. Methods Sampling was conducted at three CPFs: two located in medical institutions and one located at a different institution. Air samples were collected using a flow pump. Ion chromatographic analysis of the anionic and cationic compounds was performed. For VOC analysis, a thermal desorption analyzer coupled with capillary gas chromatograph and flame ionization detector was used. Results Analysis of the ionic substances showed that Cl-, NOx, and SOx, which were detected in large amounts in the outdoor air, were relatively less in the CPFs. Ethanol was detected as the main component in the VOC analysis. Toluene was detected at all sampling points. As compared to the other environments, air in the incubator contained larger amounts of VOCs, that included siloxane, tetradecane, and aromatics. Conclusions No VOCs or ionic substances of immediate concern to the health of the CPOs were detected during the non-operating period. However, new clinical trials of cell products are currently underway in Japan, and a variety of new cell products are expected to be approved. With an increase in cell processing, health risks to CPOs that have not been considered previously, may become apparent. We should continue to prepare for the future expansion of the industry using a scientific approach to collect various pieces of information and make it publicly available to build a database.
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Affiliation(s)
- Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
| | - Koki Abe
- Medical Environment Engineering Group, Center for Environmental Engineering, Institute of Technology, Shimizu Corporation, 3-4-17, Koto-ku, Etchūjima, Tokyo, 135-0044, Japan
| | - Takashi Kakimoto
- Medical Environment Engineering Group, Center for Environmental Engineering, Institute of Technology, Shimizu Corporation, 3-4-17, Koto-ku, Etchūjima, Tokyo, 135-0044, Japan
| | - Keiichi Yano
- Medical Environment Engineering Group, Center for Environmental Engineering, Institute of Technology, Shimizu Corporation, 3-4-17, Koto-ku, Etchūjima, Tokyo, 135-0044, Japan
| | - Yukiko Ota
- Medical Environment Engineering Group, Center for Environmental Engineering, Institute of Technology, Shimizu Corporation, 3-4-17, Koto-ku, Etchūjima, Tokyo, 135-0044, Japan
| | - Kengo Tomita
- Medical Environment Engineering Group, Center for Environmental Engineering, Institute of Technology, Shimizu Corporation, 3-4-17, Koto-ku, Etchūjima, Tokyo, 135-0044, Japan
| | - Naoki Kagi
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, Ookayama 2-12-1, Meguro-ku, Tokyo, 152-8552, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45, Bunkyo-ku, Yushima, Tokyo 113-8519, Japan
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Vilén L, Putus T. Hoarseness among nurses. J Voice 2023; 37:798.e15-798.e18. [PMID: 34016510 DOI: 10.1016/j.jvoice.2021.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 11/30/2022]
Abstract
While many occupations are at risk for vocal health issues much of the current research has focused on teachers. The prevalence of hoarseness among nurses has not received much attention. The aim of this study was to determine the current prevalence of hoarseness among nurses and also to identify potential environmental risk factors from their working environment. The health data was collected from Finnish healthcare workers. Our findings are based on 13,560 health questionnaires which were statistically analyzed. Our results suggest that the one-year period prevalence of hoarseness was 30% and all the environmental problems which we evaluated (draft, room temperature too high, variable room temperature, room temperature too low, dry air, stuffy indoor air, moist air/ high humidity, inadequate ventilation, smell of mold or cellar, sewer odor, other unpleasant odors, tobacco smoke, noise and detectable dust or dirt) had an increasing effect on hoarseness. In conclusion, clear associations were found between environmental problems and hoarseness in nurses. Furthermore, efforts should be made to repair defective ventilation systems, remediate indoor air problems due to moisture damage and improve overall maintenance to protect the vocal health of nurses.
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Affiliation(s)
- Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland.
| | - Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland
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Vilén L, Atosuo J, Putus T. Prevalence of Hoarseness in Primary Health Care and Hospitals-Associations With Different Work Tasks and Environmental Factors Among Nurses. J Voice 2022:S0892-1997(22)00063-7. [PMID: 35365386 DOI: 10.1016/j.jvoice.2022.02.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/07/2022] [Accepted: 02/24/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The voice is one of the most essential tools necessary for nurses achieve high care satisfaction and safety. Research on hoarseness has mainly focused on professional speakers, like teachers. The aim of this study was to determine the current prevalence of hoarseness among six subgroups of nurses (registered nurses, primary care nurses, pediatric nurses, laboratory nurses, dental nurses, and midwives) and also to identify potential environmental risk factors in their working environment. METHODS The health data was collected in collaboration with two health care professional trade unions. The findings are based on 15,553 returned health questionnaires which were statistically analyzed. RESULTS The 1-year prevalence of hoarseness among all participating nurses was 30.2 % in this data, but the variation between different occupational subgroups was significant; ranging from 25 % for laboratory nurses to 38 % for midwives. These findings were in line with perceived environmental problems and the differences between the sub-groups were not explained by the participants suffering from asthma, sinusitis, rhinitis, or common respiratory infections; there were no explanatory differences in the prevalence's of the above-mentioned diseases. CONCLUSIONS The variation in prevalence of hoarseness between the different occupational subgroups was significant and the prevalence was found to be in line with perceived environmental problems. The most common problems were stuffiness, dry air, and inadequate ventilation. In addition, both a perceived "sewer odor" and "smell of mold or cellar" in one's own working environment were also found to be significant risk factors for hoarseness. Based on this study, the current indoor air problems in Finnish health care facilities can be verified and are a source of risk to nurses' voices.
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Affiliation(s)
- Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland; Clinical Research Unit TROSSI, University of Turku, Turku, Finland.
| | - Janne Atosuo
- Clinical Research Unit TROSSI, University of Turku, Turku, Finland; Department of Biotechnology, The Laboratory of Immunochemistry, University of Turku, Turku, Finland
| | - Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland; Clinical Research Unit TROSSI, University of Turku, Turku, Finland
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Kalender-Smajlović S, Dovjak M, Kukec A. Sick building syndrome among healthcare workers and healthcare associates at observed general hospital in Slovenia. Cent Eur J Public Health 2021; 29:28-37. [PMID: 33831284 DOI: 10.21101/cejph.a6108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 01/19/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to assess the possible associations between self-perceived sick building syndrome (SBS) symptoms among healthcare workers and healthcare associates and self-perceived parameters of indoor work environment quality. METHODS The cross-sectional study was conducted from February to April 2019. Validated standardized evaluation tools (MM 040 NA Hospital 2007 and MM 040 NA Office 2007) were used for estimating the prevalence of SBS among observed populations. Chi-square and Mann-Whitney U tests for assessing possible associations in SBS symptoms between healthcare workers and associates were used. RESULTS The response rate was 69.8%. The results showed a lower prevalence of six or more SBS symptoms in healthcare associates (6.4%) compared to healthcare workers (12.0%). Healthcare workers perceived the most frequent risk factors for SBS to be poor air quality, an inappropriate level of relative humidity, and inappropriate room temperature, while the least frequently self-perceived risk factors were inappropriate lighting and noise levels. CONCLUSIONS This study represents a platform for further analyses - the identification of health risk factors with environmental monitoring.
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Affiliation(s)
| | - Mateja Dovjak
- Faculty of Civil and Geodetic Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Andreja Kukec
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Rautiainen P, Hyttinen M, Ruokolainen J, Saarinen P, Timonen J, Pasanen P. Indoor air-related symptoms and volatile organic compounds in materials and air in the hospital environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:479-488. [PMID: 30474394 DOI: 10.1080/09603123.2018.1550194] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/15/2018] [Indexed: 06/09/2023]
Abstract
In this case study, hospital workers did suffer from symptoms related to the poor indoor air quality. To investigate reasons for symptoms MM40-survey and house inspection methods were performed. The study consisted of 49 operating rooms and 470 employees. MM-40 survey revealed that over 40% of the staff suffered from skin reactions, over 50% had upper respiratory tract symptoms and 25% suffered headaches. No reason for the staff's symptom could be found in the structural studies of workplaces. The mean air exchange rate of the rooms was 5.51/h. In total 61 materials and 49 indoor air samples were taken. The most frequently found compounds in the material samples were 2-ethyl-1-hexanol and aliphatic hydrocarbons. VOC emissions were high in some of the material samples and they presumably were the one reason for the workers' symptoms observed in some in of the rooms. However, indoor air VOC concentrations were low in most of the cases. According to the linear regression model emissions from flooring material couldn't explain the indoor air concentration of the VOCs. One reason for that was the high ventilation rates of the rooms, which presumably kept VOC levels in indoors low. In addition, VOC concentrations indoors were strongly related to the ongoing healthcare activities in the hospital.
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Affiliation(s)
| | - Marko Hyttinen
- b Department of Environmental and Biological Sciences, University of Eastern Finland , Kuopio , Finland
| | - Joonas Ruokolainen
- b Department of Environmental and Biological Sciences, University of Eastern Finland , Kuopio , Finland
| | - Pekka Saarinen
- c Turku University of Applied Sciences, Institute of Occupational Health , Turku , Finland
| | - Jussi Timonen
- d Turku University of Applied Sciences, Mittavat Oy , Pielavesi , Finland
| | - Pertti Pasanen
- b Department of Environmental and Biological Sciences, University of Eastern Finland , Kuopio , Finland
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Kalender Smajlović S, Kukec A, Dovjak M. Association between Sick Building Syndrome and Indoor Environmental Quality in Slovenian Hospitals: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173224. [PMID: 31484409 PMCID: PMC6747401 DOI: 10.3390/ijerph16173224] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 12/21/2022]
Abstract
Increased exposure times to various health risk factors and the vulnerability of building users might result in significantly higher prevalence rates of sick building syndrome (SBS) in a hospital setting compared to other indoor environments. The purpose of our study was to assess the association between SBS symptoms and measured environmental parameters at a Slovenian general hospital. A combination of a self-assessment study and field measurements was conducted in order to estimate the health risk factors for SBS symptoms among the users of a Slovenian general hospital. The Chi-square test was used to analyse the association between observed health and environmental parameters. The response rate was 67.5%. A total of 12.0% of healthcare workers at hospital wards reported at least six SBS symptoms, 19.0% reported 2-3 SBS symptoms. At the observed hospital wards, the most deviations were recorded for the level of lighting (83.3%), noise level (73.6%), and room temperature (55.3%). A statistically significant association was found between indoor environmental quality and skin-related SBS symptoms (χ2 = 0.009; p = 0.006). This information will be of great value in defining an integral strategy of environmental health activities aimed at healthier indoor environmental quality in hospitals.
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Affiliation(s)
| | - Andreja Kukec
- Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia.
| | - Mateja Dovjak
- Faculty of Civil and Geodetic Engineering, University of Ljubljana, Ljubljana 1000, Slovenia.
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Aalto L, Lappalainen S, Salonen H, Reijula K. Usability evaluation (IEQ survey) in hospital buildings. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2017. [DOI: 10.1108/ijwhm-03-2016-0014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
As hospital operations are undergoing major changes, comprehensive methods are needed for evaluating the indoor environment quality (IEQ) and usability of workspaces in hospital buildings. The purpose of this paper is to present a framework of the characteristics that have an impact on the usability of work environments for hospital renovations, and to use this framework to illustrate the usability evaluation process in the real environment.
Design/methodology/approach
The usability of workspaces in hospital environments was evaluated in two hospitals, as an extension of the IEQ survey. The evaluation method was usability walk-through. The main aim was to determine the usability characteristics of hospital facility workspaces that support health, safety, good indoor air quality, and work flow.
Findings
The facilities and workspaces were evaluated by means of four main themes: orientation, layout solution, working conditions, and spaces for patients. The most significant usability flaws were cramped spaces, noise/acoustic problems, faulty ergonomics, and insufficient ventilation. Due to rooms being cramped, all furnishing directly caused functionality and safety problems in these spaces.
Originality/value
The paper proposes a framework that links different design characteristics to the usability of hospital workspaces that need renovation.
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Scheepers PTJ, Van Wel L, Beckmann G, Anzion RBM. Chemical Characterization of the Indoor Air Quality of a University Hospital: Penetration of Outdoor Air Pollutants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050497. [PMID: 28481324 PMCID: PMC5451948 DOI: 10.3390/ijerph14050497] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 04/27/2017] [Accepted: 05/04/2017] [Indexed: 11/24/2022]
Abstract
For healthcare centers, local outdoor sources of air pollution represent a potential threat to indoor air quality (IAQ). The aim of this study was to study the impact of local outdoor sources of air pollution on the IAQ of a university hospital. IAQ was characterized at thirteen indoor and two outdoor locations and source samples were collected from a helicopter and an emergency power supply. Volatile organic compounds (VOC), acrolein, formaldehyde, nitrogen dioxide (NO2), respirable particulate matter (PM-4.0 and PM-2.5) and their respective benz(a)pyrene contents were determined over a period of two weeks. Time-weighted average concentrations of NO2 (4.9–17.4 μg/m3) and formaldehyde (2.5–6.4 μg/m3) were similar on all indoor and outdoor locations. The median concentration VOC in indoor air was 119 μg/m3 (range: 33.1–2450 μg/m3) and was fivefold higher in laboratories (316 μg/m3) compared to offices (57.0 μg/m3). PM-4.0 and benzo(a)pyrene concentration were lower in buildings serviced by a >99.95% efficiency particle filter, compared to buildings using a standard 80–90% efficiency filter (p < 0.01). No indications were found that support a significant contribution of known local sources such as fuels or combustion engines to any of the IAQ parameters measured in this study. Chemical IAQ was primarily driven by known indoor sources and activities.
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Affiliation(s)
- Paul T J Scheepers
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Luuk Van Wel
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands.
| | - Gwendolyn Beckmann
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Rob B M Anzion
- Research Lab Molecular Epidemiology, Radboud Institute for Health Sciences, Radboudumc, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Tirkkonen J, Täubel M, Leppänen H, Peltonen M, Lindsley W, Chen BT, Hyvärinen A, Hirvonen MR, Huttunen K. Toxicity of airborne dust as an indicator of moisture problems in school buildings. Inhal Toxicol 2017; 29:75-81. [DOI: 10.1080/08958378.2017.1296511] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Jenni Tirkkonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Health Protection, Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Hanna Leppänen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Health Protection, Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Matti Peltonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Health Protection, Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - William Lindsley
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WA, USA
| | - Bean T. Chen
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WA, USA
| | - Anne Hyvärinen
- Department of Health Protection, Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Maija-Riitta Hirvonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kati Huttunen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
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Horiguchi M, Shudo E, Sato K, Nakamura M, Sai W, Ohinata T. Nurse odor perception in various Japanese hospital settings. Int J Nurs Sci 2015. [DOI: 10.1016/j.ijnss.2015.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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