Complete guide to hospital indoor air quality (IAQ) monitoring

Why indoor air quality (IAQ) is important for hospitals

‘Indoor air quality’ (IAQ) refers to the air quality within a building. Poor indoor air quality is caused by the presence of air pollutants, which can affect the health, comfort and well-being of building occupants, particularly in hospitals. 

According to the US Environmental Protection Agency (EPA), some indoor environments have levels of pollutants that are higher than levels found outside. In hospitals, the ventilation system has to contend with airborne contaminants that are more complex than those found in an average building. These include airborne germs, chemical substances, medical compounds and other harmful pollutants. 

Therefore, managing indoor air quality in healthcare facilities is critical for reducing health risks to protect patients and staff and meet regulatory requirements.

Reducing health risks

• Increasing infection control: Poor air quality in hospitals can lead to the spread of airborne illnesses such as COVID-19, tuberculosis and flu, particularly for patients with compromised immune systems.
• Greater patient safety: Although patients can be a source of many airborne contaminants, their vulnerable conditions also make them more susceptible to the harmful effects of these contaminants.
• Improving patient recovery: Improving hospital air quality helps staff in their efforts to restore patients’ health.
• Reducing respiratory health risks: Indoor air pollutants such as dust, mold and chemicals can trigger respiratory problems in patients with asthma or other respiratory conditions.
• Promoting comfort and well-being: Poor hospital air quality can increase discomfort, anxiety and stress.
• Avoiding building-related illness: Poor hospital IAQ may cause outbreaks of building-related illnesses such as headaches, fatigue, eye and skin irritations and other symptoms. 

Meeting regulatory compliance

Optimizing indoor air quality in healthcare facilities can help hospitals meet air quality standards, including: 

• ANSI/ASHRAE Standard 62.1 — 2019: Focuses on ventilation requirements for acceptable indoor air quality (IAQ).
• LEED Rating Systems: Covers comfort criteria such as air temperature, humidity, contaminants, air distribution, and pressurization.
• ASHE Standard 170: Guidelines set by the American Society for Healthcare Engineering.
• HCAHPS Surveys: Patient satisfaction surveys that include aspects of hospital air quality.

Key challenges of tracking air quality in hospitals

Complex airborne contaminants

Without effective control measures, the air in hospitals may contain many contaminants that are not found in other buildings. A study by the National Center for Biotechnology Information found that hospital air can be susceptible to many substances, including:

• Bacteria
• Airborne germs
• Chemicals such as carbon dioxide, carbon monoxide, nitrous oxide, formaldehyde and volatile organic compounds (VOCs)
• Respirable suspended particulates
• Smoking and vaping

The study also found that polymer materials used in plastic infusion bags, injectors, blood bags and rubber tubes emit phthalates, a series of chemicals detrimental to human health.

Some contaminants travel as fine particles in the air (PM2.5). The particles are so small that they can reach the respiratory tract and lungs, causing short-term health effects such as eye, nose, throat and lung irritation, coughing, sneezing, runny nose and shortness of breath.

Intensive cleaning regimes

Hospitals frequently clean walls, floors and disinfect equipment to maintain hygiene, which can raise humidity and promote mold growth. Additionally, strong cleaning products and detergents increase VOC levels in the air.

HVAC maintenance

HVAC systems are crucial for controlling hospital air quality by regulating air circulation, filtration, temperature and humidity, which can either limit or promote pollutant spread.

Inefficient HVAC systems can cause temperature fluctuations that affect patient and staff comfort, while high humidity levels can encourage microbial growth. HVAC efficiency is especially vital in operating and emergency rooms, where precise control of temperature, humidity and air quality is critical for infection prevention.

However, poor HVAC performance — due to filter inefficiencies, installation issues, or lack of maintenance — can contribute to the spread of airborne infections, as noted by the CDC.

Controlling multiple spaces

Contaminants can have their source in many different hospital areas, including patient rooms, laboratories, restrooms, waiting areas and public spaces. Hospitals also experience high traffic volumes through corridors and elevators, which can transmit contaminants from different areas throughout the hospital.

Enhancing healthcare safety with indoor air quality monitors

These complex challenges make hospital air quality monitoring an essential tool for maintaining a safe, healthy environment for patients, staff and visitors.

How do hospital IAQ monitors work? 

IAQ monitors work by detecting harmful air quality metrics and provides real-time insight and alerts. Air quality monitors provide awareness of levels of air pollution inside the building. They can also validate the efficiency and performance of HVAC systems. 

Indoor air quality monitors for healthcare facilities can incorporate different types of sensors to identify and measure specific contaminants.

• Laser-based optical sensors: Detect and measure airborne particulates, providing data on particle concentration and size distribution.
• Electrochemical sensors: Detect gases like carbon monoxide. They measure the electrical current produced when the gas interacts with the sensing electrode.
• VOC sensors: Detect volatile organic compounds (VOCs) by monitoring changes in electrical resistance when exposed to these compounds.
• Multi-purpose monitors: Measure humidity, temperature, and pollution levels using various sensors.

An indoor air quality monitor for healthcare facilities actively samples the air in different areas. Suppose the IAQ for a healthcare facility exceeds an approved limit. In that case, the monitor provides a real-time alert to health and safety professionals so they can quickly take action and eliminate risk.

To monitor the levels of different contaminants in the air, hospital air quality monitoring systems provide measurements based on the Air Quality Index (AQI). AQI values range from 0 to 500, with higher values indicating poorer air quality. Each range of values represents a different level of health concern:

• Good: 0 – 50
• Moderate: 51 – 100
• Unhealthy to Sensitive Groups: 101 – 150 
• Unhealthy: 151 – 200 
• Very Unhealthy: 201 – 300
• Hazardous: 301 – 500

IAQ monitors incorporate data logging and reporting facilities to support collection, storage and analysis of air quality data over time.

Hospital air quality monitoring parameters

The best indoor air quality monitors for healthcare facilities can accurately detect and measure levels of a wide range of general pollutants and hospital-specific substances that can cause short and long-term health problems. Hospital-specific substances include: 

• Waste anesthetic gases: These gases can reach the atmosphere through leaks in anesthesia machines, poorly fitting face masks or patients breathing in recovery rooms.
• Disinfection and sterilizing substances: Formaldehyde or glutaraldehyde can cause headaches, nausea, difficulty breathing and skin irritations.
• Surgical smoke: a byproduct of electrosurgery and laser ablation that can cause headaches, eye and throat irritation, nausea, drowsiness and dizziness.

Benefits of IAQ monitoring for healthcare facilities

Minimizes the risk of hazardous contaminants

Indoor air quality monitors for healthcare facilities minimize the risk of dangerous levels of hazardous contaminants. Health and safety teams can quickly identify the source of any problem and take immediate action. 

Enhances HVAC performance monitoring

Facility management teams can use the results to monitor the performance of HVAC systems in maintaining a safe, clean environment. If IAQ for healthcare facilities identifies recurring problems, the team can adjust HVAC operations, assess the performance of any upgrades or improve maintenance routines.

Enables informed decision-making

The data from IAQ monitors enable users to make informed, accurate decisions about ventilation, filtration and other measures to enhance air quality and well-being, making the hospital environment healthier for patients, visitors and staff.

Choosing the right IAQ solutions for healthcare facilities

Investing in high-quality indoor air quality monitoring ensures hospitals can assess air conditions and take appropriate steps to maintain a safe, healthy environment. For optimal performance, IAQ monitoring systems must meet several key requirements, including:

• Accuracy and precision: The monitor must provide consistent, accurate results, enabling health and safety teams to make data-driven decisions and maintain hospital air quality standards.
• Choice of sensors: The sensor should be appropriate for monitoring pollutants. Multi-parameter devices track various factors like particle matter (PM), VOCs, CO2, humidity and temperature, offering a broad view of air quality. However, detecting specific pollutants, such as formaldehyde or radon, may require dedicated sensors. While multi-parameter monitors provide a comprehensive overview, they may not identify specific pollutants.
• Monitoring frequency: Monitors have a set recording interval, automatically taking readings at predefined times. Selecting a model with a low interval provides the most up-to-date information so that response teams can act quickly to address poor air quality. 
• Real-time alerts: The monitor should provide real-time alerts when detecting pollution levels above the safe reference point. This ensures that health and safety teams can quickly address potential hazards.
• Effective data logging: The monitor should offer continuous data logging, giving health and safety teams access to historical air quality records for analysis, quality audits and regulatory compliance.
• Cloud storage capability: The monitor should store data in the Cloud to eliminate the need for on-site storage and enable teams to access data easily from any location. 
• Connectivity: Monitors can be connected to the hospital data network or by Wi-Fi. Wireless access allows teams to monitor air quality remotely. 
• Reliability: Monitors must be robust and reliable so they continue to operate effectively with minimal maintenance. 
• Ease of use: The device should have easy-to-use controls and clear navigation so users can access real-time data quickly and easily, change settings and view historical records. 
• Custom settings: An IAQ monitor should be customizable so users can change settings and define alarm levels to suit different operating conditions and environments. 
• Integration capabilities: IAQ monitoring systems should be based on open standards to integrate with other hospital security systems for centralized management and control of health and safety.

How the HALO Smart Sensor helps improve air quality in hospitals

As an all-in-one device, the HALO Smart Sensor is an environmental monitoring solution designed to enhance safety and air quality in hospitals and healthcare facilities. The sensor improves air quality by continuously monitoring key environmental factors such as particulate matter, VOCs, carbon dioxide (CO2), humidity and temperature. By providing real-time data on these air quality indicators, facility managers can quickly identify and address potential air quality issues.

Additionally, HALO integrates with HVAC systems to optimize ventilation and filtration, ensuring that the air remains clean and safe for patients, visitors and staff. This proactive approach reduces the risk of airborne contaminants, promotes a healthier environment, and supports infection control efforts.

While smart sensors are key to a healthier environment, they also bolster security and safety measures. For example, the HALO Smart Sensor detects vaping, smoke and sound anomalies in privacy concern areas. It also allows patients and staff to call for help using specific keywords, such as ​‘help,’ adding a layer of security where different CCTV camera types are not permitted.

Tips for implementing indoor air quality monitors

Once you have identified a suitable hospital IAQ monitor, it’s important to implement them effectively. 

Below are some best practices to follow.

1. Assessment and planning 

For new installations or upgrades, it’s important to assess existing air quality and historical records. For example, a location may have ongoing air quality problems despite the presence of an IAQ monitor. The existing device may require an upgrade or replacement to improve monitoring performance and air quality.

2. Identify placement 

While air quality is essential throughout hospitals and healthcare facilities, certain areas may have specific safety-critical requirements. These include: 

• Operating rooms: These rooms require a sterile environment to protect patients and prevent infection during procedures. IAQ monitors need highly precise sensors to maintain optimal air quality and must detect substances from waste anesthetic gases, disinfectants and surgical smoke.
• Isolation rooms: Some patients may be placed in isolation rooms to prevent the spread of bacteria or viruses. HVAC systems constantly change the air to remove contaminants and minimize the risk of airborne transmission. IAQ monitors play a vital role in ensuring that air quality meets specified standards.
• Protected environment rooms: In these rooms, patients with weakened immune systems are shielded from contaminants from nearby areas. HVAC systems refresh the air, while IAQ monitors ensure it’s free of contaminants.

3. Integration with other building management systems 

Health and safety teams need a comprehensive view of air quality throughout the hospital. Integrating IAQ monitoring with HVAC, building management, and commercial security systems provides a unified picture, allowing adjustments to improve air quality.

For example, if air quality is poor, HVAC upgrades may help, and data from IAQ monitors can track the effectiveness of these changes with ​“before and after” records.

4. Maintenance and calibration programs 

For accurate and reliable monitoring and recording, equipment must be regularly maintained and calibrated. Maintenance teams should ensure monitors are calibrated using recognized reference standards.

5. Monitoring costs 

When calculating the cost of an indoor air quality monitor for healthcare facilities, several factors need to be considered:

• The overall number of monitors required
• Number of multi-parameter or parameter-specific monitors 
• Equipment costs 
• Installation costs 
• Scheduled maintenance and calibration costs

Conclusion

Investing in indoor air quality monitoring solutions is essential for healthcare facilities. By continuously monitoring air quality, hospitals can minimize the risk of hazardous contaminants, enhance HVAC performance and make informed decisions to improve air quality and patient and staff well-being.

The HALO Smart Sensor is the ideal solution to enhance safety and air quality in hospitals and healthcare facilities. It enables facility managers to continuously monitor environmental factors, such as particulate matter, VOCs, CO2, humidity and temperature, and collect real-time data. 

By effectively implementing indoor air quality monitors, hospitals can create a healthier and safer environment for everyone.