September 12, 2022

Why is Indoor Air Quality Important in Healthcare Facilities

Healthcare Facilities

Table of contents 

  • Healthcare facility air pollutants
  • Effects of poor air quality in a hospital
  • HVAC systems for each hospital segment
  • Specialized hospital HVAC systems
  • Healthy indoor environments for elderly patients
  • Optimum ventilation requires monitoring

It would be difficult to think of an environment where air quality was more important than a healthcare facility. Today’s healthcare facilities, no matter what the size or specialty, have a complex set of hospital HVAC standards and requirements that must be met to maintain and improve hospital air quality. IAQ is key to the satisfaction of their employees, the stability of their bottom line and — most important — the health of their patients everywhere from the NICU (neonatal intensive care unit) to the waiting room.

This article discusses how an effective hospital HVAC system must address a wide range of specific requirements for optimal air quality requirements throughout a healthcare facility. We’ll also look at the importance of having an indoor air quality monitoring solution that tracks the effectiveness of hospital ventilation and air conditioning performance.

Healthcare facility air pollutants

Hospital ventilation systems must deal with a range of air pollutants, including:

  • PM2.5, PM10
  • VOCs
  • Formaldehyde
  • CO
  • CO2
  • NO2
  • Mercury

These common pollutants — and many more — must be monitored and eliminated. In addition to a wide range of airborne germs from patients and visitors, air quality issues can also stem from:

  • Outdoor air from near-constant foot traffic, nearby construction sites, industry or vehicles
  • Microbiological materials from treatment rooms, laboratories and staff
  • Airborne bacterial-count increases caused by housekeeping activities
  • Equipment, including furnaces and lighting systems, that keeps the facility up and running
  • Chemical contamination from from disinfection and sterilization activities
  • Carcinogenic surgical smoke gasses or anesthesia gasses in surgery rooms
  • Interior construction projects 
  • Vapors and particles from poorly selected furniture and building materials, such as paints, carpeting 

Effects of poor air quality in a hospital

Failing to meet a hospital’s indoor air quality challenges can have immediate and long-ranging consequences. Poor indoor air quality in hospitals can:

  • Cause infection, fatigue or headaches in patients
  • Impact the health and comfort of healthcare professionals and visitors

On the other hand, proper air quality can help safeguard vulnerable patients’ health, improve patient satisfaction and help those looking at the bottom line breathe easier.

An environment with a poorly maintained HVAC system can have a negative impact on health — a single illness can turn into a breakout and the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for many healthcare acquired infections. Patient satisfaction, reflected in Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey, also can impact CMS funding. And HVAC systems in hospitals will definitely impact patient satisfaction.

HVAC systems for each hospital segment 

Hospital air pollutants — depending on foot traffic and building characteristics —differ from one area of a healthcare facility to another – similarly the IAQ requirements and potential impact varies for each location. Because of this, separate ventilation systems can create a specialized microclimate for each hospital segment’s needs.

Surgery suites, for instance, have particularly stringent IAQ requirements because the chances and consequences of infection are particularly high – and the patients are especially vulnerable if a ventilation system is poorly maintained. Each state has its own requirements for temperature and humidity levels, but there is some consistency. For instance, 60% RH is commonly accepted as the maximum for operating rooms. 

Overall, proper humidity levels of 40 to 60 percent — in addition to reducing air pollution — can help protect heart patients from dangerous shocks. Proper humidity also contributes to the health of medical equipment and reduces the risk of bacterial and fungal infections.

For instance, a critical care space – such as an ICU or NICU — serves seriously ill and vulnerable patients. Airborne pollutants, drafts, temperature and humidity must be carefully monitored to protect the patients and deal with a particularly high level of staff and visitor activity.

The extreme level of activity in an emergency department can mean it can be the one of the most highly contaminated areas in the hospital. 

Similarly, waiting rooms and triage areas require special care because of potentially undiagnosed patients with airborne infectious diseases. A 2014 study from the Massachusetts Institute of Technology has shown that germ-filled droplets from coughs and sneezes travel much farther than previously believed. 

Standard patient rooms, while often housing less extreme levels of food traffic, but can be occupied 24 hours a day, must contend with additional airborne particles from their individual toilet areas. So the ventilation of bathrooms and bedpan closets, for instance, have their own specific building codes that could vary from state to state.  

Specialized high-risk areas, such as isolation units for airborne infection cases, protective gear changing rooms and biocontainment treatment areas are often created or expanded during times of crisis and, if poorly monitored, can spark potentially catastrophic outbreaks.

Laboratories are generally not crisis related. but need their own level of caution when it comes to indoor air quality. Bacteria, viral or nuclear materials as well as chemical fumes, odors, vapors, heat from equipment all present challenges to hospital air quality.

Separate from clinical activity, administration areas such as lobbies, record rooms admitting departments and record storage areas and business offices need separate ventilation systems to maintain the comfort and safety of workers and equipment.

Healthy indoor environments for elderly patients

Healthcare organizations that mainly serve the elderly — such as nursing homes and memory care facilities — also must keep IAQ top of mind. A 2015 study examining how Indoor air quality relates to respiratory issues in elderly nursing homes residents has shown that older people are more likely to be adversely affected by even moderate levels of air pollution. Couple that with an increased vulnerability to germs and communal living arrangements, and maintaining consistent good air quality is even more important.

Specialized HVAC systems in hospitals

The issues a busy healthcare facility must address are daily challenges for healthcare facility professionals. The fact that a hospital’s HVAC system must perform many functions makes maintaining air quality even more complex.

An effective ventilation system must filter, maintain proper temperature and humidity, pressurize or exhaust the air. If any of these functions is not working up to requirements, air quality suffers. For a facility that is occupied and operating 24 hours a day, 365 days a year, maintaining systems and avoiding problems is crucial.

For that reason ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) standards call for creating microclimates throughout healthcare facilities, using separate air systems and specialized, quality air filters for the different departments in the principal segments of an acute care hospital.

Environmental requirements for appropriate ventilation in each area differ according to function and activities, for instance:

  • An operating room must have a minimum of four outdoor air exchanges per hour — a minimum of 20 per hour overall. The temperature must be 68-75 degrees. 
  • The emergency department and public waiting area must have a minimum of two outdoor air exchanges per hour — a minimum of 12 per hour overall. The temperature must be 70-75 degrees. 
  • A patient room must have a minimum of two outdoor air exchanges per hour — a minimum of four per hour overall. The temperature must be 70 to 75 degrees. 

Maintaining indoor air quality in hospitals and other healthcare facilities is serious business, and provider organizations devote significant resources to making sure they have effective HVAC systems to clean the air and reduce risks to patients and staff.

Consistent appropriate ventilation levels require air monitoring

Making sure these systems are working properly and spotting issues as soon as (or before) they become problems is imperative. Atmocube is an all-in-one indoor environmental monitoring system that measures the levels of major air pollutants, as well as  atmospheric pressure, ambient noise and light to ensure a healthy indoor environment is maintained. 


Can your facility staff make IAQ decisions with real-time environmental data, building automation system integration and custom-range reports? Find out how the  Atmocube can be integrated into your current HVAC system and give them the tools to help keep staff, visitors — and most importantly patients —  safe and healthy as possible.

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