Assessment of Indoor Air Quality in Inpatient Wards

  • Gaetano Settimo
  • Marco GolaEmail author
  • Veruscka Mannoni
  • Marco De Felice
  • Giorgio Padula
  • Ambra Mele
  • Barbara Tolino
  • Stefano Capolongo
Part of the SpringerBriefs in Public Health book series (BRIEFSPUBLIC)


Introduction. The Indoor Air Quality is a topic that in recent years is obtaining great attention in healthcare facilities. Several studies are reporting a growing number of data and research works that allow to know all the possible indoor levels and the development of management procedures (such as materials’ choice, products for cleaning and disinfection, improvement of HVAC system, etc.) in order to improve the healing environments and health of medical and technical staffs, patients, ambulatory users and visitors. Ensuring a good IAQ in hospitals is fundamentally because there are the most vulnerable category of the population for their health conditions; although the assessment of IAQ results arduous.

State of the Art. Currently in several countries are carried out air quality monitoring in those professional workplaces in which chemicals are used (i.e. operating rooms, sterilization, anticancer preparation, etc.), but also in some typically indoor spaces for the building hygiene evaluations. Therefore it determinated the definition and adoption of limits (occupational exposure limit values, threshold limit value of the Scientific Committee on Occupational Exposure Limits-VLEP or American Conference of Governmental Industrial Hygienists-TLV to be used exclusively in workplaces) or values and guidelines (such as in the case of indoor assessments, in particular the WHO’ indoor air quality guidelines).

Methodology. Starting from these considerations, Istituto Superiore di Sanità and Politecnico di Milano have launched a research work for the evaluation and detection of air quality in inpatients rooms. The survey is examining formaldehyde and VOCs, and the relative influence of thermo-hygrometric, ventilation and concentration of pollutants’ parameters.

Discussion. This paper reports the results obtained from the indoor air monitoring in inpatient rooms. Each survey, done every month, lasted between 5 and 7 days in relation to the real function use of the rooms.

Conclusion. The analysis is continuing on the inpatient rooms for controlling the indoor air values even in summer season, and, in parallel, it is expanding to more health facilities in Lombardy and Latium regions.


Healthcare facilities VOCs Acetaldehyde, formaldehyde, benzene and toluene sampling Guidelines value Preliminary investigation 



The authors and detectors thank the chief medical officers of the hospitals analyzed and all the medical staff involved in fill in the activity logs.


  1. Boccia S, Pasquarella C, Colotto M, Barchitta M, Quattrocchi A, Agodi A. Molecular epidemiology tools in the management of healthcare-associated infections: Towards the definition of recommendations. Epidemiol Prev. 2015;39(4 Suppl 1):21–6.PubMedGoogle Scholar
  2. Buffoli M, Gola M, Rostagno M, Capolongo S, Nachiero D. Making hospitals healthier: How to improve sustainability in healthcare facilities. Ann Ig. 2014;26(5):418–25. doi: 10.7416/ai.2014.2001.PubMedGoogle Scholar
  3. Capolongo S. Social aspects and well-being for improving healing processes’ effectiveness. Ann Ist Super Sanità. 2016;52(1):11–4. doi: 10.4415/ANN_16_01_05.PubMedGoogle Scholar
  4. Capolongo S, Gola M, di Noia M, Nickolova M, Nachiero D, Rebecchi A, Settimo G, Vittori G, Buffoli M. Social sustainability in healthcare facilities: A rating tool for analyzing and improving social aspects in environments of care. Ann Ist Super Sanità. 2016;52(1):15–23. doi: 10.4415/ANN_16_01_06.PubMedGoogle Scholar
  5. Cavagliato E, di Noia M, Gherardi G, Gola M, Nickolova M, Rostagno M, et al. Testing the SustHealth Evaluation System. In: Capolongo S, Bottero MC, Buffoli M, Lettieri E, editords. Improving sustainability during hospital design and operation: A multidisciplinary evaluation tool. Cham: Springer; 2015. 115–129. doi: 10.1007/978-3-319-14036-0_5.
  6. D’Alessandro D, Tedesco P, Rebecchi A, Capolongo S. Water use and water saving in Italian hospitals. A preliminary investigation. Ann Ist Super Sanità. 2016;52(1):56–62. doi: 10.4415/ANN_16_01_11.
  7. ECA-IAQ. European concerted action indoor air quality & its impact on man (formerly COST Project 61 3) environment and quality of life. Effects of indoor air pollution on human health. Report No 10. Luxembourg: European Union; EUR 14086 EN, 1991.Google Scholar
  8. ECA-IAQ. European concerted action indoor air quality & its impact on man (formerly COST Project 613) environment and quality of life. Sampling strategies for volatile organic compounds (VOCs) in indoor air. EUR 16051 EN, 1994.Google Scholar
  9. Europe. Directive 2004/107/EC of theECA-IAQ. European concerted action indoor air quality & its impact on man (formerly COST Project 613) environment and quality of life. Strategy for sampling chemical substances in indoor air. Report No 6. Luxembourg: European Union; EUR 12617 EN, 1989.Google Scholar
  10. Europe. Directive 2008/50/EC of the European Parliament and of the Council of 21 May 2008 on ambient air quality and cleaner air for Europe. Official Journal of the European Union, L 152/1. 11 June 2008.Google Scholar
  11. Fuselli S, Pilozzi A, Santarsiero A, Settimo G, Brini S, Lepore A, et al. Strategie di monitoraggio dei composti organici volatili (COV) in ambiente indoor. Roma: Istituto Superiore di Sanità; 2013. Rapporti ISTISAN 13/4.
  12. Gray WA, Vittori G, Guenther R, Vernon W, Dilwali K. Leading the way: Innovative sustainable design guidelines for operating healthy healthcare buildings. In ISIAQ. 10th International conference on healthy buildings 2012. Red Hook: Curran Associates, 2012;1:1212–17.Google Scholar
  13. Guenther R, Vittori G. Sustainable healthcare architecture. Hoboken: Wiley; 2014.Google Scholar
  14. Italia. Decreto Legislativo 9 Aprile, No. 81. Attuazione dell’articolo 1 della legge 3 agosto 2007, n. 123, in materia di tutela della salute e della sicurezza nei luoghi di lavoro. Gazzetta Ufficiale. No. 101. 30 Aprile 2008.Google Scholar
  15. Italia. Decreto Legislativo 13 Agosto, No.155. Attuazione della direttiva 2008/50/CE relativa alla qualità dell’aria ambiente e per un’aria più pulita in Europa. No. 2016, Gazzetta Ufficiale Supplemento Ordinario, No. 217. 15 Settembre 2010.Google Scholar
  16. ISO. Indoor air. Part 1: General aspects of sampling strategy. Geneva: ISO; 2004a. 16000-1.
  17. ISO. Indoor air. Part 4: Determination of formaldehyde. Diffusive sampling method. Geneva: ISO; 2004b. 16000-4.
  18. ISO. Indoor air. Part 5: Sampling strategy for volatile organic compounds (VOCs). Geneva: ISO; 2007. 16000-5.
  19. Nyhan M, Sobolevsky S, Kang C, Robinson P, Corti A, Szell M, et al. Predicting vehicular emissions in high spatial resolution using pervasively measured transportation data and microscopic emissions model. Atmos Environ. 2016;140:352–63. doi: 10.1016/j.atmosenv.2016.06.018.CrossRefGoogle Scholar
  20. Oppio A, Buffoli M, Dell’Ovo M, Capolongo S. Addressing decisions about new hospitals’ siting: a multidimensional evaluation approach. Ann Ist Super Sanità. 2016;52(1):78–87. doi: 10.4415/ANN_16_01_14.
  21. Settimo G. Qualità dell’aria negli ambienti confinati: aspetti tecnici e legislativi. Workshop. La qualità dell’aria indoor: attuale situazione nazionale e comunitaria. Rapporto ISTISAN 15/04 (2015).
  22. Settimo G. Residential indoor air quality: significant parameters in light of the new trends. Ig Sanita Pubbl. 2012;68(1):136–8.PubMedGoogle Scholar
  23. Settimo G, D’Alessandro D. European community guidelines and standards in indoor air quality: what proposals for Italy. Epidemiol Prev. 2014;38(6):36–41.PubMedGoogle Scholar
  24. Vittori, G. Greening of healthcare. Location and design of facilities are essential to the mission of health. Modern healthcare. 2011; July 25.
  25. WHO. Indoor air quality research. EURO reports and studies Copenhagen: WHO. 1984. No.103.Google Scholar
  26. WHO. Strategic approaches to indoor air policy-making. Copenhagen: WHO European Centre for Environment and Health Bilthoven. 1999. Google Scholar
  27. WHO. Air quality guidelines. Global update 2005. Copenhagen: WHO. 2006.Google Scholar
  28. WHO. Guidelines for indoor air quality: selected pollutants. Copenhagen: WHO. 2010.Google Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Gaetano Settimo
    • 1
  • Marco Gola
    • 2
    Email author
  • Veruscka Mannoni
    • 1
  • Marco De Felice
    • 1
  • Giorgio Padula
    • 1
  • Ambra Mele
    • 2
  • Barbara Tolino
    • 2
  • Stefano Capolongo
    • 2
  1. 1.Department of Environment and HealthIstituto Superiore di SanitàRomeItaly
  2. 2.Department of Architecture, Built Environment and Construction EngineeringPolitecnico di MilanoMilanItaly

Personalised recommendations