Li Yifan, Lu Yiran, Wang Ying, Liu Li, Zhou Hao, Lin Borong, Peng Zhiyong, Yuan Yufeng
Department of Building Science, Tsinghua University, Beijing 100084, China.
Laboratory of Eco-Planning & Green Building, Ministry of Education, Tsinghua University, Beijing 100084, China.
Build Environ. 2023 Jan 15;228:109787. doi: 10.1016/j.buildenv.2022.109787. Epub 2022 Nov 12.
Chlorine-containing disinfectants are widely used in hospitals to prevent hospital-acquired severe acute respiratory syndrome coronavirus 2 infection. Meanwhile, ventilation is a simple but effective means to maintain clean air. It is essential to explore the exposure level and health effects of coronavirus disease 2019 patients' inhalation exposure to by-products of chloride-containing disinfectants under frequent surface disinfection and understand the role of ventilation in mitigating subsequent airway damage. We determined ventilation dilution performance and indoor air quality of two intensive care unit wards of the largest temporary hospital constructed in China, Leishenshan Hospital. The chloride inhalation exposure levels, and health risks indicated by interleukin-6 and D-dimer test results of 32 patients were analysed. The mean ± standard deviation values of the outdoor air change rate in the two intensive care unit wards were 8.8 ± 1.5 h (Intensive care unit 1) and 4.1 ± 1.4 h (Intensive care unit 2). The median carbon dioxide and fine particulate matter concentrations were 480 ppm and 19 μg/m for intensive care unit 1, and 567 ppm and 21 μg/m for intensive care unit 2, all of which were around the average levels of those in permanent hospitals (579 ppm and 21 μg/m). Of these patients, the median (lower quartile, upper quartile) chloride exposure time and calculated dose were 26.66 (2.89, 57.21) h and 0.357 (0.008, 1.317) mg, respectively. A statistically significant positive correlation was observed between interleukin-6 and D-dimer concentrations. To conclude, ventilation helped maintain ward air cleanliness and health risks were not observed.
含氯消毒剂在医院中被广泛用于预防医院获得性严重急性呼吸综合征冠状病毒2感染。同时，通风是保持空气清洁的一种简单而有效的手段。在频繁进行表面消毒的情况下，探索2019冠状病毒病患者吸入含氯消毒剂副产品的暴露水平及其对健康的影响，并了解通风在减轻随后气道损伤中的作用至关重要。我们测定了中国最大的临时医院——雷神山医院两个重症监护病房的通风稀释性能和室内空气质量。分析了32例患者的氯吸入暴露水平以及白细胞介素-6和D-二聚体检测结果所显示的健康风险。两个重症监护病房的室外换气次数平均值±标准差分别为8.8±1.5次/小时（重症监护病房1）和4.1±1.4次/小时（重症监护病房2）。重症监护病房1的二氧化碳和细颗粒物浓度中位数分别为480 ppm和19μg/m³，重症监护病房2为567 ppm和21μg/m³，均接近永久性医院的平均水平（579 ppm和21μg/m³）。在这些患者中，氯暴露时间和计算剂量的中位数（下四分位数，上四分位数）分别为26.66（2.89，57.21）小时和0.357（0.008，1.317）毫克。白细胞介素-6和D-二聚体浓度之间存在统计学上显著的正相关。综上所述，通风有助于保持病房空气清洁，未观察到健康风险。
