Brady Gráinne, Bennin Fiona, De Koning Rosaline, Vindrola-Padros Cecilia, Clark Sigrún Eyrúnardóttir, Tiwari Manish K, Watt Simon, Ducci Andrea, Torii Ryo, Morris Danielle, Lloyd-Dehler Elizabeth, Slann Jerry, Stevenson Fiona, Khadjesari Zarnie, Dehbi Hakim-Moulay, Ciric Lena, Epstein Ruth, Rubin John, Houlihan Catherine F, Hunter Rachael, Lovat Laurence B
Department of Targeted Intervention, Rapid Research Evaluation and Appraisal Lab (RREAL), University College London, UK.
Department of Mechanical Engineering, University College London, UK.
EClinicalMedicine. 2024 Dec 18;79:102990. doi: 10.1016/j.eclinm.2024.102990. eCollection 2025 Jan.
The COVID-19 pandemic highlighted the need for improved infectious aerosol concentrations through interventions that reduce the transmission of airborne infections. The aims of this review were to map the existing literature on interventions used to improve infectious aerosol concentrations in hospitals and understand challenges in their implementation.
We reviewed peer-reviewed articles identified on three databases, MEDLINE, Web of Science, and the Cochrane Library from inception to July 2024. 6417 articles were identified, 160 were reviewed and 18 were included.
Results on aerosol concentration were discussed in terms of three categories: (1) filtration and inactivation of aerosol particles; (2) effect of airflow and ventilation on aerosol concentrations; and (3) improvements or reduction in health conditions. The most common device or method that was outlined by researchers was high efficiency particulate air (HEPA) filters which were able to reduce aerosol concentrations under investigation across the included literature. Some articles were able to demonstrate the effectiveness of interventions in terms of improving health outcomes for patients.
The key finding is that infectious aerosol concentration improvement measures based on filtration, inactivation, improved air flow dynamics, and ventilation reduce the likelihood of nosocomial infections. However limitations of such approaches must be considered such as noise pollution and effects on ambient humidity. Whilst these efforts can contribute to improved air quality in hospitals, they should be considered with the other interacting factors such as microclimates, room dimensions and use of chemical products that effect air quality.
This study is funded by the National Institute for Health and Care Research (NIHR) (NIHR205439).
新冠疫情凸显了通过减少空气传播感染的干预措施来改善感染性气溶胶浓度的必要性。本综述的目的是梳理关于医院中用于改善感染性气溶胶浓度的干预措施的现有文献，并了解其实施过程中的挑战。
我们检索了三个数据库（MEDLINE、科学网和考克兰图书馆）从建库至2024年7月的同行评议文章。共识别出6417篇文章，其中160篇进行了评审，18篇被纳入。
从三个类别讨论了气溶胶浓度的结果：（1）气溶胶颗粒的过滤和灭活；（2）气流和通风对气溶胶浓度的影响；（3）健康状况的改善或降低。研究人员提及的最常见设备或方法是高效空气过滤器（HEPA），在所纳入的文献中，它能够降低所研究的气溶胶浓度。一些文章能够证明干预措施在改善患者健康结局方面的有效性。
关键发现是基于过滤、灭活、改善空气流动动力学和通风的感染性气溶胶浓度改善措施可降低医院感染的可能性。然而，必须考虑此类方法的局限性，如噪音污染和对环境湿度的影响。虽然这些努力有助于改善医院空气质量，但应结合其他相互作用的因素来考虑，如微气候、房间尺寸以及影响空气质量的化学产品的使用。
本研究由英国国家卫生与保健研究院（NIHR）资助（资助编号：NIHR205439）。
