Jafari Ahmad Jonidi, Tangestani Mahbubeh, Kermani Majid, Kalantary Roshanak Rezaei
Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
One Health. 2025 Aug 27;21:101182. doi: 10.1016/j.onehlt.2025.101182. eCollection 2025 Dec.
Bioaerosol and particulate matter (PM) from hospital waste and wastewater pose significant pathogen transmission and workplace safety risks to healthcare workers and surrounding communities, requiring thorough risk assessments. This study pioneers a comprehensive risk assessment of PM and bioaerosol emissions in waste disposal and wastewater treatment departments across four Iranian hospitals, employing cutting-edge methodologies like Failure Mode and Effective Analysis (FMEA) and Decision Matrix Risk Assessment (DMRA) to enhance the precision and efficacy of risk evaluation in these high-stakes environments. The study systematically identified 15 primary risk sources, with Risk Priority Numbers (RPN) ranging from 168 to 900. The investigation involved experts, focusing on evaluating health hazards faced by hospital staff through detailed analysis of emission risks, transmission pathways, and potential health implications of bioaerosols and PM. The research confirmed the reliability of the FMEA checklist for analyzing PM and bioaerosols in waste disposal and wastewater treatment departments, with intra-class correlation coefficients (ICC) and Cronbach's Alpha values of 0.913 and 0.619, respectively. The study revealed that most risks in hospital wards originated from two primary sources: technical device malfunctions and personnel skill deficiencies. Critical high-risk activities were identified, including direct dermal exposure to wastewater and wastes, leachate dispersal during waste transportation, and inadequate segregation of sharp and infectious wastes. The research advocates for comprehensive interventions, including staff training and systematic waste handling, to ensure a safer healthcare environment through One Health strategy integrating technical and educational measures. Thus, DMRA and FMEA are complementary methods that provide an effective risk assessment.
医院废弃物和废水中的生物气溶胶及颗粒物对医护人员和周边社区构成了重大的病原体传播和工作场所安全风险，需要进行全面的风险评估。本研究率先对伊朗四家医院的废弃物处理和废水处理部门的颗粒物及生物气溶胶排放进行了全面的风险评估，采用了失效模式与效应分析（FMEA）和决策矩阵风险评估（DMRA）等前沿方法，以提高这些高风险环境中风险评估的准确性和有效性。该研究系统地识别出15个主要风险源，风险优先数（RPN）在168至900之间。调查涉及专家，通过详细分析生物气溶胶和颗粒物的排放风险、传播途径及潜在健康影响，重点评估医院工作人员面临的健康危害。研究证实了FMEA检查表在分析废弃物处理和废水处理部门的颗粒物及生物气溶胶方面的可靠性，组内相关系数（ICC）和克朗巴哈系数（Cronbach's Alpha）分别为0.913和0.619。研究表明，医院病房中的大多数风险源于两个主要来源：技术设备故障和人员技能不足。确定了关键的高风险活动，包括直接皮肤接触废水和废弃物、废弃物运输过程中的渗滤液扩散以及尖锐和传染性废弃物分类不当。该研究倡导采取全面干预措施，包括员工培训和系统的废弃物处理，通过整合技术和教育措施的“同一健康”战略确保更安全的医疗环境。因此，DMRA和FMEA是提供有效风险评估的互补方法。
