Overberger P A, Wadowsky R M, Schaper M M
University of Pittsburgh Graduate School of Public Health, Department of Infectious Diseases and Microbiology, PA 15261, USA.
Am Ind Hyg Assoc J. 1995 Jul;56(7):706-12. doi: 10.1080/15428119591016737.
This study was conducted over 30 weeks on a hospital floor undergoing partial renovation. Some patients housed on the floor were immunosuppressed, including bone marrow transplant recipients. The construction zone was placed under negative pressure and was separated from patient rooms by existing hospital walls and via erection of a temporary barrier. Other control measures minimized patient exposure to airborne materials. Air sampling was done for 3 weeks prior to construction, 24 weeks during construction, and 3 weeks after renovation was completed. Airborne particulate concentrations, total spore counts, particle size, and fungal species were assessed. At the beginning of the renovation there were increases in airborne particulates (from 0.2 to 2.0 mg/m3) and fungal spores (from 3.5 to 350 colony forming units (CFU/m3), but only in the construction zone. Throughout the remainder of the renovation, particulate and fungal spore levels fluctuated inside the construction zone but remained close to baseline values in the patient area. When renovation was completed, particulates and spore counts inside the construction zone decreased to preconstruction levels. The primary fungus isolated from air samples was Penicillium. This study demonstrated that control measures were effective in reducing exposures of hospitalized patients to airborne particulates and spores and in reducing the increased risk of aspergillosis and other fungal infections associated with hospital construction projects. The data from this study may be useful in establishing exposure guidelines for other health care settings.
本研究在进行部分翻新的医院楼层上开展，为期30周。该楼层收治的部分患者存在免疫抑制情况，包括骨髓移植受者。施工区域保持负压，并通过医院现有墙壁以及设置临时屏障与病房隔开。其他控制措施将患者接触空气传播物质的情况降至最低。在施工前3周、施工期间24周以及翻新完成后3周进行了空气采样。评估了空气传播颗粒物浓度、总孢子计数、粒径和真菌种类。翻新开始时，空气传播颗粒物（从0.2毫克/立方米增至2.0毫克/立方米）和真菌孢子（从3.5菌落形成单位/立方米增至350菌落形成单位/立方米）有所增加，但仅在施工区域。在翻新的其余时间里，施工区域内的颗粒物和真菌孢子水平波动，但患者区域的水平仍接近基线值。翻新完成后，施工区域内的颗粒物和孢子计数降至施工前水平。从空气样本中分离出的主要真菌是青霉菌。本研究表明，控制措施有效地减少了住院患者接触空气传播颗粒物和孢子的情况，并降低了与医院建设项目相关的曲霉病和其他真菌感染风险增加的情况。本研究的数据可能有助于为其他医疗环境制定接触指南。
