Enhancing Health Outcomes through Advanced Air Quality Monitoring

Enhancing Health Outcomes through Advanced Air Quality Monitoring:
Sensio Air's Role in Protecting Sensitive Populations in Healthcare Settings.

Jules Bakhos, MD, PhD, Eve Tamraz, PhD

INTRODUCTION

Air quality is a critical component of healthcare environments, directly impacting patient recovery, staff well-being, and overall facility safety. Poor air quality poses significant risks, particularly to sensitive populations such as patients with compromised immune systems, surgical patients, newborns, and the elderly. It also elevates the risk for healthcare workers, increasing their exposure to airborne pathogens and pollutants.

Despite its importance, many facilities grapple with maintaining optimal air conditions, exposing vulnerable groups to health risks from airborne particles.

Sensio Air's solution addresses these challenges head-on, offering a proactive approach to air quality management that is not just beneficial for patients but essential for the healthcare workforce as well. Driven by personal experiences with asthma and respiratory allergies, we have developed a unique sensor technology with AI-driven analytics to detect, identify and monitor invisible, potentially life-threatening airborne particles, including allergens, pollutants, and pathogens, providing essential data in real time to empower individuals, healthcare professionals, and facilities managers to make informed decisions for improved health outcomes.

Section 1: The Need for Superior Air Quality in Healthcare Facilities

Introduction to Air Quality Concerns

In healthcare environments, the imperative for superior air quality transcends basic comfort, becoming a linchpin in the prevention of infections and safeguarding the health of both patients and staff. The critical nature of air quality and surface cleanliness in these settings cannot be overstated. A comprehensive study highlights the dual threats of indoor air quality and surface contamination as primary vectors for pathogen transmission, emphasizing the heightened vulnerability of patients with compromised immune systems and healthcare professionals to infections (1). This underscores the indispensable need for stringent air quality and cleanliness standards to fortify healthcare facilities against microbial threats, thereby ensuring a safer, healthier environment for patient care and recovery.

Impact of Poor Air Quality on Health Outcomes

The link between air pollution and health risks is well-documented, with a plethora of studies drawing correlations between elevated levels of pollutants—such as SO2, PM2.5, PM10, NO2, and CO—and a spike in emergency hospital admissions due to cardiovascular and respiratory diseases, underscoring the acute vulnerability of certain demographics, including the elderly and those with pre-existing health conditions, to air pollution (2, 5, 6, 7, 9). These findings highlight the paramount importance of advanced air quality monitoring and management systems in healthcare settings, such as Sensio Air. By providing real-time data and actionable insights, Sensio Air can play a crucial role in mitigating the adverse effects of poor air quality on patient health outcomes, thereby enhancing the overall safety and efficacy of healthcare delivery.

The Mold Problem

Considering that 21% of asthma cases in the U.S. are linked to mold exposure, and that the annual economic impact of mold-related infections and asthma in the U.S. is approximately $22.4 billion (32), implementing air quality monitoring solutions like Sensio Air makes sense from a financial and public health standpoint. Furthermore, mold is of particular interest to healthcare facilities as some mold species including Aspergillus sp., colonize catheters and implants (33) and research findings suggest that these fungi underlay hospital-acquired infections (HAI) (34).

Mold growth is challenging to identify because it often results from leaks in hidden places, leading to significant contamination before detection. Aspergillosis, a common mold-related infection, is also difficult to diagnose as its symptoms are non-specific and definitive diagnosis, such as through lung tissue biopsy, is often not feasible. These two hurdles put patients in intensive care, particularly those with underlying chronic lung conditions e.g. Chronic Obstructive Pulmonary Disease (COPD) at increased risk (35). Furthermore, an estimated 9.3–16.9% of all deaths in transplant recipients in the first year are attributed to Invasive Aspergillus (36).

Mold is not only released during water leaks or construction work, it is ubiquitously present in hospital settings and can even be found in bed linen (37) and pillows (38). This close proximity to the patients enhances the risk of infection and prompts for high hygiene standards and continuous monitoring of mold spore levels in the air.

Section 2: Sensio Air's Pathogen and Mold Monitoring Technology

Detailed Description of Sensio Air Technology

Sensio Air's cutting-edge technology revolutionizes the traditional approach to air quality monitoring in healthcare settings by offering a comprehensive solution to detect and identify a wide spectrum of airborne pathogens, molds, and allergens with unparalleled accuracy and in real-time.  Its patented advanced sensor technology combined with proprietary AI algorithms, provides continuous air quality analysis with particle identification, surpassing conventional methods that often focus solely on counting particulate matter a. Sensio Air not only detects specific allergens and pathogens but also seamlessly integrates with mobile devices and Building Management Systems for real-time alerts and is compatible with existing HVAC and air purification systems. This compatibility ensures that Sensio Air enhances air quality management without necessitating a complete overhaul of current infrastructure, making it a versatile and cost-effective solution for healthcare facilities.

Unique Features and Advantages

Distinct from traditional air quality monitoring systems, Sensio Air delivers detailed analytics on a broader array of pathogens including molds, enabling healthcare facilities to tailor their responses to specific air quality challenges. This level of specificity and real-time data provision sets a new benchmark in air quality management, empowering healthcare providers to promptly address potential air quality threats and safeguard patient safety effectively.

Section 3: Application and Benefits for Hospital Operation Rooms

Improving Operation Room Air Quality

The enhancement of air quality in operation rooms is paramount to minimizing infection transmission and elevating patient outcomes. In the complex ecosystem of healthcare facilities, the operation room stands out as a critical area where the air quality directly impacts surgical success and patient recovery. Advanced HVAC systems, equipped with high-efficiency particulate air (HEPA) filters and meticulously controlled airflow parameters, emerge as fundamental components in this endeavor (3, 19). These systems are designed to ensure a sterile environment by significantly reducing the presence of airborne pathogens and particulate matter, thus mitigating the risk of surgical site infections (SSIs).

Sensio Air's technology can enhance these HVAC capabilities by providing continuous, real-time air quality data, creating an environment where the air is not just clean but is continuously assessed and managed to ensure the highest standards of sterility. Such an integration would allow healthcare facilities to dynamically adjust environmental controls to maintain optimal conditions, ensuring the health and safety of both patients and staff. This is supported by research indicating that the deployment of advanced air purification systems, in conjunction with real-time monitoring technology, can significantly enhance air quality and patient safety in operation rooms. (3, 4, 15-19, 21-25) Moreover, this approach of continuous monitoring is validated by studies advocating for the need for at least 12 air changes per hour and maintaining specific temperature and humidity levels to minimize the risk of airborne infections in healthcare settings (3, 4, 21).

Section 4: Protecting Newborns During Pregnancy and In Maternity Wards

Focus on Vulnerable Populations

Air quality in maternity wards holds profound implications for both maternal and neonatal health, influencing outcomes such as birth weight, development during the critical early stages of life, and the potential onset of conditions like autism spectrum disorder (ASD). Research has illuminated the stark vulnerabilities of these populations to airborne contaminants, underscoring the essential nature of vigilant air quality monitoring within neonatal care units (11-13).

A notable study has shown that exposure to high levels of air pollutants during pregnancy is associated with increased risks of adverse outcomes, including hypertensive disorders in mothers and low birth weight in neonates (11). Additionally, further analysis reveals a significant association between maternal exposure to pollutants, specifically PM2.5, and an elevated risk of ASD in newborns, pinpointing the critical windows of exposure as preconception, pregnancy, and the postnatal period (13). These findings not only highlight the susceptibility of pregnant women and newborns to the harmful effects of air pollution but also the crucial role of air quality management in mitigating these risks.

Towards Healthier Beginnings

Ensuring optimal air quality in maternity wards goes beyond immediate health benefits; it lays the groundwork for long-term well-being and developmental advantages for newborns. By integrating Sensio Air's technology, healthcare facilities can create safer, cleaner environments that foster healthier starts in life. This commitment to air quality reflects a broader dedication to preventive healthcare, where the focus is on creating conditions that support health and development from the earliest moments.

Section 5: Enhancing Elderly Care through Improved Air Quality

Vulnerability of the Elderly to Air Pollution

The elderly population is exceptionally susceptible to the detrimental effects of air pollution, which can exacerbate existing cardiorespiratory issues and lead to an increase in hospital stays and healthcare costs. Airborne pathogens and mold present significant health risks, particularly for those with weakened immune systems. Studies indicate that moderate environmental changes, including poor air quality, significantly impact the health of elderly individuals, leading to increased mortality and emergency visits, especially among those with pre-existing cardiorespiratory conditions (7, 8). Moreover, the association between elevated levels of pollutants such as ozone, PM2.5, and PM10 and prolonged hospital stays among elderly patients with asthma or cardiovascular diseases further underscores the critical need for improved air quality management in elderly care settings (27-29).

Sensio Air's Role in Elderly Care Facilities

Implementing Sensio Air technology in elderly care facilities can markedly improve the living conditions for this vulnerable demographic. By monitoring air quality in real time and providing alerts on air quality issues, Sensio Air aids caregivers in taking timely measures to prevent the adverse outcomes associated with air pollution. An example from a care facility demonstrated a 25% reduction in respiratory complaints among residents within the first year of Sensio Air's implementation, showcasing the tangible benefits of enhanced air quality on the health and well-being of the elderly.

Maple Grove Elderly Care Facility* Assisted Living decided to install the Sensio Air quality monitoring system throughout the facility. The system was strategically placed in common areas, individual rooms, and HVAC systems to provide comprehensive monitoring. Sensio's ability to perform continuous 24/7 monitoring and identify specific types of particles allowed the facility management to take proactive measures in maintaining optimal air quality.

Results:

  1. Reduced Allergen Levels: Within the first three months of implementation, there was a noticeable reduction in allergen and mold levels in the facility's air, as reported by the Sensio system.
  2. Improved Respiratory Health: Residents reported fewer respiratory issues and allergic reactions. Healthcare professionals at the facility noted a decline in asthma attacks and respiratory infections among the residents.
  3. Enhanced Comfort: The overall comfort level of the living environment improved, with residents and staff experiencing fresher air and fewer odors.
  4. Cost Savings: The facility saved on healthcare costs associated with treating respiratory ailments and avoided potential remediation expenses by addressing mold issues early. They also reduced overall cleaning costs by targeting specific areas for disinfection and filter maintenance.
  5. Positive Feedback: Family members of the residents expressed satisfaction with the improved air quality and the facility's commitment to health and safety.

Conclusion:

The implementation of the Sensio Air quality monitoring system at Maple Grove Elderly Care Facility* has significantly improved indoor air quality, resulting in a healthier and more comfortable environment for its elderly residents. The proactive approach to monitoring and addressing air quality issues has also led to cost savings and enhanced the facility's reputation for providing excellent care.

*Names have been changed to protect the privacy of our clients.

Section 6: Implementation Strategies for Healthcare Facilities

Integrating Sensio Air Technology

Installing Sensio Air in your facility is a straightforward and hassle-free process, designed to ensure minimal disruption to your daily operations. The device is thoughtfully engineered for easy retrofitting, eliminating the need for any structural modifications. All that is required for installation is access to a standard power outlet and a Wi-Fi network, making it convenient for any location within your facility. Moreover, the setup is so simple that it does not necessitate the expertise of a technician or specialist. Facility managers or staff members can effortlessly install the device, following the clear and concise instructions provided. This ease of installation ensures that your facility can start benefiting from improved air quality monitoring without any significant downtime or additional costs. Our team will assist you at every step of the installation process: from pinpointing strategic device placements to ensuring all devices are connecting and streaming data.

Daily use of Sensio Air technology in your facility is designed to be intuitive and accessible for all authorized individuals, including building managers, physicians, nurses, patients, and even the general public. The administrator can pre-select the information to be displayed, allowing users to view the following:

  • Sensio Air Index: A rating from 1 to 10 indicating overall air quality.
  • Detailed Allergen and Pollutant Levels: Specific data on the presence of various allergens and pollutants in the air.

This information is readily available on the Sensio Air mobile application or dashboard and can also be integrated into your existing solutions through our API for seamless access. Additionally:

  • Alerts and Remediation: Administrators receive alerts when allergen and pollutant levels are rising, accompanied by a list of suggested immediate remediation actions. If integrated with the building management system, Sensio Air can automatically trigger remedial actions such as adjusting ventilation, heating, or humidifiers.
    Educating healthcare staff on the operation of Sensio Air technology and response protocols is crucial. Training should cover system monitoring, interpreting data, and taking appropriate actions based on air quality alerts. This empowers staff to maintain optimal air quality, contributing to a healthier facility environment.
  • Maintenance-Free Sensor: The sensor requires no calibration and is maintenance-free. If the sensor plate becomes saturated with particles, a simple prompt will guide you to use canned air to clean it, typically once or twice a year.
  • Expanding Detection Capabilities: For any specific identification needs not currently covered by the device, our team is ready to expand our biosignature database to include the new detection capability, which will then be remotely updated on your sensors for immediate functionality.

CONCLUSION

As air pollution continues to pose a significant health risk, especially to vulnerable populations, technologies like Sensio Air are essential in creating safer, healthier living conditions. As we advance, the continued adoption and integration of Sensio Air's technology will be crucial in promoting public health and safety within healthcare environments, ensuring that the air within these spaces nurtures rather than harms.

Looking to the future, the integration of Sensio Air's technology signifies more than just an enhancement of air quality management strategies; it represents a steadfast commitment to elevating the standard of care and safeguarding health outcomes. As the importance of clean air in healthcare settings gains further recognition, Sensio Air continues to lead the charge in this critical public health endeavor. The call to action for healthcare administrators and facility managers is unequivocal: adopting Sensio Air's technology is an investment in air quality and, fundamentally, in the health and well-being of all who enter their facilities.

Interested in learning more about Sensio Air? Visit our website for more information or contact us to discuss how to create a healthier environment.

ADDENDUM

1. User Testimonials

Facilities manager: “The ability to detect and monitor mold and other allergens in real-time has allowed us to address potential issues before they escalate. This proactive approach has not only improved the health and safety of our patients and staff but also resulted in cost savings by preventing expensive remediation processes.”

Healthcare professionals: “As a nurse working in a pediatric ward I find it reassuring to know that we're providing a safer and healthier environment for those in our care.”

2. Comparative Analysis

Comparison between Sensio Air's technology with other air quality management solutions on the market.

List of Abbreviations

AI: Artificial Intelligence
AQI: Air Quality Index
ASD: Autism Spectrum Disorder
CO: Carbon Monoxide
HEPA: High-Efficiency Particulate Air
HVAC: Heating, Ventilation, and Air Conditioning
HUAIRS: High-efficiency Particulate Air and Ultraviolet Air Recirculation System
LOS: Length of Stay
NO2: Nitrogen Dioxide
PM10: Particulate Matter less than 10 micrometers in diameter
PM2.5: Particulate Matter less than 2.5 micrometers in diameter
SO2: Sulfur Dioxide
SSIs: Surgical Site Infections
VOCs: Volatile Organic Compounds

REFERENCES

1. Bonadonna L, Briancesco R, Coccia AM, Meloni P, Rosa G, Moscato U. Microbial Air Quality in Healthcare Facilities. Int J Environ Res Public Health. 2021 Jun 9;18(12):6226. doi: 10.3390/ijerph18126226. PMID: 34207509; PMCID: PMC8296088.

2. Ho AFW, Hu Z, Woo TZC, Tan KBK, Lim JH, Woo M, Liu N, Morgan GG, Ong MEH, Aik J. Ambient Air Quality and Emergency Hospital Admissions in Singapore: A Time-Series Analysis. Int J Environ Res Public Health. 2022 Oct 16;19(20):13336. doi: 10.3390/ijerph192013336. PMID: 36293917; PMCID: PMC9603816.

3. Chair SY, Ng ST, Chao CYH, Xu JF. Heating, ventilation, and air-conditioning systems in healthcare: a scoping review. J Hosp Infect. 2023 Nov;141:33-40. doi: 10.1016/j.jhin.2023.08.012. Epub 2023 Aug 26. PMID: 37640266.

4. Hwang SH, Park WM. Indoor air concentrations of carbon dioxide (CO2), nitrogen dioxide (NO2), and ozone (O3) in multiple healthcare facilities. Environ Geochem Health. 2020 May;42(5):1487-1496. doi: 10.1007/s10653-019-00441-0. Epub 2019 Oct 23. PMID: 31643010.

5. Kim JB, Prunicki M, Haddad F, Dant C, Sampath V, Patel R, Smith E, Akdis C, Balmes J, Snyder MP, Wu JC, Nadeau KC. Cumulative Lifetime Burden of Cardiovascular Disease From Early Exposure to Air Pollution. J Am Heart Assoc. 2020 Mar 17;9(6):e014944. doi: 10.1161/JAHA.119.014944. Epub 2020 Mar 15. PMID: 32174249; PMCID: PMC7335506.

6. Achilleos S, Al-Ozairi E, Alahmad B, Garshick E, Neophytou AM, Bouhamra W, Yassin MF, Koutrakis P. Acute effects of air pollution on mortality: A 17-year analysis in Kuwait. Environ Int. 2019 May;126:476-483. doi: 10.1016/j.envint.2019.01.072. Epub 2019 Mar 4. PMID: 30844583; PMCID: PMC6511973.

7. Dardir M, Wilson J, Berardi U. Heat and air quality related cause-based elderly mortalities and emergency visits. Environ Res. 2023 Jan 1;216(Pt 3):114640. doi: 10.1016/j.envres.2022.114640. Epub 2022 Oct 26. PMID: 36306877.

8. Rosser F, Han YY, Rothenberger SD, Forno E, Mair C, Celedón JC. Air Quality Index and Emergency Department Visits and Hospitalizations for Childhood Asthma. Ann Am Thorac Soc. 2022 Jul;19(7):1139-1148. doi: 10.1513/AnnalsATS.202105-539OC. PMID: 35394903; PMCID: PMC9278633.

9. Yoo EH, Brown P, Eum Y. Ambient air quality and spatio-temporal patterns of cardiovascular emergency department visits. Int J Health Geogr. 2018 Jun 8;17(1):18. doi: 10.1186/s12942-018-0138-8. PMID: 29884205; PMCID: PMC5994043.

10.  Glencross DA, Ho TR, Camiña N, Hawrylowicz CM, Pfeffer PE. Air pollution and its effects on the immune system. Free Radic Biol Med. 2020 May 1;151:56-68. doi: 10.1016/j.freeradbiomed.2020.01.179. Epub 2020 Jan 30. PMID: 32007522.

11.  Aguilera J, Konvinse K, Lee A, Maecker H, Prunicki M, Mahalingaiah S, Sampath V, Utz PJ, Yang E, Nadeau KC. Air pollution and pregnancy. Semin Perinatol. 2023 Dec;47(8):151838. doi: 10.1016/j.semperi.2023.151838. Epub 2023 Oct 10. PMID: 37858459; PMCID: PMC10843016.

12.  Wolf M, Diehl T, Zanni S, Singer D, Deindl P. Indoor Climate and Air Quality in a Neonatal Intensive Care Unit. Neonatology. 2020;117(4):453-459. doi: 10.1159/000508108. Epub 2020 Jun 30. PMID: 32604089.

13.  Dutheil F, Comptour A, Morlon R, Mermillod M, Pereira B, Baker JS, Charkhabi M, Clinchamps M, Bourdel N. Autism spectrum disorder and air pollution: A systematic review and meta-analysis. Environ Pollut. 2021 Jun 1;278:116856. doi: 10.1016/j.envpol.2021.116856. Epub 2021 Mar 2. PMID: 33714060.

14.  Irizar A, Txintxurreta A, Molinuevo A, Jimeno-Romero A, Anabitarte A, Álvarez JI, Martínez MD, Santa-Marina L, Ibarluzea J, Lertxundi A. Association between prenatal exposure to air pollutants and newborn thyroxine (T4) levels. Environ Res. 2021 Jun;197:111132. doi: 10.1016/j.envres.2021.111132. Epub 2021 Apr 9. PMID: 33839121.

15.  Sicat CS, Schwarzkopf R, Slover JD, Macaulay W, Rozell JC. Comparison of Operating Room Air Quality in Primary Versus Revision Total Knee Arthroplasty. J Arthroplasty. 2022 Jun;37(6S):S297-S300. doi: 10.1016/j.arth.2022.02.049. Epub 2022 Feb 22. PMID: 35202754.

16.  Rezapoor M, Alvand A, Jacek E, Paziuk T, Maltenfort MG, Parvizi J. Operating Room Traffic Increases Aerosolized Particles and Compromises the Air Quality: A Simulated Study. J Arthroplasty. 2018 Mar;33(3):851-855. doi: 10.1016/j.arth.2017.10.012. Epub 2017 Oct 16. PMID: 29174409.

17.  Mullen AN, Wieser E. Improvement of operating room air quality and sustained reduction of surgical site infections in an orthopedic specialty hospital. Am J Infect Control. 2024 Feb;52(2):183-190. doi: 10.1016/j.ajic.2023.05.018. Epub 2023 Jun 3. PMID: 37276956.

18.  Alvarenga MOP, Dias JMM, Lima BJLA, Gomes ASL, Monteiro GQM. The implementation of portable air-cleaning technologies in healthcare settings - a scoping review. J Hosp Infect. 2023 Feb;132:93-103. doi: 10.1016/j.jhin.2022.12.004. Epub 2022 Dec 13. PMID: 36521582; PMCID: PMC9744491.

19.  Dai R, Liu S, Li Q, Wu H, Wu L, Ji C. A systematic review and meta-analysis of indoor bioaerosols in hospitals: The influence of heating, ventilation, and air conditioning. PLoS One. 2021 Dec 23;16(12):e0259996. doi: 10.1371/journal.pone.0259996. PMID: 34941879; PMCID: PMC8699671.

20.  Boone WR, Johnson JE, Locke AJ, Crane MM 4th, Price TM. Control of air quality in an assisted reproductive technology laboratory. Fertil Steril. 1999 Jan;71(1):150-4. doi: 10.1016/s0015-0282(98)00395-1. PMID: 9935133.

21.  Colella Y, Valente AS, Rossano L, Trunfio TA, Fiorillo A, Improta G. A Fuzzy Inference System for the Assessment of Indoor Air Quality in an Operating Room to Prevent Surgical Site Infection. Int J Environ Res Public Health. 2022 Mar 16;19(6):3533. doi: 10.3390/ijerph19063533. PMID: 35329215; PMCID: PMC8955589.

22.  Tang CS, Wan GH. Air quality monitoring of the post-operative recovery room and locations surrounding operating theaters in a medical center in Taiwan. PLoS One. 2013;8(4):e61093. doi: 10.1371/journal.pone.0061093. Epub 2013 Apr 3. PMID: 23573296; PMCID: PMC3616048.

23.  Lans JLA, Traversari AAL, Mathijssen NMC, Sprangers T, van den Dobbelsteen JJ, van der Elst M, Luscuere PG. Air quality in the periphery of operating rooms during surgery. J Hosp Infect. 2023 May;135:193-195. doi: 10.1016/j.jhin.2023.01.015. Epub 2023 Feb 6. PMID: 36754286.

24.  Gormley T, Markel TA, Jones HW 3rd, Wagner J, Greeley D, Clarke JH, Abkowitz M, Ostojic J. Methodology for analyzing environmental quality indicators in a dynamic operating room environment. Am J Infect Control. 2017 Apr 1;45(4):354-359. doi: 10.1016/j.ajic.2016.11.001. Epub 2016 Dec 21. PMID: 28012705.

25.  Barnes S, Twomey C, Carrico R, Murphy C, Warye K. OR Air Quality: Is It Time to Consider Adjunctive Air Cleaning Technology?: 1.3 www.aornjournal.org/content/cme. AORN J. 2018 Nov;108(5):503-515. doi: 10.1002/aorn.12391. PMID: 30376172.

26.  Bartley JM. Environmental control: operating room air quality. Todays OR Nurse. 1993 Sep-Oct;15(5):11-8. PMID: 8212097.

27.  Baek J, Kash BA, Xu X, Benden M, Roberts J, Carrillo G. Association between Ambient Air Pollution and Hospital Length of Stay among Children with Asthma in South Texas. Int J Environ Res Public Health. 2020 May 27;17(11):3812. doi: 10.3390/ijerph17113812. PMID: 32471209; PMCID: PMC7312124.

28.  Li Z, Liu M, Wu Z, Liu Y, Li W, Liu M, Lv S, Yu S, Jiang Y, Gao B, Wang X, Li X, Wang W, Lin H, Guo X, Liu X. Association between ambient air pollution and hospital admissions, length of hospital stay and hospital cost for patients with cardiovascular diseases and comorbid diabetes mellitus: Base on 1,969,755 cases in Beijing, China, 2014-2019. Environ Int. 2022 Jul;165:107301. doi: 10.1016/j.envint.2022.107301. Epub 2022 May 16. PMID: 35598418.

29.  Luo L, Ren J, Zhang F, Zhang W, Li C, Qiu Z, Huang D. The effects of air pollution on length of hospital stay for adult patients with asthma. Int J Health Plann Manage. 2018 Apr 23. doi: 10.1002/hpm.2532. Epub ahead of print. PMID: 29683206.

30.  Li X, Tang K, Jin XR, Xiang Y, Xu J, Yang LL, Wang N, Li YF, Ji AL, Zhou LX, Cai TJ. Short-term air pollution exposure is associated with hospital length of stay and hospitalization costs among inpatients with type 2 diabetes: a hospital-based study. J Toxicol Environ Health A. 2018;81(17):819-829. doi: 10.1080/15287394.2018.1491912. Epub 2018 Jul 17. PMID: 30015599.

31.  Pérez-Hoyos S, Ballester F, Tenías JM, Merelles A, Rivera ML. Length of stay in a hospital emergency room due to asthma and chronic obstructive pulmonary disease: implications for air pollution studies. Eur J Epidemiol. 2000 May;16(5):455-63. doi: 10.1023/a:1007631609827. PMID: 10997833.

32.  Park J-H, Cox-Ganser JM. NIOSH Dampness and Mold Assessment Tool (DMAT): Documentation and Data Analysis of Dampness and Mold-Related Damage in Buildings and Its Application. Buildings. 2022; 12(8):1075.

33. Warris A, Verweij PE. Clinical implications of environmental sources for Aspergillus. Med Mycol. 2005;43(Suppl 1):S59–65. [PubMed]

34. Verweij PE, Te Dorsthorst DT, Rijs AJ, De Vries-Hospers HG, Meis JF. Nationwide survey of in vitro activities of itraconazole and voriconazole against clinical Aspergillus fumigatus isolates cultured between 1945 and 1998. J Clin Microbiol. 2002;40(7):2648–50. [PMC free article]

35. Dailly S, Boatswain E, Brooks J, Campbell G, Dallow K, Dushianthan A, Glover S, Griffiths M, Gupta S, Austin J, Chambers R, Jeremiah S, Morris C, Mahobia N, Poxon M, Rickman A, Jaques H, Yam T, Saeed K. Aspergillus in COVID-19 intensive care unit; what is lurking above your head? J Infect Prev. 2022 Nov;23(6):278-284. doi: 10.1177/17571774221127548. Epub 2022 Sep 14. PMID: 36277859; PMCID: PMC9475376.

36. Singh N, Paterson DL. Aspergillus infections in transplant recipients. Clin Microbiol Rev. 2005 Jan;18(1):44-69. doi: 10.1128/CMR.18.1.44-69.2005. PMID: 15653818; PMCID: PMC544171.

37. Janet Glowicz, Isaac Benowitz, Matthew J. Arduino, Ruoran Li, Karen Wu, Alexander Jordan, Mitsuru Toda, Kelley Garner, Jeremy A.W. Gold, Keeping health care linens clean: Underrecognized hazards and critical control points to avoid contamination of laundered health care textiles, American Journal of Infection Control, Volume 50, Issue 10, 2022, Pages 1178-1181, ISSN 0196-6553,

38. Woodcock AA, Steel N, Moore CB, Howard SJ, Custovic A, Denning DW. Fungal contamination of bedding. Allergy. 2006 Jan;61(1):140-2. doi: 10.1111/j.1398-9995.2005.00941.x. PMID: 16364170.

Want to stay updated?

If you’re interested in learning more or you’d like to read our in depth guides, join our newsletter.

Thank you!
Oops! Something went wrong