Identification and Control of Health Risks in Hospital Environment from the Aspect of Users, Buildings and Systems

Background: Hospitals represent a very complex indoor environment where patients, staff and visitors are exposed to numerous health risk factors. Studies where health risk factors specific to the hospital environment are represented together are for the moment scarce, and they do not arise based on the relationship between users, buildings and systems. The purpose of this study is to identify physical, biological and chemical health risk factors and to prepare starting points for elaboration of recommendations for their prevention and control. In doing so, we took into account users, life cycle of buildings and building systems. Methods: Meta-analysis was carried out studying physical, chemical and biological health risk factors in the hospital environment. We searched Pub Med and Science Direct for peer-reviewed publications from 1934 to 2012. 634 sources of literature were included. The starting points for the preparation of recommendations were made through an upgraded method of engineering design. Results: On the basis of meta-analysis, the starting points for the preparation of recommendations were made. They include systematically defined actions specific for the hospital environment. For the prevention of physical health risk factors, actions are defined on the level of legislation, building and system design as well as worker qualifications. For the prevention of biological health risk factors, actions in the chain of infection are included and control of outdoor and indoor air pollution is provided. Conclusions: This study presents a new approach to the prevention of physical, biological and chemical health risk factors in the complex hospital environment, from the design stages to the stage of usage and maintenance. Efficiency of buildings and systems is attained through a holistic approach, taking into account the characteristics of users, hospital environment and energy use. The presented approach is necessary for the design of buildings and building systems and a basis for successful renovations.