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LETTER TO EDITOR
Year : 2014  |  Volume : 1  |  Issue : 1  |  Page : 18-19

Public health measures to combat airborne infections in hospitals


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kanchipuram, Tamil Nadu, India

Date of Web Publication21-May-2014

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College & Research Institute, 3rd Floor, Ammapettai, Thiruporur-Guduvanchery Main Road, Sembakkam Post, Kanchipuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-6139.132923

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Public health measures to combat airborne infections in hospitals. J Nat Accred Board Hosp Healthcare Providers 2014;1:18-9

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Public health measures to combat airborne infections in hospitals. J Nat Accred Board Hosp Healthcare Providers [serial online] 2014 [cited 2019 Oct 17];1:18-9. Available from: http://www.nabh.ind.in/text.asp?2014/1/1/18/132923

Sir,

Historically, the emergence of respiratory infections have been attributed to the exposure of human beings to the wide gamut of airborne pathogens. [1] Most of these airborne organisms tend to get dispersed in a wide geographical area and can be inhaled by susceptible individuals who have had no direct contact with the primary source of infection. [2] This sort of airborne transmission is dreadful in healthcare settings owing to excess load of patients, poorly planned hospitals - ill-ventilated, and presence of a large number of immunosuppressed patients in the hospital settings. [3]

Airborne infection control guidelines specific to developed and developing nations have been developed by multiple international agencies for the benefit of the health care providers and the general population. [4] The proposed measures broadly comprise of interventions in three major aspects namely, administrative control; environmental control; and personal respiratory protective measures. [4],[5]

Administrative control measures have been suggested to decrease the potential settings in which a susceptible person can be exposed to infectious cases. Starting from conducting training session of hospital staff about the roles and principles/practices of infection control; to outpatient department strategies (viz. screening of patients for respiratory illness, spreading awareness to encourage cough etiquette, segregation of respiratory symptomatic in a well-ventilated waiting area, adoption of triage approach to minimize duration of stay in hospitals, seating arrangement of doctor and patients, and advocating safe sputum collection); and inpatient department measures (viz. avoiding needless hospitalization, educating patients and relatives regarding cough hygiene, and routine segregation of patients to separate infectious wards). [4],[5]

Environmental control measures have been emphasized to reduce the concentration of infectious particles which are usually present in the health care settings. It comprises of maintenance of adequate bed spacing in wards; facilitating good ventilation 24 × 7; and special attention to high-risk areas such as anti-retroviral therapy centers, bronchoscopy procedure rooms, and tuberculosis patient wards. The other strategies like encouraging natural/mechanical ventilation, air changes per hour (a measure of how many times the air within a defined space is replaced per hour), and upper room ultraviolet light have been viewed as ancillary initiatives to maintain adequate ventilation. [4],[6]

Promotion of use of personal protective equipments by health personnel and respiratory symptomatic can enormously decrease the risk of airborne transmission in the hospital premises. [5] Findings of a study has emphasized the need to adopt a multi-sectoral approach to ensure an optimal control on the droplets released by the patients. [7]

In conclusion, acknowledging the global concern of airborne infections, hospital administrators should devise a comprehensive plan to minimize the potential areas of exposure of susceptible individuals to the respiratory symptomatic cases.

 
  References Top

1.Martin PM, Martin-Granel E. 2,500-year evolution of the term epidemic. Emerg Infect Dis 2006;12:976-80.  Back to cited text no. 1
    
2.Fiegel J, Clarke R, Edwards DA. Airborne infectious disease and the suppression of pulmonary bioaerosols. Drug Discov Today 2006;11:51-7.  Back to cited text no. 2
    
3.Blachere FM, Lindsley WG, Pearce TA, Anderson SE, Fisher M, Khakoo R, et al. Measurement of airborne influenza virus in a hospital emergency department. Clin Infect Dis 2009;48:438-40.  Back to cited text no. 3
    
4.Writing Committee (CDC, WHO, IUATLD). Tuberculosis infection control in the era of expanding HIV care and treatment: An addendum to WHO guidelines for the prevention of tuberculosis in heath care facilities in resource limited settings. Geneva: WHO Press; 1999. Available from: http://www.whqlibdoc.who.int/hq/1999/WHO_TB_99.269_ADD_eng.pdf . [Last accessed on 2013 Apr 22]  Back to cited text no. 4
    
5.Ministry of Health and Family Welfare. Guidelines on airborne infection control in healthcare and other settings. Nirman Bhawan, New Delhi; 2010. Available from: http://www.tbcindia.nic.in/pdfs/Guidelines_on_Airborne_Infection_Control_April2010Provisional.pdf . [Last accessed on 2013 Apr 14]  Back to cited text no. 5
    
6.Escombe AR, Oeser CC, Gilman RH, Navincopa M, Ticona E, Pan W, et al. Natural ventilation for the prevention of airborne contagion. PLoS Med 2007;4:e68.  Back to cited text no. 6
    
7.Zayas G, Chiang MC, Wong E, MacDonald F, Lange CF, Senthilselvan A, et al. Cough aerosol in healthy participants: Fundamental knowledge to optimize droplet-spread infectious respiratory disease management. BMC Pulm Med 2012;12:11.  Back to cited text no. 7
    




 

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