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Assessment of bioaerosols in tuberculosis high-risk areas of health care facilities in central Thailand

Jarmmaree Sornboot
Jarmmaree Sornboot
, 
Wichai Aekplakorn
Wichai Aekplakorn
, 
Pongrama Ramasoota
Pongrama Ramasoota
, 
Surat Bualert
Surat Bualert
, 
Somying Tumwasorn
Somying Tumwasorn
 et 
Wiroj Jiamjarasrangsi
Wiroj Jiamjarasrangsi
   | 30 avr. 2019
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Article Category: Original article
Publié en ligne: 30 avr. 2019
Pages: 55 - 63
DOI: https://doi.org/10.1515/abm-2019-0002
Mots clés
© 2018 Jarmmaree Sornboot et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Figure 1

Concentrations of airborne bacteria and fungi, indoors (black bars) and outdoors (gray bars), in the emergency department, TB clinic, bronchoscopy unit, TB ward, and all areas (total). Error bars indicate SD from the mean (indicated above bars). SD, standard deviation; TB, tuberculosis
Concentrations of airborne bacteria and fungi, indoors (black bars) and outdoors (gray bars), in the emergency department, TB clinic, bronchoscopy unit, TB ward, and all areas (total). Error bars indicate SD from the mean (indicated above bars). SD, standard deviation; TB, tuberculosis

Figure 2

Size distributions of indoor airborne bacteria and fungi in emergency department, TB clinic, bronchoscopy unit, TB ward, and all areas (total). Median concentration (cfu/m3) at each Andersen impactor stage is indicated within the stacked bars. The stages are coded according to the key at the bottom of the Figure.TB, tuberculosis
Size distributions of indoor airborne bacteria and fungi in emergency department, TB clinic, bronchoscopy unit, TB ward, and all areas (total). Median concentration (cfu/m3) at each Andersen impactor stage is indicated within the stacked bars. The stages are coded according to the key at the bottom of the Figure.TB, tuberculosis

Comparison of factors and indoor airborne bioaerosol concentration using linear regression

FactorBacteria (cfu/m3)†Fungi (cfu/m3)†
B†95% CI (lower, upper)PBa95% CI (lower, upper)P
Air change rate (h–1)–71.30–87.54, –55.06<0.001***–71.64–88.09, –55.19<0.001***
Temperature (°C)–5.54–14.77, 3.690.24–4.36–13.70, 4.990.36
Relative humidity (%)6.662.20, 11.120.004**6.071.53, 10.610.009**
TB infection control score–3.39–10.48, 3.070.35–4.77–11.89, 2.360.19
Daily number of patients with active TB (in each area)–8.69–19.24, 1.850.11–9.03–19.66, 1.610.095
Daily number of occupants in each area1.810.75, 2.870.001**1.820.75, 2.890.001**
Daily number of coughs by TB patients14.812.14, 27.470.022*10.40–2.56, 23.370.14
(not wearing a protective mask) Department‡
Emergency department130.4972.77, 188.22<0.001***133.5975.50, 191.67<0.001***
TB clinic and bronchoscopy unit19.42–45.48, 84.330.551.68–63.95, 67.300.96
Ventilation system§
Central-type air conditioner166.08102.63, 229.53<0.001***164.41100.03, 228.78<0.001***
Split-type air conditioner–46.27–105.46, 12.930.12–53.67–113.17, 5.840.077

Comparison of factors and indoor airborne bioaerosol concentration using multiple linear regression

FactorsBacteria (cfu/m3)†Fungi (cfu/m3)†
B†95% CI (lower, upper)PB†95% CI (lower, upper)P
Air change rate (h–1)–50.48–64.99, –35.97<0.001***–51.57–66.66, –36.48<0.001***
Relative humidity (%)7.274.25, 10.29<0.001***6.593.44, 9.73<0.001***
Emergency department‡65.0521.99, 108.120.003**68.3723.58, 113.150.003**
Central-type air conditioner§113.9063.60, 164.190.001**107.3855.08, 159.68<0.001***
Constant429.84191.73, 667.960.001405.80158.18, 653.420.002

Indoor bacterial and fungal concentrations in TB high-risk areas based on environmental parameters and other potential contributors

Data for TB high-risk areas Median (IQR), unless indicated otherwiseEmergency department (n = 27)TB ward (n = 47)Bronchoscopy unit (n = 7)TB clinic (n = 18)All areas (n = 99)
Air change rate (h–1)6.0 (5.9–6.2)6.7 (6.1–7.3)7.0 (5.2–7.1)6.3 (5.2–7.0)6.2 (6.0–7.1)
Temperature (°C)25.6 (25.1–27.1)31.5 (29.1–32.0)24.6 (24.2–25.7)28.3 (26.3–30.7)27.9 (25.3–31.5)
Relative humidity (%)61.7 (60.0–63.7)66.7 (57.8–70.1)57.2 (53.8–66.3)68.2 (58.2–70.6)62.2 (57.8–70.0)
TB infection control score†24.0 (21.0–28.0)26.0 (22.0–28.0)21.0 (14.0–25.0)27.0 (23.8–28.0)26.0 (22.0–28.0)
Good level, frequency (%)23.0 (85.2)37.0 (78.7)4.0 (57.1)16.0 (88.9)80.0 (80.8)
Moderate level, frequency (%)4.0 (14.8)10.0 (21.3)3.0 (42.9)2.0 (11.1)19.0 (19.2)
Daily number of occupants in each area35.0 (15.0–60.0)7.0 (5.0–10.0)6.0 (5.0–15.0)20.0 (6.8–69.3)10.0 (5.0–30.0)
Daily number of active TB patient(s) in each area–1.0 (1.0–1.0)1.0 (0.0–1.0)2.0 (1.0–7.0)1.0 (0.0–1.0)
Daily number of coughs by TB patient(s) not1.0 (0.0–1.0)3.0 (1.0–3.0)–0.0 (0.0–1.0)
wearing a protective mask in each area
Ventilation system
Natural ventilation, frequency (%)2.0 (7.4)37.0 (78.7)–8.0 (44.4)47.0 (47.5)
Central-type air conditioner, frequency (%)12.0 (44.4)––7.0 (38.9)19.0 (19.2)
Split-type air conditioner, frequency (%)13.0 (48.2)10.0 (21.3)7.0 (100.0)3.0 (16.7)33.0 (33.3)
Indoor airborne bacteria (cfu/m3)‡691.0 ± 79.61533.8 ± 132.50567.9 ± 208.55627.2 ± 124.60596.1 ± 140.90
Indoor airborne fungi (cfu/m3)‡618.4 ± 108.03464.7 ± 130.11478.1 ± 178.01539.7 ± 129.59521.2 ± 142.20
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