Process for maintaining appropriate air quality in a hospital setting during and following a nearby building implosion

Abstract

Air quality in a cancer facility is integral to the success of patient treatment. The organization must be committed to providing a patient care environment free of physical and biological hazards that result from construction and demolition activities. This project intended to safely demolish a derelict building in Texas while minimizing air quality risks and impacts to nearby hospitals and a proximal cancer hospital. Two of the neighboring facilities were less than 18 feet (5.5 m) away from the demolition location. Adjacent facilities included inpatient and outpatient cancer treatment clinics, a large data center, a pediatric hospital complex, and a heart institute. Plans to minimize infection risks and dust for respective facilities were designed before implosion and remained in place until total debris removal. Risk assessments of nearby buildings were completed to determine the appropriate precautions and physical barriers needed. Culturable and non-culturable fungal air samples were collected during implosion to verify the management of outside contaminants. Additionally, continuous particulate and routine sampling for culturable and non-culturable fungi were performed for approximately 7 months after the project demolition. Air sampling results from 32 internal areas indicated that most areas remained at pre-implosion background levels. Areas that experienced elevated particle counts were cleaned and resampled, and baseline values returned to pre-implosion levels within 12 hr. Fungal air sampling results were acceptable based on predetermined infection control guidelines. The building was successfully demolished via implosion with no injuries and minimal damage to nearby facilities. The team learned that an integrated approach to project management that includes all stakeholders is essential to success. Contingency planning should account for all variables; no assumptions should be made. Staffing plans should be reviewed to ensure the sampling strategy developed can be implemented appropriately.

Keywords:

• Asbestos
• bioaerosols
• demolition
• healthcare
• infection control
• particulates

Acknowledgments

We would like to extend our sincere thanks to Dr. Matthew Berkheiser, CIH, CSP, CHPCP for his wealth of knowledge on the subject and his leadership both during the implosion project and the writing process. We also would like to acknowledge Sandra Ramirez, Nina Gutierrez-Garcia, and Hilary Richards for their contributions of knowledge, input, and statistical support. Editorial support was provided by Bryan Tutt, Scientific Editor, Research Medical Library at MD Anderson Cancer Center. Finally, for their historical knowledge and discussions of findings, we thank Jim Mathis, Tim Hendrix, Jimmy Johnson, and Daniel Prate.

This project was employer-funded by The University of Texas at MD Anderson Cancer Center.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Raw data were generated at The University of Texas at MD Anderson Cancer Center. Derived data supporting the findings of this study are available through the Public Information Act and available upon request.