Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting
Abstract Background In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care....
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-018-0301-9 |
| _version_ | 1819116519199604736 |
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| author | Samantha D. Knowlton Corey L. Boles Eli N. Perencevich Daniel J. Diekema Matthew W. Nonnenmann CDC Epicenters Program |
| author_facet | Samantha D. Knowlton Corey L. Boles Eli N. Perencevich Daniel J. Diekema Matthew W. Nonnenmann CDC Epicenters Program |
| author_sort | Samantha D. Knowlton |
| collection | DOAJ |
| description | Abstract Background In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. The toilet flushing of patient fecal waste may be a source of bioaerosols. To date, no study has investigated bioaerosol concentrations from flushing fecal wastes during patient care. Methods Particle and bioaerosol concentrations were measured in hospital bathrooms across three sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle and bioaerosol concentrations were measured with a particle counter bioaerosol sampler both before after a toilet flushing event at distances of 0.15, 0.5, and 1 m from the toilet for 5, 10, 15 min. Results Particle concentrations measured before and after the flush were found to be significantly different (0.3–10 μm). Bioaerosol concentrations when flushing fecal waste were found to be significantly greater than background concentrations (p-value = 0.005). However, the bioaerosol concentrations were not different across time (p-value = 0.977) or distance (p-value = 0.911) from the toilet, suggesting that aerosols generated may remain for longer than 30 min post flush. Toilets produce aerosol particles when flushed, with the majority of the particles being 0.3 μm in diameter. The particles aerosolized include microorganisms remaining from previous use or from fecal wastes. Differences in bioaerosol concentrations across conditions also suggest that toilet flushing is a source of bioaerosols that may result in transmission of pathogenic microorganisms. Conclusions This study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet during routine patient care. Future studies are needed targeting pathogens associated with gastrointestinal illness and evaluating aerosol exposure reduction interventions. |
| first_indexed | 2024-12-22T05:18:22Z |
| format | Article |
| id | doaj.art-2a61eab3d7ab45d08a4e5a47cf708352 |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-22T05:18:22Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-2a61eab3d7ab45d08a4e5a47cf7083522022-12-21T18:37:48ZengBMCAntimicrobial Resistance and Infection Control2047-29942018-01-01711810.1186/s13756-018-0301-9Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care settingSamantha D. Knowlton0Corey L. Boles1Eli N. Perencevich2Daniel J. Diekema3Matthew W. Nonnenmann4CDC Epicenters ProgramDepartment of Occupational and Environmental Health, College of Public Health, University of IowaDepartment of Occupational and Environmental Health, College of Public Health, University of IowaUniversity of Iowa Health CareUniversity of Iowa Health CareDepartment of Occupational and Environmental Health, College of Public Health, University of IowaAbstract Background In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. The toilet flushing of patient fecal waste may be a source of bioaerosols. To date, no study has investigated bioaerosol concentrations from flushing fecal wastes during patient care. Methods Particle and bioaerosol concentrations were measured in hospital bathrooms across three sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle and bioaerosol concentrations were measured with a particle counter bioaerosol sampler both before after a toilet flushing event at distances of 0.15, 0.5, and 1 m from the toilet for 5, 10, 15 min. Results Particle concentrations measured before and after the flush were found to be significantly different (0.3–10 μm). Bioaerosol concentrations when flushing fecal waste were found to be significantly greater than background concentrations (p-value = 0.005). However, the bioaerosol concentrations were not different across time (p-value = 0.977) or distance (p-value = 0.911) from the toilet, suggesting that aerosols generated may remain for longer than 30 min post flush. Toilets produce aerosol particles when flushed, with the majority of the particles being 0.3 μm in diameter. The particles aerosolized include microorganisms remaining from previous use or from fecal wastes. Differences in bioaerosol concentrations across conditions also suggest that toilet flushing is a source of bioaerosols that may result in transmission of pathogenic microorganisms. Conclusions This study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet during routine patient care. Future studies are needed targeting pathogens associated with gastrointestinal illness and evaluating aerosol exposure reduction interventions.http://link.springer.com/article/10.1186/s13756-018-0301-9Health careInfectionAerosolToiletFlushingExposure |
| spellingShingle | Samantha D. Knowlton Corey L. Boles Eli N. Perencevich Daniel J. Diekema Matthew W. Nonnenmann CDC Epicenters Program Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting Antimicrobial Resistance and Infection Control Health care Infection Aerosol Toilet Flushing Exposure |
| title | Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting |
| title_full | Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting |
| title_fullStr | Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting |
| title_full_unstemmed | Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting |
| title_short | Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting |
| title_sort | bioaerosol concentrations generated from toilet flushing in a hospital based patient care setting |
| topic | Health care Infection Aerosol Toilet Flushing Exposure |
| url | http://link.springer.com/article/10.1186/s13756-018-0301-9 |
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