Proposal and Implementation of a Survey for Prevention of Aerosol Infection:

A Case Study in Medical and Elderly Care Facilities

Abstract

Airborne disease transmission can infect large numbers of individuals simultaneously; therefore, prevention is important, particularly in high-risk medical and elderly care facilities. However, currently, no checklists are available to detect and improve infection control issues at these facilities. In this study, we developed a checklist containing eight control items for each of the three protective measures against aerosol infection (ventilation, air purification, and airflow control) and specific control goals. Based on this checklist, 18 medical and elderly care facilities (a total of 263 rooms) were surveyed in this study. Our findings showed that 72% of rooms in which we detected infection control issues had inadequate mechanical ventilation, 48% of which were secondary to inadequate cleaning. As a background factor, outdoor ventilation louvers in particular were not designed to facilitate inspection and could not be cleaned; therefore, long-term dust accumulation led to blockages. Additionally, 21% of issues associated with mechanical ventilation were associated with forgetfulness regarding turning on switches and background factors such as inadequate operation of switches, difficulties with the user interface of the operation panel, and handover errors in centralized control. Furthermore, 18% of the rooms in which we detected infection control issues had snags with airflow control owing to differential pressure gradients. Although we detected flaws in <5% of rooms, faults in the installation method of blowers, inhibition of natural ventilation, and carbon dioxide concentration >1000 ppm were also observed in this study. These findings highlight the usefulness of our proposed checklist for detection of the aforementioned concerns.