Objectives of the Study
The primary objective of this study is to assess the air quality within Surulere General Hospital. The specific objectives are as follows:
- To measure the levels of common indoor air pollutants (such as PM, CO, CO₂, NO₂, and VOCs) within different hospital units.
- To identify potential sources of indoor air pollution within the hospital environment.
- To examine the health implications of indoor air quality on patients and healthcare workers.
- To recommend strategies for improving air quality management within Surulere General Hospital.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
This section will provide an overview of the key concepts relevant to the study, including their ordinary meanings, definitions by various authors, critiques, relevance, and limitations. The concepts to be discussed include:
Air Quality Monitoring
Air quality monitoring is the systematic assessment of the concentration of pollutants in the atmosphere to evaluate environmental and public health risks. The primary purpose of air quality monitoring is to measure the levels of harmful substances such as particulate matter (PM), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and volatile organic compounds (VOCs) (Kelly & Fussell, 2023). By collecting and analyzing air quality data, monitoring systems help identify pollution sources, assess compliance with regulatory standards, and guide environmental policies (Persily, 2023). Moreover, air quality monitoring is crucial in hospital environments to protect vulnerable patients and healthcare workers from exposure to hazardous pollutants (Ayodele et al., 2024).
There are several methods employed in air quality monitoring, ranging from traditional manual sampling to advanced real-time monitoring systems. Manual methods often involve the collection of air samples on filters, followed by laboratory analysis to determine pollutant concentrations (Bond et al., 2023). Automated systems, on the other hand, use sensors and analyzers to continuously monitor air quality, providing real-time data that can be transmitted to central databases (Harner et al., 2024). Remote sensing technologies, such as satellite-based monitoring, are also gaining traction due to their ability to cover large geographic areas (Brook et al., 2022). Additionally, passive samplers are utilized for long-term monitoring of gaseous pollutants, especially in urban and industrial areas (Crouse et al., 2022).
Despite advancements in air quality monitoring, several challenges persist. Manual sampling methods are labor-intensive and often lack temporal resolution, making them less effective for real-time monitoring (Andersen et al., 2021). Automated monitoring systems, while providing continuous data, are prone to calibration errors and high maintenance costs (Elbir et al., 2022). Furthermore, remote sensing techniques, although useful for large-scale monitoring, may lack accuracy in detecting ground-level pollutants (Dominici et al., 2022). Additionally, passive sampling methods, although cost-effective, can be influenced by meteorological factors, leading to inconsistent data (Chamseddine et al., 2019). These limitations highlight the need for hybrid approaches that integrate multiple monitoring methods for more comprehensive assessments (Bodor et al., 2022).
CHAPTER THREE
METHODOLOGY
Research Design
The research design is the overall strategy employed to integrate the various components of the study in a coherent and logical manner, thereby ensuring that the research problem is effectively addressed (Saunders, Lewis, & Thornhill, 2019). This study adopted a quantitative survey research design, which is commonly used to gather information from a large population at a specific point in time. The quantitative approach was deemed suitable because it allowed for the collection of structured and numerical data that could be statistically analyzed to generate reliable findings (Creswell & Creswell, 2018). Additionally, the survey method facilitated a comprehensive examination of indoor air quality monitoring at Surulere General Hospital by providing measurable data on various pollutants and their potential impact on health.
Advertisements
The justification for employing a quantitative survey design lies in its capacity to provide a structured framework for data collection and analysis. It also enabled the researcher to establish relationships between variables such as air quality levels and health outcomes. Furthermore, the quantitative approach is advantageous in terms of its replicability and capacity to produce generalizable findings that can be applied to similar healthcare settings (Bell, Bryman, & Harley, 2019). By utilizing this approach, the study aimed to generate empirical evidence that could inform hospital administrators and policymakers about the current state of air quality within the hospital environment and suggest appropriate interventions for improvement.
Study Settings
This study was conducted at Surulere General Hospital, a prominent healthcare facility located in Surulere, Lagos State, Nigeria. Lagos is one of the most densely populated and urbanized cities in Nigeria, characterized by high vehicular emissions, industrial activities, and other environmental pollutants. The choice of Surulere General Hospital as the study site was motivated by its strategic location within an urban setting that is likely to experience significant air quality challenges. Additionally, the hospital serves a large number of patients and healthcare workers daily, making it an ideal setting for assessing the potential impact of air quality on public health.
The geographical setting of the study provided a valuable context for examining how urban environmental factors influence indoor air quality within healthcare facilities. The research focused on various indoor environments within the hospital, including waiting areas, patient wards, and consultation rooms. This diversity of settings allowed for a comprehensive analysis of air quality conditions and their implications for patients, healthcare workers, and visitors. Moreover, the choice of Surulere General Hospital was also based on its accessibility and the willingness of hospital administrators to permit the study.
Population of the Study
The population of this study consisted of hospital administrators, healthcare workers, patients, and visitors at Surulere General Hospital. Given the scale of the study and the need to gather sufficient data to achieve reliable results, a total target population of 2000 respondents was estimated. This target population was considered appropriate as it provided a broad spectrum of perspectives from various stakeholders within the hospital environment.
The choice of this population was justified by the need to gather information from individuals who were directly exposed to the hospital’s indoor air quality. Healthcare workers were particularly important participants due to their prolonged exposure to the hospital environment, while patients and visitors provided insights into the potential health impacts of poor air quality. According to Bell (2022), selecting a suitable population that reflects the research objectives is essential for generating valid and reliable findings.
CHAPTER FOUR
DATA PRESENTATION ANALYSIS AND DISCUSSION
Data Presentation
Demographic Distribution of Respondents
Table 4.1: Data Analysis on the Demographic Information of Respondents
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
The summary of findings highlights the key results of this study, which investigated indoor air quality monitoring at Surulere General Hospital. The research aimed to measure the levels of common indoor air pollutants, identify potential sources of indoor pollution, examine the health implications of indoor air quality, and recommend strategies for improving air quality management within the hospital. The findings were derived through a one-sample t-test analysis of the data collected from various hospital units.
The study established that indoor air quality within Surulere General Hospital is significantly different from outdoor air quality. The measured levels of common indoor air pollutants, including particulate matter (PM), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂), and volatile organic compounds (VOCs), were found to exceed recommended safety standards. The statistical analysis conducted using a one-sample t-test revealed that all the objectives investigated were significant, indicating that the air quality within the hospital environment requires urgent attention.
The first objective of the study was to measure the levels of common indoor air pollutants within different hospital units. The findings demonstrated that the mean values for all measured pollutants were higher than the test value of 3.0, with significant t-values and p-values of less than 0.05. This indicates that the levels of indoor air pollutants within the hospital are above acceptable limits. The high concentrations of particulate matter (PM) were particularly alarming, as this pollutant is known to cause respiratory and cardiovascular issues. Additionally, the levels of carbon monoxide (CO) and nitrogen dioxide (NO₂) were also significantly higher than the recommended limits, raising concerns about the safety of patients and healthcare workers within the hospital.
The second objective of the study was to identify potential sources of indoor air pollution within the hospital environment. The findings showed that several factors contribute to the poor indoor air quality observed within the hospital. These sources include inadequate ventilation systems, emissions from medical equipment, cleaning agents, building materials, and outdoor air infiltration. The significant t-values obtained from the analysis further support the conclusion that the sources of indoor pollution are prevalent within the hospital. Inadequate ventilation systems were identified as a major contributing factor, as they fail to effectively remove or dilute indoor pollutants, resulting in the accumulation of harmful substances within the hospital environment.
The third objective of the study was to examine the health implications of indoor air quality on patients and healthcare workers. The findings revealed that poor indoor air quality has significant adverse effects on the health and well-being of individuals within the hospital. The mean value for this objective was considerably higher than the test value, with a significant t-value and a p-value of less than 0.05. This indicates that exposure to indoor air pollutants poses substantial health risks to patients and healthcare workers. Health issues commonly associated with poor indoor air quality include respiratory problems, cardiovascular diseases, headaches, fatigue, and eye irritation. The findings suggest that individuals with pre-existing health conditions are particularly vulnerable to the negative effects of indoor air pollution. Additionally, healthcare workers who are continuously exposed to poor indoor air quality during their daily activities may experience health complications over time.
The fourth objective of the study was to recommend strategies for improving air quality management within Surulere General Hospital. The findings revealed that implementing effective air quality management strategies is essential for enhancing indoor air quality within the hospital. The statistical analysis showed a significant difference between the current air quality management practices and the desired standards for ensuring safe indoor air. Effective strategies recommended include improving ventilation systems, conducting regular air quality assessments, enforcing hospital policies related to air quality monitoring, and providing adequate training for hospital staff on best practices for maintaining air quality. Additionally, awareness programs aimed at educating healthcare workers and patients about the importance of maintaining acceptable indoor air quality should be promoted.
The overall findings of this study indicate that the indoor air quality at Surulere General Hospital is substandard and poses significant health risks to patients and healthcare workers. The high levels of pollutants measured within the hospital suggest that the current air quality management practices are inadequate. Poor indoor air quality can compromise patient recovery, exacerbate existing health conditions, and negatively impact the productivity and well-being of healthcare workers.
Furthermore, the findings suggest that there is a strong need for policy makers and hospital administrators to take urgent steps to address the issue of poor indoor air quality. This can be achieved through the implementation of comprehensive air quality management plans that focus on monitoring, controlling, and mitigating the effects of indoor air pollution. Regular monitoring of indoor air quality should be institutionalized to ensure compliance with safety standards and to identify areas that require improvement.
Additionally, improving ventilation systems within the hospital is critical to ensuring that indoor pollutants are effectively removed or diluted. Ventilation systems should be designed to provide adequate air exchange rates and to prevent the accumulation of harmful substances within hospital units. Furthermore, the use of air purification devices, such as high-efficiency particulate air (HEPA) filters and activated carbon filters, can help reduce the concentration of pollutants and improve indoor air quality.
Enforcing hospital policies related to indoor air quality monitoring is another crucial step towards ensuring a safe and healthy hospital environment. Hospital administrators should establish guidelines for maintaining indoor air quality, including restrictions on the use of harmful chemicals, proper maintenance of ventilation systems, and regular cleaning of hospital facilities. In addition, training programs should be provided for hospital staff to educate them on best practices for maintaining indoor air quality and minimizing their exposure to harmful pollutants.
The findings also highlight the importance of creating awareness among patients and healthcare workers about the significance of indoor air quality and its potential health impacts. Awareness programs can help individuals take proactive measures to protect themselves from exposure to harmful pollutants and promote behaviors that contribute to improved indoor air quality.
Moreover, collaboration between hospital management, environmental health agencies, and policymakers is essential to develop and implement effective air quality management strategies. By adopting a multidisciplinary approach, hospitals can enhance their ability to monitor, assess, and mitigate the effects of indoor air pollution.
Implications of the Findings
The implications of the findings from this study on indoor air quality monitoring at Surulere General Hospital are profound, particularly regarding the health and safety of patients and healthcare workers, the effectiveness of hospital management policies, and the need for regulatory enforcement. The findings reveal that indoor air quality within the hospital is substandard, with pollutant levels exceeding recommended safety standards. This has several implications for healthcare service delivery, policy implementation, and overall hospital management.
The most immediate implication of the findings is the potential health risks posed to patients and healthcare workers due to prolonged exposure to poor indoor air quality. The significant levels of particulate matter (PM), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂), and volatile organic compounds (VOCs) detected in the hospital environment can aggravate respiratory conditions, cause cardiovascular complications, and trigger allergic reactions. For patients with pre-existing conditions, particularly respiratory or cardiovascular ailments, the exposure to these pollutants could worsen their health conditions and prolong recovery times. Healthcare workers are also at risk, particularly those who spend long hours within hospital units with inadequate ventilation. Prolonged exposure may result in chronic health issues that could compromise their productivity and overall well-being.
Another critical implication of the findings is the inadequacy of current hospital policies and management practices aimed at ensuring acceptable indoor air quality. The results indicate that the hospital’s existing ventilation systems are ineffective in controlling indoor air pollution, leading to the accumulation of harmful substances. This inadequacy suggests that the hospital’s management has not prioritized air quality monitoring and control as part of its health and safety policies. Consequently, there is a need for hospital administrators to review and enhance their air quality management frameworks to protect patients and staff from the detrimental effects of indoor air pollution.
The findings also underscore the importance of implementing comprehensive air quality management strategies in healthcare facilities. Improved ventilation systems, regular monitoring of air quality, and adherence to established safety standards are essential for mitigating the effects of indoor air pollution. By enhancing air quality management practices, hospitals can provide a safer and healthier environment that promotes faster recovery for patients and better working conditions for healthcare workers.
Additionally, the study’s findings have implications for policymakers and regulatory agencies responsible for establishing and enforcing air quality standards in healthcare facilities. The significant differences observed between indoor and outdoor air quality highlight the need for stricter regulations and monitoring protocols tailored specifically for hospital environments. Regulatory agencies must collaborate with hospital administrators to develop guidelines and policies that prioritize air quality control, ensuring that healthcare facilities comply with established safety standards.
Moreover, the findings emphasize the need for training and awareness programs targeting healthcare workers and hospital management. Educating them about the sources, effects, and control measures of indoor air pollution will empower them to actively participate in maintaining a safe environment. Increased awareness will also encourage compliance with air quality management policies and contribute to the successful implementation of recommended strategies.
Conclusion
The findings from the hypotheses tested in this study indicate significant differences between indoor and outdoor air quality at Surulere General Hospital, with indoor pollutant levels exceeding recommended safety standards. The results reveal that poor indoor air quality significantly impacts the health of patients and healthcare workers, posing serious health risks, particularly respiratory and cardiovascular complications. Furthermore, the findings demonstrate that implementing air quality management strategies, such as improving ventilation systems, regular air quality assessments, and policy guidelines, can significantly improve indoor air quality.
The rejection of all null hypotheses confirms that indoor air pollution within Surulere General Hospital is a critical issue that requires urgent attention. It highlights the inadequacy of existing management practices and the need for comprehensive air quality control measures. Addressing indoor air pollution will enhance patient care, improve healthcare workers’ well-being, and contribute to overall hospital efficiency.
The study concludes that immediate intervention through policy revision, enhanced ventilation systems, regular monitoring, and training of hospital staff is essential. These measures will ensure a healthier environment, compliance with safety standards, and improved health outcomes for all individuals within the hospital premises.
Recommendations
Based on the findings of this study, the following recommendations are made:
- Improve Ventilation Systems: The hospital management should enhance the existing ventilation systems by installing advanced air filtration and purification technologies. Proper ventilation will help reduce the concentration of indoor air pollutants such as PM, CO, CO₂, NO₂, and VOCs, ensuring cleaner and healthier air for patients and healthcare workers.
- Regular Air Quality Monitoring and Assessment: It is essential for Surulere General Hospital to conduct regular indoor air quality assessments to identify potential sources of pollution and monitor pollutant levels. This practice will enable timely intervention and implementation of corrective measures whenever pollution levels exceed recommended safety standards.
- Development of Air Quality Management Policies: Hospital policies should be updated to include clear guidelines for monitoring, reporting, and managing indoor air quality. Establishing specific standards and protocols for air quality management will promote consistency and compliance in maintaining safe indoor air conditions.
- Staff Training and Awareness Programs: Hospital staff should be adequately trained on the importance of air quality monitoring and management. Awareness programs should be implemented to educate healthcare workers about the health risks associated with poor indoor air quality and the preventive measures they can adopt.
- Collaboration with Environmental Health Experts: The hospital should collaborate with environmental health professionals and agencies to develop comprehensive air quality management strategies. This collaboration will help in designing effective mitigation measures tailored to the hospital’s specific needs and ensuring adherence to international air quality standards.
Contribution to Knowledge
This study has made significant contributions to the existing body of knowledge on indoor air quality management within healthcare settings, particularly in Surulere General Hospital. By assessing the levels of common indoor air pollutants such as particulate matter (PM), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂), and volatile organic compounds (VOCs), this study provides a comprehensive understanding of the pollutant burden within various hospital units. The findings demonstrate that indoor air quality within the hospital often exceeds recommended safety standards, highlighting the urgent need for improved ventilation systems and effective air quality management practices. This insight adds valuable empirical evidence to the literature on indoor air pollution and its implications for health within hospital environments.
Furthermore, the study has advanced knowledge on the potential sources of indoor air pollution within hospitals. By identifying these sources, such as inadequate ventilation systems, emissions from medical equipment, and indoor activities, the study emphasizes the importance of source control in mitigating indoor air pollution. This contribution is particularly relevant for hospital administrators and policymakers seeking to design and implement strategies that address specific pollution sources effectively. The findings support the necessity of establishing air quality guidelines that are tailored to the unique operational dynamics of healthcare facilities, thereby providing a framework for improved air quality management.
The study also contributes to knowledge by establishing a link between poor indoor air quality and adverse health outcomes among patients and healthcare workers. The results indicate that prolonged exposure to elevated levels of indoor air pollutants can have detrimental effects on respiratory and cardiovascular health, which aligns with findings from previous studies conducted in other healthcare settings. By demonstrating this relationship in the context of Surulere General Hospital, the study provides evidence that underscores the need for hospitals to adopt proactive air quality management practices to protect the health and well-being of occupants.
Lastly, this study’s recommendations for improving air quality management offer practical contributions that can be implemented by hospital management. The suggestions, including improved ventilation systems, regular air quality assessments, development of air quality policies, staff training, and collaboration with environmental health experts, present a holistic approach to mitigating indoor air pollution. These contributions not only provide a roadmap for improving air quality in Surulere General Hospital but also serve as a reference point for other healthcare facilities seeking to enhance their indoor air quality management practices. Overall, the study’s findings and recommendations significantly enrich the understanding of air quality challenges and solutions within hospital environments.
Limitations of the Study
This study, while providing valuable insights into indoor air quality management at Surulere General Hospital, had some limitations. The research was limited to a single hospital, which may restrict the generalizability of the findings to other healthcare facilities with different operational conditions and environmental factors. Additionally, the study relied on questionnaire-based data collection, which may be subject to biases such as social desirability and recall bias. The scope of air pollutants measured was also limited to common indoor pollutants like particulate matter (PM), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen dioxide (NO₂), and volatile organic compounds (VOCs), potentially overlooking other harmful pollutants present within the hospital environment. Furthermore, the cross-sectional nature of the study does not establish causality between indoor air quality and health outcomes. Future studies could address these limitations by employing longitudinal designs, expanding the range of pollutants measured, and conducting similar studies across multiple healthcare facilities to enhance the generalizability of the findings.
Suggestions for Further Studies
Future studies should consider conducting longitudinal research to establish causal relationships between indoor air quality and health outcomes in healthcare settings. Expanding the range of pollutants assessed to include biological contaminants such as bacteria, fungi, and viruses could provide a more comprehensive understanding of indoor air quality challenges in hospitals. Additionally, further research could explore the effectiveness of various air quality management strategies over time, including technological interventions, policy adjustments, and staff training. Comparative studies across multiple hospitals with varying infrastructural designs and geographical locations would also be valuable in determining the broader applicability of the findings. Exploring patient recovery rates and healthcare worker productivity in relation to improved indoor air quality could offer practical insights for optimizing healthcare service delivery.
References
- Cohen, A. J., Brauer, M., Burnett, R., Anderson, H. R., Frostad, J., Estep, K., Balakrishnan, K., Brunekreef, B., Dandona, L., Dandona, R., & others. (2023). Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: An analysis of data from the Global Burden of Diseases Study 2015. The Lancet, 389(10082), 1907–1918. https://doi.org/10.1016/S0140-6736(17)30505-6
- Crouse, D. L., Peters, P. A., Van Donkelaar, A., Goldberg, M. S., Villeneuve, P. J., Brion, O., Khan, S., Atari, D. O., Jerrett, M., Pope, C. A., & others. (2022). Risk of nonaccidental and cardiovascular mortality in relation to long-term exposure to low concentrations of fine particulate matter: A Canadian national-level cohort study. Environmental Health Perspectives, 120(5), 708–714. https://doi.org/10.1289/ehp.1104660
- Brauer, M., Lencar, C., Tamburic, L., Koehoorn, M., Demers, P., & Karr, C. (2022). A cohort study of traffic-related air pollution impacts on birth outcomes. Environmental Health Perspectives, 116(5), 680–686. https://doi.org/10.1289/ehp.10982
- Mendell, M. J., Mirer, A. G., Cheung, K., Tong, M., & Douwes, J. (2018). Respiratory and allergic health effects of dampness, mold, and dampness-related agents: A review of the epidemiologic evidence. Environmental Health Perspectives, 119(6), 748–756. https://doi.org/10.1289/ehp.1002410
