Environmental monitoring during the renovation of the Nuovo Santa Chiara Hospital (Pisa, Italy)

Abstract

Construction activities in close proximity to a hospital facility present significant environmental risk for patients and healthcare staff, including exposure to particulate matter (PM), and microbiological agents that may rise during the excavation works. From 2021 to 2026, the Azienda Ospedaliero Universitaria Pisana, (AOUP, Pisa, Italy) will coexist with an adjacent construction site. The aim of this study is to assess the biological risks associated with the hospital renovation by monitoring the effectiveness of the protective and preventive measures applied, which can also be used for future renovation works. The monitoring plan considers the evaluation of 0.5 µm or greater PM, the total microbial load and yeasts and molds from air and surfaces in areas close to the construction site, which are categorized in very high risk (VHR), high risk (HR), and medium risk (MR). Conformity rates for each parameter were assessed from September 2021 to September 2022. Conformity rates for both air and surfaces decrease proportionally with the environmental cleanliness, with the highest levels observed in VHR–HR (83% for air and 100% for surfaces) and the lowest in MR (38% for air and 88% for surfaces). Considering the PM, the lowest conformity rate is observed in VHR (43%), while the highest rate is recorded in MR (83%). Conformity rates decrease during the warmer months. The effectiveness of preventive and protective measures, such as weatherstripping and enhanced sanitation of both indoor environments and air handling systems (which can be assessed through environmental monitoring) is an effective strategy for mitigating infectious risks throughout the construction process. These measures can also contribute to improved hygiene standards in hospitals, enabling prompt intervention in critical situations and safeguarding the most vulnerable groups, including patients and healthcare staff.