How Can Hospitals Address Indoor Air Quality Concerns Without Disrupting Patient Care?

Hey everyone, it’s Chris White with Wynn L. White Consulting Engineers. I’ve spent decades working with building owners on environmental and building-related problems, and hospitals present an interesting challenge. You usually don’t have the luxury of treating the building like an empty construction site.

Patients still need care. Employees still need to work. Mechanical systems still need to operate. An indoor air quality concern has to be investigated while the hospital continues doing its job.

That’s why the goal isn’t just to collect data or confirm that a problem exists. It’s to understand what’s happening and give the facility team information they can actually use.

Why Are Indoor Air Quality Concerns Different in Hospitals?

Indoor air quality concerns are different in hospitals because environmental problems often must be investigated while patients are receiving care, staff are working, and critical areas of the facility remain in operation.

A patient-care area cannot be approached like an empty office because, while we are looking at moisture, mold, odors, HVAC conditions, or building materials, doctors, nurses, patients, and facility teams may be working right around us.

Through our work with hospitals and healthcare facilities, we have learned that understanding the building is only half the job; you also have to understand how the space is used and how to investigate without unnecessary disruption.

What Usually Causes Indoor Air Quality Problems in Hospitals?

Indoor air quality problems in hospitals can be caused by moisture intrusion, mold, HVAC conditions, odors, building materials, and other environmental factors, although the first thing you notice is not always the actual source.

A stained ceiling tile may be the clue, but it is not always the cause because, while the stain tells me the tile got wet, it does not tell me whether that moisture came from a roof leak, plumbing problem, condensation, air infiltration, or the mechanical system.

The same principle applies to mold. Wynn L. White and I wrote the Mold Prevention Guide around a lesson we have learned repeatedly in the field: mold does not simply appear on its own, and when it shows up, there is usually a moisture condition somewhere that needs to be understood.

Rather than stopping at what is visible, the real job is figuring out what created the condition in the first place, because finding the moisture source usually gets you much closer to solving the actual problem.

How Do You Investigate an Indoor Air Quality Complaint in an Active Hospital?

An indoor air quality investigation in an active hospital starts with the complaint, the building, and its history before jumping immediately to testing.

When somebody calls us about an odor or indoor air quality problem, I want to know where the condition is being reported, when it started, whether the area has leaked before, whether the odor happens all day or only under certain conditions, and whether anything recently changed with the HVAC system or building.

Those questions may sound simple, but they often save a lot of unnecessary investigation because the people who work in the building every day can provide context that testing alone cannot.

From there, our indoor air quality consulting may involve site observations, moisture measurements, mechanical-system evaluation, environmental sampling, document review, and conversations with facility personnel.

A facility manager who tells me, “That corner leaks every time the wind blows from the south,” has just given me a pretty useful piece of information, and that firsthand building knowledge can help point the investigation in the right direction.

Does Every Indoor Air Quality Complaint Require Air Testing?

Every indoor air quality complaint does not require air testing because testing should be selected to answer a specific question about the building or reported condition.

People understandably like test results because numbers feel definitive. Still, sometimes the building is already telling you where to look. If I am standing underneath a wet ceiling, I probably need to understand why it is wet before worrying about how many air samples I can collect.

Testing absolutely has its place, particularly when it helps identify contaminants, compare conditions or verify remediation, but the important thing is to define the question first and then choose the test that actually helps answer it.

Can Hospitals Investigate Environmental Problems Without Closing Down?

Hospitals can often investigate environmental problems without closing the entire affected area when the evaluation is coordinated with hospital operations and the condition itself does not require the space to be taken out of service.

This is where uncertainty can create as many problems as the original complaint because someone notices an odor, another person says mold, and before long employees are concerned while administrators are trying to determine whether the space is safe to use.

Before the loudest theory becomes the conclusion, it is worth figuring out what is actually happening.

We saw a version of this during our work with Ascension Parish Schools following the 2016 Louisiana flood. Employees reported odors in temporary buildings, and concerns quickly developed around potentially hazardous chemicals. However, the investigation ultimately pointed to materials in the buildings that had not completely cured, with Louisiana summer heat making the odor more noticeable.

What appeared to be one problem turned out to be another, which is a lesson that applies just as well in a hospital: do not diagnose the building before you investigate it.

Why Is Finding the Source More Important Than Cleaning Up What You See?

Finding the source of an indoor air quality or moisture problem matters more than simply cleaning up what you see because the condition can return if you don't correct the underlying cause.

If you replace a stained ceiling tile but ignore the leak, another tile gets wet; if you clean the mold but leave the moisture source, the mold may return; and if you mask an odor without finding where it came from, somebody may be making the same call next month.

That is why I have described remediation without fixing the cause as a “dress rehearsal” for doing it all over again.

We see this frequently in mold and moisture investigations because buildings are systems, and roofs, walls, HVAC equipment, humidity, air pressure, and building materials all interact.

The place where you see the problem may not be where the problem started.

How Can Hospitals Minimize Disruption During an Indoor Air Quality Investigation?

Hospitals can minimize disruption during an indoor air quality investigation by narrowing the problem, involving the people who know the building, and collecting only the information needed to make the next decision.

You do not always need more data; you need the right data, which means walking the space, talking to facility staff, reviewing the building history, looking at moisture and mechanical conditions, and then determining what information is still missing.

Just as importantly, explain the findings in plain English because hospital administrators and facility teams do not need a pile of technical terminology. They need to know what we found, what it means, and what should happen next.

When Should a Hospital Call an Environmental Consultant?

A hospital should consider calling an environmental consultant when an indoor air quality problem keeps returning, the source is unclear, occupants continue reporting concerns, or the facility needs technical information before deciding what to do next.

You probably do not need an engineer every time somebody smells something strange. But when an odor keeps returning, moisture shows up where it should not, mold comes back after cleanup, or previous repairs fail to solve the problem, there is usually a larger question worth answering.

Since 1987, Wynn L. White Consulting Engineers has helped building owners work through environmental problems involving indoor air quality, mold, moisture, asbestos, lead, and other building conditions.

After all these years, I still tend to start with three pretty basic questions: What do we know? What don’t we know? And what do we need to know before making the next decision?

How Can Hospitals Address Indoor Air Quality Concerns While Maintaining Operations?

Hospitals can address indoor air quality concerns while maintaining operations by identifying the source of the problem, coordinating the investigation around patient care, and using targeted testing when it helps answer a specific question.

There is nothing wrong with moving quickly when somebody raises an environmental concern in a hospital, but moving quickly and guessing quickly are two very different things.

Start with the space and the people who know it best, then consider the building’s history, moisture conditions, and mechanical systems before deciding whether additional testing is necessary. Sometimes the answer is fairly obvious, while other problems take a little more digging to understand.

Either way, one lesson has held up pretty well during my career: don’t just fix what you can see; figure out why it happened. That’s usually where the real solution starts.