Indoor Air Pollution of Volatile Organic Compounds (VOCs) in Hospitals in Thailand: Review of Current Practices, Challenges, and Recommendations

Indoor air pollution has become a significant concern, contributing to the decline in air quality through the presence of gaseous pollutants and particulate matter, especially under poor ventilation. Hospitals, functioning as non-industrial microenvironments, particularly in Thailand, face challenges due to insufficient and incomplete databases for effective air quality management. Within these environments, patients with heightened sensitivity, along with hospital staff who are predominantly exposed indoors, face increased risk of exposure to indoor air pollutants. This study aimed to review current evidence on VOCs in hospital settings in Thailand, identifying their sources, concentrations, and health impacts. It also aimed to provide recommendations for improved air quality monitoring and management. The review included studies published between 2008 and 2023 in English or Thai. Studies were selected based on relevance to VOCs in hospital environments, while excluding those lacking sufficient data or methodological rigor. Literature searches were conducted using Google Scholar, ScienceDirect, Scopus, and PubMed. Results from international studies were also considered to address gaps. Data extraction focused on VOC sources, concentrations, measurement methods, and associated health impacts. Results were synthesized into six thematic categories: characterization, health effects, control measures, etiological studies, monitoring systems, and comparative studies. The review identified 87 relevant studies. VOC exposure was associated with several adverse health impacts resulting from short- and long-term exposures, leading to an increased risk of cancer. Identified sources of VOC emissions within hospitals encompass anesthetic gases, sterilization processes, pharmaceuticals, laboratory chemicals, patient care, and household products, as well as building materials and furnishings. Commonly encountered VOCs include alcohols (e.g., ethanol, 2-methyl-2-propanol, isopropanol), ether, isoflurane, nitrous oxide, sevoflurane, chlorine, formaldehyde, aromatic hydrocarbons, limonene, and glutaraldehyde, among those commonly detected in hospital environments. Yet, limited knowledge exists regarding their source contributions, emissions, and concentrations associated with health impacts in Thai hospitals.