Indoor Air Quality Assessment and Influencing Factors of Bacterial Growth in Klang Valley Health Clinics

Introduction: Healthcare-Associated Infections (HCAIs) pose significant challenges to patient safety and public health, particularly in environments with high patient traffic such as health clinics. Inadequate indoor air quality (IAQ) is a well-documented contributing factor to the growth and spread of harmful microorganisms, which can lead to increased morbidity and healthcare costs. Objective: This study investigates the factors influencing bacterial growth in the Waiting Room, Medical Officer Room, and Patient Treatment Room of health clinics located in Klang Valley, Malaysia, with a focus on assessing indoor air quality (IAQ) parameters. Methods: Comprehensive assessments were conducted using industry-standard equipment to evaluate physical, chemical, and biological variables in alignment with the Industry Code of Practice (ICOP) for IAQ (2010). A one-way ANOVA test was utilized to analyze the data collected from three different health clinics, allowing for a comparative analysis of bacterial counts during morning and afternoon sessions. Results: Statistically significant differences (p<0.05) in total bacterial counts were observed across the health clinics at different times of the day. A strong positive correlation between carbon dioxide levels and bacterial concentrations was identified in most premises, with exceptions noted in locations using effective cleaning agents. In contrast, ozone (O3) demonstrated a negative correlation, indicating its potential as a disinfectant that inhibits bacterial proliferation. Conclusion: Bacterial concentrations exceeding ICOP IAQ (2010) standards were detected in the Waiting Rooms of health clinics C2 (morning and afternoon) and C3 (morning). Contributing factors included inadequate ventilation systems, elevated temperatures, low air movement, high occupancy levels, and increased PM10 concentrations. The findings underscore the urgent need for a thorough review of ventilation designs and maintenance protocols to improve indoor air quality. Moreover, emphasis on the use of personal protective equipment (PPE) and strict adherence to safety practices is warranted, as all health clinics recorded Total Volatile Organic Compounds (TVOCs) above acceptable levels, posing potential health risks. These insights are critical for informing policy and practice improvements in healthcare settings.