Is the quantitative cut-off a suitable surrogate to ensure a good indoor air quality regarding the mycobiota in health care facilities?

Abstract

Control measures are crucial in clinical environments for reducing concentrations of airborne fungal and, consequently, to avoid invasive infections acquired from indoor air. This study intends to assess mycobiota in 10 Primary Health Care Centers (PHCC) applying the Indoor Air Quality Portuguese legislation as guidance. After the quantitative cut-off analyses (ratio between indoor and outdoor load (I/O)) the fungal species identification was performed to verify if the fungal conformity was achieved. Fungal assessment was realized by air samples through an impaction device and consisted mainly of one indoor sample in each sampling location and one outdoor sample, to be used as a reference. Among the 10 PHCC 60% (6 out of 10) presented I/O > 1. However, in two PHCC that comply with the quantitative cut-off toxigenic species were identified. The quantitative cut-off applied to assess IAQ is not a suitable surrogate to ensure a good air quality and qualitative assessment should always be performed to guarantee an accurate assessment.