Methodology for semi-quantitative chemical risk assessments in healthcare facilities

The diversity of chemicals used in hospitals (detergents-disinfectants, alcohol-based hand sanitizers, drugs, etc.) and recent developments in indoor air quality regulation of public access buildings require a better understanding of chemical risks in this particular environment. We developed a methodology for semi-quantitative chemical risk assessments in this environment to prioritize inhalation risks by sector and chemical. This methodology is based on a similar approach in the workplace that defines classes of exposures and of hazards. Their combination produces a risk matrix. Four criteria were used to determine the exposure classes: quantity and frequency of the chemical's use, volatility (vapor pressure), and the type of collective protective equipment associated with each area. The hazard class is also derived from four criteria: classification as carcinogenic, mutagenic, or toxic to reproduction, the existence of a toxicity reference value, occupational exposure limit values, and risk phrases (official risk descriptions, on labels, data sheets, etc). This methodology was tested in the Rennes University Hospital (Rennes, France) in five different hospital areas, with a specific survey undertaken to collect data about chemicals in each area. The results show the spatial specificity of chemical risks. Among the various sites analysed, the chemical risks of two require priority attention: the parasitology-mycology laboratory and patients' rooms. Because of their wide use in the hospital and the volatility of some of their components (alcohols), detergents-disinfectants contribute to increasing risk levels in all areas. The model is therefore discriminatory in terms of areas and substances.