Monitoring the air fungal contamination load in two educational hospitals in Sanandaj, Iran

Document Type : Original Article


1 Department of Parasitology and Mycology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Environmental Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

4 Department of Occupational Health Engineering, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran


Opportunistic fungal pathogens are known to increase infection in the health care workers and patients with immune deficiency. This study aimed to investigate the qualitative and quantitative airborne fungal contamination load in two Sanandaj hospitals. In this cross-sectional study, 112 biological samples from 15 different hospital wards were collected for 6 months by using the single-stage Anderson sampler in Sabouraud’s dextrose agar. Data were analyzed for the descriptive and analytical tests using IBMSPSS V.21 software and the air fungal contamination load (AFCL) was calculated (cfu/m3). The average hospital AFCL in Besat and Tovhid was 21.13 and 14.51 cfu/m3, respectively. No statistically significant differences were observed between AFCL and relative humidity (RH) in the two hospital samples (p = 0.495) according to independent t-test, whereas this difference in the average temperature in the hospital wards was significant (p < 0.001). Highest AFCL was observed in the surgical ward for females (AFCL = 35.34 cfu/m3) and the lowest was observed in the surgical and urology wards (AFCL = 2.2 cfu/m3) in the two hospitals. The frequency of Penicillium was the maximum with 77.6 and 65.25% in the Besat and Tovhid hospitals, respectively. In wards such as oncology, gynecological surgery, and operating room, further studies are needed to better control environmental conditions and fungal contamination. Thus, utilizing highly efficient air purification systems and regular monitoring of the biological risk for both patient and health care employees is recommended.


  1. Wan GH, Chung FF, Tang CS. Long-term surveillance of air quality in medical center operating rooms. Am J Infect Control 2011, 39:302–308.
  2. Ruzer LS, Harley NH. Aerosols handbook: Measurement, dosimetry, and health effects. New York. CRC Press. 2004.
  3. Huffman JA, Treutlein B, Pöschl U. Fluorescent biological aerosol particle concentrations and size distributions measured with an Ultraviolet Aerodynamic Particle Sizer (UV-APS) in Central Europe. Atmos Chem Phy 2010;10:3215-3233.
  4. Stetzenbach LD, Buttner MP, Cruz P. Detection and enumeration of airborne biocontaminants. Curr Opin Biotechnol 2004;15:170-174.
  5. Wang F, Ni S-S, Liu H. Pollutional haze and COPD: etiology, epidemiology, pathogenesis, pathology, biological markers and therapy.J Thorac Dis 2016;8(1):E20-30.
  6. Folmsbee SS, Gottardi CJ. The Cardiac Protein Alpha-T-Catenin Contributes to the Pathogenesis of Occupational Asthma. J Allergy Clin Immunol 2015;135(2):AB76.
  7. Srikanth P, Sudharsanam S, Steinberg R. Bio-aerosols in indoor environment: Composition, health effects and analysis.Indian J Med Microbiol 2008;26(4):302-12.
  8. Hajjeh RA, Warnock DW. Counterpoint: invasive aspergillosis and the environment—rethinking our approach to prevention. Cli Infect Dis 2001;33(9):1549-1552.
  9. Viegas S, Faísca VM, Dias H, Clérigo A, Carolino E, Viegas C. Occupational exposure to poultry dust and effects on the respiratory system in workers.J Toxicol Environ Health A 2013;76(4-5):230-239.
  10. Khoubi J, Pourabdian S, Mohebbi I, Tajvidi M, Zaroorian O, Giahi O. Association between the high risk occupations and bladder cancer in Iran: a case-control study. Int J Occup Med Environ Health 2013;26(2):205-213.
  11. Bisesi MS, Kohn PK.Industrial hygiene evaluation methods michaels . 2nd ed.Boca Raton,FL:CRC Press;2004.
  12. Azimi F, Naddafi K, Nabizadeh R, Hassanvand MS, Alimohammadi M, Afhami S, et al. Fungal air quality in hospital rooms: a case study in Tehran, Iran. J Environ Health Sci  Eng 2013;11:30.
  13. Park D-U, Yeom J-K, Lee WJ, Lee K-M. Assessment of the levels of airborne bacteria, gram-negative bacteria, and fungi in hospital lobbies. Int J Environ Res Public Health 2013;10(2):541-555.
  14. Abdollahi A, Mahmoudzadeh S. Microbial profile of air contamination in hospital wards.Iran J Pathol 2012;7(3):177-182.
  15. Bioaerosol Sampling (Indoor Air) [Internet]. 4th ed. NIOSH Manual of Analytical Methods (NMAM); 1998. Available from:
  16. Górny R, Cyprowski M, Ławniczek-Wałczyk A, Gołofit-Szymczak M, Zapór L. Biohazards in the indoor environment–a role for threshold limit values in exposure assessment. IN:The Management of indoor air quality. London: Taylor and Francis Group 2011:1-20.
  17. Aboul-Nasr MB, Zohri A-NA, Amer EM. Indoor surveillance of airborne fungi contaminating intensive care units and operation rooms in Assiut University Hospitals, Egypt. J Health Sci 2014;2:20-27.
  18. Sautour M, Sixt N, Dalle F, L'Ollivier C, Fourquenet V, Calinon C, et al. Profiles and seasonal distribution of airborne fungi in indoor and outdoor environments at a French hospital. Sci Total Environ 2009;407(12):3766-3771.
  19. Ekhaise F, Ighosewe O, Ajakpovi O. Hospital indoor airborne microflora in private and government owned hospitals in Benin City, Nigeria. World J Med Sci 2008;3(1):34-38.
  20. Falvey DG, Streifel AJ. Ten-year air sample analysis of Aspergillus prevalence in a university hospital. J Hosp Infect 2007;67(1):35-41.
  21. Hoseinzadeh E, Samarghandie MR, Ghiasian SA, Alikhani MY, Roshanaie G. Evaluation of bioaerosols in five educational hospitals wards air in Hamedan, During 2011-2012. Jundishapur J Microbiol 2013;6(6): e10704.
  22. Azizifar M, Jabbari H, Naddafi K, Nabizadeh R, Tabaraie Y, Solg A. A qualitative and quantitative survey on air-transmitted fungal contamination in different wards of Kamkar Hospital in Qom, Iran, in 2007. Qom Univ Med Sci J 2009;3(3):25-39.
  23. Kelkar U, Bal A, Kulkarni S. Fungal contamination of air conditioning units in operating theatres in India. J Hosp Infec 2005;60(1):81-84.