Air quality in buildings directly affects patients within hospitals, healthcare facilities, and the staff caring for those patients. As places of healing and recovery, air quality in hospitals is more important than air quality in commercial offices and shopping centres. The primary purpose of hospitals is to return patients to good health. An essential aspect of this process is ensuring that airborne pathogens do not make their existing conditions worse.

The staff are just as important as patients to the viability of health care organisations. The indoor environment impacts the productivity, morale, health, welfare; and ultimately retention of a facilities’ workforce. A study by Lawrence Berkeley National Laboratory found that improved Indoor Air Quality (IAQ) improves worker productivity by 0.5% to 5%, which represents a national workforce impact of $20 billion to $200 billion. These impacts provide health care organisations with an incentive to improve the environment for their employees.

Patients may be one of the main reasons to improve IAQ. They are also a considerable source of air contaminants. Patient coughing can introduce contaminants into the air, which includes infections, viruses, and other diseases. Bodily fluids resulting from wounds, infections, incontinence etc. can be transferred from a patient to clothing, bedding, and other surfaces. Wounds and other infections and diseases, as well as various medical procedures, can introduce objectionable odours into the air.

The building itself can offer other sources detrimental to good IAQ. The ductwork used to distribute air throughout the facility can become dirty over time and trap various contaminants such as dust, dirt, and even biological organisms. Moisture from HVAC humidification can condense within the duct system. Moisture can also seep into various building components from breaches in the building envelope, concealed leaks, or even overspray from the cleaning process. This moisture can instigate mould growth over time, which is often undetected until the problem becomes substantial. Even the transportation of dirty linen throughout the building can present a detriment to IAQ.

A study conducted in 2015 after the outbreak of Middle East Respiratory Syndrome (MERS) in South Korea found that inadequate ventilation and air quality management can facilitate the spread of viruses, like the coronavirus that causes MERS. If air ventilation systems do not capture these aerosols, the infection can spread rapidly, affecting patients, visitors and healthcare workers.

A recent study by researchers at Massachusetts Institute of Technology found that coughs and sneezes can travel 200 times further than previously thought. Most scientist thought that the cloud of infected pollutants in a cough could travel for 60 metres. However, the new study has found that droplets of 100 micro metres can travel five times further than previously estimated, and that droplet s of 10 micro metre can travel 200 times further. Droplets less than 50 micro metres in size can remain airborne long enough to reach ceiling ventilation, compromising air quality that leads to infectious outbreaks.

Since the outbreak of the COVID-19 pandemic in late 2019, there have been increasing reports of transmission via aerosol particles in hospitals and nursing homes. These include scientific reports from hospitals in China and the USA, and a nursing home in the Netherlands. As further evidence, SARS-CoV-2 was detected on the dust filters of the air conditioning system.

The hygienic conditions of various areas (e.g. reception, waiting rooms, in patient wards, administrative offices) as well as building materials, equipment, and furnishings also affect the composition of the microbial community in hospital environments. All technological systems, such as plumbing, heating, air handling and air conditioning systems, and other equipment can significantly impact IAQ, becoming a potential source of bacteria, fungi, viruses and other organism.

Micro-organisms are often found on inanimate surfaces, equipment and in the indoor air of environments occupied by colonized and/or infected patients. Water distribution systems and the aerosols generated by water cooling systems can also contain pathogenic micro-organisms and opportunistic pathogens of purely environmental origin for which plumbing systems provide an ideal habitat (e.g. Legionella sp, non-tuberculous mycobacteria, and amoebae).

Addressing antibiotic-resistant bacteria is a paramount issue in hospitals as antibiotic-resistant bacteria may be responsible for serious infections associated with medical care. Alarmingly, anti-microbial resistance is still high or is even on the increase in most European countries, especially in the case of common bacteria such as the methicillin resistant Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa.

Legionella can often cause Legionnaires’ disease in healthcare facilities. Exposure to the risk of acquiring the disease occurs through the air ways as a result of inhalation of aerosols of contaminated water released from showers, air humidifiers and medical devices.

As there is quite a high probability of contracting an infectious disease in health care facilities-the need for multiple strategies to control the spread of pathogenic microorganisms, and adoption of appropriate preventive measures, is critical in the prevention of infection spread in health care settings.

A variety of measures are necessary to prevent the spread of the coronavirus SARS-CoV-2 and all other pathogens in hospitals and nursing homes. It is particularly important to develop an appropriate strategy to protect health care workers from air borne transmission. Improving HAI monitoring systems and implementing standard procedures to reduce microbial spread in higher-risk areas should be the primary goals, especially during public health emergencies.

Fortress Air is a distributor of Australian and international designed, tested and patented advanced air and surface treatment systems that safely and efficiently restore the balance of recirculated air by maintaining air quality as well as eliminating contaminated and poor-quality air in residential, commercial, industrial, retail, office, school and indoor public spaces.

These innovative technologies produces Ions and Free Hydroxyl Radicals which are naturally occurring molecules to continuously sanitise the total volume of air, while simultaneously sanitising all soft and hard surfaces, 24/7 in an indoor environment by eliminating and preventing airborne risks and cross infection in indoor spaces including:

• Bacteria which includes staph and strep;
• Mould and mould spoors;
• Odours and other toxic fumes;
• Pathogens;
• Viruses, eg:
• Common cold;
• DNA viruses which include chicken pox;
• Influenza;
• RNA viruses which include COVID-19 and measles;
• Stomach flu; and
• Volatile Organic Compounds (VOC’s).


Unpleasant odours can be a sign of poor management, residents not being looked after properly and staff not caring. The Health Care industry demands high levels of cleanliness and infection control “Premises and equipment should be visibly clean and free from odours that are offensive or unpleasant.”*.

A clean, fresh environment is good for residents, visitors and staff. Strong odours can affect a family’s choice when they are looking for a home for their loved ones and staff often take more time off when they have to work in unpleasant conditions.

The old-fashioned way of clearing smells with chemicals and masking with perfume does not get to the root cause of the problem, bacteria and odours soon return. The latest technology from Fortres Air eliminates the bacteria and odours resulting in a big saving in materials and staff time.


Air Silent Range
Ultra Violet Germacidal Irradition Range
Multiflex Range
Washroom Thermal Range

The AS Range has been specifically designed for small spaces such as bedrooms with continuous occupation, it is ideal for residents who suffer heavy incontinence. It does not have a fan making its silent thermal convection operation a favourite with residents and staff who may be disturbed by noisy machines in their rooms. It uses a standard wall socket and once installed, an AS unit runs continuously requiring just one annual lamp change.

The MF Range is designed to control odours in medium to large sized enclosed spaces. It is ideal for reception areas, corridors, dining rooms and resident’s lounges. The units are installed to suit the size of space (20 sq m to 100 sq m) and the level of contamination, they are fan driven and operate 24/7. Once installed they can be easily tweaked to achieve the optimum level of performance and an MF unit requires minimal maintenance and one annual lamp change for years of operation.

The WT Range uses the latest thermal convection technology to control high levels of odours in smaller enclosed spaces such as sluice rooms, washrooms and any rooms where there is non-continuous occupation. The units are hard-wired to an existing power source such as a lighting circuit spur to operate 24/7. In sluice rooms, the footfall tends to be quite low but there can be a rapid build-up of odour as contaminated items are processed and waiting collection.

Our groundbreaking AIRsteril technology is guaranteed to help you:
– Improve cleanliness by removing all odours.
– Improve infection control for residents, patients, staff and visitors.
– Improve air quality especially for residents with respiratory problems.
– Cut the need for cleaning chemicals and perfumes.
– Extend the life of soft furnishings.
– Cut staff turnover and absenteeism.
– Improve first impressions for new clients and families.
– Comply with regulations.


The Cancer Hospital of Thessaloniki THEAGENIO, is one of the four anti-cancer hospitals in Greece units were installed in multiple areas as part of measures to target hospital acquired infections, in addition to the reduced transmissibility of SARS-CoV-2, the improvement in air quality, elimination of unpleasant odours and medical staff feeling safe and aware with products in place were all noted, further information can be found here.”

“Endoscopy Disinfection units at Epsom & St Helier University Hospitals NHS Trust faced an air quality issue due to the use of Peracetic acid in the cleaning process. After only a few hours with the devices in use the air quality in the Endoscopy Disinfection Units improved significantly, operators expressed satisfaction at experiencing a feeling of clean fresh air, no eye or breathing irritation, no headaches, altogether a nicer place to work.”

A study of the Health Protection Agency data prompted trials of the AirSteril Air Purification units at our Cumberland Infirmary Facility. These units have proven to reduce environmental and contact surface microbial contamination significantly. The Trust Consultant Clinical Microbiologist and concerned Clinical Director have since facilitated the installation of over 30 AirSteril Multi Flex 20 Units at our West Cumberland Hospital.