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This review synthesizes key IAQ parameters, outlines current detection technologies, and evaluates the European regulatory landscape, emphasizing real-time monitoring approaches. It also provides an operational guideline that integrates continuous monitoring, evidence-based mitigation, and exposure-reduction measures to address airborne and surface threats while enabling measurable safety outcomes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/managing-and-monitoring-indoor-air-quality-and-surface-decontamination-in-healthcare-environments/444681/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/managing-and-monitoring-indoor-air-quality-and-surface-decontamination-in-healthcare-environments/444681.png","ImageObject",300,407,{"name":92,"@type":93},"Mary Man","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is indoor air quality in healthcare facilities considered critical?","Question",{"text":112,"@type":113},"Compromised IAQ increases health risks for patients and healthcare workers and is linked to infectious outbreaks and adverse health outcomes.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which pollutants and biological agents are emphasized in the review?",{"text":117,"@type":113},"The review highlights volatile organic compounds (VOCs), particulate matter, and biological agents including bacteria and viruses, alongside other chemical and biological contaminants.",{"name":119,"@type":110,"acceptedAnswer":120},"What regulatory gaps are identified at the European level?",{"text":121,"@type":113},"European regulations governing outdoor limits and indoor exposures have significant gaps, with historically greater focus on individual substances rather than an integrated approach for healthcare IAQ parameters.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},444681,1790934207,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":46,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":31},7421720224475,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Cappelli G, et al. Managing and monitoring indoor air quality and surface decontamination in healthcare environments Arh Hig Rada Toksikol 2025;76:222–241  \n222  \nReview  \nDOI: 10.2478/aiht-2025-76-4013  \nManaging and monitoring indoor air quality and surface decontamination in healthcare environments  \nGiovanni Cappelli1, Ilaria Rapi1, Stefano Dugheri2, Niccolò Fanfani1, Veronica Traversini1,3, Antonio Baldassarre1,3, Anna Korelidou4, Maali-Amel Mersel5, Filippo Baravelli6, Marinos Louka4,  \nNicola Mucci1,3, and Lina Kourtella4  \n1 University of Florence, Department of Experimental and Clinical Medicine, Florence, Italy  \n2 Link Campus University, Department of Life Science, Health, and Health Professions, Rome, Italy  \n3 Careggi University Hospital, Division of Occupational Medicine, Florence, Italy  \n4 EMBIO Diagnostics Ltd, Nicosia, Cyprus  \n5 Resysten Hungary Kft., Budapest, Hungary  \n6 CLASS srl, Budrio, Italy  \n[Received in June 2025; Similarity Check in June 2025; Accepted in December 2025]  \nIndoor air quality (IAQ) in healthcare facilities is a critical yet often underestimated factor associated with adverse health effects and increased risk of infectious outbreaks. Key pollutants include volatile organic compounds (VOCs), particulate matter, and various biological agents such as bacteria and viruses. While numerous variables contribute to IAQ, European regulations still have significant gaps, having historically focused more on individual substances than on the overall air environment. This review examines the most relevant IAQ parameters, current technologies available for their detection, and the regulatory landscape at the European level. Special attention is given to real-time monitoring systems. We also propose a concise operational guideline for IAQ management which combines continuous monitoring, evidence-based mitigation, and improvements to reduce exposure, increase resilience to airborne and surface threats, and produce measurable safety outcomes for patients and healthcare personnel within hospital settings.  \nKEYWORDS: airborne contaminants; bacteria; European regulations; exposure risk mitigation; healthcare-associated infections; healthcare workers; patients; viruses; volatile organic compounds  \nEffective assessment and management of indoor air quality (IAQ) in healthcare facilities are critical to ensure patient and healthcare worker safety. Compromised air quality, whether through direct or indirect exposure, poses significant health risks to occupants and is associated with more than half a million deaths in Europe every year (1). IAQ is influenced by a range of interconnected factors, such as outdoor air quality, indoor activities, and occupant density. Given that individuals spend about 90 % of their time indoors (2), maintaining adequate IAQ is imperative to keep adverse health effects at bay.  \nHealthcare settings are no exception (3–5). Hospital environments are influenced by a variety of factors, including seasonal and weather conditions, the design and operation of ventilation systems, outdoor humidity and microbial loads, and the number of occupants and their activities. Low relative humidity and cold temperatures are believed to increase the transmission of respiratory viruses (6) . Human activities like breathing, coughing, sneezing, talking, and laughing release viral aerosols into the indoor air (7) . The transmission of SARS-CoV-2 and cluster cases are indeed primarily associated with confined, crowded, and poorly ventilated spaces (8),  \nCorresponding author: Stefano Dugheri, Link Campus University, Department of Life Science, Health, and Health Professions, Via del Casale di San Pio V 44, 00165 Rome, Italy, E-mail: [s.dugheri@unilink.it](s.dugheri@unilink.it); ORCID: 0000-0002-3078-7188  \nwhich, together with the vulnerable population and nature of healthcare activities, underscores the importance of managing IAQ effectively in a hospital environment.  \nOver the past decade, research","cbCaiiEyWgfWYE9S","https://ap.wps.com/l/cbCaiiEyWgfWYE9S","pdf",855320,"English","# Review scope and significance\n## Key IAQ determinants and pollutants\n## Detection technologies and real-time monitoring\n# Regulatory landscape in Europe\n## EU gaps and policy initiatives\n## National approaches and challenges\n# Operational guideline for IAQ management\n## Continuous monitoring and evidence-based mitigation\n## Exposure reduction and safety outcomes","[{\"question\":\"Why is indoor air quality in healthcare facilities considered critical?\",\"answer\":\"Compromised IAQ increases health risks for patients and healthcare workers and is linked to infectious outbreaks and adverse health outcomes.\"},{\"question\":\"Which pollutants and biological agents are emphasized in the review?\",\"answer\":\"The review highlights volatile organic compounds (VOCs), particulate matter, and biological agents including bacteria and viruses, alongside other chemical and biological contaminants.\"},{\"question\":\"What regulatory gaps are identified at the European level?\",\"answer\":\"European regulations governing outdoor limits and indoor exposures have significant gaps, with historically greater focus on individual substances rather than an integrated approach for healthcare IAQ parameters.\"}]","Managing and monitoring indoor air quality and surface decontamination in healthcare environments | PDF",1790708864]