The impact of built environment engineering on healthcare-associated infection rates: A cross-sectional analysis of ventilation, materials, and layout
Mohammed Shakeebulla Khan, Ekta Patel, Basavaraj Nyamagoud & Swapnil Malipatil
Abstract
Addressing the ongoing worldwide problem of healthcare-associated infections (HAIs) requires looking beyond the microbiological interventions to the role of the built environment. This cross-sectional study conducted in a 750-bed tertiary hospital quantitatively assessed the integrated effects of three engineering controls (ventilation, surface materials and spatial layout) on HAI rates over 12 months. Data on air changes per hour (ACH), surface bioburden, room occupancy and flow of footfall patterns were correlated with laboratory confirmed HAIs on four wards. Results showed that ACH was a strong predictor of lower infection rates and each unit increase in ACH was associated with a 17.3 percent reduction in infection. Surface porosity directly contributed to bacterial colonization, which was associated with an 11% increase in contact-transmitted HAIs per 5 CFU/cm2 increased, whereas single-occupancy rooms had 42% fewer HAI rates than multi-bed rooms. A multivariate model combining these factors accounted for 78% variance of HAIs. These results show that strategic, integrated design interventions in ventilation, material choice, and layout are important in mitigating the transmission of infection and improving patient safety, with the need to address hospital design as a first line of infection control.
Keywords
health, healthcare, surface materials, hospital design
Author information & Contribution
Mohammed Shakeebulla Khan. Corresponding author. Ph.D (Pursuing). M. Tech in structural Engineering. Assistant Professor, Department of Civil Engineering St. John College of Engineering and Management, Palghar, Mumbai Maharashtra 401404, India. Email: shakeeb.ulla@gmail.com
Ekta Patel. M.E. Assistant Professor, Department of Pharmacy, St. John College of Pharmacy, Palghar, Mumbai Maharashtra 401404, India. Email: ektap@sjipr.edu.in
Basavaraj Nyamagoud. M. Tech in Highway Engineering. Assistant Professor, St. John College of Engineering and Management, Palghar, Mumbai Maharashtra 401404, India. Email: basavarajn@sjcem.edu.in
Swapnil Malipatil. M. Tech in structural Engineering. Assistant Professor, Department of Civil Engineering St. John College of Engineering and Management, Palghar, Mumbai Maharashtra 401404, India. Email: swapnilm@sjcem.edu.in
“All authors equally contributed to the conception, design, preparation, data gathering and analysis, and writing of the manuscript. All authors read and approved the final manuscript.”
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was not supported by any funding.
Institutional Review Board Statement
The conduct of this study has been given relative clearances by the Institutional Ethics Committee (Ref: IEC/2022/PH/45) and the Hospital Infection Control Committee.
Data and Materials Availability
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
AI Declaration
AI tools were not used in writing this paper.
Notes
Acknowledgement
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Cite this article:
Khan, M.S., Patel, E., Nyamagoud, B. & Malipatil, S. (2026). The impact of built environment engineering on healthcare-associated infection rates: A cross-sectional analysis of ventilation, materials, and layout. Journal of Allied Health Sciences & Medical Research, 2(1), 1-20. https://doi.org/10.53378/jahsmr.353319
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This work is licensed under a Creative Commons Attribution (CC BY 4.0) International License.
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