amid a delay over new air filters, 11 died of airborne fungus at hospital - air cleaner filter

Special report by Robert Hanley and the New York Times.
1983 this is a digital version of an article from The Times Print Archive, before it starts online in 1996.
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After the second patient was infected with fungi in the air, a new bone marrow transplant unit at a state cancer hospital here died, hospital officials asked the state to install special air filtration systems in each of the six rooms in the unit.
But the request was put on hold in the state's integrated services office.
In the next eight months, nine more of the 29 patients in the special needs unit were infected with fungal deaths, according to interviews with hospital officials and a review of the documents of the hospital and the National Ministry of Health.
After his death on April 11 last year, hospital officials at the Roswell Park Memorial Institute closed the unit
One wing of the building --
Until a new air filtration system is installed.
The wings are still closed and the state has just begun to check the cause of the outbreak, the effectiveness of the hospital response, and the operation of the wing aging ventilation system.
According to the National Health Department, the incidence of fungal infection (known as Qu's disease) increased significantly in the year the wing was dedicated to bone marrow transplant patients. Before then -
From the beginning of bone marrow transplant in Roswell Park in September 1977 to the establishment of the special group in April 1982 --
The health ministry said transplant patients were mixed with other cancer patients, and only 2 of the 80 people were infected with the infection.
The General Affairs Office, which is responsible for designing and overseeing most of the state's capital projects, said Rosewell Park's request for filter equipment was made at a time when the agency was almost fully committed to easing prison overcrowding.
Office spokesman Thomas Cooper said: "They never said there was an emergency here.
If they do, we will deal with the problem more quickly.
If Roswell Parker says, 'We need these things, they will have these new designs in less than six months.
The first six deaths occurred between June 27-11 and the month. 29, 1982.
Although transplant patients are susceptible to infection, the proportion of deaths in Roswell Park is significantly higher than other bone marrow transplant facilities with the latest Air installed
According to experts, the purification system.
Last week, the state health department said it had started a survey to determine whether the infectious fungal spores in Rosewell Park were made up of six-
Room transplant wing
The department said it would also investigate the infection.
Hospital control procedures.
Officials at Rosewell Park say since the 1970s, they believe the wing's air ventilation system is out of date.
But the state has never provided the funds for upgrading. In mid-
1981 the hospital requires a replacement system.
According to him, the money has been allocated and the state is ready to continue, but the transplant unit has opened before the work is completed. Cooper.
Officials at Rosewell Park say no spores were tested before the wing began receiving transplant patients.
Officials said no one had considered installing special air filters before the first death. Dr. C.
Aunt William, the hospital's assistant director for clinical affairs, said, "we don't think there is a problem and there will be a problem.
Advertising documents from the state health department, which approved the maintenance request in 1981 and the application for modern air filtration system in July 1982, the main complaint that Roswell Park has about the system is that it provides air that is too hot in summer and too cold in winter.
The disease that is being discussed by fungi that are harmless to healthy people, the disease of Qu, is caused by Qu, among which there are different varieties.
There are black Qu spores everywhere in the environment.
Usually they are harmless to healthy people.
But experts say the fungus is almost always fatal for leukemia patients and bone marrow transplant patients with severe damage to the immune system.
According to the doctor, the lungs are most vulnerable to infection.
According to the doctor, by the time a third death occurred at Rosewell Park in July 31, 1982, the hospital had found aspergilli spores on and near the bone marrow transplant wingAungst.
"The content of aspergatis is very low," said Dr. aspergatis . "Aungst said.
All of them are very low.
He said the number of indoor spores was the same as found in the air outside Rosewell Park.
He said hospital officials decided to keep the transplant area open after the test.
In the next eight months, there were eight more transplant patients, all of whom had leukemia, all of whom had fungal disease and died.
While health ministry and Roswell officials refused to confirm the death of the patient on the grounds that the patient was kept confidential, they said the victims included a 15-year-
A 16-year-old girlyear-old boy;
There are 4 females, aged 27, 41, 44 and 45, and 5 males, aged 24, 26, 32, 44 and 45, respectively.
Since the last death, the ceiling of the six rooms of the bone marrow transplant wing has been removed pending the installation of a new air filter called hepa-filters.
In the past few years, many other cancer agencies across the country have installed this air system to protect bone marrow transplant patients from infectious air pollutants.
Experts at the federal Centers for Disease Control and air purification in Atlanta say hepa-
The filter is 95 to 99.
9% screening bacteria is effective. The old air-
According to Gerald K, the processing system for the Rosewell Park transplant room is only 30 to 35% valid.
Xiao field, deputy director of Hospital Administration
An extensive survey of the state advertising program the Ministry of Health survey announced last week will include a review of the medical records of all bone marrow transplant patients in Rosewell Park since 1977, as well as a review of the wing air handling system, its infection control procedures, as well as the failure of hospitals to inform the ministry of health of an increasing number of cases of infection as required by the National Hospital code.
The state Health Commissioner Dr.
David Axelrod also said he would ask the federal Centers for Disease Control to "ensure that appropriate environmental assessments are conducted ".
"In a statement,
Axelrod said: "While we recognize that patients treated with bone marrow transplants are very vulnerable to a variety of common infectious diseases, what we are most concerned about is determining if there are any environmental issues or patient care practices that need to be addressed in Roswell Park to protect the high more effectivelyrisk patients.
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National regulations do not require the installation of hepa-
The filtration system in the room of the patient who is very prone to air-bone infection.
According to the doctor, after the Rosewell park wing was closed, a spore called mold was found in the duct of the ventilation system
Aunt, assistant director of clinical affairs.
He said that a different strain was found during the autopsy, called the yellow yeast.
Because the strains in the catheter are different from those in the patient, Dr.
Auntie said the hospital did not believe that the ventilation system was the cause of the exposure.
"I don't know if this is something that can be proved or denied," he said . ".
Some cancer hospitals in other institutions that suffer from the disease or have learned about it usually have hepa-installed-
According to experts in the field, filtration and purification systems.
Pharmaceutical companies, computer chipmakers, medical research laboratories, and the national space program have been using these filters for years to guarantee sterile air. Robert J.
Zhou, an environmental microbiology scientist at the Centers for Disease Control, said the filter can prevent fungal spores from entering the size of 1 micron in the air.
Micron is equivalent to the diameter of the point of a public pin. ''Aspergilli-
"Granular spores are about 3 to 4 microns," said the doctor. Weeks said.
"There are very few fungi less than 2 microns.
Advertisementhe said that about 95% of the spores will be hepa-
Filter it before they enter the room.
He went on to say that the filtered amount of air creates positive pressure in the room.
Whenever the door of the room is opened, the pressurized air inside the room rushes into the hallway and takes away any remaining spores to prevent any spores from entering the room.
Choice of filters: simple or complex
There are two hepa in 1970s-
Filter system on the market.
Easier to Use forcing
Air unit with hepa
The filter is installed at its opening.
It is attached to the ceiling pipe.
When the air passes through the filter vertically, fungi, bacteria and viruses are trapped on the filter, a fiberglass matrix shaped like an accordion.
A more complex system is called a flow chamber.
In such a room, the entire wall behind the patient's bed has a series of hepa-
Filter, the room is constantly bathed with horizontal jet of purified air.
Experts say the system makes the room more sterile than a room with only one hepafilter.
Roswell Park plans to install a simpler filtration system.
Some experts say there are two main drawbacks to the flow room.
It is more expensive than a ceiling unit.
The doctor said that patients in the bed room are kept isolated and should not be touched by relatives or medical staff. Dr.
Dean barkner, 40, assistant director
The bed bone marrow transplant department at the Fred Hutchinson Cancer Center in Seattle said that during its seven-year operation, the center's transplant facility had never had a Qufu disease.
14 of the 40 rooms feature a flow system.
Some others have single hepa-
Filter, some do not have special air filtration.
He said that the other 20 rooms will be completed soon and there will be a system for the flow of air.
"We are aware that this problem may happen to us and we want to be prepared for it," said the doctor. Buckner said.
Memorial Sloan-
The Kettering Cancer Center in Manhattan is the only hospital in New York state for a bone marrow transplant. since 1978, the center's seven transplant rooms have been equipped with laminar flow equipment. Five years after the transplant began
Its air purification system is between 1973 and 1978.
Sloane spokesman Susan Laufen Bart
Kettering said that two of the 400 transplant patients in the center died from the disease between 1973 and 1978, and two others have died since 1978.
The filter seems to help the University of Minnesota 12-
Bed bone marrow transplant, ceiling hepa-
The filter was installed in May 1981 after a series of deadly Qu bacteria infections.
Of the 66 patients who received the transplant in 1979, a total of 12 died from the disease, accounting for about 18%.
In the year after hepa
3 or 4 of the 64 transplant patients received the filter.
According to hospital environmental expert Andrew skewer, 6% of people died of fungi.
According to Dr. Roswell Parker, in 1969 there were 12 cases of fatal Qufu infection in Roswell Parker. Edward S.
Henderson, head of the Department for treating leukemia patients.
The number of infections declined in the following years.
There were no cases in 1980, only "a few" in 1981, Dr. Henderson said.
In June 1982, two months before the new bone marrow transplant unit was established, Dr. Harvey D.
Member of Dr. Preisler
Henderson's staff wrote to Michael Murphy, director of biology at Rosewell Park.
Officials said that in order to express concerns about the disease, and asked to sample air in the unit,
Schofield, deputy director in charge of management, said sampling found that the content of fungi was very low.
The first patient died in June 27, 1982 and the second in July 1. On July 12 Mr.
Schofield asked for hepa from the state-filter system.
In last August, nearly five months after the agency was closedGerald P.
Murphy, director of Rosewell Park, wrote to John C.
The general commissioner, Egan, requested a speed-up --
End of Work on filter items.
A month later, he made a similar request to the doctor.
Axrod, state health commissioner.
The design for installing the filter arrived at the park on October.
About 15 months after they were asked.
A version of this article appeared on the national edition B00001 page of November 3, 1983, with the title: 11 people died of air fungus in hospital due to delays in the new air filter.