Investigation of the Mechanism and Possibility of Transmission of Coronaviruses through Ventilation and Wastewater Plumbing Systems in Hospitals: A Narrative Review

The hospital wastewater plumbing system and ventilation systems can be possible routes of transmission of infectious agents, such as coronaviruses. Therefore, the purpose of this study was to review the conducted studies in this regard to determine the mechanism and possibility of transmission of coronaviruses through ventilation systems and wastewater plumbing in hospitals.

In this narrative review, all the articles published in English since 2000 up to September 2020 on the possibility of transmitting coronaviruses, such as severe acute respiratory syndrome coronavirus 2, through ventilation systems and wastewater plumbing in hospitals were reviewed. These studies were obtained by searching the databases, including Google Scholar, ScienceDirect, and PubMed, using several keywords, such as “Coronavirus”, “SARS-CoV-2”, “COVID-19”, “Ventilation Systems”, and “Wastewater Plumbing Systems”.  

Coronaviruses can enter wastewater through several sources, such as hand washing, sputum, vomit, and feces. Without proper maintenance and continuous monitoring, review, implementation, and update of building standards and practices, improper plumbing and sewage systems can continue to spread severe acute respiratory syndrome and some other infectious diseases. In addition, the factors, such as poor ventilation and recirculation, increase the potential for the viruses to spread indoors.

The obtained results of the current study showed that the plumbing system is not a common method of transmitting the viruses, and the most prevalent route of transmission is considered respiratory droplets. Therefore, maintaining social distance and personal hygiene are among the most effective ways to prevent the transmission of coronaviruses.