Indoor air quality and work-related symptoms among healthcare workers in a Malaysian specialist hospital: A mixed-methods cross-sectional study

Background/Objectives Indoor air quality (IAQ) in healthcare settings significantly influences the health, comfort, and productivity of healthcare workers (HCWs). Malaysia's tropical climate poses significant occupational health risks in hospital environments where inadequate ventilation, high humidity and pollutant accumulation intensify exposure hazards for healthcare workers. This study aimed to assess IAQ-related conditions across different hospital work areas (open and enclosed) and to describe environmental discomfort and self-reported health-related symptoms among healthcare workers in a major specialist hospital in northern Malaysia. Methods A mixed-methods design was employed, comprising a systematic walkthrough inspection guided by the Industry Code of Practice on Indoor Air Quality (ICOP-IAQ, 2010) and a cross-sectional survey using a validated Questionnaire for Building Occupants. Data from 265 HCWs were analysed using descriptive and inferential statistics (Chi-square test) to explore differences in environmental discomfort and reported symptoms across workstation types. Results Walkthrough inspection revealed visible fungal growth, dust accumulation, and poor ventilation across several clinical, support and administrative areas. The most commonly reported environmental discomforts were temperature variability (78.1%), dust (71.7%), and low temperature (68.3%), while the most frequently reported symptoms were fatigue (78.1%), headache (73.6%), and cough (69.1%). Open-concept workstations were significantly associated with high temperature, stuffy air, dry air, and unpleasant odours. Conclusions : The findings indicate notable IAQ-related concerns across hospital work areas, accompanied by widespread environmental discomfort and a high prevalence of self-reported SBS-like symptoms among healthcare workers.