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Review
Peer-Review Record

Indoor Air Pollution of Volatile Organic Compounds (VOCs) in Hospitals in Thailand: Review of Current Practices, Challenges, and Recommendations

Atmosphere 2025, 16(10), 1135; https://doi.org/10.3390/atmos16101135
by Wissawa Malakan *, Sarin KC, Thanakorn Jalearnkittiwut and Wilasinee Samniang
Reviewer 1: Anonymous
Reviewer 2: Anonymous
Reviewer 3: Anonymous
Atmosphere 2025, 16(10), 1135; https://doi.org/10.3390/atmos16101135
Submission received: 15 August 2025 / Revised: 19 September 2025 / Accepted: 24 September 2025 / Published: 27 September 2025

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Malakan et al. wrote a review on indoor air quality in hospitals in Taiwan. However, the review lacks certain details, particularly regarding the ranges reported in the studies conducted both in Taiwan and elsewhere, as well as the sampling techniques and instrumentation used. Additionally, the authors focus mainly on Sick Building Syndrome (SBS) rather than on the impact on occupants.

I believe the authors should have applied a more standardized procedure when presenting experimental work, including ranges of VOCs, sampling conditions, and analytical techniques. Furthermore, no figures or photos were included; adding them would be very helpful for understanding the studies.

 

Line 25: “especially under poor ventilation”

Line 69/70: please provide the list of countries.

Line 80: please provide a range/value and compared to reglementation

Line 161: review the sentence, this is a review and not an experimental work, so it is not “we found”.

Line 258: Why to start with Moreover?.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This article is a review research on indoor volatile organic compound (VOC) pollution in Thai hospitals. The authors conducted a comprehensive analysis of the sources, exposure levels, and health impacts of VOCs in hospital environments in Thailand and other countries from 2008 to 2023. The article has a complete structure, but the repetition rate needs to be reduced. The following issues may need to be addressed before publication:

1. Lines 1–49. The introduction discusses the health impacts of indoor air pollution and the research background of hospitals as special settings, but it lacks systematic analysis. In particular, there is insufficient detailed explanation and discussion of the specific mechanisms by which VOCs in hospital environments affect the health of patients and healthcare workers.

2. Lines 120–238. The article lists 87 relevant studies, but the presentation of detailed data on VOC concentrations, sources, and health impacts in these studies is insufficient, and there is a lack of in-depth comparison and analysis of different study results.

3. The study does not sufficiently analyze differences in results across different countries and regions, nor does it adequately explore possible causes of these differences, such as the impact of hospital building structures, medical equipment usage, and management measures on VOC concentrations and health impacts.

4. The article lacks a quantitative analysis of health risks at different exposure levels for VOCs, and the authors should strengthen this aspect.

5. The interpretation of key study results is superficial, such as the reasons for higher VOC concentrations in specific areas of hospitals and the potential health impacts of these high-concentration areas on patients and healthcare workers. These issues are not analyzed in detail in conjunction with actual hospital operations and environmental factors, which should be emphasized as the highlights and focal points of the article.

6. Lines 239–365. The authors need to compare and discuss their findings with existing research. While the current version mentions some studies from other countries, the comparison and analysis of these studies with the Thai research results are not sufficiently in-depth or detailed to highlight the study’s value.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

1.1. Recommendation
Reject
Title: Indoor air pollution of volatile organic compounds (VOCs) in hospitals, Thailand: review of current practices, challenges, and recommendations

Overview and General Recommendations:
Managing VOCs in hospitals is crucial because they can directly impact patients, physicians, nurses, and staff. Hospitals, in particular, use a large number of disinfectants, sterilizers, and volatile chemicals in operating rooms, which can significantly impact the health of patients and staff who spend long periods of time there. Therefore, identifying VOC concentrations and sources in Thai hospitals is of great value for research and health maintenance. The identification of VOC concentrations, trends, and sources identified in this paper will be of great help to relevant researchers.

This paper consists of an introduction, methods, results, discussion, and conclusion. However, after reviewing the quality and content of the paper, it falls short of being published in Atmosphere.

The main comments on the paper are as follows:

1. Introduction
The introduction section calls for a more detailed review paper on exposure to VOCs in hospital settings. Reviews on hospital settings are lacking.

2. Methodology

2.1. Search strategy and selection criteria

There are no major issues with the method of finding papers.

2.2. Study selection and data extraction

2.2. and 2.3. should be combined, and the study selection flow chart in Figure 1 should be presented here.

3. Results

3.1. Overall results for indoor VOCs in hospital settings

A table summarizing the results is needed in the main text. (Insert this within the main text, not in a separate summary.)

3.2. Indoor VOCs in hospitals in Thailand
Table A2. summarizes only the results for Thailand, and a clear summary is needed.

A detailed explanation of the table and the direction of implementation based on policy are lacking.

4. Discussion

A separate table summarizing international cases in Table A2 is needed. Rather than simply explaining the results, the study should compare the results with those from Thailand to identify any differences and discuss potential areas for improvement.

5. Recommendations

More detailed explanations are needed in conjunction with the discussion section, and the simple listing of monitoring parameters, equipment, risk assessment, prevention, and mitigation should be improved.

In particular, the directions for improvement should be clearly stated compared to Thailand's VOC exposure and monitoring practices.

6. Conclusion

The above conclusions are general and do not clearly summarize the findings. A detailed rewrite of the conclusions is necessary.

7. References

The paper should be rewritten in MDPI format.

Conclusively, the content of this paper lacks scientific detail and quality, making it insufficient for publication in Atmosphere.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

The author has revised all of the content mentioned above.
However, the reference format must be modified to MDPI format.
Therefore, the current paper can be published without major issues if only the reference format is revised.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

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