The hospital indoor environment includes several unwanted elements including a mix of chemical pollutants, biological contaminants and a high physical and mental stress for all the staff offering medical services. Infection risks are increased by direct contact with sick people in addition to needle and medical equipment punctures conveying blood-transmitted diseases. Although infection control measures are considered seriously they are often inadequate because of concomitant construction problems and ingress of outdoor pollutants. This is especially so in metropolitan areas where the hospitals are engulfed in an urban environment and surrounded by small scale industrial pollution and traffic air emissions. Every country and indeed every hospital has its own problems and this paper describes the progress of an environmental integrated management scheme initiated for the indoor environment of hospitals to provide greater control to protect the hospital staff from occupational hazards impacting their health, their home contacts and their patients. The scheme started with the preparation of an environmental assessment for newly built hospitals. For those hospitals currently operating the scheme comprised the organisation of an environmental health group and the preparation of a checklist of the environmental sources of indoor pollutants, contaminants and sources of infection and occupational health hazards. An environmental audit was conducted with monitoring for sources of environmental deterioration. There was a follow up for the adoption of hazardous waste management and cleaning and disinfection protocols. A reporting system was set up within the scheme which included follow up actions. The problems of adopting the system are discussed with methodologies for their solutions.