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Effective Guidelines for Control and Management of Good IAQ in Hospitals

 

These Days, Indoor Air Quality (IAQ) in hospitals is crucial for patient and staff safety. According to the World Health Organization, at any given time over 1.4 million people across the globe suffer from Hospital Acquired Infection (HAI). HAIs account for 2 million cases and about 80,000 deaths a year. Patients’ suppressed immune systems are more susceptible to adverse health effects.

Hospitals must consider buildings design to improve the air quality to avoid airborne spread for patient’s health and safety. Buildings with poor air filtration system are at a high risk of raising illness caused by airborne contaminants. Clean air is vital in hospital & healthcare facility operations to protect patients, staff, and visitors from airborne diseases & infections and to provide a comfortable, healthy, and odour-free environment.

Air quality inside the building will be affected by both internal and external parameters. Internal factors such as thermal conditions (humidity and temperature), presence of particulate and gaseous contaminants, chemical components, as well as ambient air quality contribute to indoor air quality.



The air inside the building can contain:

  •          Molds, spores, pollens
  •         Carbon monoxide, radon, volatile organic compounds (VOCs) 
  •        Bacteria, viruses and by-products
  •         Vehicle engine exhaust, exhaust from industrial plants
  •         Asbestos, clays, elemental particles and man-made fibers

Outdoor air pollution plays a significant role in indoor air exposures. Due to ventilation providing continuous air exchange in buildings, the indoor air exposure to fine PM, originates mostly from outdoor air, especially in areas affected by heavy traffic.

Importance of Air Filtration

Healthcare facilities pose a unique design challenge as the systems require broad range of ventilation requirements to provide protection from airborne hazards. Effective control of hospital outbreaks will be achieved in most instances by adapting a proper infection control system and the application of high-efficiency air filtration system to maintain clean air.                                                                                              

Several governing agencies provide guidelines to enhance the air quality before certifying any hospital premise. NABH, ISHRAE and ASHRAE standards are the most used standards followed in India for designing various types of air treatment equipment for hospitals and healthcare facilities.

To provide a healthy atmosphere for the patients, healthcare workers and others, hospitals should opt for air filtration solution which can remove airborne contaminants, microorganisms, viruses, hazardous chemicals, odour and radioactive substances etc. To achieve this, hospitals should install various filtrations starting from 20 microns to 0.3 microns or less depending on the requirement of the zone.

Recommendations:

High Efficiency Particulate Arrestance (HEPA) Filters for Fresh Air Handling Units (FAHU):

HEPA filters are the most efficient air filters recommended for the current situation. HEPA filters over the decades have proven to control the risk of airborne contamination like dust, bacteria, viruses, etc. It is recommended to upgrade the current secondary filter which will be usually a bag filter or pocket filter to HEPA filter.

HEPA filters are available in a variety of efficiencies - from 99.97% tested on 0.3 µm particles to 99.9995% and higher tested at MPPS (0.1 to 0.2µm particles).

Choose true HEPA filters:

Prefer auto-scan tested HEPA filters which are compliant with international standard EN 1822. HEPA filters should be manufactured, tested and packed in ISO Class 8 (100,000) cleanroom environment.

Air Filtration Design for Recirculating AHUs:

For recirculating systems, install a prefilter, a fine filter of grade F9 and optional HEPA H14 filters.

Ceiling Mounted Air Purifier Unit for Dental Sections and Consultation Rooms:

The compact design of a machine integrated with three-stage of high-performance filters can efficiently remove indoor airborne particles, harmful gases, bacteria and viruses. As a supplement to indoor fresh air, it can be connected to an existing fresh air system or mixed (fresh & recirculating) air system.

Recirculation Unit for Consultation rooms, waiting areas and other common spaces:

A stand-alone complete air purification system to recirculate and clean the air in a controlled environment. It combines particulate filters, gas-phase cassettes and high-efficiency filters to remove both airborne particles and gaseous contaminants, virus, bacteria, fungus & molds and provide a total clean air solution.

Containment solution for radioactive labs and exhaust of Isolation Rooms:

The Bag-In/Bag-Out (BIBO) side access filter system is a safe, simple, reliable method for removing contaminated particulate filters and/or gas absorbers in the exhaust

stream of isolation rooms. The return air should be equipped with the HEPA filter. It is strongly recommended to use BIBO unit in isolation rooms exhaust air.

Operation Theatre plenum for Operation Theatres:

This module is suitable for the installation of particulate HEPA filters, such as the AstroCel® II filter. The total installation height is only 120 mm (plus 25 mm for the connecting flange). This housing is recommended for use in operation theatres, where air quality must be an extremely high level.

Air Filtration Equipment Design for Mortuary or Autopsy Rooms:

Customized equipment should be used in these rooms which include 3 stages of filtration. Stage 1 will be a prefilter, stage 2 would be gas-phase cassettes and the last stage with high-efficiency HEPA filters.

We urge The Ministry of Health to streamline the IAQ standards by enforcing the hospitals to adopt various types of air treatment equipment in the premises. Different methods like dilution, filtration, pressurization, and disinfection should be adopted to control the airborne infectious agents.  

Also, a combination of high-efficiency air filters captures nearly all the particles in this size range, eliminating typical virus-carrying particles from airstreams inside buildings. For example, a MERV 11 pre-filter in conjunction with a MERV 16 secondary filter removes 98.66% of particles in the 0.3 - 1.0micron size range in one pass. *

The above key recommendations can bring revolutionary changes to the healthcare system. Effective implementation of these solutions helps tackle the hospital acquired infections rate. This will ensure effective practices in hospitals and boost the capacity of India’s healthcare system with high-quality products and services across the country.

* https://www.aafintl.com/en/commercial/blog/2020/05/prepare-for-the-reopening

  

Contact us:

www.aaf-india.com

www.aaf-me.info

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