Advertisement

Toward an energy efficient healthcare environment: a case study of hospital corridor design

  • E. S. MousaviEmail author
Original Paper
  • 40 Downloads

Abstract

Several studies have linked nosocomial transmission of airborne diseases to airflow in healthcare settings. Quasi-experimental methods are developed to observe the aerodynamic transport behavior of synthetic respiratory particles in the corridors of an actual hospital. Computational models are then developed to validate the experimental results and to explore the spatial relationships of supply–exhaust air ventilation under various ventilation rates in patient corridors. This work aims to study the effect of ventilation rate and arrangement on the containment and removal of airborne contaminates in patient corridors. Results suggest that distribution of bio-aerosols in hospital corridors could be exacerbated by introducing higher ventilation rates. Increasing ventilation rate appears to reduce aerosol concentrations; however, depending on release point and ventilation arrangement, the reduction may not be worth the extra cost of ventilation. Modified supply–exhaust air system configurations could reduce average particle concentration up to 30% and transport distance more than 60% without increasing air change rate. Best results were obtained by placing an air outlet grille between each two supply air intakes along the corridor.

Keywords

Ventilation Hospital design Infection control Computational fluid dynamics 

Notes

Acknowledgements

The author would like to thank Dr. Kevin Grosskopf for his comments on manuscript.

References

  1. AIA (2006) Guidelines for design and construction of health care facilities. AIA, Washington, DCGoogle Scholar
  2. Aliabadi AA, Rogak SN, Bartlett KH, Green SI (2011) Preventing airborne disease transmission: review of methods for ventilation design in health care facilities. Adv Prev Med 2011:1–21.  https://doi.org/10.4061/2011/124064 CrossRefGoogle Scholar
  3. ASHRAE Standard 170 (2013) Ventilation of healthcare facilities. ASHRAE Stand 170:1–26Google Scholar
  4. Beggs CB, Shepherd SJ, Kerr KG (2010) Potential for airborne transmission of infection in the waiting areas of healthcare premises: stochastic analysis using a Monte Carlo model. BMC Infect Dis 10:247.  https://doi.org/10.1186/1471-2334-10-247 CrossRefGoogle Scholar
  5. Brady MT (2005) Health care–associated infections in the neonatal intensive care unit. Am J Infect Control 33(5):268–275.  https://doi.org/10.1016/j.ajic.2012.06.004 CrossRefGoogle Scholar
  6. Centers for Disease Control and Prevention (2016) National and State Associated Infections Progress Report. Centers for Disease Control and Prevention (March). 10.1002/yd.282Google Scholar
  7. Chen C, Zhao B (2010) Some questions on dispersion of human exhaled droplets in ventilation room: answers from numerical investigation. Indoor Air 20(2):95–111.  https://doi.org/10.1111/j.1600-0668.2009.00626.x CrossRefGoogle Scholar
  8. Cosgrove SE, Sakoulas G, Perencevich EN, Schwaber MJ, Karchmer AW, Carmeli Y (2003) Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: a meta-analysis. Clin Infect Dis 36(1):53–59.  https://doi.org/10.1086/345476 CrossRefGoogle Scholar
  9. Grosskopf K, Mousavi E (2014) Bioaerosols in health-care environments. ASHRAE J 56(8):22–31Google Scholar
  10. Hathway EA, Noakes CJ, Sleigh PA, Fletcher LA (2011) CFD simulation of airborne pathogen transport due to human activities. Build Environ 46(12):2500–2511.  https://doi.org/10.1016/j.buildenv.2011.06.001 CrossRefGoogle Scholar
  11. Humphreys H (2004) Positive-pressure isolation and the prevention of invasive aspergillosis. What is the evidence? J Hosp Infect 56(2):93–100.  https://doi.org/10.1016/j.jhin.2003.10.011 CrossRefGoogle Scholar
  12. Lai ACK (2002) Particle deposition indoors: a review. Indoor Air 12(4):211–214.  https://doi.org/10.1034/j.1600-0668.2002.01159.x CrossRefGoogle Scholar
  13. Li Y, Leung GM, Tang JW, Yang X, Chao CYHYH, Lin JZ, Lu JW, Nielsen PV, Niu J, Qian H, Sleigh AC, Su HJJ, Sundell J, Wong TW, Yuen PL (2007) Role of ventilation in airborne transmission of infectious agents in the built environment—a multidisciplinary systematic review. Indoor Air 17(1):2–18.  https://doi.org/10.1111/j.1600-0668.2006.00445.x CrossRefGoogle Scholar
  14. Lin J, Pai JY, Chen CC (2012) Applied patent RFID systems for building reacting HEPA air ventilation system in hospital operation rooms. J Med Syst 36(6):3399–3405.  https://doi.org/10.1007/s10916-011-9800-4 CrossRefGoogle Scholar
  15. Marschall J, Agniel D, Fraser VJ, Doherty J, Warren DK (2008) Gram-negative bacteraemia in non-ICU patients: factors associated with inadequate antibiotic therapy and impact on outcomes. J Antimicrob Chemother 61(6):1376–1383.  https://doi.org/10.1093/jac/dkn104 CrossRefGoogle Scholar
  16. Matida EA, Nishino K, Torii K (2000) Statistical simulation of particle deposition on the wall from turbulent dispersed pipe flow. Int J Heat Fluid Flow 21(4):389–402.  https://doi.org/10.1016/S0142-727X(00)00004-7 CrossRefGoogle Scholar
  17. McNeill J, Hertzberg J, Zhai Z (2013) Experimental investigation of operating room air distribution in a full-scale laboratory chamber using particle image velocimetry and flow visualization. J Flow Control Meas Visual 1(1):24–32.  https://doi.org/10.4236/jfcmv.2013.11005 CrossRefGoogle Scholar
  18. Memarzadeh F (2011) The environment of care and health care-associated infections: an engineering perspective. American Society of Healthcare Engineering of the American Hospital AssociationGoogle Scholar
  19. Mousavi ES, Grosskopf KR (2014) Transport of respiratory aerosols in patient corridors subject to a directional and non-directional airflow—a case study. ASHRAE transaction, Seattle, WA, vol 120, no 2Google Scholar
  20. Mousavi ES, Grosskopf KR (2015) Ventilation rates and airflow pathways in patient rooms: a case study of bioaerosol containment and removal. Ann Occup Hyg 59(9):1190–1199CrossRefGoogle Scholar
  21. Mousavi ES, Grosskopf KR (2016) Secondary exposure risks to patients in an airborne isolation room: implications for anteroom design. Build Environ 104:131–137.  https://doi.org/10.1016/j.buildenv.2016.05.010 CrossRefGoogle Scholar
  22. Mousavi ES, Grosskopf KR (2018) Renovation in hospitals : a case study of source control ventilation in work zones. In: Advances in building energy research, Taylor & Francis, pp 1–14Google Scholar
  23. Nazaroff WW (2016) Indoor bioaerosol dynamics. Indoor Air 26(1):61–78.  https://doi.org/10.1111/ina.12174 CrossRefGoogle Scholar
  24. Norton T, Sun DW (2006) Computational fluid dynamics (CFD)—an effective and efficient design and analysis tool for the food industry: a review. Trends Food Sci Technol 17(11):600–620.  https://doi.org/10.1016/j.tifs.2006.05.004 CrossRefGoogle Scholar
  25. Novoselac A, Srebric J (2002) A critical review on the performance and design of combined cooled ceiling and displacement ventilation systems. Energy Build 34(5):497–509.  https://doi.org/10.1016/S0378-7788(01)00134-7 CrossRefGoogle Scholar
  26. Rydock J, Eian P (2004) Containment testing of isolation rooms. J Hosp Infect 57(3):228–232.  https://doi.org/10.1016/j.jhin.2004.01.032 CrossRefGoogle Scholar
  27. Sadrizadeh S, Holmberg S (2016) Evaluation of various turbulence models for indoor airflow prediction: a comparison with experimental data. In: Indoor air quality ventilation and energy conservation in buildings, pp 1–7Google Scholar
  28. Sadrizadeh S, Holmberg S, Tammelin A (2014) A numerical investigation of vertical and horizontal laminar air flow ventilation in an operating room. Build Environ 82:517–525.  https://doi.org/10.1016/j.buildenv.2014.09.013 CrossRefGoogle Scholar
  29. Srebric J, Chen Q (2002a) An example of verification, validation, and reporting of indoor environment CFD analyses (RP-1133). ASHRAE Trans 108 PART 2(2):185–194Google Scholar
  30. Srebric J, Chen Q (2002b) Simplified numerical models for complex air supply diffusers. HVAC&R Res 8(3):277–294CrossRefGoogle Scholar
  31. Stone PW (2009) Economic burden of healthcare-associated infections: an American perspective. Expert Revf Pharmacoecon Outcomes Res 9(5):417–422.  https://doi.org/10.1586/erp.09.53.Economic CrossRefGoogle Scholar
  32. Sundell J, Levin H, Nazaroff WW, Cain WS, Fisk WJ, Grimsrud DT, Gyntelberg F, Li Y, Persily AK, Pickering AC, Samet JM, Spengler JD, Taylor ST, Weschler CJ (2011) Ventilation rates and health: multidisciplinary review of the scientific literature. Indoor Air 21(3):191–204.  https://doi.org/10.1111/j.1600-0668.2010.00703.x CrossRefGoogle Scholar
  33. Tu J, Yeoh GH, Liu C (2018) Computational fluid dynamics: a practical approach. Butterworth-Heinemann, OxfordGoogle Scholar
  34. Tung YC, Hu SC, Tsai TI, Chang IL (2009) An experimental study on ventilation efficiency of isolation room. Build Environ 44(2):271–279CrossRefGoogle Scholar
  35. Turan ÖF, Azad RS (1993) Comparison of the zero-wire-length dissipation technique with spectral corrections and the effect of high turbulence intensity. Exp Therm Fluid Sci 6(3):292–308.  https://doi.org/10.1016/0894-1777(93)90070-Y CrossRefGoogle Scholar
  36. Villafruela JM, San José JF, Castro F, Zarzuelo A (2016) Airflow patterns through a sliding door during opening and foot traffic in operating rooms. Build Environ 109:190–198.  https://doi.org/10.1016/j.buildenv.2016.09.025 CrossRefGoogle Scholar
  37. Wang M, Lin CH, Chen Q (2012) Advanced turbulence models for predicting particle transport in enclosed environments. Build Environ 47(1):40–49.  https://doi.org/10.1016/j.buildenv.2011.05.018 CrossRefGoogle Scholar
  38. Whitby M, McLaws ML, Berry G (2001) Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis. Med J Aust 175:264–267CrossRefGoogle Scholar
  39. White FM (2000) Viscous fluid flow, New York, p 413Google Scholar
  40. WHO (2007) Infection prevention and control of epidemic-and pandemic-prone acute respiratory diseases in health care. WHO, GenevaGoogle Scholar
  41. Zhao B, Zhang Y, Li X, Yang X, Huang D (2004a) Comparison of indoor aerosol particle concentration and deposition in different ventilated rooms by numerical method. Build Environ 39(1):1–8.  https://doi.org/10.1016/j.buildenv.2003.08.002 CrossRefGoogle Scholar
  42. Zhao B, Zhang Z, Li X, Huang D (2004b) Comparison of diffusion characteristics of aerosol particles in different ventilated rooms by numerical method. ASHRAE Trans 110 Part 1:88–95.  https://doi.org/10.1016/j.buildenv.2003.08.002 CrossRefGoogle Scholar

Copyright information

© Islamic Azad University (IAU) 2019

Authors and Affiliations

  1. 1.2-132 Lee Hall, Department of Construction Science and ManagementClemson UniversityClemsonUSA

Personalised recommendations