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News archive - July 2015

A breath of fresh air for healthcare

A breath of fresh air for healthcare

There are certain scenarios that increase the importance of the choices made when designing ventilation systems.

In healthcare - where the careful specification of all building services is particularly crucial - indoor air quality (IAQ) is an issue that has a direct impact on what matters most: the welfare of the patients.

Ventilation, literally, is the provision of fresh air into a space. The problem is the word ‘fresh’ is not always entirely accurate. The air might flow throughout every room of the building, and in a hospital or care home, patients and occupants are vulnerable and at a high risk of contamination and infection.

Assessing the risks

While the obligation to protect the health and wellbeing of occupants in healthcare buildings is motivation enough, the safe engineering, implementation, and operation of ventilation systems in these scenarios is outlined under government-accredited guidelines. As well as the Building Regulations Approved Document F (Ventilation), ventilation is also covered under the Health Technical Memorandum 03-01.

Digesting these outlines is easier said than done, but being aware of the responsibility building services providers have in these situations is simple.

Healthcare premises are bound by the duty of care. Poor indoor air quality can foreseeably be a cause of harm, so this potential must be eradicated through carefully-considered system design. Failing to prevent, dilute or contain harmful airborne substances can result in a civil suit against designers, engineers and operators by individuals who are affected. From every angle, the necessity for adequate ventilation simply must be acknowledged.

Each room should be isolated from airborne threats, or at least have the potential to be depending on the condition and requirements of the patient or occupant.

The spread of viruses is unpredictable, but the consequences can be severe. Great care is taken in sterilising and disinfecting the equipment, objects, and indeed the people, within these buildings and the cleanliness of the air should be treated with similarly-scrupulous attention.

Isolating and eradicating contaminant airborne risks is one thing, but the constant battle against excessive CO² levels must be constantly monitored, too. Relying on windows and draughts is not sufficient as during the cold winter months it is the natural reaction to try and keep the warmth in. As a result, CO² builds up to unacceptable levels and to the detriment of occupants’ health.

The advantages of excellent indoor air quality don’t stop there. The work that nurses, doctors and carers do requires intense levels of concentration and attentiveness. It has been proven in schools and other public establishments that IAQ has a huge bearing on concentration, so inadequate levels must not be allowed to hinder their capability to perform such important work.

Natural vs Mechanical

The decision on whether to specify natural or mechanical ventilation is a step that may be influenced by unique building characteristics and requirements.

Natural ventilation is established in the design of the building: making envelopes or openings in the building itself whereby air can be channelled. If the complexities of ventilation requirements in healthcare buildings are considered in the initial design, natural ventilation is indeed a viable option. But that is not to say it is the most-suitable solution for safeguarding potentially-vulnerable occupants.

The most-pertinent issue with it is the lack of both isolation and regulation. Air flow is difficult to manage in the absence of a mechanically-supplied negative pressure, which increases the risk of contaminating adjacent rooms and corridors. It is also heavily dependent on there being natural forces available. In cold weather, for example, windows and vents might be shut and air will become stagnant as a result.

When the air flow and room temperature need such careful monitoring, the control that mechanical ventilation offers - or even a hybrid system - makes it a sensible choice.

There is the potential for staff to physically monitor temperatures, air flow rates and CO² levels, and make necessary changes accordingly. This might be a manual adjustment, but there are systems that can operate automatically to ensure that air quality does not fall below acceptable levels.

This ability to regulate ventilation should be imbalanced by the assurance that the fresh air is not being wasted where it is not needed. Mechanical systems can help circumvent this dilemma through displacement ventilation: low-velocity, draught-free fresh air introduced at a low level where it can then rise to head height where it is most required.

New technology

How can this low-level air be introduced effectively? Technological advances now mean that mechanical ventilation systems can be integrated and controlled within a heating system. Through one system operators can ensure that each room is at a suitable temperature while maintaining a steady flow of fresh, clean air. The air is pulled into the room mechanically, is passed over the heat exchanger in the radiator, which displaces stale air and pushes it upwards towards a linked extraction fan which pulls air through at the same rate as the air intake.

The elevated importance of the indoor environment can be a burden - mechanical systems can help alleviate any health risks in the most efficient manner.

Financial inefficiencies can often stem from poorly-chosen heating and ventilation measures. Again, the needless waste of money is magnified when it comes to healthcare. Money wasted on energy is money that can so easily be reallocated towards ensuring excellent levels of care. The smallest margins become a big deal when people’s health is at stake.

A mechanical, demand-controlled ventilation system soothes this sticky financial issue perfectly. If the intake of fresh air is regulated, it reduces energy wastage caused by over ventilation or overheating.

The specification of ventilation in healthcare must be done with great care. In the extreme, it could literally be a matter of life and death. Expertise in this area might not be an easy find, but the results of doing so are invaluable.

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