Follow-up Evaluation of Respiratory Isolation Rooms in 10 Midwestern Hospitals

Dahl, Karen M.; L'Ecuyer, Paul B.; Jones, Marilyn; Fraser, Victoria J.

doi:10.1017/s0195941700003593

Cited by 5 publications

(6 citation statements)

References 9 publications

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“…Previous field studies reported that up to 50% of the tested isolation rooms failed to provide a negative pressure [17][18][19][23][24][25]. The main factors that disrupted negative pressurisation included poor reliability of pressurisation control and monitoring devices, strong diffuser flow directed at the door, interaction with other exhaust ventilation systems and poor airtightness of the suspended false ceiling [19].…”

Section: Introductionmentioning

confidence: 99%

“…We carried out field measurements in selected isolation rooms in the new SARS wards between May and August 2005 after a 1.5 years operation to identify factors that affect the ventilation performance. Given the fact that the 558 SARS isolation rooms were designed and constructed nearly at the same time and represented state-of-the-art technologies, it was expected that these isolation rooms would provide better ventilation performance than those reported in the literature [17][18][19][23][24][25]. The current concerns about the risk of an influenza pandemic from avian influenza (H5N1) have made this field study timely as some of these SARS wards are expected to be used by H5N1 patients if one or more human H5N1 cases occur.…”

Section: Introductionmentioning

confidence: 99%

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An Evaluation of the Ventilation Performance of New SARS Isolation Wards in Nine Hospitals in Hong Kong

Ching

Qian

et al. 2007

Indoor and Built Environment

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In response to the 2003 outbreak of severe acute respiratory syndrome (SARS) the Hong Kong Government promptly constructed 558 new state-of-the-art SARS isolation rooms with more than 1300 beds in 14 hospitals. These were completed by the end of 2003 and some will be available for H5N1 influenza patients, if any human cases occur. We investigated the ventilation of the wards after 18 months of operation and identified the major factors that affect ventilation effectiveness. Negative pressure, airflow path, air change rate and local ventilation effectiveness in selected rooms in 9 major hospitals were measured and their performance assessed against CDC requirements. Testing in 38 rooms found that 97% met the recommended negative pressure difference of 2.5 Pa between corridor and anteroom, 89% of 48 met the same requirement between anteroom and cubicle. No leakage of air to the corridor was found, but 60% of the toilets/bathrooms were operated under positive pressure. Over 90% of corridor-anteroom or anteroom-cubicle doors had bi-directional flow when the door was open. Of 35 tested cubicles, 26% had an air change rate <12 ACH and their ventilation was non-uniform. Despite using state-of-the-art technologies, 28% of the rooms tested still failed to meet the 12 ACH ventilation requirement and 60% had the wrong airflow direction for the toilets/bathrooms, but all satisfied the requirement of no air leakage to the corridor. Regular checks of airflow direction and air change rate are highly recommended together with specific education or training of hospital maintenance engineers and health care workers.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Evaluation of the Ventilation Performance of New SARS Isolation Wards in Nine Hospitals in Hong Kong

Ching

Qian

et al. 2007

Indoor and Built Environment

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“…9 Further, spaces equipped with anterooms have been shown to more effectively maintain a negative pressure differential than spaces without anterooms. 13 However, critics of anterooms cite a lack of clinical evidence on their effectiveness. There are no published clinical or epidemiologic studies conclusively showing that anterooms diminish or prevent the spread of lab-confirmed airborne infectious human illnesses.…”

Section: Importance Of Aiirs and Anteroomsmentioning

confidence: 99%

Isolation anterooms: Important components of airborne infection control

Subhash

Baracco

Fennelly

et al. 2013

American Journal of Infection Control

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“…9 Many studies have indicated that ventilation guidelines are often violated in AIIRs. The negative pressure between the AIIR and corridor was found in 51-91% of AIIRs in the USA [10][11][12][13][14][15][16] but only 32-75% of them followed the minimum pressure difference À2.5 Pa. 15,16 The minimum requirement of 6 ACH was generally achieved in AIIRs but the ACH remained often below the recommendation of 12 ACH. 12,14,16,17 Among Scandinavian AIIRs, the ventilation requirement 12 ACH was achieved in four of six tested AIIRs, as ACHs varied from 5 to 21.…”

Section: Introductionmentioning

confidence: 99%

Performance testing of engineering controls of airborne infection isolation rooms by tracer gas techniques

Kokkonen

Hyttinen

Holopainen

et al. 2013

Indoor and Built Environment

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The ventilation performance of airborne infection isolation rooms (AIIRs) was assessed in three Finnish hospitals by examining the air change rate, contaminant removal efficiency and leakage of contaminants outside the isolation room by using tracer gas techniques. Results showed that infectious agents can escape from the AIIR during egress despite high ventilation rates in the AIIR and anteroom (air change rate, 4–24 h−1) and the pressure difference between the AIIR and corridor was −0.2 to −29 Pa. The control of impurities was often ineffective due to inappropriate direction of air flows and air moving from the patient towards the health care worker and anteroom. Although an anteroom reduces leakage of infectious agents to the corridor significantly, it does not prevent this completely when healthcare workers move between the AIIR and corridor. To enhance the protection of AIIRs, it is especially important to pay attention to the air distribution and removal efficiency of impurities in AIIRs and anterooms. Performance of AIIRs should be tested regularly, especially among older AIIRs.

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Follow-up Evaluation of Respiratory Isolation Rooms in 10 Midwestern Hospitals

Cited by 5 publications

References 9 publications

An Evaluation of the Ventilation Performance of New SARS Isolation Wards in Nine Hospitals in Hong Kong

An Evaluation of the Ventilation Performance of New SARS Isolation Wards in Nine Hospitals in Hong Kong

Isolation anterooms: Important components of airborne infection control

Performance testing of engineering controls of airborne infection isolation rooms by tracer gas techniques

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