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  • Writer's pictureTom Petersen

Identifying and Removing Air Quality Issues in your Hospital Environment

Updated: Aug 29, 2023

Just how serious can air quality issues be in your hospital environment? Consider this statistic from HPAC Engineering: “According to The New England Journal of Medicine and the University of Medicine and Dentistry of New Jersey, 90,000 to 100,000 people die from nosocomial (hospital-acquired) infections each year. This makes hospitals the fourth-leading cause of death in America, following stroke, cancer, and heart disease.”


Needless to say, hospital air quality is an extremely serious matter. Without careful regulation, your hospital environment can easily become a hazard to both patients and staff members alike. In order to address air quality best practices, we must first identify the potential factors involved in dangerous air quality issues.


According to HPAC Engineering, “There are many reasons why nosocomial infections occur. Among them are poorly designed, operated, and maintained HVAC and plumbing systems.” This is why it’s so important to get your HVAC and plumbing systems inspected and verified by professionals early and often.


You may have considered the above issues, but did you ever think about air pressure affecting your hospital environment? Andrew J. Streifel, MPH, an expert in health-care indoor-air quality (IAQ) and a member of HPAC Engineering’s Editorial Advisory Board, cites air pressure as a big hospital environment concern.


“Air pressure can be rather difficult to control, requiring continuous, concerted effort among designers and operators,” says HPAC Engineering. “For instance, wind, weather fronts, occupant activities, intentional and unintentional envelope breaches, and mechanical or electrical failures can cause short-and long-term changes in pressure patterns that are difficult to sense and diagnose. Few professionals receive formal training on how to troubleshoot air-pressure problems, and few buildings are tested for airtightness after construction or during renovation.”


Streifel also raises concern about energy-efficient “green” buildings, which can compromise air pressure in the hospital due to reduced ventilation. This is not a condemnation of green buildings – merely a caution that particular care may need to be taken to ensure that the quality of the environment can be maintained.


Streifel concludes that “the validation of ventilation is best conducted before occupancy.” If your hospital has not yet been built or is in the process of construction, you have an optimum opportunity to head off potential air quality issues before they manifest themselves in your hospital environment.


Those with existing and occupied hospitals can engage in environmental monitoring to identify and stop air quality compromises. Streifel explains, “Pressure is a controlling parameter, which helps direct the movement of particles in the air. If a particle cloud is generated in a construction zone, it should remain there with pressure control. Airflow control can be enhanced by using a window fan to pull air from inside the building to the outside. Careful control of an air supply to an exhaust fan ensures consistent negative pressure in a construction zone. The factors for such pressure management require a sufficient offset of supply-air vs. exhaust/return-air volumes.


“The amount of leakage in a special-ventilation (SPV) room or area is an important factor in providing consistent airflow management. The CDC’s ‘Guidelines for Environmental Infection Control in Health-Care Facilities’ describes a leakage of 0.5 sq ft per room. Some builders describe leakage in square inches per 100 sq ft of surface in a room. Studies that have seen leakage from 5 to 25 sq in. per 100 sq ft in airborne-infection isolation (AII) rooms have been conducted. This leakage-area standard for SPV areas in hospitals has not been addressed, other than ‘sealing the rooms.’ The respective SPV rooms should be tested by pressurizing each room prior to occupancy. Leak areas in rooms can be found using maximum air volume offset and a smoke generator to find the leaks. When air streams out of a room through a leak, the air stream is seen, and the leak is sealed with caulk.”


Whatever your situation, if you’re unsure whether or not your hospital environment maintains a high standard of air quality, it’s important to consult a professional immediately on testing your air and, if necessary, taking action. This can help avoid serious problems in the future in terms of the spread of disease and even mortality.


HE Number 7


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