Airflow patterns through single hinged and sliding doors in hospital isolation rooms – Effect of ventilation, flow differential and passage

Abstract Negative pressure isolation rooms are used to house patients with highly contagious diseases (e.g. with airborne diseases) and to contain emitted pathogens to reduce the risk for cross-infection in hospitals. Airflows induced by door opening motion and healthcare worker passage can, however, transport the potentially pathogen laden air across the doorway. In this study airflow patterns across the isolation room doorway induced by the operation of single hinged and sliding doors with simulated human passage were examined. Smoke visualizations demonstrated that the hinged door opening generated a greater flow across the doorway than the sliding door. Tracer gas measurements showed that the examined ventilation rates (6 and 12 air changes per hour) had only a small effect on the air volume exchange across the doorway with the hinged door. The results were more variable with the sliding door. Supply-exhaust flow rate differential reduced the door motion-induced air transfer significantly with both door types. The experiments showed that the passage induced substantial air volume transport through the doorway with both door types. However, overall, the sliding door performed better in all tested scenarios, because the door-opening motion itself generated relatively smaller air volume exchange across the doorway, and hence should be the preferred choice in the design of isolation rooms.

[1]  M. Oxtoby,et al.  Identification of Factors That Disrupt Negative Air Pressurization of Respiratory Isolation Rooms , 2000, Infection Control & Hospital Epidemiology.

[2]  Xu Zhang,et al.  Control room contaminant inleakage produced by door opening and closing: Dynamic simulation and experiments , 2016 .

[3]  Naiping Gao,et al.  The dynamics of the body motion induced wake flow and its effects on the contaminant dispersion , 2014 .

[4]  Robert A Lynch,et al.  The effect of pressure differential and care provider movement on airborne infectious isolation room containment effectiveness. , 2011, American journal of infection control.

[5]  Stephane B. Poussou Experimental investigation of airborne contaminant transport by a human wake moving in a ventilated aircraft cabin , 2008 .

[6]  Hannu Koskela,et al.  Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms , 2013, PloS one.

[7]  W. F. Wells,et al.  On Air-borne Infection. Study II. Droplets and Droplet Nuclei. , 1934 .

[8]  K.W.D. Cheong,et al.  Development of ventilation design strategy for effective removal of pollutant in the isolation room of a hospital , 2006 .

[9]  Brian H. Shaw Heat and mass transfer by convection through large rectangular openings in vertical partitions , 1976 .

[10]  Takashi Kurabuchi,et al.  Numerical evaluation of influence of door opening on interzonal air exchange , 2016 .

[11]  Yuguo Li,et al.  Exhaled droplets due to talking and coughing , 2009, Journal of The Royal Society Interface.

[12]  Tee Tai Lim,et al.  Flow Visualization:Techniques and Examples , 2012 .

[13]  H. S. Andleigh Air-Borne Infection , 1949, Nature.

[14]  Stephane Poussou,et al.  Vortex dynamics and scalar transport in the wake of a bluff body driven through a steady recirculating flow , 2012, Experiments in fluids.

[15]  L. Lambert,et al.  Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. , 2005, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[16]  C. Chao,et al.  Study on the interzonal migration of airborne infectious particles in an isolation ward using benign bacteria. , 2013, Indoor air.

[17]  J. Edwards,et al.  Large-eddy simulation of human-induced contaminant transport in room compartments. , 2012, Indoor air.

[18]  O M Lidwell Air exchange through doorways. The effect of temperature difference, turbulence and ventilation flow. , 1977, The Journal of hygiene.

[19]  Hannu Koskela,et al.  Airflow Patterns through Single Hinged and Sliding Doors in Hospital Isolation Rooms , 2015 .

[20]  Y. Li,et al.  How far droplets can move in indoor environments--revisiting the Wells evaporation-falling curve. , 2007, Indoor air.

[21]  Pertti Pasanen,et al.  Performance testing of engineering controls of airborne infection isolation rooms by tracer gas techniques , 2014 .

[22]  Wernher Brevis,et al.  Experimental and Modelling Investigations of Air Exchange and Infection Transfer due to Hinged-Door Motion in Office and Hospital Settings , 2015 .

[23]  M. Plesniak,et al.  Flow field in the wake of a bluff body driven through a steady recirculating flow , 2015 .

[24]  E. Mousavi,et al.  Airflow patterns due to door motion and pressurization in hospital isolation rooms , 2016 .

[25]  Ian Eames,et al.  Door-opening motion can potentially lead to a transient breakdown in negative-pressure isolation conditions: the importance of vorticity and buoyancy airflows , 2005, Journal of Hospital Infection.

[26]  Ruiqiu Jin,et al.  The influence of human walking on the flow and airborne transmission in a six-bed isolation room: Tracer gas simulation , 2014, Building and Environment.

[27]  I Eames,et al.  Movement of airborne contaminants in a hospital isolation room , 2009, Journal of The Royal Society Interface.

[28]  J P Rydock,et al.  Containment testing of isolation rooms. , 2004, The Journal of hospital infection.

[29]  Gary S. Settles,et al.  Computational Study of the Wake and Contaminant Transport of a Walking Human , 2005 .

[30]  A. Melikov,et al.  Human convective boundary layer and its interaction with room ventilation flow. , 2015, Indoor air.

[31]  Bin Zhao,et al.  Role of two-way airflow owing to temperature difference in severe acute respiratory syndrome transmission: revisiting the largest nosocomial severe acute respiratory syndrome outbreak in Hong Kong , 2011, Journal of The Royal Society Interface.

[32]  Wenguo Weng,et al.  Aerodynamic characteristics of human movement behaviours in full-scale environment: Comparison of limbs pendulum and body motion , 2015 .

[33]  Kerrie Mengersen,et al.  Size distribution and sites of origin of droplets expelled from the human respiratory tract during expiratory activities , 2009 .

[34]  P. Saarinen,et al.  Large Eddy Simulation of Air Escape through a Hospital Isolation Room Single Hinged Doorway—Validation by Using Tracer Gases and Simulated Smoke Videos , 2015, PloS one.

[35]  I. Eames,et al.  Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises , 2006, Journal of Hospital Infection.

[36]  Charles S. Hayden,et al.  Air Volume Migration from Negative Pressure Isolation Rooms during Entry/Exit , 1998 .

[37]  Godfried Augenbroe,et al.  Decision support for choosing ventilation operation strategy in hospital isolation rooms: A multi-criterion assessment under uncertainty , 2013 .

[38]  Lucia Fontana,et al.  Experimental analysis of the transport of airborne contaminants between adjacent rooms at different pressure due to the door opening , 2014 .

[39]  Magnus Mattsson,et al.  Displacement Ventilation: effects of movement and exhalation , 1997 .

[40]  Yang-Cheng Shih,et al.  Dynamic airflow simulation within an isolation room , 2006, Building and Environment.

[41]  Per Heiselberg ROOMVENT '96 : Proceedings of the 5th International Conference on Air Distribution in Rooms, Yokohama, Japan, July 17-19, 1996 , 1996 .

[42]  Ruiqiu Jin,et al.  Potential airborne transmission between two isolation cubicles through a shared anteroom , 2015, Building and Environment.

[43]  J. Edwards,et al.  Large eddy simulation and zonal modeling of human-induced contaminant transport. , 2008, Indoor air.

[44]  E. A. Hathway,et al.  CFD simulation of airborne pathogen transport due to human activities , 2011, Building and Environment.

[45]  H. Qian,et al.  Removal of exhaled particles by ventilation and deposition in a multibed airborne infection isolation room. , 2010, Indoor air.

[46]  Yukisada Sunabashiri,et al.  Vortex Shedding From a Circular Cylinder of Finite Length Placed on a Ground Plane , 1992 .