Natural ventilation for reducing airborne infection in hospitals

Abstract High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled. The high ventilation rate provided by natural ventilation can reduce cross-infection of airborne diseases, and thus it is recommended for consideration of use in appropriate hospital wards for infection control. Our results also demonstrated a possibility of converting an existing ward using natural ventilation to a temporary isolation room through installing mechanical exhaust fans.

[1]  P Heiselberg,et al.  Short-term airing by natural ventilation - modeling and control strategies. , 2009, Indoor air.

[2]  Peter Cameron,et al.  A major outbreak of severe acute respiratory syndrome in Hong Kong. , 2003, The New England journal of medicine.

[3]  G Murphy,et al.  Airborne spread of measles in a suburban elementary school. , 1978, American journal of epidemiology.

[4]  Shan-Chwen Chang,et al.  SARS in Hospital Emergency Room , 2004, Emerging infectious diseases.

[5]  F. Huang,et al.  Rapid Creation of a Temporary Isolation Ward for Patients With Severe Acute Respiratory Syndrome in Taiwan , 2004, Infection Control & Hospital Epidemiology.

[6]  M. Perino,et al.  The airborne transmission of infection between flats in high-rise residential buildings: Particle simulation , 2008, Building and Environment.

[7]  Donald E. Low,et al.  Possible SARS Coronavirus Transmission during Cardiopulmonary Resuscitation , 2004, Emerging infectious diseases.

[8]  A. Schuchat,et al.  Superspreading SARS Events, Beijing, 2003 , 2004, Emerging infectious diseases.

[9]  A. R. Escombe,et al.  Natural Ventilation for the Prevention of Airborne Contagion , 2007, PLoS medicine.

[10]  A. Apisarnthanarak,et al.  Influenza outbreak among health care workers in an avian influenza (H5N1)-endemic setting. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  R. O’Connor,et al.  Use of a portable forced air system to convert existing hospital space into a mass casualty isolation area , 2004, Annals of Emergency Medicine.

[12]  Y. Li,et al.  Role of air distribution in SARS transmission during the largest nosocomial outbreak in Hong Kong. , 2005, Indoor air.

[13]  P. Heiselberg,et al.  The airborne transmission of infection between flats in high-rise residential buildings: Tracer gas simulation , 2007, Building and Environment.

[14]  H. Dwosh,et al.  Identification and containment of an outbreak of SARS in a community hospital. , 2003, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[15]  J. A. Comer,et al.  Lack of SARS Transmission among Public Hospital Workers, Vietnam , 2004, Emerging infectious diseases.

[16]  Eric J. Esswein,et al.  Environmental and Occupational Health Response to SARS, Taiwan, 2003 , 2004, Emerging Infectious Diseases.

[17]  J. Zhan,et al.  Ventilation of wards and nosocomial outbreak of severe acute respiratory syndrome among healthcare workers. , 2003, Chinese medical journal.

[18]  O. Chay,et al.  Severe acute respiratory syndrome in Singapore , 2004, Archives of Disease in Childhood.

[19]  俊郎 黒木,et al.  Centers for Disease Control and Prevention (CDC) ホームページの活用法 , 2002 .

[20]  P V Nielsen,et al.  Role of ventilation in airborne transmission of infectious agents in the built environment - a multidisciplinary systematic review. , 2007, Indoor air.

[21]  D. Tai,et al.  Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore , 2006, Intensive Care Medicine.

[22]  Reuben Granich,et al.  GUIDELINES FOR THE PREVENTION OF TUBERCULOSIS IN HEALTH CARE FACILITIES IN RESOURCE-LIMITED SETTINGS , 1999 .