Room ventilation and the risk of airborne infection transmission in three health care settings within a large teaching hospital

Background: Room ventilation is a key determinant of airborne disease transmission. Despite this, ventilation guidelines in hospitals are not founded on robust scientific evidence related to prevention of airborne transmission. Methods: We sought to assess the effect of ventilation rates on influenza, tuberculosis (TB) and rhinovirus infection risk within three distinct rooms in a major urban hospital; a Lung Function Laboratory, Emergency Department (ED) Negative-pressure Isolation Room and an Outpatient Consultation Room were investigated. Air exchange rate measurements were performed in each room using CO2 as a tracer. Gammaitoni and Nucci’s model was employed to estimate infection risk. Results: Current outdoor air exchange rates in the Lung Function Laboratory and ED Isolation Room limited infection risks to between 0.1 and 3.6%. Influenza risk for individuals entering an Outpatient Consultation Room after an infectious individual departed ranged from 3.6 to 20.7%, depending on the duration for which each person occupied the room. Conclusions: Given the absence of definitive ventilation guidelines for hospitals, air exchange measurements combined with modelling afford a useful means of assessing, on a case-by-case basis, the suitability of room ventilation at preventing airborne disease transmission.

Investigating and understanding CO2 levels in school classrooms

 It is a reported fact that a high CO2 concentration is a problem in school classrooms. However, the mere reporting of such results stops short of investigating causes; understanding is often missing. Steady-state results are often used in situations where changes occur frequently, such as varying student numbers, opening and closing classroom doors and windows and changing weather conditions. We revisit the mass balance model commonly used to predict or track CO2 concentrations in enclosed spaces as these factors change over time under varying conditions. This has prompted the study in several classrooms of actual air exchange rates, student exhalation rates, room volumes and ventilation design. In these cases, student numbers, room ventilation conditions (open and closed doors), room volume and the CO2 concentration have been recorded throughout the day. By fitting the model equation to the data, unknown parameters such as actual air change rates and CO2 exhalation rates per student can be determined. Having verified that the data can be modelled, we can predict behaviour in other cases such as a realistic rate of CO2 increase. This allows designers to size classrooms and ventilation systems to achieve a desired CO2 characteristic for known usages while saving energy.

Caracterização de biotérios, legislação e padrões de biossegurança

The use of laboratory animals in conjunction with research on the human organism provides a basis for on understanding of several important physiological and pathological processes. Besides, the results of experimental studies enable technical and safety improvements to be made in surgical techniques used in the medical clinic. As living biological material is involved, we should guarantee its physical well-being, taking into account microbiological contamination and the genetics, nutrition and correct manipulation of the animals, in order to avoid incorrect conclusions from the experiments or unnecessarily large numbers of animals being used. In parallel with the concerns and legislation on the use of laboratory animals, there is also a growing preoccupation with the welfare and safety of those who handle the laboratory animals, since they run the risk of acquiring occupational diseases through contact with zoonotic pathogens or developing allergies. Prevention requires the application of modern technological advances in the design of the animal house and in the work routines. Unfortunately, few establishments in Brazil possess staff with adequate training and a basic infrastructure of research that includes the laboratory animal breeding centers, equivalent to those existing ones in the United States and Europe.

Study of buoyant jets in natural ventilation of a model room

Buoyant jets in natural ventilation of a model room with water as the fluid medium have been studied. A constant heat flux has been maintained on the bottom surface of the room. The buoyancy causes flow to enter through the bottom opening and leave through the top opening. The shadowgraph technique is used for visualization. At the inlet, a negatively buoyant jet is observed, whereas a positively buoyant jet is observed at the outlet. The theoretical results for the centerline trajectories of these buoyant jets using both Gaussian and top-hat profiles are discussed considering the variation of the entrainment coefficient with the local Froude number and the variation of the spreading ratio of buoyancy to velocity profile with the distance from the source. The shape of the profiles is found to evolve from top-hat to Gaussian geometry.

Transient Natural Ventilation of a Room with a Distributed Heat Source

We report on an experimental and theoretical study of the transient flows which develop as a naturally ventilated room adjusts from one temperature to another. We focus on a room heated from below by a uniform heat source, with both high- and low-level ventilation openings. Depending on the initial temperature of the room relative to (i) the final equilibrium temperature and (ii) the exterior temperature, three different modes of ventilation may develop. First, if the room temperature lies between the exterior and the equilibrium temperature, the interior remains well-mixed and gradually heats up to the equilibrium temperature. Secondly, if the room is initially warmer than the equilibrium temperature, then a thermal stratification develops in which the upper layer of originally hot air is displaced upwards by a lower layer of relatively cool inflowing air. At the interface, some mixing occurs owing to the effects of penetrative convection. Thirdly, if the room is initially cooler than the exterior, then on opening the vents, the original air is displaced downwards and a layer of ambient air deepens from above. As this lower layer drains, it is eventually heated to the ambient temperature, and is then able to mix into the overlying layer of external air, and the room becomes well-mixed. For each case, we present new laboratory experiments and compare these with some new quantitative models of the transient flows. We conclude by considering the implications of our work for natural ventilation of large auditoria.

Effect of internal partitioning on room air quality with mixing ventilation-statistical analysis

In designing modern office buildings, building spaces are frequently zoned by introducing internal partitioning, which may have a significant influence on the room air environment. This internal partitioning was studied by means of model test, numerical simulation, and statistical analysis as the final stage. In this paper, the results produced from the statistical analysis are summarized and presented.

Experimental and numerical analysis of the relationship between indoor and outdoor airborne particles in an operating room

This work investigated the impact of the HVAC filtration system and indoor particle sources on the relationship between indoor and outdoor airborne particle size and concentrations in an operating room. Filters with efficiency between 65% and 99.97% were used in the investigation and indoor and outdoor particle size and concentrations were measured. A balance mass model was used for the simulation of the impact of the surgical team, deposition rate, HVAC exhaust and air change rates on indoor particle concentration. The experimental results showed that high efficiency filters would not be expected to decrease the risk associated with indoor particles larger than approximately 1 µm in size because normal filters are relatively efficient for these large particles. A good fraction of outdoor particles were removed by deposition on the HVAC system surfaces and this deposition increased with particle size. For particles of 0.3-0.5 µm in diameter, particle reduction was about 23%, while for particles >10 µm the loss was about 78%. The modelling results showed that depending on the type of filter used, the surgical team generated between 93-99% of total particles, while the outdoor air contributed only 1-6%.

Transient natural ventilation of a space with localised heating

The natural ventilation of a well-mixed, pre-heated room with a point source of heating, and openings at the base and roof is investigated. The transient draining associated with the room being warmer than the exterior combined with the convective ow produced by the point source of heat leads to a fascinating series of transient ow regimes as the system evolves to the two-layer steady-state regime described by Linden, Lane-Ser_ and Smeed [1]. As the room begins to ventilate, a turbulent plume rises from the point source of heat to the ceiling, and typically forms a deepening layer of hot air. However, with a weak heat source, then at some point the ascending plume will intrude beneath the layer of original uid. Otherwise, the ascending plume always reaches the top of the room as the system evolves to a steady state. We develop a simpli_ed model of the transient evolution and test this with some new laboratory experiments. We conclude with a discussion of the implications of our results for real buildings.

Transient Ventilation Dynamics Following a Change in Strength of a Point Source of Heat

We investigate the transient ventilation flow within a confined ventilated space, with high- and low-level openings, when the strength of a low-level point source of heat is changed instantaneously. The steady-flow regime in the space involves a turbulent buoyant plume, which rises from the point source to a well-mixed warm upper layer. The steady-state height of the interface between this layer and the lower layer of exterior fluid is independent of the heat flux, but the upper layer becomes progressively warmer with heat flux. New analogue laboratory experiments of the transient adjustment between steady states identify that if the heat flux is increased, the continuing plume propagates to the top of the room forming a new, warmer layer. This layer gradually deepens, and as the turbulent plume entrains fluid from the original warm layer, the original layer is gradually depleted and disappears, and a new steady state is established. In contrast, if the source buoyancy flux is decreased, the continuing plume is cooler than the original plume, so that on reaching the interface it is of intermediate density between the original warm layer and the external fluid. The plume supplies a new intermediate layer, which gradually deepens with the continuing flow. In turn, the original upper layer becomes depleted, both as a result of being vented through the upper opening of the space, but also due to some penetrative entrainment of this layer by the plume, as the plume overshoots the interface before falling back to supply the new intermediate layer. We develop quantitative models which are in good accord with our experimental data, by combining classical plume theory with models of the penetrative entrainment for the case of a decrease in heating. Typically, we find that the effect of penetrative entrainment on the density of the intruding layer is relatively weak, provided the change in source strength is sufficiently large. However, penetrative entrainment measurably increases the rate at which the depth of the draining layer decreases. We conclude with a discussion of the importance of these results for the control of naturally ventilated spaces.

On the transition from displacement to mixing ventilation with a localized heat source

We investigate the steady state natural ventilation of a room heated at the base and consisting of two vents at different levels. We explore how the air flow rate and internal temperature relative to the exterior vary as a function of the vent areas, position of the vents and heat load in order to establish appropriate ventilation strategies for a room. When the room is heated by a distributed source, the room becomes well mixed and the steady state ventilation rate depends on the heating rate, the area of the vents and the distance between the lower and upper level vents. However, when the room is heated by a localised source the room becomes stratified. If the effective ventilation area is sufficiently large, then the interface separating the two layers lies above the inlet vent and the lower layer is comprised of ambient fluid. In this case the upper layer is warmer than in the well mixed case and the ventilation rate is smaller. However, if the effective area for ventilation is sufficiently small, then the interface separating the two layers lies below the inlet vent and the lower layer is comprised of warm fluid which originates as the cold incoming fluid mixes during descent from the vent through the upper layer. In this case both the ventilation rate and the upper layer temperature are the same as in the case of a distributed heat load. As the vertical separation between lower and upper level vents decreases, then the temperature difference between the layers falls to zero and the room becomes approximately well mixed. These findings suggest how the appropriate ventilation strategy for a room can be varied depending on the exterior temperature, with mixing ventilation more suitable for winter conditions and displacement ventilation for warmer external temperatures.