1. Hospital & Healthcare Facilities
Our population is aging and people are live longer lives due in part to the techniques and practices used in hospitals and healthcare facilities. Most all procedures involve the use of air filtration to provide a safe and clean environment to prevent infection and to stop the spread of airborne diseases.
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2006 Rev. 2

2. Estimated Deaths – Hospital Acquired Infections
90,000 per year
And Costs
$4.5 Billion Per Year
Source: Centers for Disease Control and Prevention
Even with the best of modern techniques, the Centers for Disease Control and prevention estimate over 90,000 people die each year due to hospital-acquired diseases – 75,000 of which are preventable. We at NAFA believe many of these deaths attributable to upper respiratory infections could be prevented with best practice use of higher efficiency air filtration.
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2006 Rev. 2

3. Airborne Contaminants Found In Healthcare Facilities
That are transmitted through the
airborne infectious droplet route
Let’s discuss some of the more common airborne contaminants found in the hospital environment
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2006 Rev. 2

4. Bacteria/Virus/Fungi
Bacteria – one-cell organisms that multiple by cell division
Virus – multiply by entering a host cell, using the cell’s DNA to manufacture clones of themselves
Fungi – multiply through the formation of spores that separate from the parent
Hospital borne infections are usually caused by viruses, bacteria or fungi.
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2006 Rev. 2

5. Sources of Contaminants in Healthcare Environment
Where do contaminants come from? Most people think outdoor air is “fresh” which, in most places it is not. Air handling systems that have not been properly maintained along with building furnishings and fixtures provide a large number of particulate and gas-phase contaminants. In hospitals and healthcare setting, people and processes are the biggest polluters of the indoor environment.
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2006 Rev. 2

6. AIA Filtration For Hospitals*
Area Designation No Filter Bank Filter Bank
filter beds # #2
All areas for inpatient care, MERV % MERV %
treatment and diagnosis, and
those areas providing direct
service or clean supplies such
as sterile and clean
processing, etc.
Protective Environment rooms MERV % % (MERV 17)
Laboratories MERV % -
Adm, bulk storage, soiled holding MERV % -
Areas, food preparation areas and
Laundries
*Guideline for Design and Construction of Hospital and Healthcare Facilities – Table 7.3
The new American Institute of Architects Guidelines for Design and Construction of Hospital and Health Care Facilities provides the air filter efficiency numbers for critical areas of a hospital or healthcare facility. Emphasize no fiberglass throwaway filters..everything starts at MERV 6 and above.
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2006 Rev. 2

7. Mini-pleat V-Cell Copyright National Air Filtration Association
2006 Rev. 2

8. History of HEPA Filters
High
Efficiency
Particulate
Air
filter
How do we remove the smallest of contaminants and make the air indoor cleaner and healthier for patients and healthcare workers? High Efficiency air filters for general ventilation and HEPA filters for critical areas are the most popular way of removing contaminants from the air.
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2006 Rev. 2

9. To Be A HEPA Filter
“Throwaway extended-medium dry-type filter in rigid frame having minimum particle-collection efficiency of 99.97% (that is a maximum particle penetration of of 0.03%) for 0.3 µm particles of thermally-generated DOP particles or specified alternative aerosol.”
--IEST
This is the definition – emphasize the 99.97% is a minimum
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2006 Rev. 2

10. Background on HEPA Filters
HEPA filters were invented during the Manhattan Project when removing nuclear particles from air was a must in the laboratories.
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2006 Rev. 2

11. HEPA Filter Testing
HEPA filters should be factory tested to assure the minimum efficiency 99.97% on 0.3 micrometer particles
Personnel installing/replacing should be trained in proper installation – proper personal protection
In-place challenging for integrity is highly recommended
There are several differences types of HEPA filters – most hospitals use the “A” type of HEPA, either downstream of all mechanical devices in the system, or mounted on the ceiling as a terminal unit. In all cases, HEPA filters should be tested at the factory and have a minimum efficiency of 99.97% on 0.3 micrometers – using an appropriate challenge. Installers of HEPA filters should be trained on the correct procedure of HEPA installation. Most manufacturers will be provide this information – if not, contact NAFA. Finally, after the filters are in, we recommend in-place filter testing.
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2006 Rev. 2

12. 2 Years in Service Copyright National Air Filtration Association
2006 Rev. 2

13. HEPA Filter Integrity Testing
In-Place Integrity (full media scan)
Also includes joints, frames, ceiling, gaskets and other seals
Even though the filters are tested at the factory, they are usually shipped via the Gorilla Trucking Company, hauled over the smoothest of roads, then transferred at a station where one or two prongs of the folklift will be run into the pack. After that, they are given to a local trucking company who kicks them off the back of the truck and warehouse people toss them onto the floor. Usually the installing individuals have not been trained in the best practice way of installing HEPA filters.
Having HEPA filters scanned in situ is one of the best things that you can do to assure integrity…not only of the media, but of joints, seals, gaskets and the conveyance system. In-place testing can usually be arranged through your local NAFA representative or through the NAFA national office.
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2006 Rev. 2

14. Biological Safety Cabinets
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2006 Rev. 2

15. Ultraviolet Germicidal Irradiation
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2006 Rev. 2

16. Chemicals and Other Ethylene Oxide Aldehydes Waste Anesthetic Gases
Surgical Smoke
Latex - Protein on Powdered Particulate
Antineoplastic Drugs
Hospitals need to be aware of chemicals used that can effect the health of all occupants. All of the above chemicals can cause problems in the indoor environment. Gas phase filters using activated carbon and/or potassium permanganate can safely and effectively capture chemical and gas odors to keep them out of the indoor environment.
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2006 Rev. 2

17. Gaseous Contaminant Removal Principle Methods
Physical – Adsorption
Activated carbons
Chemical - Chemisorption
Chemically treated activated carbons
Potassium permanganate impregnated media
As discussed in the Technology of Clean Air presentation, the type of media used to remove chemical contaminants will depend on that particular chemical…consult your NAFA representative for details.
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2006 Rev. 2

18. Proposed Standard ASHE/ASHRAE Standard 170P
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2006 Rev. 2

19. SUMMARY Good Predictive Maintenance Good Housekeeping
Listening – Observing – Following ASHE/ASHRAE and AIA Guidelines
Use of higher efficiency filters and Integrity Testing in-situ of HEPA Filters
Using gas-phase filtration for chemicals & odors
In summary, hospital and healthcare facilities can improve in their efforts to clean up the indoor environment by using higher levels of air filter efficiencies, (MERV) filters, using factory tested and in place testing of HEPA filters, and using gas-phase filtration to remove chemicals and odors from the air.
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2006 Rev. 2

20. Cleaner Air = Safer Environment
Doing this, we can reduce the number of hospital acquired illnesses and assure that when we go to a healthcare facility we go to get well.
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2006 Rev. 2