It presents solutions that are proven, cost effective, and reliable; solutions that provide low maintenance cost and high reliability, with a focus on presenting what's different about health care HVAC. For "standard" mid- to large-size hospital, typically at least , ft 2 , but the strategies apply to all sizes and classifications of large hospitals.
Download the free PDF or purchase the print edition. For small hospitals and healthcare facilities up to 90, ft 2 , which require a wide variety of heating and air-conditioning equipment. Options for daylighting are included. Health care HVAC systems serve facilities in which the population is uniquely vulnerable and exposed to an elevated risk of health, fire, and safety hazard.
Available in Spanish or English. In some cases, excess exfiltration or used for airborne infection isolation, the pressure relationship to infiltration to or from exit corridors compromises the exit corridor adjacent areas, when measured with the door closed, shall remain restrictions of NFPA 90A 7, the pressure requirements of NFPA 96 8, unchanged, and the minimum total air change rate shall be 6 ach.
During operation, a reduction to v. Room temperature ranges that exceed the minimum indicated range the number of air changes to any extent required for odor control shall shall be permitted if required by the laboratory program or laboratory be permitted when the space is not in use.
The requirement that all room air is exhausted directly to outdoors exhaust air shall be discharged directly to the outdoors and not recir- applies only to radiology waiting rooms programmed to hold patients culated to other areas. Individual circumstances may require special who are waiting for chest x-rays for diagnosis of respiratory disease.
To satisfy exhaust x. For single-bed patient rooms using Group D diffusers, a minimum of l. Systems shall be capable of maintaining the rooms within the range six total ach shall be provided and calculated based on the volume during normal operation. Lower or higher temperature shall be per- from finished floor to 6 ft 1. Examination rooms programmed for use by patients with undiag- ria documents 9 regarding occupational exposure to waste anesthetic nosed gastrointestinal symptoms, undiagnosed respiratory symp- gases and vapors and control of occupational exposure to nitrous toms, or undiagnosed skin symptoms.
System minimum outdoor air quantity shall be cal- 7. The minimum outdoor air change rate listed in this a. The room envelope shall be sealed to provide a minimum standard shall be interpreted as the Voz zone out- differential pressure of 0. Air filtration for spaces shall comply with Table 6. Each PE room shall comply with the requirements of c. Supply air outlets for spaces shall comply with Table 6. Tables 6. When occupied by patients requiring a protective environment, PE rooms shall have a d.
A local visual means shall be provided to indi- 7. Ventila- tained. Air distribution patterns within the protective environment whenever an infectious patient occupies the room: room shall conform to the following: 1.
Supply air diffusers shall be located above the patient a. Each AII room shall comply with requirements of Tables bed unless it can be demonstrated that such a location 6. AII rooms shall have a permanently is not practical. A local visual means shall be provided to indicate when- d. Differential pressure between PE rooms and adjacent ever negative differential pressure is not maintained. All air from the AII room shall be exhausted directly to in.
Spaces such as the toilet room and the outdoors. Table 7. All exhaust air from the AII rooms, associated anterooms, e.
PE rooms retrofitted from standard patient rooms may be and associated toilet rooms shall be discharged directly to ventilated with recirculated air, provided that air first the outdoors without mixing with exhaust air from any passes through a HEPA filter and the room complies with other non-AII room or exhaust system.
Section 7. Exhaust air grilles or registers in the patient room shall be f. When an anteroom is provided, the pressure relationships located directly above the patient bed, on the ceiling or on shall be as follows: 1 the PE room shall be at a positive the wall near the head of the bed, unless it can be demon- pressure with respect to the anteroom, and 2 the anteroom strated that such a location is not practical.
The room envelope shall be sealed to provide a minimum 7. PE rooms shall meet the following requirements: f. Supply air diffusers shall be located above the patient bed. Spaces such as the toilet room and b. Exhaust grilles or registers shall be located near the the anteroom if present that are directly associated with patient room door. The pressure relationship to adjacent areas for the required required to be designed with a minimum pressure differ- anteroom shall be one of the following: ence from the AII room but are still required to maintain 1.
When an anteroom is provided, the pressure relationships 2. If anesthetic gases are administered, ventilation shall anteroom. Ventilation for morgue cate whenever differential pressure is not maintained. Low sidewall exhaust grilles shall be provided unless 7. Burn- exhaust air is removed through an autopsy table designed unit patient rooms that require humidifiers to comply with for this purpose. All exhaust air from autopsy, nonrefrigerated body hold- 7. These c. Differential pressure between morgue and autopsy rooms rooms shall be maintained at a positive pressure with respect and any adjacent spaces that have other functions shall be to all adjoining spaces at all times.
A pressure differential a minimum of —0. Each room shall have individual temperature con- 7. These rooms shall be provided with a primary supply dif- a. Differential pressure between bronchoscopy procedure fuser array that is designed as follows: and sputum induction rooms and any adjacent spaces that a.
The airflow shall be unidirectional, downwards, and the have other functions shall be a minimum of —0. The diffusers shall be concentrated to b.
Local exhaust shall be provided for sputum collection pro- provide an airflow pattern over the patient and surgical team. Informative Note: For more information, see Memarzadeh 7. All exposed equipment and Manning and Memarzadeh and Jiang in located with these spaces shall have enclosures with rounded Appendix B.
With the exception of b. The coverage area of the primary supply diffuser array HVAC room recirculating units, equipment shall be arranged shall extend a minimum of 12 in.
Within the por- patient care spaces for service. However, because equipment booms, access panels, sprinklers, etc. The following general require- humidity, or a portion of the required air change rates. Spaces shall be ventilated according to Table 8.
Design of the ventilation system shall provide air move- approximately 8 in. If any form of variable-air-volume or load-shedding sys- Exception to 7. Steam that escapes from a 2. The ventilation rates in this table are intended to pro- steam sterilizer shall be exhausted using an exhaust hood or vide for comfort as well as for asepsis and odor con- other suitable means.
Ethylene oxide that escapes from a gas trol in spaces of a health care facility that directly sterilizer shall be exhausted using an exhaust hood or other affect patient care. Ventilation rates for spaces not suitable means. Where spaces with prescribed rates in dure rooms, heating with supply air or radiant panels that both Standard For design purposes, the minimum number of total air 8. Ventila- changes indicated shall be either supplied for positive tion for AII rooms shall meet the following requirements pressure rooms or exhausted for negative pressure whenever an infectious patient occupies the room: rooms.
Spaces that are required in Table 8. Each AII room shall comply with requirements of Tables to be exhausted shall use the supply airflow rate to com- 6.
AII rooms shall have a permanently pute the minimum total air changes per hour required. All air from the AII room shall be exhausted directly to lished anytime the space becomes occupied. Controls the outdoors. All exhaust air from the AII rooms, associated anterooms, 4.
The entire minimum outdoor air changes per hour and associated toilet rooms shall be discharged directly to required by Table 8. For spaces where Table 8.
Exhaust air grilles or registers in the patient room shall be lated by room units, the portion of the minimum total located directly above the patient bed, on the ceiling or on air changes per hour required for a space that is greater the wall near the head of the bed, unless it can be demon- than the minimum outdoor air changes per hour strated that such a location is not practical. The room envelope shall be sealed to provide a minimum room HVAC units.
Such recirculating room HVAC differential pressure of 0. Differential pressure between AII rooms and adjacent ii. Spaces such as the toilet room and passing over any surface that is designed to con- the anteroom if present that are directly associated with dense water. This filter shall be located upstream the AII room and open directly into the AII room are not of any such cold surface, so that all of the air pass- required to be designed with a minimum pressure differ- ing over the cold surface is filtered.
For air-handling systems serving multiple spaces, sys- Table 8. When an anteroom is provided, the pressure relationships using one of the following methods: shall be as follows: 1 the AII room shall be at a negative i. System minimum outdoor air quantity for an air- pressure with respect to the anteroom, and 2 the ante- handling system shall be calculated as the sum of room shall be at a negative pressure with respect to the the individual space requirements as defined by corridor.
System minimum outdoor air quantity shall be cal- 8. The room envelope shall be sealed to provide a minimum The minimum outdoor air change rate listed in this differential pressure of 0. Each PE room shall comply with the requirements of Tables b. When occupied by patients requiring a c. Refer to NFPA 99 10 for other requirements. Short-term excursions from mitted by Section 8. See Section 8. The sure concentrations in the laboratory work area can be achieved with a pressure relationship to adjacent areas shall remain unchanged if the lower minimum total ach ventilation rate than is listed in Table 8.
A nonrefrigerated body-holding room is applicable only to facilities room air exchanges; however, the minimum outdoor air changes of that do not perform autopsies on-site and use the space for short peri- Table 8.
A local 8. These tive differential pressure is not maintained. Air distribution patterns within the protective environment to all adjoining spaces at all times.
Supply air diffusers shall be located above the patient 2. Each room shall have individual temperature con- bed unless it can be demonstrated that such a location trol. These rooms shall be provided with a primary supply dif- is not practical.
Diffuser design shall limit air velocity fuser array that is designed as follows: at the patient bed to reduce patient discomfort. Infor- a. The diffusers shall be concentrated to the patient room door.
Spaces such as the toilet room and Appendix B. The coverage area of the primary supply diffuser array the PE room and open directly into the PE room are not shall extend a minimum of 12 in. Within the por- ence from the PE room but are still required to maintain tion of the primary supply diffuser array that consists of the pressure relationships to adjacent areas specified in an area encompassing 12 in.
PE rooms retrofitted from standard patient rooms may be portion of the primary supply diffuser array area shall be ventilated with recirculated air, provided that air first used for nondiffuser uses such as lights, gas columns, passes through a HEPA filter and the room complies with equipment booms, access panels, sprinklers, etc.
Section 8. When an anteroom is provided, the pressure relationships Additional supply diffusers shall be permitted within the shall be as follows: 1 the PE room shall be at a positive room, outside of the primary supply diffuser array, to provide pressure with respect to the anteroom, and 2 the anteroom additional ventilation to the operating room to achieve the envi- shall be at a positive pressure with respect to the corridor.
Exhaust grilles or registers shall be located near the Exception to 8. The pressure relationship to adjacent areas for the required on the walls. Steam that escapes from a 1. Ethylene oxide that escapes from a gas common space. The anteroom shall be at a negative pressure with suitable means.
If invasive procedures common space. If anesthetic gases are administered, ventilation shall air pressure. Ventilation for morgue the corridor or common space.
Low sidewall exhaust grilles shall be provided unless exhaust air is removed through an autopsy table designed 8. Burn- b. All exhaust air from autopsy, nonrefrigerated body hold- unit patient rooms that require humidifiers to comply with ing, and morgue rooms shall be discharged directly to the Table 8.
Differential pressure between morgue and autopsy rooms between spaces from positive to negative, and vice and any adjacent spaces that have other functions shall be versa, shall not be permitted. Air change rates in excess a minimum of —0. Differential pressure between bronchoscopy procedure 4. The entire minimum outdoor air changes per hour and sputum induction rooms and any adjacent spaces that required by Table 9. For spaces where Table 9. Local exhaust shall be provided for sputum collection pro- lated by room units, the portion of the minimum total cedures.
All exposed equipment than the minimum outdoor air changes per hour located with these spaces shall have enclosures with rounded required component may be provided by recirculating corners and tamper-resistant fasteners. With the exception of room HVAC units. Such recirculating room HVAC HVAC room recirculating units, equipment shall be arranged units shall such that maintenance personnel are not required to enter i. This filter shall be located upstream The ventilation requirements of this standard are minimums of any such cold surface, so that all of the air pass- that provide control of environmental comfort, asepsis, and ing over the cold surface is filtered.
However, because they are minimum requirements and because of the diversity 6. For air-handling systems serving multiple spaces, sys- of the population and variations in susceptibility and sensitiv- tem minimum outdoor air quantity shall be calculated ity, these requirements do not provide assured protection from using one of the following methods: discomfort, airborne transmission of contagions, and odors.
System minimum outdoor air quantity for an air- handling system shall be calculated as the sum of 9. The following general require- the individual space requirements as defined by ments shall apply for space ventilation: this standard. Spaces shall be ventilated according to Table 9. System minimum outdoor air quantity shall be cal- 1. Design of the ventilation system shall provide air move- culated by the Ventilation Rate Procedure multi- ment that is generally from clean to less-clean areas.
The ventilation rates in this table are intended to pro- c. In AII rooms, protective environment rooms, wound in spaces of a health care facility that directly affect intensive care units burn units , and operating and proce- patient care. Where spaces with prescribed rates in both 9.
Ventila- higher of the two air change rates shall be used. For design purposes, the minimum number of total air whenever an infectious patient occupies the room: changes indicated shall be either supplied for positive pressure rooms or exhausted for negative pressure a. Each AII room shall comply with requirements of Tables rooms. Spaces that are required in Table 9.
All air from the AII room shall be exhausted directly to maintained while the space is unoccupied and that the the outdoors. Table 9. PE rooms retrofitted from standard patient rooms may be c. All exhaust air from the AII rooms, associated anterooms, ventilated with recirculated air, provided that air first and associated toilet rooms shall be discharged directly to passes through a HEPA filter and the room complies with the outdoors without mixing with exhaust air from any Section 9. When an anteroom is provided, the pressure relationships d.
Exhaust air grilles or registers in the patient room shall be shall be as follows: 1 the PE room shall be at a positive located directly above the patient bed, on the ceiling or on pressure with respect to the anteroom, and 2 the anteroom the wall near the head of the bed, unless it can be demon- shall be at a positive pressure with respect to the corridor.
The room envelope shall be sealed to provide a minimum 9. Differential pressure between AII rooms and adjacent a. Exhaust grilles or registers shall be located near the in. Spaces such as the toilet room and patient room door. The pressure relationship to adjacent areas for the required the AII room and open directly into the AII room are not anteroom shall be one of the following: required to be designed with a minimum pressure differ- 1. The anteroom shall be at a negative pressure with g.
The room envelope shall be sealed to provide a minimum the corridor or common space. Each PE room shall comply with the requirements of 9.
When occupied by patients requiring a protective environment, PE rooms shall have a 9. A local visual means shall be provided to indi- 9. These tained. Short-term excursions from mitted by Section 9. See Section 9. The sure concentrations in the laboratory work area can be achieved with a pressure relationship to adjacent areas shall remain unchanged if the lower minimum total ach ventilation rate than is listed in Table 9.
A nonrefrigerated body-holding room is applicable only to facilities room air exchanges; however, the minimum outdoor air changes of that do not perform autopsies on-site and use the space for short peri- Table 9. For HVAC systems serving surgery and criti- used for nondiffuser uses such as lights, gas columns, cal care spaces, compliance with this standard requires prepa- equipment booms, access panels, sprinklers, etc. Additional supply diffusers shall be permitted within the General Mechanical Equipment Rooms.
The access to The room shall be provided with at least two low side- mechanical rooms shall be planned to avoid the intrusion wall return or exhaust grilles spaced at opposite corners or as of maintenance personnel into surgical and critical care far apart as possible, with the bottom of these grilles installed patient spaces. Mechanical Room Layout.
Mechanical room layout shall Exception to 9. Floors in mechanical rooms shall be sealed, including sealing around all penetrations, when 9. Steam that escapes from a they are above surgical suites and critical care spaces. Safe and practi- other suitable means. Ethylene oxide that escapes from a gas cal means of accessing equipment shall be provided.
If invasive procedures occur in this type of room, ventilation shall be provided in If any existing air-handling equipment is reused, the rooms. If anesthetic gases are administered, ventilation shall designer shall evaluate the capacity of the equipment to deter- be provided in accordance with the ventilation requirements mine whether it will meet the requirements of this standard for for operating rooms.
Prior to beginning modifications or 9. Most of these spaces also require that the exhaust air be HEPA filtered, and some are recommended to incorperate carbon filtration. Hospital air filtration and ventialation is one of the more dynamic environments for airborne pathogen and particle control, which is why we've made the ebook 'Hospital Ventialation and Filtration' available free of charge.
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