Maintaining the highest standards of indoor environmental quality (IEQ) is vital in health-care facilities and it is the HVAC system that plays a pivotal role in this area, says Talal Hasan, Gulf regional leader for Trane.

01 March 2006

While the development or redesign of any medical care facility presents design and construction teams with extraordinary challenges, it is the heating ventilation and air-conditioning (HVAC) system’s direct impact on indoor environmental quality (IEQ) that plays an integral role in achieving safe, comfortable and effective healthcare facilities.

Massive facilities offering an extensive range of specialities - such as the Dubai Healthcare City - are now taking shape in the region and hence every effort should be made to achieve integrated HVAC solutions that are tailored to meet the range of intricate requirements of such facilities.
The term indoor environmental quality refers to the nature of the indoor air as it relates to the comfort (thermal and acoustical), health and well-being of facility occupants.
Poor IEQ is a cause for concern in the management of healthcare facilities, not only with regard to the potential transmission of airborne infectious agents, but also the growth of contaminants, which may lead to structural damage.
Improper building pressure control can result in unconditioned outdoor air entering the building with normal traffic and via poorly-sealed windows, doors and inadequate moisture barriers. This air carries unwanted heat and cold, contaminants and moisture into the building environment.
HVAC design and maintenance directly impacts how much outdoor air enters the building and how the internal ventilation system handles the incoming air stream. The use of healthcare equipment, food preparation and cleaning solutions generate heat, effluent and odours that impact IEQ must also be considered in HVAC design and implementation.
Healthcare facility managers understand that “sensitive” areas of a hospital, such as surgical suites and intensive care units, require special attention to IEQ and temperature and humidity control strategies are important in mitigating the risk of nosocomial infections, especially in these high-risk areas.
It is important, therefore, to work with an HVAC consultant to assess building ventilation, create indoor environmental humidity and moisture management programmes and develop HVAC maintenance schedules that can mitigate moisture problems, improve IEQ and lower energy costs. In addition, this will help to create a more positive healing environment and a more operationally-efficient hospital.
Design and construction
Guidelines from organisations including American Society of Heating, Refrigerating and Air-Conditioning Engineers (Ashrae), the American Institute of Architects (AIA), Centers for Disease Control and Prevention (CDC) and the Joint Commission for Accreditation of Healthcare (JCAHO) have advanced best practices for the design, construction and maintenance of HVAC systems in the healthcare industry. These stipulate:
•  Effective distribution of air within spaces served by HVAC systems;
•  Requirements for total and ventilation air flow;
•  Room and building envelope pressure relationships;
•  Parameters for temperature and humidity design;
•  Filtration practices;
•  Strategies for the selection of air-handling systems, distribution systems and their associated controls; and
•  Operation and maintenance procedures for HVAC systems.

Conclusion
Proper planning and communication between facility owners, managers and design engineers is critical to the success of a renovation, retrofit or new construction in the healthcare industry.
The introduction of integrated HVAC solutions can help to maintain IEQ, which increases comfort levels of staff and patients, improves patient recovery rates, optimises facility investments and assures the reliable and efficient operation of all systems.

Trane’s HVAC tips for healthcare facilities
•  Audit sensitive parts of the hospital to establish an operating baseline and detect any moisture problems;
•  Evaluate the moisture barrier for each of these areas and, if necessary, install moisture barriers to prevent infiltration of unconditioned air;
•  Select an effective HVAC system with advanced controls that can dehumidify the space to less than 60 per cent relative humidity at all cooling loads;
•  Install the appropriate HVAC equipment. Oversized units, especially those without adequate humidity controls, can contribute to moisture problems because the space will reach the desired temperature without sufficiently lowering the humidity;
•  Use specially-designed HVAC systems in sensitive parts of the hospital to remove excess humidity, bring in fresh, filtered air, and reduce odours;
•  Facility maintenance staff should monitor all facility areas and take action at the first sign of improper moisture management; and
•  Maintenance personnel should regularly check and clean air conditioning filters and coils.

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