Thursday, February 2, 2012

Airborne Virus

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Airborne Virus Control in


There are many examples of infectious aerosols affecting occupants of health

care facilities. It is expected, patients are often the main source of infectious

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cases, and their presence is a potential hazard to other patients and to

employee. Certain infectious such as tuberculosis, chicken pox, measles, and

Germen measles can be spread easily in air.

Employees and visitors can also be the reason of airborne infection on

patients. Airborne droplets often carry bacteria such as S. aureus, S

epidermides, and gram-negative rods, which are common causes of

postoperative wound infections.

Cases of infection with Apergillus have been reported in

immunocompromised patients. So the activity as building construction and

renovation that may be removed from the patient care area has been shown

to increase the airborne concentration of fungus spores and the incidence of

aspergillosis in immunocompromised patients.

Bacterial Infection

Examples of bacteria that are highly infectious and are airborne and also

travel threw water are Mycobacterium, tuberculosis, and Legionella

(Legionnaire’s disease). Wells (14) showed that droplets or in agents of

5 mm or less in size can remain airborne indefinitely. This is because bacteria

are typically present in colony forming units that are larger than 1 mm.

Some authorities recommend the use of high efficiency particulate air

(HEPA) filters having test filtering efficiencies of .7% in certain areas.

Viral Infection

Examples of viruses that are airborne are chicken pox, Rubella, and measles.

Epidemiological evidence and other studies indicate that many of the

airborne that transmit infection are submicron in size. There is no know

method to effectively eliminate 100% of the viable particles. Ultra low

penetration (UPLA) filters provide the greatest efficiency available.

Attempts to deactivate viruses with ultraviolet light and chemical sprays

have not proven effective enough to be recommended by most codes as a

primary infection measure. Isolation rooms are used to prevent the spread of

airborne viruses in the health care environment.


Evidence indicates that some molds such as Aspergillis be fatal to advanced

leukemia, bone marrow transplant, and other immunocompromised patients.

Prevent the entering and escaping of infectious aerosols

The most fundamental principle for airborne infection control is the

prevention of contaminated air to enter to or escape from a room.

This can be done by these two methods.

Seal the room. Differential air pressure can be maintained only in an entirely

sealed room. It is important to obtain a reasonable close fit of all doors and

seal all wall and floor penetrations between pressurized areas. The opening

of a door between two areas reduces any existing pressure differential

between them to such a degree that its effectiveness is nullified.

Pressurize the room to prevent infiltrated contaminant. This pressure

differential causes air to flow out the room through various leakage areas.

The outward air prevents the contaminated air to enter the room. The

negative pressure difference is obtained by supplying less air to the area than

is exhausted from it.

The room should have a permanently installed visual mechanism to

constantly monitor the pressure status of the room when occupied.

Remove infectious aerosols from air

Sources of infectious aerosols are both from outside and inside of the room.

The microbial level in operating room air is proportional to the number of

people moving about in the room.

Recirculation air shall be filtered by high efficiency air filter as recommended

in table with the total air change rate as recommended in table .

Outdoor air, before introduces to the room, shall also be recirculation air.

Dilute the contaminated room air

General ventilation maintains air quality by two processes removal

and dilution of airborne contaminants. Uncontaminated supply air mixes

with contaminated air, which is subsequently removed from the room by the

exhaust system. These processes removes the concentration of droplet nuclei

in the room air. The outdoor air should be supplied as recommended in the

table and should be filtrated by air filter recommended in table 1.

Prevent micro-organism growth in the room

To control micro-organism aerosols, it is important to always keep room

relative humidity below 60%. Besides the air, the surface of the room must

not wet or damp to prevent micro-organism growth on the


The wall, floor, ceiling, door, window should be made of smooth surface,

easy t clean material. Air duct and pipe should not pass the room without

ceiling. Lighting fixture should have scaled cover.

Disinfect the air

Ultraviolet Germicidal Irradiation, was extensively studied in the 10s.

UV radiation is defined as the portion of the electromagnetic spectrum

Described by wavelengths from 100 to 400 nm. For convenience of

classification , the UV spectrum has been separated into three different

wavelength bands. Commercially available UV lamps used for germicidal

purposes are low-pressure mercury vapor lamps that emit radiant energy in

the UV-C range, predominantly at a wavelength of 5.7nm.

In duct irradiation systems, UV lamps are inside ducts that remove air from

rooms to disinfect the air before it is circulated. When UVGI duct systems

are properly designed, installed, and maintained, high levels of UV radiation

may be produced in duct work. The only potential for human exposure to this

occurs during maintenance operations.

Operating Room

Studies or the operating room air distribution devices and observation of

installations in industrial clean room indicate that delivery of the airborne

of the air from the ceiling, with a downward movement to several exhaust

inlets located on the opposite walls, is probably the most effective air

movement pattern for maintaining the concentration of contamination at an

acceptable level.

Operating room suites are typically in use no more than 8 to 1 hr’s per day.

For energy conservation, the air-condition system should allow a reduction

in the air supplied to some or all of the operating rooms when possible.

Positive space pressure must be maintained at reduced air volumes to ensure

sterile conditions.

Intensive Care Unit

These units serve ill patients, from postoperative to coronary patients.

Air pressure should be maintained positive with respect to any adjoining

by supplying 15% excess air. A variable range temperature capability of 4

to 7c, a relative humidity of 0% minimum and 60% maximum. Filter

efficiencies should be in accordance with table 1.


Hospitals are risk environments for airborne infection, because infection

sources and immunocompromised people are at the same place. Currently,

hospital’s are under programs to obtain certification for hospital quality

system, which is called Hospital Accreditation or HA. Accordingly, hospitals

are encouraged to promote safe and healthy environment fro patients,

relatives, visitors, and employee. However, most hospitals lack knowledge of

guidelines to effectively implement the airborne infection control measures.

This paper included basic knowledge of airborne infection, science of airborne

infection control, and the measures to effectively control infection and the

specific design criteria for several functions in hospitals.

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