unit 6.1. ventilation concepts; natural ventilation tb infection control training for managers at...
TRANSCRIPT
Unit 6.1. Ventilation concepts;
natural ventilation
TB Infection Control Training for Managers
at National and Subnational Level
ObjectivesBy the end of this unit, participants will be able
to:• Describe the concept of ventilation• State the recommended air changes per
hour (ACH) for airborne precaution rooms• Calculate ACH• Utilize directional air flow to reduce the risk
of TB transmission• Describe how to maximize natural
ventilation2
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Outline
A. Ventilation concepts– Air changes per hour– Directional airflow– Types of ventilation systems
B. Natural ventilation– Wind– Stack
C. Exercise
A. What is ventilation?
• Movement of air
• “Pushing” and/ or “pulling” of particles and vapours
• Preferably in a controlled manner
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WHO recommends that health facilities implement
ventilation systems
• the better ventilated the area, the lower risk of transmission of TB and other airborne infections
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Air changes per hour (ACH)
• Calculating ACH is the most simple way to assess ventilation
• ACH = Volume of air moved in one hour
• One ACH means that the volume of air in the room is replaced in one hour
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Air changes per hour (ACH)
• WHO recommends at least 12 ACH to prevent airborne infection
• The higher the ACH, the better the dilution and the lower the risk of airborne infection
• But too much airflow can be uncomfortable (too much draft)
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ACH and time required for removal of 99% of droplet nuclei
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ACH, time required for removal of 99% and 99.9% of droplet nuclei
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Dilution ventilation
What do you need to measure ACH? 1.A tape
measure
2.Vaneometer
3.Smoke tube
4.Calculator
5.Note pad
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Measure dimensions of the opening to calculate area
Area of window opening = length x widthExample 1: Area = 0.5 m x 0.5 m = 0.25 m2
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Use the vaneometer to measure velocity, direction
Speed = metres per second = m/s13
Measurement of air velocity Measurement of air velocity through open window in through open window in KwaKwa--
Zulu Natal, South AfricaZulu Natal, South Africa
Never put fingers on the open space of the vaneometer
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Smoke tube to monitor air flow Smoke tube to monitor air flow through a door into a sputum through a door into a sputum
collection booth in Riga, Latviacollection booth in Riga, Latvia
Is air flowing the right direction?15
Calculate air flow rate
Example 1:Air velocity through window measured by
vaneometer = 1 m/sFlow rate = Open window area x air velocity = 0.25 m2 x 1 m/second
= 0.25 m3/s x 3,600 seconds per hour= 900 m3 / hour
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Room volume = width x depth x height
Example 1:
3 m wide x 5 m deep x 3 m high = 45 m3
Calculate room volume
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Example 1: ACH calculation
• Window area = length x width = 0.25 m2
• Air velocity through window= 1 m/s• Air flow rate = window area x air velocity = 900 m3/h• Room volume = width x depth x height = 45 m3
• ACH = Air flow rate divided by room volume
= 900 m3/hour = 20 ACH 45 m3
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Bed
Bed
WindowW
indo
wWindow closed
Win
dow
clo
sed
Each open window = 1m x 1m = 1m2
Door
Example 2: ACH calculation
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Area of open windows
= 2 m2
Bed
Bed
Window
Win
dow
Window closed
Win
dow
clo
sed
1 m2 1
m2
Door
20
0.20 m/s
0.10 m/s Average air velocity =
0.20 +0.10 m/s
2
=0.15 m/sec
Bed
Bed
Window
Win
dow
Window closed
Door
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Average air velocity 0.15 m/sec
Average Flow Rate =
Average air velocity 0.15 m/sec
X Area of windows 2 m2
X 3,600 sec/h
= 1,080 m3 / h
Bed
Bed
Window
Win
dow
Window closed
Door
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Room volume:
4.5 m x 4 m
x 3.5 m= 63 m3
ACH = flow rate room volume
= 1,080 m3 / h 63 m3
= 17 ACH
Bed
Bed
Window
Win
dow
Door
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ACH examples Room volume Average air
flowrate (Air volume x h)
ACH
4m x 4m x 2.5 m m3 x h Flow/ volume
40 m3 40 1
40 m3 200 5
40 m3 300 7.5
40 m3 600 15
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Window openings
Ventilation is more effective if:
1. Air flows from “clean” to “contaminated” (directional airflow)
2. There is good air-mixing (no stagnation or short circuiting)
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Directional airflow
Locate the health care worker (or other patients) near the clean air source
Locate the person who may be infectious near a place where the air is exhausted away
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Correct working location
Health care worker (HCW) is near the clean air source
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Incorrect working location
Resolve by switching places so the health care worker is near the clean air source
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Good compromise
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Types of ventilation
1. Natural
• If feasible, maximize the use of natural ventilation before considering other ventilation systems.
2. Mechanical
3. Mixed mode
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B. Natural ventilation
Created by the use of external airflows generated by natural forces such as:
• Wind
• Differences in temperature (stack)
Naturally ventilated rooms can achieve very high ventilation rates (ACH) under ideal conditions
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Natural ventilation
Open Window
Open Window
Door C D E F
BDirection of air flow
Beds
A
Beds
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Maximize natural ventilation
• Openings on opposite walls (cross ventilation)• Openings are unrestricted (stay open)• 10% of floor space should be openable
window area on each wall• Upper levels of the building (higher from the
ground floor)• Building and openings are oriented to use the
prevailing wind, without obstruction by other nearby buildings
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Stack ventilation
Turbine driven ventilation (whirly bird)
Natural ventilationAdvantages• Can often be implemented immediately• Often low cost• Can achieve high ACH
Disadvantages• Uncontrolled• Unpredictable• Safety, comfort• Insects, noise, dust• Not suitable in cold weather
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Summary
• WHO recommends at least 12 room air changes per hour to prevent airborne infection
• Locate the health care worker (or other patients) near the clean air source
• Locate the patient who may be infectious near a place where the air is exhausted away
• In existing health care facilities with natural ventilation, the use of natural ventilation should be maximized before considering other ventilation systems.
Exercise
• How would you improve the ventilation of the following health facility, using natural ventilation concepts?
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Poorly ventilated waiting area in an out-patient clinic
Side A
Side B
Office
Office
Office
Pharmacy
Exa
min
atio
n r
oom
s
X X X X
Doors in/ out
Doors in
Plane view Front viewChairs, waiting area
Windows
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Waiting area maximizing natural ventilation
Side A
Side B
Office
Office
Office
Pharmacy
Exa
min
atio
n r
oom
s
Doors in/ out
Plane view Front view
Wai
tin
g a
rea
3 Windows tranformed into doors
Side B
Waiting area
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