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Indoor Environm e nt C e nte r >> Ae robiological Engine e ring >> Airborne Pathoge n C ontrol Te chnologie s >> Isolation Syste m s

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Aerobiological Engineering Topics Airborne Pathogen Database Airborne Pathogen Control Technologies Isolation Systems Air Filtration Ultraviolet Irradiation Outdoor Air Purging Electrostatic Precipitation Negative Air Ionization Vegetation Photocatalytic Oxidation Air Ozonation Carbon Adsorption Passive Solar Exposure Ultrasonic Atomization Microwave Atomization Pulsed Light Equipment and Services Publications
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Isolation Rooms & Pressurization Control

Isolation syste m s can be classifie d in thre e basic cate gorie s : Ne gative Pre ssure Isolation R oom s Positive Pre ssure Isolation R oom s Multi-le ve l Biohazard Laboratorie s Also, dual-purpose syste m s now e x ist that can be controlle d to se rve as e ithe r ne gative pre ssure or positive pre ssure isolation room s. The isom e tric vie w shown be low illustrate s the basic de sign principle for pre ssure control of isolation room s. It include s an ante room for se parating the isolation room from the corridor of the facility. In this diagram , air is supplie d to the isolation room and e x hauste d from both the isolation room and the ante room . The balance of airflow, or the diffe re nce be twe e n be twe e n supply and e x haust, will dictate whe the r the room e x pe rie nce s positive or ne gative pre ssure with re spe ct to am bie nt. In this diagram , air would flow be twe e n the isolation room and the ante room , m ostly through the gaps in and around the door. For a positive pre ssure room the air would flow from the isolation room to the ante room , whe re it would be e x hauste d partly by the e x haust duct and partly by flowing out to the corridor. In a ne gative pre ssure room , air would flow from the ante room to the isolation room . Pre ssure control is m aintaine d by m odulating the m ain supply and e x haust dam pe rs base d on a signal from a pre ssure transduce r locate d inside the isolation room . This is by no m e ans the only possible de sign -- the re are various configurations of supply and e x haust ductwork , dam pe rs and control syste m s that will accom plish pre ssurization. Negative Pressure Isolation Rooms Ne gative Pre ssure Isolation R oom s m aintain a flow of air into the room , thus k e e ping contam inants and pathoge ns from re aching surrounding are as. The m ost com m on application in the he alth industry today is for Tube rculosis (TB) R oom s. The infe ctivity of TB is e x tre m e ly high and the se room s are e sse ntial to prote ct he alth work e rs and othe r patie nts.

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re com m e nds 6-12 air change s pe r hour (AC H) for TB R oom s. An ante room is always re com m e nde d, as this provide s a barrie r be twe e n the TB R oom and hallways and lim its the im pact of ope ning doors and traffic. The e x haust air is norm ally filte re d through a HEPA (High Efficie ncy Particulate Air) filte r be fore be ing e x hauste d to the outside , whe re it is ultim ate ly re nde re d harm le ss by natural e le m e nts. Air which is re circulate d within the room is also norm ally filte re d. Ultraviole t Ge rm icidal Irradiation (UVGI), com m only k nown as UV light, m ay be use d to augm e nt HEPA filte rs, but cannot be use d in place of HEPA filte rs, as the ir e ffe ctive ne ss on airstre am s is lim ite d. The e x act air pre ssure diffe re ntial which is re quire d to be m aintaine d is nom inal only, as it m e re ly indicate s the airflow dire ction. It is som e tim e s state d as 0.001"wg, but this is not a pre ssure which is practical to m e asure , and the re fore othe r crite ria are give n such as m aintaining an inward ve locity of 100 fpm , or e x hausting 10% of the airflow, or e x hausting 50 cfm m ore than the supply. The e x act crite ria will always be de pe nde nt on both the size and the airtightne ss of the subje ct facility.

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Positive Pressure Isolation Rooms Positive Pre ssure Isolation R oom s m aintain a flow of air out of the room , thus prote cting the patie nt from possible contam inants and pathoge ns which m ight othe rwise e nte r. The m ost com m on application today is HIV R oom s and room s for patie nts with othe r type s of im m unode ficie ncy. For such patie nts it is critically im portant to pre ve nt the ingre ss of any pathoge ns, including e ve n com m on fungi and bacte ria which m ay be harm le ss to he althy pe ople . De sign crite ria for HIV R oom s are sim ilar to those for TB R oom s. Air supplie d to or re circulate d in HIV R oom s is norm ally filte re d through HEPA filte rs, and UVGI syste m s are som e tim e s use d in conjunction with the se . Ante room s are re com m e nde d and the air pre ssure diffe re ntial crite ria as de scribe d for TB R oom s applie s sim ilarly. Approx im ate ly 15% of AIDS patie nts also suffe r from TB, and this pre se nts a unique de sign proble m . O ne solution is to house the positive pre ssure (HIV) room within a ne gative pre ssure (TB) room , or vice -ve rsa, which would be sim ilar to a pair of ne ste d biohazard le ve ls. A m uch le ss e x pe nsive alte rnative is to de sign an e ntire house or building as a positive pre ssure (HIV) room , and this m ak e s the outdoor air play the part of the se cond pre ssure barrie r as it will e ffe ctive ly ste rilize any e x iting pathoge ns. Ex haust HEPA filte rs are still re com m e nde d, howe ve r, to prote ct any passe rsby. Pressurization Control in Buildings The basic principle of pre ssurization for m icrobial contam inant control is to supply air to are as of le ast contam ination (gre ate st cle anline ss) and stage this air to are as of progre ssive ly gre ate r contam ination pote ntial. It could be assum e d that in non-biohazard facilitie s, the e x haust or e x filtration from the building could go dire ctly to the outside . In m e dical facilitie s, lik e TB clinics, this air is ofte n HEPA filte re d and som e tim e s give n UVGI e x posure be fore e x hausting to the outside , though the re asons for this are prim arily be cause of litigation conce rns and not base d on any k nown re alitie s. An alte rnate pe rspe ctive on the de sign principle of pre ssurization control is to e x haust air from those are as which have the gre ate st contam ination pote ntial, and allow air to be stage d, or cascade d, from progre ssive ly cle ane r are as, or the are as it is de sire d to prote ct. Syste m s which com bine both ne gative pre ssurization in contam inate d are as with positive pre ssurization in cle an, or prote cte d, are as will have the gre ate st de gre e of prote ction and control. Be low is an illustration of the basic
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principle of cascading airflows from cle an are as to are as of progre ssive ly gre ate r m icrobial conatm ination pote ntial. In the

above diagram , a facility is de picte d which has office s and isolation room s, se parate d by corridors and othe r are as (storage room s, labs). Air is supplie d to the are as, usually office s, m aintaine d at the gre ate st positive pre ssure (m ark e d with a '++'), and e x hauste d from the are as m aintaine d at the gre ate st ne gative pre ssure (m ark e d with a '- -'). Transfe r air (e x filtration/infiltration) is ide ntifie d with purple arrows. This re pre se nts one possible arrange m e nt, but facilitie s ofte n diffe r m ark e dly in layouts, and the pre suurization sche m e m ust be adapte d individually for e ach facility. The unlabe le d room s in the diagram above could be laboratorie s, which usually have inde pe nde ntly ope rating e x haust hoods or se parate ve ntilation syste m s. If not, the y would be ge ne rally be de signe d as double ne gative pre ssurization are as. Biohazard Laboratories Biohazard laboratorie s are m e re ly isolation room s with strict re quire m e nts de fining the ir de gre e of airtightne ss, pre ssurization and associate d e quipm e nt. The re are four biohazard le ve ls, in le ve l 1 de fine s a sim ple isolate d are a, and in which le ve l 4 de fine s a ne ar pe rfe ctly airtight zone re quiring bre athing apparatus and airtight ante room s or staging are as. Spe cific inform ation on laboratory de sign is wide ly available from various source s, including ANSI, ASHR AE and the C DC . Bibliography

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ANSI (1992). Am e rican national standard for laboratory ve ntilation. Ne w York , Am e rican National
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Standards Institute . 2. AIA (1993). Guide line s for construction and e quipm e nt of hospital and m e dical facilitie s. Me chanical Standards. Am e rican Institute of Archite cts. W ashington. 3. 4. ASHR AE (1991). He alth Facilitie s. ASHR AE Handbook of Applications. ASHR AE. Atlanta. ASHR AE (1996). De signing HVAC syste m s for hospital isolation room s. ASHR AE Short C ourse . Atlanta, ASHR AE. 5. 6. Bartholom e w, D. (1994). TB control in hospitals. Engine e re d Syste m s July: 52-53. Bloom , B. R . (1994). Tube rculosis : Pathoge nisis, Prote ction, and C ontrol. W ashington, ASM Pre ss. Blowe rs, R . and B.C re w (1960). Ve ntilation of ope rating-the atre s. Journal of Hygie ne 58: 427448. Brie f, R . S. and T. Be rnath (1988). Indoor pollution: guide line s for pre ve ntion and control of m icrobiological re spiratory hazards associate d with air conditioning and ve ntilation syste m s. Appl. Indust. Hyg. 3: 5-10. C DC (1994). Guide line s for pre ve nting the transm ission of Mycobacte rium tube rculosis in he althcare facilitie s. Fe de ral R e giste r. C DC . W ashington, US Govt. Printing O ffice . 59. Galson, E. and K. Goddard (1968). Hospital air conditioning and se psis control. ASHR AE 10(7): 33-41. Galson, E. (1987). Facility m icrobiological te st proce dure s. ASHR AE Transactions 93(1): 12891303. Galson, E. and J. Guisbond (1995). Hospital se psis control and TB transm ission. ASHR AE May. Gill, K. E. (1994). HVAC de sign for isolation room s. HPAC July: 45-52. Gre e ne , V. W ., D. Ve sle y, e t al. (1960). The e ngine e r and infe ction control. Hospitals 34: 6974. He rs, J. F. P. and K. C . W ink le r (1973). Airborne Transm ission and Airborne Infe ction. VIth Inte rnational Sym posium on Ae robiology, Te chnical Unive rsity at Ensche de , The Ne the rlands, O osthoe k Publishing C om pany. IC C C S (1992). The Future Practice of C ontam ination C ontrol. Proce e dings of the 11th Inte rnational Sym posium on C ontam ination C ontrol, W e stm inste r, Me chanical Engine e ring Publications. Kunk le , R . S. and G. B. Phillips (1969). Microbial C ontam ination C ontrol Facilitie s. Ne w York , Van Nostrand R e inhold. Lidwe ll, O . M. and R .E.O .W illiam s (1960). The ve ntilation of ope rating-the atre s. Journal of Hygie ne 58: 449-464. Lidwe ll, O . M. (1960). The e valuation of ve ntilation. J. Hygie ne 58: 297-305. Linscom b, M. (1994). AIDS clinic HVAC syste m lim its spre ad of TB. HPAC Fe bruary.
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Malone y, S. A., M. L. Pe arson, e t al. (1995). Efficacy of control m e asure s in pre ve nting nosocom ial transm ission of m ultidrug-re sistant tube rculosis to patie nts and he alth care work e rs. Annals of Inte rnal Me dicine 122(2): 90-95.

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Mille r-Le ide n, S., C . Lobascio and W .W .Nazaroff (1996). Effe ctive ne ss of in-room air filtration and dilution ve ntilation for tube rculosis infe ction control. Journal of the Air and W aste Manage m e nt Association 46(9): 869.

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R ile y, R . L. and F. O 'Grady (1961). Airborne Infe ction. Ne w York , The Macm illan C om pany. R ubbo, S. D., T. A. Pre ssle y, e t al. (1960). Ve hicle s of transm ission of airborne bacte ria in hospital wards. The Lance t 7147: 397-400. Se agal-Maure r, S. and G. E. Kalk ut (1994). Environm e ntal control of tube rculosis: C ontinuing controve rsy. C linical Infe ctious Dise ase s 19: 299-308. Sullivan, J. F., J.R .Songe r (1966). R ole of diffe re ntial air pre ssure zone s in the control of ae rosols in a large anim al isolation facility. Applie d Microbiology 14(4): 674-678. W e dum , A. G. (1961). C ontrol of laboratory airborne infe ction. Bacte r. R e v. 25: 210-216. W e inste in, R . A. (1991). Epide m iology and control of nosocom ial infe ctions in adult inte nsive care units. The Am e rican Journal of Me dicine 91(suppl 3B): 179S-184S. W inte rs, R . E. (1994). Guide line s for pre ve nting the transm ission of tube rculosis: A be tte r solution? C linical Infe ctious Dise ase s 19: 309-310. :: Copyright Info :: 2008 The Pennsylvania State University

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