Indoor Air Quality in a Real Operating Theatre under Effective Use Conditions

Carla Balocco; Giuseppe Petrone; Giuliano Cammarata; Pietro Vitali; Roberto Albertini; Cesira Pasquarella

doi:10.4236/jbise.2014.711086

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Journal of Biomedical Science and Engine... > Vol.7 No.11, September 2014

Indoor Air Quality in a Real Operating Theatre under Effective Use Conditions ()

Carla Balocco, Giuseppe Petrone, Giuliano Cammarata, Pietro Vitali, Roberto Albertini, Cesira Pasquarella

Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy.
Department of Clinical and Experimental Medicine, University of Parma, Unit of Medical Immunology, University Hospital of Parma, Parma, Italy.
Department of Industrial Engineering, University of Catania, Catania, Italy.
Department of Industrial Engineering, University of Firenze, Firenze, Italy.
Hospital Hygiene Unit, University Hospital of Parma, Parma, Italy.

DOI: 10.4236/jbise.2014.711086 PDF HTML 3,459 Downloads 4,984 Views Citations

Abstract

The aim of this study is to investigate the impact of surgical staff on the indoor air quality in a uni-directional ventilation Operating Theatre (OT). Experimental measurements of particles and microclimate were acquired at rest and in operational conditions. The real OT (operational) use was simulated by a sham hip arthroplasty. CFD simulations were carried out outlining the studied environment used for experimental measurement campaign. A standard k-ε closure scheme based on RANS equations was implemented to solve the velocity and pressure field using an eddy viscosity approach. Temperature and relative humidity distributions were also computed keeping into account sensible and latent heat sources inside the OT. An Euler-based approach was applied to solve the concentration fields of gaseous contaminant and small particles (up to 5 μm in diameter) in the indoor air. An innovative strategy is proposed to estimate, by an iterative comparison between experimental data and numerical results, the emission rate of particles (differentiated by diameters) released by the occupants to be considered as source terms in the numerical model. Compliance with literature evidence concerning thermal and velocity fields and CO₂ concentration was confirmed. From our analyses, some IAQ indexes were deduced, allowing monitoring of the local and overall OT air quality level supplied by the ventilating system during real operational conditions. The highest values of microbial air contamination were recorded during surgical activity; nevertheless, results showed the suitability of the ventilation system in providing the expected air quality.

Keywords

Experimental Measurements, Numerical Simulation, CFD, Real Operating Theatre, Particles, IAQ Indexes

Share and Cite:

Balocco, C. , Petrone, G. , Cammarata, G. , Vitali, P. , Albertini, R. and Pasquarella, C. (2014) Indoor Air Quality in a Real Operating Theatre under Effective Use Conditions. Journal of Biomedical Science and Engineering, 7, 866-883. doi: 10.4236/jbise.2014.711086.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Chow, T.T. and Wang, J. (2012) Dynamic Simulation on Impact of Surgeon Bending Movement on Bacteria-Carrying Particles Distribution in Operating Theatre. Building and Environment, 57, 68-80. http://dx.doi.org/10.1016/j.buildenv.2012.04.010
[2]	Brohus, H, Balling, K.D. and Jeppesen, D. (2006) Influence of Movements on Contaminant Transport in an Operating Room. Indoor Air, 16, 356-372. http://dx.doi.org/10.1111/j.1600-0668.2006.00454.x
[3]	Franke, J.E. and Wadden, R.A. (1987) Indoor Contaminant Emission Rates Characterized by Source Activity Factors. Environmental Science and Technology, 21, 45-51. http://dx.doi.org/10.1021/es00155a004
[4]	Friberg, B., Friberg, S., Ostensson, R. and Burman, L.G. (2001) Surgical Area Contamination-Comparable Bacterial Counts Using Disposable Head and Mask and Helmet Aspirator System, but Dramatic Increase upon Omission of Head-Gear: An Experimental Study in Horizontal Laminar Air-Flow. Journal of Hospital Infection, 47, 110-115. http://dx.doi.org/10.1053/jhin.2000.0909
[5]	Saidi, M.H., Sajadi, B. and Molaeimanesh, G.R. (2011) The Effect of Source Motion On Contaminant Distribution in the Cleanrooms. Energy and Buildings, 43, 966-970.
[6]	Hospodsky, D., Qian, J, Nazaroff, W.W., Yamamoto, N., Bibby, K., Yazdi, H.R. and Peccia, J. (2012) Human Occupancy as a Source of Indoor Airborne Bacteria. PLOS One Sources of Indoor Airborne Bacteria, 7, 1-10.
[7]	Mackintosh, C.A., Lidwell, O.M., Towers, A.G. and Marples, R.R. (1978) The Dimensions of Skin Fragments Dispersed into the Air during Activity. The International Journal of Hygiene and Environmental Health, 81, 471-480. http://dx.doi.org/10.1017/S0022172400025341
[8]	Nazaroff, W.W. (2004) Indoor Particle Dynamics. Indoor Air, 7, 175-183. http://dx.doi.org/10.1111/j.1600-0668.2004.00286.x
[9]	Li, C.-S. and Hou, P.-A. (2003) Bioaerosol Characteristics in Hospital Clean Rooms. The Science of the Total Environment, 305, 169-176. http://dx.doi.org/10.1016/S0048-9697(02)00500-4
[10]	Pasquarella, C., Sansebastiano, G.E., Ferretti, S., Saccani, E., Fanti, M., Moscato, U., Giannetti, G., Fornia, S., Cortellini, P., Vitali, P. and Signorelli C. (2007) A Mobile Laminar Airflow Unit to Reduce Air Bacterial Contamination at Surgical Area in a Conventionally Ventilated Operating Theatre. Journal of Hospital Infection, 66, 313-319. http://dx.doi.org/10.1016/j.jhin.2007.05.022
[11]	Yu, B.F., Hu, Z.B., Liu, M., Yang, H.L., Kong, Q.X. and Liu, Y.H. (2009) Review of Research on Air-Conditioning Systems and Indoor Air Quality Control for Human Health. International Journal of Refrigeration, 32, 3-20. http://dx.doi.org/10.1016/j.ijrefrig.2008.05.004
[12]	Faulkner, D., Fisk, W.J., Sullivan, D.P. and Lee, S.M. (2004) Ventilation Efficiencies and Thermal Comfort Results of a Desk-Edge-Mounted Task Ventilation System. Indoor Air, 14, 92-97. http://dx.doi.org/10.1111/j.1600-0668.2004.00295.x
[13]	Niu, J.L., Gao, N.P., Ma, P. and Zuo, H.G. (2007) Experimental Study on a Chair-Based Personalized Ventilation System. Building and Environment, 42, 913-925. http://dx.doi.org/10.1016/j.buildenv.2005.10.011
[14]	Zhao, B. and Guan, P. (2007) Modeling Particle Dispersion in Personalized Ventilated Room. Building and Environment, 42, 1099-1109. http://dx.doi.org/10.1016/j.buildenv.2005.11.009
[15]	Chow, T.T. and Yang, X.Y. (2005) Ventilation Performance in the Operating Theatre against Airborne Infection: Numerical Study on an Ultra-Clean System. Journal of Hospital Infection, 59, 138-147. http://dx.doi.org/10.1016/j.jhin.2004.09.006
[16]	Chow, T.T. and Yang, X.Y. (2003) Performance of Ventilation System in a Non-Standard Operating Room. Building and Environment, 38, 1401-1411. http://dx.doi.org/10.1016/S0360-1323(03)00155-0
[17]	Chen, F.Z., Yu, S.C.M. and Lai, A.C.K. (2006) Modeling Particle Distribution and Deposition in Indoor Environments with a New Drift-Flux Model. Atmospheric Environment, 40, 357-367. http://dx.doi.org/10.1016/j.atmosenv.2005.09.044
[18]	Gao, N.P. and Niu, J.L. (2007) Modeling Particle Dispersion and Deposition in Indoor Environments. Atmospheric Environment, 41, 3862-3876. http://dx.doi.org/10.1016/j.atmosenv.2007.01.016
[19]	Qian, J., Hospodsky, D., Yamamoto, N., Nazaroff, W.W. and Peccia, J. (2012) Size-Resolved Emission Rates of Airborne Bacteria and Fungi in an Occupied Classroom. Indoor Air, 22, 339-351. http://dx.doi.org/10.1111/j.1600-0668.2012.00769.x
[20]	Zhao, B., Zhang, Y., Li, X.T., Yang, X.D. and Huang, D.T. (2004) Comparison of Indoor Aerosol Particle Concentration and Deposition in Different Ventilated Rooms by Numerical Method. Building and Environment, 39, 1-8. http://dx.doi.org/10.1016/j.buildenv.2003.08.002
[21]	Balocco, C., Petrone, G. and Cammarata, G. (2012) Assessing the Effects of Sliding Doors on an Operating Theatre Climate. Building Simulation, 5, 73-83. http://dx.doi.org/10.1007/s12273-012-0071-x
[22]	ANSI/ASHRAE Standard 62.1-2007 (2007) Ventilation for Acceptable Indoor Air Quality.
[23]	UNI EN ISO 14644-3 2006 (2006) Cleanrooms and Associated Controlled Environments—Part 3: Test Methods.
[24]	UNI EN ISO 14644-1 2006 (2006) Cleanrooms and Associated Controlled Environments. Part 1: Classification of Air Cleanliness.
[25]	UNI EN ISO 14644-2 2006 (2006) Cleanrooms and Associated Controlled Environments Part 2: Specifications for Testing and Monitoring to Prove Continued Compliance with ISO 14644-1.
[26]	ISO 21501-4:2007 (2007) Determination of Particle Size Distribution—Single Particle Light Interaction Methods. Part 4: Light Scattering Airborne Particle Counter for Clean Spaces.
[27]	UNI 11425 (2011) Surgery Operating Theatre, Ventilation and Air-Conditioning System for Contamination Control (VCCC)—Design, Construction, Commissioning, Qualification, Management and Maintenance (in Italian)
[28]	Hinze, J.O. (1975) Turbulence. 2nd Edition, McGraw Hill, New York.
[29]	Deuflhard, P. (1974) A Modified Newton Method for the Solution of Ill-Conditioned Systems of Nonlinear Equations with Application to Multiple Shooting. Numerische Mathematik, 22, 289-315. http://dx.doi.org/10.1007/BF01406969
[30]	Hindmarsh, H., Brown, A.C., Grant, P.N., Lee, K.E., Serban, S.L., Shumaker, R., Woodward, D.E. and Woodward C.S. (2005) SUNDIALS: Suite of Nonlinear and Differential/Algebraic Equation Solvers. ACM Transactions on Mathematical Software, 31, 363-396. http://dx.doi.org/10.1145/1089014.1089020
[31]	ONORM H 6020 (2007) Ventilation and Air Conditioning Plants for Locations for Medical Use—Design, Construction, Operation, Maintenance, Technical and Hygienic Inspections.
[32]	VDI 2167, Part 1 (2004) Building Services in Hospitals—Heating, Ventilationandair-Conditioning.
[33]	DPR 14/01/97 (1997) Approvazione Dell’atto di Indirizzo e Coordinamento alle Regioni e alle Province Autonome di Trento e di Bolzano, in Materia di Requisiti Strutturali, Tecnologici ed Organizzativi Minimi per L’esercizio Delle Attività Sanitaria da Parte Delle Strutture Pubbliche e Private. In: G.U.R.I. 20/02/1997 n.42 (in Italian).
[34]	ISPESL (2009) Dipartimento Igiene del Lavoro, Linee guida per la definizione degli standard di sicurezza e di igiene ambientale dei reparti operatori. (In Italian) http://www.ispesl.it/
[35]	NBHF (2004) Building Guidelines for a Surgical Department.
[36]	HTM 03-01 (2007) Heating and Ventilation Systems Health Technical Memorandum 03-01: Specialised Ventilation for Healthcare Premises, Part A: Design and Validation. TSO, Edinburgh.
[37]	ANSI/ASHRAE 170 (2008) Ventilation of Health Care Facilities.
[38]	Karthikeyan, C.P. and Samuel, A.A. (2008) CO2-Dispersion Studies in an Operation Theatre under Transient Conditions. Energy and Buildings, 40, 231-239.
[39]	Al-Waked, R. (2010) Effect of Ventilation Strategies on Infection Control inside Operating Theatres. Engineering Applications of Computational Fluid Mechanics, 4, 1-16.
[40]	Villafruela, J.M., Castro, F., San José, J.F. and Saint-Martin, J. (2013) Comparison of Air Change Efficiency, Contaminant Removal Effectiveness and Infection Risk as IAQ Indices in Isolation Rooms. Energy and Buildings, 57, 210-219. http://dx.doi.org/10.1016/j.enbuild.2012.10.053
[41]	Kwon, K.S., Lee, I.B., Han, H.T., Shin, C.Y., Hwang, H.S., Hong, S.W., Bitog, J.P., Seo, I.H. and Han, C.P. (2011) Analysing Ventilation Efficiency in a Test Chamber Using Age-of-Air Concept and CFD Technology. Biosystems Engineering, 110, 421-433. http://dx.doi.org/10.1016/j.biosystemseng.2011.08.013
[42]	Meiss, A., Feijó-Munoz, J. and Garcia-Fuentes, M.A. (2013) Age-of-the-Air in Rooms According to the Environmental Condition of Temperature: A Case Study. Energy and Buildings, 67, 88-96. http://dx.doi.org/10.1016/j.enbuild.2013.08.016
[43]	Abanto, J., Rarrero, D., Reggio, M. and Ozell, B. (2004) Air Flow Modelling in a Computer Room. Building and Environment, 39, 1393-1402. http://dx.doi.org/10.1016/j.buildenv.2004.03.011
[44]	Zhang, L., Chow, T.T., Fong, K.F., Tsang, C.F. and Wang, Q.W. (2005) Comparison of Performances of Displacement and Mixing Ventilations. Part II: Indoor Air Quality. International Journal of Refrigeration, 28, 288-305. http://dx.doi.org/10.1016/j.ijrefrig.2004.04.006
[45]	Petrone, G., Cammarata, L. and Cammarata, G. (2011) A Multi-Physical Simulation on the IAQ in a Movie Theatre Equipped by Different Ventilating Systems. Building Simulation: An International Journal, 4, 21-31.
[46]	Sandberg, M. and Sjoberg, M. (1983) The Use of Moments for Assessing Air Quality in Ventilated Rooms. Building and Environment, 18, 181-197. http://dx.doi.org/10.1016/0360-1323(83)90026-4
[47]	Federspiel, C.C. (1999) Air-Change Effectiveness: Theory and Calculation Methods. Indoor Air, 9, 47-56. http://dx.doi.org/10.1111/j.1600-0668.1999.t01-3-00008.x
[48]	Li, X.T., Li, D.N., Yang, X.D. and Yang, J.R. (2003) Total Air Age: An Extension of the Air Age Concept. Building and Environment, 38, 1263-1269. http://dx.doi.org/10.1016/S0360-1323(03)00133-1
[49]	Mendez, C., San José, J.F., Villafruela, J.M. and Castro, F. (2008) Optimization of a Hospital Room by Means of CFD for More Efficient Ventilation. Energy and Buildings, 40, 849-854. http://dx.doi.org/10.1016/j.enbuild.2007.06.003