A holistic approach to raise indoor air quality in hospitals to the next level.

SUMMARY REPORT OF PILOT RESULTS AT CLEMENCEAU MEDICAL CENTER, DUBAI

Abstract

This summary report provides an overview of the pilot conducted at the CLEMENCEAU MEDICAL CENTER in Dubai to raise indoor air quality to the next level and protect employees and patients from on-site infections, through the installation of an AIRLIFE in duct filtration system.?Air quality data was verified by ATMOCUBE indoor air quality monitor.

The installed AIRLIFE system is supporting and increasing the mechanical filtration efficiency of the current installation up to 99.72% at the AHU.

Also, measurements in the reference rooms have shown a significant reduction of particulate matters of more than 50%.

TVOC’s have been reduced at the AHU and inside the reference rooms by more than 50%.

Measurement methods????????????????????????????????????????????????????????????

The pilot was initiated by, HAWANA- PRO TECHnology, one of the leading suppliers of Indoor Air Quality (IAQ) solutions in the Middle East.?

After deep analysis and professional study of the current installation of the?client, we decided to go ahead with the pilot and our team?started the project mid November 2021 with the installation of 8 ATMOCUBE measurement devices in predefined reference rooms. The values from that point have been monitored and trended in an ATMOCUBE online dashboard, displaying the values of different indoor air quality parameters, such as CO2, Particulate Matter (PM1,2.5,4,10), Temperature, rel. Humidity and TVOC.

The collected data allowed to create an?indoor air quality (IAQ) baseline?before the installation of the AIRLIFE in duct solution into the selected mechanical ventilation system. With this baseline, measured values have been analyzed and improvement targets have been defined.?

To avoid any wrong interpretation of the collected data, 5 ATMOCUBE devices have been installed in rooms directly supplied by the air handling unit (AHU), which has been equipped with the AIRLIFE solution and 3 ATMOCUBE devices have been installed in areas supplied by other AHU’s. With this it was possible to exclude that changes in outdoor air quality during the pilot would be interpreted as IAQ increase or decrease due to the installed AIRLIFE solution.?

Example installation of ATMOCUBE device in patient room

Example ATMOCUBE Dashboard

From the beginning it was clear that for the pilot, primarily the focus had to be on the improvement of directly measurable room parameters, such as?particulate matters (PM2.5) and TVOC's. AIRLIFE filtration systems always contain a combination of three filter elements. Electrostatic, photocatalytic and carbon adsorption filters. With these filters also other pollutants, such as viruses, bacteria’s, mold, and odours can be filtered and deactivated.

Due to the more complex measurement needed for these pollutants it has been decided that in a second phase, later in 2022 additional petri dishes will be taken to compare also the IAQ gains with regards to bacteria.

To exclude most of the effects a varying occupation of the reference rooms could have on the measurement results, further it has been decided to select an AHU which supplies a floor with little or no occupation. This decision also has been made to reduce the number of potential interruptions of hospital core processes to a minimum during the time of the pilot.

The challenge though due to this, has been that the above-mentioned low occupation offered a limited amount of pollution to be filtered.?

The major KPI's to define the success of the pilot was a significant reduction of PM2.5 and TVOC.

The selected AHU supplying the reference rooms (amongst other rooms) is designed to recirculate up to 85% of the return air back into the fresh air. The remaining amount of fresh air is supplied mechanically pre-filtered to the mixing chamber of the AHU. The amount of fresh/return air is driven by the cooling load. The AHU itself has preinstalled two mechanical filtration steps (G4,F8) to clean the supply air before sent to the rooms.?

The AIRLIFE filtration system has been installed at the end of the AHU. With this, 100% of the supply air can be cleaned (additionally) from mechanical pollution (electrostatic filter), but also from microbiological pollution (photocatalytic filter), such as viruses, bacteria’s and mold and chemical pollution (adsorption filter) such as TVOC and odors. The system therefore also can help to?reduce or eliminate on premise infections, which can happen when air is being recirculated in a mechanical ventilation system.?

Measurement results directly at the AHU

The AIRLIFE filtration system filters pollution, which the mechanical ventilation is “delivering” to the filtration system. Some design aspects, such as where air in- and outlets in the rooms are positioned and where under- and overpressure zones are, influence the efficiency the air in the rooms is renewed.?To mostly exclude these influences, measurements directly at the unit have been taken.

The above overview demonstrates that the two mechanical filtration steps inside the AHU help to reduce the PM2.5 value by 91%. This value in theory would be a bit lower considering that the measurement has been taken already when the AIRLIFE filtration system has been installed and therefore the return air from the mixing box already went through the filtration system and the amount of recirculation at that time has been between 80%-85%.?

On the TVOC side instead due to mixing with return air and no filtration for TVOC’s the value goes up by 71%, due to TVOC pollution in the ventilated areas and rooms. To reduce TVOC’s with the system as it has been designed originally, it would be necessary to increase the amount of fresh air or remove TVOC’s in the rooms directly where they occur. An increase of fresh air would have the negative side effect of an increased energy consumption due to thermal processing the fresh air before being sent to the areas and rooms.?

With the AIRLIFE filtration system (blue box) installed on the supply side at the end of the AHU, PM2.5 can be reduced in one step additionally by 97% and improve the overall mechanical filtration efficiency up to 99.72%. TVOC’s, which before were not removed due to the lack of a filtration system now can be reduced by 56% without increasing the amount of fresh air and therefore increase IAQ without increasing energy consumption.

Measurement results in the reference rooms?

As stated, 5 reference rooms have been equipped with ATMOCUBE monitor to measure the effect on PM2.5 and TVOC’s in the rooms. Two weeks have been selected to compare “before” and “after” installation of AIRLIFE SWISS filtration system.?

To cross check if the two compared weeks (separated by the red line) offered the basis for comparison, CO2 and noise measurements have been compared. If these values showed a similar pattern, PM2.5 and TVOC’s have been compared.

Occupancy factors check

Measurement results

The above measurement results show that values in patient rooms have been already at a low level on PM2.5 and TVOC’s before the installation of the AIRLIFE filtration system and fulfilled most of the relevant guidelines for IAQ (WHO, RESET, LEED, German federal regulation).?

Even if designed for filtering significantly higher amounts of pollution the AIRLIFE filtration system has been able to reduce PM2.5 and TVOC values by another 50-60%!

In comparison below the charts of a room on the same floor, measured in the same time period?not supplied by AIRLIFE filtration system.

In this case it is clearly visible that there has not been a change in PM2.5 and TVOC values within the two measured time periods.

Conclusion

In principle values measured at Clemenceau Medical Center, Dubai have been already at a good or even very good level, especially with regards to particulate matters. This partially because the floor selected for the pilot has not been occupied during the period of the measurement and therefore a limited internal pollution could be generated, but also due to a triple mechanical filtration already in place. Fresh air is prefiltered in a central unit and then filtered again twice inside the AHU.?

The installed AIRLIFE system is supporting and increasing the mechanical filtration efficiency of the current installation up to 99.72% at the unit. Also, measurements in the reference rooms have shown a significant reduction of particulate matters of more than 50%. This proofs that the installed AIRLIFE system is capable to filter particles even at a very low level.??

In addition to this with the AIRLIFE filtration system it’s now possible to filter out TVOC’s coming from the rooms through the recirculation or from fresh air as proven by ATMOCUBE monitors. Before the installation of the filtration system this would have been only possible with an increase of fresh air, if mentioned fresh air would have a lower value than return air or additional filtration devices in the room where TVOC pollution occurs. The process of reducing TVOC’s with more fresh air would have significantly increased the amount of energy used to thermally prepare fresh air. With the AIRLIFE solution TVOC’s now can be reduced by more than 50% without increasing energy consumption.?

The AIRLIFE filtration solution is also containing a photocatalytic filter, which deactivates viruses, bacteria’s, and mold. From now on it will support the reduction of on premise infections since the entire supply air is passing the AIRLIFE solution before sent to the areas and rooms.