ELECTRICAL SAFETY


The system consists of a medical isolation transformer and the IMD, which must comply with IEC 61557-8. For fault location, IEC 61557-9 defines the requirements for insulation fault location systems (IFLS). In practice, this means


that Group 2 locations must be designed not only for safe operation under normal conditions, but also for resilience against insulation faults, with staff immediately alerted and able to act. National regulations may complement or supplement these international and European standards and must also be respected.


Electrical installations in hospitals – an Indian perspective In recent years, there has been a significant increase in hospital accidents, especially in high-risk areas such as Neonatal Intensive Care Units (NICUs), ICUs, and OTs, where patient evacuation is challenging. Detailed studies reveal that most of these accidents are due to the non- operation of protective devices during overcurrent or fault conditions. The studies also show that protective measures, such as equipotential bonding, are rarely implemented or maintained in medical settings. As a leading global destination for medical tourism,


India’s healthcare sector must improve the safety of electrical installations and maintain standards comparable to those of Western countries.


n The legal framework for electrical safety Safety requirements in medical locations were first introduced in the National Electrical Code (NEC) of 1985 (SP 30, Part 3, Section 4). This code included provisions for system earthing (TN-S & IT), disconnection times, touch-voltage limits, continuity of supply, supplementary equipotential bonding, and requirements for oxygen-rich areas. The NEC 2011 elaborated on these requirements with illustrations for clarity, while the NEC 2023 further refined them, classifying locations into Group 1 and Group 2 and aligning the requirements with IEC 60364- 7-710.


n Implementation challenges The implementation of electrical safety in Indian hospitals remains a major challenge. There is no agency to enforce or verify compliance, leading to widespread non-implementation and a depletion of knowledge. Most hospitals are accredited under systems designed to improve patient safety and care, but electrical safety is not included in these frameworks. Instead, practices such as the thermal imaging of panels – not recognised in the NEC – are often emphasised, further diverting attention from critical safety measures. Earthing practices present another problem. While the NEC recommends TN-S systems for general applications and IT systems for Group 2 locations, unrecognised alternatives are commonly used, causing dangerous failures. Global medical equipment manufacturers often demand separate ‘earth pits’ (dedicated earthing electrodes) with a resistance of ≤ 1 Ω for biomedical equipment – a non-standard practice that conflicts with


equipotential bonding and compromises patient and staff safety. Often, guarantees and warranties are tied to this requirement, leading hospital management to refuse to implement supplementary equipotential bonding. As a result, one of the most important protective measures against electric shock in Group 1 and Group 2 locations is routinely neglected. The use of medical IT systems is still rare, although some are implemented in modular operating theatres or integrated with UPS systems. Monitoring the continuity of PE conductors in such systems is particularly important due to the frequent confusion in protective earthing practices.


n Additional safety considerations Public utilities or distribution companies supply most medical establishments and rely on multiple backup diesel generators. The capacity of these sources varies widely, which in turn influences circuit impedance. Under such conditions, implementing automatic disconnection is difficult. The use of a three-phase UPS without isolation for single-phase loads adds further complexity. The NEC 2023 introduced requirements for initial and periodic verification. In existing hospitals, conducting such verification is difficult because switching off power is often not feasible. Nevertheless, several new hospitals have already adopted initial verification, ensuring compliance before commissioning — a significant improvement.


n Changing scenario and mass awareness Recent fire accidents in medical facilities – many caused by medical electrical equipment – have triggered large- scale discussions on fire safety. In this context, electrical safety is increasingly being recognised as a measure to reduce fire risks. Following the publication of NEC 2023, large-scale awareness campaigns and training programmes have been launched. These have led to a better understanding of the subject, with some leading hospitals beginning to implement the NEC 2023 recommendations. New hospitals are considering the use of IT systems in accordance with IEC 60364-7-710, which incorporates isolation transformers (IEC 61558-2-15), insulation monitoring devices (IEC 61557-8), and insulation fault location systems (IEC 61557-9). While adoption is still limited, these developments represent progress. The use of PE conductor monitoring is proving to be a valuable tool for ensuring the reliable operation of


In India, professional events such as ELECRAMA promote electrical safety awareness.


Gopa Kumar


Gopa Kumar is the National President of the National Federation of Engineers for Electrical Safety, a not-for-profit organisation working on awareness and skill development programmes on electrical safety. He is also a member of ETD 20 of the Bureau of Indian Standards (committee responsible for standards such as NEC of India 2023, IS732, IS 3043; IS 17512, etc.) and a member of MT 40 of IEC TC 64 (responsible for the maintenance of IEC 60364-7-710; Low-voltage electrical installations – Requirements for special installations or locations – Medical locations).


May 2026 Health Estate Journal 29


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