AIR QUALITY
air purifiers or ceiling-mounted units – provide a faster, less costly way to improve air quality without ripping out existing infrastructure. From an environmental perspective, deploying the Blast
and the Blast Mini, with the additional smart module at hospitals can significantly help reduce power consumption while delivering clean air at full capacity. The smart module helps the units to operate at full capacity when needed, while helping reduce electricity use compared to older, always-on HVAC systems. This helps hospitals move towards Net Zero goals while still prioritising clinical safety. The technology is compliant with HTM-03 recommendations (UKCA, EN 1822-1:2019, EN ISO 294633:2018). Moreover, by reducing the risks of SSIs, smart filtration indirectly cuts down on hospital stays, antibiotic use and repeated procedures. This represents a significant cost saving for the NHS and frees up valuable resources. In a two-year study at a UK NHS Trust, a reduction in SSI saved the NHS added a median 10 days to hospital stay and cost the Trust approximately £5,239 per case, adding up to an extra £2.4 m overall.11 Ultimately, improving air quality in theatres is not just a technical challenge, it’s a cultural one. Staff must understand the limitations of ventilation and the value of filtration. Infection control teams, estate managers, surgeons and procurement teams all have a role to play in championing smarter air quality solutions. Training and awareness are key. From clinical directors
to theatre staff, understanding the role of HEPA filters, the value of smart monitoring and how to respond to air quality data can ensure systems are used to their full potential.
Conclusion Operation theatres are no place for compromise. Clean air is non-negotiable in such a high-stakes environment where every detail matters. While ventilation has served as the traditional guardian of air quality, it cannot stand alone. Filtration must now be part of the conversation. We’ve reached a point where the question is no longer
“Can we afford to add filtration?” but rather “Can we afford not to?” Every preventable infection avoided, every hospital bed freed up, every patient who recovers without complication is a win, not just for the hospital but for the entire healthcare system. Filtration must be recognised as a safety measure, as well as a strategic investment in sustainable patient care. From portable units that provide quick wins to integrated AHU upgrades and intelligent monitoring systems, the tools are available, accessible and scalable. As Trusts and estate teams look to achieve infection control, as well as achieve Net Zero, filtration offers a pragmatic, impactful and cost-effective solution. Investing in filtration isn’t about ticking boxes; it’s about
using the tools we already have to do better for patients, for staff and for the system. It is time to stop treating filtration as an optional extra and start recognising it as essential to safe, modern and sustainable surgical care.
References 1 Guest JF et al. (2020) Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England, BMJ Open. Available at:
https://bmjopen.bmj.com/ content/10/1/e033367 (Accessed: 05 June 2025).
2 Healthcare Design & Management. (n.d.). Controlling airborne contamination within operating theatres. Healthcare Design & Management. Retrieved June 5, 2025, from https://www.
healthcaredm.co.uk/controlling-airborne-contamination-within- operating-theatres.
Case study: Dublin hospital
In 2024, Akara Robotics deployed Blast and Blast Mini units at one of Ireland’s oldest hospitals. The hospital, focused on long-term rehabilitative care, needed a scalable clean air solution that could be deployed with minimal disruption. The Blast units were placed in larger wards while the Blast Mini were placed in single infection isolation rooms. Highlights included: n Air changes per hour (ACH) adjusted dynamically via Akara smart scheduling.
n Automatic increase in fan speed during high- activity periods.
n Real-time tracking of airflow, filter health and pressure through onboard diagnostics.
n Confirmation of correct filter installation and obstruction monitoring.
3 Preventing surgical site infections (2023) Health Innovation West of England. Available at:
https://www.healthinnowest. net/our-work/transforming-services-and-systems/ preventing-surgical-site-infections/ (Accessed: 05 June 2025).
4 (2021) Operating room ventilation systems: Recovery degree, Cleanliness Recovery Rate and air change effectiveness in an ultra-clean area. Journal of Hospital Infection. Available at:
https://www.journalofhospitalinfection.com/article/ S0195-6701(21)00459-X/fulltext (Accessed: 07 June 2025).
5 Wang Q et al. (2020) Association of Laminar airflow during primary total joint arthroplasty with periprosthetic joint infection, JAMA Network Open, 3(10). doi:10.1001/ jamanetworkopen.2020.21194.
6 Salmonsmith J et al. (2023) Use of portable air purifiers to reduce aerosols in hospital settings and cut down the clinical backlog, Epidemiology and Infection. Available at: https://
pmc.ncbi.nlm.nih.gov/articles/PMC9990385/ (Accessed: 06 June 2025).
7 Health Technical Memorandum 03-01. Specialised ventilation for healthcare premises Part A: The concept, design, specification,installation and acceptance testing of healthcare ventilation systems (no date) England NHS. Available at:
https://www.england.nhs.uk/wp-content/ uploads/2021/05/HTM0301-PartA-accessible-F6.pdf (Accessed: 07 June 2025).
8 Fennelly M et al (2023), Portable HEPA filtration successfully augments natural-ventilation-mediated airborne particle clearance in a Legacy Design Hospital Ward, Journal of Hospital Infection, 131, pp. 54–57. doi:10.1016/j.jhin.2022.09.017.
9 Falkenberg T et al. (2023) ‘Effect of portable HEPA filters on COVID-19 period prevalence: An observational quasi- interventional study in German kindergartens’, BMJ Open, 13(7). doi:10.1136/bmjopen-2023-072284.
10 NHS Estates Technical Bulletin (NETB 2023/01A): application of HEPA filter devices for air cleaning in healthcare spaces: guidance and standards, NHS. Available at: https://www.
england.nhs.uk/long-read/application-of-hepa-filter- devices-for-air-cleaning-in-healthcare-spaces-guidance-and- standards/ (Accessed: 06 June 2025).
11 R;, J.P.M.S. Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital, Journal of Hospital Infection. Available at:
https://pubmed.ncbi.nlm.nih. gov/24268456/ (Accessed: 06 June 2025).
Acknowledgement n This article was originally prepared for HEJ’s sister
publication, Clinical Services Journal. We are grateful to CSJ’s Editor Louise Frampton for kindly permitting its inclusion in this month’s issue.
Sanathoi Bachaspatimayum
Sanathoi Bachaspatimayum is a Marketing & PR assistant at Smart Air UK. Sanathoi holds two master’s degrees in Media and Communication and in Advertising and Public Relations.
Since joining Smart Air UK, she has learned a significant amount of clean air knowledge and now champions raising awareness and clean air initiatives through marketing and PR strategies.
October 2025 Health Estate Journal 127
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