VENTILATION
Figure 1. A scanning electron microscope (SEM) image of typical filter media installed in HVAC installations.
stage filtration and energy-efficient HVAC systems that are responsive and adaptive constitutes an innovative way toward a modern and sustainable hospital environment.
Figure 2. Foam media.
Understanding the importance of IAQ in healthcare facilities IAQ in healthcare facilities is critical to patient safety, infection control, and overall health outcomes. Hospitals, clinics, and other healthcare environments, must maintain exceptionally high air quality standards due to patients’ vulnerability, the presence of airborne pathogens, and the necessity of a sterile environment for medical procedures. Poor IAQ can exacerbate respiratory conditions, contribute to hospital-acquired infections (HAIs), and negatively impact the wellbeing of healthcare workers and visitors. Research has emphasised the critical role of indoor air quality in hospitals for the health and safety of staff, patients, and visitors. It highlights the potential health risks and cognitive decline that can arise from poor IAQ.4,5 Additionally, studies have explored the complexities of indoor environmental quality (IEQ) in healthcare facilities, stressing the urgent need for more research to develop healthier and more comfortable environments for all occupants, not just patients.6-8
Maintaining superior IAQ in healthcare settings Hygienic HVAC (heating, ventilation, and air-conditioning) and filtration systems are central to maintaining superior IAQ in healthcare settings. These systems help control airborne contaminants, regulate temperature and humidity, and ensure the appropriate and efficient indoor circulation of clean and fresh air. An inadequately designed or poorly maintained HVAC system can compromise patient health and safety, increase energy consumption, and elevate operational costs. IAQ in healthcare environments is a determining factor in disease prevention and patient recovery. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) emphasise the need for stringent air quality measures to mitigate airborne disease transmission, particularly in high- risk areas such as operating rooms, intensive care units, and isolation wards. Patients in healthcare settings are often immunocompromised, making them more susceptible to airborne infections. Contaminated air can introduce bacteria, viruses, mould spores, and volatile organic compounds (VOCs) into the respiratory system, exacerbating asthma, chronic obstructive pulmonary disease, and pneumonia. Inadequate IAQ has also been linked to the spread of airborne diseases like tuberculosis, COVID-19, and influenza. Furthermore, studies have shown that improved IAQ contributes to faster recovery times, reduced readmission rates, and overall better patient outcomes. Proper air filtration and ventilation in patient rooms and surgical suites can significantly reduce infection risks.9,10 Healthcare professionals are exposed to poor IAQ in
hospitals, leading to occupational illnesses like respiratory infections and fatigue, impacting their performance and increasing absenteeism. The high volume of hospital visitors raises the risk of airborne pathogen transmission, complicating IAQ management. Despite efforts to improve IAQ through advanced filtration systems, uncontrolled contamination from staff and visitors remains a challenge. Additionally, environmental factors like sandstorms and wildfires can hinder air filter performance. At the same time, excessive use of cleaning agents containing volatile organic compounds further complicates achieving optimal IAQ, and requires extensive employment of chemical filters. The question remains: When would a particle become a pollutant, and at what concentration? When should our HVAC and filtration systems respond to the presence of particles and bioaerosol, and at which stage? More critical than infection control is infection prevention, and that requires a well-maintained HVAC system to ensure that contaminants are efficiently filtered, reducing the risk of pathogen spread among patients, staff, and visitors, in the first place.
The road ahead
Ensuring compliance requires continuous monitoring, regular HVAC maintenance, and staff training on IAQ best practices for optimising healthcare HVAC systems. These practices include, but are not limited to: 1 Adhere to a regular HVAC maintenance and filter replacement programme, where routine inspections and data-driven filter replacement are scheduled to ensure optimal system performance and IAQ outcomes.
2 Employ advanced filtration technologies, where chemical filters in an air purification system capable of disinfecting the air for bioaerosols are critically important.
3 Design for zoning and ventilation control where proper 68 Health Estate Journal September 2025
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