senior living HVAC technicians, who are trained on best practices and confirm there is sufficient ion density after every installa- tion,” says Walter.

Pros and cons Communities are also using portable high efficiency particular air (HEPA) filtration units, either alone or in conjunction with NPBI. Pfeffer cautions that there currently is a long lead time to get the filters, because of rising demand. Another technology uses UV light within

the system. The pros are that it works well where there are wet surfaces, Pfeffer says, such as on the downstream side of a cooling

coil, where trouble can grow. While it may be a good solution for some situations, it also requires careful and experienced instal- lation, is costly, needs yearly bulb changes, and uses more energy than NPBI. What’s important, says Pfeffer, is choosing

what’s right for your buildings and com- munity. Getting good indoor air quality is a balancing act of multiple factors: Are you in a warmer or colder climate, a dryer or more humid one? What are your energy- use goals? What do the building plans look like—and what are you expecting to change in years to come? What size are the spaces, and how many people do they usually host? An improved filter, for instance, will likely

mean more energy will need to be used to move the air. Bringing in more outdoor air, which can improve indoor air quality, will require more energy use. Installation costs as well as operational costs over time will come into play.

Hidden issues Everything inside your community has some effect on the indoor air quality—and some are more obvious than others. During the pandemic, cleaning solutions

can sometimes be a culprit. “Throughout the pandemic, we have seen an increase in ‘homemade’ solutions, experimental appli- cation and the promotion of various broad

Tips and Resources

From Linda Homan, RN, BSN, CIC, senior manager of clinical affairs, Ecolab:

“When it comes to improving indoor air quality, Ecolab supports many of the recommendations issued by EPA and OSHA related to maintaining good ventilation. Some important yet simple best practices include the following:

ƒ Make sure exhaust fans in restrooms are working at maximum capacity and are set to stay on

ƒ Open windows or other sources of fresh air when possible

ƒ Direct airflow so that it doesn't blow directly from one person to another

ƒ Increase air turnover rate with current HVAC system

ƒ Use air filtration with filters rated to very small particulates from the air

ƒ Consider using portable air cleaners to supplement increased HVAC system ventilation and filtration, especially in areas where adequate ventilation is hard to achieve.”

From Marla Thalheimer, senior ESG program manager at RE Tech Advisors:

ƒ “Know your building.” Do regular preventive maintenance and know what to look for.

ƒ Do annual indoor air quality testing. “A vendor can test to see if you need adjustments. You can take it to the next level and use technology to monitor levels on a regular basis.”

ƒ Recognize that maintenance people are part of the care community. They're also charged with helping keep residents and staff healthy through good preventive maintenance of building systems.

For more information

ƒ The EPA’s Indoor Air Quality website has information on protecting IAQ in buildings, reducing VOCs, and more:

ƒ ASHRAE’s Indoor Air Quality page has free and for sale resources and training: bookstore/indoor-air-quality-resources

ƒ Details and more information from Carrier’s CogFXStudy and the full report can be found at

ƒ Direct Supply offers a blog post looking at indoor air quality solutions in senior living: blog/evaluating-3-indoor-air-quality-solutions/

ƒ The CDC offers several resources related to indoor air quality:

• National Institute for Occupational Safety and Health page on Indoor Environmental Quality has information on dampness and mold, what to do during construction, and more: topics/indoorenv

• The Legionella page gives ways to prevent Legionnaire’s disease and Pontiac Fever: legionella/index.html

• Correct ventilation in buildings is part of the CDC’s recommended multilayered approach to reducing coronavirus exposure. The Ventilation in Buildings page is regularly updated: coronavirus/2019-ncov/community/ventilation.html


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