HESNI Wilson 5-4-12 Web

PositivEnergy Practice HESNI 2012 Annual Conference
Conversation
with
HESNI 2012 Annual Conference Attendees
about
Health Care HVAC Systems
ANSI/ASHRAE/ASHE Standard 170-2008

May 4, 2012

International Experience w/ Local Impact

Leadership Skills facilitate Servicing
Sophisticated Clients, Partners

Management Skills facilitate Servicing
Large, New Construction Projects
as well as Small, Complex
Renovation Projects

Proficiency in High-Performance Building System Analysis, Design and
Construction Administration

Culture Relationship-Driven (Service), Mission-Driven (Product)

Overview of PEP
Systems consist of
sources and distribution.

FP
FAS
HVAC
SW
BAS
IT
EP
P
NP
G/V
LTG
IC
LS
HVAC-Heating, Ventilating
and Air Conditioning
IC-Instrumentation & Controls
BAS Building Automation
F/G-Fuel Oil/Natural Gas
LS-Life Safety
G/V Gas/Vacuum
P -Plumbing
SW-Special Water
NP Normal Power
EP Essential Power
LTG Lighting FAS Fire Alarm
IT Information Technology
FP - Fire Protection

F/G
Systems are living entities that are:
-conceived (design)
-born (construction)
-assessed (Cx)
-nurtured (O&M)

SYSTEM
PHILOSOPHY
Laws/Codes/Standards/Guidelines
Climate Analysis
Design Criteria
Systems Description
Materials
Contract Considerations
Calculations
Unresolved Issues

HVAC Systems - Basis of Design
IDPH 250 Hospitals (effective 9-15-1995)
IDPH 205 Ambulatory Surgical Treatment Centers (effective
dates vary between 1982 and 2010 for different sections)
ASHRAE Fundamentals Handbook 2009, 2005, 2001
ASHRAE Systems/Equipment Handbook 2012, 2008, 2004,
2000
ASHRAE Application Handbook 2011, 2007,2003,1999
ASHRAE Standards (15-2010, 34-2010 55-2010, 62.1-2010,
90.1-2010, 100-2006, 170-2008, 188-proposed, 189.1-2011)
ASHRAE HVAC Design Manual for Hospitals and Clinics, 2003
NFPA Standards (90A-1999, 99-1999, 101-2000)
FGI/AIA Guidelines for Design and Construction of Health
Care Facilities 2010, 2006, 2001, 1996

Compliance is required with laws and codes.

Compliance is required with standards and guidelines only if
a particular standard or guideline is invoked by a law or code.

IDPH does not currently invoke ASHRAE Standard 170-2008
City of Chicago Building Code - 2012 does not currently
invoke ASHRAE Standard 170-2008
International Mechanical Code - 2012 does not currently
invoke ASHRAE Standard 170-2008


FGI/AIA Guidelines for Design and
Construction of Health Care Facilities
2010 edition does currently invoke
ASHRAE Standard 170.
It is important to note that JCAHO, HFAP
and CMMS require compliance with the
FGI/AIA Guidelines for Design and
Construction of Health Care Facilities so,
in turn, as these entities adopt the 2010
edition, compliance with ASHRAE Standard
170-2008 will become widely enforced.


It is critical that a thorough analysis be
done on each and every project in order
to determine all applicable laws, codes,
standards and guidelines.
Conflicting requirements must be identified and classified as
either simple or complex in terms of their system
implications.
In simple cases, choosing the most conservative solution is
usually appropriate.
In complex cases, variances must be sought in order to
satisfy all AHJs.

ASHRAE Standard 170-2008

Purpose is to define HVAC system
parameters (both at the source and
out in the distribution) aimed at
improving comfort and
contamination control in health care
facilities.
-Planning
-Systems & Equipment
-Space Ventilation
-Construction


Scope applies to new
buildings, additions,
renovations and
infrastructure upgrades
for hospitals, ambulatory
care
centers and nursing
homes during both the
design phase and the
construction phase of a
project (addresses O&M in
an
informational way only).


Scope considers
chemical, physical and
biological contaminants
that can affect the delivery
of medical care to
patients; the
convalescence of
patients; and the safety of
patients, health care
workers and visitors.


Sponsored jointly by
ASHRAE and ASHE unique!
Reviewed by public four (4)
times
Approved by ASHRAE
Standards Committee 6-21-
2008
Approved by ASHRAE Board
of Directors 6-25-2008
Approved by ASHE 7-18-2008
Approved by ANSI 7-24-2008
Consensus standard
currently under continuous
maintenance by ASHRAE
SSPC
Written in mandatory and
enforceable language so it
can be more easily invoked
by AHJs


The standard was created, in part,
because of the risk that the 2003
ASHRAE HVAC Design Manual
for Hospitals and Clinics would be
invoked by various AHJs (in much the
same way that the ASHRAE
Applications
Handbook has been invoked over the
years including IDPH) AHJs invoking
documents written in a form
that is not a proper standard could
create confusion , problems or liability.

The standard also creates an
opportunity to incorporate new
research and technology without having
to write another book.

Compliance applies to
both new buildings as well
as additions and
alterations to existing
buildings/systems/spaces
; the documentation
required includes plans,
specs, BoD and calcs;
alternates to the
prescriptive criteria put
forward can always be put
forward to the AHJ for
their approval

ASHRAE Standard 170-2008-Errata 4-15-2011

Changes reference from AIA
(2001) to AIA (2006) .
Only one (1) errata issued
because this standard is
under continuous
maintenance (not unusual).

ASHRAE Standard 170-2008-IC #170-2008-1

Dated 8-18-2010
Put forward by Ron Lyon of
KJWW
Addressed the use of an AII
room used during the
occupation by a patient
requiring AII versus a patient
simply requiring normal acute
care.
Pressurization should remain
unchanged i.e. negative all
the time
This IC was codified in the
subsequent Addenda F
issued 2-3-2011.
Important to submit Requests
for Interpretations helps
clarify the proposed intent!

American College of Surgeons Guidelines for Optimal
Ambulatory Surgical Care and Office-based Surgery,
2000
Class A: Minor Surgical Procedures Performed
Under Topical and Local Infiltration Blocks with
or without Preoperative Sedation (Spinal,
Epidural, Auxiliary, Stellate Gangloin Blocks,
Regional Blocks, Supraclavicular,
Infraclavicular, and Intravenous Regional
Anesthesia are Excluded)

Class B: Minor or Major Surgical Procedures
Performed in Conjunction with Oral, Parenteral,
or Intravenous Sedation or Performed with the
Patient Under Analgesic or Dissociative Drugs

Class C: Major Surgical Procedures that
Require General or Regional Block Anesthesia
and Support of Vital Bodily Functions
ASHRAE Standard 170-2008-Addendum (a)

Approved by ASHRAE
2009
Changes NICU temp range
from 70-75 F to 72-78 F
(warmer)
Changes corridor to
patient corridor in Inpatient
Nursing
Clarifies RH range to be
anywhere within the specified
temperature range
Clarifies monitoring device
alarm to be pressure
monitoring device alarm

ASHRAE Standard 170-2008-Addendum (b)

Approved by ASHRAE
2009
Clarifies filtration for PE
rooms as HEPA ilo MERV
17
Changes separation
requirements for relief air in
order to distinguish relief air
from exhaust air
Adds requirement to minimize
air leakage through filter bank
assemblies


Requires each OR to have
individual temperature
control
Requires that differential
pressure of .01 wc be
maintained between morgues
and autopsy rooms and
adjacent spaces to those
morgues and autopsy rooms


Changes particular design
parameters for specific rooms
(refer to table 7-1)
-new entry of Intermediate
Care Area (ICA)
-CCU, ICU, WICU and ICA
have no pressurization
requirements
-defined RH as Design
RH
-twelve (12) different
laboratories are now
allowed to use re-
circulating air room units
-Endoscopy room name is
changed and supply
airflow rate reduced from
15 AC/HR to 6 AC/HR


Changes particular design
parameters for specific rooms
(refer to table 7-1)
-stipulates that a Triage
room does not need to be
a waiting room for
patients awaiting chest x-
rays for diagnosis of
respiratory disease it
can be used for any type
of patient
- stipulates that a
Radiology Waiting room
needs to be considered a
waiting room for patients
awaiting chest x-rays for
diagnosis of respiratory
disease

ASHRAE Standard 170-2008-Addendum (c)

Discontinued by ASHRAE
Standards Committee after
comments received from first
public review
Would have added an
exception to 6.4 Filtration
that would have required re-
circulating room units to be
equipped with filters having a
MERV rating of 7 or higher
located upstream of the
heating and/or cooling coil.

ASHRAE Standard 170-2008-Addendum (d)

Approved by ASHRAE
Standards Committee 6-26-2010
Approved by ASHRAE Board of
Directors 6-30-2010
Reduces the minimum RH level
down from 30% to 20% for many
Surgery and Critical Care
spaces:
Class B & C ORs
Cystoscopic ORs
C-Section ORs
Treatment Rooms
Trauma Rooms
Laser Eye Rooms
Class A ORs


Reduces the minimum RH
level down from 30% to 20%
for Gastrointestinal
Endoscopy Procedure Rooms


Rationale was research undertaken
by ASHRAE at the request of the
State of California because they were
responsible for enforcing the
provision of booster humidifiers that
were required by design but were
hardly ever needed because the RH
rarely dipped below 30% - so booster
humidifiers were provided and then
promptly turned off, never to be used
again. Other States had similar
enforcement dilemmas. So, ASHRAE
Standing Standard Project
Committee (SSPC) 170 undertook the
research which represented both
ASHRAE and FGI. ASHRAE enlisted
the help of NIH, AORN and the CDC.

Process included assessing the use
of flammable anesthesics, static
electricity, viral infections and
surgical site infections (SSIs); SSIs
are caused by bacteria and fungi, not
viruses; SSIs are more dominant
with prolonged periods of high RH
over 60%, not low RH.
As a result of all the multi-
disciplinary research, NFPA 99
reduced their lower limit RH level
from 35% to 20% and ASHRAE
Standard 170 reduced their lower
limit RH level from 30o% to 20% (as
did FGI).
Conclusionlower RH might affect
comfort but not infection control.

ASHRAE Standard 55 Thermal
Environmental Conditions for
Human Occupancy addresses Tdb,
RH, Tmrt and Air Speed.
No minimum RH level identified
w.r.t. thermal comfort although
ASHRAE acknowledges that non-
thermal comfort factors may place a
lower limit on space RH.

$-
$100.00
$200.00
$300.00
$400.00
$500.00
$600.00
$700.00
20% 25% 30% 35% 40% 45%
Relative Humidity of Interior Space (%)
Annual Cost to Humidify a 600 sf OR

15 25 35 45
A
n
n
u
a
l

S
a
v
i
n
g
s

(
$
)

Space Relative Humidity (%)
waterside economizer

airside economizer

Results include:
Elimination of booster
humidifiers including steam
piping, condensate piping, trim,
controls, stainless steel
ductwork, drain, insulation, etc.
Energy consumption reduced
Energy cost reduced
Water consumption reduced
Chemical use reduced
Maintenance reduced in a very
congested busy area of a
hospital
Reduction in disruption to
Clinical staff
Easier contamination control if
moisture source is removed from
OR suite
Reduce risk of fogging in an OR

ASHRAE Standard 170-2008-Addendum (e)

Approved by ASHRAE
2011
Clarifies that an AII room that
is being retrofitted can be
provided with a re-circulating
unit fitted out with a HEPA
filter

ASHRAE Standard 170-2008-Addendum (e)

Clarifies that exhaust
ductwork removing air from
AII rooms, bronchoscopy
rooms, ED waiting rooms,
nuclear medicine labs,
radiology waiting rooms and
lab chemical fume hoods
must be under negative
pressure within the building
unless its in an equipment
room, in which case it must
be sealed to SMACNA Class
A.

ASHRAE Standard 170-2008-Addendum (f)

Approved by ASHRAE
2011
Clarifies that dP shall be
between an AII or PE room
and the corridor whether or
not an anteroom is provided
AII anteroom (-) to corridor;
allows reduction of airflow
with non-AII patient from 12
AC/HR to 6 AC/HR (i.e.
contact isolation or droplet
isolation)
PE anteroom (+) to corridor

ASHRAE Standard 170-2008-Addendum (f)

Addresses a new category of
room called a Combination
AII/PE for a patient that is
immunosuppressed and has
an airborne infectious
disease
Patient room must be
exhausted to the outdoors
Anteroom (-) to corridor and
anteroom (-) to patient room
---OR---
Anteroom (+) to corridor and
anteroom (+) to patient room

ASHRAE Standard 170-2008-Addendum (g)

Approved by ASHRAE
2011
Adds definition of patient
care area
Defines supply air outlet
types for single bed patient
rooms
Allows displacement
ventilation in single bed
patient rooms with 6 air
changes per hour

ASHRAE Standard 170-2008-Addendum (h)

Approved by ASHRAE
Standards Committee June
25, 2011
of Directors June 29, 2011
Approved by ASHE May 16,
2011
Approved by ANSI July 27,
2011
Filtration requirements
clarified w.r.t. any space in
which a recirculating unit is
allowed.
Clarified that gravity type
(convection) heating or
cooling units and radiators
shall not be used in an OR or
other special care spaces.


Spaces that are to be negatively
pressurized (i.e. physical therapy,
hydrotherapy, general lab) but do not
have to have that air exhausted to the
outdoors shall have the supply
airflow rate used to calculate the
required AC/HR rate (typically, a
negatively pressurized space has the
AC/HR rate applied to the exhaust
airflow while a positively pressurized
space has the AC/HR rate applied to
the supply airflow).
The filter requirements are to be
applied to the minimum outdoor air
brought into a space through an
HVAC system.


Recirculating units such as
fan coil units, heat pumps
and active chilled beams are
now permitted in certain
spaces such as Intermediate
Care Rooms, Patient Rooms,
LDRPs, LDRs, Patient
Corridors, X-Ray Rooms,
Labs, Pharmacy, Exam
Rooms, Medication Rooms,
Treatment Rooms,
Hydrotherapy Rooms,
Physical Therapy Rooms,
Sterile Storage Rooms, Clean
Linen Storage Rooms, Clean
Workroom and Clean Holding
Rooms


Airflow rates shall be any
AC/HR rate required beyond
the minimum outdoor air
requirement.
The outdoor air provided to
the space, which is delivered
via a separate, independent
HVAC system, must be
properly conditioned (i.e.
heated, cooled, humidified,
dehumidified, filtered,
cleaned, etc.)
The recirculating unit must
serve only a single space.
MERV 6 filtration upstream of
any local cooling coil


Certain spaces such as ED
Waiting Rooms and
Radiology Waiting Rooms
can have HEPA filters added
into the airstream drawn from
those spaces and have that
air subsequently returned to a
recirculating fan system.

ASHRAE Standard 170-2008-Addendum (i)

Does not exist.

ASHRAE Standard 170-2008-Addendum (j)

Approved by ASHRAE
Standards Committee tbd
of Directors tbd
Approved by ASHE tbd
Approved by ANSI tbd
Will address filtration for
several residential health care
occupancies among other
things.

ASHRAE Standard 170-2008-Addendum (k)

Approved by ASHRAE
of Directors tbd
Will address the requirement
to exhaust to the outdoors all
the air from an AII room and
will provide limitations w.r.t.
the reuse of that air stream
for energy recovery.

ASHRAE Standard 170-2008-Addendum (l)

Approved by ASHRAE
2012
Adds Operating/Surgical
Cystoscopic Rooms and C-
Section Delivery Rooms to
Class B and C Operating
Rooms

ASHRAE Standard 170-2008-Addendum (l)

Approved by ASHRAE
2012
Adds four (4) specialty rooms
to the category of D/T
Spaces:
Dialysis treatment area
Dialyzer reprocessing
room
Nuclear medicine hot lab
Nuclear medicine
treatment room

ASHRAE Standard 170-2008-Addendum (m)

Approved by ASHRAE
2012
Clarifies that spaces that
have positive or negative
pressurization requirements
should have fully ducted
return or exhaust systems,
respectively.

ASHRAE Standard 170-2008-Addendum (m)

In addition, this addendum
clarifies that the following
spaces that have no specific
pressurization requirements
should have fully ducted
return air systems:
Recovery rooms
Critical care units (CCU)
Intensive care units (ICU)
Wound intensive care
units (WICU)
Intermediate care areas
(ICA)

ASHRAE Standard 170-2008-Addendum (n)

Approved by ASHRAE
of Directors tbd
Will address how designers
may determine outdoor air
flow rates when the system
serves multiple spaces.

ASHRAE Standard 170-2008-Addendum (o)

Approved by ASHRAE
of Directors tbd
Will address office-based
surgery.

ASHRAE Standard 170-2008-Addendum (p)

Approved by ASHRAE
of Directors tbd
Will address Nourishment
Rooms.

ASHRAE Standard 170-2008-Addendum (q)

Approved by ASHRAE
of Directors tbd
Will address Pharmacies.

ASHRAE Standard 170-2008-Addendum (r)

Approved by ASHRAE
of Directors tbd
Will address new definitions
such as absorption
distance and essential
accessories .
Will address coordination of
requirements within the FGI
Guidelines.
Will address several new
equipment requirements.
Will address contamination
control in coughing areas.

ASHRAE Standard 170-2008-Addendum (s)

Approved by ASHRAE
of Directors tbd
Will address coordination of
requirements within the FGI
Guidelines.

6.0 Systems and Equipment
6.1 Utilities
6.2 Air Handling Unit Design
6.3 Outdoor Air Intakes and Exhaust Discharges
6.4 Filtration
6.5 Heating and Cooling Systems
6.6 Humidifiers
6.7 Air Distribution Systems

Systems and Equipment 6.1 Utilities
Ventilation Required on the Essential Power System
Airborne Infectious Isolation Rooms
Protective Environment Rooms
Class B and C Operating Rooms including C-Section
ORs and Cysto ORs


Reserve Heating Capacity (n + 1) Required
for Sterilization, Dietary, and Space
Heating for Operating, Delivery, Birthing,
Labor, Recovery, Intensive Care, Nursery,
and Inpatient Rooms
Not required if the ASHRAE 99% dry bulb
is greater than or equal to 25 F


Reserve Cooling Capacity (n + 1) Required
if the Cooling Load is Greater Than 400
Tons
Not required if the ASHRAE 1% dry bulb is
less than or equal to 85 F

Systems & Equipment 6.2 AHU Design
Air Handling Unit Casing
Prevent Water Intrusion
Resist Corrosion
Permit Access for O&M

Air Handling Unit Interior Surfaces
Comply with ASHRAE Standard
62.1-2007
Resistant to Mold Growth
Resistant to Erosion


Systems & Equipment 6.3 OAI

OAI must be at least 25 feet from
cooling towers and exhaust discharges
OAI must be at least 6 feet above grade
and 3 feet above a roof
OAI must be protected from public
access (moderate and high-risk)
OAI must prevent entrainment of wind-
driven rain with features to drain away
precipitation
OAI must have birdscreen mesh (no
smaller than inch)

Systems & Equipment 6.3
Exhaust Discharges
Exhaust discharge from AII Rooms,
Bronchoscopy, ED Waiting Rooms, Nuclear
Medicine Labs, Radiology Waiting Rooms,
Laboratory Chemical Fume Hoods shall comply
with the following:
Exhaust Ductwork in Occupied Spaces is
Negative
Exhaust Ductwork in Equipment Rooms can
be Positive if Sealed
Discharge at least 10 feet above roof level
Discharge not less than 10 feet from OAI,
windows, and occupied areas that are higher
than the exhaust discharge
Minimize recirculation of exhausted air back
into the building

Systems & Equipment 6.4 Filtration
Refer to Table 6.1 for Filter Efficiency
Requirements
Filter Bank 1 must be upstream of heating
and cooling coils such that all mixed air is
Filtered
Filter Bank 2 must be downstream of wet
Cooling Coils and Supply Fans
Filter Bank 2 Filters shall have Sealing
Interface Surfaces
Filters with Efficiency Greater than MERV 12
must have a Differential Pressure Monitor
Emphasis on Eliminating Bypassed Air

Table 6-2 Space Designation
Filter Bank
1-MERV
Filter Bank
2-MERV
Class B and Class C Surgery; Inpatient and Ambulatory
Diagnostic and Therapeutic Radiology; Inpatient Delivery
and Recovery Spaces
7 14
Inpatient Care, Treatment, Diagnosis, and those Spaces
Providing Direct Service or Clean Supplies and Clean
Processing
7 14
Airborne Infectious Isolation Rooms 7 14
Protective Environment Rooms 7 HEPA
Laboratories, Class A Surgery 13 N/R
Administrative, Bulk Storage, Soiled Holding Spaces, Food
Preparation Spaces, and Laundries
7 N/R
All Other Outpatient Spaces 7 N/R
Skilled Nursing Facilities 7 N/R
U.S. Standards
Particle Size
Range, m
Applications
ASHRAE 52.2 ASHRAE 52.1
MERV
Particle Size Range Test
3 to 10
m
1 to 3 m 0.3 to 1 m Arrestance Dust Spot
1 <20% - - <65% <20%
>10
Residential, light,
pollen, dust mites
2 <20% - - 65 - 70% <20%
3 <20% - - 70 - 75% <20%
4 <20% - - >75% <20%
5 20 -35% - - 80 - 85% <20%
3.0 - 10
Industrial, dust,
molds, spores
6 35 - 50% - - >90% <20%
7 50 - 70% - - >90% 20 -25%
8 >70% - - >95% 25 - 30%
9 >85% <50% - >95% 40 - 45%
1.0 - 3.0
Industrial,
Legionella, dust
10 >85% 50 - 65% - >95% 50 - 55%
11 >85% 65 - 80% - >98% 60 - 65%
12 >90% >80% - >98% 70 - 75%
13 >90% >90% <75% >98% 80 - 90%
0.3 - 1.0
Hospitals, Smoke
removal, bacteria
14 >90% >90% 75 - 85% >98% 90 - 95%
15 >90% >90% 85 - 95% >98% -95%
16 >95% >95% >95% >98% >95%
17 - - 99.97% - -
<0.3
Clean rooms,
Surgery, chem-bio,
viruses
18 - - 99.99% - -
19 - - 99.999% - -
20 -
-
99.9999%
- -
Systems & Equipment 6.5 Heating, Cooling
Systems
Cooling coil drain pans must comply with
ASHRAE Standard 62.1-2007
Sloped 1/8 per foot
Drain outlet at lowest point
Trap seal
Minimum drain pan dimensions
Chilled water supply temperature for
ceiling-mounted radiant cooling panels
must be greater than the space dewpoint
temperature

Systems & Equipment 6.5 Heating, Cooling
Systems
Ceiling-mounted radiant heating panels in
AII Rooms, PE Rooms, and Burn Units
must have smooth, flat, cleanable surfaces;
radiant floors may also be used

Systems & Equipment 6.6 Humidifiers
Humidifiers are required when internal moisture
sources are insufficient to maintain minimum RH
levels indicated in Table 7.1
Chemical additives must comply with FDA
requirements
No reservoir or evaporative pan humidifiers
only direct steam injection types can be used
High RH limit set at 90% is required
Humidifier control valves must close when the
AHU is not operating

Systems & Equipment 6.7 Air Distribution
Systems
Maintain pressure relationships as specified in Table 7.1 in all
modes of operation
Provide ducted return air paths
Design must account for filter loading
Access doors required for inspection and cleaning

Systems & Equipment 6.7 Air Distribution
Systems
Group A: Outlets mounted in or near the ceiling that
discharge air horizontally.

Group B: Outlets mounted in or near the floor that
discharge air vertically in a non-spreading jet.

Group C: Outlets mounted in or near the floor that
discharge air vertically in a spreading jet.

Group D: Outlets mounted in or near the floor that
discharge air horizontally.

Group E: Outlets mounted in or near the ceiling that
project primary air vertically.
7.0 Space Ventilation
7.1 General
7.2 Room Specific Requirements
7.3 Critical Care Units
7.4 Surgery Rooms
7.5 Support Spaces

Space Ventilation 7.1 General
Table 7.1 defines design parameters
Air movement should always be from clean to less clean
VAV systems cannot compromise pressure relationships
or minimum air change requirements
Air change rates shall be based on supply for positive
pressure rooms and shall be based on exhaust for negative
pressure rooms
Refer to ASHRAE Standard 62.1 for ventilation rates for
spaces not listed in ASHRAE Standard 170
Air changes can be reduced when a space becomes
unoccupied provided that required air pressure relationship
is maintained
Higher air change rates may be required to maintain room
temperatures

Room Porosity Determines delta Airflow Required to
Achieve the Design delta Pressure
0
200
400
600
800
1,000
1,200
1,400
1,600
1,800
2,000
-0.01 0.01 0.03 0.05
O
f
f
s
e
t

A
i
r

F
l
o
w

(
C
F
M
)

Differential Pressure (inches w.g.)
Space Ventilation 7.1 General
Permanently installed device required in order
to constantly monitor differential pressure
Local visual monitor required
All air to be exhausted directly outdoors
Existing rooms that are retrofitted may
recirculate air through units equipped with
HEPA filters
Dedicated exhaust system is required for AII
rooms (multiple rooms can be serviced by a
single system)
Exhaust grilles should be positioned behind and
above the patients bed
Room envelope must be sealed
Differential pressure should be -0.01 w.g. (-2.5
Pa)

Space Ventilation 7.2 Room Specific
Requirements (AII)
Requirements (PE)
Permanently installed device required in order
to constantly monitor differential pressure
Local visual monitor required
Supply air diffusers should be positioned above
the patients bed
Return air grilles should be positioned near the
patient room door
Existing rooms that are retrofitted may
recirculate air through units equipped with
HEPA filters
Pa)

Requirements (AII + PE)
Two (2) permanently installed devices required
in order to constantly monitor differential
pressure
Local visual monitors required
Supply air diffusers should be positioned above
the patients bed
Exhaust air grilles should be positioned near the
patient room door
Pa)
Anteroom (-) to corridor and (-) to patient room
---OR---
Anteroom (+) to corridor and (+) to patient room

Requirements (WICU)
Burn unit patient rooms and NICU spaces
that require booster humidifiers (40%) shall
be provided with independent temperature
and relative humidity control

Sterilization Rooms
Exhaust hoods shall be provided for steam and ETO sterilizers
Imaging Procedure Rooms
Ventilation same as Class A Surgery
Ventilation same as Class B or C Surgery if Anesthetic Gases
are Administered

Requirements (Surgery Rooms)

Class B and C Operating Rooms
0.01 w.g. positive pressure at all times
Primary supply diffuser array at 70% of surgery area (12
overhang beyond the surgical table)
Primary supply diffusers at 25 to 35 CFM/SF
At least two (2) low sidewall return grilles (bottom at 8 AFF) on
opposite sides of room
Each OR shall be provided with independent temperature and
relative humidity control
Requirements (Surgery Rooms)
Questions?
Comments?
Question #1 Does CMMS invoke ASHRAE/ASHE Standard 170 directly?

Answer #1 Immediate response by the author was No followed up by some
research that confirmed that CMMS does not directly invoke
Standard 170.

Question #2 If the indoor relative humidity was driven down from 40-45% to
20%, why was it not driven down to 0%?

Answer #2 Initial response was that, practically, 0% relative
humidity cannot be achieved. If the committee wanted to allow
relative humidity levels to float and potentially fall below 20%, the
designation N/R would have been used. As for the committees
decision to purposefully choose 20% as the lower limit, that
decision appears to have been made after an extensive literature
search found that no clinical study had looked at relative
humidity levels lower than 20%.


Question #3 Are there any plans to address the redundancy of HVAC system
components beyond the steam and cooling sources?

Answer #3 None that the author is aware of but its logical to extend the
redundancy beyond the sources in order to eliminate obvious
weak links in the chain ; technical and economic feasibilty
studies in this area are important as well communication
between all team members.

Question #4 Are there any plans to drive the prevalent minimum total air
change rate down below 6 ac/hr?

Answer #4 None that the author is aware of but the standard does allow
reductions if supplementary heating and/or cooling subsystems
are used.
Thank You!


References

-Paul Ninomura, P.E.; Judene Bartley, MS; Christopher Rousseau, P.E. : Health Care
Standard Update , ASHRAE Journal March 2011
-Christopher Rousseau, P.E.; Standard 170-2008 Update ; Arkansas ASHRAE
Chapter Meeting February 2011

-Judene Bartley MS; Russ Olmsted MPH; Behind the Change in ASHE/ASHRAE
Standard 170 ; Engineered System magazine, February 2011

-Richard D. Hermans, P.E.; Breath of Fresh Air A Look at New Health Facility
Ventilation Standard ; Health Facilities Magazine, January 2009

- Ed Tinsley P.E.; ASHRAE Standard 170 ; Alabama ASHE Chapter Meeting, October
2008

-Joanna R. Turpin, Standard Operating Procedure ; Engineered System magazine,
July 2005

-Various ASHE and ASHRAE alerts including the June 8, 2010 Demystifying the
Myth proceedings

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Laurence V. Wilson, P.E.
ASHRAE HFDP, LEED AP
Director
312-374-9219 office
312-405-7031 cell
lwilson@pepractice.com

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