High-Efficiency Particulate Air

Filters (HEPA)in the Era of

COVID-19: Function and Efficacy
Received May 25, 2020; accepted May 29, 2020.

David A. Christopherson1, William C. Yao, MD2, Mingming Lu, PhD3, R.

Vijayakumar, PhD4, and Ahmad R. Sedaghat, MD, PhD1
American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020
 Dr Sudjoko Kuswadji (MSc(OM) NUS , PKK IDI, SpOk IDI)

● 1972 Fakultas Kedokteran Universitas Indonesia (Jakarta);

● 1974-1980 TNI AU Wamil (Halim, Kalijati, Timtim);
● 1980-1983 Tesoro Indonesia Migas (Tarakan);
● 1983-1996 Unocal Indonesia Migas (Balikpapan);
● 1987-1988 National University of Singapore COFM
● 1996-1999 Internasional Health Benefits Indonesia JPKM (Jakarta);
● 1999-2001 Sucofindo BUMN (Jakarta);
● 2001-2004 SOS International Kesehatan Kerja (Jakarta);
● 2005- sekarang trainer dan konsultan bebas (Jakarta);
 Swiss Cheese Model Prevention
https://www.youtube.com/watch?v=MfWpMrEOlJ8
Swiss Cheese
 Covid 19 Swiss Cheese
https://www.youtube.com/watch?v=sR30WoJd5QE
 Upaya Penanganan Covid

• Tidak ada satu upaya apapun juga yang dipastikan bisa

menumpas virus corona ini.
• Setiap usaha merupakan satu lapis dari keju Swiss yang
berlubang-lubang.
• Dari banyak lubang itu kita tidak pernah tahu lubang mana
yang menyebabkan virus bisa lolos dan melakukan
penularan kepada manusia;
• Yang pasti makin sedikit lubang maka semakin kecil
kemungkinan virus itu akan lolos;
 Penyebaran virus Covid 19

• Droplets, ketika berbicara dan bernapas, lewat butir

droplets yang besar dan berat jatuh ke bawah pada jarak 50
cm;
• Yang kecil dan ringan (aerosol) terbang di udara lewat
batuk mencapai jarak 1-2 meter;
• Yang ringan (aerosol) bisa terbang dengan
menggumpal-gumpal (turbulence) mencapai jarak 8-9
meter;
Bernapas, bicara, batuk dan bersin
https://www.youtube.com/watch?v=piCWFgwysu0&feature=youtu.be
 Kesan...
• Virus dalam tubuh manusia sukar dikendalikan: tanpa
gejala, diagnosis, patofisiologi, obat, vaksin dst;
• Virus di luar tubuh lebih mudah dikendalikan, bisa dihitung
viral loadnya, antiseptik dst.
• Konsentrasi penanganan lebih banyak menyangkut
manusia, dengan segala macam kesulitannya;
• Protokol kesehatan mestinya protokol kesehatan dan
lingkungan;
• Perlu disusun program pengendalian Covid 19 dalam
lingkungan;
 Health care–associated infection of
patients and health care providers
• Aerosol-generating procedures in the office represent a
major concern for health care–associated infection of
patients and health care providers by SARS-CoV-2, the
causative agent for coronavirus disease 2019 (COVID-19).
• Although the Centers for Disease Control and Prevention
has not yet provided any recommendations for the use of
portable air purifiers, air purifiers with high-efficiency
particulate air (HEPA) filters have been discussed as an
adjunctive means for decontamination of SARS-CoV-2
aerosols in health care settings.
 Theoretical efficacy for HEPA filters
• This commentary discusses HEPA filter mechanisms of
action, decontamination time based on efficiency and flow
rate, theoretical application to SARS-CoV-2, and limitations.
• HEPA filter functionality and prior guidance from the
Centers for Disease Control and Prevention for
SARS-CoV-1 suggest theoretical efficacy for HEPA filters to
decontaminate airborne SARSCoV-2, although direct
studies for SARS-CoV-2 have not been performed.
 Adjunctive infection control measure
• Any portable HEPA purifier utilization for SARSCoV-2
should be considered an adjunctive infection control
measure and undertaken with knowledge of HEPA filter
functionality and limitations in mind.
To know HEPA
HEPA filters are usually manufactured by
pleating microfiber glass or other fibrous
media made with multiple layers of randomly
arranged fibers, with diameters ranging from
2 to 500 nm.4
As air flows through the filter and in between
the fibers, airborne particles—such as
respiratory and aerosol droplets—will be
trapped by 1 of 3 mechanisms: impaction,
interception, and diffusion (Figure 1).5
Adhesion to filter fibers may occur through
Van der Waals forces, electrostatic attraction,
and capillary action.
For particle sizes .1 mm, impaction and
interception are the most significant
mechanisms of filtration, whereas diffusion is
the dominant mechanism for trapping
particles \0.1 mm.4
Particles between 0.1 and 1 mm are
influenced by all 3 methods of capture to a
lesser degree than those larger or smaller,
which leads to a lower efficiency of filtration.4
To qualify as HEPA grade, filters must
remove at least 99.97% of all particles
that are 0.15 to 0.2 mm, for which
HEPA fil-C(t)=CO e-(V )t , ters are least
effective.
Thus, HEPA filters have at least
99.97% efficiency for removing all
particles, with even higher
efficiencies for particles both larger
and smaller than 0.15 mm (Figure 2).
The interesting U-shaped efficiency
curve of all HEPA filters, which has a
minimum at 0.15 mm, is due to the
relative effectiveness of the 3
mechanisms of particle capture at
various sizes.
Filters with efficiencies .99.99% are
also termed ultralow penetration air
filters.
The idea behind the development of
the HEPA filter was born from gas
masks worn by soldiers fighting in
World War II.
A piece of paper found inserted into a
German gas mask had a remarkably
high capture efficiency for chemical
smoke.
The British Army Chemical Corps
duplicated this and began to
manufacture it in large quantities for
their own service gas masks.
They needed another solution for
operational headquarters, where
individual gas masks were
impractical.
The Army Chemical Corps developed
a combination mechanical blower
and air purifier unit, which
incorporated cellulose-asbestos
paper in a deeply-pleated form with
spacers between the pleats.
It was referred to as an "absolute" air
filter and laid the groundwork for
further research to come in
developing the HEPA filter.[28]
Diffusion: An enhancing
mechanism that is a result of the
collision with gas molecules by
the smallest particles, especially
those below 0.1 μm in diameter,
which are thereby impeded and
delayed in their path through the
filter; this behavior is similar to
Brownian motion and raises the
probability that a particle will be
stopped by either interception or
impaction; this mechanism
becomes dominant at lower air
flow. Diffusion predominates
below the 0.1 μm diameter
particle size, whilst impaction and
interception predominate above
0.4 μm.[11]
Interception: Particles following a
line of flow in the air stream come
within one radius of a fiber and
adhere to it. In between, near the
most penetrating particle size
(MPPS) 0.21 μm, both diffusion
and interception are
comparatively inefficient.[12]
Because this is the weakest point
in the filter's performance, the
HEPA specifications use the
retention of particles near this
size (0.3 μm) to classify the
filter.[11]
Impaction: Larger particles are
unable to avoid fibers by
following the curving contours of
the air stream and are forced to
embed in one of them directly;
this effect increases with
diminishing fiber separation and
higher air flow velocity.
HEPA trapping
 Particles are trapped

• HEPA filters are composed of a mat of randomly arranged fibres.[10]

• The fibers are typically composed of fiberglass and possess
diameters between 0.5 and 2.0 micrometers. Key factors affecting its
functions are fiber diameter, filter thickness, and face velocity.
• The air space between HEPA filter fibers is typically much greater
than 0.3 μm. Unlike sieves or membrane filters, where particles
smaller than openings or pores can pass through, HEPA filters are
designed to target a range of particle sizes.
• These particles are trapped (they stick to a fiber) through a
combination of the following three mechanisms:
 Work much differently than how flies
are trapped by a screen
• HEPA filters work much differently than how flies are trapped by a
screen, as pictured. HEPA filters trap particles much differently than a
simple screen or net.
• Here’s the reality: HEPA filters are a complex weave of tiny fibers that
carry an electrostatic charge which attracts bypassing
particles—more like a magnet than a net.
• The smaller the fiber with the greater charge coefficient, the greater
the likelihood of trapping ever smaller particles.
• All of this is effective to the extent that air can be channeled through
enough filter material without air bypassing around it.
Air purifiers alone will not
protect you from viruses,
but they can contribute to
an overall healthier indoor
environment and better
sleep.

A purifier’s effectiveness
depends on its ability to
draw in contaminated air
and circulate pure air
throughout your entire
breathing space or 'box.’

Alen is proud to make

top-rated purifiers that do
just that—quietly and
efficiently.
Air purifiers alone will not protect you
from viruses
• Air purifiers alone will not protect you from viruses, but they can
contribute to an overall healthier indoor environment and better
sleep.
• A purifier’s effectiveness depends on its ability to draw in
contaminated air and circulate pure air throughout your entire
breathing space or 'box.’
• Alen is proud to make top-rated purifiers that do just that—quietly
and efficiently.
• In between, near the most penetrating particle size (MPPS) 0.21 μm,
both diffusion and interception are comparatively inefficient.
There are three ways that particles
get blocked when passing through
the filter.

The first is by impaction. Simply, the

particles hit the fibers of the filter and
stop like a car hitting a brick wall.

The second is by interception. The

particle tries to go around the fibers and
gets it's trousers stuck on the door knob.

The third mechanism is by diffusion.

Nano-particles move by what is call
Brownian motion meaning that they
collide with one another on a constant
basis causing a zig-zag motion. This
motion causes them to get stuck as they
collide with one another and diffuse into
the fibrous network and get stuck.
 HEPA filters are even more efficient
• This is due to Brownian motion, which is the random motion of particles
suspended in a fluid such as air.
• Particles smaller than 0.3 microns are subjected to Brownian motion, which causes
them to flow in a zig-zag motion as indicated in the illustration.
• Even though the particles could fit through the fibers of the filter, the particles’
motion and size causes them to come into contact with the fibers and are captured
by the filter media due to diffusion.
• Since particles that are 0.3 microns and larger are not impacted by Brownian
motion, HEPA filters are tested at the 0.3 micron size, which is the most difficult
particle size to capture.
• Therefore, even though the SARS-CoV-2 virus is smaller than the tested micron
size, HEPA filters are even more efficient at capturing particles of this size than
particles at 0.3 microns.
Aerosol Test
An aerosol of di-octyl phthalate (DOP)
• The conventional way to test the integrity of the HEPA (high
efficiency particulate air) filters used in cleanrooms and
safety cabinets is to challenge them with an aerosol of
di-octyl phthalate (DOP) or, more correctly, bis (2ethyl
hexyl) phthalate, and to measure the penetration through
the filter.
• This method of testing has been in use for a long time and
is built in to the tests specified in Australian Standard (AS)
1807.
 Group 3: 'not classifiable as to
carcinogenicity to humans
• In 1985 the World Health Organization's International Agency for Research on
Cancer (IARC) classified DOP, based on rodent studies, as Group 2B: 'possibly
carcinogenic to humans’.
• This decision caused great concern to users and, more particularly, in-house and
contract testers of these rooms and devices.
• However, some users have not allowed DOP to be used, even though results with
other chemicals could not be validated.
• This has been a very unsatisfactory state of affairs, but fortunately DOP was
reassessed by IARC in early 2000 with the result that it was downgraded to Group
3: 'not classifiable as to carcinogenicity to humans’.
• This result was due essentially to new evidence that 'the mechanism by which DOP
increases the incidence of hepatocellular tumours in mice is not relevant to
humans'.
HVAC
 Closed spaces and the role HVAC

• Evidence for transmission in closed spaces and the role of heating, ventilation and
air-conditioning (HVAC) systems Heating, ventilation and air-conditioning (HVAC)
systems are used to provide comfortable environmental conditions (temperature
and humidity) and clean air in indoor settings such as buildings and vehicles.
• HVAC systems can be configured in a variety of ways, depending on their
application and functions of the building/vehicle.
• Ventilation systems provide clean air by exchanging indoor and outdoor air and
filtering.
• Air-conditioning systems can be part of integrated HVAC systems or stand-alone,
providing cooling/warming and dehumidification. Stand-alone systems usually
recirculate the air without mixing it with outdoor air.
Particle Sizes
Comparison chart
 Filter Efficiency
Efficiency of a filter is calculated by measuring the particle
count downstream and upstream from the filter. The
downstream count is divided by the upstream count then
this number is subtracted from one then multiplied by 100 to
create an efficiency percentage3.
MERV ratings refer
to the minimum
efficiency reporting
value and helps
classify filters. The
chart below details
different MERV
ratings, efficiency
and filters at that
rating7.
Electric charged
Electrospun fibre
 Amounts of fiber

• The optimal amounts of fiber in each module depended on

the diameter of fibers in the module.
• Small fiber diameter that has already high performance
required small amounts of fibers per module.
• In contrast, large diameter fiber required larger amounts of
fibers per module to compensate for the poorer
performance provided it did not incur significantly
additional pressure drop.
 Efficiency reaching 94%.
•This approach was applied to develop four new
nanofiber filters tailored for capturing 100-nm
airborne COVID-19 to achieve over 90% efficiency
with pressure drop not to exceed 30 Pa (3.1 mm
water).
•One filter developed meeting the 90% efficiency has
ultralow pressure drop of only 18 Pa (1.9 mm water)
while another filter meeting the 30 Pa limit has high
efficiency reaching 94%.
Protecting the general public from the
deadly airborne COVID-19

•These optimized filters based on rigorous en-

gineering approach provide the badly needed
technology for protecting the general public
from the deadly airborne COVID-19 and other
viruses, as well as nano-aerosols from air
pollution which lead to undesirable chronic
diseases.
Electrospinning
 KESIMPULAN
• HEPA filter kenyataannya bukan yang dimaksudkan
sebagai filter atau penyaringan virus corona.
• Virus ini terlalu kecil untuk disaring dia bergerak semau
sendiri (Brown).
• Ketika saringan diberi muatan listrik dia bisa terjebak tapi
tidak mati, virus masih hidup.
• Jika digabung dengan UVC virus bisa mati.
• Namun sering dikeluhkan tenaga listrik yang dipakai jadi
semakin tinggi, namun mungkin tidak begitu.