Engineering Staff at the Forefront of Patient Safety

In hospitals and healthcare facilities, the responsibility to clean and maintain HVAC systems goes beyond just keeping the equipment from breaking down. HVAC maintenance can involve serious health concerns, especially for those working in buildings where the occupants may be sick or have weakened immune systems. In 2014 the CDC published its major Healthcare Associated Infections (HAI) Study noting that in 2011 there were roughly 722,000 cases of HAI’s in U.S. hospitals, and about 75,000 of those patients died. 2011 was a wakeup call and the survey prompted increased precautions on the part of designers and maintenance staff regarding hospital infection control. Now, nearly all large clinics and hospitals have infection control plans that include standards for HVAC maintenance and construction. The CDC’s “Guidelines for Environmental Infection Control in Health-Care Facilities” has infection control requirements related to cooling towers, air handlers, ductwork, and water treatment and can be used as a guideline for local facilities.

So what steps do hospital and healthcare facilities and engineering staff need to take to minimize the spread of infections, the accumulation of mold, or the spreading of bacteria through the HVAC system? HVAC equipment manufacturers have excellent guidelines in their equipment manuals. For cooling tower cleaning, Marley Cooling Towers recommends that a “cooling tower must be thoroughly cleaned on a regular basis to minimize the growth of bacteria, including Legionella Pneumophila, to avoid the risk of sickness or death.” There are two important messages here regarding tower cleaning. First, the maintenance of towers and the prevention of bacteria go beyond just water treatment. Towers require regular cleaning to physically remove bacteria, molds, and biofilms from the equipment. Second, the presence of bacteria in cooling towers presents a “risk of sickness or death.” Bacteria present in cooling tower water can work its way into a hospitals HVAC system and make people sick or die.

Wet cooling coils and damp sections of ductwork also offer a collection point for various molds and mildews to grow. Even if there is no bacterial threat from these spores, for occupants with lung conditions or with sensitive respiratory tracts, mold spores can have an immediate and irritating effect. With long-term exposure to mold spores some people will develop sinus problems and breathing difficulties that can become serious. In additional to the health impact, dirty cooling coils may also have a negative impact on the actual performance of the HVAC systems. If a cooling coil becomes clogged with dirt, dust, or even organic growth the supply fan will need to work harder to move the proper amount of air through the coil. If the fan is unable to adjust to the increased pressure drop across the coil, airflow through the entire system is reduced. This has a downstream effect on other design parameters like room pressure control. Pressure control in hospitals is necessary to prevent the spread of germs and odors between areas of the facility. If a sick room is designed to be under negative pressure to keep biological contaminants from spreading, a poorly performing HVAC systems that loses pressure control allows air to flow out of the sick room and puts the entire hospital population at risk.

To make matters worse, coils and duct with mold growth can lead to outbreaks throughout the hospital’s occupied space. As air moves past a moldy coil, spores are picked up and blown around the hospital eventually settling in the patient rooms. The spores may remain dormant resting on food preparation surfaces, operating tables, surgical instruments, walls, and carpets. If the spores come into contact with moisture, they regenerate and develop a mold colony even as the original source of the mold, the dirty cooling coil, is on the other side of the building. Maintenance staff now have a mold remediation emergency on their hands.

Considering the risks associated with dirty coils and ductwork, a hospital’s infection control plan will likely address the maintenance of these components to include procedures for disinfection and cleaning of coil and duct surfaces. Maintenance staff should have regularly scheduled cleaning as part of their standard preventative maintenance processes. The steps needed to clean coils and are relatively easy, but the benefits to improving and maintaining a clean indoor environment cannot be overstated. A variety of drain pan tablets and coil cleaning chemicals are readily available and staff already familiar with basic HVAC cleaning procedures will need little training to learn how to use these cleaners.

Facility managers who are not as familiar with the tools and chemicals needed to properly clean HVAC systems in healthcare buildings should work with a professional supplier for help. The staff at Goodway have a full line of HVAC system maintenance solutions, including coil cleaners, cooling tower cleaning systems and tube cleaners, in addition to their surface sanitation system.

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