A study on performances of different ventilation schemes provided by vertical and horizontal uni-directional air flow was carried out in a standard orthopaedic operating theatre (OT). Starting from our previous studies of a real OT under operating use conditions, in this research different air flow configurations, considering some air curtain solutions on the ceiling and at the sliding door always assumed to be open as a basic boundary condition, were investigated by numerical simulations. Indoor air quality (IAQ) indexes and thermal comfort parameters, deduced from simulation results were calculated and discussed referring to the best performance and efficacy between the air flow schemes to contrast the incorrect use conditions of the OT. Referring to the studied schemes, the reciprocal comparison emphasizes that a successful outcome in preventing surgical site infection can depend as much on resolving human factors ( i.e. operational use conditions, door opening/closing), as on overcoming physical and technical obstacles.
ONORM-H-6020 (2007) Ventilation and Air Conditioning Plants for Locations for Medical Use—Design, Construction, Operation, Maintenance, Technical and Hygienic Inspections. Austrian Standards Institute/Osterreichisches Normungsinstitut (ON), Wien.
VDI-2167-1 (2004) Building Services in Hospitals—Heating, Ventilation and Air-Conditioning. Swiss Guidelines for Hospital. www.eurocode-online.de
NBHF (2004) Building Guidelines for a Surgical Department. The Netherlands Boards for Healthcare Institutions. www.bouwcollege.nl
HTM-03-01 (2007) Heating and Ventilation Systems Health Technical Memorandum 03-01: Specialised Ventilation for Healthcare Premises Part A: Design and Validation. TSO, Edinburgh.
ANSI/ASHRAE-170 (2008) Ventilation of Health Care Facilities. ASHRAE Standards Committee, the ASHRAE Board of Directors, and the American National Standards Institute, USA. www.ashrae.org
ANSI/ASHRAE-62-1 (2007) Ventilation for Acceptable Indoor Air Quality. ASHRAE, Atlanta.
UNI-EN-ISO-14644-3 (2006) Cleanrooms and Associated Controlled Environments—Part 3: Test Methods.
UNI-EN-ISO-14644-1 (2006) Cleanrooms and Associated Controlled Environments. Part 1: Classification of Air Cleanliness.
UNI-EN-ISO-14644-2 (2006) Cleanrooms and Associated Controlled Environments Part 2: Specifications for Testing and Monitoring to Prove Continued Compliance with ISO 14644-1.
ISO-21501-4 (2007) Determination of Particle Size Distribution—Single Particle Light Interaction Methods. Part 4: Light Scattering Airborne Particle Counter for Clean Spaces.
UNI-11425 (2011) Surgery Operating Theatre, Ventilation and Air-Conditioning System for Contamination Control (VCCC)—Design, Construction, Commissioning, Qualification, Management and Maintenance. Italy. (In Italian)
Zoon, W.A.C., Loomans, M.G.L.C. and Hensen, J.L.M. (2011) Testing the Effectiveness of Operating Room Ventilation with Regard to Removal of Airborne Bacteria. Building and Environment, 46, 2570-2577. http://dx.doi.org/10.1016/j.buildenv.2011.06.015
Cow, T.T. and Yang, X.Y. (2003) Performance of Ventilation System in a Non-Standard Operating Room. Building and Environment, 38, 1401-1411. http://dx.doi.org/10.1016/S0360-1323(03)00155-0
Méndez, C., San José, J.F., Villafruela, J.M. and Castro, F. (2008) Optimization of a Hospital Room by Means of CFD for More Efficient Ventilation. Energy and Buildings, 40, 849-854. http://dx.doi.org/10.1016/j.enbuild.2007.06.003
Pfost, J.F. (1981) A Re-Evaluation of Laminar Air Flow in Hospital Operating Rooms. ASHRAE Transactions, 87, 729-739.
Kameel, R. and Khalil, E.E. (2003) Experimental and Numerical Investigations of Heat Transfer in Air-Conditioned Operation Theatres. Proceedings of 14th USNCTAM, Symposium on Recent Advances in Three Dimensional Flow Modelling, June 2002, Paper 52.
Ho, S.H., Rosario, L. and Rahman, M.M. (2009) Three-Dimensional Analysis for Hospital Operating Room Thermal Comfort and Contaminant Removal. Applied Thermal Engineering, 29, 2080-2092. http://dx.doi.org/10.1016/j.applthermaleng.2008.10.016
Villafruela, J.M., Castro, F., San José, J.F. and Saint-Martin, J. (2013) Comparison of Air Change Efficiency, Contaminant Removal Effectiveness and Infection Risk as IAQ Indices in Isolation Rooms. Energy and Buildings, 57, 210-219. http://dx.doi.org/10.1016/j.enbuild.2012.10.053
Chow, T.T. and Yang, X.Y. (2005) Ventilation Performance in Operating Theatres against Airborne Infection: Numerical Study on an Ultra-Clean System. Journal of Hospital Infection, 59, 138-147. http://dx.doi.org/10.1016/j.jhin.2004.09.006
Chow, T.T. and Wang, J.L. (2012) Dynamic Simulation on Impact of Surgeon Bending Movement on Bacteria Carrying Particles Distribution in Operating Theatre. Building and Environment, 57, 68-80. http://dx.doi.org/10.1016/j.buildenv.2012.04.010
Dong, S.Y., Tu, G.B., Cao, R.G. and Yu, Z.F. (2009) Numerical Study on Effects of Door-Opening on Airflow Patterns and Dynamic Cross-Contamination in an ISO Class 5 Operating Room. Transactions of Tianjin University, 15, 210-215. http://dx.doi.org/10.1007/s12209-009-0037-y
Santa Cruz, A., Guillou, S. and Makhloufi, R. (2007) Effect of Moving Person on Airflow Patterns in a Ventilated Enclosure (Operating Theatre Applications). ITBM RBM (Revue Europeenne de Technologie Biomedicale, In French Language), 28, 49-55. (In French) http://www.sciencedirect.com/science/journal/19590318
Brohus, H., Balling, K.D. and Jeppesen, D. (2006) Influence of Movements on Contaminant Transport in an Operating Room. Indoor Air, 16, 356-372. http://dx.doi.org/10.1111/j.1600-0668.2006.00454.x
Balocco, C., Petrone, G., Cammarata, G., Vitali, P., Albertini, R. and Pasquarella, C.I. (2015) Experimental and Numerical Investigation on Airflow and Climate in a Real Operating Theatre under Effective Use Conditions. International Journal of Ventilation, in Press.
Balocco, C., Petrone, G. and Cammarata, G. (2012) Assessing the Effects of Sliding Doors on an Operating Theatre Climate. Building Simulation: An International Journal, 5, 73-83.
Balocco, C., Petrone, G. and Cammarata, G. (2013) Numerical Multi-Physical Approach for the Assessment of Coupled Heat and Moisture Transfer Combined with People Movements in Historical Buildings. Building Simulation: An International Journal, 7, 289-303.
Yam, R., Yuen, P.L., Yung, R. and Choy, T. (2011) Rethinking Hospital General Ward Ventilation Design Using Computational Fluid Dynamics. Journal of Hospital Infection, 77, 31-36. http://dx.doi.org/10.1016/j.jhin.2010.08.010
Jaramillo, J., Oliva, A., Perez-Segarra, C.D. and Oliet, C. (2008) Application of Air Curtains in Refrigerated Chambers. International Refrigeration and Air Conditioning Conference, Purdue France, 14-17 July 2008, Vol. 2403, 2-8.
El Harriry, G., Abu Zeid, A. and Khalil, E. (2010) An Investigation of Air Curtains Flows Effects on Heat and Mass Transfer Characteristics in a Cold Room. 46th AIAA/ASME/SAE/ASEE Joint Propulsion Conference & Exhibit, Nashville, 25-28 July 2010, 2010-6931.
Wang, L.Z. and Zhong, Z.P. (2014) An Approach to Determine Infiltration Characteristics of Building Entrance Equipped with Air Curtains. Energy and Buildings, 75, 312-320. http://dx.doi.org/10.1016/j.enbuild.2014.02.020
Gil-Lopez, T., Castejon-Navas, J., Galvez-Huerta, M.A. and O’Donohoe, P.G. (2014) Energetic, Environmental and Economic Analysis of Climatic Separation by Means of Air Curtains in Cold Storage Rooms. Energy and Buildings, 74, 8-16. http://dx.doi.org/10.1016/j.enbuild.2014.01.026
Chen, Y.G. (2009) Parametric Evaluation of Refrigerated Air Curtains for Thermal Insulation. International Journal of Thermal Sciences, 48, 1988-1996. http://dx.doi.org/10.1016/j.ijthermalsci.2009.03.003
Zhai, Z.Q. and Osborne, A. (2013) Simulation-Based Feasibility Study of Improved Air Conditioning Systems for Hospital Operating Room. Frontiers of Architectural Research, 2, 468-475. http://dx.doi.org/10.1016/j.foar.2013.09.003
Partridge, L.E., Groenhout, K. and Al-Waked, R. (2005) Comparative CFD Analyses of Hospital Ward Ventilation Systems on Reducing Cross Infection Rates. Australian Institute Refrigeration Air Condition Heat Journal, 4, 26-31.
Loomans, M.G.L.C., van Houdt, W., Lemaire, A.D. and Hensen, J.L.M. (2008) Performance Assessment of an Operating Theatre Design Using CFD Simulation and Tracer Gas Measurements. Indoor and Built Environment, 17, 299- 312.
Chow, T.T. and Yang, X.Y. (2004) Ventilation Performance in Operating Theatres against Airborne Infection: Review of Research Activities and Practical Guidance. Journal of Hospital Infection, 56, 85-92. http://dx.doi.org/10.1016/j.jhin.2003.09.020
Balocco, C., Petrone, G., Cammarata, G., Vitali, P., Albertini, R. and Pasquarella, C. (2014) Indoor Air Quality in a Real Operating Theatre under Effective Use Conditions. Journal of Biomedical Science and Engineering, 7, 866-883. http://dx.doi.org/10.4236/jbise.2014.711086
ISPESL (2009) Dipartimento Igiene del Lavoro, Linee guida per la definizione degli standard di sicurezza e di igiene ambientale dei reparti operatori. [Department of Occupational Hygiene, Guidelines for the Definition of Safety Standards and Environmental Health Departments Operators (in Italian)]. http://www.ispesl.it/
COMSOL (2012) Multiphysics User’s Guide v. 4.3. Comsol Inc. http://www.comsol.com/
Ignat, L., Pelletier, D. and Ilinca, F. (2000) A Universal Formulation of Two-Equation Models for Adaptive Computation of Turbulent Flows. Computer Methods in Applied Mechanics and Engineering, 189, 1119-1139. http://dx.doi.org/10.1016/S0045-7825(99)00370-9
Launder, B.E. and Spalding, D.B. (1974) The Numerical Computation of Turbulent Flows. Computer Methods in Applied Mechanics and Engineering, 3, 269-289. http://dx.doi.org/10.1016/0045-7825(74)90029-2
Deuflhard, P. (1974) A Modified Newton Method for the Solution of Ill-Conditioned Systems of Nonlinear Equations with Application to Multiple Shooting. Numerische Mathematik, 22, 289-315. http://dx.doi.org/10.1007/BF01406969
Hindmarsh, A.C., Brown, P.N., Grant, K.E., Lee, S.L., Serban, R., Shumaker, D.E. and Woodward, C.S. (2005) SUNDIALS: Suite of Nonlinear and Differential/Algebraic Equation Solvers. Transactions on Mathematical Software ACM (TOMS), 31, 363-396.
UNI EN ISO 7730 (2006) Ergonomics of the Thermal Environment. Analytical Determination and Interpretation of Thermal Comfort Using Calculation of the PMV and PPD Indices and Local Thermal Comfort Criteria. European Committee for Standardization, Brussels.
ANSI ASHRAE Standard 55 (2013) Thermal Environmental Conditions for Human Occupancy. ASHRAE Standards Committee, the ASHRAE Board of Directors, and the American National Standards Institute, USA. www.ashrae.org
Karthikeyan, C.P. and Samuel, A.A. (2008) CO2-Dispersion Studies in an Operation Theatre under Transient Conditions. Energy and Buildings, 40, 231-239. http://dx.doi.org/10.1016/j.enbuild.2007.02.023
Al-Waked, R. (2010) Effect of Ventilation Strategies on Infection Control inside Operating Theatres. Engineering Applications of Computational Fluid Mechanics, 4, 1-16. http://dx.doi.org/10.1080/19942060.2010.11015295
Liu, J.J., Wang, H.D. and Wen, W.Y. (2009) Numerical Simulation on a Horizontal Airflow for Airborne Particles Control in Hospital Operating Room. Building and Environment, 44, 2284-2289. http://dx.doi.org/10.1016/j.buildenv.2009.03.019