Abstract

The use of hospital isolation rooms has increased considerably in recent years due to the worldwide outbreaks of various emerging infectious diseases. However, the passage of staff through isolation room doors is suspected to be a cause of containment failure, especially in case of hinged doors. It is therefore important to minimize inadvertent contaminant airflow leakage across the doorway during such movements. To this end, it is essential to investigate the behavior of such airflows, especially the overall volume of air that can potentially leak across the doorway during door-opening and human passage. Experimental measurements using full-scale mock-ups are expensive and labour intensive. A useful alternative approach is the application of Computational Fluid Dynamics (CFD) modelling using a time-resolved Large Eddy Simulation (LES) method. In this study simulated air flow patterns are qualitatively compared with experimental ones, and the simulated total volume of air that escapes is compared with the experimentally measured volume. It is shown that the LES method is able to reproduce, at room scale, the complex transient airflows generated during door-opening/closing motions and the passage of a human figure through the doorway between two rooms. This was a basic test case that was performed in an isothermal environment without ventilation. However, the advantage of the CFD approach is that the addition of ventilation airflows and a temperature difference between the rooms is, in principle, a relatively simple task. A standard method to observe flow structures is dosing smoke into the flow. In this paper we introduce graphical methods to simulate smoke experiments by LES, making it very easy to compare the CFD simulation to the experiments. The results demonstrate that the transient CFD simulation is a promising tool to compare different isolation room scenarios without the need to construct full-scale experimental models. The CFD model is able to reproduce the complex airflows and estimate the volume of air escaping as a function of time. In this test, the calculated migrated air volume in the CFD model differed by 20% from the experimental tracer gas measurements. In the case containing only a hinged door operation, without passage, the difference was only 10%.

Highlights

  • It is this heightened awareness of the potential for airborne transmission of various infectious agents, together with the traditionally precautionary approach to infection control that means that patients infected with potentially highly contagious diseases are being routinely quarantined in negative pressure isolation rooms to prevent further spreading of the disease, to protect patients, staff and visitors

  • Whilst this is the case for some infectious agents, others are transmitted by larger droplets, subject to gravitational settling

  • The mock-up consists of two rooms, the isolation room being connected to an anteroom by a hinged door in the middle of a separating wall (Fig 1)

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Summary

Introduction

The usage of hospital isolation rooms has been increasing world-wide after the demonstration of the airborne transmission potential of various infectious agents, such as severe acute respiratory syndrome-associated coronavirus (SARS-CoV) [1,2,3,4,5,6] and influenza viruses [7,8,9,10,11]— though for human-to-human airborne transmission of influenza, there has been an ongoing, fierce debate about the proportion of transmission that is truly airborne [12,13,14,15,16,17,18]. Concerns about airborne transmission have even been raised for Ebola virus during the current epidemic in West Africa, even though this virus is normally transmitted via direct contact [19] It is this heightened awareness of the potential for airborne transmission of various infectious agents, together with the traditionally precautionary approach to infection control that means that patients infected with potentially highly contagious diseases are being routinely quarantined in negative pressure isolation rooms to prevent further spreading of the disease, to protect patients, staff and visitors. Even though the air volume migrated (AVM) is closely connected to the number of pathogens potentially escaping, a linear dependence requires that the pathogens are aerosolized and fully airborne, and capable of long-range transmission Whilst this is the case for some infectious agents, others are transmitted by larger droplets, subject to gravitational settling. The estimations about the extent to which airborne transmission contributes to the overall infection rates in hospitals vary from 10% to 30% [23]

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