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1 Scope
This standard specifies the management and hygienic requirements, air purification methods and air purification effects of hospital air purification. This standard applies to hospitals of all levels and categories. Other medical institutions may refer to it for implementation.
(Figure 1: Hospital air purification)
2 Normative references
The following documents are essential for the application of this document. For all dated references, only the dated documents are used. For all undated references, the latest version (including all amendments) applies to this document.
GB15982 Hospital Disinfection and Hygiene Standard
GB50333 Technical Specifications for the Construction of Clean Operating Rooms in Hospitals
Sanitary Standards for Central Air Conditioning and Ventilation systems in Public Places Ministry of Health
Sanitary Evaluation Standards for Central Air Conditioning and Ventilation Systems in Public Places Ministry of Health
Cleaning Standards for Central Air Conditioning and Ventilation Systems in Public Places Ministry of Health
(Figure 2: Hospital disinfection and hygiene standards)
3 Terms and Definitions
The following terms and definitions apply to this document.
3.1 Air purification
Technology or methods to reduce microorganisms, particulate matter, etc. in indoor air to make them harmless,
3.2 Clean operating room
It adopts certain air purification technology to make the air colony count and dust particle count reach the corresponding cleanliness level standard of the operating room (room).
(Figure 3: Clean operating room)
3.3 Natural ventilation
Ventilation that uses the heat pressure or wind pressure caused by the density difference between the air inside and outside the building to promote air flow.
3.4 Central air conditioning and ventilation system
The sum of all equipment, pipelines and accessory instruments and meters for processing, transportation and distribution in order to make the parameters such as air temperature, humidity, cleanliness and air flow velocity in the room or closed space meet the set requirements.
3.5 Air purification and disinfection device
A device that removes microorganisms, particulate matter and gaseous pollutants in the air supplied by the central air conditioning and ventilation system.
(Figure 4: Air purification and disinfection device)
4 Management and hygiene requirements
4.1 Air purification management requirements
4.1.1 Hospitals should formulate corresponding air purification management systems and organize their implementation in accordance with the provisions of laws, regulations and standards related to air purification and disinfection and in combination with the actual situation of the hospital.
4.1.2 Hospitals should train the users and managers of air purification and disinfection facilities and medical staff on the knowledge of laws, regulations and standards related to air purification and disinfection, clarify their respective positions and tasks, and ensure the normal operation of air purification facilities.
4.1.3 Hospitals should take appropriate air purification measures based on infection risk assessment of clinical departments to ensure that indoor air quality meets the requirements of relevant national standards.
4.1.4 Hospitals should inspect and guide the air quality of relevant clinical departments throughout the hospital.
(Figure 5: Air purification hygiene requirements)
4.2 Air purification and hygiene requirements
4.2,1 Clean operating rooms (rooms) and other clean places (such as clean bone marrow transplant wards), during new construction and renovation acceptance, after replacing high-efficiency filters, and during daily monitoring, the total number of bacterial colonies in the air should meet the requirements of GB50333,
4.2.2 The total number of bacterial colonies in the air of non-clean operating rooms (rooms), non-clean bone transplant wards, delivery rooms, catheter rooms, neonatal rooms, organ transplant wards, burn wards, intensive care units, and hematology wards is ≤4cfu/(15min diameter 9cm plate).
4.2.3 The total number of bacterial colonies in the air of pediatric wards, mother-child rooms, obstetrics and gynecology examination rooms, abortion rooms, treatment rooms, injection rooms, dressing rooms, blood transfusion departments, disinfection supply centers, hemodialysis centers (rooms), emergency rooms, laboratories, various general wards, infectious disease clinics and their wards is ≤4CFu/(5min diameter 9cm plate)
5 Air purification methods
5.1 Ventilation
5.1.1 Natural ventilation
Ventilation should be carried out in a timely manner according to the season, outdoor Wind speed and temperature.
(Figure 6: Mechanical ventilation)
5.1.2 Mechanical ventilation
5.1.2.1 Working principle
By installing ventilation equipment, the power generated by the operation of fans and exhaust fans is used to make the air flow.
5.1.2.2 Ventilation methods
5.1.2.2,1 Mechanical air supply and natural exhaust are suitable for places where pollution sources are dispersed and indoor air pollution is not serious. The mechanical air supply outlet is directly away from doors and windows.
5.1.2.2.2 Natural air supply and mechanical exhaust are suitable for places with heavy indoor air pollution. The indoor exhaust vent should be away from the door and should be placed on the wall opposite the door.
5.1.2.2.3 Mechanical air supply and mechanical exhaust are suitable for places with high requirements for sanitary conditions. Set the number of air changes or maintain positive or negative pressure within the rate according to the needs of ventilation
5.1.3 Precautions
5.1.3.1 The functional requirements of the room, the sanitary conditions of the adjacent rooms and the indoor and outdoor environmental factors should be fully considered to select the ventilation method and the positive and negative pressure in the room.
5.1.3.2 Mechanical ventilation equipment should be cleaned regularly and cleaned and disinfected in time when contaminated.
(Figure 7: Centralized air conditioning and ventilation system)
5.2 Central air conditioning and ventilation system
5.2.1 Central air conditioning and ventilation system should strengthen sanitary management and comply with relevant national regulations.
5.2.2 The sanitary requirements and detection methods of central air conditioning and ventilation system should comply with the provisions of the "Sanitary Standards for Central Air Conditioning and Ventilation Systems in Public Places".
5.2.3 The hygienic evaluation of central air conditioning and ventilation system should comply with the provisions of the "Sanitary Evaluation Standards for Central Air Conditioning and Ventilation Systems in Public Places".
5.2.4 The cleaning of the central air conditioning and ventilation system shall comply with the provisions of the "Cleaning Specifications for Central Air Conditioning and Ventilation Systems in Public Places".
5.3 Air Cleaning Technology
5.3.1 Design Requirements
The design of clean operating rooms and other clean places shall comply with the requirements of GB50333.
5.3.2 Maintenance and Maintenance Requirements
5.3.2.1 Air handling units and fresh air units should be inspected regularly and kept clean.
(Figure 8: Air purification technology)
5.3.2.2 The coarse filter of the fresh air unit should be cleaned every 2 days; the coarse filter should be replaced every 1 to 2 months; the medium filter should be checked weekly and replaced every 3 months; the sub-high efficiency filter should be replaced every year. If contamination and blockage are found, replace them in time.
5.3.2.3 The terminal high efficiency filter should be inspected once a year and replaced when the resistance exceeds the initial design resistance of 160Pa or has been used for more than 3 years.
5.3.2.4 The medium efficiency filter in the exhaust fan unit should be replaced every year, and if contamination and blockage are found, replace them in time.
5.3.2.5 Check the return Air Filter regularly, clean it once a week and replace it once a year. If there is special pollution, replace it in time and wipe the inner surface of the return air filter with disinfectant.
5.3.2.6 Set up special maintenance management personnel to follow the instructions for use of the equipment for maintenance and maintenance; and formulate an operation manual with inspection and records.
5.4 Ultraviolet disinfection
5.4.1 Scope of application
Applicable to the disinfection of indoor air in an unmanned state
5.4.2 Disinfection method
Ultraviolet lamps are suspended or mobile for direct irradiation. When installing, the ultraviolet lamp (30w ultraviolet lamp, the intensity at 1.0m>70uW/cm) should be 21.5W/m, and the irradiation time should be ≥30min.
(Figure 9: Ultraviolet disinfection)
5.4.3 Precautions
5.4.3.1 The surface of the ultraviolet lamp should be kept clean and wiped once a week with 75%~80% (volume ratio) ethanol cotton balls. If dust or oil is found on the surface of the lamp tube, it should be wiped in time.
5.4.3.2 When using ultraviolet lamps to disinfect indoor air, the room should be kept clean and dry to reduce dust and water mist. When the temperature is <20℃ or >40℃, or the Relative humidity is >60%, the exposure time should be appropriately extended.
5.4.3.3 Ultraviolet lamps should not be used for disinfection when there are people in the room.
5.5 Circulating air ultraviolet air disinfector
5.5.1 Scope of application
Applicable to indoor air disinfection when there are people.
5.5.2 Disinfection principle
The disinfector consists of high-intensity ultraviolet lamps and a filtration system, which can effectively kill microorganisms entering the narrow air of the disinfector and effectively filter out dust particles in the air.
5.5.3 Instructions for use
The product instructions approved by the Ministry of Health's disinfection product hygiene license should be followed and correctly installed and used in the specified space.
5.5.4 Precautions
5.5.4.1 Doors and windows should be closed during disinfection.
5.5.4.2 The air inlet and outlet should not be covered or blocked by objects.
5.5.4.3 When cleaning the machine with a wet cloth, the power supply must be turned off first.
5.5.4.4 The inspection and maintenance of the disinfector should follow the product instructions.
5.5.4.5 The disinfector should obtain the disinfection product sanitation license issued by the Ministry of Health.
(Figure 10: Electrostatic adsorption air sterilizer)
5.6 Electrostatic adsorption air disinfector
5.6.1 Scope of application
Applicable to indoor air purification when there are people.
5.6.2 Disinfection principle
Use electrostatic adsorption and filtration materials to eliminate dust and microorganisms in the air.
5.6.3 Instructions for use
Follow the product instructions approved by the disinfection product sanitation license issued by the Ministry of Health, and install and use it correctly in the specified space.
5.6.4 Precautions
5.6.4.1 Doors and windows should be closed during disinfection.
5.6.4.2 The air inlet and outlet should not be covered or blocked by objects:
5.6.4.3 The circulating Air volume (m3/h) of the disinfector should be more than 8 times the volume of the dry room:
5.6.4.4 The disinfector should obtain the disinfection product hygiene license of the Ministry of Health,
5.6.4.5 The inspection and maintenance of the disinfector should follow the product instructions.
(Figure 11: Chemical disinfection)
5.7 Chemical disinfection method
5.7.1 Ultra-low volume spray method
5.7.1.1 Scope of application
Applicable to indoor air disinfection in an unmanned state.
5.7.1.2 Disinfection principle
The disinfectant is atomized into tiny particles below 20um, and evenly sprayed in the air to make it fully contact with the microbial particles in the air to kill the microorganisms in the air.
5.7.1.3 Disinfection method
Use 3% hydrogen peroxide, 5000mg/peracetic acid, 500mg/peroxyacetic acid, etc., add disinfectants to the electric ultra-low volume sprayer at a dosage of 20mL/m3~30mL/m3, turn on the power, and spray disinfection. Close the doors and windows before disinfection. When spraying, spray from top to bottom, left to right, inside to outside, surface first and space later, step by step. Action time: 30min~60min for hydrogen peroxide and gas dioxide, h for peroxyacetic acid. After disinfection, open the doors and windows for thorough ventilation.
5.7.1.4 Precautions
5.7.1.4.1 When spraying, the disinfection personnel should take personal protection, wear protective gloves and masks, and wear gas masks and protective clothing when necessary.
5.7.1.4.2 Before spraying, the indoor corrosive instruments and equipment, such as monitors and displays, should be covered.
5.7.2 Fumigation method
5.7.2.1 Scope of application
Applicable to indoor air disinfection in an unmanned environment.
5.7.2.2 Disinfection principle
Use the volatility of chemical disinfectants to evaporate them in a certain space by heating or other methods to achieve air disinfection.
5.7.2.3 Disinfection method
Use 0.5%~1.0% (5000mg/L~10000mg/L) peracetic acid aqueous solution (1g/m3) or gas dioxide (10mg/m3~20mg/m3), heat and evaporate or add activator; or use ozone (20mg/m3) for fumigation disinfection. The amount of disinfectant, disinfection time, operation method and precautions should follow the instructions for use of the product. Close the doors and windows before disinfection, and open the doors and ventilate thoroughly after disinfection.
5.7.2.4 Precautions
5.7.2.4.1 The temperature and humidity of the room should be appropriate during disinfection.
5.7.2.4.2 The container for the disinfectant should be corrosion-resistant and of suitable size.
(Figure 12: Hospital outpatient department)
6 Air purification methods for different departments
6.1 The following methods can be used to purify the air in the operating department (room)
Central air conditioning and ventilation system with air purification and disinfection equipment installed;
Air purification technology;
Circulating air ultraviolet air disinfector or electrostatic adsorption air disinfector or other air disinfector with the Ministry of Health's disinfection product sanitation license
Ultraviolet light disinfection;
Other air disinfection products that can make the total number of bacteria in the air after disinfection ≤ 4 CFU/(15min diameter 9cm plate) and obtain the Ministry of Health's disinfection product sanitation license.
6.2 Ways to purify the air
Delivery room, catheter room, neonatal room , organ transplant wards, burn wards, intensive care units, hemorrhage wards, etc., can choose the following methods to purify the air:
Ventilation;
Centralized air conditioning and ventilation system equipped with air purification and disinfection equipment;
Air purification technology;
Circulating air ultraviolet air disinfector or electrostatic adsorption air disinfector or other air disinfector that has obtained the Ministry of Health's disinfection product health license;
Ultraviolet light irradiation disinfection;
Other air disinfection products that can make the total number of bacteria in the air after disinfection ≤4CFU/(15min diameter 9cm plate) and have obtained the Ministry of Health's disinfection product health license.
6.3 Ways to purify the air
The following methods can be used to purify the air in pediatric wards, mother-child rooms, obstetrics and gynecology examination rooms, abortion rooms, injection rooms, treatment rooms, dressing rooms, blood transfusion departments, disinfection supply centers, hemodialysis centers (rooms), emergency rooms, laboratories, various general wards, infectious disease clinics and their wards:
Ventilation;
Central air conditioning and ventilation system;
Circulating air ultraviolet air sterilizer or electrostatic adsorption air sterilizer or other air sterilizers that have obtained the Ministry of Health's disinfection product health license;
Ultraviolet light irradiation disinfection;
Chemical disinfection;
Other air disinfection products that can make the total number of bacteria in the air after disinfection ≤4CFU/(5min diameter 9cm plate) and have obtained the Ministry of Health's disinfection product health license.
(Figure 13: Natural ventilation)
7 Air purification methods in different situations
7.1 The following methods can be used when there are people
Natural ventilation is preferred for general wards: if natural ventilation is poor, mechanical ventilation should be adopted:
Central air conditioning ventilation system;
Circulating air ultraviolet air disinfector or electrostatic adsorption air disinfector or other air disinfector that has obtained the sanitary license for disinfection products from the Ministry of Health;
Air purification technology;
Other air disinfection products that have obtained the sanitary license for disinfection products from the Ministry of Health and are harmless to human health.
7.2 The following methods can be used when there are no people
(Figure 14: Spray disinfection)
The air purification method in 7.1 can be used;
Disinfection with ultraviolet light;
Chemical disinfection;
Other disinfectants that have obtained the sanitary license for disinfection products from the Ministry of Health and are suitable for ultra-low volume spray disinfection are used for spray disinfection. The use method and precautions shall follow the product instructions.
7.3 The following methods can be used in places where patients with respiratory infectious diseases are located
Hospitals limited by objective conditions can use ventilation, including natural ventilation and mechanical ventilation, and mechanical exhaust is preferred;
Negative pressure isolation wards:
Central air conditioning ventilation system with air purification and disinfection equipment installed;
Use air purification Equipment that has obtained the sanitary license for disinfection products from the Ministry of Health, and its operation methods, precautions, etc. should follow the product instructions.
(Figure 15: Negative pressure isolation ward)
7.4 The following methods can be used in wards after ordinary patients are discharged or die
Ventilation.
Ultraviolet light irradiation disinfection;
Use air purification equipment that has obtained the sanitary license for disinfection products from the Ministry of Health, and its operation methods, precautions, etc. should follow the product instructions.
7.5 After the discharge or death of patients with respiratory infectious diseases, the ward can use the following methods
Ultraviolet light irradiation disinfection:
Chemical disinfection:
Use air purification equipment that has obtained the Ministry of Health's disinfection product health license. The operation method, precautions, etc. should follow the product's instructions.
8 Monitoring of air purification effects
8.1 Monitoring departments
The hospital should monitor the air purification and disinfection quality of high-risk infection departments such as operating departments (rooms), delivery rooms, catheter rooms, laminar flow clean wards, bone marrow transplant wards, organ transplant wards, intensive care units, neonatal rooms, mother-child rooms, hemodialysis centers (rooms), and burn wards.
(Figure 16: Air purification effect monitoring)
8.2 Monitoring requirements
8.2.1 Monitoring frequency
The hospital should monitor high-risk infection departments every quarter; clean operating departments (rooms) and other clean places should be monitored during new construction and renovation acceptance and after the replacement of high-efficiency filters: when a hospital infection outbreak is suspected to be related to air pollution, it should be monitored at any time and the corresponding pathogenic microorganisms should be tested.
8.2.2 Monitoring methods and result determination
8.2.2.1 Clean operating rooms (rooms) and other clean places shall reasonably arrange the number of rooms to be monitored each time according to the total number of clean rooms to ensure that each clean room can be monitored at least once a year. The monitoring methods and result determination shall comply with the requirements of GB50333.
8.2.2.2 For departments that do not use clean technology to purify the air, the monitoring methods and result determination shall comply with the requirements of GB15982.
