Large Eddy Simulation of Air Escape through a Hospital Isolation Room Single Hinged Doorway--Validation by Using Tracer Gases and Simulated Smoke Videos

Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review

The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.

Dispersion of virus-laden droplets in ventilated rooms: Effect of homemade facemasks

In December 2019, the SARS-CoV-2 virus emerged and rapidly spread throughout the world. It causes the respiratory disease COVID-19 via the transmission of microbial pathogens within bio-aerosols during speaking, sneezing, and coughing. Therefore, understanding bioaerosol dynamics is important for developing mitigation strategies against droplet-induced infections. Computer modelling, using Computational Fluid Dynamics, has become a useful tool in studying and visualising the spread of atomised bio-droplets but the effect of using cloth facemasks has not been fully quantified. In this study, simulations were carried out to quantify the extent of respiratory droplet transfer with and without facemasks between a pair of ventilated rooms by a mathematical model for the first time. A 600-μm pore facemask was used, representing the porosity of a typical cloth facemask. Using the discrete phase model, the transport of ejected droplets was tracked. The results show that in the facemask cases, more than 96% of all the ejected droplets in all scenarios were trapped in the recommended 2 m social distancing radius around the human source. Correspondingly, only a maximum of 80% of droplets were deposited within the social distancing radius in the no facemask scenarios, with >20% airborne and transported to the second room. One-dimensional empirical correlations were developed for droplet concentration as a function of distance from the bioaerosol source. The models show that droplet concentration decays exponentially from the source especially in the facemask cases. The study therefore reinforces the importance of face coverings in lessening the transmission of possibly infected respiratory droplets that transmit highly infectious diseases such as COVID-19.

Emissions, airflow patterns and modeling of test compounds in controlled hospital environments

Spreading and distribution of selected volatile organic compounds (VOCs) released as point source emissions in a hospital environment were investigated in two office rooms and two patient rooms. Six tracer compounds were released from six locations and their concentrations were measured in five sampling sites during two consecutive days. The air flow rates, velocity and flow direction, air temperature, pressure differences between adjacent rooms, and relative humidity and concentrations of the tracer compounds were measured. The results revealed that the size of the examined space and ventilation rates, the monitoring point should be either close to the exhaust terminal device or in the middle of the occupied zone the way that supply air flows do not interfere the measurements. Depending on the inlet terminal device and its location, the air is either delivered parallel to the ceiling or it can be directed to a desired spot into the occupied zone. The tracer compounds did spread evenly within the room and their concentrations decreased inversely with the distance. In rooms with a good ventilation, the concentrations at the exhaust air terminal units were close to those measured near the source point. The results obtained from modeling were consistent with the measurements.

Airflow Characteristics in Aeromedical Aircraft: Considerations During COVID-19

Objective

The aeromedical transport of coronavirus patients presents risks to clinicians and aircrew. Patient positioning and physical barriers may provide additional protection during flight. This paper describes airflow testing undertaken on fixed wing and rotary wing aeromedical aircraft.

Methods

Airflow testing was undertaken on a stationary Hawker Beechcraft B200C and Leonardo Augusta Westland 139. Airflow was simulated using a Trainer 101 (MSS Professional A/S, Odense Sø, Syddanmark, Denmark) Smoke machine. Different cabin configurations were used along with variations in heating, cooling, and ventilation systems.

Results

For the Hawker Beechcraft B200C, smoke generated within the forward section of the cabin was observed to fill the cabin to a fluid boundary located in-line with the forward edge of the cargo door. With the curtain closed, smoke was only observed to enter the cockpit in very small quantities. For the Leonardo AW139, smoke generated within the cabin was observed to expand to fill the cabin evenly before dissipating. With the curtain closed, smoke was observed to enter the cockpit only in small quantities

Conclusion

The use of physical barriers in fixed wing and rotary wing aeromedical aircraft provides some protection to aircrew. Optimal positioning of the patient is on the aft stretcher on the Beechcraft B200C and on a laterally orientated stretcher on the AW139. The results provide a baseline for further investigation into methods to protect aircrew during the coronavirus pandemic.

Assessment of displacement ventilation systems in airborne infection risk in hospital rooms

Efficient ventilation in hospital airborne isolation rooms is important vis-à-vis decreasing the risk of cross infection and reducing energy consumption. This paper analyses the suitability of using a displacement ventilation strategy in airborne infection isolation rooms, focusing on health care worker exposure to pathogens exhaled by infected patients. The analysis is mainly based on numerical simulation results obtained with the support of a 3-D transient numerical model validated using experimental data. A thermal breathing manikin lying on a bed represents the source patient and another thermal breathing manikin represents the exposed individual standing beside the bed and facing the patient. A radiant wall represents an external wall exposed to solar radiation. The air change efficiency index and contaminant removal effectiveness indices and inhalation by the health care worker of contaminants exhaled by the patient are considered in a typical airborne infection isolation room set up with three air renewal rates (6 h-1, 9 h-1 and 12 h-1), two exhaust opening positions and two health care worker positions. Results show that the radiant wall significantly affects the air flow pattern and contaminant dispersion. The lockup phenomenon occurs at the inhalation height of the standing manikin. Displacement ventilation renews the air of the airborne isolation room and eliminates the exhaled pollutants efficiently, but is at a disadvantage compared to other ventilation strategies when the risk of exposure is taken into account.

A Risk Assessment Approach for Evaluating the Impact of Toxic Contaminants Released Indoors by Considering Various Emergency Ventilation and Evacuation Strategies

The release of toxic airborne contaminants resulting from terrorist attacks on buildings can lead to disastrous consequences. To evaluate and reduce the effects of these emergencies, various methods and models have been developed in the past few years. Such work has provided effective tools for the building management system to do risk assessment of the contaminated areas. Although risk analysis methods to describe the contaminant dispersion scenarios made significant progress, these approaches did not generally consider the releasing scenario occurring in the ventilation system and the effect of human behavior during the developing process of an emergency event. Emergency strategies chosen by the decisionmaker are not always associated with the early-warning system, such as the sensor monitoring network and the source identification system inside the building. This study aims to provide a risk assessment model considering both the variation of contaminant concentration and occupant distribution after the release of toxic agents to obtain the exposure risk for people indoors. The contaminant dispersion is simulated using computational fluid dynamics. The evacuation process for people is modeled using Pathfinder, and the exposure risk for occupants under various emergency strategies is calculated using the efficiency factor of the contaminant source. The results of the exposure risk for 40 basic cases are discussed, and the optimal ventilation mode for these specific cases is recommended. Next, the impact of the variation of human behavior, contaminant detection time needed by sensors, and source identification time needed by inverse modeling on the exposure risk for people indoor is studied. The uncertainty and reproducibility of the numerical simulations are emphatically discussed in the Supporting Information.

Effect of heated-air blanket on the dispersion of squames in an operating room

High-fidelity, predictive fluid flow simulations of the interactions between the rising thermal plumes from forced air warming blower and the ultra-clean ventilation air in an operating room (OR) are conducted to explore whether this complex flow can impact the dispersion of squames to the surgical site. A large-eddy simulation, accurately capturing the spatiotemporal evolution of the flow in 3 dimensions together with the trajectories of squames, is performed for a realistic OR consisting of an operating table (OT), side tables, surgical lamps, medical staff, and a patient. Two cases are studied with blower-off and blower-on together with Lagrangian trajectories of 3 million squames initially placed on the floor surrounding the OT. The large-eddy simulation results show that with the blower-off, squames are quickly transported by the ventilation air away from the table and towards the exit grilles. In contrast, with the hot air blower turned on, the ventilation airflow above and below the OT is disrupted significantly. The rising thermal plumes from the hot air blower drag the squames above the OT and the side tables and then they are advected downwards toward the surgical site by the ventilation air from the ceiling. Temporal history of the number of squames reaching 4 imaginary boxes surrounding the side tables, the OT, and the patient's knee shows that several particles reach these boxes for the blower-on case.

Large-eddy simulation of the containment failure in isolation rooms with a sliding door-An experimental and modelling study

In hospital isolation rooms, door operation can lead to containment failures and airborne pathogen dispersal into the surrounding spaces. Sliding doors can reduce the containment failure arising from the door motion induced airflows, as compared to the hinged doors that are typically used in healthcare facilities. Such airflow leakage can be measured quantitatively using tracer gas techniques, but detailed observation of the turbulent flow features is very difficult. However, a comprehensive understanding of these flows is important when designing doors to further reduce such containment failures. Experiments and Computational Fluid Dynamics (CFD) modelling, by using Large-Eddy Simulation (LES) flow solver, were used to study airflow patterns in a full-scale mock-up, consisting of a sliding door separating two identical rooms (i.e. one isolation room attached to an antechamber). A single sliding door open/ hold-open/ closing cycle was studied. Additional variables included human passage through the doorway and imposing a temperature difference between the two rooms. The general structures of computationally-simulated flow features were validated by comparing the results to smoke visualizations of identical full-scale experimental set-ups. It was found that without passage the air volume leakage across the doorway was first dominated by vortex shedding in the wake of the door, but during a prolonged hold-open period a possible temperature difference soon became the predominant driving force. Passage generates a short and powerful pulse of leakage flow rate even if the walker stops to wait for the door to open.

ELECTRONIC SUPPLEMENTARY MATERIAL ESM

supplementary material is available in the online version of this article at 10.1007/s12273-017-0422-8.

Airflow patterns through single hinged and sliding doors in hospital isolation rooms - Effect of ventilation, flow differential and passage

Negative pressure isolation rooms are used to house patients with highly contagious diseases (e.g. with airborne diseases) and to contain emitted pathogens to reduce the risk for cross-infection in hospitals. Airflows induced by door opening motion and healthcare worker passage can, however, transport the potentially pathogen laden air across the doorway. In this study airflow patterns across the isolation room doorway induced by the operation of single hinged and sliding doors with simulated human passage were examined. Smoke visualizations demonstrated that the hinged door opening generated a greater flow across the doorway than the sliding door. Tracer gas measurements showed that the examined ventilation rates (6 and 12 air changes per hour) had only a small effect on the air volume exchange across the doorway with the hinged door. The results were more variable with the sliding door. Supply-exhaust flow rate differential reduced the door motion-induced air transfer significantly with both door types. The experiments showed that the passage induced substantial air volume transport through the doorway with both door types. However, overall, the sliding door performed better in all tested scenarios, because the door-opening motion itself generated relatively smaller air volume exchange across the doorway, and hence should be the preferred choice in the design of isolation rooms.