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Assessing Effectiveness of Ceiling-Ventilated Mock Airborne Infection Isolation Room in Preventing Hospital-Acquired Influenza Transmission to Health Care Workers

机译:评估天花板通风模拟空气传播隔离室在预防医院获得的流感向医护人员传播方面的有效性

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摘要

Exposure to airborne influenza (or flu) from a patient's cough and exhaled air causes potential flu virus transmission to the persons located nearby. Hospital-acquired influenza is a major airborne disease that occurs to health care workers (HCW).This paper examines the airflow patterns and influenza-infected cough aerosol transport behavior in a ceiling-ventilated mock airborne infection isolation room (AIIR) and its effectiveness in mitigating HCW's exposure to airborne infection. The computational fluid dynamics (CFD) analysis of the airflow patterns and the flu virus dispersal behavior in a mock AIIR is conducted using the room geometries and layout (room dimensions, bathroom dimensions and details, placement of vents and furniture), ventilation parameters (flow rates at the inlet and outlet vents, diffuser design, thermal sources, etc.), and pressurization corresponding to that of a traditional ceiling-mounted ventilation arrangement observed in existing hospitals. The measured data shows that ventilation rates for the AIIR are about 12 air changes per hour(ach). However, the numerical results reveals incomplete air mixing and that not all of the room air is changed 12 times per hour. Two life-sized breathing human models are used to simulate a source patient and a receiving HCW. A patient cough cycle is introduced into the simulation and the airborne infection dispersal is tracked in time using a multiphase flow simulation approach.The results reveal air recirculation regions that diminished the effect of air filtration and prolong the presence of flu-contaminated air at the HCW's zone. Immediately after the patient coughs (0.51 s), the cough velocity from the patient's mouth drives the cough aerosols toward the HCW standing next to patient's bed. Within 0.7 s, the HCW is at risk of acquiring the infectious influenza disease, as a portion of these aerosols are inhaled by the HCW.As time progresses (5 s), the aerosols eventually spread throughout the entire room, as they are carried by the AIIR airflow patterns. Subsequently, a portion of these aerosols are removed by the exhaust ventilation. However, the remaining cough aerosols reenter and recirculate in the HCW's zone until they are removed by the exhaust ventilation.The infectious aerosols become diluted in the HCW's region over a period of 10 s because of the fresh air supplied into the HCW's zone. The overall duration of influenza infection in the room (until the aerosol count is reduced to less than 0.16% of the total number of aerosols ejected from the patient's mouth) is recorded as approximately 20 s. With successive coughing events, a near-continuous exposure would be possible. Hence, the ceiling-ventilation arrangement of the mock AIIR creats an unfavorable environment to the HCW throughout his stay in the room, and the modeled AIIR ventilation is not effective in protecting the HCW from infectious cough aerosols. The CFD results suggest that the AIIR ceiling ventilation arrangement has a significant role in influencing the flu virus transmission to the HCW.
机译:患者的咳嗽和呼出的空气暴露于空气传播的流感(或流感)中,可能会将流感病毒传播给附近的人。医院获得性流感是医护人员(HCW)发生的一种主要的空气传播疾病。本文研究了天花板通风的模拟空气传播感染隔离室(AIIR)的气流模式和流感感染的咳嗽气溶胶运输行为,以及其有效性。减轻医护人员的空气传播感染。模拟AIIR中的气流模式和流感病毒扩散行为的计算流体动力学(CFD)分析使用房间的几何形状和布局(房间尺寸,浴室尺寸和细节,通风口和家具的放置),通风参数(流量)进行进风口和出风口的风速,扩散器设计,热源等),以及与在现有医院中观察到的传统吊顶式通风装置相对应的加压。实测数据表明,AIIR的通风速率约为每小时12个空气变化(ach)。但是,数值结果显示空气混合不完全,并非所有室内空气每小时都会变化12次。使用两个与实际大小一样的呼吸人体模型来模拟源患者和接收HCW。在模拟中引入了患者咳嗽周期,并使用多相流模拟方法及时跟踪了空气传播的感染扩散,结果表明空气再循环区域减少了空气过滤的影响并延长了HCW处的被流感污染的空气的存在区。患者咳嗽后(0.51 s),患者口中的咳嗽速度立即将咳嗽气溶胶推向站立在患者床旁的HCW。在0.7 s之内,HCW就有被传染的流感病的危险,因为这些气溶胶的一部分被HCW吸入。随着时间的流逝(5 s),气溶胶最终会传播到整个房间, AIIR气流模式。随后,通过排气通风除去一部分这些气雾剂。但是,残留的咳嗽气溶胶会在HCW区域再次进入并再循环,直到通过排气通风将其清除。由于向HCW区域提供了新鲜空气,传染性气溶胶在HCW区域被稀释了10秒钟。整个房间内流感感染的总持续时间(直到气溶胶计数减少到少于从患者口中喷出的气溶胶总数的0.16%)才被记录为大约20 s。随着连续的咳嗽事件,几乎连续的暴露是可能的。因此,模拟AIIR的天花板通风布置为整个HCW在房间中营造了不利的环境,而模拟的AIIR通风对于保护HCW免受传染性咳嗽气溶胶无效。 CFD结果表明,AIIR天花板通风装置在影响流感病毒向HCW的传播方面具有重要作用。

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