Applying the Wells-Riley equation to the risk of airborne infection in hospital environments: The importance of stochastic and proximity effects

Although the Wells-Riley equation for airborne infection is used to estimate infection risk in a range of environments, researchers generally assume complete air mixing and don’t consider either the stochastic effects in a small population or the proximity of susceptible people to an infectious source. This study presents stochastic simulations using the Wells-Riley model to evaluate the infection risk and variability among small populations such as hospital patients. This is linked with a simple multi-zone ventilation model to demonstrate the influence of airflow patterns and proximity to an infectious source on the risk of infection for an individual. The results also highlight that risk assessments made using data derived using complete mixing assumptions may significantly underestimate the real risk for those close to the infectious source

Modelling the air cleaning performance of negative air ionisers in ventilated rooms

Negative air ionisers have seen increasing use as devices for improving indoor air quality, including some success in clinical environments for reducing the transmission of infection. This study uses a ventilation model and a CFD model to examine the physical effects of negative ionisers in indoor environments. The results demonstrate how the negative ion distribution and electric field due to an ioniser are influenced by both the room airflow and the ion generation rate. It is shown that ion concentrations greater than 1010 ions/m3 are necessary for the electrical effects to be significant. The effect on particles is also considered, with the results demonstrating that the ioniser will only increase the deposition of particles when the particle concentration is high enough to contribute to the space charge in the room

Modelling the air cleaning performance of negative air ionisers in ventilated rooms

Negative air ionisers have seen increasing use as devices for improving indoor air quality, including some success in clinical environments for reducing the transmission of infection. This study uses a ventilation model and a CFD model to examine the physical effects of negative ionisers in indoor environments. The results demonstrate how the negative ion distribution and electric field due to an ioniser are influenced by both the room airflow and the ion generation rate. It is shown that ion concentrations greater than 1010 ions/m3 are necessary for the electrical effects to be significant. The effect on particles is also considered, with the results demonstrating that the ioniser will only increase the deposition of particles when the particle concentration is high enough to contribute to the space charge in the room

CFD modelling of transient pathogen release in indoor environments due to human activity

Certain routine hospital activities have been identified as a potential source for the airborne dispersal of micro-organisms. With increasing use of CFD to model hospital situations a method of modelling this type of spread within a simple steady state model is required. Since this type of dispersal will vary with space and time a single point source would not provide adequate information to represent these sources. Instead a zonal bioaerosol source is introduced to represent the time average of the varying release from the activity. In this paper, data from experiments conducted in a bioaerosol test chamber are compared to CFD results. Numerical validation is also carried out comparing the zonal source to an equivalent transient source. The results indicate that the zonal source provides excellent comparison to the time averaged behaviour of a moving source, but greatly underestimates the maximum value at any one location

CFD modelling of a hospital ward: Assessing risk from bacteria produced from respiratory and activity sources

It has been identified that potentially pathogenic acteria, such as MRSA can be released from the skin during routine activities within hospital wards, such as bed-making, washing patients, dressing and walking. CFD is often used to study airflow patterns and ventilation regimes within hospitals, however such models tend not to consider these types of dispersal mechanisms and concentrate on respiratory transmission, using a point source at the mouth position. A zonal source is demonstrated to represent this release from activity within CFD simulations using both passive scalar and Lagrangian particle tracking. Sensitivity studies are carried out for point and zonal sources. The point source was found to not adequately represent the release of bacteria from a zone and therefore the zonal source is recommended to be used in conjunction with this type of source in order to simulate both respiratory and activity sources of bacteria

The bactericidal effects of negative ions in air

The use of negative ions to improve indoor air quality has attracted increasing attention in recent years. Although the physical action of air ionisers is accepted, there is still debate over their apparent biocidal action. A recent clinical trial in an intensive care unit suggested that air ionisers may have a role in reducing the transmission of infection in healthcare environments1 and several authors have reported that ions inhibit the growth of a range of microorganisms. A further understanding of this process was gained through bench scale experiments exposing sessile cultures to positive and negative ions2. The aim of the work presented here was to follow on from the bench scale experiments to investigate the efficacy of negative ions with aerosolised microorganisms

Bactericidal action of positive and negative ions in air

In recent years there has been renewed interest in the use of air ionisers to control of the spread of airborne infection. One characteristic of air ions which has been widely reported is their apparent biocidal action. However, whilst the body of evidence suggests a biocidal effect in the presence of air ions the physical and biological mechanisms involved remain unclear. In particular, it is not clear which of several possible mechanisms of electrical origin (i.e. the action of the ions, the production of ozone, or the action of the electric field) are responsible for cell death. A study was therefore undertaken to clarify this issue and to determine the physical mechanisms associated with microbial cell death. In the study seven bacterial species (Staphylococcus aureus, Mycobacterium parafortuitum, Pseudomonas aeruginosa, Acinetobacter baumanii, Burkholderia cenocepacia, Bacillus subtilis and Serratia marcescens) were exposed to both positive and negative ions in the presence of air. In order to distinguish between effects arising from: (i) the action of the air ions; (ii) the action of the electric field, and (iii) the action of ozone, two interventions were made. The first intervention involved placing a thin mica sheet between the ionisation source and the bacteria, directly over the agar plates. This intervention, while leaving the electric field unaltered, prevented the air ions from reaching the microbial samples. In addition, the mica plate prevented ozone produced from reaching the bacteria. The second intervention involved placing an earthed wire mesh directly above the agar plates. This prevented both the electric field and the air ions from impacting on the bacteria, while allowing any ozone present to reach the agar plate. With the exception of Mycobacterium parafortuitum, the principal cause of cell death amongst the bacteria studied was exposure to ozone, with electroporation playing a secondary role. However in the case of Mycobacterium parafortuitum, electroporation resulting from exposure to the electric field appears to have been the principal cause of cell inactivation. The results of the study suggest that the bactericidal action attributed to negative air ions by previous researchers may have been overestimated

Use of CFD modelling to optimise the design of upper-room UVGI disinfection systems for ventilated rooms

The installation of upper-room ultraviolet germicidal irradiation (UVGI) devices in ventilated rooms has the potential to reduce transmission of infections by an airborne route. However, the performance of such devices is dependant on several factors including the location of the lamp and the ventilation airflow in the room. This study uses a CFD model to evaluate the performance of UVGI devices by considering the cumulative UV-C dose received by the bulk room air in a ventilated room. By evaluating the UV dose rather than the resulting micro-organism inactivation the methodology can be used to optimise UVGI systems at the design stage, particularly when the source location of bioaerosol contaminants is not known. The study investigates the relationships between the lamp location, lamp power, ventilation system and room heating in a small, ventilated room. The results show that with ventilation air supplied at low level and extracted at high level the UVGI system performs better than with the air supplied at high level and extracted close to the floor. In addition the results show the presence of a heater in the room is unlikely to have a detrimental effect on performance and may promote mixing to increase the extent of disinfection

Air ion behavior in ventilated rooms

Air ionizers have seen increasing use as devices for improving indoor air quality, including applications designed to reduce the transmission of infection in healthcare environments. However, little attention has been given to understanding and quantifying the physical behavior of ions in indoor air. This study presents experimental data and a theoretical model to examine the factors that influence the concentration of ions in a ventilated room. The results demonstrate how, with an ionizer in operation, the ion concentration is governed by ion—ion interactions and electrical deposition at the walls, with the ventilation rate having a minimal influence. The results also demonstrate that an ion concentration > 1010 ions · m x3 is necessary for these electrical effects to be significant, which has implications for the suitability of an ionizer for a particular location