Hillary Spicer of E-CO UK on why air conditioning and ventilation systems may be scuppering infection control in hospitals
Last month, the Sunday Express claimed compensation for victims of healthcare associated infections (HCAIs) has topped £10m in the past two years. Arguments surround this data, but what is becoming increasingly clear is that attention on infection rates, and how the NHS is managing infection control, remains significantly high and on the increase. HILLARY SPICER, founder and director of E-CO UK discussed the effect air conditioning systems may be having on these figures
Hospital trusts have made great strides in tackling infection control, but while the emphasis has largely remained on cleanliness of internal surfaces for breaking the chain of airborne transmission, there is a lack of acknowledgment of transmission through ventilation and air-conditioning systems, despite mounting evidence indicating a higher risk in spreading airborne infections.
To effectively tackle HCAIs, it is imperative that NHS trusts decontaminate the whole environment continuously 24/7and not just periodically, as they do now
Air quality in many buildings, including healthcare facilities, is worryingly poor and typically twice as polluted as it is outdoors. HCAIs are not just transmitted through cross-contamination via hard surfaces and floors, but also by airborne germs, through sneezing, and by round-the-clock movement of visitors, patients and staff as they are drawn into and distributed by heating, ventilation and air-conditioning (HVAC) systems. Hospital patients are typically much more susceptible to contracting infections due to diminished, disabled or compromised immune systems, and the ventilation systems in healthcare facilities are simply helping to further spread bacteria and infections.
To effectively tackle HCAIs, it is imperative that NHS trusts decontaminate the whole environment continuously 24/7and not just periodically, as they do now. This can be easily achieved by harnessing readily available Ultra Violet Germicidal Irradiation (UVGI) technology. Commonly used in hospital and commercial buildings across the USA, this simple technology retrofits into existing heating, ventilation and air conditioning systems. It significantly improves indoor air quality and reduces healthcare associated infections for patients and NHS professionals.
It seems to be a case of ‘out of sight, out of mind’ as the NHS has largely failed to tackle the questionable quality of air in hospitals and the spread of infection through ventilation systems
It achieves this by destroying thousands of airborne contaminants including fungal pathogens, viruses like Norovirus, that closes so many wards and results in cancelled operations, and bacteria such as MRSA, C.difficile and Ventilator Associated Pneumonia etc, regardless of type or virulence.
Indoor air quality is taken far more seriously across the world. During the SARs outbreak in 2003, the Chinese government standardised UVC technology for all public building and transportation systems because it is proven to intercept and kill viruses and bacteria before they infect people. But the UK has failed to follow suit.
It seems to be a case of ‘out of sight, out of mind’ as the NHS has largely failed to tackle the questionable quality of air in hospitals and the spread of infection through ventilation systems.
Research into the links is readily available. I have followed closely the work of Dr Ghasson Shabha, senior lecturer at the Birmingham School of the Built Environment. He has published extensively his findings on the link between unclean air conditioning systems and the spread of HCAIs and he believes it comes down to a change of culture.
The current short-term vision for tackling HCAIs will always backfire and this strategy is at the detriment of patient safety
He has said: “MRSA is a frequent component of hospital dust which can easily circulate through the air supply and return via ventilation systems, and this poses a major risk of cross infection. The current short-term vision for tackling HCAIs will always backfire and this strategy is at the detriment of patient safety. The loss of one life is too many when you consider the hazardous conditions posed by dirty ducting and AHU and grills.”
Perhaps, as well as culture, there is a concern over costs. But this technology could, in fact, provide critical cost savings in other areas. Hospitals and healthcare facilities are the second most energy-intensive building sectors in the UK, open 24 hours a day and with an extra commitment on air filtration and circulation and air cooling. Energy savings should be a top priority for the NHS and UVC technology delivers a second major benefit reducing energy consumption of HVAC systems by 15-20%, as well as significantly reducing HVAC maintenance costs. A trial with an NHS trust, where UVC light emitters were fitted into an existing HVAC system, showed a return on investment in just one year on energy savings alone.
The results speak for themselves and I believe these systems should be installed in every air conditioning unit in every building in the UK. The technology and products are tried and tested and available to help, not only in the fight against HCAIs, but to reduce operating costs. NHS trusts simply cannot afford to continue ignoring this costly issue. With 2013 being the European Year of Air, there’s never a better time to address it.