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评估天花板通风模拟空气传播感染隔离病房在预防医院获得性流感传播给医护人员方面的有效性。

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

作者信息

Thatiparti Deepthi Sharan, Ghia Urmila, Mead Kenneth R

机构信息

Doctoral candidate, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH.

Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH.

出版信息

ASHRAE Trans. 2016;122(2):35-46.

Abstract

Exposure to airborne influenza (or ) 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.

摘要

接触患者咳嗽和呼出气体中的空气传播性流感(或 )会导致流感病毒潜在地传播给附近的人。医院获得性流感是医护人员(HCW)易患的一种主要空气传播疾病。本文研究了在天花板通风的模拟空气传播感染隔离病房(AIIR)中的气流模式和流感感染咳嗽气溶胶传输行为,以及其在减轻医护人员暴露于空气传播感染方面的有效性。使用房间几何形状和布局(房间尺寸、浴室尺寸及细节、通风口和家具的位置)、通风参数(进风口和出风口的流量、扩散器设计、热源等)以及与现有医院中观察到的传统天花板式通风布置相对应的增压情况,对模拟AIIR中的气流模式和流感病毒扩散行为进行了计算流体动力学(CFD)分析。测量数据表明,AIIR的通风率约为每小时12次换气(ach)。然而,数值结果显示空气混合不完全,并非所有房间空气每小时都能更换12次。使用两个真人大小的呼吸人体模型来模拟源患者和接收医护人员。将患者咳嗽周期引入模拟,并使用多相流模拟方法及时跟踪空气传播感染的扩散。结果揭示了空气再循环区域,这些区域削弱了空气过滤的效果,并延长了流感污染空气在医护人员区域的存在时间。患者咳嗽后立即(0.51秒), 患者口腔咳出速度将咳嗽气溶胶吹向站在病床旁的医护人员。在0.7秒内,医护人员有感染流感疾病的风险,因为这些气溶胶的一部分被医护人员吸入。随着时间推移(5秒),气溶胶最终随着AIIR气流模式扩散到整个房间, 随后,这些气溶胶的一部分被排气通风排出。然而,剩余的咳嗽气溶胶重新进入并在医护人员区域再循环,直到被排气通风排出。由于向医护人员区域供应新鲜空气,感染性气溶胶在10秒内会在医护人员区域被稀释。记录房间内流感感染的总持续时间(直到气溶胶数量减少到患者口腔喷出的气溶胶总数的0.16%以下)约为20秒。随着连续咳嗽事件的发生,可能会出现近乎持续的暴露。因此,模拟AIIR的天花板通风布置在医护人员在房间停留的整个期间为其创造了一个不利的环境,并且模拟的AIIR通风在保护医护人员免受感染性咳嗽气溶胶方面无效。CFD结果表明,AIIR天花板通风布置在影响流感病毒传播给医护人员方面具有重要作用。

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本文引用的文献

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Flow dynamics and characterization of a cough.咳嗽的流动动力学和特征。
Indoor Air. 2009 Dec;19(6):517-25. doi: 10.1111/j.1600-0668.2009.00619.x. Epub 2009 Jul 31.
4
Reintroduction of influenza A to a nursing building.甲型流感病毒在一座护理楼中的再次出现。
Infect Control Hosp Epidemiol. 2000 Nov;21(11):732-5. doi: 10.1086/501715.
6
An outbreak of influenza A in a neonatal intensive care unit.新生儿重症监护病房甲型流感暴发。
Infect Control Hosp Epidemiol. 2000 Jul;21(7):449-54. doi: 10.1086/501786.
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Influenza control in acute care hospitals.急性护理医院中的流感防控
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