Heating and Ventilation Systems

Heating and ventilation systems
Health Technical Memorandum

03-01: Specialised ventilation for
healthcare premises
Part A: Design and validation
DH INFORMATION READER BOX
Policy Estates
HR / Workforce Performance
Management IM & T
Planning Finance
Clinical Partnership Working
Document Purpose Best practice guidance

ROCR Ref: 0 Gateway Ref: 8949
Title Health Technical Memorandum 03-01: Specialised ventilation for
healthcare premises. Part A - Design and installation
Author Department of Health / Estates and Facilities Division
Publication Date November 2007
Target Audience PCT CEs, NHS Trust CEs, SHA CEs, Care Trust CEs, Foundation
Trust CEs , PCT PEC Chairs, NHS Trust Board Chairs, Special HA
CEs
Circulation List Department of Health libraries, House of Commons library,

Strategic Health Authorities, UK Health Departments, Directors of
Estates and Facilities,
Description The document gives comprehensive advice and guidance to

healthcare management, design engineers, estates managers and
operations managers on the legal requirements, design implications
and maintenance of specialised ventilation in all types of healthcare
premises.
Cross Ref N/A

0
Superseded Docs Health Technical Memorandum 2025
0
Action Required N/A
0
Timing N/A
Contact Details Ken Holmes
Department of Health/Estates and Facilities Division
Quarry House, Quarry Hill
Leeds
LS2 7UE
email: ken.holmes@dh.gsi.gov.uk
0
0
For Recipient's Use
Heating and ventilation systems
Health Technical Memorandum 03-01:
Specialised ventilation for healthcare premises
Part A: Design and validation
London: The Stationery Office

Heating and ventilation systems – HTM 03-01: Specialised ventilation for healthcare premises – Part A
Published by TSO (The Stationery Office) and available from:

Online
www.tsoshop.co.uk
Mail, Telephone, Fax & E-mail
TSO
PO Box 29, Norwich NR3 1GN
Telephone orders/General enquiries 0870 600 5522
Fax orders 0870 600 5533
E-mail customer.services@tso.co.uk
Textphone 0870 240 3701
TSO Shops
16 Arthur Street, Belfast BT1 4GD
028 9023 8451 Fax 028 9023 5401
71 Lothian Road, Edinburgh EH3 9AZ
0870 606 5566 Fax 0870 606 5588
TSO@Blackwell and other Accredited Agents
© Crown copyright 2007

Published with the permission of the Estates and
Facilities Division of the Department of Health,
on behalf of the Controller of Her Majesty’s Stationery Office.
This document/publication is not covered by the HMSO
Click-Use Licences for core or added-value material. The paper used in the printing of this document
If you wish to re-use this material, please send your application (Greencoat Velvet) is produced in a mill that has obtained
to: both ISO 9001 and ISO 14001 accreditations, which
means that all responsibilities to the local environment and
Copyright applications manufacturing processes are strictly monitored. Greencoat
The Copyright Unit Velvet boasts the following environmental credentials:
OPSI
St Clements House • 80% recycled post-consumer fibre
2–16 Colegate • 10% TCF (Totally Chlorine Free) virgin fibre
Norwich NR3 1BQ
• 10% ECF (Elemental Chlorine Free) fibre
ISBN 978-0-11-322805-8
• FSC certification
First published 2007
• NAPM recycled certification
Printed in the United Kingdom for The Stationery Office
ii
Preface
About Health Technical Memoranda main source of specific healthcare-related guidance for
estates and facilities professionals.
Engineering Health Technical Memoranda (HTMs)
give comprehensive advice and guidance on the design, The core suite of nine subject areas provides access to
installation and operation of specialised building and guidance which:
engineering technology used in the delivery of healthcare. • is more streamlined and accessible;
The focus of Health Technical Memorandum guidance • encapsulates the latest standards and best practice in
remains on healthcare-specific elements of standards, healthcare engineering;
policies and up-to-date established best practice. They are
applicable to new and existing sites, and are for use at • provides a structured reference for healthcare
various stages during the whole building lifecycle. engineering.
Figure 1 Healthcare building life-cycle
DISPOSAL CONCEPT
RE-USE
DESIGN & IDENTIFY
OPERATIONAL OPERATIONAL
MANAGEMENT REQUIREMENTS
Ongoing SPECIFICATIONS
MAINTENANCE TECHNICAL & OUTPUT
Review
PROCUREMENT
COMMISSIONING
CONSTRUCTION
INSTALLATION
Healthcare providers have a duty of care to ensure that Structure of the Health Technical
appropriate engineering governance arrangements are in Memorandum suite
place and are managed effectively. The Engineering
Health Technical Memorandum series provides best The series of engineering-specific guidance contains a
practice engineering standards and policy to enable suite of nine core subjects:
management of this duty of care. Health Technical Memorandum 00
It is not the intention within this suite of documents to Policies and principles (applicable to all Health
unnecessarily repeat international or European standards, Technical Memoranda in this series)
industry standards or UK Government legislation. Where Health Technical Memorandum 01
appropriate, these will be referenced. Decontamination
Healthcare-specific technical engineering guidance is a Health Technical Memorandum 02
vital tool in the safe and efficient operation of healthcare Medical gases
facilities. Health Technical Memorandum guidance is the
iii
Health Technical Memorandum 03 Electrical Services – Electrical safety guidance for low
Heating and ventilation systems voltage systems
Health Technical Memorandum 04 In a similar way Health Technical Memorandum 07-02
Water systems will simply represent:
Health Technical Memorandum 05 Environment and Sustainability – EnCO2de.
Fire safety
All Health Technical Memoranda are supported by the
Health Technical Memorandum 06 initial document Health Technical Memorandum 00
Electrical services which embraces the management and operational policies
from previous documents and explores risk management
Health Technical Memorandum 07
issues.
Environment and sustainability
Some variation in style and structure is reflected by the
Health Technical Memorandum 08
topic and approach of the different review working
Specialist services
groups.
Some subject areas may be further developed into topics
DH Estates and Facilities Division wishes to acknowledge
shown as -01, -02 etc and further referenced into Parts A,
the contribution made by professional bodies,
B etc.
engineering consultants, healthcare specialists and
Example: Health Technical Memorandum 06-02 Part A NHS staff who have contributed to the review.
will represent:
Figure 2 Engineering guidance

FIC DOC
H SPECI UM
L T EN
A TS
HE
HTM 08
HTM 01
Specialist
Services Decontamination
S T R Y S TA N D A
DU RD
IN S
& EUROPEAN
NAL ST
HTM 07
IO HTM 02
T
AN
NA
Environment & Medical

DA
H E A LT H S P E
INTER
CUMENTS
Sustainability Gases
RDS
HTM 00
RDS
INTER
Policies and
Principles
DA
NA
AN
IO
ST
T
NA
DO
HTM 06 L& N HTM 03

Electrical
IN EUROPEA S Heating &
DU D
C
Services STR AR Ventilation

IF I
IC
Y S TA N D Systems
IF
C
EC
D
HTM 05 HTM 04
O
Fire
SP
U Water
C
M Safety Systems H
EN T
TS AL
HE
iv
Executive summary
Preamble Main changes from Health Technical

Health Technical Memorandum 03-01 – ‘Specialised Memorandum 2025
ventilation in healthcare premises’ is published in two This Health Technical Memorandum has been revised to
parts: Part A deals with the design and installation of reflect the current guidance on theatre suite layout and
ventilation systems; Part B covers operational room sizes given in Health Building Note 26, Volume 1
management. – ‘Facilities for surgical procedures’, including the
The document gives comprehensive advice and recommended air-change rates.
guidance on the legal requirements, design implications,
maintenance and operation of specialised ventilation in Other key issues
all types of healthcare premises. • It addresses the issues relating to patient comfort and
The guidance contained in this Health Technical the prevention and control of healthcare-associated
Memorandum applies to new installations and major infections. Specialised ventilation systems play a
refurbishments of existing installations. central role in these important areas.
Health Technical Memorandum 03-01 supersedes all • It looks at the methods of controlling the casual
previous versions of Health Technical Memorandum exposure of staff to anaesthetic substances.
2025 – ‘Ventilation in healthcare premises’. • It outlines the design and acceptance testing of general
and ultra-clean ventilation (UCV) systems.
Who should use this guidance?
• It sets out the minimum requirements for the design
This document is aimed at healthcare management, of air-handling units with regard to the control of
design engineers, estates managers and operations Legionella and safe access for routine inspection and
managers. maintenance.
v
Acknowledgements
Malcolm Thomas – Consulting Engineer – Lead Author University of Leeds

CIBSE Healthcare Group
Principal contributors
IMechE/ASHRAE
Craig Macintosh – Principal Clinical Scientist – Wirral
Hospitals NHS Trust IHEEM
Andy McGrath – BSRIA Instrument Solutions HEFMA
Helen & Philip Sturdy – DSSR consultancy BSI
Richard Gatley – Apreco Faber Maunsell consultancy
Russell Pitman – Henderson Green consultancy Couch Perry Wilkes consultancy
Kevin Reynolds – Deputy Head of Estates – Sandwell DSSR consultancy

and West Birmingham NHS Trust Howorth Airtech
Ian Fraser – Department of Health Medical Air Technology/Thermo Electric
BPG Medical
Main Steering Group and Working
Groups comprising representatives Admeco/Trumpf Medical Systems
from: Volkes SPX
Department of Health Weiss Klimatechnik
Welsh Health Estates Sound Research Laboratories
NHS in Scotland NHS Security Management Service
Health & Social Services, Northern Ireland Pennine Acute NHS Trust
Health Protection Agency (HPA) Hospital Infection Society (HIS)
Building Research Establishment (BRE) Central Sterilising Club
Building Services Research and Information Association HEVAC – Air-handling Unit Manufactures Group
(BSRIA)
vi
Contents
Preface
Executive summary
Acknowledgements
Chapter 1 Introduction 1
Preamble
Ventilation in healthcare premises
Reasons for ventilation
Ventilation – application examples
Statutory requirements
Health and Safety at Work etc Act 1974
COSHH
Fire regulations
Plants installed in units manufacturing medicinal products
Plants installed in laboratories
Codes of practice and other guidance
Design and validation process
Ventilation – terms in use
Ventilation
Air-conditioning
Specialised ventilation
Local exhaust ventilation
Chapter 2 Provision of ventilation in healthcare buildings 8
Natural ventilation
Extract ventilation systems
Supply-only ventilation
Supply and extract ventilation
Comfort cooling
Air-conditioning
Ventilation for general areas
Acceptable methods
Use of natural ventilation
Mixed mode ventilation
Mechanical extract ventilation
Mechanical supply systems
Balanced ventilation
Cascade ventilation
Recirculation systems
Chilled beams
Split comfort air-conditioners
Dilution ventilation and clean air-flow paths
Mechanical ventilation systems
System selection
vii
Choice of central/local plant

Zoning of the building
Chapter 3 Assessment of service requirement 13
Selection of design criteria
External design conditions
Internal design conditions
Minimum fresh-air requirements
Limiting supply air conditions
Air purity
Humidity control requirements
Noise levels
Calculation of building loads
Air infiltration
Summertime temperatures
Peak heating load
Condensation risk
Peak cooling load
Annual energy consumption
Calculation of plant requirements
Air-supply volumes
Plant sizing
Plantroom size and location
Provision of primary services
Inlet and discharge sizing and location
Heat-rejection devices
Chapter 4 Air-handling unit design and specification guidance 18
General requirements
Location and access
Technical requirements
AHU drainage system
Layout of AHU
Provision of dampers
Vibration
Sequence of components
Fans
Acceptable types
Selection
Location and connection
Supply fan drive arrangements
Extract fan drive arrangements
Control
Heater-batteries
Acceptable types
Location
Control
Cooling coils
Selection
Location
Control
Humidifiers
viii
Contents
Design need
Acceptable types
Selection
Location
Control
Filtration
Definition of filter terms
Selection
Location
Control
Energy recovery
Location
Control
Attenuation
Acceptable types and location
Chapter 5 Air distribution system 31
Air distribution arrangements
Ductwork distribution systems
Ductwork materials and construction
Fire aspects, damper types and locations
Duct sections
Standard ductwork fittings
Thermal insulation
Noise generation within the ductwork
Volume control damper locations
Cleaning and access door locations
Flexible ducting
Diffuser and grille selection and sizing
Transfer grille – size and location
Pressure stabilisers – size and location
Chapter 6 Automatic controls 37
Objectives of the control system
Location of controls
Fire aspects
Time switching
Start-up control
Set-back control
Use control
Environmental control
Temperature control methods and application
Humidity control methods and application
Multi-zone control methods and application.
Alarms and indication
Chapter 7 Specialised ventilation systems 45
General information
Air-movement control
Temperature and humidity control
Removal and dilution of waste anaesthetic gases
ix
Fire aspects
Door protection
Systems design
Operating department ventilation systems
General
Fire aspects
Door protection
Standard air-movement control schemes
Air terminals and air distribution within rooms
Automatic control
Ventilation of operating department ancillary areas
Reception
Sterile pack bulk store
Recovery
Ultra-clean ventilation systems
Types of UCV system
Filters
Noise level
Lighting and operating lights
Controls and instrumentation
Extract systems
Hood extract systems
Bench extract systems
Safety cabinet and fume-cupboard extract systems
Plantroom ventilation
Assessment of ventilation levels
Choice of ventilation system
Ventilation of hydrotherapy suites
Control of hydrotherapy pool installations
Chapter 8 Validation of specialised ventilation systems 66
Definitions
Commissioning
Location of dampers and test holes
Commissioning personnel
Commissioning brief
Pre-commissioning checks
Standard of installation
Cleanliness of installation
Certification of equipment
Equipment tests
Dynamic commissioning
Air-handling and distribution system
Room-air distribution
Air-conditioning plant
Control system
Specific performance standards
Air movement
Plant capacity and control
Noise levels – general
Filter challenge
x
Contents
Bacteriological sampling
Ventilation system commissioning/validation report
Validation of UCV operating suites
General
Basic requirement
UCV unit validation procedure
Test and measuring conditions
Test and measuring equipment
Test grid – vertical units
Test grid – horizontal units
UCV terminal challenge tests (vertical and horizontal systems)
Vertical UCV terminal air velocity tests
Horizontal UCV terminal air velocity test
UCV entrainment test (vertical systems only)
UCV visualisation
UCV noise level
UCV control system checks
UCV theatre microbiological tests
UCV validation report
General
Air intake
Damper
Ducting
Fan
Attenuator/silencer
Filter
Appendix 1 Use and function of typical equipment used in ventilation systems 81
Heater coil/battery
Humidifier
Chiller battery/cooling coil
Eliminator
Drainage system
Access doors and observation ports
Energy recovery
Typical plant
Appendix 2 Recommended air-change rates 83
Appendix 3 Hierarchy of cleanliness 84
Appendix 4 Leakage flows in m3/s through closed door gaps 85
Appendix 5 Recommended air-flow rates in m3/s through a doorway between rooms of different
cleanliness to control cross-contamination 86
Appendix 6 Typical approximate pressures in an operating suite when a given door is open 87
Appendix 7 Operating suites standard design solutions 88
Appendix 8 Design of air-movement control schemes for operating theatres 97
General
Peripheral room type
Single flow
Parallel multi-flow
Parallel/series multi-flow
Series multi-flow (unbalanced)
Series multi-flow (balanced)
Bay
Air-movement control in peripheral rooms
Single flow rooms
xi
Parallel multi-flow rooms

Parallel-series multi-flow rooms
Series multi-flow (unbalanced)
Bay
Operating room
Corridors
Door opening
Transfer grilles
Pressure-relief dampers
Pressure stabilisers
Door leakage flows
Room temperature estimation
Relief of excess air from operating room when all doors are closed
By transfer devices via the anaesthetic room
By pressure stabilisers to the corridor
References 118
Acts and regulations
British Standards
Department of Health publications
Chartered Institution of Building Services publications
Heating & Ventilating Contractors’ Association (HVCA) publications
Other publications
xii
1 Introduction
Preamble Reasons for ventilation

1.1 Health Technical Memorandum 03-01 – The Building Regulations require that all enclosed
‘Specialised ventilation in healthcare premises’ is workspaces be ventilated by either natural or
published in two parts: Part A deals with the design mechanical means. The following are some of the
and installation of ventilation systems; Part B factors that determine the ventilation requirements of
covers operational management. a workspace:
1.2 The document gives comprehensive advice and • human habitation (minimum fresh-air
guidance to healthcare management, design requirement);
engineers, estates managers and operations
managers on the legal requirements, design • the activities of the department, that is, extraction
implications, maintenance and operation of of odours, aerosols, gases, vapours, fumes and dust
specialised ventilation in all types of healthcare – some of which may be toxic, infectious, corrosive,
premises. flammable, or otherwise hazardous (see the Control
of Substances Hazardous to Health (COSHH)
1.3 The guidance contained in this Health Technical Regulations);
Memorandum applies to new installations and
major refurbishments of existing installations. • dilution and control of airborne pathogenic
material;
1.4 Health Technical Memorandum 03-01 supersedes
all previous versions of Health Technical • thermal comfort;
Memorandum 2025 – ‘Ventilation in healthcare • the removal of heat generated by equipment
premises’. (for example catering, wash-up, sterilizing areas,
electrical switchrooms, and some laboratory areas);
Ventilation in healthcare premises
• the reduction of the effects of solar heat gains;
1.5 Ventilation is used extensively in all types
of healthcare premises to provide a safe and • the reduction of excessive moisture levels to prevent
comfortable environment for patients and condensation (for example hydrotherapy pools);
staff. More specialised ventilation is provided in • combustion requirements for fuel burning
primary patient treatment areas such as operating appliances;
departments, critical care areas and isolation units.
• “make-up supply air” where local exhaust
1.6 It is also installed to ensure compliance with quality ventilation (LEV) etc is installed.
assurance of processed items in pharmacy and
Mechanical ventilation systems are expensive in terms
sterile services departments, and to protect staff
of capital and running costs, and planning solutions
from harmful organisms and toxic substances (for
should be sought which take advantage of natural
example in laboratories).
ventilation, provided the above criteria are met.
1.7 The sophistication of ventilation in healthcare
premises is increasing. Patients and staff have a
right to expect that it will be designed, installed,
operated and maintained to standards that will
enable it to fulfil its desired functions reliably and
safely.
1
Ventilation – application examples

Requirement Reason Application
Statutory Health and Safety at Work etc Act Operating departments
COSHH Regulations Laboratories
Local exhaust ventilation (LEV) Pharmacies
Areas containing identified biological or chemical hazards
Areas containing oxygen-displacing gases
Enclosed workspaces
Workshops
Functional Comfort Situations where the quality of the environment for staff
and patients is critical to their general performance and
well-being
Clinical Reduction of surgical site infection Ultra-clean operating suites, conventional operating
suites and treatment rooms used for all types of surgical
procedures
Obstetrics and maternity procedures
Source and protective isolation Isolation units for patients who present a biological,
chemical or radiation hazard to others
Isolation units for patients with a reduced immune system
prevent contamination, closely control the

Statutory requirements environment, dilute contaminants or contain
Increased health risks to patients will occur if hazards, their very presence indicates that potential
ventilation systems do not achieve and maintain the risks to health have been identified.
required standards. The link between surgical site
infection and theatre air quality has been well COSHH
established. Plants serving a conventional operating 1.9 The Control of Substances Hazardous to
department, for instance, will be required to ensure the Health (COSHH) Regulations 2002 place upon
separation of areas within the suite by maintaining a management an obligation to ensure that suitable
specific direction of air flow between rooms, even measures are in place to protect their staff and
when doors are opened. They will also maintain the others affected by the work activity. These methods
selected operating department’s environmental may include both safe systems of work and the
conditions regardless of changes in outside air provision of a specialised ventilation system. In
conditions or activities within the space. laboratories the requirements are often met by the
In addition, ultra-clean ventilation systems (which are provision of fume cupboards and microbiological
designed to provide a zone around the patient that is safety cabinets.
effectively free of bacteria-carrying airborne particles 1.10 The requirements to provide ventilation, implicit
while the operation is in progress) have been shown to under the Health and Safety at Work etc Act 1974
significantly reduce surgical site infection in patients and COSHH, have been made explicit by the
undergoing large joint replacement surgery. Their use Management of Health and Safety at Work
for other forms of surgery may well be indicated. Regulations 1999, the Workplace (Health, Safety
and Welfare) Regulations 1992 and the Provision
and Use of Work Equipment Regulations 1998,
Health and Safety at Work etc Act 1974
all issued as a result of European Directives.
1.8 The Health and Safety at Work etc Act 1974
1.11 Where specialised ventilation plant is provided as
is the core legislation that applies to ventilation
part of the protection measures, there is a statutory
installations. As these installations are intended to
requirement that it be correctly designed, installed,
2
1 Introduction
commissioned, operated and maintained. The local Commission’s Health Services Advisory Committee
exhaust ventilation (LEV) section of COSHH in:
requires that the plant be inspected and tested at
• ‘Safe working and the prevention of infection in
least every 14 months by a competent person and
clinical laboratories and similar facilities’;
that management maintain comprehensive records
of its performance, repair and maintenance. • ‘The management, design and operation of
microbiological containment laboratories’.
1.12 Certain substances have workplace exposure limits
(WELs) set out in the Health and Safety Executive’s
(2005) Guidance Note EH40 – ‘Workplace
Note
exposure limits: containing the list of workplace If the ventilation plant has been installed to dilute or
exposure limits for use with the Control of contain harmful substances (the definition of which
Substances Hazardous to Health Regulations 2002 now includes microorganisms), its failure may expose
(as amended)’. If specialised ventilation systems are people to unacceptable levels of hazard. Proven failures
provided in order to achieve these standards, they can give rise to a civil suit against the designers and
will be subject to the COSHH Regulations as operators by the individuals who have been affected.
above. This would be in addition to the actions brought as a
result of breaching the statutory requirements.
Fire regulations
1.13 The fire regulations require that, if ventilation Codes of practice and other guidance
ductwork penetrates the compartment or
subcompartment of a building, it should be 1.17 All ventilation systems should conform to
designed and installed so as to contain the spread of the principles set out in the Health and Safety
fire (see Health Technical Memorandum 05-02 – Commission’s Approved Code of Practice and
‘Guidance in support of functional provisions for guidance document ‘Legionnaires’ disease: the
healthcare premises’ for further guidance). control of Legionella bacteria in water systems’
(commonly known as L8), and Health Technical
Plants installed in units manufacturing medicinal Memorandum 04-01 – ‘The control of Legionella,
products hygiene, “safe” hot water, cold water and drinking
water systems’.
1.14 Plants installed in units manufacturing medicinal
products to the standards set out in the current 1.18 The Department of Health publication
European guide to good manufacturing practice ‘The Health Act 2006: code of practice for the
(http://ec.europa.eu/enterprise/pharmaceuticals/ prevention and control of healthcare associated
eudralex/homev4.htm) may also be subject to infections’ is a code of practice that has been
particular legislation with regard to their operation brought out to help NHS bodies to plan and
in addition to that mentioned above. implement how they can prevent and control
healthcare-associated infections. It sets out criteria
1.15 Records should be kept of equipment design and by which managers of NHS organisations are
commissioning information. The Health and Safety to ensure that patients are cared for in a clean
Executive, Medicines Inspectorate and other environment and where the risk of healthcare-
interested bodies have a statutory right to inspect associated infections is kept as low as possible.
them at any time. All records should be kept for at Specialised ventilation systems often play a central
least five years. role in achieving this objective.
Plants installed in laboratories This document deals with the healthcare-specific
1.16 Specialised ventilation plants installed in aspects of ventilation. Basic information on the design,
laboratories dealing with research, development installation, commissioning and testing of ventilation
or testing, whether involving drugs, animals or systems is contained in documents produced by the
genetically modified organisms, may be subject to following (see the References section):
particular legislation with regard to their operation • the Chartered Institute of Building Services
in addition to that mentioned above. Further Engineers (CIBSE);
information is given by the Health & Safety
3
• International and British Standards (ISO and Design and validation process
BS EN); 1.19 It is essential, when undertaking the design of a
• the Building Services Research and Information specialised ventilation system, that the project be
Association (BSRIA); considered as a whole. The process model set out in
Table 1 should ensure that all relevant factors are
• trade associations such as the Heating and considered.
Ventilating Contractors’ Association (HVCA).
Table 1 Design and validation process model

Step Question Design statement and information required Comment
1 Why is the system required? Healthcare applications
Statutory elements
Non-healthcare applications
2 What is the required system performance? Room air-flow pattern
Air-change rate
Differential pressures
Air quality
Room air-condition
Noise limits
3 What are the constraints on the distribution Ducts:
system? Location, size, materials
Dampers, access, insulation
Fire considerations
Room terminals
4 What are the minimum requirements for the Intake/discharge positions
air-handling units (AHUs)? Legionella, health and safety
Access, fire, electrical safety
Leaks, insulation, cleanliness
Filtration, drainage
5 What control functions are required? User control requirements
Estates control functions
Energy management
Environmental conditions
Control sequence logic
Run, set-back, Off philosophy
6 How will the system performance be Validation methodology
validated? Instruments used
Design information required:
• design air-flow rates
• design air velocities
• pressure differentials
• noise levels
• air quality
• installation standard
7 The system will only be acceptable to the client if at the time of validation it is considered fit for purpose and will only
require routine maintenance in order to remain so for its projected life.
8 Handover to client1 Basic design information
Commissioning results
Validation report
Note: 1. W
hen new ventilation systems are accepted for use, full information as to their designed mode of operation together
with recommended maintenance procedures should be provided as part of the handover procedure
4
1 Introduction
Ventilation – terms in use e. to provide close control of temperature;

1.20 The terms “ventilation” and “air-conditioning” are f. to provide close control of humidity.
often used interchangeably to describe the same 1.26 The following departments will usually have
equipment. A general explanation of the terms is specialised ventilation requirements, either for a
given below. single room or throughout a suite of rooms:
Ventilation a. operating department;
1.21 Ventilation is a means of removing and replacing b. laser surgery unit;
the air in a space. In its simplest form this may be c. operative imaging unit;
achieved by opening windows and doors.
d. intensive treatment unit;
1.22 Mechanical ventilation systems provide a more
controllable method. Basic systems consist of a e. infectious diseases isolation unit;
fan and collection or distribution ductwork; more f. wards housing immunocompromised patients;
complex systems may include the ability to heat
and filter the air passing through them. g. manufacturing pharmacy;
1.23 Ventilating equipment may be required in order to h. specialised imaging, X-ray and scanning unit;
remove smells, dilute contaminants and ensure that j. pathology containment laboratories;
a supply of fresh air enters a space.
k. mortuary and dissection suite;
Air-conditioning m. research laboratories;
1.24 Air-conditioning is the ability to heat, cool, n. sterile services department;
dehumidify and filter air. For full air-conditioning,
p. emerging treatment technologies, including
humidification may also be provided. This means
gene therapy and stem cell units.
that the climate within a space being supplied by
an air-conditioning plant can be maintained at a 1.27 Ventilation may be provided in a wide variety of
specific level regardless of changes in outside air ways. These will include:
conditions or the activities within the space. Air-
• extensive purpose-built air-handling units
conditioning equipment may be required in order
housed in their own plantrooms;
to provide close control of “comfort conditions”
within a space. • proprietary “packaged” systems often sited
outside on a roof; or
• wall-mounted electric fans located at the point
1.25 In healthcare premises, certain activities will of use.
necessitate the provision of ventilation equipment
1.28 A fixed volume of air may be supplied, often
with additional special features in order to achieve
expressed in terms of the resulting number of air
and maintain specific conditions. These may be
changes per hour (ac/h), within the space being
needed in order to assist with the treatment of
ventilated. Alternatively the volume of air supplied
patients or maintain the health and safety of staff.
may be varied in order to maintain a specific
The precise reason for providing specialised
pressure relationship between the area supplied
ventilation will depend upon the intended
and other surrounding areas. In some situations
application. The list below indicates some of the
a combination of both methods may be adopted.
more typical reasons:
1.29 Modern plants should be fitted with the means to
a. to remove, contain or dilute specific
recover energy from the extract air without causing
contaminants and fumes;
contamination of the incoming supply air.
b. to ensure the isolation of one space from
1.30 Ultra-clean systems use the same basic plant and
another;
equipment as standard air-conditioning systems,
c. to preserve a desired air-flow path from a clean but are in addition fitted with a terminal device
to a less clean area; that supplies the air in a unidirectional manner to
the working area. Their standard of filtration will
d. to provide control of the cleanliness of a space;
5
be capable of delivering air with a very low particle 1.34 In laboratories, pharmaceutical manufacturing
count to the space that they serve. facilities and operating suites, LEV systems usually
take the form of semi-open-fronted cabinets within
Local exhaust ventilation which the hazardous substance is manipulated.
These cabinets either have their own filtered air
1.31 Local exhaust ventilation (LEV) is a term used to
supply or are fed with air from the room. The
describe systems installed to prevent hazardous
air extracted from the cabinet is passed through
substances from entering the general atmosphere
a high-efficiency filter before being discharged
of the room in which they are being used. Their
either to the atmosphere or back into the room.
primary function is to protect staff from the effects
Microbiological safety cabinets, laboratory fume
of their work activity.
cupboards, cytotoxic drug cabinets and fixed or
1.32 Simple LEV systems comprise a receptor or capture mobile disinfection enclosures are all examples of
hood, extract ductwork and a fan. These are used to this type of facility.
contain industrial types of hazard such as fumes
1.35 Mortuaries and dissection suites may have LEV
from welding processes, gas discharges from
systems incorporated within the dissection table,
standby battery banks and dust from woodworking
specimen bench and bone saw.
machinery.
1.36 The layout of a typical plant that conforms to the
1.33 The vapour given off when large quantities of
regulations for healthcare applications is shown in
chemicals are decanted into ready-use containers
Figure 1. For an explanation of the equipment used
and fumes from X-ray film processing units are
in the diagram, see Appendix 1.
examples of chemical hazards often controlled by
LEV systems.
6
Figure 1 Example of a typical operating theatre ventilation system
Energy
Primary recovery Chiller & Heater
MD filter device eliminator battery VC D
Intake
Attenuator Attenuator
Fog Supply fan & Secondary
coil blast plate filter
Drainage
FD
system
Trimmer
battery
Pressure
Operating room Anaesthetic room stabiliser
Lay up
prep room
Corridor
Extract Extract
1 Introduction
7
2 P
rovision of ventilation in healthcare
buildings
2.1 Planning constraints caused by a building’s shape (of a design that facilitates natural ventilation)
and/or the functional relationships of specific areas should be provided.
will invariably result in some measure of deep
planning, thus reducing the opportunity for natural Note
ventilation.
If natural ventilation is “single-sided”, it will usually
2.2 However, ventilation costs can be minimised by only be effective for a three-metre depth within the
ensuring that, where practicable, core areas are space. Beyond that it will need to be supplemented by
reserved for those rooms that need to have mixed-mode or forced ventilation.
mechanical ventilation. Examples are:
• sanitary facilities, dirty utilities and those rooms 2.7 Current guidance restricts the opening of windows
where clinical or functional requirements have for safety reasons; also, as many designs are top-
specific environmental needs; and hung, their ability to permit natural ventilation is
limited. It may therefore be necessary to provide
• those rooms where – for reasons of privacy, dedicated ventilation openings in the fabric of the
absence of solar gain etc – windowless building to allow a sufficient natural flow of air
accommodation is acceptable. into and out of the space.
2.3 Other spaces appropriate to core areas are those 2.8 In all cases, excessive heat gain, indoor air-quality
which have only transient occupation and therefore requirements or external noise may limit or
require little or no mechanical ventilation (for preclude the use of natural ventilation.
example circulation and storage areas).
2.9 Detailed guidance on natural ventilation can be
found in CIBSE’s (2005) Applications Manual
Natural ventilation AM10 – ‘Natural ventilation in non-domestic
2.4 Natural ventilation is usually created by the effects buildings’.
of wind pressure. It will also occur if there is a
temperature difference between the inside and the Extract ventilation systems
outside of a building. The “thermo-convective”
effect frequently predominates when the wind 2.10 Extract ventilation is required in sanitary facilities,
speed is low, and will be enhanced if there is a dirty utilities and rooms where odorous but
difference in height between inlet and outlet non-toxic fumes are likely; this is to ensure air
openings. movement into the space. A single fan/motor unit
should be provided to meet this need. There is no
2.5 Ventilation induced by wind pressures can induce healthcare requirement to provide a separate foul/
high air-change rates through a building, provided dirty extract system.
air is allowed to move freely within the space from
the windward to the leeward side. However, in 2.11 WCs should have an extract rate as set out
most healthcare applications, internal subdivisions in Approved Document F of the Building
will restrict or prevent this effect. Regulations. Where WCs are located in shower and
bathroom spaces, the ventilation required for the
2.6 It is almost impossible to maintain consistent flow WC will normally be adequate for the whole space.
rates and ensure that minimum ventilation rates
will be achieved at all times. However, this Supply-only ventilation
variability is normally acceptable in such areas as
office accommodation, staff areas, library/seminar 2.12 Mechanical supply ventilation is required in areas
rooms and dining rooms, where opening windows where it is important to maintain a positive
8
2 Provision of ventilation in healthcare buildings
pressure in order to prevent the ingress of less Specialised ventilation

clean air (for example in units caring for immuno-
compromised patients, aseptic suites in pharmacies, 2.20 Owing to the nature and extent of activities carried
packing rooms in sterile services departments, out in healthcare buildings, there will be a need
operating theatres and theatre preparation rooms; for a wide range of specialised ventilation systems.
air-change rates are given in Appendix 2). Information on systems for individual departments
is given in Chapter 7.
Supply and extract ventilation
2.13 Mechanical supply and extract ventilation should
be provided in rooms where there is a need to 2.21 Wherever the escape of chemicals, toxic fumes,
control room pressure in relation to adjacent biological materials or quantities of dust into the
spaces. Critical care areas, isolation suites and general area would present a hazard to the
treatment areas are typical applications. occupants, LEV must be provided. This is a
statutory requirement under COSHH.
Comfort cooling
Ventilation for general areas
2.14 Cooling is very expensive in terms of energy costs
and should be provided only where necessary to 2.22 Appendix 2 provides recommended air-change
maintain a comfortable environment for staff rates, temperatures and pressures for general areas
and patient, or to ensure satisfactory operation of requiring mechanical ventilation in healthcare
equipment. The imaging department in particular buildings.
may require cooling to offset the equipment load.
Acceptable methods
2.15 Calculations and thermal modelling should be
undertaken to ensure that, during the summertime, Use of natural ventilation
internal temperatures in patient areas do not exceed
28oC (dry bulb) for more than 50 hours per year. 2.23 The airtightness of new buildings has improved to
the point that infiltration through building leakage
2.16 Certain non-patient areas may also require cooling can no longer be relied upon to provide sufficient
(for example laboratories and other areas that are air flow. Attention must therefore be given to the
subject to high heat gains from equipment). provision of purpose-made ventilation openings to
2.17 Where deep planning of other continuously achieve the necessary flow rates. The air entering
occupied spaces (for example offices) is the openings may need to be controlled by
unavoidable, there will also be occasions when motorised dampers linked to temperature and/or
acceptable levels of comfort can only be maintained occupancy sensors in the ventilated space.
by cooling. 2.24 Internal partitions, fire compartment walls and
2.18 Refrigeration plant should be of sufficient capacity closed doorways can often impede the flow path;
to offset heat gains and maintain areas at a when this happens, the process will be more
temperature that does not exceed the external dependent on single-sided ventilation.
design shade temperatures by more than about 3 K, Nevertheless, even with this degree of
taking into account the level of design risk for the compartmentation, acceptable ventilation may still
application. be achieved without window openings, which
would prejudice safety, security or comfort.
Air-conditioning 2.25 Some types of window (for example vertical sliding)
2.19 Owing to capital and running costs, full air- can enhance single-sided air change by temperature
conditioning should be used only in essential areas. difference, and these will improve the overall rate of
These include operating departments, critical care natural ventilation in protected or sheltered areas
areas, manufacturing pharmacies and areas with where the effect of wind pressure is likely to be
particularly sensitive equipment. minimal.
2.26 Natural cross-flow ventilation is able to give
reasonable air distribution for a distance of up to
6 metres inwards from the external facade, provided
9
that reasonably clear air paths are maintained. 2.34 Information on specialised extract systems is given
Beyond this distance – in areas where clear air paths in Chapter 7.
cannot be maintained and in areas where high
minimum air-change rates are specified – Mechanical supply systems
mechanical ventilation should be provided. 2.35 Where mechanical supply systems are required,
2.27 Further information can be found in Health the fresh air should be tempered and filtered before
Technical Memorandum 55 – ‘Windows’, BS 5925 being delivered to the space in order to avoid
and CIBSE’s (2005) Applications Manual AM10 – discomfort.
‘Natural ventilation in non-domestic buildings’. 2.36 The air should be heated using a constant or
variable temperature source, but generally only to
Mixed mode ventilation
the space air temperature. In most instances, the
2.28 Mixed mode ventilation is an assisted form of low pressure hot water (LPHW) heating system
natural ventilation. Fans are fitted in purpose- should offset any fabric loss so that set-back room
made damper-controlled ventilation openings. temperatures can be maintained during unoccupied
Alternatively, a separate draw- or blow-through periods without the need for the ventilation system
ventilation unit may be installed. In both cases the to operate.
dampers and fans are controlled by temperature
and occupancy sensors to ensure a minimum Balanced ventilation
air-flow rate while taking advantage of natural 2.37 A balanced ventilation system is a combination
ventilation effects when present. of both a supply and an extract system of equal
2.29 Where natural or mixed mode ventilation is volume; either a single space or a whole building
adopted with complex air paths, the designer may be considered to be balanced.
should produce an air-flow diagram in order to 2.38 A balanced system is necessary in instances where
ensure correct provision of air-transfer devices. it is essential to maintain consistent air movement
CIBSE’s (2000) Applications Manual AM13 – within an area (for example treatment rooms).
‘Mixed mode ventilation’ gives guidance.
Cascade ventilation
Mechanical extract ventilation
2.39 In operating departments, it is normal practice to
2.30 General extract systems can vary in complexity
supply air to the operating room and allow it to
from a single wall-mounted fan to a ducted air flow through less clean areas – corridors, utility
system with dual extract fans. rooms etc (from where it is eventually extracted).
2.31 Replacement air either is provided by a central
supply system or enters the building through gaps Recirculation systems
in the structure or purpose-made openings. Unless 2.40 Air recirculation systems are normally used in
special precautions are taken, the latter may result HEPA-filtered clean rooms where the extract air is
in an unacceptable level of draughts occurring in significantly cleaner than the outside supply and
winter, and possible risk of unacceptable levels of where odour levels are not significant.
noise transmission.
2.41 Recirculation is also routinely used in the canopy
2.32 If individual systems are used, the ventilation can section of ultra-clean operating theatre ventilation
be operated intermittently, provided it continues to systems.
run for at least 15 minutes after the room is vacated
(as with light-switch-operated fans in individual 2.42 Where the designer is considering the installation
toilets). of an air recirculation system, due account must be
taken of:
2.33 If general exhaust systems are used, filtered and
tempered replacement air should be provided via a. minimum fresh-air-supply volume required
a central supply plant to adjoining lobbies or by the Building Regulations Part F – Non-
corridors, to prevent the risk of discomfort caused domestic Buildings;
by the ingress of cold air. Fire compartmentation b. prevention of contamination of supply air from
requirements must be maintained. vitiated air in extract systems;
10
2 Provision of ventilation in healthcare buildings
c. prevention of stratification occurring within 2.50 Whether single or multiple systems are used, it is
plenum chambers and mixing boxes, which essential that the designer give due consideration to
may result in freezing of downstream coils; the source of electrical supply, location of the heat
rejection unit, environmental effects to the
d. ensuring sufficient velocities through control
refrigerant used and drainage provision for the
dampers (ideally 5–6 m/s) to provide suitable
cooling-coil condensate.
authority and good shut-off;
2.51 Recirculated room air affects indoor air quality
e. modulating control of mixing to provide
and may increase the risk of healthcare-associated
optimum on-plant conditions;
infection (HCAI). Split units should therefore not
f. use of “free cooling” by cycling the dampers to be used in critical care areas.
minimum fresh air when the enthalpy of the
2.52 The units should be easily accessible for cleaning
outside air is greater than that of the extract air
and maintenance.
under conditions when cooling is required.
Dilution ventilation and clean air-flow paths
Chilled beams
2.53 Dilution ventilation has been used to control levels
2.43 The use of chilled beams for the provision of
of hazardous substances in a space. This approach
heating, cooling and ventilation is increasingly
in itself is no longer considered acceptable.
common in healthcare premises.
COSHH requires that known hazardous substances
2.44 Active chilled beams providing tempered, filtered should be substituted for safe alternatives. If this is
air to the room can provide effective local control not possible, they should be controlled at source by
of environmental conditions. using a closed system (such as an anaesthetic gas
2.45 Care should be taken in positioning chilled scavenging unit) or a protective enclosure (such
beams to ensure that cold draughts are avoided, as a fume cupboard). A good level of background
particularly when used in the cooling mode. The ventilation will assist in diluting any casual release
control settings should ensure that the external of the substance.
elements of the beam are always above dew-point. 2.54 The exposure of staff to casual spillages of
Manufacturers of these devices are able to provide substances such as medical gases in anaesthetic
specific advice on the siting and design limits of rooms should in the first instance be dealt with by
their equipment. establishing a clean air-flow path. Air should be
2.46 Chilled beam units should be easily accessible for supplied at high level and extracted at low level
cleaning and maintenance. directly behind the anaesthetic equipment position.
The philosophy of establishing a clean air-flow path
Split comfort air-conditioners – from the air-supply point, to the staff, on to the
patient, and out via a low-level extract – would also
2.47 Split comfort air-conditioners, room conditioners apply in recovery rooms and birthing rooms. A
or cassette units are used increasingly where suitable air-change rate will provide background
there is a small local requirement for cooling for dilution ventilation as an additional safeguard. This
operational purposes. They can provide an effective approach ensures that “all reasonable steps are taken
economic solution to cooling needs where a central to prevent or control exposure (of staff ) to the
refrigeration system is not practicable. hazardous substance” as required by COSHH.
2.48 A fresh-air make-up system to the standard 2.55 In operating theatres, patients will be on a closed
required by the Building Regulations Part F – breathing circuit in a room with a high air-change
Non-domestic Buildings must be provided. rate. Under these circumstances, the dilution effect
2.49 Split units may be used for single applications or would be considered sufficient to control any casual
as multiple linked units that can independently exposure to anaesthetic gases.
provide either heating or cooling – all served by a
single outdoor unit. These systems help to maintain
a more precise temperature control across multiple
rooms, with maximum energy efficiency.
11
Mechanical ventilation systems Zoning of the building

2.61 The efficiency and effectiveness of any ventilation
System selection or air-conditioning installation depends largely
2.56 Natural ventilation is always the preferred solution on the zoning and control of the installation. The
for a space, provided that the quantity and quality factors to consider when determining the zoning of
of air required, and consistency of control to suit a ventilation system for a building or department
the requirements of the space, are achievable. If this are:
is not the case, a mechanical ventilation system will a. periods of occupancy;
be required.
b. fresh-air/ventilation requirements;
Choice of central/local plant c. smoke control.
2.57 Mechanical ventilation is expensive to operate – it 2.62 Where the ventilation system is not merely
should therefore be used only when the space being tempering the air, but also providing the heating
served requires ventilation. In addition, loads on and/or cooling requirements, the following
air-conditioning plant are rarely constant owing to additional factors will need to be considered:
changes in solar gain, occupancy, the use of heat-
generating equipment and lights. Therefore control a. internal or peripheral location;
of the supply-air temperature is critical. b. orientation of windows;
2.58 If the ventilation loads throughout a department c. variation in internal loads;
or building are in phase, or are not significant,
a central plant with single zone control can be d. level of control required.
adopted. However, this is rarely the case, so the 2.63 For single-zone plant in staff areas, local control
condition or quantity of supply air to different (with a run-on-timer if required) is recommended,
areas or zones of the building must be varied as the system can be turned off when the space is
accordingly. This can be achieved by either not in use, thus saving both thermal and electrical
providing individual plants to each zone or energy. Most supply and extract systems,
providing separate controls for each zone such as conversely, are required to operate continuously
provided by a variable air volume (VAV) system. while the department is occupied; thus some form
Where there is a high density of rooms with similar of time or use control is necessary.
ventilation requirements in an area of a building or
department, it is usually economical to combine 2.64 The control of individual plant items is covered
them into a central system. in Chapter 4, with examples of typical control
strategies in Chapter 5. For control of particular
2.59 In large buildings, a choice between a single specialised ventilation and air-conditioning
distribution system and multiple smaller systems systems, see Chapter 7.
may arise. Large distribution systems and their
plant can have the advantage of lower operating 2.65 On rare occasions a duplicate standby air-handling
costs, but require more space for vertical shafts. plant may be justified. If installed, it must be
In general, very long runs of ducting should be provided with a gas-tight damper at its junction
avoided to prevent undue heat losses or gains, with the supply distribution duct so that no back-
excessive leakage, and difficulties in balancing flow can occur. Standby plants can become sources
during commissioning. As the pressure losses in the of contamination if warm moist air is allowed to
long runs will be greater and a higher initial static dwell within them. Their design and control system
pressure will be required, this will lead to a more must ensure that this cannot happen.
expensive class of ductwork.
2.60 Multiple smaller distribution systems may be more
expensive in capital and operating costs but they
avoid long runs, large ducts and vertical shafts, and
this may reduce overall building costs. They also
provide a more robust service, as the failure of an
individual system does not prevent the use of the
rest of the building.
12
3 Assessment of service requirement
Selection of design criteria room air, rather than the actual temperature of the
supply air, which is the critical factor. The
External design conditions maximum recommended supply-to-room-air
temperature differential is:
3.1 The most accurate data that is available for the
summer and winter conditions at the site should be • summer cooling: –7 K
used. The Met Office can supply data for the • winter heating: +10 K.
United Kingdom (www.metoffice.gov.uk).
3.10 In areas that have high heat gains from equipment
3.2 Healthcare ventilation systems will normally be (for example critical care areas), the summer
“full fresh air”. cooling temperature differential limit given
3.3 Local adjustments, such as for height above sea above may result in excessive air-change rates.
level, exposure factor or other climate peculiarities, A differential of up to –10 K is acceptable in these
should be made as appropriate. circumstances, providing the supply-air diffusers
are of a type that provide good mixing.
Internal design conditions 3.11 If a humidifier is fitted, it is necessary to keep
3.4 The design conditions selected within patient supply-air humidity below 70% during winter in
areas must strike a balance between the comfort order to minimise the risk of condensation on cold
requirements of staff and patients, who often have surfaces.
very different levels of clothing and activity.
Air purity
3.5 Recommendations for the dry resultant
temperature and humidity of individual spaces are 3.12 In healthcare premises, the standard of filtration
shown on Activity DataBase A-sheets. Appendix 2 will depend on the activities within the occupied
gives a summary. spaces. With the exception of specialist areas (for
example manufacturing pharmacies), aerobiological
Minimum fresh-air requirements requirements are not stringent, and filtration is
only required to:
3.6 The dilution of body odours is the critical factor
in determining ventilation requirements. Where a. maintain hygienic conditions for the health and
natural ventilation or full fresh-air systems are used, welfare of occupants, or for processes such as
all ventilation air will be fresh. food preparation;
3.7 Where odour dilution is the overriding factor, it is b. protect finishes, fabrics and furnishings in order
recommended that 10 litres per second per person to reduce redecoration costs;
should be taken as the minimum ventilation rate. c. protect equipment either within the supply air
3.8 In non-standard applications such as laboratories, system (that is, to prevent blocking of coils), or
aseptic suites, operating departments etc, the in the space itself to prevent dust build-up.
particular requirements for each area should be 3.13 Given that almost all viable particles originate
considered independently in order to determine the from the occupants of a space and not from the
overriding minimum requirement for ventilation. incoming air, dilution is the more important factor
aerobiologically. Therefore, for general areas a G4
Limiting supply air conditions
filter is suitable. More critical areas will require an
3.9 For most applications in healthcare buildings, it is F7 filter. High-efficiency particulate air (HEPA)
the temperature differential between the supply and
13
filters are required only in ultra-clean systems calculation of air infiltration. Pressure testing
(information on filter grades is given in Chapter 4). enables the true infiltration rate to be established.
In all cases the requirements of the appropriate
Humidity control requirements section of the Building Regulations Part L2 must
3.14 Providing humidification is expensive in terms be met.
of plant, running costs and maintenance, and
Summertime temperatures
therefore its use should be restricted to where it is
necessary for physiological or operational reasons. 3.23 The calculation method for determining the
summertime temperature is described in CIBSE’s
3.15 Humidification was originally required for some
Guide A. It is very important to select the time
healthcare applications (for example operating
of day and time of year of peak loadings for the
theatres) in order to control the risk associated with
calculations. These will be dependent on the
the use of flammable anaesthetic gases. The use
building orientation and proportion of solar to
of such gases has now ceased. Humidification is
total heat gain. In establishing design values, the
therefore no longer required unless there is a very
design risk – having regard to the function and
specific application requirement.
occupancy of the building – should be considered.
Noise levels 3.24 Calculations and thermal modelling should
3.16 Noise will be generated by fans, ductwork fittings, be undertaken to see whether, during the
dampers and grilles. The specified maximum noise summertime, internal temperatures in patient areas
level will depend on the activities within the will exceed 28oC dry bulb for more than 50 hours
occupied spaces. per year. It can generally be assumed that for a
naturally ventilated building, the internal
3.17 Attention must be given to the reduction of tonal temperature will be approximately 3 K above
components. High tonal components from air the external shade temperature. For a building
diffusers etc can seriously disturb concentration with simple mechanical ventilation, the internal
over longer periods even when the overall noise temperature can never be less than the external
level is low. Broadband noise causes less annoyance. shade temperature and will invariably be higher.
3.18 Attenuation should be incorporated into the The relationship between preferred indoor
ductwork system or plant arrangement as necessary temperatures and mean outside temperature is
to reduce noise from fans and plant items in order discussed in CIBSE’s Guide A.
to achieve acceptable limits within rooms at the 3.25 Where calculations indicate that internal
design air flows. temperatures will exceed the selected design for
3.19 The designer must also consider noise escaping to a period that exceeds the building design risk,
the external environment, and this must not be methods of reducing temperature rise should be
unacceptable to occupants of adjacent areas or implemented. Options include:
buildings. • reducing solar and casual gains;
3.20 The overall noise levels should not exceed the • the use of chilled beams or ceilings;
values given in Health Technical Memorandum
08-01 – ‘Acoustics’. • increasing ventilation rates; or
3.21 Plant noise is subject to the Control of Noise at

• providing mechanical cooling.
Work Regulations 2005 and should not exceed 3.26 In some situations it may be possible to alter the
80 dB(A) within a plantroom. It should be reduced thermal mass of the structure to “move” the peak
to lower levels where the plant is near to temperature event time so that it occurs outside of
departments sensitive to noise. the occupancy period.
Calculation of building loads Peak heating load

3.27 Peak heating local calculations are necessary on all
Air infiltration mechanical supply systems to establish the size of
3.22 CIBSE’s (2006) Guide A – ‘Environmental design’ heater-batteries and subsequently the central plant.
provides information and formulae for the
14
3.28 Where ventilation systems provide tempered air to 3.35 Once the lowest required supply temperature of the
spaces that have supplementary LPHW to offset air-handling unit (AHU) has been established, and
the building fabric losses, the plant’s heating load an allowance made for temperature rise through the
should be based on the design values of the external fan and ductwork (usually 1 K for low-pressure
winter temperature and internal air temperature, systems), the off-plant enthalpy can be established
and the calculated total air volume (including a from a psychrometric chart or table.
suitable allowance for leakage).
3.36 The cooling loads for all plants on the chilled
3.29 Where the ventilation system is the only means of water system should be calculated at each of
heating a space, an increase in load equivalent to the individual peak times in order to accurately
the calculated fabric heat losses from the space establish the required (diversified) capacity of the
should be added to the ventilation load. A check of chiller.
supply temperature difference should be made. If it
exceeds 10 K, the ventilation supply volume should Annual energy consumption
be increased to suit. 3.37 Annual energy consumptions of heating-only
ventilation systems are simple to calculate, based
Condensation risk
on supply-to-external air temperature rise, and
3.30 A check should be made to ensure that the selected frequency of occurrence of external temperature
air condition will not lead to surface condensation data (see CIBSE’s Guide A).
on low-temperature elements of the ventilated
3.38 Minimum air volumes are usually fixed by the
space.
room loads or fresh-air requirements; however, the
3.31 Where there are local sources of moisture that designer may increase air flow to some rooms or
would require excessive levels of ventilation to zones in order to balance loads (as detailed in
avoid condensation, the designer should consider paragraphs 3.42–3.71).
the capture and removal of moisture at the source
3.39 The method of zoning and control can significantly
of the evaporation via an exhaust hood or similar
influence energy consumption.
device.
3.40 The concept of load and plant operation charts
3.32 In intermittently heated buildings, it is necessary to
is outlined in CIBSE’s Guide A. The method
consider the condensation risk at night set-back
requires the designer to establish the minimum and
conditions as well as during normal operation.
maximum loads on all zones across the range of
Calculation methods for this assessment are given
external temperatures between winter and summer
in CIBSE’s Guide A.
design conditions. Once the load chart is complete,
the plant chart converts the loads to supply
Peak cooling load
temperatures, which are then superimposed on
3.33 In addition to the base data of air-flow rates and external air temperatures.
temperatures, when calculating cooling loads, the
3.41 When all temperatures for all zones are plotted
designer must take into account:
on the plant operation chart, set-points and
a. solar cooling loads; resetting schedules can be established. From this
b. surface conduction cooling loads; information, the outputs of individual heaters,
coolers and humidifiers can be established at any
c. internal gain cooling loads; given external temperature. When those loads are
d. cooling loads due to high-level humidity computed against annual frequency of occurrence
control; of external temperatures (as given in CIBSE’s
Guide A), the annual energy consumption of
e. method of control of internal conditions; individual elements, and thus the air-conditioning
f. fluctuations in internal temperatures. system, can be established.
3.34 When the peak internal loads have been assessed
and a suitable allowance made for non-coincidence,
the supply temperature can be calculated.
15
Calculation of plant requirements 3.48 Resistances of ductwork and fittings may be

obtained from CIBSE’s Guide A; however, the
Air-supply volumes designer should exercise some care when using
tabulated pressure loss information for fittings that
3.42 The minimum air supply volume for a room is
are relatively close together.
determined by the greater of the following three
criteria: 3.49 Upon completion of the resistance calculation
exercise, the designer should make allowances for
a. the minimum fresh-air requirement; calculation and construction tolerances as indicated
b. the minimum supply volume for the room load in Table 2.
as determined by the maximum heating or
cooling supply temperature differential; Table 2 Typical fan volume and pressure margins
c. the desired air-change rate. Medium/
Low-
high-
Criteria pressure
Plant sizing pressure
systems
systems
3.43 Once the design air flow has been established, the
cross-sectional area of the AHU can be calculated Volume flow rate margin for
+5% +5%
leaking and balancing requirements
based on a maximum coil face velocity of 2.0 m/s.
Total pressure loss margin:
3.44 In order to establish the length of the AHU, a. for increase in volume flow rate +5% +5%
it will be necessary to refer to manufacturers’ (above)
literature, ensuring all necessary access panels and
b. for uncertainties in calculation +5% +10%
components are included as detailed in Chapter 4.
Combined total pressure loss +10% +15%
3.45 The fan duty should be calculated by adding the margin
resistances of all elements that contribute to the
pressure drop of the index circuit. Plantroom size and location
3.46 The main elements that must be considered are: 3.50 The ventilation plant and associated equipment
a. inlet or discharge louvres; should be positioned to give maximum reduction
of noise and vibration transmitted to sensitive
b. plant entry and discharge; departments; and at the same time, achieve an
c. attenuators; economic solution for the distribution of services.
d. components within the AHU; 3.51 It is not recommended that noise and vibration
generating plant be housed either directly above
e. duct-mounted heaters and filters (including a
or below sensitive areas (for example operating or
dust allowance);
anaesthetic rooms) unless there is no alternative, in
f. ductwork distribution; which case additional care and attention must be
given to the control measures.
g. ductwork fittings including: fire dampers,
volume control dampers, bends and sets, tees, 3.52 The plant must also be located so that it is remote
changes of section; from possible sources of contamination, heat gains
and adverse weather conditions. The design should
h. air terminal device;
ensure that wind speed and direction have a
j. discharge velocity. minimal effect on plant throughput.
3.47 Where packaged AHUs are installed, the fan 3.53 Safe access to and around plant is essential to
pressure drop is usually quoted as external plant facilitate inspection, routine maintenance, repair
resistance, and thus the designer does not need to and plant replacement.
calculate the resistances of individual plant items.
The designer should, however, ensure that an Provision of primary services
allowance has been made for “dirty filter”
3.54 Where more than one air-handling plant requires
conditions, and confirm whether the fan pressure
cooling, remote central cooling plants with piped
quoted is fan total or static pressure.
chilled water are preferred. In the case of a single
16
plant, a multi-stage direct expansion cooling separation of 4 m between them, with the discharge
coil with refrigerant piped from an adjacent mounted at a higher level than the intake.
compressor/condensing plant could be considered.
3.63 Discharges from LEV systems should preferably be
If this option is selected, a refrigerant gas detector
vertical and usually not less than 3 m above roof
mounted in the base of the duct and an alarm
level. They should not be fitted with a cowl that
system audible to the end-user will also need to be
could cause the discharge to be deflected
provided (as dictated by the COSHH Regulations).
downwards.
3.55 Clean, dry steam is preferred for humidification,
3.64 Each intake and discharge point should be fitted
provided that the boiler water treatment does
with corrosion-resistant weatherproof louvres or
not render the steam unusable for direct
cowls to protect the system from driving rain
humidification.
(BS EN 13030, Class B).
3.56 If a suitable supply of steam cannot be obtained
3.65 It is recommended that louvres be sized based on a
from the steam main, a steam generator should
maximum face velocity of 2 m/s in order to prevent
be provided locally, or a self-generating humidifier
excessive noise generation and pressure loss.
installed. The location of a local steam generator is
critical if condensate is to drain back into it. 3.66 The inside of the louvres should be fitted with a
mesh of not less than 6 mm and not more than
Inlet and discharge sizing and location 12 mm to prevent leaves being drawn in and
infestation by vermin.
3.57 Air intakes and discharge points should preferably
be located at high level, to minimise the risks of 3.67 The duct behind a louvre should be self-draining.
noise nuisance to surrounding buildings, If this is not practicable, it should be tanked and
contamination and vandalism. provided with a drainage system.
3.58 Intakes and discharges should be designed and 3.68 Cleaning access must be provided either from the
located so that wind speed and direction have a outside via hinged louvres or by access doors in
minimal effect on the plant throughput. the plenum behind the louvre. Where a common
plenum is provided, cleaning access should be via a
3.59 Helicopter landing pads in the vicinity of
walk-in door.
ventilation intakes and discharges can result in
large short-term pressure changes. This can cause
Heat-rejection devices
pressure surges in supply systems and reverse air
flows in extracts. Exhaust fumes from the helicopter 3.69 The design conditions given in Chapter 2 make no
may also be drawn into intakes. allowance for the elevated temperatures that can
occur on the roof of buildings. Refrigeration
3.60 Intake points should be situated away from cooling
condensers and cooling towers should, if
towers, boiler flues, vents from oil storage tanks,
practicable, be shaded from direct solar radiation,
fume cupboards and other discharges of
or the design should be adjusted to take account of
contaminated air, vapours and gases, and places
the gain.
where vehicle exhaust gases may be drawn in.
3.70 Air-cooled condensers should be the first choice for
3.61 Where intakes have necessarily to be sited at or
heat rejection from any refrigeration plant.
near ground level, the area around them should be
paved or concreted to prevent soil or vegetation 3.71 Evaporative cooling systems should not be used
being drawn in. They should also be caged or in healthcare premises unless limitations of space
located within a compound to prevent rubbish mean that they are the only way that the cooling
being left in the vicinity. The likely proximity of load can be met. If they are used, guidance on
vehicle exhausts should be taken into account when preventing and controlling legionellae must be
determining the protected area around the intake. closely followed (see Health Technical
Memorandum 04-01 – ‘The control of Legionella,
3.62 The discharge from a general extract system must
hygiene, “safe” hot water, cold water and drinking
be located so that vitiated air cannot be drawn back
water systems’; and the Health and Safety
into the supply-air intake or any other fresh-air
Commission’s Approved Code of Practice and
inlet. Ideally, the extract discharge will be located
guidance document ‘Legionnaires’ disease: the
on a different face of the building from the supply
control of Legionella bacteria in water systems’
intake(s). In any event, there must be a minimum
(commonly known as L8)).
17
4 A
ir-handling unit design and specification
guidance
General requirements 4.7 Fire precautions should be incorporated in

accordance with Firecode (the Health Technical
Location and access Memorandum 05 series). See also Chapter 3.
4.1 AHUs should be located in an accessible area 4.8 Combustion equipment must not be located
secured from unauthorised entry. Siting units in a fire compartment that houses air-handling
in ceiling voids above occupied spaces is not equipment.
appropriate.
Technical requirements
4.2 Units located on roofs should have a safe means of
access together with suitable precautions to prevent 4.9 The basic technical requirements of the whole of
personnel or equipment falling or being blown off the ventilation system should meet the relevant
during maintenance activities. clauses of Model Engineering Specification C04
– ‘Mechanical ventilation and air-conditioning
4.3 Units located at ground level should be secured systems’. This document contains a menu of clauses
within a compound to prevent unauthorised access. that cover a wide range of applications, so it is
Measures should be taken to exclude vehicles from important to select only those that are relevant to
the vicinity to ensure that exhaust fumes will not be the specific application.
drawn into intakes.
4.4 Units may have a working life of 25 to 30 years. Note
It can be anticipated that over this period there will At the time of writing, Model Engineering
be a need to access every element within the unit Specification C04 was due for revision in order to
for deep cleaning. It is also quite possible that the bring it into line with the revised standards set out
main fan and individual heater and chiller batteries in this Health Technical Memorandum. Where
will need replacement. Suitably positioned service conflicts in specification arise, the Health Technical
connection joints and adequate spacing should Memorandum takes precedence.
permit these items to be withdrawn without
the need to dismantle other installed plant or
4.10 It is essential that the main plant/ductwork is
equipment. Batteries that are significantly wider
located far enough from the floor to permit the
than 1 m should be split to permit withdrawal from
correct installation of drainage systems for cooling
both sides.
coils, humidifiers and heat-recovery systems. Easy
4.5 It is essential that AHUs are positioned so that access for maintenance of drainage systems and
all parts are easily and safely accessible for routine their associated pipework must be provided.
inspection and service. If a unit is located against a
4.11 Organic materials or substances that can support
wall or backs onto another unit, access to all parts
the growth of microorganisms must not be used
must be available from the front. Units greater than
in the construction of the plant or its distribution
1 m wide should preferably have access from both
system. The Water Regulations Advisory Scheme’s
sides or have access doors large enough to permit
(WRAS) (2005) ‘Water Fittings and Materials
the full and safe entry of maintenance personnel.
Directory’ lists suitable materials for sealants and
4.6 The area around the unit should be tanked to gaskets.
prevent water penetration to adjacent areas, and
4.12 The plant and its distribution system must not
should be adequately drained.
contain any material or substance that could cause
or support combustion.
18
4 Air-handling unit design and specification guidance
4.13 Plants should have a high standard of airtightness. style movable steps. The installation of distribution
The double-skin method of construction with ductwork and other electrical or mechanical
insulation sandwiched between two metal faces is services should provide sufficient clearance to allow
recommended. The panels may be available in a the pulpit steps to be easily wheeled into position.
variety of colours at no additional cost. This can
aid identification by colour-coding of units in AHU drainage system
a plantroom (for example green for general 4.21 All items of plant that could produce moisture
ventilation; blue for theatres; red for laboratories must be provided with a drainage system. The
and isolation facilities; grey for extract etc). system will comprise a drainage tray, glass trap,
4.14 The inside of the plant should be as smooth as air break and associated drainage pipework.
possible. Channels, rolled angles or formed sections 4.22 The drainage tray should be constructed of a
that could trap or hold moisture should be kept to corrosion-resistant material – stainless steel is
a minimum. If stiffeners are required, they should preferred – and be so arranged that it will
be fitted externally. If internal bracing has to be completely drain. To prevent “pooling”, it is
fitted, it must be of a design that will not trap or essential that the drain connection should not have
hold moisture. an up-stand and that a slope of approximately 1 in
4.15 Air flow across air treatment components such 20 in all directions should be incorporated to the
as filters, heat exchangers and humidifiers will be drain outlet position. The tray must be completely
influenced by the pattern of the approaching air accessible or, for smaller units, easily removable for
stream. If unsatisfactory conditions are created, the inspection and cleaning.
performance of the component will be reduced.
4.16 Access to items that require routine service such as
filters, fog coils and chiller batteries should be via
hinged doors. The doors should be large enough
(for example 500 mm minimum) to allow easy
access. Items requiring infrequent access, such as
attenuators, may be via bolted-on, lift-off panels.
All doors and panels should be close-fitting and
without leaks.
4.17 Care should be taken during installation to ensure
that electrical and mechanical services are not
installed in positions that will reduce or impede
access.
4.18 It can be difficult to turn off AHUs in order to
inspect filters and drainage trays. Viewing ports and
internal illumination will therefore facilitate routine
patrol inspection of such items. Viewing ports
should be at a convenient height. In double-stacked
units, placing the viewing ports at the bottom of
Removable drainage tray
the access doors of the upper unit will remove the
need to use temporary ladders or steps when
carrying out patrol inspections. 4.23 Each drainage tray should be provided with its own
drain trap. The drain trap should be of the clear
4.19 Internal illumination should be provided by
(borosilicate) glass type. This permits the colour of
fittings to at least IP55 rating. Fittings should be
the water seal to be observed, thus giving an early
positioned so that they provide both illumination
indication of corrosion, biological activity or
for inspection and task lighting. All lights in a unit
contamination within the duct. The trap should
should be operated by a single switch.
have a means for filling and incorporate couplings
4.20 Access to AHUs and items in the distribution to facilitate removal for cleaning. It should be
system such as filters or heater/chiller batteries located in an easily visible position where it will
should be via fixed ladders and platforms or pulpit- not be subject to casual knocks. The pipework
19
connecting it to the drainage tray should have a 4.32 The quality of motorised dampers is critical. They
continuous fall of not less than 1 in 20. should:
4.24 Traps fitted to plant located outside or in unheated • be rigid;
plantrooms may need to be trace-heated in winter.
• have square connections fitted with end and
The trace-heating must not raise the temperature of
edge seals of a flexible material; and
water in the trap above 5oC.
• have minimal play in linkages.
4.25 Water from each trap must discharge via a clear air
gap of at least 15 mm above the unrestricted spill- The leakage on shut-off should be less than 2%.
over level of either an open tundish connected to a 4.33 A manually operated isolating damper should
foul drainage stack by way of a second trap, or a be installed between the main AHU and its
floor gully (or channel). A support should be distribution system to enable the unit to be isolated
provided to ensure that the air gap cannot be when cleaning is in progress.
reduced. More than one drain trap may discharge
into the tundish providing each has its own air 4.34 Some systems will require the fitting of a main
break. volume control damper so that the design air-flow
rate can be set at commissioning. The damper
4.26 Drainage pipework may be thermoplastic, copper
should be lockable in any position. If it will also
or stainless steel. Glass should not be used. The be used for plant isolation, it should be capable of
pipework should be a minimum diameter of being reset to give the design air flow without the
22 mm and have a fall of at least 1 in 60 in the need for remeasurement.
direction of flow. It should be well supported and
located so as not to inhibit access to the AHU. 4.35 Internal plant-isolating dampers are not required.
Neither is the provision of fittings for shut-off
Layout of AHU plates between items within a unit.
4.27 The AHU should be arranged so that most items
Vibration
are under positive pressure. Any item of plant
requiring a drain should be on the positive pressure 4.36 Vibration from a remote plantroom can be
side of the fan. A recommended layout is given in transmitted by the structure of the building, may
Figure 1. be regenerated and may sometimes be magnified
many times. Units should be selected to have the
4.28 A separate extract unit will generally be required for
minimum vibration generation and to be installed
the area served by each supply unit. on suitable anti-vibration mounts. Pipe and
4.29 An energy recovery system will normally be fitted ductwork should incorporate anti-vibration
between the supply and extract units. couplings, preferably in two planes at right
angles, as close to the vibration source as possible.
Provision of dampers Consideration should be given to the use of anti-
vibration pipe hangers and supports.
4.30 Fire- or smoke-actuated dampers should be
provided at the locations required by Health
Sequence of components
Technical Memorandum 05-02 – ‘Guidance in
support of functional provisions for healthcare 4.37 The following arrangement of plant components is
premises’ (see also paragraph 5(c) in Appendix 1 typical, although in many instances not all elements
and paragraph 6.21). will be required:
4.31 Motorised low-leakage shut-off dampers should a. fresh-air intake;
be located immediately behind the intake and b. motorised isolation/smoke damper;
discharge of each supply and extract system
respectively. They should be of the opposed-blade c. frost/fog coil;
type, opening through a full 90 degrees, and must d. prefilter;
close automatically in the event of power failure or
plant shut-down to prevent any reversal of the e. energy-recovery device;
system air flow.
20
f. attenuator (these may be located in the intake 4.44 Axial flow or propeller fans are generally only used
and discharge duct if they are of a suitable type in local through-the-wall systems or systems with
– see also paragraph 4.166); very low-pressure requirements.
g. fan; 4.45 Cross-flow fans have very low operating efficiencies,
and thus their use is restricted to applications such
h. blast plate;
as fan-coil units.
j. attenuator (see (f ));
Location and connection
k. chiller battery;
4.46 Fans are normally positioned to “blow through” the
m. eliminator;
central plant so that the cooling coil and humidifier
n. heater-battery; drains will be under positive pressure.
p. humidifier; 4.47 The fan performance figures given by
q. final filter; manufacturers in their catalogue data are based on
tests carried out under ideal conditions, which
r. manual isolation/volume control damper. include long uniform ducts on the fan inlet/outlet.
4.38 There may be instances where this arrangement is These standard test connections are unlikely to
not appropriate, and the plant arrangement should occur in practice; the designer should therefore
be planned accordingly. ensure as far as is practical that the fan performance
will not be significantly de-rated by the system.
This objective can be approached by ensuring that
Fans
the fan inlet flow conditions comprise uniform
General requirements axial flow velocities with low levels of turbulence.
4.48 Where the outlet duct is larger than the fan
4.39 The fan should be selected for efficiency and
minimum noise level, but the overriding factor discharge connections, there should be a gradual
should be the selection of a fan characteristic such transition, with a following section of straight duct
that the air quantity is not greatly affected by having a length equivalent to three duct diameters.
system pressure changes due to filters becoming 4.49 The design of the fan inlet connection must be
dirty or due to external wind effects. carefully considered to avoid swirl in the air stream.
When the air spins in the same direction as the
Acceptable types impeller, the performance and power consumption
4.40 Fans can be of the axial, centrifugal, cross-flow, of the fan are reduced. When the air spins in
mixed-flow or propeller type, depending on the the opposite direction to the impeller, power
requirements of the system. consumption and noise will increase with hardly
any pressure increase. Air-stream swirl is usually
4.41 Where used, centrifugal fans should preferably induced by large variations across the fan’s inlet
be of the backward-blade type. Alternatively, eye, caused by the air passing round a tight bend
where noise levels are more critical and pressure immediately before the eye.
requirements are lower, forward-curved blade fans
are acceptable. For high-power applications, 4.50 Where a centrifugal fan is located with a free inlet,
aerofoil-blade fans are appropriate. the clear distance between the suction opening and
the nearest wall should be not less than half the
4.42 In all cases the fan power performance diameter of the inlet. If two fans with free inlets are
requirements of the Building Regulations Part L2 positioned within the same chamber, their adjacent
must be met. suction openings should be at least one (inlet)
diameter apart.
Selection
4.51 Airtight flexible joints should be provided at the
4.43 Generally, large ventilation systems will use fan’s inlet and outlet connections. They should be
centrifugal fans due to their efficiency, non- equal in cross-section to the points of connection,
overloading characteristics and developed pressures. and be neither longer than 200 mm nor shorter
than 100 mm.
21
4.52 For centrifugal fans, a diffuser screen/blast plate Extract fan drive arrangements
should be fitted immediately downstream of their
4.57 Where the fan drive is via a motor-driven belt-and-
discharge.
pulley arrangement, it should be located external to
the air stream.
Supply fan drive arrangements
4.58 The fan drive and motor may be located inside
4.53 Where the fan drive is via a motor-driven belt and
the duct within the air stream, provided the motor
pulley, it should be external to the air stream. This
windings are protected from over-temperature by a
arrangement has the following advantages:
thermister and lockout. The drive train should be
a. the fire risk is reduced; easily visible through a viewing port, have internal
b. the drive is visible, so it is simple to check that illumination, and be accessible via a lockable
the belt is still there; hinged door.
c. particles shed from the drive belt are outside of 4.59 Where the system air is explosive, aggressive or
the air stream; has a high moisture content, the extract fan motor
must be located outside the air stream. This is
d. if the belt slips, the “burning rubber smell” is generally achieved with axial fans by using a
not transmitted down into occupied areas of the bifurcated unit.
premises;
e. noise generated by the motor and drive will not Control
be transmitted along the ductwork; 4.60 Fans in healthcare applications are generally either
f. waste heat is excluded from the system; single- or two-speed. Where there is a requirement
for two-speed operation, this is generally via a local
g. the drive may be through a V-belt or toothed user control (for example in a hood-extract system
belt and pulley. The latter has the advantage of to provide a boost facility) or via a time schedule
eliminating belt squeal on start-up and has a for energy saving during unoccupied periods.
longer service life. It is particularly suitable
where the fan’s drive motor is fitted with a soft 4.61 Normally, only a single motor is required with a
start. standby motor available for fitting as necessary,
or fitted, but not belted. Twin, run and standby
4.54 The drive train should be easily visible without the motors – with the standby being jockeyed around
need to remove access covers. Protecting the drive – are not required.
train with a mesh guard is the preferred option.
For weatherproof units designed to be located 4.62 Where there is a specified requirement for standby
outside, the fan drive will be external to the duct, fans, the system should incorporate an automatic
but enclosed. It should be easily visible through a changeover facility activated via an air-flow sensor.
viewing port with internal illumination and be Fault indication should be provided.
accessible via a lockable hinged door. 4.63 In terms of start-up and operation, fans are
4.55 For direct-coupled fan and motor units, the motor increasingly becoming computer-controlled.
may be within the air stream, provided the motor Inverter-drive, variable-speed and soft-start systems
windings are protected from over-temperature by a are becoming a standard approach. Most healthcare
thermister and lockout relay. applications require known amounts of air to be
delivered while the system is in use. Constant-
4.56 For induction-drive “plug” motor arrangements volume systems that deliver specified air-change
(where the motor is fitted within the fan and is rates are therefore the norm. Duct- or room-
integral to it) and in-line axial fans with a pod pressure-controlled, variable-speed systems have a
motor, the fan/motor combination may be within very limited application in healthcare.
the air stream, provided the motor windings are
protected from over-temperature by a thermister 4.64 It is necessary to ensure that – should the computer
and lockout relay. control system or its software develop a fault – the
fan can be switched to a direct-start, fixed-speed
manual operation. This is particularly important
for critical care systems serving operating suites,
high-dependency care units of any type, isolation
22
facilities, laboratories and pharmaceutical Location

production suites. Off-site software support is not a
4.72 Where possible, wet-trimmer heater-batteries
substitute for the ability of on-site staff to override
should be located in plant areas.
automatic controls and keep the system operating
in an emergency. Under these circumstances, 4.73 Where it is necessary to locate auxiliary heater-
actions that may shorten the life of the plant are batteries in false ceilings, consideration should be
considered of secondary importance to that of given to the use of electric heaters. If this is not
preserving the health and safety of patients and practicable, a catch tray should be installed under
staff. both the battery and the control-valve assembly to
protect the ceiling from leaks. A moisture sensor
Heater-batteries and alarm should be fitted in the tray. In any event,
to facilitate maintenance access, auxiliary wet
General requirements heater-batteries should be located above corridors
or other non-critical areas and not above patient-
4.65 Fog/frost heating coils are installed to protect the
occupied spaces.
downstream filters from low-temperature, high-
humidity intake air conditions. As they handle 4.74 Auxiliary fan-coil units should not be installed in
unfiltered air, they should be constructed of plain the ceiling above an occupied space. They should
tubing without fins and be as near to the outside be accessible for routine maintenance and cleaning
as possible to minimise condensation during cold without the need to cause significant disruption to
weather. Access for cleaning will need to be the operation of the department that they serve.
provided to both sides of the coil.
Control
4.66 Where steam coils are used for a fog/frost battery,
they may be constructed using spiral-finned copper 4.75 LPHW fog/frost coils should be controlled
tube. As they will be prone to fouling, the tube by an off-coil temperature sensor operating a
layout and spacing should permit easy access for motorised valve to provide a minimum plant “on
regular cleaning. temperature” of between 2oC and 5oC. The off-coil
temperature of the frost coil is generally sensed by
4.67 Main and branch heater-batteries should be a serpentine thermostat downstream of the coil or
constructed of solid-drawn copper-tube coils with upstream of the next plant item. This thermostat
copper fins, generally connected in parallel. will shut the fan down if any part of the air stream
4.68 Where there is a wet heating system in the areas is below the minimum set-point.
served, the main heater-battery should be sized for 4.76 Steam-supplied fog/frost coils should be fitted with
the ventilation requirements only, and not for the an on/off control operated by a temperature sensor
fabric loss. mounted upstream of the battery. These are
4.69 Access for cleaning must be provided to both sides normally set to fully open the control valve when
of all fog coils and heater-batteries. the outside temperature drops to +1oC. This will
ensure that there is no standing condensate in the
Acceptable types base of the coil.
4.70 Electric, water or steam heater-batteries may 4.77 The main heater-battery should be controlled in
be considered; however, electric heater-batteries the same manner under the dictates of either an
are expensive to operate and, where there are off-coil temperature sensor or a room temperature
alternatives, their use should be restricted to low- sensor, depending on the plant configuration and
power use (for example trimming control). method of control. Trimmer heater-batteries are
generally controlled by one or more averaging
4.71 Where steam-supplied heater-batteries are used,
temperature sensors within the room or rooms in
their control, venting and trapping systems should
the zone.
be designed so that a vacuum cannot occur within
the coil. The condensate drainage arrangements 4.78 Heater-battery control valves should automatically
should not allow pressure to build in the main, close on system shut-down or fan failure. The
resulting in a back-up of condensate in the coil. control system should then automatically set to
provide frost protection.
23
Cooling coils the operation of the department that they serve.

The drainage of such items is often problematic.
General requirements If a suitable fall in the drain line cannot be
achieved, a pump-out system must be provided.
4.79 Cooling coils will need to be periodically cleaned or
decontaminated. They must have good access both 4.88 Where any cooling coil has to be located above a
up- and downstream. Hinged access doors with ceiling, an external catch tray should be installed
viewing ports and illumination inside the duct under the unit and its control valve assembly to
should be provided both sides of the coil. protect the ceiling from leaks. A moisture sensor
and alarm should be fitted in the catch tray.
4.80 An eliminator will be required downstream of all
To facilitate maintenance access, coils should be
cooling coils. The eliminator may take the form of located above corridors or other non-critical areas,
an extension of the coil fins or be a separate device. but not above patient-occupied spaces.
If a separate device, it should be removable as a unit
to permit cleaning of the coil face. Control
4.81 All cooling coils must be fitted with their own 4.89 There are three basic methods of control for
independent drainage system as specified above. cooling coils:
A baffle or similar device must be provided in the
drain tray to prevent air bypassing the coil. The a. Temperature control. A room or duct
tray should be large enough to capture the moisture temperature sensor controls the cooling coil
from the eliminator, bends and headers. and heater-battery in sequence to maintain the
desired room temperature. This is used where
4.82 Where coils are greater than 1 m high, intermediate close control of room humidity is not required.
drain trays are needed. If a suite of rooms is served by the same unit,
the control sensor may be located in a common
Selection extract duct to achieve an “average” condition.
4.83 Cooling coils supplied with chilled water are the
b. Temperature and humidity control. Room
preferred option. For small loads or where chilled temperature and humidity sensors control the
water is not available, direct expansion coils may be cooling coil, heater-battery and humidifier in
used. sequence. The room temperature and humidity
4.84 Care must be taken to minimise electrolytic action are kept within an acceptable range, with
resulting from condensation on the air side. Coils temperature taking precedence over humidity.
constructed from copper tubes with copper fins It is usual to interlock the cooling coil and
extended on the downstream side in the form of an humidifier so that they cannot be on together.
eliminator, and electro-tinned after manufacture, c. Full temperature and humidity control.
are preferred. Aluminium fins should only be used Room temperature and humidity sensors
if vinyl-coated. control the heater-battery, humidifier, cooling
4.85 All parts of the coil and its associated ductwork in coil and a re-heater-battery in sequence to
contact with moisture must be manufactured from maintain a specific room condition regardless of
corrosion-resistant materials. Pressed-steel coil the room load. This is very expensive in energy
headers, even if treated, have been shown to be and can rarely be justified. In healthcare it is
prone to corrosion over time and should not be only likely to be considered for specialised
used. Steel mounting frames and casings present research facilities.
similar problems, so stainless steel is preferred. 4.90 It is usual to isolate the cooling coil upon selection
of set-back operation. In addition, on system shut-
Location
down, low air flow or fan failure, the cooling coil
4.86 Cooling coils in AHUs should be located upstream must be isolated.
of the final filter.
4.87 Auxiliary fan-coil units should not be installed in
the ceiling above an occupied space. They should
be accessible for routine maintenance and cleaning
without the need to cause significant disruption to
24
Humidifiers must not be added to the water supply to

humidifier units.
Design need 4.100 If the quality of the water supply to a self-
4.91 Humidification was originally required for some generating humidifier unit cannot be assured, an
healthcare applications in order to control the risk ultraviolet (UV) system to control microbiological
associated with the use of flammable anaesthetic growth could be installed. However, given the
gases. The use of such gases has now ceased. limitations of UV systems, this will require high-
Humidification is therefore no longer required quality water filtration to ensure the effective
unless there is a very specific application exposure of organisms to the UV irradiation. As
requirement. with all water-treatment systems, the unit should
be of proven efficacy and incorporate UV monitors
4.92 Operating-theatre AHUs do not generally require
so that any loss of transmission can be detected.
humidifiers, but provision for their retrofitting in
terms of space provision and a capped drainage 4.101 Provision should be made for draining down
system should be provided. supply pipework and break tanks serving self-
generating humidifiers during the seasons when
4.93 Where humidification is required, it will be subject
they are not required in service. Isolation of the
to the specific requirements set out below. These water supply should be at its junction with the
are intended to ensure that the unit will operate “running” main to prevent the creation of a dead-
safely and not become a source of contamination. leg. All parts of the system should be capable of
being cleaned and/or disinfected as necessary.
4.94 The most important requirement for a humidifier Acceptable types
is to create complete mixing of the steam with the 4.102 Only steam-injection manifold-type humidifiers
air. The manufacturers’ instructions should be are suitable for use within air-conditioning systems
closely followed regarding minimum distances, in healthcare facilities. Water-curtain, spray or mist
which should be allowed before bends or other humidifiers of any type should not be used.
components. This is particularly important with
respect to a filter mounted downstream. If it 4.103 Steam may be derived from the central steam
becomes saturated by the humidifier, organisms supply provided that it does not contain any
can grow through the filter and be released into the treatment carry-over, or may be generated locally
duct. These may then be carried on the air stream either within or adjacent to the humidifier.
into an occupied space. 4.104 The introduction of steam should be by an
4.95 The section of ductwork containing the humidifier appliance specifically designed to discharge dry
may need to be periodically cleaned. Hinged access steam into the air-conditioning system without
doors with viewing ports and internal illumination objectionable noise or carry-over of moisture.
should be provided. A label warning that the device 4.105 During the design stage, consideration should be
emits live steam and should be isolated prior to given to the proposed methods for the regular
opening should be affixed to the access door. cleansing of the humidifier(s) and their
4.96 All parts of the humidifier and its associated components.
ductwork in contact with moisture must be
manufactured from corrosion-resistant materials; Selection
stainless steel is preferred. 4.106 The number and length of steam-injection
4.97 The electrodes of self-generating electrode-boiler manifolds to be used is dependent on various
humidifiers should be stainless steel. factors such as duct cross-sectional area, air
velocity, dry-bulb temperature and manifold
4.98 All humidifiers must be fitted with their own design. Guidance from the manufacturer should
independent drainage systems as detailed above. be closely followed.
4.99 For self- and locally-generated steam humidifiers, 4.107 A mains steam humidifier can be noisy and will be
the cleanliness of the water supply is essential for difficult to control if it is operated at an excessive
their safe operation. The water supply should be steam pressure. It should be sized for an operating
derived from a potable source. Chemical treatments pressure of approximately 1 bar. The pipework
25
supplying it should be provided with a dirt pocket, moisture; it is not necessary to install a
pressure-reducing valve and steam trap installed as dehumidifier to reduce the humidity of the
close as practicable to the humidifier so that the incoming air if it already exceeds 70%. The
steam condition at entry is as dry as possible. humidifier control system should ensure that the
A temperature switch on the condensate line humidifier is switched off when the fan is not
(or equivalent design provision by the humidifier running.
manufacturer) should be incorporated to prevent
4.114 It is usual to isolate the humidifier upon selection
“spitting” on start-up.
of set-back operation. In addition, on system shut-
4.108 Most operational problems with mains steam down, low air flow or fan failure, the humidifier
humidifiers arise because of back-pressure in the should be isolated.
condensate discharge line, which will result in
4.115 If a water-supplied local steam generator is
flooding into the duct. Unless the condensate
unused for a period exceeding 48 hours, it must
from the device can be discharged and collected
automatically self-drain (that is, all water content
at atmospheric pressure, it should be discharged
must drain out – including that contained in the
directly to drain.
supply pipework – all the way back to the running
4.109 Some steam generators incorporate a heated tank main) and remain empty.
that requires regular cleaning and descaling. The
design must allow the steam-supply manifold to be Filtration
physically isolated from the air duct in order to
prevent contamination of the air stream by General requirements
cleaning agents while this is taking place.
4.116 The purpose of filtration is to reduce the level of
Location airborne contamination in an air stream. It is
generally carried out in stages.
4.110 Careful siting of the humidifier lance is required to
4.117 Filters must be securely housed and sealed in well-
prevent the steam impinging onto the side(s) of
the duct, condensing and generating excess fitting frames that minimise air bypass. Air bypass
moisture. significantly reduces filtration efficiency: the
higher the filter grade, the greater the effect.
Control Mounting frames should be designed so that the
air flow pushes the filter into its housing to help
4.111 Accurate humidity control can only be provided minimise air bypass. Mounting frames that
on single-zone systems or multi-zone systems with withdraw so that the filter can be changed without
zonal humidifiers. In the former, humidity sensors having to reach into the unit are preferred.
control the humidifier for low-level humidity
control and override the temperature controls to 4.118 Neither the filter media nor any material used in
open the cooling-coil valve for high-level humidity the construction of the filters should be capable of
control. sustaining combustion. The filter media should be
such that particles of it do not detach and become
4.112 Multi-zone systems are more usually controlled by carried away by the air flow.
a minimum humidity sensor located in the supply
duct(s) following the last heater-battery. 4.119 Filters need to be readily accessible for
replacement; therefore, a hinged access door
4.113 Overriding controls separate from the normal should be provided. The upstream side of the filter
plant humidistat should be installed. Their should be visible for inspection through a viewing
purpose is to prevent excessive condensation in the port with internal illumination.
conditioned space when starting up. A time delay
should be incorporated into the humidifier control 4.120 All filters should be provided with a means of
system such that the humidifier does not start visually checking the differential pressure across
until 30 minutes after the ventilation/plant start- them. Direct-reading dial-type gauges marked with
up. In addition, a high-limit humidistat should be clean and dirty sectors are preferred.
installed to limit the output of the humidifier so 4.121 A complete spare set of filters must be provided to
that the saturation in the duct does not exceed the client at handover.
70%. This humidistat is to control the added
26
Definition of filter terms Table 4 Fine filters

4.122 Particulate air filters are divided into four BS EN 779
categories: grade Notes and typical healthcare
% Efficiency
(Eurovent applications
a. general ventilation filters graded G1 to G4;
grade)
b. fine filters graded F5 to F9; F5 (EU5) 40 to <60 General-purpose panel/bag
c. HEPA filters graded H10 to H14; filter
F6 (EU6) 60 to <80 Basic grade bag filter
d. ultra-low particulate air filters (ULPA) graded
F7 (EU7) 80 to <90 Medium grade bag or pleated
U15 to U17.
paper
4.123 General filters are graded in terms of their Conventional operating theatre
“synthetic dust weight arrestance”. This represents supply air
the percentage of a test dust captured by a filter. F8 (EU8) 90 to <95 High grade bag or pleated
“Arrestance” provides a good indication of a filter’s paper
ability to remove the larger, heavier particles found F9 (EU9) >95 Basic HEPA filter – level 8
in outdoor air. These are of a size to block finned clean rooms
batteries and large enough to settle out in the air
4.125 High-efficiency filters (HEPA and ULPA) are
distribution system (see Table 3).
graded in terms of their ability to capture their
Table 3 General filters “most penetrating particle size” (MPPS).
4.126 High-efficiency filters self-select the particle that
BS EN 779
they are least able to trap, hence the MPPS. They
grade Notes and typical healthcare
(Eurovent
% Arrestance
applications
are then tested against that size of particle.
grade) 4.127 These filters are designed to provide very high-
G1 (EU1) <65 Metal-mesh grease filter efficiency filtration of particles in the sub-micron
G2 (EU2) 65 to <80 Coarse primary filter size range (see Table 5).
G3 (EU3) 80 to <90 Primary air intake;
Return air; Table 5 High efficiency (HEPA) filters
Energy-recovery device % Efficiency
protection BS EN
at most
G4 (EU4) >90 General-purpose tempered air 1822 grade Notes and typical healthcare
penetrating
supply (Eurovent applications
particle size
grade)
(MPPS)
4.124 Fine filters are graded in terms of their
“atmospheric dust spot efficiency”. This is a H10 85 Ultra-clean theatre terminal
measure of the filter’s ability to remove the very (EU10)
fine staining particles found in outdoor air. It will H11 95
indicate how “visibly” clean a filter will keep a (EU11)
ventilated space. The staining particles are H12 99.5
approximately the same size as most common (EU12)
bacteria so it is also a rough measure of the filters’ H13 99.95
ability to remove them (see Table 4). (EU13)
H14 99.995 Pharmacy aseptic suite
(EU14) Category 3 room extract
U15–U17 – Not generally used in
healthcare
27
Selection High-efficiency filters – HEPA and ULPA

4.135 HEPA filters are expensive. Therefore, their
Primary filters
use should be kept to a minimum. Applications
4.128 All filters should be of the dry type. requiring HEPA filters include the air supply to
4.129 Panel filters are cheap and disposable with aseptic suites in manufacturing pharmacies and the
relatively low dust-holding capacity. They are discharges from microbiological safety cabinets.
generally used as prefilters to eliminate large 4.136 If used, HEPA filters should be of the replaceable-
particles which would otherwise clog or cause panel type with leak-proof seals. They should
damage to the fan and finned heating and cooling be installed in a manner that permits on-site
batteries. Stainless steel frames that hold disposable validation of the filter and its housing. This may
pre-cut filter pads are more economic, create less involve the release of a dispersed oil particle
waste and are therefore the preferred option. (DOP) challenge smoke through an injection
4.130 General ventilation supply plant should point upstream of the filter plus measurement of
incorporate primary air filters of grade G3, sized the DOP penetration across the downstream face.
for a maximum face velocity of 2 m/s. Additional Alternatively, a particle-counting method may be
coarse prefilters may be justified where the intake used.
air is exceptionally polluted. They are sometimes 4.137 HEPA filters are sometimes fitted in extract
fitted as a temporary measure when building work systems to capture hazardous substances or
is being carried out in the vicinity of the air intake. organisms. Design provision must be made for the
subsequent safe handling of contaminated filters
Secondary filters by maintenance staff. This may be achieved by:
4.131 Where a higher standard of filtration is required, • sealing the hazardous substance into the filter
secondary bag or pleated-paper panel filters can before it is removed;
be used. Rigid frame filters incorporating pleated-
paper elements are preferred over bag filters for • providing a system to fumigate the filter to kill
critical care applications such as operating theatres. any organisms;
4.132 In urban or other areas of high atmospheric • housing it in a ”safe change” unit that permits
pollution, a higher standard of filtration may be the filter to be ejected into a bag and sealed
justified to reduce the level of staining to internal without staff having to come into direct contact
finishes. with it.
4.138 In view of the costs and problems associated
Extract air filters with placing HEPA filters in extracts, it is
4.133 Extract filtration will generally only be required recommended that a full risk assessment be carried
where heat-recovery devices are installed. There are out at the design stage. This should include
a very limited number of specialised applications defining the need for HEPA filters in an extract;
(microbiological safety cabinets and similar LEV validation of its performance at installation; the
systems) where contaminated air is required to be method of safely changing a contaminated filter;
filtered prior to discharge to atmosphere. If it is and its subsequent disposal.
safe for staff to work in a room without wearing 4.139 ULPA filters are very expensive and are designed
respiratory protective equipment, it is safe to to remove particles below a size that are either
discharge the room air to atmosphere without surgically or aerobiologically significant. There
filtration. would have to be exceptional circumstances in
order to justify their use in healthcare ventilation
Return-air filters systems.
4.134 Return-air filters are used to reduce the load on
HEPA filters in recirculating applications such as Activated carbon filters
ultra-clean operating suite ventilation canopies and 4.140 Activated carbon filters are able to remove gases
pharmacy aseptic suites. and vapours from the air stream and are graded
according to the range of substances they can
28
remove. They are not normally fitted in air- 4.148 The following are the minimum energy transfer
conditioning supply systems. efficiencies required for devices handling equal air
volumes:
4.141 They are occasionally fitted retrospectively because
the main air intake has been poorly sited and is • run-around coil – 45%;
drawing in traffic fumes. Where used, they must
• plate heat exchanger – 50%;
be protected by a particulate air filter.
• thermal wheel – 65%;
4.142 Activated carbon filters are more commonly used
in specialised fume-extraction systems when the • any other energy-recovery device – 50%.
location of the discharge means that dilution 4.149 If a plate heat exchanger is chosen, the plates
cannot be relied upon to disperse noxious fumes. should be constructed of metal. An internal bypass
is not always required but, if fitted, plastic should
Location
not be used for the internal dampers and drive
4.143 The primary filter should be positioned on the gears.
inlet side of the supply fan, downstream of the
4.150 Whichever energy-recovery device is chosen, the
frost coil. The secondary filter, when fitted, should
extract side will need to be protected by a G3 filter
be on the positive-pressure side of the fan. This
and provided with a drainage system (as described
will prevent air being drawn into the system after
above) to remove condensate.
the filter and capture any particles shed by items of
equipment within the AHU. Location
4.144 The filter installation must be arranged to provide 4.151 Energy-recovery devices should be located
easy access to filter media for cleaning, removal or downstream of the fog coil and prefilter, prior
replacement, with side or front withdrawal as to the cooling coil or main heater-battery on the
required. supply side. If heat pipes are selected, it may be
possible to use them to replace the fog coil.
Control
4.145 Differential-pressure transducers should be Control
provided to remotely monitor and alarm on 4.152 It is essential to consider the control of both the
excessive filter pressure drop. In critical care areas, energy-recovery device and the fog/frost coil when
dirty-filter indication lights should be provided at assessing the economics of recovery, as all energy
the point of use. provided by the frost coil will directly reduce the
heat exchange of the recovery device. To this end,
Energy recovery the off-coil setting of the frost coil should be the
minimum possible to protect the primary filter
General requirements (for example +2oC).
4.146 Energy recovery must be fitted to all healthcare 4.153 The control of the energy-recovery device should
ventilation systems. It may be omitted only where be fully integrated with that of the main plant to
it would clearly be uneconomic (for example to a ensure maximum economic benefit.
single WC extract system).
4.154 Plate heat exchangers and heat pipes can be self-
4.147 For systems in healthcare premises, a plate heat controlling in the sense that energy will transfer
exchanger or “run-around coil” system is suitable. across the device from the extract to the supply at
Thermal wheels may be used providing they are winter design values and from the intake to the
fitted with a purge sector. The small amounts of extract discharge at summer design values, thus
air leakage across these devices are not considered obviating the need for a bypass and sophisticated
significant. Other systems such as heat pumps or control system.
heat pipes are also suitable. Selection should be
based on the relative locations of the supply and
extract units, ease of maintenance and practicality.
Cleaning access will be required to both sides of
any energy-recovery device.
29
Attenuation 4.160 Provided care is taken in the design and

construction of low-pressure systems to avoid
General requirements significant noise generation in the ductwork,
attenuation should only be needed to absorb fan
4.155 Noise is generated in an air distribution system by noise.
the fan, plant items and air flow. The ductwork is a
very effective transmitter of this noise; hence, there 4.161 Noise break-out from all equipment housed in
is generally a need to limit the noise transmission the plantroom must be taken into consideration
to meet the requirements of the building. This if control is to be satisfactory. Any ductwork
normally involves the provision of sound within the plantroom after the silencer should be
attenuation treatment as part of the overall acoustically insulated to prevent noise break-in.
ductwork system design. 4.162 There is no complete means of control over
4.156 A thorough assessment of the design should be external noise generation from sources such as
made to assess the noise impact. This should take road traffic, aircraft, factory and community noise.
into account the following primary factors: Consideration must be given to this at the design
and planning stage.
• fan- and plant-noise generation;
• air-flow-generated noise in ductwork fittings Acceptable types and location
and dampers; 4.163 The noise levels produced by ventilation and other
• noise generated at grilles, diffusers and other plant should be reduced by either lining the inside
terminals; of the duct with sound-absorbing material or
fitting bespoke attenuator units.
• noise break-in and break-out of ductwork;
4.164 In supply systems, sound-absorbing material
• cross-talk and similar interference; should not be applied to the inside surface of
• the noise limitations for the building and a duct system downstream of the final filter,
surrounding areas; owing to the risk of mechanical damage and
the subsequent dispersal of the media into the
• external noise generation.
ventilation system.
4.157 A method of assessment of these factors and the
4.165 In supply and extract systems, sound-absorbing
sound attenuation requirements of ductwork
material should not be applied to the inside of a
systems is given in CIBSE’s Guide B.
duct within 1 m of a fire damper. The material
4.158 The fan is usually the main source of system noise. should be non-particle-shedding and fire-resistant
The sound power that it generates varies as the (see Health Technical Memorandum 05-02).
square of the fan pressure, and thus to limit the fan Where sound-absorbing material is applied in a
noise level the system resistance should be kept as section of duct that will be routinely exposed
low as economically possible. As a general rule, the during maintenance activities, it should be
selected fan should operate close to its point of protected from mechanical damage.
maximum efficiency to minimise its noise
4.166 Bespoke attenuator units with a sound-absorbing
generation. Where there is disturbance to the air
in-fill suitable for the quality of air being handled
flow at the fan inlet, the manufacturer’s stated fan
and protected by a perforated sheet metal casing
noise levels should be increased by up to 5 dB(A).
are the preferred option for critical systems.
More precise guidance on this aspect may be
Absorption of moisture, dirt and corrosive
available from the manufacturers.
substances into the “in-fill” and the release of
4.159 Fans radiate noise through both the inlet and fibrous particles into the air stream should be
outlet connections, and it may be necessary to prevented by the use of a membrane. The
provide attenuation to limit the noise from both of membrane material should have a declared service
these connections. It is always preferable and more life of at least 25 years. If these conditions can be
economic to control noise and vibration at source, met, the attenuator may be located in the supply
or as close to source as possible. It should be noted ductwork downstream of the final filter. When so
that attenuators offer a resistance to air flow. The located, cleaning access should be provided at both
resistance must be included in the fan and ends of the attenuator unit.
ductwork calculations.
30
5 Air distribution system
Air distribution arrangements appropriate. If they are a source of vibration, they

should be linked to the distribution ductwork via
Ductwork distribution systems flexible connections.
5.1 Ductwork systems for ventilating and air- 5.6 The fan of an LEV system provided under the
conditioning applications are referred to by COSHH Regulations should be located outside the
their velocity or pressure category, that is, as low, building so that all ductwork within the building is
medium or high velocity (or pressure) systems. under negative pressure. Where the fan has to be
HVCA limits are up to: within the building, it should be located as close
as practicable to the outside, with an absolute
• 10 m/s or 1000 Pa in the case of conventional minimum run of discharge ductwork within the
low-pressure systems; building. This discharge ductwork will be under
• 20 m/s or 1750 Pa in the case of conventional positive pressure, so it must not be penetrated by
medium-pressure systems; and test holes or inspection hatches.
• 40 m/s or 3250 Pa in the case of high-pressure Ductwork materials and construction
systems.
5.7 The choice of duct material should take account of
Note the nature of the air or gas being conveyed and the
environment in which the duct will be placed.
High-pressure systems are disappearing because of the
constraints of the Building Regulations, but existing 5.8 Galvanised-sheet-steel ductwork is the most
systems may sometimes need to be altered or extended. suitable and economical choice for normal
ventilating and air-conditioning applications. Its
5.2 For normal applications in healthcare buildings, inherent mechanical strength renders it resistant to
low-velocity systems are recommended; the use of casual damage both during the construction phase
higher velocities than those recommended may not and throughout its service life when mechanical
be economical. Future trends are for even lower and electrical services around it are altered. It also
optimum duct velocities; however, velocities below readily withstands the impacts sustained when
2 m/s are unlikely to be justified. rotary equipment is used to clean it internally.
5.3 The site will often dictate the main routing of 5.9 In instances where moisture levels and/or corrosive
ductwork systems but, in general, the design should elements in the air being conveyed are very high,
seek to make the layout as symmetrical as possible; aluminium, stainless steel, PVC or GRP (glass-
that is, the pressure loss in each branch should be reinforced plastic) ducts should be used. Stainless
as nearly equal as possible. This will aid regulation or black steel are the only suitable materials for
and may reduce the number and variety of duct high-temperature ductwork.
fittings that are needed. 5.10 In inherently wet areas, such as the base of fresh-air
5.4 Main distribution ductwork should not be routed inlet ducts and some extract systems, the ductwork
above sleeping areas. Where there is no alternative may require draining to prevent a build-up of
route, additional acoustic insulation is required. standing water. The layout of the drains should be
as specified in Chapter 4.
5.5 Where auxiliary air-conditioning units, fans, filters
or trimming devices are installed in the distribution 5.11 Where builders’ work ducts or plenum chambers
system, they must be independently supported and are used, these may be constructed of various
fitted with a suitable drainage system, where materials. However, all such ducts must be
31
rendered and sealed to prevent dust-shedding. 5.20 An access hatch should be provided adjacent to
A greater allowance may need to be made for each fire damper so that its correct operation can be
leakage. directly observed. The hatch must be suitably sized
to permit inspection, testing and maintenance.
5.12 Galvanised, black and stainless steel ductwork
should be manufactured and installed to the 5.21 Smoke-diverting dampers must be provided on
current HVCA specification for sheet metal recirculation air systems to automatically divert any
ductwork DW144, but excluding the use of smoke-contaminated return air to the outside of
bolt-through supports. the building in the event of a fire. It should be
arranged such that the normal open smoke-
5.13 GRP and PVC ductwork should be manufactured
diverting damper on the return-air branch to the
and installed to the current HVCA specification for
input unit closes and all the return air is exhausted
plastic ductwork DW154.
through the extract fan. Guidance is available in
5.14 Flexible ductwork is unsuitable for air distribution Health Technical Memorandum 05-02 and
in healthcare applications. It should only be used BS 5588-9.
to make the final connection to a terminal (see
paragraphs 5.53–5.54). Duct sections
5.15 Where phenolic-board ductwork is considered, care 5.22 Ducting is generally available in rectangular,
should be taken to ensure that it is fabricated to a circular and flat oval sections, although other
quality standard and installed strictly in accordance sections may be manufactured for particular
with the manufacturers’ instructions. Its pressure situations.
rating and degree of support should be suitable for
5.23 Rectangular ducting is most common on low-
the application, and the duct should be fitted with
pressure systems for the following reasons:
mechanical protection where required.
• it can be readily adapted to fit into the space
5.16 The inside of the ductwork should be free from
available;
structural projections and as smooth as possible.
Flanged gasketed joints between sections are • fittings are cheaper than those for circular or flat
preferred. oval ductwork;
• it can be readily joined to such component
Fire aspects, damper types and locations
items as heating and cooling coils, and filters.
5.17 It is essential that all relevant fire aspects of ducting
5.24 When sizing ductwork, the designer should take
systems are agreed with the fire officer before the
into account:
design is finalised.
• installation and operating costs;
5.18 Ductwork must be fire-stopped where it penetrates
fire compartment walls, floors and enclosures, • space limitations imposed by the structure and
cavity barriers and subcompartment walls other services;
or enclosures, and must be provided with • operating noise levels;
weatherproof collars where roofs or external
walls are penetrated. • requirements of regulation at the
commissioning stage.
5.19 Fusible-link and automatically controlled fire
dampers should be provided at the locations 5.25 For overall economy and performance, the aspect
required by Health Technical Memorandum 05-02. ratio should be as close to 1:1 as possible, since
The fire-damper mounting frame must be securely high aspect ratios increase the pressure loss, heat
attached to the building fabric. Where a fire gains or losses and overall cost (for example,
damper is not mounted directly in a fire changing the aspect ratio from 1:1 to 1:4 can
compartment wall, it must be correctly supported typically increase the installed cost of the ductwork
and the ductwork between it and the firewall must by 40% and add 25% to the heat gains or losses).
possess the same fire rating as the firewall that it 5.26 Circular ducting is preferable for high-pressure
penetrates. The fire-rated portion of ductwork systems and for systems operating at high negative
must not be penetrated by test holes or inspection pressures. In the latter case, additional stiffening
hatches. rings may be necessary. Machine-formed spirally-
32
wound ducting and a standard range of pressed and Changes of section

fabricated fittings can sometimes make circular
5.34 The expansion of a duct section should be formed
ducting more economical, particularly in low-
with sides having a total included angle of no
pressure systems having a relatively low proportion
more than 30 degrees, and preferably less than
of fittings.
20 degrees. If the angle of expansion is greater, the
5.27 Flat oval ducting provides an alternative to circular flow is not likely to remain attached to the walls of
ducting, principally where there is a limitation on the duct, and large eddies will be formed with flow
one of the dimensions in the space available for the reversal at the walls. This leads not only to a high-
duct run. pressure loss, but also to non-uniform velocity
pattern at the outlet. Where there is insufficient
5.28 Other sections may be used, such as triangular
space for a gentle expansion and a greater angle is
sections to pass through roof trusses. Such sections
necessary, internal splitters should be used.
present difficulties in the provision of fittings and
connections to standard plant items, and are likely 5.35 A contraction in a duct section is less critical, but
to be more expensive than traditional sections. the total included angle of the taper should not
exceed 40 degrees (or 20 degrees where the
Standard ductwork fittings contraction is made on one side of the duct only).
5.29 All fittings should conform to current HVCA 5.36 The most economical way to change the section of
specification DW144. Wherever possible, long a rectangular duct is to restrict the change of duct
radius bends, large radius main branches, sub- size to one side only. If the calculated reduction or
branches with angles no greater than 45 degrees, increase to the side dimension is 50 mm or less, it
and long-taper transformations should be used. is usually not economical to change the size at the
5.30 Fittings should be arranged with vanes in sub- position. The minimum size of a rectangular duct
branches connected directly to grilles and diffusers, should be 150 mm × 100 mm.
and turning vanes in square bends (when used).
Other fittings
When vanes are used, additional cleaning access
will be required. 5.37 Fittings that have abrupt changes in direction and
sharp edges should be avoided, as this will increase
5.31 The number of duct fittings should be kept to a
turbulence, thus increasing pressure loss and
minimum, and there should be a conscious attempt
causing noise generation. If the fitting leads to
to achieve some standardisation of types and sizes.
the flow preferentially attaching to one side of the
Increasing the number and variety of fittings in a
outlet, a significant length of straight downstream
system can markedly increase its overall cost.
duct is necessary before the next branch or fitting;
5.32 Bad design in relation to air flow can lead to this length should be greater than five equivalent
vibrating flat duct surfaces, increases in duct- diameters.
generated noise and pressure loss, unpredictable
behaviour in branch fittings and terminals, and Thermal insulation
adverse effects on the performance of installed
5.38 Thermal insulation is applied to ductwork to
plant items (such as trimmer batteries).
reduce heat exchange and to prevent condensation.
Branches 5.39 In a duct system, the air-temperature changes can
be significant, especially when passing through
5.33 There are many designs of branch and junction
untreated space, and these have the effect of
in use. The important features are that the flow
reducing the heating or cooling capacity of the air
should be divided (or combined) with the
and of increasing the energy input to the system.
minimum interference and disturbance. Changes in
The heat transmission to and from the surrounding
duct sizes should not be made at the branch but at
space can be reduced by effective insulation of the
a short distance downstream (or upstream). A good
ducts.
dividing-branch design cannot be effective if the
flow entering the branch is not uniform across the 5.40 Condensation can arise in ductwork systems
section. conveying cooled air and, apart from creating
conditions conducive to corrosion of ductwork,
condensation affects the heat and vapour-resisting
33
properties of insulating materials themselves, which b. in branches of zone ducts;

may induce further condensation.
c. in sub-branch ducts serving four or more
5.41 In normal circumstances, the insulation thickness terminals;
for heat resistance is sufficient to prevent surface
d. at terminals not covered by (c) above.
condensation, but in extreme conditions the
insulation thickness for vapour resistance may be 5.48 Dampers integral with terminals should only be
greater than that for heat resistance. When cold used for final trimming of air volumes; otherwise
ducts pass through areas that have a high dew- noise and air distribution problems may ensue.
point, carefully selected vapour barriers should be 5.49 Dampers in rectangular ducts should be single-
applied externally to the insulation. bladed when the longer side is up to 450 mm, but
be of the opposed-blade multi-leaf type when above
Noise generation within the ductwork
this size. In circular ducts, iris-type dampers are
5.42 Noise is generated in ductwork at sharp edges, and recommended. Dampers must be accessible, and
by tie rods, damper blades, duct obstructions and incorporate a position indicator and means of
sharp bends. This air-flow-generated noise becomes locking in the commissioned position. Dampers
an important factor if it is about the same or should be located as far away as possible from
greater level than the upstream noise level. adjacent branches or plant items.
(Air-flow-generated noise is often referred to as
“regenerated noise”.) Cleaning and access door locations
5.43 The noise level generated by the air flow in 5.50 Cleaning and access doors are required to facilitate
ductwork is very sensitive to the velocity. The access to plant items and ductwork components for
sound power of this noise is approximately inspection, maintenance, cleaning and replacement.
proportional to the sixth power of the velocity; that They must be of sufficient size to permit safe access
is, a doubling of the duct velocity will increase the for the required functions. Consideration should
sound power by a factor of 64. The duct velocities also be given to the number of doors to be
should therefore be kept as low as possible. In provided.
general, duct fittings that have lower pressure-loss 5.51 Recommended locations for access doors are given
factors in similar flow conditions will generate less in current HVCA specification DW144. They are
noise. generally provided to give access to:
5.44 Ductwork serving quiet areas should not be routed
• every regulating damper;
through noisy areas, where noise break-in can occur
and increase the noise level in the ductwork. • every fire and motorised damper;
5.45 Grille register and louvre noise should be kept to a • filters (to facilitate filter withdrawal);
minimum by selecting types that: • both sides of cooling/heating coils;
• have low noise-producing characteristics; and • humidifiers;
• are without high tonal noise. • fans; and
They should be fitted with acoustically-treated • motors and impellers.
external inlet and outlet louvres.
5.52 Care should be taken when siting cleaning and
5.46 Cross-talk attenuators may be necessary where access doors to ensure that no other services to be
noise intrusion between adjacent spaces can arise installed will prevent reasonable access.
and where confidentiality is required. They will
normally be of the “through-the-ceiling, up-and- Flexible ducting
over” type, and may include a fire damper if
required. 5.53 Flexible ductwork may be used for final
connections to grilles and diffusers, provided
Volume control damper locations it is constructed to meet the fire precautions
recommended in BS 8313. It must not pass
5.47 Manually-operated balancing dampers are needed through fire compartment or subcompartment
generally: enclosures, or through cavity barriers.
a. in the main duct downstream of the fan;
34
5.54 Flexible ducting will cause a significant frictional b. spread – defined as the width of the 0.5 m/s
loss and may be difficult to clean without damage. isovel; and
It should never be used in lieu of a bend. Where
c. drop – defined as the vertical distance from the
installed, it should take the most direct route and
centre line of the terminal to the bottom edge of
be as short as possible, never exceeding 1 m in
the 0.25 m/s isovel.
length.
5.60 It is necessary to consider each of these parameters
Diffuser and grille selection and sizing in both summer and winter conditions to ensure
satisfactory operation of the air-terminal device, as
5.55 The effectiveness of all ventilation and air-
warm jets behave very differently from cold jets.
conditioning systems depends on the methods
by which air is introduced to, and vitiated air is 5.61 A warm jet tends to rise until it attaches itself to
removed from, the space. The usual results of poor a horizontal surface, while a cold jet falls. Care
air-terminal selection and/or positioning are: must be taken to ensure that this does not lead to
unacceptable temperature gradients in winter, or
• draughts;
excessive air velocities in the occupied zone in
• stagnation; summer.
• poor air quality; 5.62 In order to ensure satisfactory air movement
• large temperature gradients; and within a space, it is necessary to consider
interaction between air movement from adjacent
• excessive noise. terminals and ceiling-mounted fixtures (light
5.56 Air can be supplied to a space in a number of ways, fittings etc), as well as interaction between air
although any device can be broadly placed into one movement and room surfaces.
of two categories: 5.63 If the supply and extract terminals are too close,
a. that producing a diffused supply; or short-circuiting may occur; if they are too far
apart, stagnant zones may be formed. Where two
b. that producing a perpendicular jet. opposing air streams meet, the individual velocities
Diffusers may be radial or linear, and normally must not be greater than 0.25 m/s.
utilise the Coanda effect (that is, adhesion of the air 5.64 Supply and extract grilles and diffusers should
stream to an adjacent surface) to reduce the risk of be fitted with opposed-blade dampers for fine
excessive room-air movement. A perpendicular jet balancing purposes.
is formed by discharging air through grilles, louvres
or nozzles, which are generally adjustable. 5.65 Further guidance on the selection of grilles and
diffusers is given in CIBSE’s Guide B.
5.57 Supply air terminals can be incorporated into any
room surface (for example floors, walls (high or low 5.66 In operating theatres, supply terminals must be able
level) and desktop). to produce a down-flow movement of air in the
operating zone, 1 m above floor level. The
5.58 As they operate on the jet principle, the use of side- following supply terminals are acceptable:
wall and linear grilles is restricted to areas where
air-change rates are fewer than ten per hour. • ceiling-mounted diffusers with fixed directional
Perforated rectangular diffusers can provide vanes that provide a downward turbulent air
acceptable conditions within the occupied zone flow are the preferred option;
at up to 15 air changes per hour. In areas where a • plenum boxes fitted with perforated screens
higher air-change rate is required, square or circular that produce a parallel downward flow;
ceiling-mounted diffusers should be used.
• linear ceiling-mounted diffusers that provide
5.59 The performance of supply air-terminal devices is a downward air curtain around the operating
based on three criteria: zone (additional supply terminals may be
a. throw – defined as perpendicular or parallel located within the area bounded by the linear
distance from the terminal to the point at which diffusers to provide ventilation within the air-
the air velocity is 0.5 m/s isovel; curtained zone).
5.67 Nozzles or jets of any type are not acceptable in
an operating theatre. Side-wall-mounted linear
35
diffusers that utilise the Coanda effect to send air 5.75 Fire precautions for pressure stabilisers are the
across the ceiling and “drop” it into the operating same as for transfer grilles. For sizing criteria,
zone are not suitable. see Chapter 7.
5.76 Pressure stabilisers should be of the balanced-blade
Transfer grille – size and location
type, with the facility to make fine adjustments to
5.68 Air-transfer grilles in walls, partitions or doors form the pressure setting. They should be silent in
an integral part of the building’s air distribution operation and give a seal as tight as practicable
system. Modern doorsets have very low leakage when closed. The materials of construction and
rates, so cannot be relied upon to permit even quite method of assembly should allow for cleaning and
small air flows. Failure to make adequate provision disinfection.
for air to move from room to room will result in
5.77 Pressure stabilisers should be installed in a visible
excessive pressure differentials and “door whistle”.
location so that their operation can be readily
5.69 Transfer grilles are required in locations where there observed.
is a significant imbalance between the supply and
5.78 Cross-talk attenuators may be necessary where
extract rates in a room. They will relieve any
noise intrusion between adjacent spaces can arise
pressure differential that may affect the operation
and where confidentiality is required. In these
of the spaces and/or the ventilation system, and
cases, the pressure stabiliser and cross-talk
permit air flow in a known direction.
attenuator should be mounted in a short length
5.70 Care needs to be taken to ensure that the of ductwork within the ceiling void.
positioning of transfer grilles does not interfere
5.79 Pressure stabilisers may need to be fitted with a
with the fire or smoke integrity of the building. In
stand-off baffle on their discharge side to prevent
general, air-transfer grilles should not be installed
a sight line in situations where a laser will be used.
within fire-resisting boundaries, although if this is
Baffles may also be required to preserve privacy
unavoidable, they should be fitted with fire or
or to prevent discharge air causing draughts or
smoke dampers.
disturbing the air-distribution pattern in an
5.71 Where installed, transfer grilles should be of the adjoining room. They are also useful in low-level
non-vision type and sized for a maximum face locations to prevent the air-flow path being
velocity of 1.5 m/s. obstructed by portable equipment.
5.72 In photographic darkrooms, lightproof transfer
grilles are recommended.
5.73 Cross-talk attenuators may be necessary where
noise intrusion between adjacent spaces can arise
and where confidentiality is required (see also
paragraphs 5.42–5.46).
Pressure stabilisers – size and location

5.74 Pressure stabilisers are required in lieu of air-
transfer grilles in areas where it is necessary to
maintain pressure differentials between adjacent
rooms to prevent reversal of air flows (for example
in operating suites, isolation facilities and clean
rooms (see also Chapter 7)).
Pressure stabiliser with stand-off cage
36
6 Automatic controls
6.1 Various options for control of single and multi- Objectives of the control system
zone air-conditioning systems are given in CIBSE
6.8 The primary objective of a ventilation or air-
Guide B.
conditioning plant control system is to keep the
space served within the required environmental
General requirements control limits, at the appropriate times – regardless
6.2 The basic requirements for an automatic control of external conditions or internal loads – and with
system are as follows: the minimum energy consumption.
• facilities to start, set-back and stop the plant; 6.9 Control of most systems will be via a building
management system (BMS). This will enable the
• facilities to control the volumetric air flow; operating conditions and control tolerances to be
• facilities to control the system or room pressure; set and monitored. Often, it is not possible to
accurately predict building load variation at the
• temperature control and indication;
design stage. Information provided by monitoring
• humidity control and indication; the operation of the plant via a BMS will enable
optimum set-points to be established and energy
• devices to monitor and indicate the plant’s
consumption reduced. The BMS may also be set
operating state;
to log the actual energy consumed by the system
• alarms to indicate plant failure, low air flow and together with that recovered by the energy-recovery
filter state. device. This will provide a useful check on overall
6.3 The control functions provided will depend on the operating efficiency and provide evidence that
purpose of the ventilation system. energy targets are being achieved.
6.4 There will also be a need to determine the control 6.10 A BMS incorporating self-adaptive control
strategy in the event of a fire either within the zone algorithms that automatically adjust the set-point
being served or within an adjoining zone. to suit the usage and load is preferred. The
provision of movement sensors within the
6.5 Designers should consider whether it is necessary controlled space in order to determine the actual
for the supply and extract fans to be interlocked – occupancy will facilitate this process.
either so that the supply fan will not operate unless
air flow is established within the extract system, or 6.11 The failure of specialised ventilation systems
vice-versa depending on the required pressures can have grave consequences for the delivery of
within the rooms being served. healthcare. Control systems should therefore be
simple, robust and reliable.
6.6 The sequence switching of units in order to prevent
transient reverse air flows will be particularly 6.12 Computer-software-driven control systems are
important in laboratories and pharmacies that becoming the norm in building services. However,
contain fume cupboards, safety cabinets and other healthcare ventilation systems need to be available
LEV systems. for operation outside of normal working periods
when software support is not available. Should the
6.7 Alarms should be provided to show “filter fault” software fail, it will be left to site staff, who may
and “low air flow”. The “filter fault” alarm should have little knowledge of the control algorithms,
be initiated by a predetermined increase of pressure to restart the ventilation system. It is therefore
differentials across the filter. The “low air flow” essential to ensure that a simple means of restarting
alarm should be initiated when the supply-air critical systems in the event of a software failure is
quantity falls to 80% of the design value. provided (see also paragraphs 4.62–4.63).
37
Location of controls 6.20 In all critical care areas, the ventilation system
should continue to operate unless smoke starts to
6.13 Whether within the plant, duct or room, sensors
enter the AHU. A notice should be affixed to the
should be located to provide accurate measurement
fire control panel stressing the need to liaise with
of the condition of the air being monitored.
departmental staff before switching off fan units.
6.14 Sensors and control items such as control valves
6.21 All supply AHUs should have a smoke sensor
should be located close to the element being sensed
mounted in the main supply duct immediately
or plant item being controlled in order to minimise
downstream of the AHU. In the event of a fire in
time lags within the system, which may create over-
the AHU or smoke being drawn into the system
shoot of conditions beyond the design envelope
from an outside source, it should cause the supply-
and result in additional energy consumption.
air fire damper to close and shut down the AHU.
6.15 There are practical advantages in locating
all control valves for an AHU in a bank (at a Time switching
convenient height) at one end of the unit. (This
should not result in an additional control lag.) 6.22 Facilities to start, set-back and stop the plant
should be provided in the plantroom. Remote start
6.16 Some applications require intermittent mechanical and set-back control and indication, if required,
ventilation, frequently at a high air-change rate (for should be provided at a manned staff location
example in bathrooms and treatment rooms). Local (for example at the reception or staff base).
controls to facilitate this mode of operation should
be placed in a prominent position to encourage 6.23 Many ventilation systems may be completely shut
economical use. down when the area served is not in active use (for
example operating theatres). Alternatively, where
6.17 Local controls that enable the user to select more there is a need to maintain a background condition,
than one mode of operation should be clearly the ventilation output can be reduced by “setting
labelled to identify the particular mode selected. back” the system. This will significantly reduce
Where the system allows different room pressures energy consumption and extend the life of filters
to be selected, a direct-reading pressure gauge and other system components.
should be fitted within the eye line of the users
to provide an independent confirmation of the Start-up control
resultant mode of operation. A clear description
6.24 The plant’s start control should contain a control
of the selectable modes of operation should be
mounted adjacent to the control switch. logic that will start the plant in the sequence set out
in the algorithms in Figures 2–5.
Fire aspects
Set-back control
6.18 A fire control panel should be mounted at the
6.25 Where variable-speed controls are installed, the
entrance of the area that the ventilation serves.
Access to the panel should be restricted to the fire set-back facility for each plant should depress the
officer and include independent on/off controls control temperature to around 15oC; exclude any
and an indication of the supply and extract systems. humidification and cooling from the system;
and reduce the supply and extract air volumes to
6.19 In certain critical care areas, it is preferable to around 50%. The extract fan can also be turned off
maintain the supply ventilation in case of a fire as long as the desired direction of air movement
within the area. For example, in an operating from clean to less clean will be maintained.
department, while undergoing surgery, the patient
cannot always be easily moved without significant Use control
risk. In the event of a fire in a staff or support
6.26 The installation of movement detectors allows
area of the department, or adjoining zone, the
for “use control” of ventilation systems. A simple
continued supply of air to a theatre will maintain it
control logic that reduces the system to a “set-back”
at a positive pressure and protect the patient and
condition if there has been no movement detected
staff from the effects of smoke. This will allow time
in the space for, say, 30 minutes and that switches
for the patient to be stabilised so that he/she can be
the system “off ” if no movement is detected for
safely evacuated if necessary.
one hour is recommended for many applications,
38
Figure 2 Typical plant control algorithm – normal start-up sequence
PLANT OFF
INITIATE START SEQUENCE
L.O. ISOLATION DAMPERS OPEN
FROST/FOG COIL – ON
SUPPLY FAN – START
EXTRACT FAN – START
L.O. ESTABLISH AIR FLOW
L.O. ACHIEVE MIN AIR TEMP +2ºC
RELEASE HEATER/CHILLER
HUMIDIFIER TIME DELAY
OFF CONDENSATE STAT MADE
RELEASE HUMIDIFIER
PLANT RUNNING
MONITORING FUNCTIONS CONTROL FUNCTIONS
MINIMUM AIR FLOW FROST/FOG COIL
MINIMUM AIR TEMPERATURE OPERATING ROOM AIR TEMP
HUMIDIFIER HIGH LIMIT 70% OPERATING ROOM HUMIDITY
HUMIDIFIER CONDENSATE
39
Figure 3 Plant control algorithm – normal shut-down sequence
PLANT RUNNING
INITIATE SHUTDOWN
DISABLE ALARMS
SHUT DOWN HUMIDIFIER
START FAN RUN-ON TIMER
SHUT DOWN CHILLER
SHUT DOWN HEATERS
SHUT DOWN EXTRACT
SHUT DOWN SUPPLY
ISOLATION DAMPERS CLOSED
PLANT OFF
FROST PROTECTION FROST PROTECTION SEQUENCE
CONDENSATION PROTECTION RUN PLANT AT SET-BACK
40
Figure 4 Plant control algorithm – set-back sequence
PLANT RUNNING
INITIATE SET-BACK
DISABLE ALARMS
SHUT DOWN HUMIDIFIER
SHUT DOWN CHILLER
SET-BACK ROOM TEMP 15ºC
REDUCE/SHUT DOWN EXTRACT
REDUCE SUPPLY TO 50%
PLANT RUNNING SET-BACK
41
Figure 5 Plant control algorithm – restart from set-back
PLANT RUNNING SET-BACK
INITIATE RESTART
ALARM SUPPLY TO FULL OUTPUT
EXTRACT FAN – START
L.O. ESTABLISH AIR FLOW
RESET ROOM TEMP SET POINT
RELEASE CHILLER
HUMIDIFIER TIME DELAY
OFF CONDENSATE STAT MADE
RELEASE HUMIDIFIER
PLANT RUNNING
HUMIDIFIER HIGH LIMIT 70% OPERATING ROOM HUMIDITY
HUMIDIFIER CONDENSATE
42
including operating suites (see paragraphs specified temperature range to suit the user
7.31–7.90). requirement with a control tolerance of ±1 K. All
other control set-points should be selectable either
6.27 A variation on this can be provided by linking
on the control panel or at the BMS interface.
ventilation controls to the lighting. For example, in
an operating theatre, the system may be off outside 6.34 Where local control is provided, an indication of
of working hours, could run at set-back when the temperature will be required locally or at a staff
general lighting is switched on, and increase to full base (if appropriate) using an analogue or digital
speed when the operating lamp is switched on. indicator. The indicator should be large enough
As with movement detection, a 30-minute run-on to be read from the normal working position (for
should be provided at each stage when the lights are example at the operating table in a theatre). This
turned off. may be mounted in a supervisory control panel,
with the signal repeated on the main system control
6.28 Either of the above control strategies may be
panel or BMS. It is important that this indicator
refined by linking to the BMS to provide a
displays the actual measured temperature and not
control logic related to normal working hours and
the selected temperature.
associated “real-time” movement within the zone
being controlled. This should result in significant
Frost coil control
energy savings.
6.35 Steam-supplied fog/frost batteries must be operated
Environmental control as on/off devices with their sensor mounted
upstream of the battery. This will give “open loop”
Temperature control methods and application control. A set-point of +1oC is recommended.
6.36 LPHW-supplied frost batteries should be
General controlled using the proportional mode. Their
6.29 All control valves must fail-safe, that is, close in sensor should be located downstream of the battery
the event of power or air-flow failure, with the to give “closed loop” control. A set-point of
exception of the fog/frost battery control valve, between 2oC and 5oC is recommended.
which should open upon power or air-flow failure. 6.37 If the temperature downstream of the frost battery,
6.30 Control valves should be located in an accessible as sensed by a serpentine thermostat, falls below
position. Isolation valves should be provided to the required set-point over any part of the coil, the
enable the control valve to be removed for service plant must automatically shut down in order to
without the need to drain-down the system. prevent damage to the other batteries. The
serpentine thermostat must not be in direct contact
6.31 Care should be taken to ensure that the installation
with the coil.
of control valves and their associated pipework do
not obstruct access to the AHU inspection doors Off-plant control
and hatches.
6.38 The control logic must prevent the chiller and pre-
Room temperature control heater being on at the same time.
6.32 The limits for room temperature set-point are
Humidity control methods and application
generally between 16oC and 25oC depending on
the particular application, and in some specialised 6.39 In order to prevent excessive condensation when
instances (for example operating departments) are starting up from a total plant shut-down, a time
adjustable within a predetermined range by the delay should be incorporated into the control
user. system such that the humidifier does not start until
30 minutes after the ventilation plant starts up.
6.33 The selection of temperature set-point for each
room or zone may be by a control facility in 6.40 Irrespective of the method of control, a high-limit
the room/zone or be carried out remotely at the humidistat should be installed to ensure that when
control panel or BMS. Where the control device is the humidifier operates, the condition of the air
mounted within the room/zone and is adjustable in the duct does not exceed 70% saturated,
by the user, it should be marked either “raise” and particularly during plant start-up.
“lower” or “+” and “–”. It should control within a
43
6.41 With certain types of steam humidifier, it may be within the central plant, with trimmer heater-
necessary to install a thermostat in the condensate batteries on individual zones.
line from the humidifier’s steam supply, to ensure
that the steam at the control valve is as dry as Alarms and indication
possible before it is injected into the air supply. 6.48 Supply and extract systems should include indicator
6.42 The humidifier and cooling-coil control must be lamps on the control panels to confirm the
interlocked so that they cannot be on at the same operational status of each system. Where the usage
time. is on a regular daily pattern, time control with a
user-operated, timed manual override should be
6.43 The humidifier control system should ensure that
provided.
it is switched off with the fan. It is preferable to
design the control system so that the humidifier 6.49 Where a system is provided for a particular space,
is isolated for an adequate time before the fan is the indicator should be in, or immediately adjacent
turned off so as to purge humid air from the to, that space, and local controls should be
system. provided with labels clearly defining their function
(for example isolation suites).
6.44 All control valves must fail-safe (that is, close in the
event of power failure), and the humidifier must be 6.50 The “plant failure” and “low air flow” alarm should
interlocked with the low air-flow switch. be initiated by a paddle switch or other device
located in the main air-supply duct. This should
Multi-zone control methods and application. operate when the air quantity fails to reach or falls
to around 80% of the design value and will give
6.45 Close control of all air-conditioning parameters
indication of fan failure, closed damper, left-open
may be difficult to achieve with multi-zone
access door, or any other eventuality that could
systems, since each zone will in theory require a
cause a reduction of air quantity. Monitoring the
reheater and humidifier to give total control of
current drawn by the fan motor is not a substitute
humidity, if that is what is required. In reality, such
for a sensing device that is directly affected by the
close control is rarely required. It is therefore usual
air flow.
with multi-zone systems to provide control of zonal
temperature only, with humidity control, where 6.51 The “filter fault alarm” should be initiated by a
fitted, being based on average conditions within all predetermined increase of pressure differential
zones, or minimum conditions within one zone. across the filters, thereby indicating a dirty filter.
6.46 Where there is a requirement for close control of 6.52 Direct-reading gauges or manometers should be
air-conditioning parameters in a number of zones installed across filters to give maintenance staff an
(for example an operating department), separate indication of their condition.
plants should be provided for each zone in order
6.53 Visual indication should be provided at a manned
to avoid the need for expensive over-cooling and
staff location (for example the reception or staff
reheating of individual zones.
base), on the main control panel and on the BMS
6.47 The control of most multi-zone systems within to show “plant failure” and “low air flow”.
healthcare premises is based on off-coil control
44
7 Specialised ventilation systems
7.1 This section contains design information for a g. Pathology departments:

range of healthcare ventilation applications.
(i) laboratories;
7.2 The following departments will require a degree of
(ii) Category 3 and 4 rooms.
specialised ventilation:
h. Mortuary and post-mortem rooms:
a. Operating departments:
(i) mortuaries;
(i) treatment rooms;
(ii) post-mortem rooms;
(ii) endoscopy, day-case and minimum
invasive suites; (iii) specimen stores.
(iii) cardiology e j. Hydrotherapy units.
(iv) conventional operating theatres; k. Burns units:
(v) ultra-clean ventilation (UCV) operating (i) burns theatres;
theatres; (ii) treatment rooms;
(vi) barn theatres; (iii) isolation rooms;
(vii) recovery and ancillary areas. (iv) tissue banks.
b. Obstetrics: m. Emerging specialties:
(i) maternity theatres; (i) gene therapy units;
(ii) birthing rooms. (ii) stem-cell laboratories.
c. Critical areas and high dependency units of any n. Infrastructure:
type.
(i) plantrooms housing combustion
d. Isolation facilities: equipment;
(i) infectious diseases units; (ii) welding facilities;
(ii) bone marrow and other transplant units; (iii) woodworking workshops;
(iii) chemotherapy and oncology units. (iv) electric-vehicle charging areas.
e. Sterile services departments: 7.3 Design information for many of these applications
(i) wash rooms; is given in this chapter and also in Appendix 2.
(ii) inspection and packing rooms;
General information
(iii) storage rooms.
7.4 The section on operating theatre suites is the most
f. Pharmacy departments: extensive and contains much information that is
(i) aseptic suites; common to other applications. Where no specific
guidance is given, the principles set out below
(ii) extemporaneous preparation areas; should be followed:
(iii) radio pharmacies. a. The foregoing sections of the document contain
general information on healthcare-specific
45
aspects of ventilation system design and required for this aspect. It is important that the
specification. design makes the best possible use of the air
available, as excessive supply air flows for the
b. A set of standard solutions for the design of
control of air movement should not be used. The
general operating theatre suites to conform to
amount of air supplied will be determined by the
past and new standards is given in paragraphs
number of doors and desired air-change rate.
7.31–7.90, and those for UCV theatres in
paragraphs 7.91–7.147. 7.7 Airborne contaminants may enter a room via the
following routes:
c. The CIBSE guides A and B contain basic
information on ventilation design, which can be a. through the supply air;
applied to most applications.
b. shed directly by the room occupants;
d. Where a British or European standard exists
c. as a result of work activities;
that is specific to the application (for example a
clean room), it should be used as the basis of the d. transferred from adjacent spaces.
design requirement. 7.8 Particles entering with the supply air can be
e. Air should always move from clean to less clean controlled by the selection of suitable filter grades.
areas. A hierarchy of room cleanliness is given in 7.9 Particles shed directly by the room occupants can
Appendix 3. be controlled by:
f. Differential pressure will prevent contamination a. restricting access to essential persons only;
between areas when doors are closed.
Information on air leakage through closed doors b. the choice of the occupants’ clothing;
and hatches for a range of differential pressures c. the room’s air-change rate.
is given in Appendix 4.
7.10 Particles arising as a result of the work activity can
g. The flow of air will prevent contamination be controlled by:
between areas when doors are open.
Information on air leakage through open doors a. enclosing, semi-enclosing, or otherwise, the
and hatches for a range of differential pressures work-based source;
is given in Appendix 6. b. the room air-change rate.
h. If anaesthetic gases are used, 15 air changes per 7.11 The transfer of particles from adjacent spaces can
hour will be required. be controlled by:
j. A methodology for calculating a design solution a. differential pressure;
for a non-standard suite of operating rooms is
given in Appendix 8. This may be adapted as b. clean air-flow paths.
necessary to suit other less complex applications 7.12 Air-change rates are given in Appendix 2. These
where air is required to cascade from clean to figures have been found to give sufficient dilution
less clean areas. of airborne contaminants, provided the mixing of
7.5 The supply of air to a room has four main room air is reasonably uniform.
functions: 7.13 Downward-displacement turbulent air distribution
a. to dilute airborne contamination; is generally preferred. The supply and extract
diffusers should be positioned to ensure that all
b. to control air movement such that the transfer parts of the room are actively ventilated and that,
of airborne contaminants from less clean to where necessary, staff will be in a clean air-flow
cleaner areas is minimised; path (see Chapter 5 for additional guidance on
c. to control the temperature and, if necessary, the supply terminals).
humidity of the space; 7.14 Horizontal-flow room-air distribution with or
d. to assist the removal of, and dilute, waste gases without a Coanda effect can be a source of draughts
where used. and difficult to set up correctly. Its use should be
confined to non-critical areas.
7.6 Because of the complexities of controlling air-
movement patterns, much design effort will be
46
Air-movement control level with an extract at low level, adjacent to the

anaesthetic-gas terminal units, will ensure that staff
7.15 The design of the system should seek to minimise
are in a clean air-flow path.
the movement of contaminated air from less clean
to cleaner areas. Transfer grilles enable air to pass 7.21 In birthing rooms, the use of anaesthetic gas is
in either direction between rooms of equal class controlled on demand by the patient. This may
and pressure. Pressure stabilisers operate in one result in significant leakage that – in order to
direction only; they allow excess air to be directed reduce staff exposure – will need to be controlled
to the area desired and assist in maintaining room- by establishing a clean air-flow path. A supply at
pressure differentials. When closed, they prevent high level at the foot-end of the bed with extract at
significant reverse air flow. low level at the head-end will provide such a path.
7.16 The relative locations of supply and extract
Fire aspects
terminals and their design air-volume rates will
determine the basic air flow between adjacent 7.22 When considering the overall air-flow movement,
spaces. Transfer grilles and pressure stabilisers will careful thought needs to be given to the operation
permit and control the flow of air between spaces, of the ventilation system, to limit smoke spread in
ensuring a flow from the clean to less clean areas. the event of a fire.
Failure to provide such devices will lead to
uncontrolled air flows when personnel move Door protection
between rooms. It may also result in doors being 7.23 Air should flow from the cleaner to the less clean
held partially open by air pressure. areas as shown in Appendix 3. There are several
factors that affect the likelihood of reverse air flow
Temperature and humidity control through doorways:
7.17 To achieve the required room conditions, supply • when a person passes through a doorway, both
flow rates are calculated conventionally, taking the passage of the person and the movement of
account of all heat and moisture gains and losses, the door flap cause a transfer of air between the
and of maximum permissible temperature areas separated by the door;
differences between the room and supply air. In
most applications, the base heating load will be • when a door is left open, there is a transfer of air
provided by a heating system. In critical systems, between the two areas separated by the doorway.
the room or suite being considered will be within This is caused by air turbulence, but is greatly
the heated building envelope so the ventilation will increased by any temperature differential
be sized to suit the casual gains or losses. between the areas (a 1.4 m wide doorway may
allow the transfer of 0.19 m3/s of air in each
7.18 Temperature differences of up to 10 K for winter direction when there is no temperature
heating and 7 K for summer cooling should not be difference, but when the temperature
exceeded (see paragraph 3.10). differential increases to 2 K, the volume
7.19 It is acceptable for supply-air humidity to swing transferred may increase to 0.24 m3/s).
uncontrolled between 35% and 70% saturation. 7.24 In order to reduce the likelihood of contamination
of a clean area by reverse air flow from a less clean
Removal and dilution of waste anaesthetic gases
area, two methods of door protection are used:
7.20 Anaesthetic gases are subject to workplace exposure
a. closed door protection – a pressure differential
limits. Waste anaesthetic gases must be contained
is created across a closed door so that any air
and removed by a suitable gas-scavenging system.
leakage is from the clean to the less clean area.
Some leakage from anaesthetic equipment and the
Appendix 4 gives details of closed-door leakage
patient’s breathing circuit will occur with all
rates for a range of differential pressures;
systems, particularly during connection and
disconnection, and from the interface with the b. open door protection – the pressure differential
patient. The air-movement scheme should ensure drops (see Appendix 6) and is effectively
that this leakage is diluted and removed from the replaced by a flow of air through the doorway
room. Anaesthetic agents are heavier than air; from the clean to the less clean area. The flow of
therefore, placing the supply terminal at high air needs to be sufficiently large to ensure that
significant reverse air flow cannot occur, and
47
will be related to the relative cleanliness of the Additional information for UCV theatres is given
areas being considered. Appendix 5 gives air- in paragraphs 7.91–7.147.
flow rates for open-door protection related to
door/opening size and classification of the General
adjoining areas. 7.33 The supply of air to an operating room has four
7.25 Pressure stabilisers enable the room’s differential main functions:
pressure to be set when the doors are shut, thus a. to dilute airborne contamination;
providing closed-door protection. When a door is
opened, the stabilisers will close, forcing air to be b. to control air movement within the suite such
directed through the doorway, thus providing that the transfer of airborne contaminants from
open-door protection. less clean to cleaner areas is minimised;
7.26 The recommended air-flow rates to achieve this c. to control the temperature and, if necessary, the
are given in Appendix 4. Provided that the dilution humidity of the space;
criteria in Appendix 2 are met, the occasional small d. to assist the removal of, and dilute, waste
back-flows created (when two doors are opened anaesthetic gases.
simultaneously or when there is a high temperature
difference across an open door) will have little 7.34 Because of the complexities of controlling air-
effect on the overall air cleanliness of the affected movement patterns, much design effort will be
room. required for this aspect. It is important that the
design makes the best possible use of the air
7.27 In applications where it is critical to maintain available, as excessive supply air flows for the
a specific air flow and/or pressure regime (for control of air movement should not be used. The
example isolation rooms), all windows in the zone amount of air supplied to the operating room will
should be locked shut or sealed. Trickle vents, if be determined by the number of doors and desired
fitted, should also be sealed. air-change rate.
Systems design 7.35 The detailed considerations upon which the supply
air-flow rate is based are as follows.
7.28 The design of the ventilation system for an
area depends on the overall configuration of the Dilution of airborne bacterial contaminants
department. Where the department is served by
more than one AHU, the control of the units may 7.36 Airborne contaminants may enter an operating
need to be interlocked so that reverse air-flow room via the following routes:
patterns do not occur. a. through the supply air;
7.29 Dual-duct high-velocity systems have advantages, b. shed by operating staff;
but are noisy, costly, and may give rise to
unacceptable values of humidity. Single-duct, c. through surgical activities;
low-velocity/pressure systems are preferred. d. transferred from adjacent spaces.
7.30 Extract grilles should be sited and balanced to 7.37 Supply flow rates for the main rooms of the
promote air movement in the desired direction. operating suite are given in Appendix 7. For the
other areas where room sizes and activities vary
Operating department ventilation from site to site, air-change rates are given in
systems Appendix 2. These figures have been found to
give sufficient dilution of airborne bacterial
7.31 The information given in this section relates to contaminants, provided the mixing of room air is
general operating suites. It is also applicable to reasonably uniform.
other types of theatre suite such as maternity,
burns, cardiac etc. The standard values given may 7.38 Downward-displacement air distribution is
need to be adjusted to reflect non-standard room preferred, and may be either turbulent or parallel
sizes, pressure regimes and air-change rates. downward flow. For turbulent flow, supply-air
diffusers should be positioned either in the centre
7.32 A method of obtaining a design solution for of each quadrant of the ceiling or along a line
non-standard theatres is given in Appendix 8. between the centres of each quadrant. This should
48
ensure that all parts of the room are actively between rooms and doors are held partially open
ventilated and that there will be adequate air by air pressure.
movement at the operating table. Parallel
downward flow is provided by a perforated plenum Temperature and humidity control
terminal centred above the operating table (see 7.48 Supply flow rates to achieve the required room
Chapter 5 for additional guidance on supply conditions are calculated conventionally, taking
terminals). account of all heat and moisture gains and losses,
7.39 Suspended, articulated pendants in theatres require and of maximum permissible temperature
significant structural steelwork in the ceiling void differences between the room and supply air. In
to cater for the loads imposed by the resulting most applications the base heating load will be
bending moments. It is important to ensure that provided by a heating system, or the room being
the void is deep enough to accommodate both the considered will be within the heated building
steelwork and the ventilation ducts. However, the envelope.
location of the steelwork must not prevent a 7.49 Temperature differences of up to 10 K for winter
suitable layout of the ventilation ductwork and the heating and 7 K for summer cooling must not be
appropriate positioning of supply air terminals – exceeded.
the correct ventilation of an operating theatre
plays a significant role in controlling healthcare- 7.50 It is acceptable for the humidity to swing
associated infections and should not therefore be uncontrolled between 35% and 60% saturation.
compromised by the need to facilitate the
movement of equipment. Removal and dilution of waste anaesthetic gases
7.40 Horizontal-flow distribution with or without a 7.51 Anaesthetic gases are subject to workplace exposure
Coanda effect can be difficult to set up correctly limits. The air-movement scheme should ensure
and is unlikely to be as effective in theatre that staff are in a clean air-flow path (see paragraphs
applications. It should not be used in new 7.20–7.21).
installations; however, space constraints may force 7.52 Air extracted from operating suites should not
its retention or replacement when refurbishing be recirculated, as it may contain malodorous
existing installations. Where fitted, the supply contaminants; however, an energy-recovery system
grilles will require a means of directional must be fitted in the extract in order to reduce
adjustment. the plant’s energy consumption (see paragraphs
7.45 For general operating theatres, the air supply is 4.146–4.154).
filtered in the AHU. Terminal or HEPA filters are
not generally required. Fire aspects
7.53 When considering overall air-flow movement,
Control of air movement within the suite careful thought needs to be given to the operation
7.46 The design of the system should seek to minimise of the ventilation system in order to limit smoke
the movement of contaminated air from less clean spread in the event of a fire. However, this is a
to cleaner areas. Transfer grilles enable air to pass highly staffed department with a low fire risk/load
in either direction between rooms of equal class status, and these factors need to be recognised
and pressure. Pressure stabilisers operate in one when developing the fire strategy. It is considered
direction only; they allow excess air to be directed satisfactory to treat the complete operating
to the area desired and assist in maintaining room- department as a single fire compartment providing
pressure differentials. there are at least two exits from it. Over-
compartmentalisation can lead to difficulties in
7.47 The relative locations of supply and extract establishing clean air-flow paths and room-air
terminals and their design air-volume rates will dilution rates, which in turn may lead to an
determine the basic air flow between adjacent increased risk of healthcare-associated infections.
spaces. Transfer grilles and pressure stabilisers will Staff areas within the department should be treated
permit and control the flow of air between spaces, as a subcompartment (see paragraphs 6.19–6.21).
ensuring a flow from the clean to less clean areas of
the suite. Failure to provide such devices will lead
to uncontrolled air flows when personnel move
49
Door protection in the corridor. This would require local extract

to prevent a build-up of moisture.
7.54 Air should flow from the cleaner to the less clean
areas as shown in Appendix 3. The factors that • Preparation room “sterile pack store” (SPS) –
affect the likelihood of a reverse air flow through if it is intended to lay-up instruments in the
doorways are discussed in paragraphs 7.24–7.26. operating room, the preparation room will
simply be used as a sterile pack store. The
7.55 It is not possible to design an air-movement
nominal room pressure can therefore be the
scheme, within the restraints of the amount of
same as that of the operating room and the air
air available, that will protect the operating room
flow between the two rooms in either direction.
when two doors are simultaneously opened. The
Air supplied to the preparation room may be
design process that has been used considers that
directed into the operating room either through
each door is opened in turn and ensures that the
a door-mounted transfer grille, or if no door is
direction and rate of air flow through any open
fitted, through the opening. Alternatively, stock
doorway is sufficient to prevent any serious back-
ready-use sterile items can be located in a bay
flow of air to a cleaner area.
within the theatre. In this case a portion of the
7.56 Provided that the air-change rates in Appendix 2 total theatre supply air should be provided in
are met, dilution will be sufficient to ensure that the bay to ensure it is actively ventilated.
the occasional small back-flows created (when two
• Preparation room “lay-up” – when the
doors are opened simultaneously or when there is a
preparation room is used as an instrument
high temperature difference across an open door)
“lay-up” room, it should be regarded as being of
will have little effect on the overall air cleanliness of
greater cleanliness than the operating room, and
the affected room.
the design should minimise the transfer of air
7.57 The following general points should be taken into from the operating room to the preparation
consideration during the design of operating suites: room. Air supplied to the room may be directed
• Number of exits – the fewer the number of to the operating room through a pressure
rooms (and therefore doorways) leading from stabiliser, taking care not to compromise the
the operating room, the better, as traffic is air-flow pattern in the operating room. The air
reduced and less complicated air-movement may also be directed into a corridor.
control schemes are required. • Shared preparation rooms – if the preparation
• Scrub and hand-wash facilities – these may be a room is to be shared between two theatres, it
part of the operating room, often in a bay. The should be at a higher pressure (35 Pa) than
bay would count as a part of the operating room either of the theatres – even if it is only to be
volume and should have a low-level active or used as a sterile pack store. The doors to the
passive extract to remove the moisture-laden air. theatres should be interlocked to prevent them
Should a separate room be required for the both being open at the same time, and the
scrub area, a door between the scrub-up room stabilisers should be positioned to discharge into
and the operating room is an inconvenience to the corridor.
scrubbed staff, and could be replaced by an • Service corridor – if materials to be disposed
opening that is wider than a normal single of are placed in impervious material for
doorway. In this case, the scrub would not be transportation, it is not necessary to have a
considered a part of the operating room volume. separate corridor for this purpose. However,
• If a shared scrub is provided for a pair of a service corridor has many operational
theatres, it should have an active extract to advantages in terms of the flow of materials
ensure that air flow is always into it from either through the theatre suite. It also permits
theatre. routine service and maintenance access without
compromising the use of adjacent theatre suites.
• If an alcohol scrub regime is employed,
individual theatre scrubs may not be required Standard air-movement control schemes
and would be replaced by a common
7.58 In previous versions of this guidance, standard
departmental pre-/post-operation scrub position
air-movement control schemes were given that
provided a range of design solutions to typical
50
operating-suite layouts. These were satisfactory 1 Typical conventional theatre – room sizes as
design solutions for “standard” sized rooms within Health Building Note 26.
the suite, but were never intended to be universal
2 Typical UCV theatre – room sizes as Health
for any sized room or suite. Health Building Note
Building Note 26.
26 – ‘Facilities for surgical procedures’ increased
the recommended size of the operating room from 3 Health Building Note 26 illustrated
approximately 35 m2 to 55 m2. Ancillary room conventional theatre.
sizes and air-change rates also increased. This meant 4 Health Building Note 26 illustrated theatre with
that the original standard solutions were no longer UCV terminal fitted.
appropriate for new-build installations.
5 Pre-2006 conventional theatre, single corridor
7.59 Because of the resulting increase in the volume of
(Health Technical Memorandum 2025; 1b).
air supplied to the theatre, provision needs to be
made to either actively remove it or allow it to 6 Pre-2006 UCV theatre, single corridor (Health
passively escape through pressure stabilisers. The Technical Memorandum 2025; 1a).
increase in room size has also made the number 7 Pre-2006 conventional theatre, two corridors
and position of air-supply terminals critical to the (Health Technical Memorandum 2025; 5b).
effective ventilation of the room.
8 Pre-2006 UCV theatre, two corridors (Health
7.60 Four new standard solutions have been developed Technical Memorandum 2025; 5a).
to reflect the current guidance on theatre suite
layout and room sizes given in Health Building 7.65 Details of these standard solutions are given in
Note 26, as well as the general increase in air- Appendix 7, which contains diagrams showing the
change rates. relationship of rooms and the various doors and
transfer devices between them, but these should
7.61 The most commonly used original standard not be regarded as architectural layouts. The
solutions have been revised and updated. They have schemes have been developed using the calculation
been retained in this guidance, as they will remain procedure described in Appendix 8. Important
applicable to older theatre suites that are being features of the solutions are:
refurbished to their original performance standards
or are being converted from conventional to UCV • Zone trimmer heaters – a trimmer heater-
theatres. They will also be applicable in existing battery is advocated when calculations indicate
operating departments where space constraints that the temperature differential between rooms
do not permit a complete upgrade to the latest may be greater than 2 K. Generally this will
standard of performance or where a pre-built only be the case in the preparation room when
“shell” is being fitted out. designated as a lay-up, although they are
sometimes required for anaesthetic rooms.
7.62 It is important to recognise that in any situation
where a non-standard room size or theatre suite • The preparation room (sterile pack store)/
layout is being considered, the designer must return operating room interface – these rooms are
to first principles when developing a solution. deemed to be of equal cleanliness, and thus a
Examples of non-standard configurations are: transfer grille is required between them, or the
door can be replaced with an opening wider
• cardiac theatres that typically have an operating than a standard door.
room 50% larger than a normal theatre, a
perfusion laboratory and no anaesthetic room; • Preparation room (lay-up)/operating room
interface – pressure stabilisers are recommended
• operating departments served by a central here to provide an air path when doors are
instrument lay-up preparation area rather than closed, while preventing back-flow when a door
individual preparation rooms; is opened elsewhere.
• balanced-flow theatres for infectious cases. • Operating room/anaesthetic room interface –
7.63 Appendix 8 contains a methodology for assisting pressure stabilisers, or in some cases carefully
the designer to arrive at a suitable solution. sized transfer grilles, are recommended here and
also between the anaesthetic room and corridor.
7.64 The new and revised standard design solutions are
The amount of air being passed through the
as follows:
51
anaesthetic room should not be so great as to a. ceiling-mounted circular “air-master”-style

cause an unacceptable draught. diffusers; and
• Operating room/clean and service corridors b. square “four-way-blow” diffusers; or
interface – pressure stabilisers combined with
c. similar designs to those in (a) and (b) (see
low-level active or passive extracts appropriately
paragraph 5.68).
spaced to ensure air movement in all parts of
the operating room. 7.70 Plenum-type laminar-flow-style diffusers with a
footprint that encompasses the operating site are
• Operating room/scrub room interface – an
acceptable but may be prone to buoyancy effects as
opening is provided between these rooms.
a result of temperature difference. Manufacturers’
The flow of air through the opening provides
type-test data should be consulted to ensure that
protection and gives bacterial dilution within
the terminal will achieve the required performance
the scrub room; the air is then exhausted to the
envelope. Note that these are not true laminar-flow
corridor via a pressure stabiliser.
systems in the strict sense of the word, but produce
7.66 Mechanical supply or extract ventilation is not downward-displacement parallel-flow air
normally provided in the scrub room; thus, when a distribution.
door is opened elsewhere in the suite, the stabiliser
7.71 The diffuser equipment chosen should not cause
will close, allowing the air to be redirected in order
“dumping”, and it should provide a velocity 1 m
to help protect the doorway. If the scrub is a bay
above floor level at the operating position of
within the theatre or if its configuration is liable
between 0.2 m/s and 0.3 m/s.
to cause (in air-movement terms) “dead areas”,
a combination of a suitably positioned pressure 7.72 In the operating room, the supply air terminals
stabiliser and/or active extract should be provided must be at high level and should all be adjustable
to ensure air movement and to prevent a local for rate of flow, as well as being easily cleaned and
build-up of moisture. silent in operation.
7.67 Any other scheme may be used and the standard 7.73 In order to ensure that all parts of the operating
solutions applied if the following conditions are room are actively ventilated, there should be an
met: air-out path on each face or in each corner of
the theatre. This may be provided by a pressure
• room relationships in air network terms are as
stabiliser, transfer grille, or active or passive extract
shown in the plans;
terminal. A minimum of three, but preferably four,
• door-gap measurements approximate to those air-out paths – approximately equally spaced –
given in Health Technical Memorandum 58 – should be provided.
‘Internal doorsets’ (but see also Appendix 4);
Automatic control
• casual heat gains are accounted for;
7.74 The automatic control of ventilation in operating
• a trimmer battery is installed in the air-supply
suites needs to be simple and robust. Over-reliance
system to the preparation room;
on complex room pressure and flow relationships
• leakage through the structure is kept to a linked to automatic fan speed control are
minimum. unnecessary and in the long term have been shown
to be unreliable. Complex software algorithms that
7.68 It is recommended that every effort should be made
can only be accessed and interpreted by off-site
to adopt one of the schemes described above.
specialists should not be used. Whichever control
Air terminals and air distribution within rooms strategy is chosen, it is important that on-site staff
have the facility to override the control system
7.69 The selection and sighting of air diffusers is critical and keep the ventilation operating at least until
in establishing an efficient pattern of mixing. the surgical procedure is complete (see also
To this end, the diffusers selected must be fit for paragraph 6.12).
purpose. Diffuser designs that provide a downward-
7.75 Theatre air-conditioning control sensors should be
displacement turbulent air flow are the preferred
option, for example: actively ventilated. They would typically be located
in a sampling duct mounted in the surgeon’s panel
52
and be accessible for cleaning and the removal of in Appendix 5 for the operating suite are not
fluff and lint. necessary for other areas of the department;
however, air-flow directions must be maintained
7.76 Wall-mounted passive-temperature and humidity
from the clean to the less clean areas.
sensors are not recommended.
7.84 All windows in the department should be double-
7.77 Controls should be provided to enable operating
glazed and hermetically-sealed in order to ensure
department ventilation plants to be closed down
that the desired air-flow pattern is maintained
when the operating suites are unoccupied (see also
under all external environmental conditions and to
paragraphs 6.26–6.28).
avoid infestation. Trickle vents, if fitted, should be
7.78 When in the “off ” mode, the control system should sealed.
ensure that the ventilation plant is automatically
reinstated if the space temperature falls below Systems design
15oC.
7.85 The design of the ventilation system for ancillary
7.79 The theatre’s control panel should include: rooms depends on the overall configuration of the
department. The ancillary rooms’ plant may need
• plant status indication;
to be interlocked to the theatre suite’s plants so that
• clearly-readable temperature and humidity reverse air-flow patterns do not occur.
gauges; and
7.86 Extract grilles should be sited and balanced to
• a means of adjusting the set-point for promote air movement along the clean and access
temperature (see paragraphs 6.32–6.34). corridors towards the reception/transfer areas.
The theatre’s ventilation-plant status indication This should not affect the air distribution in the
should also be located at the staff control base. operating suite(s).
7.80 Where it is considered necessary to fit a humidifier, Reception

it should be selected to humidify to 40% saturation
7.87 The aim in these areas is to provide comfortable
at 20oC during external winter design conditions.
conditions, having regard to the movement-control
The cooling coil should be able to remove sufficient
requirements of the department as a whole.
moisture so that 60% saturation at 20oC is not
The number of air changes will depend on the
exceeded during external summer design
particular design.
conditions.
7.81 Each operating suite should be served by an Sterile pack bulk store
independent supply and extract plant.
7.88 The store needs to be maintained at a positive
pressure in order to preserve the cleanliness of the
Ventilation of operating department ancillary areas
outside of the packs; six air changes are
General recommended.
7.82 There are advantages in providing mechanical Recovery

ventilation to all areas of the department.
7.89 The air-change rate in the recovery room will be
Maintaining operating-suite air-flow patterns is
rather higher than that needed merely to provide
simpler; grilles and diffusers can be sited to
clean, comfortable conditions, as it is necessary
eliminate condensation on windows. Where
to control the level of anaesthetic gas pollution;
radiators or embedded wall or ceiling panels are
15 air changes are recommended, with a balanced
installed, they should be confined to the corridors
air flow.
and staff-only areas of the department.
7.90 The supply air terminals should be ceiling-
Ventilation requirements mounted above the foot-end of the bed. Extract
7.83 Appendix 3 gives guidance on the operating should be at low level (bed height or below) behind
department areas in descending order of cleanliness, the bedhead or in the corners. This will establish a
and this should be considered in the overall design clean air-flow path so that all reasonable steps are
of the department ventilation systems. The taken to reduce the risk of staff inhaling anaesthetic
specified flow rates of air through doors given gases exhaled by recovering patients.
53
Ultra-clean ventilation systems within it. Other designs utilise slotted linear supply
terminals to produce an air curtain around the
General requirements clean zone together with laminar-flow diffusers to
provide a downward-displacement supply within it.
7.91 The design philosophy of a conventionally
Notwithstanding any variation in the design
ventilated operating suite is based on the need to philosophy, all UCV systems will be required to
dilute contaminants and control both the condition completely achieve the performance standards
and movement of air in an operating suite. Ultra- set out in Chapter 8.
clean ventilation (UCV) is a means of significantly
increasing the dilution effect by providing a large 7.95 As with conventional theatres, each UCV operating
volume of clean filtered air to the zone in which suite should have its own dedicated AHU to the
an operation is performed and sterile items are standard set out in Chapter 4.
exposed. Air is discharged above the operating 7.96 To ensure operational flexibility and permit routine
zone and, while not truly laminar, its downward maintenance, AHUs should not be shared between
displacement purges the clean zone of any suites.
contaminants and particles generated within it. The
air flow in and around the clean zone also serves to 7.97 In retrofit installations, site conditions may
prevent particles originating outside the zone from preclude individual AHUs for each suite. In these
entering. The resulting reduction in contaminants circumstances, an AHU may be shared between not
has been shown to significantly reduce post- more than two operating suites, providing each
operative sepsis following certain orthopaedic suite has its own control of temperature.
procedures. 7.98 An accessible air-flow measurement test-point
7.92 The number of bacteria that are present in the should be provided in the branch supply duct to
air at the wound site and exposed surgical items is each theatre so that the primary air volume to each
dependent on the operating team, their procedural UCV canopy can be determined.
discipline, choice of clothing and the type of UCV 7.99 In addition, the branch supply and extract should
system. Ultra-clean air is defined as that containing be capable of being physically isolated and the main
not more than 10 CFU/m3. air-flow rate reduced so that either suite can be
7.93 UCV systems are very successful in reducing taken out of use without detriment to operating
contaminants at the wound site, so it is often conditions in the other.
considered that there is no need for complex air- 7.100 An inherent feature of a UCV system is its large air
movement control schemes in the rest of the suite. flow, so it is essential to recirculate the air supplied
However, when designing the ventilation scheme, to the operating theatre and/or to recover its
it should be noted that the users may switch the energy in order to optimise operating costs.
UCV terminal to set-back when non-orthopaedic
surgery is taking place. This is because the high air- 7.101 The primary fresh-air volume supplied to a UCV
flow rate can cause increased moisture evaporation suite will be the same as in a conventional suite,
of exposed tissue, which may be detrimental to and it should be dispersed to the rooms in the
the surgical outcome. In recognition of this, the suite in the same manner. This is an important
ventilation scheme should be capable of providing aspect of the design. Requests by UCV suppliers
operating conditions to at least a conventional for increased primary air-supply volumes should
theatre standard throughout the suite with the be resisted.
UCV in set-back mode. It should also be 7.102 Laying-up in the clean zone is preferable for
remembered that suitable levels of ventilation will infection control reasons. Where a preparation
always be required in the peripheral rooms. room/sterile pack store is provided, a transfer grille
7.94 UCV systems can be designed and built from first should be installed in the preparation room/theatre
principles; or a range of bespoke modular units door.
of varying shapes and sizes are available, each 7.103 If the preparation room is intended to be used for
manufacturer having a slightly different approach laying-up instruments, a pressure stabiliser will
to UCV design. Some systems are fitted with be required between the preparation room and
partial or full walls to delineate the clean zone and theatre. It should be fitted with a stand-off baffle
direct a laminar or exponential downflow of air
54
to prevent air transfer disturbing the ultra-clean 7.108 This arrangement is the preferred option for new
air-flow distribution. installations as it has the following advantages:
7.104 Separate scrub-up or disposal facilities are not • recirculation fans are located outside the theatre,
necessary for air cleanliness, although operational thus reducing noise. Multiple recirculation fans
policy may prefer such a provision. However, can be replaced by a single fan unit with its
a separate anaesthetic room should be provided. drive out of the air stream;
7.105 There is no aerobiological reason why two or more • casual heat gains from recirculation fan(s),
UCV systems should not be installed in a common canopy lights, equipment and people within the
area as long as adequate spacing is provided. This theatre can be removed by a chiller battery in
type of arrangement is known as a “barn theatre” the return air stream. This will prevent heat
and requires special design considerations and build-up in the theatre;
operational discipline.
• return-air filters can be changed without
7.106 The relative positions of the UCV units, needing access to the theatre, making routine
temperature control range and location of doors maintenance more feasible;
and openings to other areas will all significantly
• the opportunity exists to locate HEPA filters in
affect the air flow at the operating positions.
the primary supply duct rather than the theatre
terminal. This will reduce the number of filters
Types of UCV system
required and allow them to be changed without
Remote plant systems entering the theatre.
7.107 In a remote plant system, all air-conditioning Modular systems

equipment is located outside of the operating
7.109 Modular systems are frequently used in retrofit
room, except for the unidirectional air-flow
applications. Vertical or horizontal units are
terminal, terminal filter, air diffuser and the
available.
return-air grilles (see Figure 6).
Figure 6 UCV theatre with remote air recirculation
Auxiliary chiller
with eliminator Attenuator
Recirculation
fan
Drain
Primary conditioned
supply air from main
air handling unit
G3 filter
HEPA filters
UCV canopy with diffuser screen
Return air grille
Operating theatre
55
7.110 Vertical-flow modular units comprise a ceiling- partial walls should be provided to control short-
mounted air-terminal module containing return- circuiting. For a 2.8 m × 2.8 m terminal, the
air filters, return-air fans, final filter and air partial walls should be not less than 1 m from the
diffuser. Primary air is supplied by a remote operating room walls. The clearance should be
air-conditioning unit at the volume and to the increased proportionally for larger terminals (that
standard required for a conventional operating is, 1.15 m for 3.2 m × 3.2 m units; and 1.25 m for
suite (see Figure 7). 3.5 m × 3.5 m units). In all cases, the side walls
should terminate at 2 m above floor level.
7.111 Horizontal- or cross-flow modular units comprise
a wall-mounted air-terminal module standing 7.114 Siting the return-air grilles around the periphery
vertically to produce a horizontal flow of air and of the theatre at low level will eliminate short-
containing final filter/diffuser, return-air filters circuiting, remove the need for partial walls and
and fans. The module may incorporate a full air- give an improved air-flow path. In any event, there
conditioning unit or be supplied with fresh air should be an air-out path on each face or in each
from a separate primary air-conditioning system. corner of the theatre. These may be provided by
combination of pressure stabilisers and passive or
Vertical-flow UCV systems active low-level extract grilles. Failure to provide
7.112 Vertical-flow systems have a superior performance air-out paths on all faces of the theatre may result
and are more effective at reducing infection risks. in the surplus air causing entrainment into the
Air-curtain or partial-wall systems are acceptable, clean zone.
but are known to be more susceptible to problems 7.115 Vertical systems should have a clean zone large
arising from performance deterioration, poor enough to encompass the operating site and all
operating-team discipline and high occupancy of the instrument trays likely to be needed for the
rates than is the case with full-wall systems. A full surgical procedures to be undertaken. Ophthalmic
wall is considered to be any wall terminating not and minor hand surgery would typically require a
more than 1 m above the finished floor level. 1.4 m circular or rectangular terminal. For major
7.113 Because of the large volume of air being moved in orthopaedic procedures, a minimum size of 2.8 m
a relatively small space, the siting of the return-air × 2.8 m will be required. This is the area projected
grilles can cause short-circuiting of the air on the floor under the supply air terminal within
discharged through the UCV terminal. If the the partial walls, full walls or air curtain. Any air
return-air grilles are positioned at high level, outside this zone cannot be guaranteed to be ultra-
Figure 7 UCV theatre with modular system
Primary conditioned
supply air from main
air handling unit
Recirculation
fan
G3 filter
HEPA filters
UCV canopy with diffuser screen
Return air grille
Operating theatre
56
clean although – given the dilution factor – the • partial-wall system = 0.38 m/s average;
level of microbiological contamination will be
• full-wall system = 0.30 m/s average.
much lower than the general level in a
conventional operating room. The use of lines or a 7.121 In order to ensure that the terminal quadrants
coloured area on the floor delineating the extent of are in balance, the average air velocity for each
the clean zone will assist staff and is therefore quadrant should not exceed ±6% of the measured
essential. average velocity for the terminal.
7.116 When upgrading an existing conventional theatre Air velocity 1 m above floor level:
to an ultra-clean standard, the only solution may • all systems = 0.2 m/s minimum within the
be the installation of a modular system. In these operating zone.
units, the heat gains from the return-air fans and
terminal lights may warrant the inclusion of 7.122 Chapter 8 gives details of the method of
supplementary cooling within the module. measurement.
However, issues of cooling-coil drainage, 7.123 Variable-speed recirculation fans with differential-
condensate removal and maintenance access within pressure control may be the most suitable solution
the space constraints of the module may make this for maintaining consistent performance and energy
option impracticable. The additional cooling load saving.
should then be accommodated by conditioning
the primary air to compensate. Horizontal UCV systems
7.117 If an existing AHU is to be retained, it may 7.124 Horizontal UCV air-flow systems have been
require modification to ensure that it achieves the shown to be less effective than vertical systems
minimum standards set out in Chapter 4. The fan and are not the preferred solution. There may
may need re-rating to accommodate the change in be occasions, however, where architectural,
system resistance. The cooling coil may also need engineering, economic or workload considerations
to be upgraded to cater for the increased load prevent the installation of a vertical-flow system
resulting from the return-air fans and terminal and only a horizontal-flow system can be installed.
lights. Failure to make adequate provision for this
may make the theatre unusable during prolonged 7.125 Horizontal- or cross-flow modular units comprise
warm spells. a wall-mounted air terminal standing vertically
to produce a horizontal flow of air across the
7.118 A factor affecting air-flow pattern is the supply-air operating field. The terminal module contains the
and room-air temperature difference. When the final filters, air diffuser, return-air grilles, filters
supply-air temperature is significantly above room and fans. The module may incorporate a full air-
temperature, buoyancy effects will reduce the conditioning unit or be supplied with fresh air
volume of air reaching the operating zone. If it from a separate primary air-conditioning system.
is anticipated at design stage that this will be a In the latter case, the return-air fan power may
regular occurrence, a system incorporating full warrant the inclusion of a supplementary cooling
walls should be used. Demountable extensions coil within the module.
that convert a partial wall to a full-wall unit are
available. 7.126 The system should have side-wall panels at least
2.4 m apart. The panels may fold to facilitate
7.119 Convection up-currents from the surgical team cleaning of the theatre. The minimum height of
and operating lamp tend to counter the movement the terminal should be 2.1 m, and a deflector at
of clean air towards the operating site; hence, the the top of the filter/diffuser will be acceptable as
air velocity reaching the operating level is critical. an alternative to a full roof. These dimensions
The minimum velocity given in paragraphs reflect currently available equipment and may
7.120–7.121 has been selected to take account of impose operational constraints in addition to a
these factors and is greater than the theoretical lower level of performance common to these
minimum value. systems.
7.120 For all vertical UCV systems, the design discharge
velocities will be as follows:
Air velocity 2 m above floor level:
57
to open the unit’s inspection panels. Alternatively,

Note direct-reading pressure gauges should be fitted.
In horizontal-flow systems, personnel working between 7.133 The UCV system will require a return-air filter to
the filter and surgical wound will disperse bacteria capture the relatively coarse particles that would
that are more likely to contaminate exposed surgical otherwise significantly reduce the life of the final
instruments and enter the wound. This may be filter. This should be at least a G3 grade to BS EN
minimised by the use of improved clothing and 779. In remote recirculation systems, there may be
operating procedure to reduce dispersion of bacteria. advantages in fitting a higher grade return-air filter
The use of lines on the floor delineating the extent of as it will reduce the load on the terminal HEPA
the clean zone and hatching or colour-coding the “no- filters and extend their life.
entry” zone between the air diffuser and patient will
serve to prompt staff and are therefore essential. Noise level
7.134 If sound-attenuating material is used to line any
7.127 The air discharge velocity as measured 1 m from portion of the inside of the UCV unit, it should
the diffuser face should have a mean value of be non-particle-shedding and fire-resistant (see
0.4 m/s. Chapter 8 gives details of the method Health Technical Memorandum 05-02).
of measurement.
7.135 The maximum noise level in an operating room
Filters fitted with a UCV terminal of any type should
not exceed 50 NR. Chapter 8 gives details of the
7.128 The main plant’s primary and secondary filters
method of measurement.
should be to the standards and in the location set
out in Chapter 4. Lighting and operating lights
7.129 Terminal filters should be provided within the 7.136 CIBSE lighting guide LG2 and BS EN 12464-1
air-flow terminal or in the air supply to it. HEPA give detailed information on lighting requirements.
filters grade H10 (as specified in BS EN 1822) Operating luminaires should comply with the
should be installed. There is no aerobiological photometric requirements detailed in relevant
benefit in fitting filters of a higher grade than sections of BS EN 60601.
this, although for practical reasons most UCV
manufacturers recommend the fitting of H12- 7.137 The position of the UCV light fittings and style of
grade filters. partial walls, where fitted, should neither adversely
disturb the air flow nor result in significant spatial
7.130 In some modular UCV units, the terminal filter variations in illuminance levels.
is used as a pressure equaliser to balance air flow;
filters of a higher grade with a greater pressure 7.138 In vertical units, specialised task lighting should be
drop may be recommended by manufacturers. The provided by toroidal, cruciform or small multiple
increased resistance may affect the velocity of air dome-shaped luminaires, as they have good
reaching the operating level, and there will be aerodynamic properties. The ideal luminaire will
penalties in terms of installed fan power and have a minimal effect on the air flow regardless of
higher noise levels. where it is positioned. Large-diameter saucer-
shaped luminaires should not be used in vertical-
7.131 The final filters should be installed in a leak-proof flow systems as they will occlude the air flow in the
housing in a manner that allows the terminal unit, critical central zone. It is important to consider the
filters and their seals to be validated. A challenge suitability of existing luminaires when retrofitting
test should be carried out during commissioning UCV systems.
to prove the effectiveness of the complete
installation. 7.139 In vertical UCV installations, a minimum of
2.75 m from floor to underside of the diffuser
7.132 Where UCV units are constructed in sections, a is required to allow for supporting mechanisms
means of measuring the pressure drop across the and lamp articulation. When upgrading existing
terminal filters in each section should be provided. systems, this dimension may not be achievable;
The pressure test-points should be located outside however, when parked, the lowest point of the
of the partial wall, capped to prevent air leakage central light stem, luminaire and articulation arms
and accessible within the theatre without the need should never be less than 2 m above floor level.
58
7.140 The traditional means of light support is a central temperature of the air being supplied by the
column that passes through the UCV terminal UCV terminal;
and is rigidly fixed to the building structure. The
• a read-out sufficiently large to be clearly visible
position of the support therefore prevents air being
from the operating table that shows the relative
supplied at the centre of the terminal. Separate
humidity of the air being supplied by the UCV
supports displaced from the centre of the clean
terminal;
zone would lead to improved air flow.
• a red indicator light that will illuminate when
Note either the supply AHU or the UCV terminal
fails; either or both are switched off or the
This approach was advocated in the 1994 version
AHU and UCV terminal are at set-back;
of this guidance but at the time of writing, no UK
manufacturer has chosen to adopt this solution. • an amber indicator light that will illuminate
when the UCV terminal is at set-back and the
7.141 In horizontal units, the size or shape of the supply AHU is running;
specialised task luminaire has little effect on the • a green indicator light that will illuminate
air-flow pattern. when both the supply AHU and UCV terminal
are operating at full speed;
Controls and instrumentation
• a blue indicator light that will illuminate when
7.142 The functions of the supply AHU and extract the UCV terminal’s HEPA-filter resistance
ventilation should be continuously monitored causes the air delivered to fall below 80% of the
by a BMS control unit. The controls and design flow rate.
instrumentation for the main plant are set out in
Chapter 6. See Table 6.
7.143 UCV systems will additionally require: 7.144 The switching devices and indicators should
be incorporated in the surgeon’s panel and their
• a set-back facility that can reduce the air functions clearly labelled. In retrofit installations,
supplied through the UCV terminal to a an auxiliary panel for the UCV may be the most
volume that equates to an amount not less than practical option. If fitted, it should be mounted
25 air changes per hour of the operating room’s adjacent to the surgeon’s panel and their control
gross volume whilst still leaving the supply functions interlocked as necessary.
AHU operating at full speed;
7.145 When a system is designed to have partial walls
• a facility to turn off the entire system, the with full-wall extensions, a volume control facility
supply AHU and the UCV terminal (an may be incorporated to allow the system to be run
emergency stop is not required); with reduced velocity when the demountable full
• a read-out sufficiently large to be clearly visible walls are in place. It is the responsibility of the user
from the operating table that shows the to ensure correct operation of the system. To assist
Table 6 Indicator-light logic table

AHU UVC terminal Indicator light Comment
Off or Fault Off or Fault
Off or Fault On (set-back)
Off or Fault On (full speed) Ventilation not operating at a suitable level to commence surgical
Red
On (set-back) Off or Fault procedures
On (full speed) Off or Fault
On (set-back) On (set-back)
On (full speed) On (set-back) Amber Ventilation provided to at least conventional theatre standard
On (full speed) On (full speed) Green Full UCV standard conditions
– – Blue HEPA-filter resistance causing low air flow
59
the user, an explanatory notice should be included multiple safety cabinets, cut-up benches, fume
on the theatre’s control panel. cupboards and specimen stores.
7.146 A direct-reading gauge should be fitted in the 7.151 Typical LEV systems found in healthcare premises
theatre to show a representative pressure drop include:
across the final filters. If the UCV control box
• microbiological safety cabinets and Category 3
is located out of the theatre and has a means
containment rooms;
of manually adjusting the return-air fan speed,
it should also be fitted with a direct-reading • fume cupboards and plate-staining equipment;
differential-pressure gauge. The means of adjusting • welding-fume extracts;
the return-air fan speed should be lockable to
prevent casual adjustment. The direct-reading • woodworking-machinery dust collectors;
gauges should be fitted with a means of indicating • battery-charging bay extracts;
the correct operating pressure range.
• powered plaster and bone saws;
7.147 The UCV-unit manufacturer’s control box should
be located in an accessible position, preferably in • pharmaceutical preparation cabinets and tablet
the operating department adjacent to the operating machines;
theatre that it serves. A service corridor, if • dissection benches, cut-up benches and some
provided, is an ideal location. The control box specimen stores;
should be clearly labelled with the identity of the
operating theatre that it serves. • isolation facilities for medium- and high-risk
infectious diseases;
Extract systems • dental furnaces, grinders and polishers.
7.148 Extracts may be provided for a variety of reasons 7.152 General design information and guidance for
including: LEV systems is produced by the Health and Safety
Executive (HSE) as HS(G)37. Information on the
• simple odour control (for example in a WC or
design and installation of microbiological safety
mortuary);
cabinets is given in BS5726 and that for fume
• to receive and remove moisture-laden air (for cupboards is given in BS EN 14175. Their
example in a kitchen); recommendations should be closely followed.
• as part of a combined supply/extract balanced 7.153 LEV systems are statutory items that are subject to
system (for example in an operating suite); an independent inspection and test at least every
• to capture a hazardous substance at source (for 14 months.
example a safety cabinet).
Hood extract systems
7.149 Devices that use an inflow of air to control
exposure of staff to hazardous substances are Special requirements
classified as LEV systems under the COSHH
7.154 Extract canopies are required over steam-and-heat-
Regulations.
emitting appliances, for example sterilizers, and
7.150 An LEV system may comprise a self-contained catering and washing equipment.
unit incorporating its own carbon filter such as a
7.155 Perimeter-drain gulleys and corrosion-proof grease
simple bench-top fume cupboard. Alternatively, it
eliminators should be provided on kitchen hoods.
may be a complete ventilation system comprising
a make-up air supply, multiple-exhaust-protected Typical arrangements
workstations, branch and central extract ductwork,
duplex extract fans and a high-level discharge 7.156 An air-flow velocity of 0.25 m/s to 0.5 m/s is
terminal. It may also incorporate a special filtration suitable to collect and remove evaporation of steam
system appropriate to the hazardous substance and cooking vapours. Excessive velocities are
being controlled. Such systems could be required wasteful of power and generate noise.
for workshops containing woodworking machinery 7.157 The lowest edge of the canopy should be 2 m
or large centralised pathology laboratories housing above finished floor level, with a minimum of
60
300 mm overhang beyond the edge of the allow for cleaning). The minimum velocity across
equipment on all sides. any part of the grille should be 1 m/s. The grille
should be readily demountable to allow for
7.158 A compact arrangement of equipment (but with
cleaning.
access for maintenance) will minimise the canopy
area and hence reduce the air volume necessary to
Control of bench extract systems
achieve the optimum capture velocity.
7.165 Provided that it does not interfere with the
7.159 Hoods required for the control of heat gain and
operation of the department when not in use, the
vapours may be connected to the general extract
ventilation system for the bench extract and any
system when it is convenient to do so, but where
associated make-up supply can be shut down.
non-corrosive ductwork materials are necessary,
However, a run-on timer with a minimum setting
a separate discharge is preferred.
of 30 minutes must be provided. To this end, local
7.160 Lighting and internal divider plates are often or automatic-use control should be provided.
included in the perimeter of large canopies;
however, built-in shelving systems are not Safety cabinet and fume-cupboard extract systems
recommended as they interfere with the air flow 7.166 Safety cabinets and fume cupboards are devices
and constitute a maintenance problem. that use an inflow of air to control exposure of
staff to hazardous substances. The units, their
Control of hood extracts
exhaust systems, filters, fans and discharge
7.161 Provided that it does not interfere with the terminals are all classified as local exhaust
operation of the department when not in use, the ventilation (LEV) systems under the COSHH
ventilation system for the hood extract and any Regulations. The make-up air system to a room
associated supply make-up can be shut down. To that contains an LEV system should also be
this end, local or automatic-use control should be considered as an essential part of the system and
provided. be included in the LEV classification.
7.167 Information on the design and installation of
Bench extract systems
microbiological safety cabinets is given in BS5726
Special requirements and that for fume cupboards is given in BS EN
14175. Their recommendations should be closely
7.162 Bench extract ventilation is required in followed. The Advisory Committee on Dangerous
departments such as pathology and mortuary Pathogens (ACDP) publishes ‘The Management,
where activities involve the release of malodorous Design and Operation of Microbiological
fumes or hazardous substances. Where hazardous Containment Laboratories’ covering the general
substances are being controlled, the system should environment in which they are used and
be designated an LEV. operational considerations.
7.163 Processes that produce hazardous vapours, fumes,
dusts or vapours should be enclosed or semi- Special requirements
enclosed in a suitable cabinet or exhaust-protected 7.168 The supply-air system should not distort the
workstation. unidirectional and stable air pattern required
for fume cupboards and microbiological safety
Typical arrangements cabinets. In general, supply-air ceiling diffusers
7.164 Each ventilated position will usually be should not discharge directly towards fume
accommodated in a continuous run of benching, cupboards or safety cabinets, unless the terminal
which should not be more than 650 mm from velocity is such that the air-flow pattern of the
front to rear and which should be provided with cabinet is unaffected. The design should ensure
a continuous upstand at the rear. Each position that high air-change rates and/or the opening and
should have a 1200 mm × 150 mm linear extract closing of doors do not have any adverse effect
grille mounted on a purpose-designed plenum box on the performance of safety cabinets or fume
(incorporating guide vanes as necessary), with its cupboards. A damped door-closure mechanism
face flush with the upstand. The bottom of the may help.
grille should be as close as practicable to the level
of the working surface (usually 75 mm above, to
61
7.169 In order to safeguard the user, all safety cabinets discharge outlet, to maintain the duct within the
and fume cupboards must be fitted with a clear building under negative pressure. The discharge
indication that they are operating correctly. point on a flat roof should be through a 3 m high
Direct-reading gauges or falling-ball indicators terminal. This is required to safeguard staff who
are preferred (in addition to electronic pressure may need to periodically access the roof for
indicators). The system should be set to audibly maintenance. This requirement will also be
alarm if the face velocity falls below the minimum applicable to fume-cupboard discharges.
safe operating level.
7.176 Where this is impracticable, discharge into the
room via a double HEPA filter has been accepted;
Arrangements for safety cabinet installations
the preferred method, however, is to discharge
7.170 A Class 1 microbiological safety cabinet must above the roof line as above.
be specified for routine work involving Group 3
pathogens. It should be housed in a Category 3 Arrangements for fume-cupboard installations
containment room. Information on containment
7.177 The primary factors which contribute to the
rooms is issued by ACDP in ‘The Management,
effective performance of fume cupboards include:
Design and Operation of Microbiological
Containment Laboratories’. • an adequate volume of supply air;
7.171 Siting and installation of microbiological safety • an effective exhaust system to promote the safe
cabinets are of particular importance because: dispersal of waste products to atmosphere.
• protection afforded to the operator by the 7.178 The air velocities through sash openings must
cabinet depends on a specific and stable be sufficient to prevent hazardous materials from
unidirectional air flow through the open front; entering the laboratory while avoiding excess
flow rates that interfere with the investigation
• protection to the environment by the cabinet
process. The design velocity must be maintained
depends on HEPA filters. The exhaust air
irrespective of whether the sash opening is varied
should never be considered as totally free from
or whether doors or windows are open or closed.
microbiological hazard.
Variable air volume (VAV) cupboards are available,
7.172 Extract air from a microbiological safety cabinet which will offer a reduction in energy costs.
is HEPA-filtered prior to discharge to the outside.
7.179 The possibility of a fire or explosion which may
The extract ductwork should as far as practicable
not be contained by a fume cupboard must always
be kept under negative pressure while inside the
be considered. A fume cupboard should not,
building.
therefore, be sited in a position where exit to an
7.173 Current standards permit the installation of escape route will necessitate passing directly in
microbiological safety cabinets with integral fans, front of it.
provided that the extract ductwork can be kept
7.180 Fume-cupboard fans should be installed as near
short (that is, less than 2 m); such an installation,
as possible to the termination of the duct, thus
however, is likely to be noisy and is not
maintaining the maximum amount of ductwork at
recommended for use in new buildings.
negative pressure.
7.174 The discharge from the cabinet should be
7.181 Where there are adjacent buildings with opening
fitted with a back-draught damper. In multiple
windows, or where down-draughts occur, it may
installations where several cabinets discharge into
be necessary to increase the height of discharge
a common extract and discharge duct, it must be
ducts in order to achieve adequate dispersal. In
possible to isolate each cabinet from the system
complex locations, air-flow modelling or wind-
when not in use.
tunnel tests may be required to determine the
7.175 Roof-level discharge, wherever practicable, is optimum height of the stack (see also paragraph
preferred since it removes much of the uncertainty 7.174).
over air re-entering the building through
7.182 Fume cupboards for certain processes must have
ventilation inlets and/or windows. In such an
separate extract systems; however, if permissible,
installation, the extract fan should be situated
individual fume-cupboard exhaust systems may
separately from the cabinet and close to the
discharge via non-returning dampers into a single
62
collection duct rather than having a large number

of separate stacks. The collection duct should:
• have a large cross-sectional area to minimise its
effect on individual exhaust systems;
• be open to atmosphere upstream of the first
connection; and
• be designed to discharge a total air volume at
least equal to the combined individual extract
systems.
7.183 Individual fume-cupboard extract systems,
discharging either directly to atmosphere or into
a collection duct, do not require duplex fans.
However, a collection duct designed to provide Typical LEV discharge stacks
dispersal of effluent from a number of individual
extracts should have duplex fans with automatic they are not blocked, closed deliberately (except in
change-over. the case of fire shutters if required) nor rendered
7.184 Some fumes are particularly corrosive, so the inoperative by prevailing winds.
choice of material for the ductwork and type of 7.190 Plantroom ventilation air should not be used
extract fan fitted should reflect the nature of the for any other purposes, such as make-up air for
fume being conveyed. extract. Where the plantroom contains combustion
equipment, the appliance pressure must not fall
Control of extract systems below the outside air pressure.
7.185 It is desirable to provide local control of safety
7.191 Specialised healthcare air-handling equipment
cabinets in order to maximise the life of the HEPA must not be located in a fire compartment that
filter and to permit the sealing of the cabinet and houses combustion equipment.
room for fumigation if spillage occurs.
7.192 Statutory regulations for plantroom ventilation are
7.186 To cope with the risk of an accident or spillage
contained in the Building Regulations Part J, and
outside safety cabinets, a panic button should be further guidance in given in the CIBSE Guides A
provided to switch off the supply to that area and and B.
to discharge all extracted air to atmosphere.
7.193 Plant noise is subject to the Control of Noise at
7.187 In pathology departments, it is necessary to have
Work Regulations 2005 and should not exceed
one or more microbiological safety cabinets and 80 dB(A) within a plantroom. It should be
one or more fume cupboards available for use at reduced to lower levels where the plant is near
all times, including weekends; therefore, local to departments sensitive to noise.
overriding controls for all these items and any
associated ventilation plant will be necessary. Assessment of ventilation levels
Plantroom ventilation 7.194 Ventilation requirements must take into account

all heat sources within a plantroom and, where
General requirements there are large glazing areas, solar gains. The
ventilation rate should limit the maximum
7.188 Plantrooms need to be ventilated to maintain temperature within the plantroom to 32oC.
acceptable temperatures for satisfactory operation
of the plant and controls, and for maintenance 7.195 As the level of equipment operating during mid-
activities. In the case of plantrooms housing season and summer is often lower than winter
combustion equipment, a secondary function of conditions, and the cooling effect of the outside
the ventilation is to provide make-up air for the air is reduced, it is necessary to calculate the
combustion process. minimum volume for each season of operation,
and the inlet and outlet grilles or fan sizes should
7.189 The air required should be introduced into the be chosen to cater for the largest seasonal air
space through inlets positioned to minimise the volume.
discomfort to occupants. It should be ensured that
63
7.196 Replacement air should not be drawn through 7.206 The necessary free opening areas for a naturally
pipe trenches or fuel service ducts. Where metal ventilated plantroom may be calculated using the
ducts penetrate walls and floors, effective sealing method in the CIBSE Guides A and B.
should be provided to confine the ventilation
7.207 A combined natural and mechanical ventilation
to the boiler room and to meet fire protection
system should allow for natural extract at high
requirements. Penetration of fire-barrier walls by
level, to take advantage of convective forces in the
ventilation ducts should be avoided if possible.
room, with mechanical supply at low level. The
7.197 Fire dampers in plantroom ventilation ducts high-level natural ventilators should be sized to
should be electrically interlocked with the boiler cope with the total quantity of ventilation air,
plant. as above.
7.198 Care must be taken to prevent any noise generated 7.208 To prevent leakage of flue gases and to ensure that
in the plantroom emerging from natural or the flue draught is not impeded at any time, air
mechanical ventilation openings to the detriment pressure in the boiler room must not exceed the
of the surrounding environment. Particular care is prevailing outside pressure. Therefore, the fan
necessary with mechanical flue draughts and fan- duty should exceed the calculated total combined
diluted flue systems. combustion and ventilation air quantity by at least
7.199 Information on required air volumes in contained
25%. Fan-powered inlets should be arranged to
in the CIBSE Guides A and B. flow outside air into the space at a point where
cross-ventilation will ensure pick-up of heat
7.200 Where combustion plant is installed, the high-level without causing discomfort to occupiers.
(outlet) openings should be sized to cater for the
7.209 Where it is impractical to provide sufficient
total ventilating air quantity, and the low-level
(supply) openings sized to cater for the total natural ventilation to remove the heat emitted by
combined ventilating and combustion air quantity. the plant, both mechanical supply and extract will
be required.
Choice of ventilation system 7.210 The high-level extract should be sized to cater
7.201 Ventilation air may be introduced and exhausted for the total ventilating air quantity, and the low-
by either natural or mechanical means or a level supply should exceed the total combined
combination of both; however, where possible, combustion and ventilating air quantity by at least
natural systems are preferred. 25%, as above.
7.202 Generally, small installations at or above ground Ventilation of hydrotherapy suites

level should have their combustion and ventilation
air provided by natural means, employing both General requirements
high- and low-level openings.
7.211 In a hydrotherapy suite, heat recovery should be
7.203 Basement, internal and large installations at via a heat pump.
or above ground level will usually require
a combination of natural and mechanical 7.212 The quantity of supply air should be calculated as
ventilation. If the air-flow rate is difficult, both 25 L/s per square metre of wetted surface, with the
supply and extract may require mechanical means. wetted surface taken as 110% of the pool water
surface area.
7.204 Whether natural or mechanical, the system should
be designed to avoid both horizontal and vertical 7.213 A recirculation plant is recommended with fresh
temperature gradients. Both inlet and outlet air make-up to the standard required by the
openings should be placed on opposite or adjacent Building Regulations Part F – Non-domestic
sides of the building to reduce the effect of wind Buildings. In practice this may need to be
forces. increased to control condensation.
7.205 Where mechanical air supply is employed, 7.214 As far as practicable, recirculated pool air should
electrical interlocks with the boiler plant should be be provided to the ancillary changing and recovery
provided to prevent damage in the event of failure accommodation, with the only extract from the
of the supply fan(s) once the air volume is toilets, laundry/utility room and pool hall.
established.
64
7.215 Supply air to the pool hall should be introduced 7.218 Night set-back temperature (in the range of
at high level and directed towards the perimeter to 21–25oC) and high humidity control (in the range
mitigate condensation, with extract air taken from of 60–75% sat) should be provided to override the
directly over the pool. time-clock in order to prevent condensation. The
exact set-points should be ascertained post-
Control of hydrotherapy pool installations installation.
7.216 The supply and extract fans should be interlocked 7.219 A remote indication panel should be provided in
so that the supply fan does not operate until flow the pool hall, giving a visual display of the pool
is established within the extract system. water and pool air temperature.
7.217 Time-clock control should be provided, with
a local override switch to extend the normal
operating period as required.
65
8 Validation of specialised ventilation systems
Definitions Commissioning
Commissioning. Commissioning is the process of 8.1 Commissioning is an essential process for
advancing a system from physical completion to an ventilation systems. It is therefore important that
operating condition. It will normally be carried out adequate provision for the process be made at
by specialist commissioning contractors working in the design stage of the project. Procedures for
conjunction with equipment suppliers. Commissioning commissioning air-handling systems are given in
will normally be the responsibility of the main contractor. CIBSE Commissioning Codes and BSRIA
Application Guide Set COMPAK 1.
Validation. A process of proving that the system is fit
for purpose and achieves the operating performance 8.2 The duct-sizing procedure should take into account
originally specified. It will normally be a condition of the requirements of system balancing, and the
contract that “The system will be acceptable to the client position and number of regulating dampers
if at the time of validation it is considered fit for purpose included in the design should be sufficient for
and will only require routine maintenance in order to this purpose.
remain so for its projected life.”
Location of dampers and test holes
Commissioning is often subdivided into sections (for
8.3 Balancing/commissioning dampers should be
example AHU, automatic controls, air-side balance,
installed in each branch of the distribution
building fabric and fittings). Each section may be
ductwork.
commissioned by its specialist installer, and they are
often accepted in isolation. Validation differs from 8.4 Test holes for the measurement of air-flow should
commissioning in that its purpose is to look at the be provided at carefully selected points in main and
complete installation from air intake to extract all branch ducts. The number and spacing of holes
discharge and assess its fitness for purpose as a whole. are given in the BSRIA Application Guide Set
This involves examining the fabric of the building COMPAK 1. Their positions must be identified
being served by the system as well as inspecting the at the design stage.
ventilation equipment fitted and measuring the actual
8.5 The test positions need to be accessible for
ventilation performance.
commissioning to take place. They may also be
It is unlikely that “in-house” staff will possess the required for subsequent annual verification of the
knowledge or equipment necessary to validate critical system performance, so they should be capped to
ventilation systems such as those serving operating prevent air leakage but not covered by permanent
suites, pharmacy clean rooms and local exhaust lagging.
ventilation systems. Validation of these systems should
8.6 The measurement point should be in a straight
therefore be carried out by a suitably qualified
length of duct as far away as possible from any
Authorised Person appointed by the client.
upstream bends, dampers or other elements that
It is anticipated that training and certification in the could cause disturbance to the air flow. The actual
validation of specialised healthcare ventilation systems location should be:
for Authorised Persons will become available during
a. at least 1.5 duct diameters upstream of sources
the life of this Health Technical Memorandum.
of turbulence (such as dampers and bends);
b. if (a) is not possible, ten duct diameters
downstream of dampers, bends or tees, and five
66
duct diameters downstream of eccentric • full details of the design conditions, both inside
reducers; and out, for winter and summer together with
the control strategy;
c. where there is enough space round the duct to
insert the Pitot tube and to take readings; • the equipment manufacturer’s type-test data,
commissioning, operation and maintenance
d. where the duct has a constant cross-sectional
recommendations;
area.
• drawings showing the layout of the system,
8.7 Test holes for measuring total air-flow from a
positions of air-flow measurement test-points,
fan should be located either four duct diameters
dampers, regulating devices and filters within
upstream or ten duct diameters downstream of the
the duct runs, together with sizes of ducts
fan. Provision should also be made for ascertaining
and terminal fittings. It will save time if these
the direction and measuring the speed of rotation.
drawings are annotated with the design volumes
Commissioning personnel and static pressures required at each branch and
outlet point (see Table 7 for information to be
8.8 It is unlikely that one particular individual will included on schematic drawings);
have all of the required commissioning skills; a
commissioning team is therefore usually needed. • wiring diagrams for all electrical equipment
The objective of commissioning is to ensure that associated with the air-handling systems
the necessary performance and safety requirements including motor control circuit details and
are met. any interlocking and safety devices such as
emergency-stop buttons adjacent to the item of
8.9 During the commissioning process, a great deal of plant.
information will be generated, which will form an
8.12 CIBSE’s Commissioning Code A – ‘Air distribution
invaluable future source of reference about the
plant. It is essential to ensure that it is collected systems’ provides full guidance on the information
together in the form of a commissioning manual that will be required by the commissioning team.
and handed over to the client on completion of the 8.13 The designer should include in the contract
contract together with the as-fitted drawings. The documents instructions on verifying the accuracy
information should be both in hard copy and of test instruments, which should be supported by
electronic format. reference to relevant calibration certificates.
8.10 In order to be successful, the commissioning 8.14 On completion, the system should be operated
process must start before practical completion, as by the contractor as a whole and subject to
many parts of the system will become progressively performance tests in accordance with the contract
less accessible. The correct installation of those requirements. For critical systems, these should
parts will need to be witnessed, and leak-rate tests include independent validation of the system
carried out as construction proceeds. Failure to performance on behalf of the client.
establish responsibility for commissioning early
8.15 The commissioning process should be carried out
enough will delay the completion of the project or
in the order in which it appears in this guidance
lead to unsatisfactory plant performance.
document; that is, the static checks and visual
Commissioning brief inspections should be followed by the dynamic and
performance tests (as outlined in this chapter) and
8.11 The commissioning team will require a detailed finally the handover procedures.
brief from the system designer. This should include:
8.16 Prior to dynamic commissioning, it is essential that
• a user brief comprising a description of the builders’ work in the area served by the system is
installation and its intended mode of operation; complete, all rubbish and dust is removed, Institute
• the precise design requirements with regard of Plumbing service (IPS) panels are in position
to the scheme of air movement, room static and ceiling tiles are in place and clipped. Floors
pressures, supply and extract air-flow rates and should be mopped, and visible dust removed from
acceptable tolerances; all other surfaces.
8.17 Once the system is shown to meet the design
intent, the handover documentation should be
67
Table 7 Information to be provided on schematic drawings

Items in system Information to be provided
Fans Fan total pressure
Volume flow rate at high and low speed
Maximum motor current
Plant items Type and identification numbers from equipment schedules
Fluid and air-volume flow rates
Fluid and air-side pressure losses
Dry-bulb temperatures
Wet-bulb temperatures
Humidity
Dampers, including motorised and fire dampers Identification numbers from equipment schedules
Location
Identification number
Volume flow rate
Main and branch ducts Dimensions
Volume flow rates and velocities
Identification numbers from equipment schedules
Terminal Location
Grille or diffuser factor
Volume flow rate and neck velocity
Operating static pressure
Test holes and access panels Location
Controllers Set-points
Notes: F
an total pressure is the difference between the total pressure (static pressure + velocity pressure) at the fan outlet and the
total pressure at the fan inlet.
Where volume flow rates are variable, maximum and minimum values should be provided.
completed. In the event of performance not being • that only approved sealants have been used in
acceptable, the matter should be dealt with in the installation;
accordance with the contract arrangements.
• that all components function correctly;
Pre-commissioning checks • that the satisfactory sealing of access doors and
viewing ports have been carried out;
8.18 The pre-commissioning checks consist of visual
inspection, manual operation of equipment, static • that air-pressure tests and air-leakage tests on
measurements and functional tests of individual ventilation ducting have been carried out in
components. They should be carried out prior to accordance with the methods set out in the
setting the system to work and undertaking the HVCA’s (1998) ‘DW/143 – A practical guide to
dynamic commissioning process set out in ductwork leakage testing’. It is usual to carry
paragraphs 8.29–8.42. out these tests a section at a time as the
ductwork is installed and before its insulation is
Standard of installation applied. The results must be recorded in the
commissioning manual;
8.19 During the installation of the system, the following
must be witnessed by either the client or his • that gaps around doors and hatches are as
representative: specified in the design;
• that the plant and installations have been • that the correct operation of pressure stabilisers,
provided and installed in accordance with the and control, isolating and non-return dampers
design specification and drawings; have been checked and installed in the correct
orientation for air flow;
68
• that test holes have been provided in their 8.22 Builders’ work ducts of brick or concrete must be
specified locations and are sealed with suitable surface-sealed to prevent the release of dust before
grommets; being taken into use.
• that control dampers are secured and their 8.23 The area around the supply-air intake must be free
quadrants fitted correctly; of vegetation, waste, rubbish, builders’ debris or
any other possible source of contamination.
• that any interlocks are operative and in
accordance with specification;
Certification of equipment
• that the electric circuits are completed, tested
8.24 The following test certificates should be assembled
and energised;
by the commissioning team and be available for
• that electric motors have been checked for inspection at any time during the contract period.
correct direction of rotation at both full speed They will form part of the handover information
and set-back; and should be placed in the commissioning
manual:
• that cooling and heating media are available
at correct temperatures and pressures, and in • type-test performance certificates for fans;
specified quantities;
• pressure-test certificates for:
• that the air-conditioning plant’s components
– heater-batteries;
and controls function correctly;
– cooling coils;
• that the air-conditioning plant’s interlocks and
safety controls function correctly; – humidifiers (if appropriate);
• that the plant is physically complete, insulation • type-test certificates for attenuators;
is applied, and all ducts and pipework are • type-test certificates for primary and secondary
identified as specified; filters;
• that the building housing the ventilation plant • individual test certificates for HEPA filters.
is generally in a fit condition for commissioning
and performance tests to commence – that is, Equipment tests
windows, doors, partitions etc are completed,
surfaces sealed and their final finish applied; 8.25 Prior to setting the system to work, the checks in
paragraphs 8.26–8.28 should be witnessed, and
• that the areas containing the ventilation plant proving tests should be carried out as detailed.
and those being served by it are clean;
• that access to all parts of the system is safe and Filters
satisfactory. 8.26 The quality of filter housing and, in particular, seals
is a critical factor in maintaining the efficacy of the
Cleanliness of installation filtration system by ensuring that air does not
8.20 During installation it must be established that bypass the filter panels. Therefore, the following
ductwork is being installed to the “advanced level” checks should be made:
as defined in the HVCA’s (2005) ‘TR/19 – Guide • filter seals should be fitted and in good
to good practice: internal cleanliness of ventilation condition;
systems’. This specifically includes ensuring that
ductwork sections arrive on site and are stored with • filters should be installed correctly with respect
their open ends sealed and that open ends remain to air flow;
sealed during installation to prevent the ingress of • bag filters should be installed so that the bags
builders’ dust. are vertical and their pockets free;
8.21 Should any doubt exist as to whether the guidance • HEPA filters should be installed in a sealed
has been observed, the ducts must be cleaned housing and their seals tested to DIN 1946 if
internally to restore them to this standard before specified;
being taken into use.
69
• all filters should be checked to ensure they are Dynamic commissioning

free of visible damage;
• the differential-pressure indicators should be Air-handling and distribution system
checked for accuracy and to see that they are 8.29 The fan drive, direction of rotation, speed and
marked with the initial and final filter current drawn should be set in accordance with
resistance. manufacturers’ instructions.
Drainage arrangements 8.30 After the installation has been checked to ensure
that it is in a satisfactory and safe condition for
8.27 The drain should conform in all respects to start-up, it should be set to work and regulated to
the guidance given in this Health Technical enable the plant to meet its design specification.
Memorandum. In addition, the following must be The proportional balancing method described
proved: in CIBSE’s Commissioning Code A should be
• that the drain tray is easily removable; followed. The air-flow rates must be set within the
tolerances laid down in the design brief. This will
• that a clear trap is fitted and is easily removable; normally be the design air-flow rate +10% –0%,
• that the drain has a clear air gap of at least that is, the measured value must at least achieve the
15 mm; design but must not exceed it by more than 10%.
• that the pipework and trap are supported so 8.31 When combined supply and extract systems are to
that the air break cannot be reduced; be balanced and the area that they serve is to be at
or above atmospheric pressure, the supply should
• that the drain system from each drain tray is be balanced first with the extract fan switched off,
independent up to the air break; and then the extract balanced with the supply
• that the operation of the drainage system is fan(s) on.
proved by introducing water into the duct at 8.32 For combined systems where the area that they
the drain tray and observing that it completely serve is to be below atmospheric pressure, the
drains out. This check is to be repeated both at extract should be balanced first with the supply fan
normal speed and set-back once the fans have switched off and then the supply balanced with the
been commissioned. At this time, the clear trap extract fan on.
can be marked to indicate the normal water
level with the fan running. 8.33 On completion of the balance, all volume air flows
in supply and extract ducts and from grilles and
Fire dampers diffusers must be measured and recorded. The true
air-change rate can then be calculated from the data
8.28 The following must be witnessed, and proving tests
obtained.
should be carried out as detailed:
8.34 The main supply and extract duct-volume control
• the operation of all fire dampers;
dampers should be locked and their position
• access provided to enable the dampers to be marked.
visually inspected and/or re-set should be
8.35 All grille and diffuser volume-control registers
sufficient for the purpose;
should be locked to prevent alteration and their
• indication should be provided of the dampers’ final position marked.
position (open/tripped);
Room-air distribution
• indication of the fire dampers’ location should
be provided both on the ductwork and at a 8.36 Pressure-relief dampers and pressure stabilisers
visible point on the building fabric if the should be set to achieve the specified room’s
ductwork is concealed. static pressures and should be locked. The grille’s
direction-control vanes and diffuser cones must
be set to give the specified air-movement pattern.
Visualisation techniques may need to be employed
in order to prove that the required air-flow
pattern is being achieved. This may be a particular
70
requirement when commissioning LEV systems or external winter and summer design conditions
rooms that contain them. must be proved. Artificial loads will be required in
order to simulate the internal gains/losses and the
Air-conditioning plant external design conditions.
8.37 The specified flow rate and/or pressure drops must 8.46 On completion of the plant’s performance test,
be set for all heater-batteries, cooling coils and recording thermo-hygrographs should be placed
humidifiers. The methods described in CIBSE’s in each room/area served by the plant and also the
Commissioning Codes W and R should be supply-air duct upstream of the fog/frost coil. The
followed. On completion, their regulating devices plant should be run for 24 hours with all doors
must be locked to prevent alteration. closed. During this period, the inside conditions
must stay within the tolerances specified.
Control system Alternatively the BMS may be used to obtain the
8.38 The control system should not be commissioned information required.
until both the air distribution system and air-
conditioning equipment have been commissioned. Noise levels – general
8.47 The commissioning noise level is that measured
8.39 Because of the specialised nature of control systems
and the fact that each manufacturer’s system will with a sound-level meter in the unoccupied room,
contain its own specific components and settings, taking account of the external noise together with
the commissioning should be completed by the the noise generated by the ventilation system.
supplier and contractor before being witnessed by a Appendix 2 gives a summary for many applications.
representative of the client. Full details and design information are contained
in Health Technical Memorandum 08-01 –
8.40 The location of all control and monitoring sensors ‘Acoustics’.
should be checked and their accuracy proved.
8.48 The noise levels apply at the maximum velocity for
8.41 The control system’s ability to carry out its specified which the system is designed to operate. Acoustic
functions must be proved. In this respect it is commissioning tests should be carried out with
essential that control indication lights on the panel all plant and machinery running normally and
or mimic on the BMS actually relate to the running achieving the design conditions of air flow,
of a specific fan or movement of a damper. temperature and humidity.
8.42 If the plant is provided with a user’s control panel 8.49 An industrial-grade Type 2 sound-level meter fitted
in addition to the one located in the plantroom, with a muff will normally be sufficient to check the
the operation of both must be proved. This will noise level. Its accuracy should be checked using a
typically apply to operating departments and calibrated sound source before use.
laboratory systems.
8.50 The noise-level readings should be taken at typical
normal listening positions 1.5 m above floor level
Specific performance standards and at least 1 m from any surface, and not on any
line of symmetry. In critical care areas, the noise
Air movement
should be measured near to the centre of the room
8.43 The performance of the system should be measured and near to the centre of each quarter. The mean of
and compared with information provided by the the five readings should then be calculated.
designer.
8.51 In the event of a contractual deficiency, a Type 1
Plant capacity and control precision-grade sound-level meter should be used,
and the noise level determined by the procedure
8.44 When setting to work and proving the design, given in Health Technical Memorandum 08-01.
both the contractor responsible for the air-handling
plant and the control specialist should attend the Filter challenge
site together and jointly commission the system.
General ventilation filters
8.45 If any doubt exists as to the capacity of the installed
system, its ability to achieve the specified internal 8.52 In-situ performance tests will not normally be
design conditions with the plant operating at required for primary and secondary filters and
71
their housings. However, filters should be visually 8.58 Should the HEPA filter fail this test, it must be
inspected for grade, tears, orientation and fit within replaced. Should the filter mounting seal or
their housings. Filters should be clean and a housing fail this test, it may be repaired and the test
replacement set should be available. Bag filters repeated.
should be installed so that their bags are vertical,
and spaced so that air can move through them Bacteriological sampling
freely. Any filter found to be wet should be replaced
and the cause investigated. General ventilation systems
8.59 Bacteriological sampling will not normally
HEPA filters (for exhaust protective enclosures and be required for either general or local exhaust
laboratories) ventilation (LEV) systems unless otherwise
8.53 Pathogenic material may be discharged through specified.
damaged or badly installed HEPA terminal filters.
The complete installation must be tested using Conventional operating rooms
the method set out in BS EN: 14644 ‘Method of 8.60 Before commencing bacteriological testing,
Testing for the Determination of Filter Installation the room and its ventilation system should
Leaks’. have achieved a steady state condition (see also
8.54 The challenge tests may be carried out using either paragraph 8.75).
of the following techniques: 8.61 The level of airborne bacteria introduced by the
• use DOP to provide the challenge and a supply air should be checked by closing all doors
photometer to detect leaks; and leaving the operating room empty with the
ventilation system running for 15 minutes.
• use a discrete particle counter (DPC) to detect An active air sampler set to take at least a 1 m3
leaks. (In order to obtain a sufficient challenge, sample and mounted in the centre of the room
it may be necessary to temporarily remove the approximately 1 m above floor level should then
supply AHU’s secondary filters.) be activated remotely. Aerobic cultures on non-
8.55 In both cases, the upstream challenge should be selective media should not exceed ten bacterial and/
measured. A measurement of particle penetration or fungal colony forming units per cubic metre
through a representative section of the HEPA-filter (CFU/m3).
media is then taken and used as the reference 8.62 The results should be examined to establish
background level. These two readings enable the the broad category of organisms present. A high
range of the detecting instrument to be set. preponderance of fungal organisms may be an
8.56 A challenge aerosol of inert particles of the indication of inadequate filtration for the particular
type produced by a DOP generator should be installation. Precise guidance is inappropriate and
introduced into the air, upstream of the HEPA will depend on local circumstances.
filter. The downstream face of the filter, its 8.63 A check of airborne bacteria should be carried
mounting seal and housing would then be scanned out during a surgical operation. Unless there are
for leakage using a photometer. A leak should be unusually high numbers of personnel or extensive
deemed to have occurred if a steady and repeatable activity in the room, the number of airborne
reading on the photometer at any point exceeds bacterial and/or fungal CFU averaged over any five-
0.01% of the upstream reading. minute period would be unlikely to exceed 180 per
8.57 Alternatively, a DPC may be used. For the DPC m3.
method, the filter face is sampled at several points
to establish the smallest non-penetrating particle The Hospital Infection Society has issued guidance
size. This will directly relate to the grade of filter on the microbiological testing of operating theatres
under test. The filter face, its seal and housing (www.his.org.uk/_db/_documents/OTIC-final.pdf ).
are then scanned, and if a significant number of Information on the additional validation testing
particles at or above this size are detected, there is of UCV operating suites is given in paragraphs
deemed to be a leak at or near the test position. 8.66–8.164.
72
Ventilation system commissioning/validation 8.69 The following regime of inspection and testing
report should be applied to the validation of new
installations designed to provide ultra-clean
8.64 Following commissioning and/or validation, a full
conditions in an operating suite. The test regime
report detailing the findings should be produced.
has been devised to ensure that the system, as
The system will only be acceptable to the client
installed, fully achieves the design requirement for
if at the time of validation it is considered fit for
these systems as set out in paragraphs 7.91–7.147.
purpose and will only require routine maintenance
in order to remain so for its projected life.
Basic requirement
8.65 The report should conclude with a clear statement
8.70 The operating suite to be validated should be
as to whether the ventilation system achieved or
physically complete with final finishes applied. All
did not achieve the required standard. A copy of
ventilation systems serving it should be operating
the report should be lodged with the following
correctly and delivering their design air-flow rates.
groups:
8.71 In order to avoid preloading the UCV terminal’s
• the user department;
recirculation ducts and HEPA filters, the operating
• infection control (where required); suite should be free of any obvious dust and at least
“builders clean” before the recirculation fans are set
• estates and facilities.
to work (see also paragraph 8.16).
Validation of UCV operating suites 8.72 The validation procedure for a conventional theatre
suite should have been satisfactorily completed to
General the standard set out in this chapter prior to
attempting to validate the UCV unit. In particular:
8.66 Commissioning of a UCV terminal will normally
be carried out by its supplier. Commissioning of • the supply AHU will have achieved the
the AHU, fire dampers, distribution ductwork and minimum standard;
control systems may be undertaken by different • the operation of all fire dampers will have been
teams. It is therefore important to recognise that proved;
the UCV terminal is only one element of the
specialised ventilation system serving the operating • the supply and extract air-flow rates as measured
suite, and it cannot be accepted in isolation. in ducts and at room terminals will achieve their
design values +10% –0% (see paragraph 8.30);
8.67 In order to ensure that the complete system
operates correctly, it will be necessary to validate • the room’s differential pressures will be correct.
the system as a whole from the air intake through 8.73 Evidence of the satisfactory achievement of the
to the extract discharge. foregoing standards should be available for
8.68 It is unlikely that in-house staff will possess the inspection and independently measured as
knowledge or equipment necessary to undertake necessary prior to validating the UCV unit.
this process. Therefore, a suitably qualified
Authorised Person appointed by the client should UCV unit validation procedure
carry out the validation of ultra-clean operating 8.74 Tests to validate the suitability and performance of
theatre ventilation systems. an ultra-clean operating suite should be undertaken
in the order that they appear in Table 8. Should an
Note item fail to meet the required standard, it should be
It is anticipated that training in the validation rectified and successfully retested before passing on
of specialised healthcare ventilation systems for to the next test.
Authorised Persons will become available during the
life of this Health Technical Memorandum.
73
Table 8 Summary of test regime projected by the inside dimensions of the side walls
or boundary air curtain. A suitably marked test
1. C
hallenge tests to ensure that: sheet will provide a consistent standard of test grid.
• the UCV terminal unit is correctly assembled and
sealed so that no air will bypass the filters; 8.79 The test grid should comprise test squares of
280 mm each side.
• the terminal filters are correctly sealed in their
housings; 8.80 The test grid should be aligned along the centre
• the terminal filters are of the same grade, of uniform lines of the terminal footprint with its centre under
quality and undamaged. the centre point of the terminal.
2. A
ir velocity measurements to ensure that: 8.81 Any test square with 80% or more of its area within
• a sufficient quantity of air is being delivered by the the UCV footprint should be used as a test
terminal; position.
• the terminal quadrants are in balance; 8.82 An inner zone should be designated that is not
• the air flow has sufficient velocity to reach the working less than 36% of the total footprint. It should be
plane. made up of a number of test squares distributed
3. A
n entrainment test to ensure that contaminants arising symmetrically about the terminal footprint’s centre-
outside of the UCV terminal footprint are not drawn into line. Regardless of the shape of the terminal
it. footprint, the inner zone should comprise a
4. V
isualisation techniques to gain an understanding of the minimum grid of 6 × 6 test squares.
overall system performance. 8.83 Unless specified otherwise, a test position should be
5. N
oise measurement to ensure that working conditions are in the geometric centre of a test square.
satisfactory.
8.84 Test position 1 should be the leftmost test square
6. C
ontrol system checks to ensure that the system operates
as specified.
in the row nearest to the operating room wall that
houses the surgeon’s panel.
7. B
iological monitoring to determine how effective the
system is in use. 8.85 Figure 8 shows a grid for a 2.8 m × 2.8 m terminal.
Test and measuring conditions Test grid – horizontal units

8.75 While validating the UCV terminal, the conditions 8.86 A line of test positions should be marked on the
in the operating room should be stable and within floor 1 m in front of the face of the UCV terminal.
the given ranges: 8.87 A test position should be marked in the centre of
• temperature: 19–23oC dry bulb; the line. Additional test positions should be marked
at 280 mm intervals along the line either side of the
• humidity: 30–65% relative humidity.
centre position, up to the full face width of the
unit.
Test and measuring equipment
8.76 Any test or measuring equipment used should have UCV terminal challenge tests (vertical and
a certificate to prove that it has been validated horizontal systems)
within the previous 12 months at a calibration
8.88 The diffuser screen fitted below the face of the
facility using traceable national standards.
terminal HEPA filters should be lowered or
8.77 In the case of a noise meter, its “matched sound removed while the challenge tests are being
source” should have a certificate to prove that it carried out.
has been validated within the previous 12 months
8.89 The installed HEPA filters should be checked to
at a calibration facility using traceable national
ensure that their grades accord with the design
standards. The noise meter should be calibrated to
specification and that their performance has been
the sound source on each occasion that it is used.
certified by the manufacturer.
Test grid – vertical units 8.90 The challenge tests may be carried out using either
of the following techniques:
8.78 A test grid should be constructed on the floor
within the ultra-clean terminal footprint as
74
Figure 8 Example of a test grid for a 2.8 m x 2.8 m UCV terminal
Surgeon’s panel
1 2 3 4 5 6 7 8 9 10
A + + + + + + + + + +
1
A + B + x x x x x x x + +
280 mm
C + x x x x x x x + +
280 mm D + x x x x x x x + +
E + x x x x x x x + +
Measure velocity
+ at 2 m above floor
F + x x x x x x x + +
level
Measure velocity G + x x x x x x x + +
x at 2 m and 1 m
above floor level H + x x x x x x x + +
I + + + + + + + + + +
Centre point
J + + + + + + + + + +
• use DOP to provide the challenge and a UCV terminal unit clean zone leak test
photometer to detect leaks;
8.94 This test will confirm that there is no unfiltered air
• use a DPC to detect leaks. (In order to obtain bypassing the HEPA filter.
a sufficient challenge, it may be necessary to
8.95 The joints and service penetration points under the
temporarily remove the supply AHU’s
UCV terminal within its side walls or boundary air
secondary filters.)
curtain should be scanned to prove that there are
8.91 In both cases, the upstream challenge should be no leaks.
measured. A measurement of particle penetration
8.96 A leak is defined as a significant rise above the
through a representative section of the HEPA-filter
background level.
media is then taken and used as the reference
background level. These two readings enable the Terminal HEPA filter seal leak test
range of the detecting instrument to be set.
8.97 This test will confirm that there is no unfiltered air
8.92 For the DOP test, this should be set as the
bypassing the HEPA filter’s seal.
reference level, and a leak will be declared
significant if penetration greater than 0.01% of the 8.98 Each HEPA filter’s seal should be scanned to prove
range is detected (see paragraph 8.56 for details). that there are no leaks.
8.93 For the DPC method, the filter face is scanned to 8.99 A leak is defined as a significant rise above the
establish the smallest non-penetrating particle size. background level.
If significant particles at or above this size are
detected when subsequent scans are made, there Terminal HEPA filter media leak test
is deemed to be a leak at or near the test position 8.100 This test will confirm that the HEPA filters have
(see paragraph 8.57 for details). not sustained damaged while being installed.
75
8.101 The face of each HEPA filter should be scanned to 8.108 Readings are to be taken at the test positions –
prove that there are no leaks. with the instrument probe facing the wall that
houses the surgeon’s panel – commencing at the
8.102 A leak is defined as a significant rise above the
first test position. Readings are taken either
background level.
working along the row from left to right and back,
Vertical UCV terminal air velocity tests or for all test positions in one quadrant at a time.
8.109 When all the test positions under one half of
Test set-up the terminal have been covered, readings of
a. The terminal face diffuser screen should be in temperature and humidity are taken at the
place for these tests. specified height in the centre of the terminal.
The read-outs on the surgeon’s panel should be
b. Take spot readings to establish that the room is recorded at the same time.
within the specified temperature and humidity
test conditions. 8.110 Having completed one half of the test grid, the
operating lamp arms and any other stem arms
c. Set out the test grid as described in paragraphs should be swung round through 180 degrees and
8.78–8.85. the test stand reversed so that the wall that houses
d. Swing the operating lamp arms and any other the surgeon’s panel is behind the test person.
stem arms so that they align to present the least Readings are recommenced starting at the right of
resistance to air flow, are perpendicular to the the test row and working from right to left or a
front edge of the test sheet, and face the back quadrant at a time, as above.
edge. Any lamp and equipment heads should
as far as practicable be outside of the UCV UCV high level discharge velocity test
terminal footprint. 8.111 Measurements of air velocity are to be taken at
every test position 2 m above floor level, and the
Test instrument results averaged.
8.103 The measuring instrument should be a hot- 8.112 The average of the total readings taken is to be not
wire anemometer with a digital read-out. The less than:
instrument resolution should be at least 0.01 m/s,
have a tolerance of ±0.015 m/s or 3% of the • 0.38 m/s for a partial-wall system;
reading, and be calibrated down to 0.15 m/s or • 0.30 m/s for a full-wall system.
lower. An alternative instrument may be used,
8.113 The average air velocity for each quadrant should
providing it is of no lesser specification.
not exceed ±6% of the measured average velocity
Test method for the terminal.
8.104 The instrument should be mounted on a test stand UCV low level air velocity test
and set to record a mean reading over a ten-second
8.114 Measurements of air velocity are to be taken at
sample interval.
each of the inner zone test positions 1 m above
8.105 It is recommended that a printer be linked to floor level.
the test instrument so that readings are recorded
8.115 The measured velocity at every test position in
automatically. Alternatively they could be
downloaded to a computer or data logger at the the inner (operating) zone should be not less than
end of the test. 0.2 m/s.
8.106 The test stand should be positioned at each test Horizontal UCV terminal air velocity test
point in turn and the reading taken when the
instrument has stabilised. Test set-up
8.107 When taking a reading, the test person should a. Set out the line of test positions as described
not stand within the same quadrant as the test previously.
instrument.
b. Swing the operating lamp arms and any other
stem arms so that they align to present the least
76
resistance to air flow and are perpendicular to 8.127 UCV systems having permanently fitted full side
the line of test positions. walls do not need to be tested, as the side walls
physically prevent entrainment.
Test instrument
Principle of the test
8.116 See paragraph 8.103.
8.128 A source of particles is produced outside of the
Test method UCV terminal and is used to challenge the system.
8.117 The instrument should be mounted on a test stand A detector is placed within the ultra-clean air flow
and set to record a mean reading over a ten-second and used to determine the percentage penetration
sample interval. of the test particles at predefined locations under
the UCV terminal footprint. The source and
8.118 It is recommended that a printer be linked to detector are moved in tandem around the UCV
the test instrument so that readings are recorded canopy and pairs of readings taken, from which
automatically. Alternatively, they could be the percentage penetration at specified locations
downloaded to a computer or data logger at the is calculated. The degree of penetration should be
end of the test. below specified maximum limits if entrainment is
8.119 The test stand should be positioned on each test to be declared not significant.
point in turn and the reading taken when the 8.129 The entrainment test may be carried out using
instrument has stabilised. either of the following techniques:
8.120 When taking readings, the test person should • use DOPs to provide the challenge source at
stand well downstream of the instrument. the specified release position and a photometer
8.121 Readings are to be taken at the test positions – to measure the entrainment; or
with the instrument probe facing the UCV • duct non-HEPA-filtered air to the specified
terminal – commencing at the first test position release position and use a DPC to measure the
on the left and working along the row from left entrainment.
to right at the specified height.
8.122 The instrument should be reset to the next Test set-up
specified height and the test repeated, and so on. a. The terminal face diffuser screen should be in
8.123 Readings of temperature and humidity should be place for these tests.
taken at the specified height in the centre of the b. The test should be performed without any
terminal. The read-outs on the surgeon’s panel equipment in place beneath or closely adjacent
should be recorded at the same time. to the UCV terminal.
UCV discharge velocity test c. Theatre lights should be moved to a central

position beneath the terminal and raised to 2 m
8.124 Measurements of air velocity are to be taken at all above floor level so as not to interfere with the
test positions at 1 m, 1.5 m and 2 m above floor peripheral air flows.
level.
d. Take spot readings at the centre of the canopy,
8.125 The average of the total readings taken should be 1 m from floor level, to establish that the room
no less than 0.4 m/s. is within the specified temperature and
humidity test conditions.
UCV entrainment test (vertical systems only)
e. Set out the test grid as described previously.
Rationale for the entrainment test f. For either of the entrainment tests mentioned
8.126 The performance of UCV systems may be in paragraphs 8.131–8.132, a measurement of
compromised by room air being drawn into the particle penetration through a representative
ultra-clean air flow, a phenomenon known as section of the HEPA-filter media is to be taken
“entrainment”. Significant levels of entrainment and used as the reference background level.
could lead to microbial contamination of items left
exposed on instrument trolleys laid out beneath
the canopy.
77
Test equipment
a. Challenge source, measuring instrument and
Note
detector head The use of DOP for testing is gradually being phased
out and replaced by a natural challenge measured with
8.130 The challenge and detector equipment should be
a DPC. At the time of writing research is under way
chosen so that:
to more precisely define a challenge source unit for
• the tracer particles are mainly within the size natural particles. It is anticipated that such a unit,
range 0.3–5 μm and thus capable of remaining together with a matching test methodology, will
airborne for a substantial time; become available during the life of this Health
• the particles used should not be able to Technical Memorandum.
penetrate the terminal filters in sufficient
numbers to cause a background count that is The detector
more than 0.1% of the challenge count;
8.133 This may be a photometer or a DPC. It is
• the choice of particle and detector will enable recommended that a printer be linked to the
a minimum of a three-logarithm (1000-fold) test instrument so that readings are recorded
range of counts to be recorded between the automatically. The instrument should be capable
highest (that is, source) and lowest (that of sampling a minimum of 28.3 L of air (1 ft3)
is, background) readings expected. per minute and, in the case of the DPC, provide
(A concentration of approximately 105 particles readings for particle size ranges from 0.3 µm to
per cubic metre of source air has been shown to 5 µm and greater. The instrument should be
be adequate.) compliant with the requirements of BS EN ISO
14644-1. An alternative instrument may be used
b. Challenge source – DOP providing it is of no lesser specification.
8.131 The DOP generator should be able to produce
a cloud of test particles in the form of a visible Test positions and orientation of source and
smoke. The test smoke should be delivered via an detector
aperture so that it flows vertically downward from 8.134 The test positions should be at the centre of each
the lowermost edge of the partial wall, on the test square, as defined for the velocity test.
outside of the UCV canopy.
8.135 For rectangular UCV terminals, measurements
of penetration are to be taken at the four corner
Note test squares of the test grid and at intermediate
To prevent undue contamination of the theatre and positions along the line of test squares between the
filters with deposits of oil, DOP should only be corners. The number of intermediate test positions
released for the minimum amount of time necessary to should be as equally spaced as possible around the
complete the test. periphery, with no fewer than three and no more
than five complete test squares between test
positions.
c. Challenge source – natural particles
8.136 A further series of measurements are to be
8.132 The source unit should be a fan/blower or other
obtained around the periphery of the inner zone.
method that takes non-HEPA-filtered air and
Measurements of penetration are to be taken at the
expels it via a delivery head at the specified release
four corner test squares of the inner zone of the
position to provide the particle challenge. The
test grid and, if necessary, at intermediate positions
challenge air should be delivered vertically
along the line of test squares between the corners
downwards from the lowermost edge of the partial
as equally spaced as possible, with no fewer than
wall, on the outside of the UCV canopy, parallel
three and no more than five complete test squares
to the air flow coming from the diffusers. The
between test positions.
challenge air velocity should be the same as the
measured average velocity at 2 m for the terminal 8.137 A single measurement should be taken at the
under test. geometric centre of the UCV terminal footprint.
The centre measurement should be taken with the
78
detector head mounted vertically upwards, 1 m Analysis and interpretation

above floor level.
8.144 The following standard is to be achieved:
8.138 The centre of the challenge particle source should
• at each test position in the outer zone,
be aligned with the centre of the designated test
penetration is to be no greater than 10% of the
square, with its longer edge against the outer edge
challenge;
of the partial wall and delivering the challenge
from the lower edge of the partial wall. The air • at each test position in the inner zone,
containing challenge particles is directed vertically penetration is to be no greater than 1% of the
downwards from the lower edge of the partial wall, challenge;
in a plane parallel to the partial wall. Where there • at the centre test position, penetration is to be
is physical interference due to obstructions such as no greater than 0.1% of the challenge.
gas pendants, the source should be moved to the
next available non-obstructed test-square location 8.145 If a result is close to, or above, the given limits,
nearest to the stipulated sampling position. The a further reading must be obtained using a longer
detector should then also be moved to remain time base (one minute), and the penetration must
opposite the source. not exceed the given limit.
8.139 In the case of non-rectangular terminals,
an interpretation of the above strategy should
Note
be adopted that will yield a no less searching The entrainment test is based on the research of
examination of the unit’s ability to control Whyte et al (1974) and Whyte et al (1983).
entrainment.
UCV visualisation
Test method
8.146 The use of smoke to gain an understanding of the
8.140 The sampling head of the detector instrument is
overall performance of the system may prove useful
mounted on a test stand with its sampling orifice
at this stage in the validation process but cannot be
facing outwards horizontally from the centre of the
relied on to produce a contractually definitive
UCV canopy, 1 m above floor level. The sampling
measure of performance.
head should be orientated at right-angles to the
partial wall when sampling along the sides of the UCV noise level
test grid, but should be set to bisect the angle
when measuring at the corner test positions. 8.147 An industrial-grade Type 2 sound-level meter
fitted with a muff should be used to check the
8.141 The test will commence at the first test position,
noise level. The instrument should be calibrated
this being designated the leftmost corner of the using a matched sound source prior to each set of
test grid when facing the wall housing the readings.
surgeon’s panel. The penetration should also be
measured at the corresponding test point on the Vertical systems
inner zone commencing at the corner nearest to
the first test position. When these tests have been 8.148 The noise level readings should be taken at typical
completed, the source and detector equipment normal listening positions 1.5 m above floor level
should be moved to the next test positions, and at least 1 m from any surface and not on any
working around the test grid in a clockwise line of symmetry. Measurements should be taken
direction. approximately under the centre of each quadrant
of the UCV terminal and the four readings
8.142 The test stand should be positioned on each test averaged.
point in turn and a pair of readings (challenge,
then penetration) taken when the instrument has Horizontal systems
stabilised. The detector should be set to take a
reading over a 15-second sample interval. 8.149 The noise-level readings are to be taken at typical
normal listening position 1.5 m above floor level
8.143 When taking a reading, the test person should on the test line. The width of the unit should be
stand within the UCV terminal footprint but divided in two and a measurement taken in the
not in the same quadrant as the detector head.
79
centre of each half but avoiding any line of BMS interface

symmetry. The two readings should be averaged.
8.159 The operation, monitoring and alarm functions
8.150 Measurements should also be taken in each room must be proved to conform to those set out in the
of the suite. design specification.
8.151 In the event of a contractual deficiency, a Type 1
UCV theatre microbiological tests
precision-grade sound-level meter should be
used in accordance with Health Technical 8.160 There is little value in performing microbiological
Memorandum 08-01. sampling in a new theatre supplied with ultra-
clean ventilation. The foregoing filter challenge
8.152 For vertical or horizontal systems, the noise level
tests, air velocity measurements and entrainment
should not exceed:
test should have proved that the system operates
• 50 NR [55 dB(A)] – for UCV operating rooms satisfactorily and achieves the contracted level
and spaces without doors that open directly of performance. The HEPA filters will remove
onto it (for example the scrub); bacteria-sized particles from the air supplied
through the UCV terminal. Therefore there will be
• 40 NR [45 dB(A)] – for all other peripheral
an insignificant number of bacterial and/or fungal
rooms of the suite.
CFU present until the theatre is actually used.
UCV control system checks 8.161 Once the theatre has been taken into use,
microbial sampling during a surgical procedure
Temperature should help to confirm the satisfactory
8.153 The readings of temperature taken under or in performance of the system and discipline of the
front of the UCV unit should be within ±1 K of users. Before commencing bacteriological testing,
each other and the read-out on the surgeon’s panel. the room and its ventilation system should have
achieved a steady state condition (see also
Humidity paragraph 8.75).
8.154 The readings of humidity taken under or in front 8.162 The installation should be tested during surgical
of the UCV unit should be within ±5% of each procedure at intervals between the time of first
other and the read-out on the surgeon’s panel. incision and final closure of the wound. On
average, air sampled within 300 mm of the wound
Direct-reading differential-pressure gauges should not contain more than 10 CFU/m3.
8.155 The accuracy of the indicated reading of these The Hospital Infection Society has issued guidance on
gauges should be checked by measuring the actual the microbiological testing of UCV operating theatres
differential pressure across the terminal filter(s). (www.his.org.uk/_db/_documents/OTIC-final.pdf ).
Control functions
UCV validation report
8.156 The operation of all control functions provided
on the surgeon’s panel should be proved for 8.163 Following validation, a full report detailing the
conformity with the design specification. findings should be produced. The report should
conclude with a clear statement as to whether the
8.157 If an auxiliary panel has been fitted, its
UCV theatre suite achieved or did not achieve the
interlocking with the control functions of the standard set out above.
main surgeon’s panel must be proved to conform
to the design specification. 8.164 A copy of the report should be lodged with the
following groups:
Panel indicator lights • operating department;
8.158 The panel indicator lights should illuminate as • infection control;
appropriate when the control functions are selected
or warning levels are reached. • estates and facilities.
80
Appendix 1 – Use and function of typical
equipment used in ventilation
systems
A1.1 Typical equipment used in ventilation systems is d. plant-isolating dampers are fitted so that
listed below together with a brief description of the main plant can be isolated from its air
both function and use. distribution duct system. They are manually
operated, and enable cleaning and maintenance
General of the air-conditioning equipment to be carried
out.
A1.2 The equipment built into the ventilation system
and its ductwork should be of a type that will
neither cause nor sustain combustion.
Ducting
A1.6 Ducting is the means by which air is conveyed
A1.3 No materials that could sustain biological activity
from the intake to its point of use. It is usually
should be used in the construction or assembly of
constructed of galvanised steel and will normally be
the system.
insulated to reduce noise and conserve energy.
Ducts can also be formed in concrete, brickwork,
Air intake stainless steel or plastic, and may be rigid or
A1.4 An uncontaminated air supply to the system is flexible.
essential. In order to achieve this, the air intake
should be positioned so that air discharged from Fan
extract systems or other sources of dubious quality
A1.7 A fan is a series of rotating blades that move the air
cannot be drawn in. Exhaust fumes from vehicles
in the direction required. Fans are usually powered
can present particular problems. The area
by electric motors either directly connected to them
surrounding the intake will need to be kept clean
or driven through belts and pulleys. A fan may be
and free of vegetation and waste material in order
arranged to either force air into or draw air from a
to reduce the possibility of biohazards or fire. The
ductwork system.
intake itself should be protected by a louvre and
mesh screen to prevent rainwater, vermin and leaves
etc entering the system. Attenuator/silencer
A1.8 An attenuator is a device that will contain and
Damper absorb the noise emitted by a fan. It may be
required to reduce disturbance caused by noise
A1.5 Several types of damper may be fitted:
breaking out through the air intake and also noise
a. automatic dampers fitted immediately behind transmitted along the ductwork to the conditioned
the air intake and extract louvres. They will space.
automatically close when the system is shut
down in order to prevent an uncontrolled Filter
circulation of air;
A1.9 A filter consists of a labyrinth of fibrous material
b. balance dampers are fitted into each branch contained in a frame. It is designed to capture
of the air distribution ductwork system so that and hold particles being carried in the air stream.
the design air-flow rate can be set during the Because of the size range and number of particles
commissioning process; that exist in air, no filter can remove them all.
c. where ductwork passes through a fire The purpose of filtration is to reduce their number
compartment wall, ceiling or floor, a fire and/or and size range to an acceptable level. Filters of
smoke damper may be required; progressively higher grades are fitted through the
ventilation system:
81
• primary filters (coarse) are designed to collect Eliminator

the larger particles and are intended to keep the
air-handling plant clean; A1.15 An eliminator is a device for catching and
removing water droplets from an air stream. It may
• secondary filters (fine) remove the staining form part of a cooling coil or be a separate device.
particles from air and keep the ventilated space
visibly clean; Drainage system
• high efficiency particulate air filters (HEPA/ A1.16 The drainage system is a means of removing
absolute) remove virtually all particles from air. water from ductwork and disposing of it safely.
These may be required in order to reduce Typically it will consist of a tray mounted in the
contamination in the working area either duct to catch moisture, a glass water-seal trap,
biologically or in terms of particle count. continuously falling drainage pipework and an
A1.10 Filters may be fitted to extract systems to protect air break in the drain run to prevent waste water
energy-recovery devices. They are also fitted to returning and contaminating the duct.
remove biological, radiation or chemical hazards.
They are often contained in a “safe change” facility Access doors and observation ports
in order to protect those carrying out maintenance.
A1.17 Access doors and observation ports are doors and
A1.11 Activated carbon filters will reduce odours in removable panels that provide access for routine
extracted or recirculated air. maintenance and cleaning. The doors should be
fitted with glazed ports, and suitable lighting
Heater coil/battery should be provided so that the condition and
correct operation of devices such as cooling coils,
A1.12 A heater coil/battery is a series of coils with or
humidifiers and filters can be easily observed
without fins through which steam or hot water
without needing to switch off the plant.
is circulated. Heat is given up to the air passing
over the battery, thus increasing its temperature.
Heating is usually carried out in stages, the final Energy recovery
battery being controlled by the end-user. Small A1.18 Modern plants are fitted with the means to
batteries may be electric. recover energy from the extract air without causing
contamination of the incoming supply air. These
Humidifier devices will be fitted with a drainage system and
may incorporate an eliminator. Several types of
A1.13 A humidifier is a device for increasing the
energy-recovery system are available.
humidity of air by adding moisture. For
ventilation in healthcare premises, this is normally A1.19 Precise definitions of ventilation and air
achieved by releasing clean steam into an air- conditioning terms are given in CIBSE Guide B.
supply duct. The steam should be completely
absorbed into the air, increasing its humidity. Typical plant
The level of humidity may be preset or controlled
A1.20 The layout of a typical plant that conforms to the
by the end-user.
requirements for healthcare applications is shown
in Figure 1 in Chapter 1 of this document. It
Chiller battery/cooling coil contains most of the equipment described above.
A1.14 A chiller battery/cooling coil is a series of finned
coils mounted in the air-supply duct. Either
chilled water or refrigerant is circulated through
the coils, causing heat to be removed from the air.
This will reduce its temperature and may also
condense moisture out of the air. As free moisture
in a duct can be a source of contamination, the
coil will be fitted with an eliminator and drainage
system.
82
Appendix 2 – Recommended air-change rates
Pressure Supply Noise Temp Comments (for further
Application Ventilation AC/hr
(Pascals) filter (NR) (°C) information see Chapter 6)
General ward S/N 6 – G4 30 18–28
Communal ward toilet E 6 –ve – 40 –
Single room S/E/N 6 0 or –ve G4 30 18–28
Single room WC E 3 –ve – 40 –
Clean utility S 6 +ve G4 40 18–28
Dirty utility E 6 –ve – 40 –
See Health Building Note
Ward isolation room – – – – – –
04-01 (Supplement 1)
Infectious diseases Extract filtration may be
E 10 –5 G4 30 18–28
isolation room required
Neutropeanic patient
S 10 +10 H12 30 18–28
ward
Isolation room may be –ve
Critical care areas S 10 +10 F7 30 18–25
pressure
Birthing room S&E 15 –ve G4 40 18–25 Provide clean air-flow path
Isolation room may be –ve
SCBU S 6 +ve F7 30 18–25
pressure
Preparation room (lay-up) S >25 35 F7 40 18–25
Preparation room/bay *50 NR if a bay in a UCV
S 10 25 F7 40* 18–25
(sterile pack store) theatre
Operating theatre S 25 25 F7 40 18–25
H10 or *Fresh-air rate; excludes
UCV operating theatre S 25* 25 50 18–25
greater recirculation
Anaesthetic room S&E 15 >10 F7 40 18–25 Provide clean air-flow path
Theatre sluice/dirty utility E >20 –5 – 40 –
Recovery room S&E 15 0 F7 35 18–25 Provide clean air-flow path
Catheterisation room S 15 +ve F7 40 18–22
Endoscopy room S 15 +ve F7 40 18–25
Endoscopy cleaning E >10 –ve – 40 –
Day-case theatre S 15 +ve F7 40 18–25
Treatment room S 10 +ve F7 35 18–25
# See EGGMP (Orange
Pharmacy aseptic suite S 20 # H14 – 18–22
guide) a
Category 3 or 4 # See ACDP guide; *Filter in
# >20 # H14* – 18–22
containment room extract
S = 10
Post-mortem room S&E –ve G4 35 18–22 Provide clean air-flow path
E = 12
Fan accessible from outside
Specimen store E – –ve – – –
of store
8–22oC indicates the range over which the temperature may float.
Notes: 1
18–22oC indicates the range over which the temperature should be capable of being controlled.
S = suppy
E = extract
N = natural ventilation
a–E uropean guidelines on good manufacturing practice published by the Medicines and Healthcare products Regulatory
Agency (MHRA)
83
Appendix 3 – Hierarchy of cleanliness
Air-flow rate for bacterial contaminant dilution

Nominal
Class Room pressure Flow in or supply (m3/s) Flow out or extract (m3/s)
(Pa)a
Sterile Preparation room See standard schemes in Appendix 7 for recommended design values
(a) lay-up 35
(b) sterile pack store 25
Operating room 25
Scrub bayb 25
Clean Sterile pack bulk store +ve 6 AC/h –
Anaesthetic roomc 14c The greater of 15 AC/hr or 0.15 The greater of 15 AC/hr or 0.15
Scrub room 14 – 0.10
Transitional Recovery room 3 15 AC/hrd 15 AC/hrd
Clean corridor 0 (See note e) 7 AC/hr
General access corridor 0 (See note e) 7 AC/hr
Changing rooms 3 7 AC/hr 7 AC/hr
Plaster room 3 7 AC/hr 7 AC/hr
Dirty Service corridor 0 – (See note f )
Disposal room –5 or 0 – 0.41 or 0.10
Notes:
a. Nominal room pressures are given to facilitate setting up of pressure-relief dampers, the calculation process, and the sizing
of transfer devices. In practice, the resultant pressures are not critical, provided the desired air-flow rates and movement are
achieved.
b. An open or semi-open bay is considered to be part of the operating room; provided air movement is satisfactory, no specific
extract is required. However, if the layout means that air movement is poor, a local extract may be required to control local
condensation on the building surfaces, which can result in mould growth.
c. For design purposes, anaesthetic should be assumed to be at 14 Pa. When commissioning, 10 Pa is considered suitable.
d. 1 5 AC/hr is considered necessary for the control of anaesthetic gas pollution.
e. S upply air-flow rate necessary to make up 7 AC/hr after taking into account secondary air from cleaner areas.
f. No dilution requirement. Temperature control requirements only.
84
Appendix 4 – Leakage flows in m3/s through
closed door gaps
Pressure difference (Pa)

Type
5 10 15 20 25 30 40
Single door 0.03 0.05 0.06 0.06 0.07 0.07 0.08
Double door 0.04 0.08 0.10 0.11 0.12 0.13 0.14
High permanent length of 3 mm gap 0.004 0.008 0.010 0.011 0.012 0.012 0.013
Designers’ notes:
The door gaps assumed are 4 mm along the bottom, 3 mm at the top and sides, and 2 mm between double leaves.
If doors are fitted with cold smoke seals, these will significantly reduce the door leakage rate when new and undamaged. It is
therefore recommended that provision for the design leakage be factored into the size of the appropriate transfer grille or pressure
stabiliser. Failure to do this will result in air-gap whistles and doors being held partially open by air pressure.
Factory-assembled door-sets with a steel frame and pre-hung leaves are becoming common. There is effectively no leakage across
these doors when closed. Therefore, when this type of door assembly is fitted, the door leakage can be ignored and the design air
flow into the room reduced accordingly. The design air flow would then become that required either (i) for open door protection
(Appendix 5), or (ii) to achieve the specified air-change rate – whichever is the greater.
85
Appendix 5 – Recommended air-flow rates

in m3/s through a doorway between rooms
of different cleanliness to control cross-
contamination
Room class Dirty Transitional Clean Sterile

Sterile Hatch 0.3 0.24 0.18
0.39 0.28 0 or 0.28a
Single door 0.47
0.75 0.57 0 or 0.57a
Double door 0.95
Clean Single door 0.39 0.28 0 or 0.28a
0.57 0 or 0.57a
Double door 0.75
Transitional Single door 0.28 0 or 0.28a
0 or 0.57a
Double door 0.57
Dirty Single door 0 Open single door = 0.80 m × 2.01 m high
Double door 0 Open double door = 1.80 m × 2.01 m high
Designers’ notes:
The degree of protection required at an open doorway between rooms is dependent on the degree of difference in cleanliness
between them.
Flow rate required between rooms within the same class tends to zero as class reduces.
a. If two rooms are of equal cleanliness, no flow is required (in practice there will be an interchange in either direction) and the
design of the air movement will assume zero air flow. In certain cases, however, interchange is not permitted, and a protection
air flow of 0.28 is assumed in the design – for example in the case of a preparation room used as a “lay up”
86
Appendix 6 – Typical approximate pressures in
an operating suite when a given
door is open
Typical approximate effect on other rooms

Typical approximate
Door open between resultant pressure in Room Pressure (Pa)
these rooms (Pa)
Operating room and corridor 0 Anaesthetic 0
or Preparation – lay-up 12
Scrub bay and corridor Disposal –6
Preparation – sterile pack store 5
Operating room and anaesthetic room (or other 17 Preparation – lay-up 26
series room with double doors)
Disposal –9
Operating room and disposal room 25 No change
or
Operating room and preparation room
Anaesthetic room and corridor 0 Preparation – lay-up 30
(or other series room with double doors)
Disposal –6
Operating room 20
Preparation room and corridor 0 No change
or
Disposal room and corridor
Disposal room and outer corridor 0 No change
Notes:
The room differential pressure protects against reverse flows when the door is closed.
The flow of air through a doorway protects against reverse air flow when the door is open.
Pressure stabilisers control flow and ensure a known air-flow path between rooms when doors are closed, and also reduce
back-flow between rooms when doors to other rooms are open
87
Appendix 7 – Operating suite standard design

solutions
Operating suite design logic
Is it a new build
operating suite?
YES NO
It is a refurbishment
Is it a
conventional suite?
Is it a scheme
based on a standard
layout from
NO YES HTM 03-01?
NO YES
Does it have NO
a “lay-up” prep?
Use standard layouts

5 to 8
YES Do the room NO

sizes accord with
HBN 26 Vol 1?
YES
Use standard layout

Is it a UCV suite? 1 or 3
NO YES Does it have NO

an SPS prep?
YES
Do the room NO
sizes accord with
HBN 26 Vol 1?
YES
Use standard layout

2 or 4
Apply basic design principles and/or use
the design method in Appendix 8
88
Appendix 7 – Operating suite standard design solutions
Standard layout 1 – Suitable for a typical conventional theatre suite
Room Size (m3)‡ Air-change rate (AC/hr) Nominal pressure (Pa) Flow rate (m3/s)
Theatre 165 25 25 1.15
Anaesthetic 57 15 >10 0.24
Lay-up-prep 36 >25 35 0.28**
Scrub * – 25 –
Notes:
‡ Derived from Health Building Note 26.
* This is a separate scrub and is not considered as being part of the theatre volume.
** Interchange is not permitted between the theatre and lay-up prep; therefore, as in Appendix 5, an air-flow protection of
0.28 m3/s is required as a minimum (but see also the “designers’ notes” in Appendix 4).
The volume of air to be extracted from the theatre should be determined by subtracting the air flow required for door protection
at the key door from the total air entering the space. The balance should be equally divided between the passive or active extract
locations.
The extracts within the theatre may be either passive and fitted with pressure stabilisers, or active and connected to the extract
system. They should where possible be located at low level and positioned to promote the ventilation of all areas of the space
Corridor 0
KEY TO SYMBOLS
>10 0.24
Supply volume (m3/s)
Anaesthetic Scrub
0.24 15
Extract volume (m3/s)
Nominal room pressure (Pa)
Air change rate (ac/h)

1.15
Pressure stabiliser
Operating theatre
Low-level active extract or
0.28 25 25
LLE pressure stabiliser to assist
air distribution in theatre
Prep (lay up)
Transfer grille
35 >25 LLE
Service corridor 0 Fire door
89
Standard layout 2 – suitable for a typical UCV theatre suite

Theatre 165 25 25 1.15**
Sterile pack store prep 36 10 25 0.10
Scrub * – 25 –
Notes:
‡ Derived from Health Building Note 26
* This is a separate scrub and is not considered as being part of theatre volume.
** Primary fresh-air volume only.
The volume of air to be extracted from the theatre should be determined by subtracting the air flow required for door protection
at the key door from the total air entering the space. The balance should be equally divided between the passive or active extract
locations.
system. They should be located at low level and positioned to promote the ventilation of all areas of the space
Corridor 0
KEY TO SYMBOLS
>10 0.24
Anaesthetic Scrub
0.24 15

1.15
Pressure stabiliser
UCV primary
air flow rate (m/s)
LLE pressure stabiliser to assist 0.10
Prep (SPS) UCV operating theatre
Transfer grille
25 10 25 25 LLE
Service corridor 0 Fire door
90
Standard layout 3 – suitable for a typical conventional theatre suite

Theatre 165 25 25 1.15
Lay-up prep 36 >25 35 0.34**
Scrub * – 25 –
Dirty utility 36 – –5 0.41
Notes:
** Interchange is not permitted between the theatre and lay-up prep; therefore, as in Appendix 5, an air-flow protection of 0.28 +
0.06 closed-door air flow is required as a minimum (but see also the “designers’ notes” in Appendix 4).
The volume of air to be extracted from the theatre should be determined by subtracting the air flow required for protection at
the key door from the total air entering the space. The balance should be equally divided between the passive or active extract
locations.
LLE
Scrub
KEY TO SYMBOLS
1.15
>10 0.24 Operating theatre

Anaesthetic 25 25
Nominal room pressure (Pa) 0.24 15

–5
0.41 0.34
Pressure stabiliser
>20
Dirty utility Prep (lay up)
LLE pressure stabiliser to assist >25
35
Transfer grille Exit bay 0
91
Standard layout 4 – suitable for a typical UCV theatre suite

Theatre 165 25 25 1.15**
Sterile pack store prep 36 10 25 0.10
Scrub * – 25 –
Dirty utility 36 – –5 0.41
Notes:
** Primary fresh-air volume only.
The volume of air to be extracted from the theatre should be determined by subtracting the air flow required for protection at the
key door from the total air entering the theatre space. The balance should be equally divided between the passive or active extract
locations.
UCV operating theatre LLE

Scrub
KEY TO SYMBOLS
1.15
>10 0.24 UCV primary

air flow rate (m/s)
Anaesthetic
Nominal room pressure (Pa) 0.24 15 25 25

LLE
–5
0.41
Pressure stabiliser
>20 0.10
Dirty utility
Low-level active extract or Prep (SPS)
LLE pressure stabiliser to assist
air distribution in theatre 10
25
Transfer grille Exit bay 0
92
Standard layout 5 (Health Technical Memorandum 2025 existing standard plan “1b”) –
typical layout for a conventional theatre suite
Note
This layout and data is for historical purposes only. The information is to be used for the evaluation of existing
systems, the fitting out of existing shell schemes or rebalancing following ventilation system cleaning.
Room Size Air-change rate (AC/hr) Nominal pressure (Pa) Flow rate (m3/s)
Theatre 20 25 0.65
Anaesthetic 15 >10 0.15
Existing theatre suite
Lay-up prep – 35 0.34*
to be measured on site
Scrub – 25 –
Disposal – –5 0.41
Notes:
* See the “designers’ notes” in Appendices 4 and 5.
The disposal layout detailed will remain the same should a hatch be utilised instead of a door onto the outer corridor
0 Corridor
KEY TO SYMBOLS
Supply volume (m3/s) >20 –5 0.15

>10
Dirty utility Anaesthetic
Exit bay
15
Extract volume (m3/s) 0.41 0.15
Air change rate (ac/h) 0.34
0.65 Prep (lay up)

Pressure stabiliser
Operating theatre >20 35

Optional low-level active extract
LLE or pressure stabiliser. May be added 20 25
during refurbishment to assist
Transfer grille
Scrub
LLE
93
Standard layout 6 (Health Technical Memorandum 2025 existing standard plan “1a”) –
typical layout for a UCV theatre suite
Note
If difficulties are experienced with entrainment around the periphery of the UCV, adding a low-level active or
passive extract in the location indicated will usually resolve the problem.
Theatre 20 25 0.75*
Sterile pack store prep 10 25 0.1
Scrub – 25 –
Disposal – –5 0.41
Notes:
* Primary fresh-air-flow volume
The disposal layout detailed will remain the same should a hatch be utilised instead of a door onto the outer corridor
0 Corridor
KEY TO SYMBOLS
Supply volume (m3/s) >20 –5 0.15

>10
Dirty utility Anaesthetic
Exit bay
15
Extract volume (m3/s) 0.41 0.15

UCV operating theatre
Air change rate (ac/h) 0.10
0.75 Prep (SPS)

Pressure stabiliser
10 25
Optional low-level active extract UCV primary
or pressure stabiliser. May be added air flow rate (m/s)
LLE air distribution in theatre and
overcome entrainment problems
with the UCV terminal
>20 25
Scrub
Transfer grille LLE
94
Standard layout 7 (Health Technical Memorandum 2025 existing standard plan “5b”) –
typical layout for a conventional theatre suite
Note
Theatre 20 25 0.65
Lay-up prep >20 35 0.34*
Scrub – 25 –
Disposal – 0 0.1
Notes:
* See the “designers’ notes” in Appendices 4 and 5.
The disposal layout detailed will remain the same should a hatch be utilised instead of a door onto the outer corridor.
Alternatively the disposal room could be omitted and replaced with a disposal hatch between the theatre and corridor
0 Corridor
KEY TO SYMBOLS
Supply volume (m3/s) 0.15 >10

Anaesthetic Exit bay
Scrub
15
Extract volume (m 3/s) 0.15

0.34
0.65
Pressure stabiliser
Prep (lay up)
Operating theatre
Optional low-level active extract
>20 35
LLE or pressure stabiliser. May be added 20 25
Transfer grille Disposal
0.10
0
LLE
0 Service corridor
95
Standard layout 8 (Health Technical Memorandum 2025 existing standard plan “5a”) –
typical layout for a UCV theatre suite
Note
If difficulties are experienced with entrainment around the periphery of the UCV, adding a low-level active or
passive extract in the location indicated will usually resolve the problem.
Theatre 20 25 0.75*
Sterile pack store prep 10 25 0.1
Scrub – 25 –
Disposal – 0 0.1
Notes:
* Primary fresh-air-flow volume only
The disposal layout detailed will remain the same should a hatch be utilised instead of a door onto the outer corridor.
Alternatively the disposal room could be omitted and replaced with a disposal hatch between the theatre and corridor
0 Corridor
KEY TO SYMBOLS
Supply volume (m3/s) 0.15 >10

Anaesthetic Exit bay
Scrub
15
Extract volume (m3/s) 0.15
UCV operating theatre

0.10
0.75
Pressure stabiliser
Prep (SPS)
Optional low-level active extract UCV primary 25
10
or pressure stabiliser. May be added air flow rate (m/s)
LLE air distribution in theatre and
overcome entrainment problems Disposal
with the UCV terminal 0.10
>20 25
0
Transfer grille LLE
0 Service corridor
96
Appendix 8 – Design of air-movement control
schemes for operating theatres
General ED – extract air-flow rate for dilution of bacterial

contaminants;
A8.1 Standard operating suite design solutions are given
in paragraphs 7.31–7.90 and Appendix 7. If these SF – final supply air-flow rates
standard solutions cannot be used, the following EF – final extract flow rates;
procedure should be adopted, which will result in
an acceptable design. Note that the method SAMC – air-supply flow rate for air-movement
employed can equally be used to provide a design control;
solution to a ventilated suite of rooms for any EAMC – air-extract flow for air-movement control;
application.
LOUT – leakage air-flow rate outward;
A8.2 The method is concerned with the calculation of
air-flow rates to ensure that correct air movement LIN – leakage air-flow rate inward;
occurs between rooms when any one door is open. ∑OUT – total air-flow rate outward;
Under most circumstances, the air quantities
∑IN – total air-flow rate inward.
required for air-movement control will approximate
to those for either temperature control or bacterial A8.4 To simplify the procedure, standard worksheets
contaminant dilution. This flow rate is sufficient to (WS1 to WS7) have been devised. For each
control the effects of any slight reverse flows operating suite, a set is required comprising one
occurring when a door is opened. each of WS1, WS3, WS5, WS6a, WS6b and WS7,
one WS4 for each corridor and one WS2 to cover
A8.3 The progression through the design procedure
each peripheral room. WS2 has five versions:
is shown in the air-flow design procedure chart
(Figure A3) and is supported by worksheets • WS2a single flow,
WS1 to WS7 described in paragraph A8.4. It is
• WS2b parallel/series multi-flow,
recommended that a plan of the suite and an air-
flow network be made (Figure A2) to collate all • WS2c parallel multi-flow or series multi-flow
information. Flow rates, air-transfer devices etc (unbalanced);
should be entered as required. The remainder of • WS2d series multi-flow (balanced); and
this Appendix may be treated as reference data to
assist in the various steps. The following symbols • WS2e bay (semi-open).
are used:
SS – supply air-flow rate for summer temperature
Peripheral room type
control; A8.5 The rooms in the operating suite other than the
operating room and corridor are referred to as
SW – supply air-flow rate for winter temperature
peripheral rooms. Peripheral rooms have been
control;
classified according to the flows in and out. These
SD – supply air-flow rate for dilution of bacterial room classifications are defined in paragraphs
contaminants; A8.6–A8.11.
SL – supply air-flow rate for heat loss;
SG – supply air-flow rate for heat gain;
97
Single flow a particular field of application within the design,

as described in paragraphs A8.34–A8.43. Air
A8.6 This is a room with only one door and a net
movement is controlled in each of the different
surplus of supply or extract air.
room types described in paragraphs A8.13–A8.31.
Parallel multi-flow
Key
A8.7 This is a room with two or more doors through
H High Transfer grille
each of which the air flows either outwards (high
pressure) or inwards (low pressure) (for example the
Prep (lay-up) in standard layout 5 in Appendix 7). M Medium Pressure stabiliser
Parallel/series multi-flow L Low
A8.8 This is a room having a net surplus of supply or

extract and with two or more doors. One or more S Supply E Extract
doors will be to an area of equal cleanliness and
need not be protected; hence, the flow may vary
between inwards and outwards, the remaining door Single flow rooms
being to an area of greater or lesser cleanliness (for
example the Prep (SPS) in standard layout 6 in A8.13 An appropriately-sized transfer grille should be
Appendix 7). located in or adjacent to the door of each single
flow room to relieve the pressure differences across
Series multi-flow (unbalanced) the door when closed.
A8.9 This is a room having a net surplus of supply or
extract and with two or more doors. Air flows
inwards through one or more doors and outwards S
through one or more doors.

A8.10 This is a room as in paragraph A8.9 above, but H
having either no mechanical ventilation or no L
net surplus of supply or extract (for example an
anaesthetic room). Single flow
Bay
Parallel multi-flow rooms
A8.11 A room which has a permanent opening to the
A8.14 The pressure difference across the closed doors
operating room may be considered as a bay off the
must be relieved, but transfer grilles are not
latter (for example a scrub). Two categories exist:
appropriate where two doors lead to areas of
• open bay – the opening is larger than a different pressures, because reverse flow could
normal single door opening. The bay may occur when the other door is open. For this reason,
be considered as part of the main room; pressure stabilisers are used.
• semi-open bay – the opening is no larger than
a normal single door opening. In this case it is
possible to protect the bay from the main room
S
by provision of air supply or extract in the bay,
or by passing air to or from another area.
Air-movement control in peripheral

rooms M
H
L M
A8.12 For the design of air-movement control, two types
Parallel multi-flow
of air-transfer device are considered. These are (high-pressure room)
transfer grilles and pressure stabilisers. Each has
98
Appendix 8 – Design of air-movement control schemes for operating theatres
transfer grille to the area of equal cleanliness. The

doorway to the lower pressure area is protected by
E the combination of the supply air and the air that
will flow inwards through the transfer grille from
the area of equal cleanliness.
L E
L M S H
Parallel multi-flow
(low-pressure room)
A8.15 These rooms will be either high-pressure or low-

pressure with respect to the adjacentHareas (see L
H L L H
preparation lay-up room and disposal room,
respectively, in standard layout 5 of Appendix 7).
Parallelisseries
The pressure-relief damper alwaysmulti-flow
situated Parallel series multi-flow
between the room and area, which results in the
smaller differential pressure to ensure best use of A8.19 Conversely, where the nominal pressure equals
air. that of the lower-pressure adjacent room, extract
ventilation and a transfer grille to the lower
A8.16 Just as reverse flow can occur if transfer grilles are pressure adjacent room should be provided (for
used, it can similarly occur via door gaps when the example the disposal room in standard layout 8 of
other door is opened. It is not possible to avoid Appendix 7).
this, except by using air locks, but due to the low
flow rates and short durations involved, this is not Series multi-flow (unbalanced)
considered to be of importance.
A8.20 These rooms are somewhat similar to those in
Parallel-series multi-flow rooms paragraph A8.15 above, but because the pressure
lies between that of the rooms on either side, the
A8.17 These rooms are similar to those in paragraph back-flow problem does not exist.
A8.14 above, but because the room is of equal
cleanliness to one of the adjacent rooms, the
nominal pressures will be equal and air may flow
through the adjoining doorway in either direction S
(for example the Prep (SPS) in standard layout 6 of
Appendix 7).
E M
S H L
Series multi-flow
(unbalanced)
A8.21 Where the room has a net surplus of mechanical

H L
H L L supply air, a transfer grille shouldHbe located in
or adjacent to the door through which air flows
Parallel series multi-flow outwards,
Parallel andmulti-flow
series the mechanical supply flow rate
to the room should be chosen to give protection
A8.18 Where the nominal room pressure equals that of when this door is open.
the higher-pressure adjacent room, the best use A8.22 Where the room has a net surplus of mechanical
of air is by supplying air required for bacterial extract air, a transfer grille should be located
dilution only and allowing this to exhaust via a adjacent to the door through which the air flows
99
inwards, and the mechanical extract flow rate to Semi-open bay

the room should be chosen to give protection
A8.28 In a bay of the semi-open type, protection of
when this door is open.
one area from the other is possible (for example
A8.23 The grille must be sized for the protection scrub-up).
requirement of the opposing door when open.
A8.29 As stated previously, the need for protection
When the room on the high-pressure side
between operating room and scrub-room is not
depressurises, there is a possibility of back-flow
very great. Better use of air can therefore be
through gaps around the door, but this problem
achieved in this case by installing a pressure
may be ignored.
stabiliser between the scrub-room and clean
corridor. This will allow a flow of air through
the scrub-room at all times, except when a door
A8.24 In these rooms, a transfer device adjacent to each is opened elsewhere in the suite. The pressure
doorway is required in order to provide a flow path stabiliser will then close and the air will be diverted
for the air required to protect the opposing door to the other door. When it is considered necessary
when opened. to protect the scrub-room at all times, either a
transfer grille to the corridor or mechanical extract
in the scrub-room should be provided.
S E
Operating room
A8.30 Once the peripheral rooms have been considered,
H M L the operating room requirements may then be
decided and the supply flow rate required for
Series multi-flow (balanced) air-movement control calculated. This flow rate
should be such that, with any one door open, the
A8.25 These transfer devices will normally be pressure correct air movement directions are maintained.
stabilisers, although transfer grilles may be used There will be one door in the suite that will
where a large amount of excess air is to be require the largest supply flow rate to the operating
exhausted from the operating room when all doors room for protection when open. This is called
are closed (for example anaesthetic rooms). the “key door” and is discussed separately in
A8.26 The calculation procedure is to assume that paragraph A8.33. Use of this concept avoids
pressure stabilisers are being used; then – if there is repetitive calculations for each door in turn.
sufficient excess air – change to transfer grilles as Having established the required supply flow rate,
described in paragraph A8.50. a relief route must be provided to the clean
corridor for any excess air when the doors are
Bay closed. This would be via transfer grilles or
pressure stabilisers through a series-flow room
Open bay or via pressure stabilisers to the clean corridor
directly.
A8.27 A bay of the open type (for example scrub-up)
is considered to be part of the operating room.
Provided air movement is satisfactory, no specific
extract is required.
H L
H H L
H
Bay (semi-open)
Note: the pressure stabiliser
may be replaced by
Bay (open) mechanical extract
100
Corridors A8.37 The transfer grille may be replaced by carefully

proportioned door undercuts of the equivalent free
A8.31 All surplus air from the suite, except that lost
area.
through structure leakage and any passing to the
outer corridor, will arrive in the patient/staff A8.38 The function of the transfer grille is to provide a
corridor. Should this air be insufficient to achieve means of air-flow control by which the volume
the required air-change rate (see Appendix 3), and pressure loss can be established. If a grille is
some additional air supply should be provided. used, it should have an easily removable core to
(The air balance should take account of structural facilitate cleaning.
leakage.)
Pressure-relief dampers
Door opening A8.39 The functions of a pressure-relief damper are now
A8.32 Whereas the resulting pressures are dependent carried out by pressure stabilisers. Accordingly,
on ductwork layout, room relationships and all mention of them has been removed from this
characteristics of the fan, the generalisations shown document.
in Appendix 6 can be used to estimate the change
in room pressure when a door is opened. Pressure stabilisers
A8.33 The “key door” will be the open double door A8.40 Pressure stabilisers can be adjusted to hold
which leaves the operating room at the highest the pressure constant over a wide range of flow
pressure, and/or requires the largest air flow. rates. They are used where requirements exist for
This should be determined using the procedure accurate room-pressure control or rapid shut-off
in worksheet WS3. on pressure fall.
A8.41 The installation of a grille or baffle in
Transfer grilles association with a stabiliser will alter the operating
A8.34 These may be used to limit the pressure differences characteristics. It is recommended that a location
across the closed door of a single-flow room or, in be chosen to avoid the need for visual screening,
some instances, for protection of a series-flow or for example, at high level. The location should be
parallel-series-flow room. They allow air flow in chosen to minimise the likelihood of damage.
both directions and may not be suitable for all A8.42 The stabilisers used should be virtually silent in
applications. operation, adjustable on site, maintenance-free and
A8.35 The free area of a grille is calculated from the of a type which cannot be wrongly inserted. They
following equation: should not be used in external walls or where the
pressure difference is less than 5 Pa. The required
A= Q
size of a pressure stabiliser is dependent on the
0.84√∆P design pressure difference across it and flow rate
where: through it. The manufacturer should provide data
relating pressure difference to mean velocity (or
A is free area (m2)
flow rate per unit area). From this, the required
Q is flow rate (m3/s) area can be calculated and then rounded-up to the
P is pressure difference (Pa). nearest size manufactured or nearest combination
of smaller sizes.
A8.36 The flow through a grille at a different pressure
A8.43 It is sometimes possible to arrange for a pressure
may be found from the following equation:
stabiliser to perform two tasks. In an anaesthetic
Q2 = Q1 ∆P1
∆P2 √ room, for example, the two pressure stabilisers may
be made to pass the open door protection air, and
where: also control the operating and anaesthetic room
pressures with the door closed. To achieve this, the
1 and P1 are original flow and differential
Q stabilisers are sized for the flow rate required with
pressure one of the doors open, but the pressure setting is
Q2 and P2 are new flow and differential pressure.
101
adjusted to be the value required with the doors figures shown in Appendix 6 are based on the
closed. This is shown in Figure A1. temperature differences that will normally occur
in practice, assuming heat gains and losses in
Door leakage flows accordance with Appendix 4.
A8.44 For an air-movement control scheme to work A8.46 At step 11 of the air-flow design process, the
satisfactorily, it is essential that the estimates of temperature differences across the doors of all
door-gap leakage made at the design stage are rooms classed as “sterile” are calculated. Worksheet
closely related to those which are achieved in WS6 is recommended for the calculations, using
practice. The calculation of gap-flows is the following criteria:
complicated by the fact that such flows generally a. assume that the operating room is being
fall into the transition region between laminar and controlled at 20oC and calculate the incoming
turbulent flow and hence do not follow the normal air-supply temperature as shown on worksheet
flow equations. The gaps assumed are 4 mm along WS6;
the bottom, 3 mm at the top and sides, and 2 mm
between double leaves. Doors should not have b. the calculation should be repeated for both
wider gaps than these. Tighter gaps would result in summer and winter conditions, with an
lower flow-rate requirements and hence lower fan operation in progress;
power, but care should be taken to ensure that all c. assume all doors are closed;
doors in the suite have similar gap dimensions. It
may be possible to ignore the door leakage and so d. use the room supply flow rates from WS1;
reduce the air-flow requirement (see the “designers’ e. use the inward air flows through air-transfer
notes” in Appendix 4). devices and closed door leakages from WS2a
to WS2E;
Room temperature estimation f. the formula used in worksheet WS6 is as
A8.45 The air-flow rate required to prevent back-flow follows:
through an open door is dependent on the
(t Q + t Q + . . . + tnQn) + 0.828H
temperature difference across the door. The design T= 1 1 2 2
(Q + Q + . . . Q )
1 2 n
Figure A1 Pressure stabilisers performing two tasks

Flow rate
P2 P1 Pressure difference
102
where: room, and 14 Pa between anaesthetic room and

corridor; the volume of air passed by the transfer
Q = flow rate from source (m3/s)
devices will be modified as shown in the following
t = the temperature of source (oC) formula:
H = the room heat gain (kW).
A8.47 If the evaluated temperature differences between

∆P
Q = Q1 1 ½
∆P2 ( )
rooms do not exceed 2oC, the solution is
satisfactory; otherwise proceed as follows:

= 0.47
11
14
½ ( )
(i) check the assumption on which the heat = 0.42 m3/s
gains are based;
where:
(ii) take steps to reduce the heat gains;
Q = “excess” air to be vented with doors closed
(iii) if the door is to a corridor, the flow through
Q1 = air flow required for door protection
the open door will be larger than the value
through transfer device
given in Appendix 6. Calculate on WS3,
assuming it is the “key door” with door-flow ΔP1 = nominal differential pressure with door to
unknown, and the supply as known; operating room closed and door to corridor
closed
(iv) if the door leads to a room with mechanical
supply, install a trimmer heater in the supply ΔP2 = nominal differential pressure between either
to the room controlled by either a the anaesthetic room and corridor when
differential thermostat or a thermostat slaved the operating room door is open, or the
to the operating room thermostat to ensure anaesthetic room and operating room
that T is minimised; when the corridor is open. This differential
pressure is used when selecting size of both
(v) if the door leads to a room with no
devices.
mechanical supply, increase the door
protection flow as follows: A8.51 If the “excess” air is less than 0.42 m3/s, a pressure
[ ]
stabiliser is required to ensure that the correct
∆T + 1
Qnew = Qold protection air-flow is available to pass through
2
the door.
A8.48 These options should be considered in this order,
A8.52 If the “excess” air is greater than 0.42 m3/s, a
and (i), (ii) and (iii) should be investigated
transfer grille is acceptable because at all times
thoroughly before proceeding to (iv) or (v). The
the air-flow will exceed the flow required for
mechanical supply may need to be increased in
door protection.
order to achieve the desired air-change rates.
By pressure stabilisers to the corridor
Relief of excess air from operating room
A8.53 If it is undesirable to pass operating room air
when all doors are closed through the anaesthetic room, it may be passed
A8.49 As the mechanical supply to the operating room directly to a corridor via a separate pressure
is sized to provide an appropriate flow outward stabiliser.
through any door which is opened, it follows that
A8.54 If there is sufficient “excess” air, the transfer grille
when all doors are closed, there will be more air
solution at paragraph A8.52 should be adopted, as
supplied to the operating room than can exit from
it provides the simplest solution and, once set up,
it via leaks etc. This “excess” air can be relieved by
will require no further maintenance. With less
either of the two methods described in paragraphs
excess air, it is recommended that the air be passed
A8.50–8.54.
through the anaesthetic room via the pressure
By transfer devices via the anaesthetic room stabilisers as at paragraph A8.51, thus keeping the
number of pressure stabilisers to a minimum. Both
A8.50 For door protection, the transfer devices in the these solutions increase the air-change rate in the
anaesthetic room are typically designed to pass anaesthetic room, but care should be taken to
0.47 m3/s at a differential pressure of 14 Pa. When avoid passing excessive amounts through that
the doors are closed, the differential pressure will would cause discomfort to the occupants.
change to 11 Pa between theatre and anaesthetic
103
Figure A2 An example of an air-flow network Ca
Transitional
Ro
Corridor 1.
patients/staff
Pass through
Supply
2.
hatch
3.
Preparation
Clean (sterile supply Sterile
Sterile bay
Scrub Anaesthetic store)
(semi-open) 4.
Sterile Parallel/series 5.
multi-flow
Series multi-flow 6.
(balanced)
Operating
room
7.
Disposal hatch
Pass through 8.
Corridor 9.
Dirty
outer
(disposal)
10.
11.
12.
13.
14.
104
Figure A3 Air-flow design procedures
Step Description Worksheet

1 Show nominal room pressures and air flow directions on the plan of the theatre suite and WS1 WS1
Enter heat/loss/gain data and calculate supply air flow rates for temperature control only.
2 WS1
Categorise room types, eg sterile, clean etc
Enter air flows required for bacterial contamination control or air change rate, whichever is the
3 WS1
greater; add supply and extract volumes (SD, ED) on the plan
Select from
4 Define peripheral room types, see paragraphs A8.5–A8.11, and select appropriate worksheets
WS2a to WS2e
Selected worksheets
5 Locate air transfer devices, enter details on worksheets and locate on the plan and Figure A2
from WS2a to WS2e
For each peripheral room, determine air flows through doors when open and calculate
6 as above
mechanical supply or extract and transfer device flows
7 Select “Key Door” and calculate air supply for operating room WS3
Does this door produce NO

solution with greatest flow?
YES
8 Transfer to WS1 and select final rate SF and EF WS1, WS3

Selected worksheets
9 Make provision for relief of excess air with doors closed
and WS3
10 Calculate supply and extract flow rates for corridor(s) WS4, WS5
11 Calculate room temperatures (all doors closed) and ∆T’s WS6a and WS6b
Do any ∆T’s across doors to Rectify as in

sterile rooms exceed 1.0C? YES paragraph A8.47
NO
12 Make summary of flows WS6a and WS6b
13 Size transfer devices, size ductwork, central plant etc WS7

14 Design ductwork layout, control plant etc –
105
Calculation sheet for flow rates Worksheet WS1

Reference:
Room name
1. Summer temperature control
Heat gain kW
2. Acceptable ∆t C
3. Air flow rate (SG)
= Gain m3/s
∆t × 1.2
4. Winter temperature control

kW
Heat loss
5. Acceptable ∆t C
6. Air flow rate (SL)

= Loss m3/s
∆t × 1.2
7. Dilution of bacterial contaminants

Air flow rate m3/s
SD or ED
8. Desired air change rate AC/hr
AC/hr × room volume (m3)

m3/s
3600
9. Maximum of SG, SL, SD or ED or
m3/s
air change rate from step 8
S
10. Air movement control
m3/s
Air flow rate for air movement
control SAMC or EAMC
E
(from WS2, WS3 or WS4)
m3/s
11. Final supply flow rate (SF) m3/s
12. Final extract m3/s
13. Total supply m3/s
14. Total extract m3/s
Surveyor (AP(V)/CP(V)) ...................................................................... Date ................................................
106
Air movement control Worksheet WS2a

Peripheral room .......................... type, single flow Reference:
Nominal pressure: Pa
Consider door to ............................. open
Air flow, m3/s
Pa ∆t Out In Remarks
Flow required through doorway to give protection
Structural leakage
Total
(( ∑ – ∑ )) m3
SSAMC
AMC OUT – ∑IN
∑OUT IN m3/s
/s
or
or
E (( ∑ – ∑IN )) m3
EAMC
AMC IN – ∑OUT
∑OUT m3/s
/s
Transfer
Transfer SSAMC or E to WS1
AMC or EAMC
AMC to WS1
Consider door to ........................... closed
Consider door to ........................... closed
Closed door leakage
Closed door leakage
Structural leakage
Total
Total
Return SF and EF to WS1

Return SF and EF to WS1
Flow through transfer grille outward (SF – EF – LOUT)
Flow through transfer grille outward (SF – EF – LOUT)
or
or
Flow through transfer grille inward (EF – SF – LIN)
Flow through transfer grille inward (EF – SF – LIN)
107
Air movement control Worksheet WS2b

Peripheral room .......................... type, parallel/series multi-flow Reference:
Door from this room to ...................................................... (room of equal cleanliness) is not to be protected.
A transfer grille is located in, or adjacent to, this door
Consider other door to ................... open.

Room pressure now becomes or or Pa (see Appendix 6)
Air flow, m3/s
Out In Remarks
At above pressures leaks through closed doors Pa ∆P
Mechanical supply or extract (SF/EF)
Total
X ( ∑OUT – ∑IN ) or Y ( ∑IN – ∑OUT )
Transfer grille required

from high-pressure zone Flow = X
or at ∆Pa
to low-pressure zone Flow = Y
Size of transfer grille (free area) A1
Consider doors and hatch closed – room presssure becomes Pa (nominal)
Closed door leakage from Appendix 4

Pa ∆P Out In Remarks
(assuming no transfer grille)
Mechanical supply or extract
Total
Air flow required through transfer grille = IN – OUT = Z
or OUT – IN = Z˝
Transfer grille required flow Z or Z˝ @ ∆P
Size of transfer grille (free area) A2 =
Select larger of A1 or A2
Surveyor
108 (AP(V)/CP(V)) ...................................................................... Date ................................................
Air movement control Worksheet WS2c

Peripheral room .......................... type, parallel multi-flow high/low or Reference:
series multi-flow (unbalanced)
Consider door from this room to ................................. open.
Room pressure now becomes or or Pa (see Appendix 6)
Air flow, m3/s
Out In Remarks
Flow required through open doorway to give protection
At above pressures leaks through closed doors are: Pa ∆P
Total
S1 ( ∑OUT – ∑IN ) or E1 ( ∑IN – ∑OUT )
Consider door from this room to ................................. open.

Room pressure now becomes or or Pa
Out In Remarks
Total
S2 ( ∑OUT – ∑IN ) or E2 ( ∑IN – ∑OUT )
Consider doors closed. Closed doors leakage from Appendix 4
Door to: Pa ∆P Out In Remarks
Total
Return SF and EF from WS1

Flow through transfer device outward (SF – LOUT) to ......................................
or
Flow through transfer device inward (EF – LIN) from ......................................
Transfer grille Pressure relief damper

109
Air movement control Worksheet WS2d

Peripheral room .......................... type, Reference:
series multi-flow (balanced)
Note: In this type of room the supply and extract air flow rates are equal and take no part in the air movement control (AMC)
First, open door to higher pressure area.

Room pressure then becomes or or Pa (see Appendix 6)
Air flow, m3/s
Out In Remarks
Flow required through open doorway to give protection. See Appendix 6
Total
Q1 ( ∑IN – ∑OUT ) (+ve inwards)
Next, open door to lower pressure area.

Room pressure then becomes or or Pa
Out In Remarks
Total
Q2 ( ∑OUT – ∑IN ) (+ve outwards)
Lower
Flow through transfer device (TD1) to protect pressure TD1
door 1 = Q1 at resultant
∆P ............................ Door 2
Flow through transfer device (TD2) to protect

Door 1
door 2 = Q2 at resultant
TD2
∆P ............................ Higher pressure
110
Air movement control Worksheet WS2e

Peripheral room .......................... type bay (semi-open) Reference:
Note: If the room is of the open bay type (ie opening is larger than normal single doorway), the room should be considered part of
the main room. No air movement control considerations need then be made, and this sheet can be discarded. Supply and/or
extract flow will be based on air distribution considerations.
Consider permanent opening
Air flow, m3/s
Out In Remarks
Flow required through opening to give protection
Leaks through closed doors to: Pa ∆P
Total
EAMC or flow outward through transfer device ( ∑IN – ∑OUT )
Transfer SAMC or EAMC to WS1
Transfer device – transfer grille
– pressure stabiliser
Size select transfer device for flow rate @ ∆P
Note: A door from the bay is considered with the peripheral room to which it leads or, if it leads to the corridor, it is considered with
the main room
111
Air movement control Worksheet WS3

Operating room Reference:
Note: To avoid considering each door open in turn, the “key door” concept is introduced. This is the door which requires the
greatest mechanical flow when open. See paragraph A8.33
Select “key door” (see above).

Consider this door open – room pressure now becomes Pa (see Appendix 6)
See Appendix 7 for room pressures
Air flow, m3/s
Out In Remarks
Air flow “out” or “in” via doors, transfer devices etc Pa ∆P
Mechanical extract
Total
SAMC ( ∑OUT – ∑IN ) transfer SAMC to WS1
Consider all doors closed.

Return SF from WS1 Room pressure now Pa (nominal)
Air flow “out” or “in” via door leakage, transfer devices

Pa ∆P Out In Remarks
etc
Mechanical extract and supply
Total
Flow ( ∑IN – ∑OUT ) through transfer device @ ∆P to ................................

For final selection of transfer device see paragraphs A8.50–A8.54
112

Corridor Reference:
Consider all doors closed
Air flow, m3/s
Out In Remarks
Leaks through closed doors, transfer devices, permanent

Pa ∆P
openings etc
Total flow inwards (S1)
Add mechanical input (S2) if necessary to increase S1 to give 7 AC/hr
Total flow outwards and inwards
SAMC = ( ∑OUT – ∑IN + S2) Transfer to WS5
or EAMC = ( ∑IN – ∑OUT + S2) Transfer to WS5
Note: this sheet to be used for each individual operating theatre suite (or pair of suites if they share a preparation room)
113

Reference:
Summary of air supply and extract for an operating suite
Anaesthetic
Air flow to corridor All doors closed
(key door open)
m3/s m3/s
From preparation
From operating room
From scrub
From anaesthetic
Total (a)
Air flow to corridor
From disposal
From other source
Total (b)
Other room supplies ......................................................................... Total (c)
Total air supply (a) + (b) + (c)
Consider corridor ventilation (see Appendix 3) and calculate air volume required, based on 7 AC/hr (see Note 1)
m3/s
Air flow required to ventilate corridor
Air flow required to ventilate service corridor (see Note 2)
If the air flow from the operating suite (a) and (b) is greater than the calculated required volume, no further supply air is necessary
m3/s
Additional air to ventilate corridor
Additional air to ventilate service corridor (see Note 2)
Air extract
The size of the extract plant should be of the order of 10% below the supply to assist in maintaining the
department under positive pressure relative to the outside departments
m3/s
Extract plant = Supply less leakage
Less 10% of supply
Total extract (see Note 3)
Notes: 1. In the case of a multi-theatre operating department, the air balance for the corridor should be considered as a separate
exercise, taking into account the final dispersal of excess air.
2. Omit these if only one corridor in operating suite.
3. The extract volume includes 0.24 m3/s from the anaesthetic room for a balanced condition
114
Room temperature – summer Worksheet WS6a

Reference:
Find summer supply temperature TSS = 20 – 0.828H(O/R)

= TSS C
Q(O/R)
Note: the temperature of a space may be calculated from
t1Q1 + t2Q2 + ........... + tnQn + (0.828H)
T=
Q1 + Q2 + . . . Qn
Where t1 is temperature of source 1 (C)
Q1 is flow from source 1 when all doors are closed (m3/s)
H is heat gain in space (kW)
Supply Flows inwards

Heat gain Temperature
Room From From From From From
kWh C T
Q TSS
Q t Q t Q t Q t Q t
Check doors to sterile areas
Calculated room Maximum ∆T

Door between Remarks
∆T (C) permitted

115
Room temperature – winter Worksheet WS6b

Reference:
Find winter supply temperature TSW = 20 – 0.828H(O/R)

= TSW C
Q(O/R)
Note: the temperature of a space may be calculated from
t1Q1 + t2Q2 + ........... + tnQn + (0.828H)
T=
Q1 + Q2 + . . . Qn
Where t1 is temperature of source 1 (C)
Q1 is flow from source 1 when all doors are closed (m3/s)
H is heat gain in space (kW)
Supply Flows inwards

Heat gain Temperature
Room From From From From From
kWh C T
Q TSW
Q t Q t Q t Q t Q t
Check doors to sterile areas
Calculated room Maximum ∆T

Door between Remarks
∆T (C) permitted

116
Transfer grilles, pressure relief dampers and pressure stabilisers Worksheet WS7
Reference:
Transfer grilles – see paragraphs A8.34–A8.38

Pressure
Flow rate Free area Resultant
No Location difference Model Remarks
m3/s m2 ∆p Pa
Pa
Pressure relief dampers – see paragraph A8.39

Pressure Pressure
Flow rate Free area
No Location difference setting Remarks
m3/s m2
Pa Pa
Pressure stabilisers – see paragraphs A8.40–A8.43

Note: where a stabiliser is acting both as series room door protection and operating pressure control, “pressure difference” and “flow
rate” are from WS2d; “pressure setting” is from WS3
Pressure Pressure
Flow rate Free area
No Location difference setting Remarks
m3/s m2
Pa Pa

117
References
Acts and regulations Provision and Use of Work Equipment Regulations

1998. SI 1998 No 2306. HMSO, 1998.
Building Regulations 2000. SI 2000 No 2531. HMSO, www.opsi.gov.uk/SI/si1998/19982306.htm
2000.
www.opsi.gov.uk/si/si2000/20002531.htm Workplace (Health, Safety and Welfare) Regulations
1992. SI 1992 No 3004. HMSO, 1992.
Building Regulations 2000: Approved Document B: www.opsi.gov.uk/si/si1992/Uksi_19923004_en_1.htm
Fire Safety – Volume 2. Department for Communities
and Local Government, 2005.
British Standards
Building Regulations 2000: Approved Document F:
BS 5410-1:1997. Code of practice for oil firing.
Ventilation. Department for Communities and Local
Installations up to 45 kW output capacity for space
Government, 2006.
heating and hot water supply purposes.
Building Regulations 2000: Approved Document J:
Combustion appliances and fuel storage systems.
Installations of 45 kW and above output capacity for
Department for Communities and Local Government,
space heating, hot water and steam supply services.
2006.
Building Regulations 2000: Approved Document
Installations for furnaces, kilns, ovens and other
L2A: Conservation of fuel and power in new buildings
industrial purposes.
other than dwellings. Department for Communities and
Local Government, 2006. BS 5440-1:2000. Installation and maintenance of flues
and ventilation for gas appliances of rated heat input not
Building Regulations 2000: Approved Document
exceeding 70 kW net (1st, 2nd and 3rd family gases).
L2B: Conservation of fuel and power in existing
Specification for installation and maintenance of flues.
buildings other than dwellings. Department for
Communities and Local Government, 2006. BS 5440-2:2000. Installation and maintenance of flues
and ventilation for gas appliances of rated heat input not
Control of Noise at Work Regulations 2005. SI 2005
exceeding 70 kW net (1st, 2nd and 3rd family gases).
No. 1643. HMSO, 2005.
Specification for installation and maintenance of
www.opsi.gov.uk/si/si2005/20051643.htm
ventilation for gas appliances.
Control of Substances Hazardous to Health
BS 5588-9:1999. Fire precautions in the design,
Regulations (COSHH) 2002. SI 2002 No 2677.
construction and use of buildings. Code of practice for
HMSO, 2002.
ventilation and air conditioning ductwork. British
www.opsi.gov.uk/si/si2002/20022677.htm
Standards Institution, 1999.
Health Act 2006. HMSO, 2006.
BS 5726:2005. Microbiological safety cabinets.
www.opsi.gov.uk/ACTS/acts2006/20060028.htm
Information to be supplied by the purchaser to the
Health and Safety at Work etc Act 1974. HMSO, vendor and to the installer, and siting and use of cabinets.
1974. Recommendations and guidance.
Management of Health and Safety at Work BS 5925:1991. Code of practice for ventilation
Regulations 1999. SI 1999 No 3242. HMSO, 1999. principles and designing for natural ventilation.
www.opsi.gov.uk/SI/si1999/19993242.htm
BS 6798:2000. Specification for installation of gas-fired
Medicines Act 1968. HMSO, 1968. boilers of rated input not exceeding 70 kW net.
118
References
BS EN 779:2002. Particulate air filters for general Health Technical Memorandum 58 – Internal
ventilation. Determination of the filtration performance. doorsets. The Stationery Office, 2005.
BS EN 1822-1:1998. High efficiency air filters (HEPA Health Technical Memorandum 04-01 – The control
and ULPA). Classification, performance testing, marking. of Legionella, hygiene, “safe” hot water, cold water
and drinking water systems. The Stationery Office,
BS EN 1822-2:1998. High efficiency air filters (HEPA
2006.
and ULPA). Aerosol production, measuring equipment,
particle counting statistics. Health Technical Memorandum 05-02 – Guidance in
support of functional provisions for healthcare
premises. The Stationery Office, 2007.
and ULPA). Testing flat sheet filter media.
Health Technical Memorandum 08-01 – Acoustics.
The Stationery Office, 2007.
and ULPA). Determining leakage of filter element (scan
method). Model Engineering Specification C04 – Mechanical
ventilation and air conditioning systems. The
Stationery Office, 1997.
and ULPA). Determining the efficiency of filter element.
BS EN 12464-1:2002. Light and lighting. Lighting of Chartered Institution of Building
work places. Indoor work places.
Services publications
BS EN 12469:2000. Biotechnology. Performance criteria
Applications Manual AM10 – Natural ventilation in
for microbiological safety cabinets.
non-domestic buildings. CIBSE, 2005.
BS EN 13030:2001. Ventilation for buildings.
Applications Manual AM13 – Mixed mode
Terminals. Performance testing of louvres subjected to
ventilation. CIBSE, 2000.
simulated rain.
Commissioning Code A: Air distribution systems.
BS EN 14175-2:2003. Fume cupboards. Safety and
CIBSE 1996.
performance requirements.
Commissioning Code R: Refrigerating systems. CIBSE
BS EN ISO 14644-1:1999. Cleanrooms and associated
2002.
controlled environments. Classification of air cleanliness.
Commissioning Code W: Water distribution systems.
BS EN ISO 14644-4:2001. Cleanrooms and associated
CIBSE 2003.
controlled environments. Design, construction and start-
up. Guide A: Environmental design. CIBSE, 2006.
BS EN 60601-2-41:2000, IEC 60601-2-41:2000. Guide B: Heating, ventilating, air conditioning and
Medical electrical equipment. Particular requirements for refrigeration. CIBSE, 2005.
safety. Particular requirements for the safety of surgical Lighting guide LG2: Hospitals and health care
luminaires and luminaires for diagnosis. buildings. CIBSE, 1989.
Department of Health publications Heating & Ventilating Contractors’

(The) Health Act 2006: Code of practice for the Association (HVCA) publications
prevention and control of healthcare associated
infections. 2006. DW/143 – A practical guide to ductwork leakage
www.dh.gov.uk testing. HVCA Publications, 1998.
Health Building Note 26 – Facilities for surgical DW/144 – Specification for sheet metal ductwork,
procedures. The Stationery Office, 2004. low, medium & high pressure/velocity air systems.
HVCA Publications, 1998.
Health Facilities Note 30 – Infection control in the
built environment. The Stationery Office, 2002. DW/154 – Specification for plastics ductwork. HVCA
Publications, 2000.
Health Technical Memorandum 55 – Windows.
The Stationery Office, 1998. TR/19 – Guide to good practice: internal cleanliness
of ventilation systems. HVCA Publications, 2005.
119
Other publications Health & Safety Commission’s Health Services Advisory

Committee (2003). Safe working and the prevention of
Advisory Committee on Dangerous Pathogens (2001). infection in clinical laboratories and similar facilities.
The management, design and operation of HSE Books, 2003.
microbiological containment laboratories. HSE Books,
2001. Health & Safety Commission’s Health Services Advisory
Committee (2003). Safe working and the prevention of
Building Services Research & Information Association infection in the mortuary and post-mortem room.
(BSRIA). Application Guide AG 3/89.3 – HSE Books, 2003.
Commissioning of air systems in buildings. BSRIA,
2001. Hospital Infection Society (2005). Microbiological
commissioning and monitoring of operating theatre
Building Services Research & Information Association suites. HIS, 2005.
(BSRIA). COMPAK 1 – Commissioning guides set. www.his.org.uk/_db/_documents/OTIC-final.pdf
DIN 1946-4. Ventilation and air conditioning – Medicines and Healthcare products Regulatory Agency
ventilation in hospitals. Deutsches Institut für Normung, (2007). Rules and guidance for pharmaceutical
1999. manufacturers and distributors (The Orange Guide).
Health & Safety Commission (2000). Approved Code of Pharmaceutical Press, 2007.
Practice, Legionnaires’ disease: the control of www.mhra.gov.uk
legionella bacteria in water systems (L8). Health and Water Regulations Advisory Scheme (WRAS) (2005).
Safety Executive, 2000. Water Fittings and Materials Directory. WRAS, 2005.
Health & Safety Executive (1993). HS(G)37: an www.wras.co.uk
introduction to local exhaust ventilation. HSE Books, Whyte W, Lidwell OM, Lowbury EJL and Blowers R
1993. (1983), Suggested bacteriological standards for air in
Health & Safety Executive (2005). Workplace exposure ultraclean operating rooms. J Hosp Infect, Vol 4, pp 133–
limits: containing the list of workplace exposure limits 139.
for use with the Control of Substances Hazardous to Whyte W, Shaw BH and Freeman MAR (1974), An
Health Regulations 2002 (as amended). HSE Books, evaluation of a partial-walled laminar-flow operating
2005. room. J Hyg Camb, Vol 73, pp 61–75.
120

Heating and Ventilation Systems - HTM 03-01

Uploaded by

Copyright:

Available Formats

Heating and Ventilation Systems - HTM 03-01

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Heating and Ventilation Systems - HTM 03-01

Uploaded by

Copyright:

Available Formats

Health Technical Memorandum

Document Purpose Best practice guidance

Circulation List Department of Health libraries, House of Commons library,

Description The document gives comprehensive advice and guidance to

Cross Ref N/A

Part A: Design and validation

London: The Stationery Office

Published by TSO (The Stationery Office) and available from:

© Crown copyright 2007

Figure 1 Healthcare building life-cycle

Figure 2 Engineering guidance

Environment & Medical

HTM 06 L& N HTM 03

Services STR AR Ventilation

Preamble Main changes from Health Technical

Malcolm Thomas – Consulting Engineer – Lead Author University of Leeds

Andy McGrath – BSRIA Instrument Solutions HEFMA

Helen & Philip Sturdy – DSSR consultancy BSI

Richard Gatley – Apreco Faber Maunsell consultancy

Russell Pitman – Henderson Green consultancy Couch Perry Wilkes consultancy

Kevin Reynolds – Deputy Head of Estates – Sandwell DSSR consultancy

Choice of central/local plant

Parallel multi-flow rooms

Preamble Reasons for ventilation

Ventilation – application examples

prevent contamination, closely control the

Table 1 Design and validation process model

Ventilation – terms in use e. to provide close control of temperature;

pressure in order to prevent the ingress of less Specialised ventilation

Mechanical ventilation systems Zoning of the building

3.21 Plant noise is subject to the Control of Noise at

Calculation of building loads Peak heating load

Calculation of plant requirements 3.48 Resistances of ductwork and fittings may be

General requirements 4.7 Fire precautions should be incorporated in

facilities, laboratories and pharmaceutical Location

Cooling coils the operation of the department that they serve.

Humidifiers must not be added to the water supply to

Definition of filter terms Table 4 Fine filters

Selection High-efficiency filters – HEPA and ULPA

Attenuation 4.160 Provided care is taken in the design and

Air distribution arrangements appropriate. If they are a source of vibration, they

wound ducting and a standard range of pressed and Changes of section

properties of insulating materials themselves, which b. in branches of zone ducts;

Pressure stabilisers – size and location

Pressure stabiliser with stand-off cage

Figure 2 Typical plant control algorithm – normal start-up sequence

INITIATE START SEQUENCE

L.O. ISOLATION DAMPERS OPEN

SUPPLY FAN – START

EXTRACT FAN – START

L.O. ESTABLISH AIR FLOW

L.O. ACHIEVE MIN AIR TEMP +2ºC

HUMIDIFIER TIME DELAY

OFF CONDENSATE STAT MADE

MONITORING FUNCTIONS CONTROL FUNCTIONS

MINIMUM AIR FLOW FROST/FOG COIL

MINIMUM AIR TEMPERATURE OPERATING ROOM AIR TEMP

HUMIDIFIER HIGH LIMIT 70% OPERATING ROOM HUMIDITY

Appendix 7 – Operating suite standard design