Good morning, following on from a visit by the Health and Safety Authority to our hospital, I was requested to carry out an indoor air quality risk assessment on the basis of the document ‘Code of Practice for Indoor Air Quality’ (HSA, 2023). On the day, the inspector was very keen on the use of CO2 monitors and mentioned a direct link between raised CO2 readings and Covid-19 outbreaks. I’ve done some research since but couldn’t find enough evidence to support this claim. Is the use of CO2 monitors something that is recommended in healthcare facilities? Also, the use of HEPA filters was mentioned but again, it’s very hard to find guidance on their use (e.g. in which settings or situations) based on evidence. I have done the risk assessment as requested, but am still unsure on how to proceed with these two items. Our hospital is a small community type hospital, an older building with only windows for ventilation. As our biggest risk I would see the two 12-bedded nightingale wards. I would be very grateful for your advice on this!
Indoor Air Quality
Hi Natascha,
We have used CO2 monitor in our organisation to identify or demonstrate factors that increase the level of CO2 in a shared room during the pandemic. The thought behind use of CO2 monitor is not to measure air quality but to demonstrate the build up of CO2 where ventilation is poor (No fresh air intake or flow due to closed doors/window).
It helped us with our risk assessment on maintaining good air flow in a shared bay or communal room. What we found is that by opening a door or window regularly (hourly for 5 minutes)in a single/shared room used for isolation of patients, the CO2 level goes down and we interpret this as fresh air flowing in the room therefore diluting air inside a confined area improving ventilation.
happy to chat about this matter with you if it helps 🙂 [email protected]
Hi Natascha,
We may be able to help you with some information on potential solutions for HEPA and UVC Air Purification systems. Happy to discuss further if you are interested – [email protected].
Hi there, I also read such info. During the pandemic we measured CO2 levels in rooms across our retirement villages/care homes that did not have an openable window – initial surveys of rooms with windows showed that they were all of acceptable CO2 levels. Surprisingly, even some of our enclosed rooms (clinical rooms, some staff rooms etc) had acceptable levels. We used this data to advise the procurement of UV air purifier devices to place in communal areas and for use in rooms of residents with known/suspected infection. (at that time there wasnt a HEPA device available to us to purchase at NHS-land had bought everything up!!). I dont know if it helped – we did have extremely low rates, but of course that may have been to a multitude of other factors, most importantly single care home rooms. It certainly felt comfortable to say we were trying everything humanly possible to try in the organisation. I would agree with you – the Nightingale wards would be the areas I was most concerned about, and we did find residents (and some staff!) were more complainy about drafts in the colder weather. We tried to address this by opening higher up windows for 5 mins, before group activities, during a group activity and ten a good blast through after an activity. Same for staff rooms, especially shared offices etc. In the event of a death, we made it our practice to put a bigger UV device into the room and lock the door for I think it was 48 hours before housekeeping went in the next day to do the deep clean. Similarly, if working in a room with an infected resident, staff would open the window for a minimum of 5 mins before starting care delivery. I suggest formalising your approach, perhaps informed by one-off CO2 measurements across a range of different types of room, and describe in your risk assessment that CO2 levels could be re-recorded in the event of any change in room usage (e.g. more people occupying the room etc). Practices to improve air quality such as regular window opening (or as we found best, leaving high up windows just very slightly ajar), HEPA filter location based on specific risk etc might be useful to you. Let us know what you decide!
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