Hospitals, Dentists, Surgeries & Care

Hospitals, dental practices, GP surgeries and care

Hygiene is crucial in all settings providing healthcare services, not least because of unwell patients who may be most vulnerable to any disease or infection. Like, all workplaces, clinical settings are not immune from the legal obligations to protect staff and visitors from harm and do all that is reasonably practicable to eliminate or control risk,

With COVID-19 putting healthcare settings such as hospitals under immense pressure, it is vital that healthcare professionals can continue to treat patients while mitigating the risk of staff becoming infected themselves or of patients and visitors transmitting the virus to others.

Other nosocomial or hospital-acquired infection risks that have returned to cause considerable concern are respiratory Fungal Spore infections and respiratory syncytial virus (RSV).

The PP-L team’s experience in healthcare is long-standing, and our UV-C products were successfully deployed to suppress the transmission of SARS in Singapore and Hong Kong hospitals during the 2003 coronavirus pandemic in South East Asia.

Current risks in healthcare settings

Despite the best efforts of staff and facilities managers, the transmission of COVID-19 is incredibly high within healthcare settings.

Respiratory transmission

This is due to the virus being airborne, primarily spread through respiratory transmission.

Ventilation Systems are inconsistent

There can be a mix of systems and competency of systems on sites. They range from fresh air systems to operating theatres with HEPA Filters and high air-change rates to those areas with recirculated air or dead air zones or sub-optimal air change rates. This is one of the reasons why some hospitals and regions have performed better than others concerning HIA’s and Covid-19.

Contamination

Contamination within common areas such as wards, corridors, canteens and toilet facilities.

Recirculated air

Indeed, some types of interior spaces may actually accelerate infection because of their ventilation arrangements, irrespective of the facilities managers following Covid-Secure Guidelines to the letter, e.g. recirculated air systems or low-level heating or floor grill systems.

How to achieve better biosafety in healthcare settings

The interior air quality has to be the priority, given the nature of the airborne pathogen hazards (RSV, Spores, Covid-19) now escalating risk within our healthcare settings, so inside environments now will need to reassess potential improvements for pandemic resilience:

  • Ventilation strategy and system
  • Ventilation airflow rate rates,
  • Ventilation system filtration
  • Supply of clean, uncontaminated air
  • Risk of exposure to bio-aerosols in all environments
  • Local Source Control of aerosol generation
  • Zones and airlocks with negative pressure

Our solutions:

As Professional Engineers, scientists, and Medics, we know how to intimately target the infection risks by designing targeted solutions and combining established and proven engineering and health technologies to take your biosafety to a new level.

We can assess your building configuration, engineering infrastructure, occupancy use and risks. We then will model and engineer a bespoke solution to suit your asset and user requirements through the use of:

  • Better ventilation air flows, distribution and filtration. CFD Modelling if necessary.
  • In-duct GUV devices in HVAC systems – One way to counteract disease spreading is with efficient air circulation systems, which can be fitted with UV-C devices to destroy any airborne microbes while the air is circulated through it.
  • Upper Room GUV systems and Medical Grade HEPA devices – these can be put in place to reduce the localised spreading of the diseases at or near the source. These systems, when correctly specified, will be able to significantly reduce the transmission rate of harmful aerosols and control COVID-19 sources.
  • Direct UV-C surface disinfection – In areas of particular surface hazard, use UV-C surface disinfection for whole room decontamination. They should be on timers/movement sensors/contacts/interlocks because direct emitters should not be deployed in occupied spaces.

Current risks in dental practices

Dental practices have several infection hazards, which can be readily managed through good hygiene and precautions which are common throughout dental procedures.

However, COVID-19 poses significant new challenges for dental practices as dental studios carry a heightened risk of surface contamination and airborne contamination:

  • Waiting areas – Patients often linger in reception or waiting areas, touch surfaces and produce volumes of aerosol that can carry COVID-19 and linger in the air for several hours. Dedicated timing slots can manage this but not always.
  • Poor ventilation – While ventilation can reduce the viral load in an environment, most spaces are poorly ventilated and possess sufficient changes of air to eliminate the risk of infection from airborne pathogens. In dental clinical settings, one should be achieving an absolute minimum of 6ACH and ideally 10 ACH in treatment and consulting rooms to protect and comply with the guidance.
  • Aerosol generating procedures (AGPs) – Additionally, practice rooms themselves will have a very high aerosol load by the very nature of the AGP work undertaken by the dentist. Patients will undertake a variety of actions that will add to aerosol, from rinsing, spitting, and coughing to those more anxious patients that add more through heavy breathing, creating more viral load from the human aerosol, which can be airborne in the room for 3 hours. This is a contamination hazard to the staff and subsequent patients.

Dental practices must remain open, but they can’t do this by seeing only one patient potentially every 3 hours (allowing sufficient air changes through existing ventilation systems). Dentists need to be much more rigorous in reducing the risk of transmission to themselves, their employees and their patients. To do this, a dentist can employ a combination of strategies.

“PP-L have safe technologies that can reduce fallow time to the minimal – the time it takes to prepare for the next patient.”

Our solution: Medical Grade Air Purifiers and UV based Source Control

  • To reduce the risk of airborne transmission, dentists can install our medical grade air purification and/or air decontamination devices fitted with UV-C disinfection capabilities.
  • However, when our double HEPA Filters are combined with UV-C in medical-grade air purifiers, the UV-C light quickly and cost-effectively disinfects the air. It destroys any remaining viral particles that pass through the system.
  • Combined, this is highly effective for small rooms within dental clinics.
  • Traditional upper room UV based devices are highly effective on their own and can be fan assisted too. These are decades proven for airborne disease control.
  • Our blended specification solution will deliver no less than the equivalent decontamination that 12 Air Changes per Hour would create, hence the fallow time reduction to under 15 minutes, the usual time between one patient and another.

While there is less risk of transmission than in hospitals and dental practices, GP surgeries are still high risk compared to other buildings, for similar reasons to the above, so the interventions are the same:

  • Better airflow distribution and air change rates
  • Better HVAC filters and in-duct UV-C devices if mechanical ventilation systems prevail
  • Upper Room UV-C devices in poorly ventilated areas, in consulting/treatment rooms, waiting rooms, corridors and toilets