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Ventilation performance evaluation of an operating room with temperature-controlled airflow system in contaminant control: A numerical study
KTH, School of Architecture and the Built Environment (ABE), Civil and Architectural Engineering.
Faculty of Architecture and the Built Environment, Delft University of Technology, The Netherlands; Reinier de Graaf Hospital, Delft, The Netherlands.
KTH, School of Architecture and the Built Environment (ABE), Civil and Architectural Engineering, Concrete Structures.ORCID iD: 0000-0002-5901-1586
Faculty of Architecture and the Built Environment, Delft University of Technology, The Netherlands.
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2024 (English)In: Building and Environment, ISSN 0360-1323, E-ISSN 1873-684X, Vol. 259, article id 111619Article in journal (Refereed) Published
Abstract [en]

This article investigates the efficacy of temperature-controlled airflow systems in modern operating rooms for contaminant control, a critical factor in preventing surgical site infections. We have conducted experimental measurements in an operating room equipped with temperature-controlled ventilation to map the airflow field and contaminant dispersion (airborne particles with diameters ranging from 0.5 to 1 μm). The results were used to validate the computational fluid dynamics code, which was then employed to simulate and examine different conditions, including contaminant release locations and air supply rates. Realizable k-epsilon and passive scalar models were utilized to simulate airflow and airborne particle phases. We assessed the airflow distribution and contaminant dispersion, utilizing indices such as ventilation and air change efficiency scales. The analysis provided quantitative insights into the distribution and removal of contaminants, as well as the speed at which the room air was replaced. Contamination was found to be effectively reduced when contaminants were released near exhaust outlets or under central unidirectional inlets. The presence of the operating table caused a big distortion of the central downward airflow, forming a horizontal air barrier at the periphery. Under this unique interior configuration, an appropriate air supply ratio between central and periphery zones was required to achieve optimal overall ventilation performance.

Place, publisher, year, edition, pages
Elsevier BV , 2024. Vol. 259, article id 111619
Keywords [en]
Contaminant dispersion, Numerical simulation, Operating room, Temperature-controlled ventilation
National Category
Other Civil Engineering
Identifiers
URN: urn:nbn:se:kth:diva-347298DOI: 10.1016/j.buildenv.2024.111619ISI: 001247316100001Scopus ID: 2-s2.0-85194167872OAI: oai:DiVA.org:kth-347298DiVA, id: diva2:1867230
Note

QC 20240702

Available from: 2024-06-10 Created: 2024-06-10 Last updated: 2025-09-29Bibliographically approved
In thesis
1. Airflow and Particle Transport in Hospital Environments: Evaluation of Ventilation Systems and Adaptive Local Exhaust Strategies
Open this publication in new window or tab >>Airflow and Particle Transport in Hospital Environments: Evaluation of Ventilation Systems and Adaptive Local Exhaust Strategies
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In hospitals, it is essential to control the pathogen transmission for health aspects in addition to ensuring occupant comfort. High occupant density and frequent movement of staff and visitors accelerate pathogen spread, making hospitals at risk of airborne transmission. From the perspective of engineering controls, ventilation remains one of the most efficient and reliable strategies for mitigating airborne transmission. The key challenge, therefore, is not whether to ventilate, but how to design systems appropriately, operate them correctly, and ensure sufficient adaptability to varying indoorconditions in hospitals.This thesis examines two representative scenarios. The first scenario is surgical site infection in operating rooms, where maintaining an ultraclean environment is essential to prevent wound contamination. The second is respiratory infection in patient rooms, driven by human respiratory activities; here, the goal is early mitigation of exhaled particles to prevent onward spread.Computational fluid dynamics is employed to assess system performance across operating conditions. A literature review first characterizes emission sources in each scenario, with particular attention to particle size distributions. These characteristics inform the modeling strategy, either Lagrangian discrete-particle tracking or an Eulerian passive-scalar formulation. To preserve realism, the operating-room simulations replicate the actual room configuration, while the patient-room simulations implement the realistic human respiration model. Quantitative metrics are used to compare designs and sensitivities and to reveal how system behavior changes under different settings.For the hybrid operating room, the results demonstrate that the current Temperature-controlled Airflow installation establishes two distinct ventilation zones: a central zone with strong contaminant transport capacity and a peripheral zone where the short distance to the exhausts enables effective contaminant removal. In patient rooms, the work captured the full evolution of cough-generated air–particle mixtures, from an initial stage where particle motion is dominated by size, through an intermediate period of dispersion shaped by the thermal plume, and to a final stage of background ventilation removal. The intermediate period, typically between 5 and 23 s after a cough, was revealed as a critical window for local exhaust intervention. Simulations of different configurations showed that a ceiling-mounted system leveraging the body’s thermal plume offers a robust and effective solution. Furthermore, the analyses highlight the role of background ventilation in determining the optimal placement and performance of such ceiling-mounted systems, offering practical guidance for their application in patient care environments.Based on the analysis, this thesis advances the understanding of ventilationdriven contaminant transport in hospitals and establishes ventilation as a dynamic tool for infection control rather than a fixed design parameter. It emphasizes resilience and adaptability as key to creating safer healthcare environments.

Abstract [sv]

På sjukhus måste inomhusmiljön inte bara säkerställa komfort utan också begränsa smittspridning. En hög patientbeläggning och frekvent rörlighet av personal och besökare påskyndar spridningen av patogener. Det gör sjukhus särskilt sårbara för luftburen smitta. Detta gör sjukhus särskilt utsatta för luftburen smittspridning. Ur ett ekonomiskt perspektiv anses ventilation ofta vara kostsamt, men det är fortfarande en av de mest effektiva och tillförlitliga strategierna för att minska luftburen smittspridning. Den viktigaste frågan är därför inte om man ska ventilera, utan hur man skall utforma systemen på rätt sätt, använda dem korrekt och säkerställa tillräcklig flexibilitet för varierande kliniska förhållanden. I denna avhandling undersöks två representativa scenarier för sjukhusinfektioner. Det första är infektioner i operationssalen, där det är viktigt att upprätthålla en ultraren miljö för att förhindra kontaminering av sår. Det andra är luftvägsinfektioner i patientrum orsakade av människors andningsaktivitet. Här är målet att tidigt minska partikelhalten från utandningsluft för att förhindra vidare spridning.Numeriska strömningsberäkningar används för att utvärdera systemprestanda under olika driftsförhållanden. En litteraturgenomgång karakteriserar först utsläppskällor i varje scenario, med särskild uppmärksamhet på partikelstorleksfördelningen. Detta ligger till grund för modelleringsstrategin –antingen Lagrangesk diskret partikelspårning eller en Eulerisk passiv skalärformulering. För att bevara realismen replikerar operationssalssimuleringarna den verkliga rumskonfigurationen, medan patientrumssimuleringarna implementerar en realistisk modell för mänsklig andning. Kvantitativa mått används för att jämföra konstruktioner och känsligheter och för att visa hur systemets beteende förändras under olika förhållanden.För hybridoperationssalen visar resultaten att den nuvarande TcAFinstallationen skapar två distinkta ventilationszoner: en central zon med stark transport av föroreningar och en perifert belägen zon där korta avstånd till evakueringspunkterna möjliggör effektiv evakuering av föroreningar. I patientrummen utforskades alla förlopp av luft-partikelblandningar som genereras vid hostning, från ett inledande skede där partikelrörelsen domineras av momentum, genom en mellanperiod av partikelspridning som formas av den termiska plymen, till ett slutskede av partikelupptagning i bakgrundsventilation. Mellanperioden, vanligtvis mellan 5 och 23 sekunder efter hosta, visade sig vara en kritiskt tidsram för lokal partikeltransport. Simuleringar av olika konfigurationer visade att ett takmonterat system som utnyttjar kroppens termiska plym erbjuder en robust och effektiv lösning. Dessutom visar analyserna bakgrundsventilationens roll för att bestämma den optimala placeringen och prestandan för sådana takmonterade system. Det ger praktisk vägledning för deras tillämpning i patientvårdsmiljöer.Baserat på analysen bidrar denna avhandling till en ökad förståelse av ventilationsdriven transport av föroreningar i sjukhus och etablerar ventilation som ett dynamiskt verktyg för infektionskontroll snarare än en fast designparameter. Den betonar att resiliens och anpassningsförmåga är nyckeln till att skapa säkrare vårdmiljöer.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2025. p. 70
Series
TRITA-ABE-DLT ; 2536
Keywords
Contaminant control, Exhaled particles, Coughing, Local exhaust, Targeted Ventilation
National Category
Engineering and Technology
Research subject
Civil and Architectural Engineering, Fluid and Climate Theory
Identifiers
urn:nbn:se:kth:diva-370682 (URN)978-91-8106-407-0 (ISBN)
Public defence
2025-10-28, Kollegiesalen, Brinellvägen 8, KTH Campus, public video-conference link https://kth-se.zoom.us/j/62003260630, Stockholm, 10:00 (English)
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Note

QC 20251006

Available from: 2025-10-06 Created: 2025-09-29 Last updated: 2025-10-29Bibliographically approved

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Hu, NanGram, AnnikaSadrizadeh, Sasan

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