Facilities Quality Service
INDOOR AIR QUALITY
TOPIC: ADMITTING AND WAITING ROOMS
ISSUE:
Ventilation requirements for admitting and waiting rooms (TB or Non-TB) at VA
medical facilities.
BACKGROUND:
This design alert is in response to inquiries from several VAMCs and consultants
concerning ventilation requirements for admitting and waiting areas.
DISCUSSION:
1. American Society of Heating, Refrigerating, and Air-Conditioning Engineers
(ASHRAE), 1999 HVAC Applications Handbook, Chapter 7 on Health Care
Facilities, Table 3, recommends following for admitting and waiting rooms:
Pressure relationship to adjacent areas: Negative
Minimum air changes of outdoor air/hour:
2
Minimum total air changes/hour:
6
All air exhausted directly to outdoors:
Yes
Air Re-circulated within room units:
*Optional
*Re-circulating HEPA filter units used for infection control (without heating or cooling coils)
are acceptable.
2. Centers for Disease Control (CDC) Guidelines for Preventing the
Transmission of Mycobacterium Tuberculosis in Health-Care Facilities, 1994,
under Section II F, recommends:
"Health-care facilities serving populations that have a high prevalence of TB may need to
supplement the general ventilation or use of additional engineering approaches (i.e., HEPA
filtration or UVGI) in general-use areas where TB patients are likely to go (e.g., waiting-room
areas, emergency departments, and radiology suites). A single-pass, non-recirculating system
that exhausts air to the outside, a recirculation system that passes air through HEPA filters
before recirculating it to the general ventilation system, or upper air UVGI may be used in
such areas".
3. Department of Veterans Affairs, Veterans Health Administration, Program and
Facility Planning Guideline for Tuberculosis Programs dated August 18, 1995,
recommends:
"Unscheduled areas: All unscheduled ambulatory care areas and associated waiting areas
should have ventilation designed and maintained to reduce the risk of tuberculosis
transmission. Germicidal UV lamps and/or HEPA filters may provide additional benefit when
12 October 1999
FM-181A-DA 101
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