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Performance evaluation of personalized ventilation personalized exhaust (PV PE) system in air conditioned healthcare settings 9

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Chapter 9: Conclusions and Recommendations 9.1 Review and Achievement of Research Objectives This study has evaluated the feasibility and performance of a novel PV-PE system in the prot

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Chapter 9: Conclusions and Recommendations

9.1 Review and Achievement of Research Objectives

This study has evaluated the feasibility and performance of a novel PV-PE system in the protection of a Healthy Person (such as a doctor) and in the ventilation control of airborne infectious disease induced by exhaled contaminated air from an Infected Person (such as a patient) in mock-up consultation rooms in healthcare centres

The three specific objectives of this research and the achievements are reviewed below:

First Objective

The first objective was to “Evaluate the potential of a PE device to enhance the

performance of a PV device in terms of pulling the PV conditioned outdoor air towards a Healthy Person”

The conclusions from the study related to this objective are summarized as follows:

• For the same PV flow rate and manikin location, the personal exposure

effectiveness increased with the increase of the PE airflow rate for most of the cases One exception was when PV was supplying fresh air at 10 l/s with a 0.2 m distance from the manikin In this scenario, the combined PV-PE did not help with the pulling effect because the PV could deliver the conditioned outdoor air to the breathing zone with a high momentum and short distance

• When the manikin was moved longitudinally along the centerline of PV ATD, the

PV fresh air could still reach the breathing zone However, when the manikin was moved in an arc away from the centreline of the PV ATD, the amount of PV air in the inhaled air dropped quickly to 0

• After adding the PE device, with both MV and DV conditions, the PE was able to divert the PV air to some extent The larger distance and degree were achieved with DV compared with MV because the relative higher room air velocity with

MV tends to disturb the local environment created by PV-PE When PE was set at

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20 l/s, the effective area could be enlarged to 45 degree for all the cases with DV and up to 60 degree for a short distance of 0.2 m

• During a normal consultation process in healthcare centres, where the Infected Person and the Healthy Person are sitting face to face, the results indicated that the combined PV and PE for HP could achieve the highest PEE It was also observed that the shoulder-PE performed a little better than top-PE in terms of increasing the PV air in the inhaled air

• The above-mentioned conclusions imply that when a Healthy Person is working in

a consultation room or a health care setting room, the use of combined PV-PE for the Healthy Person could provide more fresh air than PV alone, which can

contribute to the infectious control during or after a consultation and check-up procedure with an Infected Person

Second Objective

The second objective was to “Determine the effectiveness of airborne infection

control of the combined PV-PE system in conjunction with background MV or

DV systems in terms of the localized extraction of the contaminated exhaled air from an Infected Person in healthcare settings” Three scenarios were considered

for this objective, as shown below:

a Infected Person seated facing the seated

Healthy Person

b Infected Person seated under two different

configurations by the side of the seated

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c Healthy Person standing facing the seated

Infected Person

Important conclusions from the study related to this objective areas follows

• In the context of airborne transmission control when the HP and IP are sitting face to face, the use of PV alone has a potential to protect the HP; the use of combined PV-PE alone for HP could achieve the lowest Intake Fraction The use of PE for IP alone showed much better performance than using PV for HP alone However, after activating the PE for IP, the use of PV for HP was observed to lead to higher or lower exposure The increase or decrease depends on the effects of background ventilation type, PE type and PV flow rates

• For better airborne transmission control, top-PE is preferred than shoulder-PE because it could achieve better exposure reduction and lower intake fraction with a lower flow rate

• The type of background air was found to have an impact on the flow pattern of exhaled air With MV, when PE was not used, the highest exposure possibility was when the HP and IP are 45 degrees to each other (case B) Case C (HP and IP are 90 degrees to each other) was found to lead to the lowest exposure

of exhaled contaminated air With DV, case D (HP standing facing the seated IP) was observed to result in the highest exposure of the HP while case B could achieve the best protection for the HP among the three cases when PE was not switched on

• After using either shoulder-PE or top-PE, the transmission of exhaled air to the breathing zone of the HP was largely reduced for cases B to D The performance of top-PE was better than that of the shoulder-PE since it achieves better protection with lower flow rate, thus saving energy and reducing the noise level

• For infectious transmission control concerns, both the exposure duration and the concentration of the infection were found to be critical factors The longer

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the IP stays in the consultation room, the higher is the exposure and the risk for the HP By using PE for the IP, the exposure at 30 minutes after entering the consultation room of the IP was lower than the exposure at 10 minutes without PE

Third Objective

The third objective was to “Evaluate the potential for energy savings using the

most optimal PV-PE configuration from objectives1 and 2”

Important conclusions from the study related to this objective areas follows:

With MV, with the increase of flow rate from 4 l/s to 7 l/s, the reduction of IF was very small From 7 l/s to 10 l/s, there was a larger drop of iF With DV, at low flow rate of PE, the decrease of iF was not obvious from 4 l/s to 6 l/s A more pronounced reduction was observed from flow rates of 6 l/s to 7 l/s and 8 l/s to 9 l/s Compared with MV, a higher flow rate was required with DV to achieve the same iF The flow rate to be applied in the real healthcare settings can be chosen according to the target

of the iF

9.2 Contributions

This study has developed a novel PV-PE system, which will help in the ventilation design in consultation rooms in healthcare centres and hospitals to obtain better infection control as well as a better inhaled air quality The main findings from the research are summarised as the key contributions to the body of knowledge:

Hypothesis 1: Combined PV and PE system can enhance the inhaled air quality by pulling the PV air towards the HP when the HP is moving around his/her desk

Hypothesis 2: Combined PV and PE system for HP can achieve the highest

Personalized Exposure Effectiveness (PEE)

Hypothesis 3: PV for HP helps to reduce the exposure from IP

Hypothesis 4: PE for IP helps reduce the exposure for HP

4a: Top-PE is better than shoulder-PE

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4b: In the presence of PE for IP, DV system leads to a better exposure reduction than

MV system

Hypothesis 5: PE for IP with PV for HP provides the best exposure reduction; PE for

IP is more effective than PV for HP

Hypothesis 6: With MV, the highest exposure case among the 4 cases studied is when

HP and IP are at 45 degrees to each other, while with DV, the highest exposure is when HP is standing, facing the seated IP In the context of airborne infection control

in healthcare settings, this novel PV-PE system is developed to help with the

ventilation design which aims at the protection of a Healthy Person The exposure to the exhaled contaminated air of a Healthy Person can be largely reduced with the help

of the PV-PE system The most significant contributions from this study are in

identifying a suitable design for the PE system and the factors and components

responsible for good infection control in consultation rooms in healthcare centres, including small clinics and hospitals

The experimental data and the CFD plots of lower flow rates of PE can lead to a design guide for HVAC designers/consultants to design the consultation rooms with respect to infection control PE flow rate can be selected according to the plots in real healthcare environments, depending on the target value of the Intake Fraction (iF) Energy saving implication is evaluated in this study and a few recommendations can

be drawn from this study to save energy

In addition, the concept of PV-PE system is not only applicable to consultation rooms

in healthcare settings but also to some other potential environment such as offices The ability of PE to divert the PV air can be applied in any place with PV installed for better inhaled air quality The advantage of PE for infection control can be applied in any open area with the presence of an Infected Person

9.3 Limitation of the study

The experiments performed and reported in Chapter 5 were limited to only a few of the many possible manikin locations and flow rate conditions that would occur in practice

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The PV and room air temperature were kept at 23 °C through all the experiments However, the change of PV air temperature and room air temperature may also affect the performance of the local environment created by the PV-PE system

In the CFD study, constant continuous inhalation/exhalation was used for the manikin instead of cyclic variations in the velocities of respiratory breath This may lead to a difference of the results especially for the exhalation case

The study focuses on normal exhalation process with small diameter of droplets The results of this study cannot be applied to larger droplets with different scenarios such

as coughs and sneezes

Lastly, there is a draft risk (Draft Rating is more than 15%) potential after using the

PE Further investigation on the users’ acceptability of PE may be interesting

9.4 Recommendations for Future Work

9.4.1 Recommendation on Scientific Research

Firstly, in the present study, the objective is mainly focussed on the feasibility of the integrated PV-PE system, driven primarily by experimental work involving objective measurements Its practical applicability and user acceptability in real healthcare settings are recommended for the thermal comfort, draft rating and inhaled air quality aspects Further optimisation of the PV-PE system integrated with background

systems (such as MV or DV) in actual healthcare settings and other application areas would also be possible Theusers’ preference of different types and locations of PE is yet another dimension worth exploring In this study, only MV and DV are examined

in the experiments For further research, the performance of the novel system in rooms with other background ventilation systems, i.e UFAD or downward ventilation systemcan be evaluated

In the present study, the indoor temperature level was controlled at 23°C for all experimental cases The effect of different room air temperature on the objective measurement of the transmission of exhaled air and subjective responses when PE is applied might be worth exploring The individual control with larger range of PE air flow rate is another possible dimension to explore

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It is recommended that the performance of the novel PV-PE system should be studied with the inclusion of more realistic scenarios such as a third person walking in the immediate vicinity, and changes in the postures of either IP or HP, changes in the skin temperatures of the IP (eg, IP with fever)

Lastly, further optimisation of energy saving potential of the PV-PE system integrated with background air conditioning and air distribution systems with full scale energy measurements is also worth exploring

9.4.2 Recommendation on Technology Development

The PE outlet mounted either on top or at shoulder level can be further developed that can slide not only up and down according to a person’s height but also forward or backward This may cater for the varying “sitting” posture of an Infected Person

Moreover, the PE outlet used in this study is some basic round outlet with damper, through which the air is sucked in a straight line parallel to the axis Perforated panel

or other designs could be tested However, the design of the PE outlet needs to be carefully justified, since it might affect the flow characteristics, suction efficiency and consequently the contaminant distribution The results presented in this thesis may not

be directly applicable to a different configuration of the PE outlet

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