The clinical and environmental effects of an advanced air purification technology in multiple healthcare settings

Figures & data

Fig. 1. Schematic representing zones A, B, and C and the existing heating ventilation, and air conditioning layout for all zones (Stawicki et al. 2020). Figures reproduced under the terms of byncnd4.0 international license. Figure previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 1. ACH-MSF environmental sampling.

Location	Surface samples	Airborne samples	TVOC samples
Zone A (2 patient rooms)	IV control faceplate, pressure cuff bulb, bedside table, IV support pole, patient remote control	Patient room	Patient room
Zone B (2 patient rooms)	IV control faceplate, pressure cuff bulb, bedside table, IV support pole, patient remote control	Patient room	Patient room
Zone C (2 patient rooms)	IV control faceplate, pressure cuff bulb, bedside table, IV support pole, patient remote control	Patient room	Patient room

Table previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 2. Multi-site hospital setting environmental sampling.

Location	Surface samples	Airborne samples
AAPT PACU	Bed table, bed rail	Patient room
AAPT ICU	Bed table, bed rail	Patient room
AAPT MS	Bed table, bed rail	Patient room
HEPA PACU	Bed table, bed rail	Patient room
HEPA ICU	Bed table, bed rail	Patient room
AAPT MS	Bed table, bed rail	Patient room

Fig. 2. Schematic representing the air purity in the various locations of the study floor. Region 1 represents areas that were directly supplied by the AAPT (54.6%). Region 3 represents ventilation air that is AAPT protected air mixed with return air from the same space (8.9%). Region 2 represents areas with no direct supply of AAPT air to the space and these spaces are negative to one of the Region 1 spaces which pull diluted AAPT protected air into the space (29.9%). Region 4 represents no direct supply of AAPT air to the space and these spaces are negative to one of the Region 2 spaces and pull even more diluted AAPT air into the space (2.4%). Region 5 represents spaces that have no ventilation at all and have no AAPT protection (4.1%).

Table 3. SLF environmental sampling.

Location	Surface samples	Airborne samples	TVOC sampling
Corridor (CORR)	Hallway railing, nurses station	Corridor	Corridor
Resident room wing (RRW)	TV remote, bathroom fixture, bed table	Room, bathroom	Room
Resident room annex (RRA)	TV remote, bathroom fixture, bed table	Room, bathroom	Room
Community area (CA)	Chair handles/table, TV remote	Room	Room
Dining area (DA)	Food cart handle, chair handles/table	Room	Room

Table previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 4. ACH-MSF key environmental metrics associated with environmental purity.

Parameter	Zone A	Zone B	Zone C
Viable fungi by air (CFU/m^3)	0	7	144
Viable fungi by swab (CFU/in^2)	0	50	25
Viable bacteria by air (CFU/m^3)	0	35	141
Viable bacteria by swab (CFU/in^2)	25	0	425
Volatile organic compounds (ppb)	1300	2350	3100

Previously published and reproduced with permission (Stawicki et al. 2019, 2020). Table also previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Fig. 3. The clinical and economic outcomes mirrored the level of environmental purity from zone C to zone B to zone A. PT: particulates; VBBA: viable bacteria by air; VBBS: viable bacteria by swab; VFBA: viable fungi by air; VFBS: viable fungi by swab (Stawicki et al. 2020). Figures reproduced under the terms of byncnd4.0 international license. Figure previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 5. ACH-MSF key environmental metrics associated with environmental purity.

Parameter	PACU		ICU		MS
	AAPT	HEPA	AAPT	HEPA	AAPT	HEPA
Viable fungi by air (CFU/m^3)	7	126	21	126	7	105
Viable fungi by swab (CFU/in^2)	100	0	0	0	0	0
Viable bacteria by air (CFU/m^3)	84	CG	49	CG	77	CG
Viable bacteria by swab (CFU/in^2)	100	850	150	1050	150	50

CG: confluent growth.

Table 6. SLF demographics.

Parameter	Study floor	Control floor	p-Value
Mean number of residents during study period	37.2	36.5	NS
Sex (% female)	73.0	78.4	NS
Caucasian (%)	91.9	94.6	NS
African American (%)	–	0.03	NS
Hispanic (%)	0.03	0.03	NS
Other (%)	0.05	–	NS
Eitology (% dimentia)	94.6	78.4	NS
Mean age (years)	89.6	88.3	NS

NS: not significant.

Fig. 4. SLF airborne environmental metrics associated with environmental purity. Figure modified from previously published figure in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Fig. 5. SLF surface environmental metrics associated with environmental purity. Figure previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 7. SLF clinical outcomes: number of FAIs.

	Control floor	Study floor
Study period	53	32
Pre-installation	41	44
Post-installation	43	20

Table previously published in Conference Paper for the 2022 ASHRAE Annual Conference (Worrilow et al. 2022).

Table 8. Pathogens cultured from control floor residents.

Microorganism	Classification	Airborne transmission
Citrobacter	Gram negative bacilli	Yes
Enterobacter	Gram negative bacilli	Yes
Escherichia coli	Gram negative bacilli	Yes
Klebsiella	Gram negative bacilli	Yes
Morganella	Gram negative bacilli	No
Proteus mirabilis	Gram negative bacilli	No
Providencia	Gram negative bacilli	No
Pseudomonas aeruginosa	Gram negative bacilli	Yes
Serratia	Gram negative bacilli	Yes
Hafnia alvei	Gram negative bacilli	Yes
Moraxella	Gram negative cocci	Yes
Trichomonas vaginalis	Protozoa	No
Corynebacterium	Gram positive bacilli	Yes
Lactobacillus	Gram positive bacilli	Yes
Stenotrophomonas	Gram positive mixed	Yes
MRSA	Gram positive mixed	Yes
VRE	Gram positive mixed	No
ESBL	Gram positive mixed	No
Cytomegalovirus	Virus	No
Viral respiratory—(influenza, adenovirus, etc.)	Virus	Yes
Candida	Fungi	Yes
Histoplasma capsulatum	Fungi	Yes

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