/ ASHRAE SSPC 170

Memo

To:Paul Ninomura, Chairman

From:Michael Sheerin

CC:Chris Rousseau, Secy

Date:October 1-2, 2009

Re:Meeting Minutes – ASHE Headquarters Chicago, IL

Attendees: (see log at end of minutes)

  1. GENERAL:
  2. Meeting called to order at 1:00 pm by Chairman Paul Ninomura. Members and guests were welcomed to the meeting. Sign-in sheet was circulated by Michael Sheerin.
  3. Dale Wooden of ASHE welcomed committee to ASHE Headquarters and thanked them for their efforts in working to reconcile and align the 170 and Guideline documents into a seamless package, and wished the committee continued success and the support of ASHE.
  4. Chairman indicated that ASHRAE Healthcare Design Certification exam is being updated.
  5. NFPA 99: Doug Erickson provided update on the NFPA 99 revision – has been sent back to committee for revisions and adjustments to improve numerous issues still better resolved prior to issuance than was or could be done previously and will be re-sent for member approval in approx. Jan 2011, in alignment with the NFPA 101 Life Safety time schedule.
  6. 2010 FGI: Doug Erickson provided status update of the 2010 FGI Guidelines for Design and Construction of Health Care Facilities (Guidelines).Healthcare Guidelines Revision Committee (HGRC) had completed their efforts, including edits to strip content that was duplicative or less stringent than the 170 requirements that would be adopted into the 2010 FGI. Final edits occurring now, and publication is imminent within the next 30-60 days, with document available by about Jan 3, 2010.
  7. CODE IMPLEMENTATION: General discussion about timeline of present and future addenda and how inclusion into the published 2010 FGI will occur. Practical reality is that present addenda would make it into the publication but others would be issued later and that a consistent mechanism between ASHRAE and ASHE was needed to ensure this continued to occur. Equally important was the aspect of AHJ adoption of the 2010 FGI as code in force, and how certain jurisdictions adopt 6 – 12 months after new FGI is issued, thus enabling this committee to develop, issue, PR, and approve additional addenda that in all eventuality could become part of the adopted FGI – while reminding the committee that different jurisdictions have different quirks in this regard (some adopt only “known” (already issued) addenda, some will adopt incl any addenda on an as-issued basis; AZ adopts FGI and includes Normative Appendices as part of the code!). Some of this info was further discussed on October 2, 2009 continuation meeting but is condensed here for brevity.
  8. PAST MINUTES: Chairman sought approval of the past meeting’s minutes as previously distributed. Motion to approve by Sheerin / Seconded by Kloostra - no comments or clarifications noted. VOTE Approved 10-0-0
  9. ADDENDA: Chairman updated committee on present status of previously approved Addenda a, b, c. Chairman also reminded committee that new SSPC 170 website is now up and running and will have all addenda posted and available for reference, along with member use area, etc.
  10. ASHRAE 62.1: Hermans was asked to update committee on status of ASHRAE 62.1 action to remove HC spaces from Ventilation Table from 62.1 document – Hermansindicated that he had not been notified from Dennis Stanke of 62.1 if action had been approved, but will attempt to confirm, and inform committee.
  11. VARIABLE AIR VOLUME: Sheerin and Erickson led a discussion on the application of Variable Air Volume use in Healthcare settings, the premise of which is derived from multiple important points of interest:
  12. ASHRAE 90.1 is targeting HC and Lab settings for improved energy efficiency, and aggressively so.
  13. Continued perception by many AHJs that constant air volume is necessary to accomplish room pressurization control, even after the FGI interpretation was issued that defined that “N.R.” = no requirement for room pressurization control ie for patient room may still result in the design application of neutral relative pressure and constant air volume.
  14. Erickson noted that Phoenix (an air terminal manufacturer) had expressed frustration that the application of their healthcare focused units was being hampered by this perception.
  15. Bartley noted that 99% of transmission issues in healthcare setting are thru surface or droplet contact sources, not airborne, so this is a PERCEPTION and ENFORCEMENT ISSUE. Only clear airborne source is TB because no vaccine is available, but with clear protocol addressing protection.
  16. All noted that 170 adequately addresses that VAV is allowed, just as FGI has in the past.
  17. General discussion about whether positive or negative general med-surg patient room is an exposure issue. Sheerin noted that the potential is high that any room is actually moderately positive or negative or could become so - even in constant air volume design - due to external weather conditions, wind pressures, stack effect, patient doors propped open, HVAC equipment degradation, etc, and that a well designed VAV system can likely result in no different pressure variations from room to corridor than such conditions.
  18. Gregory noted concern only that designers have on occasion offered designs proposing grossly positive or grossly negative air balance, which would seem to fly in the face of reasonableness. All agreed however likewise no design criteria is defined in 170 or previously in FGI. Arguably, by being mute, the code implies that this is not an issue of concern. Given Bartley comments, this may be the case.
  19. Erickson noted that some hospitals employ supply and return VAV as advocated by AHJ to maintain room pressure control. Others noted the burden of cost and complexity of such system.
  20. The following action items were generally recognized to occur:
  21. Erickson to contact Tim Peglow on 90.1 Mechanical Sub – Healthcare Working Group (MSHCWG) to understand 90.1 direction and upcoming changes.
  22. Sheerin/Hermans/Erickson to provide stronger liaison between 170 and 90.1 MSHCWG and also advise of upcoming 90.1 addenda PR for 170 review and comment.
  23. 170 Mechanical Sub to review further via conference call and consider development of white paper to advise designers and AHJs of addressing this issue (or non-issue).
  24. OPERATING ROOM PRESSURE MONITORING: Based on discussion between Dan Koenigshofer and Doug Erickson, the necessity of room pressure monitors (RPM) for Operating Rooms was discussed. It was noted that CMS (hospital licensure org) requires temperature and humidity logging on some basis, no critical need was determined to warrant requiring RPMs in these locations, especially as it was noted that these staff are generally more focused and trained to recognize room HVAC performance issues.
  25. ADDENDA “C” FILTRATION – DOMBROWSKI COMMENT: Extensive and wide ranging discussion occurred regarding this comment:
  26. Dombrowski offered that the comment was submitted to address the disparity between the FGI, which allows only MERV 3 filtration for recirculating units and the 170 document which does not address the matter, thus resulting in the requirement of 2 filter beds (MERV 7 pre and MERV 14 post the coil), in the most stringent interpretation of the document, which is a very big difference and would result in the unintended likelihood of disallowing fan coil units and similar recirculating systems for patient room type areas.
  27. Langowski noted that hybrid systems (ie chilled beam, others) would also need to be addressed at some point as this issue is reviewed. Shah noted the cost burden to owner’s of not carrying forward as similar allowance, especially for nursing homes.
  28. Further discussion about MERV 3 (FGI) versus MERV 6 (which is now the minimum in ASHRAE 62.1 per Mamayek) or MERV 7 (ASHRAE 170) – all generally agreed that we could not advocate lower than 62.1 MERV 6, and many noted the increased availability and low cost of higher efficiency filters even in residential use, thus justifying the market direction, availability and cost of MERV 6 or 7 for these recirculating units.
  29. MOTION: Hermans motion to REJECT Comment 001 of Addenda C / Seconded by Sheerin Discussion: Justification was that the committee will work with forthcoming addenda to incorporate MERV 6 or 7 for these units. VOTE Affirmative 9-0-0 - Chair to review if letter ballot required.
  30. MOTION: Langowski motion to WITHDRAW Addendum C / Seconded by Mamayek Discussion: Recognizing the above determinations, this is the corrected course of action. VOTE Affirmative 9-0-0 - Chair to review if letter ballot required.
  31. ADDENDUM “D” LOW HUMIDITY: As requested via California health officials (Tony Modessette), this addendum sought the elimination of the low humidity limit in short term occupancy spaces to avoid unnecessary humidification operation and equipment. Chairman highlighted to the committee that the vote tabulation of this Addendum had resulted in a 9-3-0 (4 non-votes), and that he had sought feedback from the 3 “NO” votes to understand their concerns and issues with the actions as presented in the Addendum (Hermans, Keen, and Mamayak). Chairman opened the floor for discussion:
  32. Bartley: indicated that she’d still vote YES – as, based on her experience, the primary transmission of influenza is contact/droplet, and we need to remember what we are trying to prevent – low humidity is the least of our worries.
  33. Chairman indicated that Memarzedah had indicated that he would still vote YES
  34. Mamayek expressed concern that 100% Outside Air (OA) systems at low ambient temperatures have been seen to create unsatisfactory comfort conditions, and that some ORs are 100% OA so concerned that may result in staff issues in these locations – less a California issue than a true “northern” issue. He would be in favor of lowering the criteria to 20% RH versus dropping altogether.
  35. Erickson agreed it was good to review this in steps, to deal with the issue at hand, and the AHJ and CMS responses therein, then look at other areas and boundaries as necessary. Thanked Bartley and Memarzedah for their literature search efforts and commentary from a clinical basis. Agreed that 20% would be a good compromise adjustment.
  36. Sheerin indicated that Keen, not able to attend this meeting, had concerns similar to Mamayek due to Toronto winter conditions.
  37. Hermans noted that the research, past (Sterling, et al) and present, had equal basis in setting a criteria of 20% RH as the 30% value presently defined.
  38. MOTION: Erickson motion to RETURN & RECONSIDER Addendum “D” by committee / seconded by Langowski. VOTE Approved 9-0-0
  39. MOTION: Mamayek motion to ISSUE REVISED ADDENDUM D for PUBLIC REVIEW as modifed for the spaces indicated from Max 60 % to 20%-60% RH / seconded by Bartley. Discussion reinforced that 20% basis was founded on reasonable info in Rosenberg (pg 8, Humidity Airway), Memarzedah and Sterling studies. It was noted that the Addensum foreword should be revised accordingly. VOTE Approved 9-0-0.
  40. MOTION: Langowski motion to PROVIDE ACCEPT IN PRINCIPLE RESPONSE to Change Proposal CM 170-09-12-0001/001 as reflected in the actions above / seconded by Mamayek. VOTE Approved 9-0-0 Chairman will advise Modessette of this change.
  41. HUMIFICATION FDA CHEMICALS - BOLDT COMMENT Chairman and Sheerin reviewed the Change Proposal as submitted by Jeff Boldt, acknowledging the well-documented and research proposal and related back-up data.
  42. Langowski commented that there are two issues involved, water and chemicals. He expressed concern that the proposal as submitted implied approval of atomizing type humidifers, and noted that the FGI Guidelines had not allowed.
  43. Erickson relayed that in discussions with Streifel (wasn’t able to attend this meeting), Streifel’s opinion was to stick with the FDA criteria as it represents the only “science” out there addressing this matter.
  44. Hermans asked how facility directors would determine whether they were in compliance with the parts per million (ppm) levels set forth in the proposal? He continued on that the criteria as presently defined is easy to enforce, while the proposed “prescriptive requirements” are not easily measurable.
  45. Hardin noted that past studies had shown that using the FDA chemicals had resulted in levels very safely below the threshold values.
  46. MOTION: Langowski motion to REJECT PROPOSAL CM 170-09-12-002 / seconded by Bartley. Justification that committee felt current requirement is more enforceable. Committee did not need to or choose to address non-steam humidification as this time. No evidence that differing threshold values was necessary. VOTE Affirmative 8-0-1 (Chair Ninomura abstain)
  47. OPERATIONS & MAINTANENCE – ASHRAE STD 180: Mamayek provided a brief overview and summary of the goals and details developed in Standard 180, including the following:
  48. The document is largely tabular data for equipment maintenance
  49. The standard recognizes and allows the flexibility to adjust maintenance schedules based on performance and history factors
  50. Mamayek would recommend inclusion to Informative Appendix
  51. Erickson noted that some states (AZ, one other) actually adopt Appendices as requirements, resulting in burden of extra and sometimes unintended requirements on facilities. In this case, O&M likely would have limited AHJ involvement due to lack of enforcement pathway or mechanisms presently in place.
  52. No action taken.
  53. PATIENT ROOM AIR CHANGE RATE – GREELEY COMMENT-
  54. MOTION: Sheerin motion to REJECT Change Proposal CM 170-09-12-003 / seconded by Bartley. Greeley proposes to reduce patient room total air change rates from 6 ACH to 2 ACH. Discussion and justification that no evidence is provided to persuade the committee in this matter, especially given the Memarzedah patient room study, et al. VOTE affirmative 9-0-0.
  55. START DAY 2 MEETING
  56. Committee discussed the importance of maintaining the user friendliness of the 170 document, especially recognizing that addenda are issued after the published document and are loose from the document. Sheerin noted that addenda that involved scattered small adjustments can result in difficult to track and use, thus creating confusion or AHJ interpretative issues. Chair and Erickson will encourage ASHRAE issue addenda as full page updates. Erickson further noted that 2010 FGI will be printed in book, binder and electronic version, binder version allowing easy updating by page. Chair understood that 170 reprint would occur in 2011. As the 2010 FGI is adopted by various states, addenda issued up to that time would be included. Erickson to look at wording in 2010 FGi about how 170 is included – if it can included “all approved addenda” then the implication is that on-going addenda releases could become part of FGI/170 requirements upon committee approval / ASHRAE issuance.
  57. NEW PROPOSED ADDENDUM “-” (“X”) – LANGOWSKI ITEMS:
  58. Need to resolve filtration level required at recirculating room units, as Guidelines had previously required only MERV 3 while present 170 makes no exception for recirc units, thus by interpretation requiring MERV 7/14 two bank filtration, which the committee recognizes is very different and a much higher level, and cannot be supported easily with many room recirc units as presently offered by manufacturers, thus implying or compelling all air systems. Between Dobrowski comment discussion and herein, it was recognized that a number of gap issues will need to be addressed as we move from Guidelines-centric to 170-centric code enforcement. Wording from Guidelines addressing this issue was reviewed as reference info.
  59. Another gap issue to resolve is negative, non-exhausted spaces (ie PT), where the Total Air Change Rate is pegged on the exhaust as prescribed by the 170 Standard. Chairman charged Sheerin and the HVAC Sub-Committee with developing an Addendum to address and word-smith this issue.
  60. Other items in this proposed addendum were noted as being covered in the FGI/170 Recap to follow.
  61. FGI / 170 RECAP – lead by Rousseau based on updated FGI spreadsheetthat denotes items that Healthcare Guidelines Revision Committee (HGRC) have retained in 2010 FGI to ensure they are addressed and highlight any items that need more immediate action by this committee.
  62. See summary info provided by Rousseau and attached
  63. Is return air ductwork required? “patient care area” …..as defined in NFPA 99.
  64. Extensive discussion on constant / variable air volume at AII / PE rooms, including the necessity to maintain pressure control, reviewed allowing lower ACH (ie 6 in lieu of 12) when not used for AII / PE use, and the reminder that past FGI work (addressing switchable rooms) moved away from complex arrangements to avoid failure conditions.
  65. Erickson noted that some consultants had expressed that allowing the reduction of patient room air change from 6 to 4 ACH could yield a 30% energy savings (Sheerin to review further).
  66. How do we address catheterization and I-MRI type rooms from a ceiling air distribution condition?
  67. AII Room Anteroom - FGI had developed some advisory language, via Streifel, for a variety of room arrangements. Standard anteroom arrangement was negative to corridor / positive to AII room / monitor from AII to corridor.
  68. Chairman charged Erickson and Clinical Sub-Committee to address the AII Room / PE Room (items 2,3,4,5 from Langowski addendum) requirements and supplemental guidelines associated with anterooms.
  69. The issue of seals and sweeps at AII Rooms was also discussed. 2010 FGI has a requirement for door seals and sweeps at AII Rooms, however they have recognized this may be a problematic issue both from an air control (need some undercut for negative air) and maintenance perspective, and will be evaluating further for modification in the FGI by removing sweep requirement or redefining as reduced undercut (1” down to ½” at air transfer doors).
  70. Rousseau questioned issue noted in item 8, discharge of HEPA filtered air from AII rooms to general exhaust. Item 8 proposed treating air as hazardous, resulting in the implied need to upgrade general exhaust discharges. Given the use as retrofit condition only, the consensus was to edit the relevant 170 section to allow only in retrofit condition and strike the treatment of the general exhaust discharge as hazardous type.
  71. Item 9, exhaust duct under negative pressure - further review is also needed to determine if any CDC or OSHA guidelines dictate any requirements beyond what is addressed in this code, as modified.
  72. NEW BUSINESS
  73. ASHRAE POSITION PAPER on INFECTIOUS DISEASES developed by ASHRAE Environmental Health Committee - circulate by Sheerin for committee review. Erickson commented to Hermans that ASHRAE may be advised to seek the wider involvement and input of this committee and TC 9.6 membership when developing such a document.
  74. NEXT MEETING IS SUNDAY, JANUARY 24, 2010 8am-12pm in ORLANDO, FL.
  75. Chair thanked the committee for their efforts in keeping things moving forward and their time in preparation and for this interim meeting.
  76. MOTION TO ADJOURN: Kloostra motion to adjourn, seconded by Sheerin VOTE Approved 9-0-0.

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