Assessing the effects of transient weather conditions on airborne transmission risk in naturally ventilated hospitals

J Hosp Infect. 2024 Mar 4:148:1-10. doi: 10.1016/j.jhin.2024.02.017. Online ahead of print.

Abstract

Background: Many UK hospitals rely heavily on natural ventilation as their main source of airflow in patient wards. This method of ventilation can have cost and energy benefits, but it may lead to unpredictable flow patterns between indoor spaces, potentially leading to the unexpected transport of infectious material to other connecting zones. However, the effects of weather conditions on airborne transmission are often overlooked.

Methods: A multi-zone CONTAM model of a naturally ventilated hospital respiratory ward, incorporating time-varying weather, was proposed. Coupling this with an airborne infection model, this study assessed the variable risk in interconnected spaces, focusing particularly on occupancy, disease and ventilation scenarios based on a UK respiratory ward.

Results: The results suggest that natural ventilation with varying weather conditions can cause irregularities in the ventilation rates and interzonal flow rates of connected zones, leading to infrequent but high peaks in the concentration of airborne pathogens in particular rooms. This transient behaviour increases the risk of airborne infection, particularly through movement of pathogens between rooms, and highlights that large outbreaks may be more likely under certain conditions. This study demonstrated how ventilation rates achieved by natural ventilation are likely to fall below the recommended guidance, and that the implementation of supplemental mechanical ventilation can increase ventilation rates and reduce the variability in infection risks.

Conclusion: This model emphasizes the need for consideration of transient external conditions when assessing the risk of transmission of airborne infection in indoor environments.

Keywords: Airborne transmission; CONTAM; Hospital; Natural ventilation; Transient; Weather conditions.