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From Air Removal to Infection Control: Rethinking Hospital Exhaust System Design

Yaseen Khan Mohammed CEng

The COVID-19 era exposed critical gaps in how we manage airborne infection risks in healthcare facilities.

Most current codes strongly emphasize indoor air quality — ventilation rates, filtration, and pressure control — yet there appears to be comparatively limited guidance on the treatment of contaminated exhaust air before it is discharged into the atmosphere.

Research indicates that microorganisms from areas such as isolation rooms, laboratories, dental suites, and decontamination spaces can survive under certain environmental conditions and, in poorly designed exhaust configurations, may pose potential exposure risks — particularly in dense urban environments.

This raises an important question:
Should hospital exhaust systems be considered a formal part of infection control strategies, rather than merely air removal systems?

Technologies such as HEPA filtration, UV disinfection, and controlled exhaust discharge design are already applied in laboratories and high-risk facilities.

Is it time for similar risk-based approaches to be incorporated into healthcare ventilation codes and standards?

I’m interested to hear from fellow HVAC engineers, infection control specialists, and code professionals:
 Point right Have you encountered projects where exhaust air treatment was required or debated?
 Point right Do you see current standards as sufficient, or is there a gap that needs to be addressed?

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  • This sort of thing has been mentioned before, last sentence:-

    "The very first canon of nursing, the first and the last thing upon which

    a nurse's attention must be fixed, the first essential to a patient,

    without which all the rest you can do for him is as nothing, with which
I had almost said you may leave all the rest alone, is this: TO KEEP THE
AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM. Yet
what is so little attended, to? Even where it is thought of at all, the
most extraordinary misconceptions reign about it. Even in admitting air
into the patient's room or ward, few people ever think, where that air
comes from. It may come from a corridor into which other wards are
ventilated, from a hall, always unaired, always full of the fumes of
gas, dinner, of various kinds of mustiness; from an underground kitchen,
sink, washhouse, water-closet, or even, as I myself have had sorrowful
experience, from open sewers loaded with filth; and with this the
patient's room or ward is aired, as it is called--poisoned, it should
rather be said. Always, air from the air without, and that, too, through
those windows, through which the air comes freshest. From a closed
court, especially if the wind do not blow that way, air may come as
stagnant as any from a hall or corridor."
    Notes on Nursing, 1860, Chapter 1
Reply

  • This sort of thing has been mentioned before, last sentence:-

    "The very first canon of nursing, the first and the last thing upon which

    a nurse's attention must be fixed, the first essential to a patient,

    without which all the rest you can do for him is as nothing, with which
I had almost said you may leave all the rest alone, is this: TO KEEP THE
AIR HE BREATHES AS PURE AS THE EXTERNAL AIR, WITHOUT CHILLING HIM. Yet
what is so little attended, to? Even where it is thought of at all, the
most extraordinary misconceptions reign about it. Even in admitting air
into the patient's room or ward, few people ever think, where that air
comes from. It may come from a corridor into which other wards are
ventilated, from a hall, always unaired, always full of the fumes of
gas, dinner, of various kinds of mustiness; from an underground kitchen,
sink, washhouse, water-closet, or even, as I myself have had sorrowful
experience, from open sewers loaded with filth; and with this the
patient's room or ward is aired, as it is called--poisoned, it should
rather be said. Always, air from the air without, and that, too, through
those windows, through which the air comes freshest. From a closed
court, especially if the wind do not blow that way, air may come as
stagnant as any from a hall or corridor."
    Notes on Nursing, 1860, Chapter 1
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