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ASHRAE SSPC 170 Meeting Minutes Annual Meeting Denver, CO June 25, 2013 1. Meeting opened. The meeting was opened by Chair Ninomura at 8:10 a.m. 2. Attendance: a. Voting members present: Ninomura, Sheerin, Rousseau, Erickson (part time), Hermans (part time), Kloostra, Langowski, Moeller, Platt (part time), Seth, Sharp. b. Voting members not present: Gregory, Mamayek, Memarzadeh, Streifel. c. Non-voting members present: Dombrowski, Olmsted. d. Non-voting members not present: none. e. Liaisons present: none f. See attached sign-in sheet for other attendees. g. A quorum was maintained throughout the meeting. 3. Review Agenda. No new items added under new business: 4. Dallas meeting minutes. Rousseau advised that the date on the Voting Records from the Dallas meeting were incorrect. The correct date is 4/22/13. Erickson moved the corrected minutes of the January 29, 2013 Dallas meeting be accepted. Langowski seconded. Motion passed (9-0-0). 5. FGI Design and Construction Update. Erickson reported that the Guidelines would be published early next year. He indicated that the new residential health care book would follow shortly after that. ASHRAE Standard 170 will be referenced for three residential health care occupancies: Nursing Homes, Hospice, and Assisted Living. Erickson also indicated that ASHE would like for SSPC 170 to examine Kaiser Permanente’s exam room airflow reduction proposal, perhaps in concert with research performed by ASHRAE or FGI. 1.

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ASHRAE SSPC 170

Meeting Minutes Annual Meeting Denver, CO June 25, 2013 1. Meeting opened. The meeting was opened by Chair Ninomura at 8:10 a.m. 2. Attendance:

a. Voting members present: Ninomura, Sheerin, Rousseau, Erickson (part time),

Hermans (part time), Kloostra, Langowski, Moeller, Platt (part time), Seth, Sharp.

b. Voting members not present: Gregory, Mamayek, Memarzadeh, Streifel.

c. Non-voting members present: Dombrowski, Olmsted.

d. Non-voting members not present: none.

e. Liaisons present: none

f. See attached sign-in sheet for other attendees.

g. A quorum was maintained throughout the meeting.

3. Review Agenda. No new items added under new business: 4. Dallas meeting minutes. Rousseau advised that the date on the Voting Records

from the Dallas meeting were incorrect. The correct date is 4/22/13. Erickson moved the corrected minutes of the January 29, 2013 Dallas meeting be accepted. Langowski seconded. Motion passed (9-0-0).

5. FGI Design and Construction Update. Erickson reported that the Guidelines would be

published early next year. He indicated that the new residential health care book would follow shortly after that. ASHRAE Standard 170 will be referenced for three residential health care occupancies: Nursing Homes, Hospice, and Assisted Living.

Erickson also indicated that ASHE would like for SSPC 170 to examine Kaiser Permanente’s exam room airflow reduction proposal, perhaps in concert with research performed by ASHRAE or FGI.

1.

6. SPLS Liaison: Doug Abramson reported the following:

a. SPLS is in place to help with procedural issues, they are not technical subject experts.

b. Process is very important in achieving the ANSI designation.

c. Doug is rotating off of SPLS. Our new liaison will be John Dunlop. 7. Package Rooftop Units. Ninomura indicated that additional discussion of this topic would be

deferred to the next meeting. 8. EHC Airborne Infectious Disease Position Paper. Olmsted reported that the primary items

being addressed by the committee were:

a. Whether influenza should be considered an airborne disease.

b. UV effectiveness.

Ninomura asked if a draft would be available prior to publication. Olmsted indicated he would provide a copy for committee review.

9. AORN. Ramona Conner, with the Association of Perioperative Registered Nurses, Center for

Nursing Practice, and the FGI Health Care Guidelines Revision Committee gave an excellent presentation on current sterilization procedures. Sub-sterile rooms in the OR Suite are no longer required, due to container-based central sterilization procedures. Conner suggested that 70-75degF might be more appropriate for Sterile Procedure spaces, rather than the 68-73degF currently required by Standard 170. Conner described the new OR classification system beingt implanted with the 2014 edition of the Guidelines. Instead of the previous three categories (A, B, and C) there will be two: Operating Rooms and Procedure Rooms. AORN recommends that the new Procedure Room be ventilated similarly to the current Treatment Room, rather than the higher requirements of the current Procedure Room. Erickson inquired about differential pressures in the OR Suite. Conner indicated that AORN recommended an airflow cascade from the OR, to the semi-restricted spaces, to the unrestricted spaces. The committee agreed that the Standard should potentially be clarified to require this cascade, since the current wording only requires positive pressure relative to other spaces for the OR. Conner reported that AAMI Standard ST 79, which includes requirements for ventilation of central sterile areas, will be open for public comment in September (aorn.org). Conner said she welcomed comments and questions from the committee at [email protected].

10. OR Classification. Rousseau presented a draft of the potential editorial change approved in

concept in St. Louis. The intent of this editorial change is to incorporate the new FGI operating room terminology (see Item 12 above) into the 2013 edition of the Standard, rather than an addendum. Conner indicated that Caesarian Delivery Rooms and Cystoscopic operating rooms both fell under the new definition of Operating Room, so there is no need to define or list requirements for them separately. Erickson indicated that the deletion of these two spaces from the Standard at this point would not be editorial. This will be addressed in a future addendum. Hermans indicated that any change to definitions or deletion of definitions would also not be considered editorial. Platt (a member of the Standards Committee) suggested indicating the new terms in the existing definitions, with the current terms retained parenthetically. Mark Weber (our Staff Liaison) also concurred with this approach.

2.

a. Motion: Rousseau moved, and Seth seconded, that the agreed upon changes

discussed in the meeting (copy attached) be forwarded on, without public review, as an editorial change for the 2013 edition. Vote: Approved, 10-0-0.

ACTION: Rousseau to update and provide text to Weber for incorporation into the 2013 edition.

11. Addendum u. Ninomura presented a public review comment on Addendum u (copy

attached). The comment was ruled Deferred, Out of Scope, since it was not based on changes included in Addendum u. However, the committee felt that a reduction in the exhaust stack height requirement for air being discharged from ED and Radiology Waiting Rooms was appropriate due to the lower level of risk. ACTION: Langowski, with help from Flannery, will propose an addendum to address this issue. Fauber suggested that Hot Labs and Nuclear Medicine Labs should also be included in this evaluation. Ninomura will follow up with the commentor.

12. Design Manual. Koeingshofer reported that the Design Manual has been published, and is

available for purchase.

13. Addendum y (Duct Lining). Rousseau presented a response (copy attached) to the one comment received during the public review. Kloostra indicated there were impervious types of duct lining that would meet the committee’s intent, but that were precluded by the current addendum language. Rousseau agreed, and indicated (promised, in fact) that this would be discussed at a future meeting. The comment revolved around two issues: 1) the distance in which duct lining would be allowed downstream of a humidifier, and 2) a prohibition on duct lining located upstream of any high limit humidistat provided. The committee ultimately decided on Response #1b (no change), and 2a (with the first sentence modified to read: “We generally agree with this comment….”

a. Motion: Rousseau moved, and Langowski seconded, that Responses #1b and #2a (as

modified) be accepted. Vote: Approved, 10-0-0.

ACTION: Rousseau will propose addendum language regarding the high limit humidifier lining requirements.

14. Interpretation requests from Kaiser Permanente. Responses to two Interpretation

Requests (copies attached) were reviewed:

a. Interpretation #1, regarding usage of Standard 62.1 – Based on the committee’s June 13, 2013 telephone conference (minutes attached), Ninomura reported that the sub-committee response was Yes. Several committee members expressed concern about natural ventilation in some areas of a building interfering with pressure relationships in other areas of the building. It was agreed that that natural ventilation warranted additional discussion. 1) Motion: Ninomura moved, and Rousseau seconded, that the response to this

interpretation request be Yes. Vote: Approved, 9-0-1.

3.

b. Interpretation #2, regarding ventilation of exam rooms - Based on the committee’s June 13, 2013 telephone conference (minutes attached), Ninomura reported that the sub-committee response was Yes. Erickson indicated that the ICRA process is only intended for construction and should not be used for design issues. It was agreed that the topic of varying level of risk applicable to exam rooms warranted additional discussion.

1) Motion: Ninomura moved, and Rousseau seconded, that the response to this

interpretation request be Yes. Vote: Approved, 10-0-0. 15. Addendum status. Ninomura reported that Addenda w, z, and ab would all be voted on by

the Board at this meeting. See attached Standard 170 Addendums List. 16. Addendum ac (Plenum vs. Ducted Return Air). Ninomura presented responses to the one

substantitive comment received during the public review (copy attached). The comment asked several questions, but did not make any specific recommendations. The comment was deemed to be Accepted, as submitted.

a. Motion: Ninomura moved, and Seth seconded, that the response be approved. Vote:

Approved, 9-0-0.

Ninomura will advise the commentor that the committee will discuss the issues of outpatient facility definitions in the future. Dombrowski questioned whether we could rely on FGI for definitions, since Standard 170 needed to stand alone when not used with the Guidelines. This issue will be discussed further in the future.

17. Addendum tae (FGI items). Ninomura indicated the continuation letter ballot is in process.

18. Kaiser Permanente Presentation. Travis English gave a presentation on findings from KP’s

recent webinars and a literature search regarding natural ventilation. He recommends ASHRAE do more research on natural ventilation.

19. Filtration, Table 6-1. Rousseau presented proposed revisions to the table. Charlie Seyffer

recommended that all MERV 7 requirements be changed to MERV 8, since MERV 7 filters are not readily available in the industry. A straw vote indicated a fairly even split between those who felt a second filter back was needed for non-surgical portions of outpatient facilities, and those who felt one filter bank was adequate. ACTION: Zied Driss volunteered to prepare a history of changes in issue through recent editions of the FGI Guidelines. ACTION: Based on the assumption that the Standard was not intended to significantly change requirements for outpatient facilities from the 2006 Guidelines, Rousseau will provide a revised table based on those requirements for committee review.

20. Switchable Pressure Controls. Rousseau presented revisions to Table 7-1 footnotes

regarding switchable controls (copy attached). There was agreement that the committee’s intent was to avoid switchable controls in all applications, not just AII and PE rooms. To that end, the committee had the following recommendations:

a. Keep the footnote n terminology.

b. Change “switching controls” to simply “switching”.

4.

c. Keep footnote u terminology, perhaps relocate to footnote n.

d. Review footnote t for applicability to this list.

ACTION: Rousseau will prepare a revised addendum.

21. Laboratory Modifications. Sharp presented a recommendation (copy attached) to delete the

ventilation requirements for laboratories from the Standard, and instead refer to ANSI/AIHA/ASSE Standard Z9.5-2012, American National Standard for Laboratory Ventilation. Several members expressed concern that health care clinical laboratories were significantly different from the types of laboratories addressed by Z9.5. Sharp indicated that the Z9.5 addressed all types of laboratories. ACTION: Committee members should familiarize themselves with Z9.5, so this issue can be discussed further at the next meeting.

22. Sterile Storage. Langowski presented information and an addendum (copies attached) to

reduce the outside and total air change rates in Clean Supply Rooms and Clean Linen Storage, based on usages defined in the FGI Guidelines.

a. Motion: Langowski moved, and Rousseau seconded, that these reductions be issued

in an addendum for public review. Vote: Approved 6-1-1. Note: Voting members understood that these votes were for public review and, if no comments or only supportive comments were received, subsequent publication.

23. Membership changes. Ninomura advised the following:

a. Kloostra, Seth, and Streifel are rotating off the committee.

b. Flannery and Hosking are rotating on as Voting Members.

24. OR air distribution. Hosking advised that Kloostra and Reg Brown are involved with

developing a Work Statement for research on operating room air distribution using air curtains. It is proposed that TC 9.6 be the cognizant TC. TCs 4.10 and 5.3 are anticipated to be co-sponsors.

25. Clinical Subcommittee. Minutes and sign-in sheet attached.

26. Action Items.

a. Outstanding items from previous meetings. 1) Boldt – Cooling tower placement language (Item 23, Chicago

Interim).

2) Hermans – discuss outside/exhaust air recirculation research with TC9.6 (Item 17, San Antonio).

3) Sheerin – recommendation on alternate air change rate calculation method (Item 19, San Antonio).

5.

b. New items from this meeting.

1) Rousseau – forward OR terminology editorial information to Weber (Item 10, Denver).

2) Langowski – prepare addendum for waiting exhaust requirements (Item 11, Denver).

3) Rousseau – prepare addendum for no lining at high limit humidity sensors (Item 13, Denver).

4) Driss – prepare history of outpatient filtration requirements (Item 19, Denver).

5) Rousseau – prepare revised filtration table (Item 19, Denver).

6) Rousseau – prepare revised switchable controls addendum (Item 20, Denver).

7) All – review ANSI Z9.5 (Item 21, Denver).

27. Next meeting. Winter Meeting, January 21, 2014, New York, NY.

28. Adjournment. Adjournment at approximately 12:53 p.m.

29. List of Attachments

a. Sign-in sheet.

b. Editorial text for OR/Procedure Room terminology changes.

c. Addendum u comment response.

d. Addendum y comment response.

e. KP Interpretation requests.

f. Minutes of June 13, 2013 Conference Call.

g. Addendums List.

h. Addendum ac comment response.

i. Switchable controls.

j. Laboratory presentation.

k. Sterile Storage documentation.

l. Sterile Storage addendum.

6.

7.

m. Voting records (6).

CPR 7/5/13

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Editorial Change From Class A, B, and C to Operating and Procedure Rooms 3. DEFINITIONS classification of surgeries:

Class A surgery: provides minor surgical procedures performed under topical, local, or regional anesthesia without preoperative sedation. Excluded are intravenous, spinal, and epidural procedures, which are Class B or C surgeries. Class B surgery: provides minor or major surgical procedures performed in conjunction with oral, parenteral, or intravenous sedation or performed with the patient under analgesic or dissociative drugs. Class C surgery: provides major surgical procedures that require general or regional block anesthesia and/or support of vital bodily functions.

For more information on this method of classifying surgeries, see ACS (2000) in Informative Annex B: Bibliography.  

6.1 Utilities 6.1.1 Ventilation Upon Loss of Electrical Power. The space ventilation and pressure relationship requirements of Table 7-1 (see page 7) shall be maintained for the following spaces, even in the event of loss of normal electrical power: a. AII rooms b. PE rooms c. Class B & C Operating Rooms, including Delivery Rooms (Caesarean) For further information, see NFPA 99 (2005), in Informative Annex B: Bibliography.  

6.5 Heating and Cooling Systems  

TABLE 6-1 Minimum Filter Efficiencies

Space Designation (According to Function)

Filter Bank Number 1 (MERV)a

Filter Bank Number 2 (MERV) a

Class B&C surgery Operating Rooms, inpatient and ambulatory diagnostic and therapeutic radiology; inpatient delivery and recovery spaces

7 14

Laboratories; Class A surgery Procedure Rooms, and associated semi-restricted spaces

13b N/R*

*NR = not required

Note a: The Minimum Efficiency Reporting Value (MERV) is based on the method of testing described in ANSI/ASHRAE Standard 52.2. (see Informative Annex B: Bibliography.)

Note b: Additional prefilters may be used to reduce maintenance for filters with efficiencies higher than MERV 7.

Note c: As an alternative, MERV-14 rated filters may be used in Filter Bank No. 2 if a tertiary terminal HEPA filter is provided for these spaces.

Note d: High-Efficiency Particulate Air (HEPA) filters are those filters that remove at least 99.97% of 0.3 micron-sized particles at the rated flow in accordance with the testing methods of IEST RP-CC001.3 (see Informative Annex B, Bibliography).

TABLE 6-2 Supply Air Outlets

Space Designation (According to Function) Supply Air Outlet Classificationa All Class A, B and C Surgeries Operating Rooms, Procedure Roomsb Primary Supply Diffusers Group E, non-aspirating

additional Supply Diffusers, Group E

Protective Environment (PE) Rooms Group E, non-aspirating

6.5.3 Radiant Heating Systems. If radiant heating is provided for an AII room, a protective environment room, a wound intensive care unit (burn unit), an Operating Room, or a Procedure Room for any class of surgery, either flat and smooth radiant ceiling or wall panels with exposed cleanable surfaces or radiant floor heating shall be used. Gravity-type heating or cooling units such as radiators or convectors shall not be used in operating rooms and other special care areas.  

6.7 Air Distribution Systems  

6.7.2 Air-Distribution Devices. All air-distribution devices shall meet the following requirements: a. Surfaces of air-distribution devices shall be suitable for cleaning. Supply air outlets in accordance with Table 6-2 shall be used. b. The supply diffusers in Classes B and C surgeries Operating Rooms shall be designed and installed to allow for internal cleaning. c. Psychiatric, seclusion, and holding-patient rooms shall be designed with security diffusers, grilles, and registers.  

7. SPACE VENTILATION 7.1 General Requirements. The following general requirements shall apply for space ventilation:  

4. In AII rooms, protective environment rooms, wound intensive care units (burn units), Operating Rooms, and Procedure rooms for all classes of surgery, heating with supply air or radiant panels that meet the requirements of Section 6.5.3 shall be provided.  

 

7.4 Surgery Rooms

7.4.1 Class B and C Operating Rooms, Operating/Surgical Cystoscopic Rooms, and Caesarean Delivery Rooms. These rooms shall be maintained at a positive pressure with respect to all adjoining spaces at all times. A pressure differential shall be maintained at a value of at least +0.01 in. wc (2.5 Pa). Each room shall have individual temperature control. These rooms shall be provided with primary supply diffusers that are designed as follows:  

7.4.3 Imaging Procedure Rooms. If invasive procedures occur in this type of room, ventilation shall be provided in accordance with the ventilation requirements for Class A surgery Procedure Rooms. If anesthetic gases are administered, ventilation shall be provided in accordance with the ventilation requirements for Class B or C surgery Operating Rooms.  

8. PLANNING, CONSTRUCTION, AND SYSTEM STARTUP  

8.6 Duct Cleanliness. The duct supply system shall meet the following requirements for cleanliness: a. The duct system shall be free of construction debris. New supply duct system installations shall comply with level “B,” the

Intermediate Level of SMACNA Duct Cleanliness for New Construction Guidelines.9 b. The supply diffusers in the Class B & C Operating Rooms shall be opened and cleaned before the space is used. c. The permanent HVAC systems shall not be operated unless protection from contamination of the air distribution system is

provided.  

 

 

TABLE 7-1 Design Parameters

Function of Space

Pressure Relationship to Adjacent Areas

(n)

Minimum Outdoor

ach

Minimum Total ach

All Room Air Exhausted Directly to

Outdoors (j)

Air Recirculated by Means of Room

Units (a)

RH (k) (%)

Design Temperature (l), (°F/°C)

SURGERY AND CRITICAL CARE

Class B and C Operating room, (m),(n) (o) Positive 4 20 N/R No 20-60 68-75/20-24

Operating/surgical cystoscopic rooms, (m), (n) (o) Positive 4 20 N/R No 20-60 68-75/20-24

Delivery room (Caesarean) (m),(n), (o) Positive 4 20 N/R No 20-60 68-75/20-24

Class A Operating/Procedure room (o) (d) Positive 3 15 N/R No 20-60 70-75/21-24

 

 

 

CPR

6/24/13

 

 

 

 

 

 

 

COMMENT Comment Key  7167 Cmnter Number  0001 Cmnt Number  001 Document  BSR/ASHRAE/ASHE Addendum u to ANSI/ASHRAE/ASHE Standard 170‐2008, 

Ventilation of Health Care Facilities (Second Public Review Draft) Review Period  30‐Day Public Review Period from April 19, 2013 to May 19, 2013 Committee  SSPC170 Comment Title  ER Waiting Exhaust Section Type  Table Section Number  7‐1 Supportive  No Comment Text  Since these rooms are occupied with both healthy and sick patients, my comment 

is   “Can the requirement for 10 foot exhaust stacks be eliminated for rooms occupied by both health and sick patients where occupants are not required to where a “gas mask” ? 

 Associated Reference Materials 

No Attachments 

Substantiating Comments 

 

Comment Status* 

New ‐ Submitted 

Administrative Information 

Committee Tag*   

Assigned Responder/SC/WG* 

 

COMMITTEE RESPONSE Committee Notes Change Type  X  None 

  Editorial   Substantive 

 

Resolution Potential 

  No contact required   Contact required   Contacted, likely resolved   Contacted, likely unresolved 

 

General Notes   

Committee Response  Response Status  X  Draft 

  Ready for Approval   Response Approved 

Approval Date Enter date formatted as mm/dd/yyyy 

 

Approval Method    PC Meeting X  Letter Ballot 

 

Approval Location 

 

Committee Response 

  Accepted as submitted   Accepted with minor changes   Accepted in principle   Rejected except as noted   Rejected   More information is needed X  Deferred, Out of Scope   Deferred, Late 

 

Response Text  Thank you for your  comment.   However, your comment is unrelated to the changes proposed by Addendum u.  Consequently, your comment is classified as deferred. The committee will retain your comment for future consideration.    

    

 Response Sent* Do not edit. 

   

Reply Deadline If left blank, the ‘Reply Deadline’ will be set to 30 days from when the response has been sent.   Enter date formatted as mm/dd/yyyy.  

 

Associated Reference Materials 

No Attachments Attachments must be added via the online system following upload. Please note in the “Committee Notes” field, above, if an attachment will be included with the committee response. 

 

Comment on Addendum y Background: I believe having a generic number without referencing the absorbtion distance of the humidifier does not meet the intent of this addendum of making sure any duct linig will not get wet. Humidifier absorption distance depends on air temperature, entering/leaving relative humidity and the mixing level of the air stream. For a single tube dispersion, the absorbtion can reach 9’ to 10’. Addendum r had added the definition of absorbtion distance to the standard. Also, the standard has linked, for example, the rohibition of duct take-offs to the absorbtion distance and not to a generic distance (addendum r, Section 6.4). Furthermore, most manufacturers recomment and most designers incorporate, a high limit humidity sensor well downstream of the humidifier to shut down the humidifier in case of excess water carry over. As as safety precation, it is recommended to prohibit duct lining anywhere upsteram of the high limit humidity sensor as well. Based on the above, I would recommend sub-clause d be reworded as follows: Suggested Change: Duct lining shall not be installed within 15’ downstream of humidifiers or 10’ plus the humidifier absorbtion distance, whichever is greater. Duct lining shall not be installed upstream of any high humidity safety devices installed to shutdown the humidifier in case of excessive water carry over. Committee Response:

Issue 1 – Absorption Distance. a. We agree with this comment, and will incorporate it into the Standard. b. We agree with this comment in principle, however, 10’ plus the absorbtion distance is

difficult for AHJs to enforce, therefore, no change will be made to the Standard. c. We agree with this comment in principle, however, to be consistant with the duct

take-off text, we will modifiy this requirement to simply read: Duct lining shall not be located within the humidifier's absorption distance.

Issue 2 – High Limit Sensor a. We agree with this comment, and will incorporate it into the Standard. b. We agree this is good design practice, but should not be a minimum requirement,

therefore, this will not be incorporated into the Standard. CPR 6/24/13

Page 1 of 1 ©2013 ASHRAE. All Rights reserved.

Interpretation IC 170-2008-X of ANSI/ASHRAE Standard 170-2008 Ventilation of Health Care Facilities

Date Approved:

Request from: Travis R. English ([email protected]), Kaiser Permanente, 4175 E La-Palma Ave, Suite 200, Anaheim, CA 92882. (Phone: 714-469-9553) Reference: This request for interpretation refers to the requirements in ANSI/ASHRAE/ASHE Standard 170-2008, Section 7.1.1b, regarding ventilation rates in spaces other than those found in Table 7-1. Background: Section 7.1.1b states that ventilation rates for many areas not specified in Table 7-1 can be found in ANSI/ASHRAE Standard 62.1-2007. Please confirm that the intent of the phrase “ventilation rates” in section 7.1.1b is to direct users to Part 6 of ANSI/ASHRAE Standard 62.1: Procedures. As such, users could comply using any of the three Procedures in 62.1, Part 6: 6.1.1 Ventilation Rate Procedure, 6.1.2 IAQ Procedure, or 6.1.3 Natural Ventilation Procedure. Interpretation: The intent of the phrase in Section 7.1.1b of Standard 170 is to direct users to Section 6 of ANSI/ASHRAE Standard 62.1-2007 and as such, users can comply by using any of the three procedures in Standard 62.1: Section 6.1.1 Ventilation Rate Procedure, Section 6.1.2 IAQ Procedure, or Section 6.1.3 Natural Ventilation. Question: Is this interpretation correct? Answer: Comments:.

Page 1 of 1 ©2013 ASHRAE. All Rights reserved.

Interpretation IC 170-2008-X of ANSI/ASHRAE Standard 170-2008 Ventilation of Health Care Facilities

Date Approved:

Request from: Travis R. English ([email protected]), Kaiser Permanente, 4175 E La-Palma Ave, Suite 200, Anaheim, CA 92882. (Phone: 714-469-9553) Reference: This request for interpretation refers to the requirements in ANSI/ASHRAE/ASHE Standard 170-2008, Section 7.1.1b and Table 7-1, regarding ventilation rates for Examination rooms. Background: Please refer to part two of a standard Infection Control Risk Assessment Matrix of Precautions for Construction and Renovation available as a resource on the ASHE website at: http://www.ashe.org/advocacy/organizations/CDC/ An exam room in a hospital emergency room, designed to FGI Guidelines Section 2.1-3.2, Common Elements for Hospitals, Examination / Treatment Room or Area, would be considered a “Highest Risk” space on an Infection Control Risk Assessment (ICRA). The ventilation requirement for this space is line 51 of Table 7-1 in Standard 170, “Examination Room”. An exam room in an Ambulatory Care Podiatry Clinic, designed to FGI Section 3.1-3.2, Common Elements for Outpatient Facilities, Examination and Treatment Room, would be considered a “Highest Risk” space on an Infection Control Risk Assessment (ICRA). The ventilation requirement for this space is line 51 of Table 7.1, “Examination Room”. Interpretation: It the intent of Standard 170 that these two areas receive the same prescriptive ventilation treatment, regardless of the difference in infection control risk. Question: Is this interpretation correct? Answer: Comments:.

DEPARTMENT OF HEALTH & HUMAN SERVICES Memorandum Indian Health Service Division of Engineering Services 2201 Sixth Ave MS RX=-24 Seattle, WA 98121 Phone (206) 615-2095 Fax (206) 615-2466

Date June 18, 2013 From Mechanical Engineer,

DES -Seattle

Subject 170, sub committee telcon, Jun 13 2013   To SSPC 170 .

1.   SSPC 170 Clinical sub‐committee, KP Interpretations 

2. Telcon, Jun 13, 2013,   1130am PDT.     

3.   In attendance 

a. Rick b. Mike Mamayek c. Dick d. Russ e. Peter f. Michael Sheerin g. Chris h. Paul 

 

4. Discussed KP interpretation 1 ( referring to Std62.1).   Rick indicated the answer to the interpretation should be Yes; because Natural ventilation was addressed in Standard 62.1 when 170 was developed.   Mamayek explained that during the development of 170, he did not consider use of the natural ventilation procedure in Std 62.1; however he thinks it is applicable.   Sheerin expressed his opinion that the response should be Yes.   Paul concluded that the majority opinion is Yes – [the reference to Std 62.1 in 170 allows the natural ventilation provisions in Std 62.1. ] 

5. Discussed KP interpretation 2 ( exam room question).  Peter reminded that he had presented in St Louis on a proposal to expand the Exam rooms in Std 170.   Russ expressed the opinion that the KP evaluation of the two exam rooms based on the ICRA may be a misapplication of the ICRA.  The general sense from the discussion was that 

Page 2 of 2 – Clinical subcommittee KP interpretation Jun 13 2013

the response to the interpretation should be Yes – (the intent of 170 is that the ventilation for the two exam rooms should be the same).  

Paul Ninomura, P.E. cc: C:\Users\pninomura\Documents\ashrae\2013\Clinical subcommittee KP interpretation Jun 13 2013.doc

revised Jun 15 2013

Tyler Ninomura

Standard 170 Addendums List

PublicationCurrent statusPublication PublicReview

Brief description

PublishedP R Jun 20 -Jun 25,

2009Space Design Parametersa

PublishedPROct14-Nov16,2009

lndoor Ventilation and Health

Care Facility Designb

rescindedcPublishedP R Jun 26 -Jul 10,

2010Humidity Range Lower Limitd

PublishedPRJan29-Feb3,20t7

e Occupied Space

PublishedPR Jan 29 - Feb 3,

20ttAll, PE, and All/PE Room

uirementsf

PublishedPR Jan 29 - Mar 3,

207tVentilation Diffusersg

PublishedPRJun 25-Jul27,20L]-

h Recirculating HVAC Units

Not usedPublishedOct2,20t2

Addendum changed toone filter MERV 13.

2Nd PPR

PR Mar 29 -MaY 9,

207LJune 8, 20L2 to July

8,2012

Filters for Nursing facilitiesj

PublishedJan 26

2073

PPR from Jan 6 to Feb 5,

2072. 5 commentsreceived.

PPR on Jan 6,2OL2.Energy recoveryk

Published Jan 26,2012P R May 27 -JulY

7L,207tL Delivery room editorial change,

Dialysis & Nuclear Medicineadded to Table 7-1

Published Jan26,2072P R May 27 - JulY

LL,?OLIm Ducted return for recovery,

lntensive, intermediate and

woundPublishedJan 26

2073

Responses approved bY

chair May 17,20t2.30-day publicreview Sep 2, 2011

to October 2,207t

Multiple zone system

calculationn

o Office Su al facilitiesPublishedOct 2,

20L2

Responses Approved bY

chair May 17,30-day publicSeptember 2,zOlLto October 2,LOLL

P Nourishment room

PublishedAprovedOct 2,

20t2

Approved for PPR on Mar

7,2Or2o l comment rec'd

Boldt

Public Review Mar23 - May 7,2012

q Pharmacy & areawaYs

r Multiple FGI reconciliationitems

PR Sep 30, 2011 toNov 14, 2011:

Responses tocommenters issued onMar 21. Replies are dueon April4.

Published

June 28,

2012

s Humidifiers and fire smokedampers.

Publíc Review Mar23 - May 7,2012

Approved for PPR on Mar7,2072

PublishedJune 28,

2072t Referrals to FGI corrected 1st PPR June 8, 2Ot2To

July 8,2OI2PublishedOct 2,

2072u Noteq&w 2nd PPR scheduled

for Apr 19, 2013 toMay 19, 2013

Expected approvalDenver

v 20%RH Recovery room Voted for PPR . Sentrecommendation toASHRAE tuly 24,2O!2

PublishedapprovedJan 26

2013w Gl Procedure rm public review

March 22,2Ot3toApril21,2013

Expected approvalDenver

X Hospice & assisted Living Response to commentsLB motion pass Mar 28.

and approved mar 28Expected approvalDenver

v Duct lining 1st PPR scheduledfor Apr 19, 2013 toMav 19, 2013

z ED Exam room 1st PPR scheduledfor Apr 19, 2013 toMay 19, 2013

Expected approvalDenver

aa lndividual temp patient rm Addendum failed9-5-0-1

ab Patient room 4 ACH 1st PPR scheduledfor Apr 19, 2013 toMav 19, 2013

Expected approvalDenver

ac Ducted returns l't PPR May 17,

2013 to June 16,

2013ad Exam rooms CLB due Jul 3

tae FGlcoordination CLB due Jul 3tz OR classification

PublishedJune 28,

2072

Responses tocommenters issued on

Mar 21. Replies are due

on April4.

PR Sep 30, 2011 toNov 14, 2011:

Multiple FGI reconciliationitems

r

PublishedJune 28,

2072

Approved for PPR on Mar

7,2Ot2Public Review Mar23-May7,20!2

Humidifiers and fire smoke

dampers.s

PublishedOct 2,

2072

1st PPR June 8, 2OtZloJuly 8,2OI2

t Referrals to FGI corrected

Expected approvalDenver

2nd PPR scheduledfor Apr 19, 2013 toMav 19, 2013

u Noteq&w

PublishedapprovedJan 26

2013

Voted for PPR . Sent

recommendation toASHRAE July 24,20L2

20%RH Recovery roomv

Expected approvalDenver

public reviewMarch 22,2Ot3toApril 21,2013

Gl Procedure rmw

Response to commentsLB motion pass Mar 28.

and approved mar 28

Expected approvalDenver

x Hospice & assisted Living

lst PPR scheduledfor Apr 19, 2013 toMay 19, 2013

v Duct lining

Expected approvalDenver

1st PPR scheduled

for Apr 19, 2013 toMay 19, 2013

z ED Exam room

Addendum failed9-5-0-1

aa lndividual temp Patient rm

Expected approvalDenver

lst PPR scheduled

for Apr 19, 2013 toMav 19, 2013

ab Patient room 4 ACH

1st PPR May 17,

2013 to June 15,

2013

Ducted returnsac

CLB due Jul 3ad Exam roomsCLB due Jul 3FGI coordinationtae

tz OR classification

 

COMMENT Comment Key  7244 Cmnter Number  0002 Cmnt Number  001 Document  BSR/ASHRAE/ASHE Addendum ac to ANSI/ASHRAE/ASHE Standard 170‐2008, 

Ventilation of Health Care Facilities (First Public Review Draft) Review Period  30‐Day Public Review Period from May 17, 2013 to June 16, 2013 Committee  SSPC170 Comment Title  BSR/ASHRAE/ASHE Addendum ac to ANSI/ASHRAE/ASHE Standard 170‐2008, 

Ventilation of Health Care Facilities ( Section Type  General Section Number  6.7 Air Distribution Systems Supportive  No Comment Text  This is an overall question ‐ is there a clear defintion in the ASHRAE 'requirements 

of what cleary defines an outpatient facility?  Does a Drs office fall under the ASHRAE requirements? Or does only a 'liscenesed' facality fall under ASHRAE? 

 Associated Reference Materials 

No Attachments 

Substantiating Comments 

 

Comment Status* 

New ‐ Submitted 

Administrative Information 

Committee Tag*   

Assigned Responder/SC/WG* 

 

COMMITTEE RESPONSE Committee Notes Change Type  X  None 

  Editorial   Substantive 

 

Resolution Potential 

  No contact required   Contact required   Contacted, likely resolved   Contacted, likely unresolved 

 

General Notes   

Committee Response  Response Status  X  Draft 

  Ready for Approval   Response Approved 

Approval Date Enter date formatted as mm/dd/yyyy 

 

Approval Method  X  PC Meeting   Letter Ballot 

 

Approval Location 

Denver 

Committee Response 

  Accepted as submitted   Accepted with minor changes   Accepted in principle   Rejected except as noted X  Rejected   More information is needed   Deferred, Out of Scope   Deferred, Late 

 

Response Text  In response:  You did not submit a comment; they were questions.   Your comment is rejected because it is not in a format that could be approved.  However, the committee will provide the responses to your questions as follows:   Question 1.  ‐ is there a clear defintion in the ASHRAE 'requirements of what cleary defines an outpatient facility?   Response 1:   No, there is no definition of an outpatient facility in ASHRAE Standard 170.   ASHRAE Standard 170 relies on other documents such as the FGI “Guidelines for Design and Construction of Health Care Facilities, 2010” for this purpose.           Question 2.  Does a Drs office fall under the ASHRAE requirements? Response 2.   The scope of ASHRAE Standard 170 (2. Scope)  does not include private practice doctors offices.    Question 3.  Or does only a 'liscenesed' facality fall under ASHRAE? Response 3.   The scope of ASHRAE Standard 170 (2. Scope)  “applies to patient care areas and related support areas within health care facilities, including hospitals, nursing facilities, and outpatient facilities”   The standard does not address whether a facility is licensed.          

Response Sent* Do not edit. 

   

Reply Deadline If left blank, the ‘Reply Deadline’ will be set to 30 days from when the response has been sent.   Enter date formatted as mm/dd/yyyy.  

 

Associated Reference Materials 

No Attachments Attachments must be added via the online system following upload. Please note in the “Committee Notes” field, above, if an attachment will be included with the committee response. 

 

Addendum w footnote revisons

TABLE 7-1 Design Parameters

Function of Space

Pressure Relationship to Adjacent Areas

(n)

Minimum Outdoor

ach

Minimum Total ach

All Room Air Exhausted Directly to

Outdoors (j)

Air Recirculated by Means of Room

Units (a)

RH (k) (%)

Design Temperature (l), (°F/°C)

 SURGERY AND CRITICAL CARE

Class B and C Operating room, (m),(n) (o) Positive 4 20 N/R No 20-60 68-75/20-24

Operating/surgical cystoscopic rooms, (m), (n) (o) Positive 4 20 N/R No 20-60 68-75/20-24

Delivery room (Caesarean) (m),(n), (o) Positive 4 20 N/R No 20-60 68-75/20-24

DIAGNOSTIC AND TREATMENT Bronchoscopy, sputum collection, and pentamidine administration (n) Negative 2 12 Yes No N/R 68-73/20-23

Autopsy room (n) Negative 2 12 Yes No N/R 68-75/20-24  

n. If pressure monitoring device alarms are installed, allowances shall be made to prevent nuisance alarms. Short term excursions from required pressure relationships shall be allowed while doors are moving or temporarily open. Simple visual methods such as smoke trail, ball-in-tube, or flutterstrip shall be permitted for verification of airflow direction. Controls intended to change the pressure relationship between spaces shall not be permitted.

u. The AII room described in this standard shall be used for isolating the airborne spread of infectious diseases, such as measles, varicella, or

tuberculosis. Supplemental recirculating devices using HEPA filters shall be permitted in the AII room to increase the equivalent room air exchanges; however, the minimum outdoor air changes of Table 7-1 are still required. AII rooms that are retrofitted from standard patient rooms from which it is impractical to exhaust directly outside may be recirculated with air from the AII room, provided that the air first passes through a HEPA filter. When the AII room is not utilized for airborne infection isolation, the pressure relationship to adjacent areas, when measured with the door closed, shall remain unchanged and the minimum total air change rate shall be 6 ach. Switching controls for reversible airflow provisions shall not be permitted.

 CPR 2/3/13 

Suggested Changes to Lab Suggested Changes to Lab ClassificationsClassifications

Unofficial Lab SubcommitteeUnofficial Lab Subcommittee: : Sharp/Langowski/Olmsted Sharp/Langowski/Olmsted

Draft 2014 FGI References to LabsDraft 2014 FGI References to Labs

Draft 2014 FGI References to LabsDraft 2014 FGI References to Labs

FGI does not have the many lab classifications that are in 170

Current 170 Lab ACH Rates Current 170 Lab ACH Rates

These areas are not patient related areas and not governed by healthcare related issues, but are

governed by other standards

Industry Recommendations on Lab ACH Rates Industry Recommendations on Lab ACH Rates

ASHRAE 62.1Reference to Labs

�At best for Univ./college labs: ~ 1.2 ACH fresh air

Industry Recommendations on ACH Rates Industry Recommendations on ACH Rates

No codes other than ASHRAE 62.1

�Exhaust rate guidance only for high school labs

– Only Educational Science Labs (Not University/College Labs)

ASHRAE Recommendations on ACH Rates & DBC ASHRAE Recommendations on ACH Rates & DBC

2011 ASHRAE Handbook, Lab chapter 16:

� …recent university research (Klein et al. 2009) showed a

significant increase in dilution and clearing performance by

increasing the air change rate from 6 to 8 ach with diminishing

returns above 12 ach.

� …This information indicates that minimum ventilation rates at the lower end of the 6 to 12 air change per hour range may not be appropriate for all laboratories.the lower end of the 6 to 12 air change per hour range may not be appropriate for all laboratories.

� …As the operation, materials, and level of hazard of a room change, an increase or decrease in the minimum ventilation rate should be evaluated.

� …Active sensing of the air quality in individual laboratories is an alternative approach for dealing with the variability of appropriate ventilation rates, particularly when energy efficiency is important or when less may be known about the hazard level.

ANSI/AIHA Z9.5 Laboratory Ventilation StandardANSI/AIHA Z9.5 Laboratory Ventilation Standard

Recommended Change to Table 7Recommended Change to Table 7--11

N/RLaboratory work areas (v), (w)

Suggest removing all current lab areas and replace with one area that uses FGI terminology

Recommended Change to Table 7Recommended Change to Table 7--1 Notes1 Notes

Add new note “w” to reference other standards:

(w) Laboratory air change rates in certain laboratory areas may

be appropriately set to higher rates based on the type of use and

level of hazard involved. Relevant standards and information that

may be of assistance in setting appropriate air change rates

include ASHRAE 62.1-2010 (University/college laboratories

category), the ASHRAE 2011 HVAC Applications Handbook category), the ASHRAE 2011 HVAC Applications Handbook

chapter 16, and the ANSI/AIHA Standard Z9.5-2012 on

Laboratory Ventilation. Demand based control of lab air change

rates based on active sensing of contaminants per ASHRAE

2011 HVAC Applications Handbook chapter 16 may also be

considered for energy efficiency.

Adding above note brings 170 into alignment with other more relevant standards and allows for

higher rates where appropriate

Final Open Question on new FGI areaFinal Open Question on new FGI area

Do we need to add “Specimen Collection Facilities”

� Is this a treatment or examination room?

� Is this a new area category?

Table 7-1 lists about 90 spaces. A subset of that total

includes certain spaces which meet ALL these criteria:

Spaces which are not required to be all exhausted.

Spaces which do not have inherent asepsis and

contaminant control functions.

Spaces where recirculated room units dedicated to

serving that single space ARE allowed.

Spaces where the minimum Total ACH required is

greater than the minimum outdoor ACH required.

Spaces that do not ever house patients.

Five spaces in the Table meet ALL of the above five

criteria.

Space Min OA ACH Min Total ACH

Lab, media transfer 2 4

Pharmacy 2 4

Sterile storage 2 4

Clean linen storage N/R 2

Clean workroom or clean

holding

2 4

Deleting pharmacy and the lab from the list, just

because it’s a whole ‘nuther issue.

Note: (From FGI 2014 draft):

Clean linen storage can be within a portion of

a clean workroom, within a separate closet, or in a

covered cart located in an alcove in a corridor:

Q: Then why do we require 2 ACH of outdoor air to the

unoccupied sterile storage and clean holding but not in

the clean linen storage?

A: Not sure; We can positively pressurize all three

spaces with air that is not 100% outdoor air.

FGI 2006 did not have ANY outdoor ACH requirements

for these spaces:

1. clean linen storage,

2. clean workroom,

3. sterile storage.

Respectively request SSPC 170 to consider an addenda to

revise these two spaces as follows.

Inserted two unchanged spaces for clarity of the big picture in the

mini-table below.

Unchanged space notes:

1. Clean workroom does not allow recirc units.

2. Clean linen storage entry currently exists with N/R & 2 under the

SERVICE heading.

Space Min OA ACH Min Total ACH

CENTRAL MEDICAL AND

SURGICAL SUPPLY

Clean Workroom 2 4

Sterile Storage Clean Supply

Room

2 N/R 4 2

SERVICE

Clean linen storage N/R 2

SUPPORT SPACE

Clean workroom or clean

holding Clean linen storage

2 N/R 4 2

Standard 170 scope paragraph 2.3 scope review.

Does a minimum 2 ACH total air change rate in these two

spaces affect the scope of the Standard?

Does a No Requirement (N/R) for outdoor ACH air change

rate in these two spaces affect the scope of the Standard?

The Three Scope Questions of 170 paragraph 2.3:

Q1: Does reduced ACH affect contaminants affecting

delivery of medical care to patients?

A1: There are no inherent asepsis issues in the

programmed use of these two spaces because there are no

patients within these spaces and all the sterile items are

sealed closed in the clean workroom before they ever get

to these spaces. The recirculating FCU will blow any

unprogrammed contaminated air round and round in each

of these spaces either way.

Q2: Does reduced ACH affect the convalescence of

patients?

A2: The sealed sterile items are not opened up and

delivered to patients within these two spaces.

Q3: Does reduced ACH affect the safety of patients,

healthcare workers and visitors?

A3: No safety issues perceived.

BSR/ASHRAE/ASHE Addendum ?

to ANSI/ASHRAE/ASHE Standard 170-2008

_____________________Public Review Draft

Proposed Addendum ? to Standard 170-2008, Ventilation of

Health Care Facilities

First Public Review (Mar 2013) (Draft shows Proposed Changes to Current Standard)

This draft has been recommended for public review by the responsible project committee. To submit a comment on this proposed standard, go to the ASHRAE website at www.ashrae.org/standards-research--technology/public-review-drafts and access the online comment database. The draft is subject to modification until it is approved for publication by the Board of Directors and ANSI. Until this time, the current edition of the standard (as modified by any published addenda on the ASHRAE website) remains in effect. The current edition of any standard may be purchased from the ASHRAE Online Store at www.ashrae.org/bookstore or by calling 404-636-8400 or 1-800-727-4723 (for orders in the U.S. or Canada). This standard is under continuous maintenance. To propose a change to the current standard, use the change submittal form available on the ASHRAE website, www.ashrae.org. The appearance of any technical data or editorial material in this public review document does not constitute endorsement, warranty, or guaranty by ASHRAE of any product, service, process, procedure, or design, and ASHRAE expressly disclaims such. © 2012 ASHRAE. This draft is covered under ASHRAE copyright. Permission to reproduce or redistribute all or any part of this document must be obtained from the ASHRAE Manager of Standards, 1791 Tullie Circle, NE, Atlanta, GA 30329. Phone: 404-636-8400, Ext. 1125. Fax: 404-321-5478. E-mail: [email protected]. ASHRAE, 1791 Tullie Circle, NE, Atlanta GA 30329-2305

(This foreword is not part of this standard. It is merely informative and does not contain requirements necessary for conformance to the standard. It has not been processed according to the ANSI requirements for a standard and may contain material that has not been subject to public review or a consensus process. Unresolved objectors on informative material are not offered the right to appeal at ASHRAE or ANSI.)

FOREWORD This addenda clarifies requirements for an certain clean spaces. The space name terminology is revised to better correlate with FGI Guidelines for Design and Construction of Health Care Facilities. It also reflects that certain unoccupied storage spaces do not require a minimum requirement for outdoor ventilation air change rates. [Note to Reviewers: This addendum makes proposed changes to the current standard. These changes are indicated in the text by underlining (for additions) and strikethrough (for deletions) except where the reviewer instructions specifically describe some other means of showing the changes. Only these changes to the current standard are open for review and comment at this time. Additional material is provided for context only and is not open for comment except as it relates to the proposed changes.] Addendum ? to 170-2008

Revise Table 7-1 and its notes as shown below. Table 7-1 and the notes were modified by several addenda to Standard 170-2008 currently published for free on the ASHRAE website at http://www.ashrae.org/standards-research--technology/standards-addenda. The remainder of Table 7-1 remains unchanged.

Table 7-1 Design Parameters

Function of Space

Pressure Relationship to Adjacent Areas

(n) Minimum

Outdoor ach Minimum Total ach

All Room Air Exhausted Directly to

Outdoors (j)

Air Recirculated by means of Room Units

(a)

Design Relative

Humidity (k), (%)

Design Temperature

(l), (°F/°C)

CENTRAL MEDICAL AND SURGICAL SUPPLY Sterile storage Clean supply room Positive 2 N/R 4 2 N/R N/R max 60 72-78/22-26

SUPPORT SPACE

Clean workroom or clean holding Clean linen storage Positive 2 N/R 4 2 N/R N/R N/R N/R

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 1 Moved by Rousseau Seconded Seth Motion To approve the editorial changes agreed upon in the meeting, to reflect new terminology

for Operating Rooms classification. Note: Voting members understood that this vote was for editorial changes, and no public review would be implemented.

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest x James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User x Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 4 0 0 0 4 General Interest 2 0 0 2 4 Infection Control Practitioner 0 0 0 1 1 Producer 2 0 0 1 3 User 2 0 0 1 3

TOTAL 10 0 0 5 15

PASSED x FAILED

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S):

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 2 Moved by Rousseau Seconded Langowski Motion To approve Addendum y comment response #1b and #2a (modified).

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest x James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User x Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 4 0 0 0 4 General Interest 2 0 0 2 4 Infection Control Practitioner 0 0 0 1 1 Producer 2 0 0 1 3 User 2 0 0 1 3

TOTAL 10 0 0 5 15

PASSED x FAILED

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S):

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 3 Moved by Ninomura Seconded Rousseau Motion To approve the response to KP Interpretation Request #1 as Yes.

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest x James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User x Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 4 0 0 0 4 General Interest 2 0 0 2 4 Infection Control Practitioner 0 0 0 1 1 Producer 1 0 1 1 3 User 2 0 0 1 3

TOTAL 9 0 1 5 15

PASSED x FAILED

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S): Kloostra indicated he was not familiar with the current requirements of Standard 62.1 in this context.

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 4 Moved by Ninomura Seconded Rousseau Motion To approve the response to KP Interpretation Request #2 as Yes.

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest x James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User x Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 4 0 0 0 4 General Interest 2 0 0 2 4 Infection Control Practitioner 0 0 0 1 1 Producer 2 0 0 1 3 User 2 0 0 1 3

TOTAL 10 0 0 5 15

PASSED x FAILED

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S):

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 5 Moved by Ninomura Seconded Seth Motion To approve the response to the comment on Addendum ac as Accepted, as submitted.

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest x James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User NP Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 4 0 0 0 4 General Interest 2 0 0 2 4 Infection Control Practitioner 0 0 0 1 1 Producer 2 0 0 1 3 User 1 0 0 2 3

TOTAL 9 0 0 6 15

PASSED x FAILED

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S):

Version 3/18/2011

SSPC 170 - Roll Call Vote Record

Date 6/25/13 Motion # 6 Moved by Langowski Seconded Rousseau Motion To approve the draft of a proposed Addendum, regarding clean storage, to Standard 170-

2008 for publication public review. Note: Voting members understood that these votes were for public review and, if no comments or only supportive comments were received, subsequent publication.

X denotes votes cast NP denotes not present CLB denotes votes cast by Continuation Letter Ballot CNV denotes Chair Not Voting

SSPC VOTING MEMBERS INTEREST CATEGORY YES NO ABSTAIN NOT VOTING

Paul Ninomura, Chair General Interest x Chris Rousseau, Co-Vice Chair Designer x Michael Sheerin, Co-Vice Chair Designer x Douglas Erickson General Interest NP James (Skip) Gregory User NP Richard Hermans Producer NP Marvin (Leon) Kloostra Producer x Peter Langowski Designer x Michael Mamayek General Interest NP Farhad Memarzadeh General Interest NP Richard Moeller Designer x Heather Platt User NP Anand Seth User x Gordon Sharp Producer x Andrew Streifel Infection Control Practitioner NP

Interest Category Yes No Abstain Not Voting TOTAL Designer 3 1 0 0 4 General Interest 0 0 1 3 4 Infection Control Practitioner 0 0 0 1 1 Producer 2 0 0 1 3 User 1 0 0 2 3

TOTAL 6 1 1 7 15

PASSED FAILED Status pending letter ballot.

REASONS FOR NEGATIVE VOTE(S): REASONS FOR ABSTENTION(S): Ninomura indicated he needed more time for consideration.

ASHRAE SSPC 170

Meeting Minutes Clinical Sub-Committee Meeting Annual Meeting Denver, CO June 24, 2013

1. Meeting opened. The meeting was opened by Chair Ninomura at 4:00 p.m.

2. Attendance:

a. See attached sign-in sheet for other attendees.

3. FGI Guidelines for Residential Health Care. Jane Rhode explained the new chapters that will be included in the new Residential Guidelines book. Three occupancies will reference Standard 170: Nursing Homes, Hospice, and Assisted Living. Rousseau indicated that the Standard 170 probably needs some work to adequately support these occupancies, and encouraged additional discussion between our committee and Jane’s.

4. Interpretation Requests. Travis English presented a discussion about two outstanding Interpretation Requests, regarding use of Standard 62 in health care, and the need for different levels of ventilation in exam rooms for differing levels of risk. A copy of his presentation is attached.

5. Addendum ac comment. Ninomura presented a response to the comment received during the public review of this addendum (copy attached). A straw vote of the voting members in attendance (10) indicated support for an Accepted, as submitted response.

6. Clean Storage. Langowski presented a recommendation to redefine and reduce air change rates for several clean spaces in Table 7-1. A copy of his presentation is attached. This will be discussed further at the main committee meeting.

7. OR air distribution. Kloostra presented some additional work done in his laboratory indicating preferable airflow over operating room tables with the used of air curtains surrounding the unidirectional airflow diffusers. He asked for SSPC 170’s support in the research on this topic being advanced in TC 9.6.

8. Adjournment. Adjournment at approximately 6:15 p.m.

9. List of Attachments

a. Sign-in sheet.

b. KP Interpretation requests.

c. Sterile Storage presentation.

d. OR air distribution presentation.

CPR 7/5/13

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