Transcript 2009 Influenza A & Building’s Indoor Air

Airborne Pandemic nH1N1
Swine Flu in Buildings
Proactive Strategies for
Property Managers
International Facility Managers Association
Atlanta Chapter
September 10, 2009
Steven Welty CAFS, CIE, LEED AP
Green Clean Air Reston, VA
703.927.7532
[email protected]
During the Swine Flu Pandemic
Keep your Building’s Air Safe
Protect Your Occupants’ Health by
Preventing Airborne Virus Transmission.
This will:
1. Keep The Building Open
2. Assure Business Continuity
3. Keep tenants happy
The 2009 Swine Flu Pandemic is
being caused by a Novel Influenza
Virus called nH1N1
•The “n” before H1N1 denotes that it is a Novel virus.
•Novel viruses cause pandemics because no one has
immunity antibodies to the novel virus.
•INFECTED PERSONS can transmit virions before they
become physically sick.
•Infected persons who don’t have physical symptoms can
still be infectious and are called asymptomatics.
•Infected persons can eject airborne virions into the air by
coughing, sneezing, talking or singing.
•In addition, the flushing action of a toilet can eject virions
into the air.
Indoor Air Can Recirculate Airborne
Viruses Which Make People Sick
1. Return air sucks in viruses and redistributes those viruses
back into occupied spaces,
2. In wintertime, dry outdoor air + heat = dry indoor air =
the perfect environment for airborne virus transmission
(contagion),
3. Dry indoor air dries out occupant’s mucus lining which
compromises their natural filtration system making it
easier to get sick.
©2009 Steven Welty
4
CDC’s Top Influenza Scientist
states that flu is Airborne
Nancy J. Cox PhD Director of CDC Influenza Division
“It is generally accepted that influenza viruses are spread primarily
by aerosols* of virus-laden respiratory secretions that are expelled
into the air during coughing, sneezing, or talking by an infected
person.”
From : Virology 2005 (Medical School Textbook and Doctor Reference book)
*Droplet Nuclei which can stay airborne indefinitely- Aerosols are Not Large Droplets which can
infect at @ 3-6 feet away and quickly fall to the ground.
©2009 Steven Welty
5
ASHRAE says that the
Swine Flu Virus is Airborne
“While the long-standing public health view is that influenza
transmission occurs through direct contact or large droplets,
newer data suggests it also occurs through the airborne route,
meaning HVAC&R systems may contribute far more to
transmission of the disease and, potentially, to reduction of that
same transmission risk.”
Gordon Holness, President of ASHRAE (American Society of Heating,
Refrigerating and Air-Conditioning Engineers Atlanta, GA)
Scientists from the Prestigious RAND Center
for Domestic and International Health Security
state that the Swine Flu Virus is Airborne
“Experience from seasonal influenza also provides evidence of
contact, droplet and aerosol transmission of influenza that lend
support for N95 respirators, which are designed to stop up to
95% of small airborne particles.”
Non-pharmaceutical public health interventions for pandemic influenza
Published in: BMC Public Health Journal 2007
Infectious Disease Professor Dr. John J Treanor
describes Airborne Influenza Virus
“Influenza virus infection is acquired by a mechanism involving the
transfer of virus-containing respiratory secretions from an infected to a
susceptible person. A number of lines of evidence indicate that small
particle aerosols are the predominant factor in such person-to-person
transmission.
The explosive nature and simultaneous onset in many persons suggest
that a single infected person can transmit virus to a large number of
susceptible persons.”
©2009 Steven Welty
8
British Scientists state that Influenza
infection is by Airborne Transmission
“Influenza viruses are highly infectious, being readily
transmitted in both large and small droplets. It is the
small-droplet spread which accounts for the explosive
nature of influenza outbreaks in closed environments,
where one infected person can potentially infect a large
number of susceptible hosts.”
Donald Jeffries & Celia Aitken Department of Virology-Royal
London Hospital
Published in: Clinical Microbiology Reviews July 2001 Page 532)
©2009 Steven Welty
9
More Leading Influenza Scientists who
state that Influenza is Airborne
Professor Peter Wright- Vanderbilt- School of Medicine
Professor Gabrielle Neumann- University of Wisconsin
Professor Yoshihiro Kawaoka- University of Tokyo
“The incubation period is about 3 days for influenza A viruses (H1N1). The
most effective means of spread among humans are (airborne) aerosols.
Most aerosol droplets formed during sneezing or coughing are less than
2µm (microns) in diameter and are preferentially deposited in the lower
airways of the lung.”
©2009 Steven Welty
10
The New Swine Flu Virus
will Kill Many People
September 2009
1,700 total deaths linked to nH1N1
Many victims are healthy people under 30
nH1N1 causes more vomiting & diarrhea
We are not yet into flu Season: Oct-March
©2009 Steven Welty
11
The Flu Virus is the perfect
airborne smart bomb
1. Flu Virions are so microscopic they can float for
days in building’s indoor air.
2. Flu Virions invade their hosts and use them to
make billions of clones of themselves.
3. Flu Virions can hide in people’s bodies (not
making them sick) but the person can still infect
others with the flu. (Asymptomatics)
©2009 Steven Welty
12
nH1N1 “Swine Flu” has Swine,
Bird, Human Flu RNA
©2009 Steven Welty
13
©2009 Steven Welty
14
©2009 Steven Welty
15
©2009 Steven Welty
16
©2009 Steven Welty
17
What’s Influenza A Virus &
How does it infect people?
Influenza A causes disease primarily in the lungs as it loves to infect
the lower respiratory system.
It is not a rhinovirus which primarily causes infection in the nose and
upper respiratory system.
Washing your hands will do little to prevent flu viruses from entering
deep into your lungs unless you put your finger into your nose.
Touching your mouth or eye has not been shown to transmit
Influenza Infection.
NO matter how sterile your hands are, you’ll still be fully exposed to
airborne Influenza viruses entering and depositing into your lungs to
cause disease.
©2009 Steven Welty
18
How does Influenza A
Virus kill people?
Influenza A likes to multiply at 98.6° which is the temperature of the lower
respiratory system. (The upper respiratory system- nasal cavity & pharynx- are
approx. 93° which rhinoviruses favor for multiplication).
Influenza A infects and destroys its victim’s lung surface tissue (the
epithelium). The damaged lung tissue has compromised its protective layers
which can lead to pneumonia or massive bacterial infection.
Victims may die from aggressive Staph infections like Methicillin Resistant
Staphylococcus Aureus (MRSA) or Strep.
©2009 Steven Welty
19
NIOSH scientists captured thousands of
airborne viruses in a Hospital’s air
As recent as 2004, Harvard’s Don Milton said: “infectious aerosols are
usually extremely dilute, and it is hard to collect and culture fine
particles.” NEJM 4.22.04
Air testing equipment has finally improved enough to meet the challenge
of finding airborne virions.
In 2008, NIOSH found 15,000 airborne flu viruses in just one area of a
hospital waiting room. Remember: it can take just 1 (one) airborne flu
virus to infect and sicken you with the flu.
©2009 Steven Welty
20
If I’m now infected with the
H1N1 Swine Flu Virus……
1. How long will it take me to infect everyone
in this room? (1-2 hours depending on
humidity, air flow patterns and air exchange
rates)
2. How long will it take for me to infect everyone
in this building? (varies depending on
humidity, the HVAC system configuration, air
sterilization & purification systems)
©2009 Steven Welty
21
Public Health Officials advice on
preventing the Swine Flu Pandemic:
1. Wash your hands.
2. Cover your cough.
3. If you’re sick, stay home.
This advice ignores studies showing that 30-50% of infected
influenza carriers have NO symptoms. (Asymptomatics)
It also ignores both human airway and toilet water viral
aerosolization. These both are critical modes of airborne contagion
within a building’s indoor spaces.
©2009 Steven Welty
22
Here’s a short list of Human Indoor
Airborne Virus Transmission Issues:
1. How can people eject Flu Viruses into the Air?
2. What different forms can airborne viruses take?
3. How far can those viruses travel & how can they
circulate within buildings and inside their HVAC units?
4. What conditions increase Airborne Flu Viruses Survival?
5. What Systems are Available to Sterilize, Capture and/or
Kill Airborne Flu Viruses?
Airborne Transmission depends on people to
launch viruses into the air. People can shed
this many Flu Viruses into the air:
1. Coughing
300+
2. Sneezing
300+
3. Breathing Nose-Few Mouth-10+
4. Talking/Singing
100+
5. Vomiting
100+
6. Diarrhea*
2,000+
*As a Result of Toilet Water Aerosolization
©2009 Steven Welty
24
How far can Airborne Viruses Travel?
Large/Small Droplets
Droplet Nuclei
1. Coughing
1-6 feet
160+ feet
2. Sneezing
8-15 feet
160+ feet
1-3 feet
160+ feet
4. Mouth Breathing 1-3 feet
160+ feet
5. Diarrhea*
160+ feet
3. Singing, Talking
6 feet+
*As a Result of Toilet Water Aerosolization and Mechanical Fan
Dispersion into outdoor air (2003 Hong Kong SARS Virus Epidemic)
Infectious Droplets & Droplet Nuclei
©2009 Steven Welty
26
Infectious Droplets & Droplet
Nuclei travel lengths
©2009 Steven Welty
27
1 Person Coughing out 900 virions
can infect 300 People
©2009 Steven Welty
28
Droplet Nuclei Travel Within Buildings
©2009 Steven Welty
29
Microscopic Particles are measured
in Micrometers or Microns
• The scientific symbol for a micron is: µm.
• A micron or 1/1,000,000 of a meter.
• The smallest particle size you can see is
30µm and that is a tiny, tiny speck. You’ll
never ever see an airborne virion.
©2009 Steven Welty
30
Airborne Influenza Virions (.3-2µ) penetrate
deep into the lungs producing fill blown flu illness.
©2009 Steven Welty
31
Large Droplet Influenza (10µ) does NOT
Penetrate into the lungs and therefore
DOESN’T produce fill blown flu illness.
©2009 Steven Welty
32
Toilet Aerosolization Droplet Nuclei
Recirculation in buildings
©2009 Steven Welty
33
Proactive Toilet Aerosolization
Droplet Nuclei Infection Prevention
©2009 Steven Welty
34
Air Filters, UV Lights and Photo-catalytic Oxidation
Can Kill, Sterilize & can Capture Viral Droplet Nuclei
©2009 Steven Welty
35
Buildings are Ideal Swine Flu
Transmission Locations
Dry environments! In winter Many buildings have 20-30% relative humidity levels
indoors! This is the PERFECT environment for airborne Viral transmission and
contagion.
Low MERV Filter Ratings! Many building have low MERV rated filters like MERV 10.
You need a MERV 13 or higher to have any real effect on airborne viral capture.
No Ultraviolet Lights! Few non-Federal buildings use ultraviolet lights. Buildings with
UV lights have enjoyed lower airborne viral transmission rates and higher indoor air
quality.
Bathrooms with ceiling exhaust fans! Airborne aerosolized viruses will infect bathroom
users in addition to returning into the Building through the fresh air ventilation ducts.
Air Recirculation! HVAC systems are constantly recirculating viruses to infect more
victims.
©2009 Steven Welty
36
Indoor Air Doesn’t Have to
Infect People with Swine Flu!
All you have to do is fix these three things:
1. Air Filtration & UV Sterilization systems
2. Increase Winter Humidity
3. Direct Bathroom Air down & away
from the Breathing Zone. Sterilize air before
exhausting outdoors.
©2009 Steven Welty
37
AIrborne Influenza A (H1N1) Building Safety Guide:
These are the calculated Influenza capture and/or sterilization
rates in one pass within a surveyed office building
Filter M.E.R.V. Rating -% of Influenza Captured
6
7
8
6.2%
7%
11%
10
13
15
12%
46%
71%
16
76%
HEPA
99.9%
Ultraviolet Irradiation Output -% of Influenza Sterilized
UVR-6
UVR-7
UVR-8 UVR-10 UVR-13
UVR-15
UVR-16
(75mw *) (100mw ) (150mw ) (500mw ) (2,000mw ) (4,000mw ) (5,000mw )
4.4%
5.8%
8.5%
25.7%
69.5%
90.7%
94.9%
*mw=microwatts
UV Irradiation & Filters-% of Influenza Sterilized
UVR-6
UVR-7
UVR-8
UVR-10
UVR-13
UV R-15
UVR-16
MERV 6 MERV 7 MERV 8 MERV 10 MERV 13 MERV 15 MERV 16
10%
12%
19%
35%
84%
97%
98.8%
This guide shows how much influenza virus can recirculate in buildings with MERV
10 or below filters. A MERV 13 filter along with a UV system rated at UVR 13
may capture or sterilize 84% of airborne influenza viruses in just one pass.
Steven Welty LEED AP, CIE, CAFS
Green Clean Air
©2009 Steven Welty
Adapted f rom ÒModeling I mmune Building Systems f or Bioterrorism Def enseÓ
Journal of Architectual Engineering June 2003
703.927.7532
38
Combined UV Light & Filtration can Kill
or Sterilize Flu this % of Viruses:
MERV & UVR Combined
6
7
8
10
13
15
16
17
%Viruses Killed/Sterilized
10%
12%
19%
35%
84%
97%
98.8%
99.9+
©2009 Steven Welty
39
Recommendations….
1. Seal your filter rack & HVAC system
2. Keep wintertime humidity @ 40% or more.
3. Get the Highest MERV rated filter that your filter rack and air
handling fan can tolerate.
4. Put as much UV light within your coil plenum to achieve a
99% single pass kill rate.
5. Increase air exchange rates.
6. Configure air supply vents to direct air down to prevent
droplet nuclei from staying airborne.
7. Install Photocatalytic Oxidation and Bi-Polar Ionization for
additional viral sterilization.
8. Install bathroom exhausts 1-12” above the floor.
9. Coughing or sneezing occupants must stay at home or wear a mask.
©2009 Steven Welty
40
Airborne Pandemic nH1N1
Swine Flu in Buildings
Proactive Strategies for
Property Managers
International Facility Managers Association
Atlanta Chapter
September 10, 2009
Steven Welty CAFS, CIE, LEED AP
Green Clean Air Reston, VA
703.927.7532
[email protected]