Abstract
Laminar airflow (LAF) is essential for maintaining a sterile environment in operating rooms, but its rapid unidirectional flow decay leads to low airflow efficiency and increases energy consumption. The objective of this study is to investigate the energy-saving and air quality benefits of using a low-turbulence air curtain around laminar airflow, which is referred to as protective laminar airflow (PLAF). Numerical simulations were used to model airflow and particle transport, and a series of experiments were conducted in a real operating room at St. Olavs Hospital, Norway, to validate the simulation results. The findings indicate that when the unidirectional airflow supply velocity is maintained at 0.25 m/s, combined with an air curtain that has the width of 2 cm and the velocity of 1.5 m/s, the PLAF system outperforms the conventional LAF system operating at a unidirectional airflow supply velocity of 0.30 m/s. This configuration results in a 17.3% energy saving, showing the potential of this airflow distribution strategy to enhance both cleanliness and energy efficiency.
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Abbreviations
- c :
-
volume concentration of bacteria-carrying particles (CFU/m3)
- C 1, C 2, C 1ε, C 3ε :
-
model coefficients
- d :
-
diameter of particulate matter(m)
- \(\overline{d}\) :
-
average diameter of particulate matter(m)
- F :
-
body force per unit mass (m/s2)
- F D :
-
drag factor or inverse of relaxation time (s−1)
- g :
-
gravitational acceleration (m/s2)
- G AHU :
-
mass flow of air from AHU (kg/h)
- G k, G b :
-
turbulent kinematic energy production terms (J/(m3·s))
- G out :
-
mass flow of fresh air (kg/h)
- G return1 :
-
mass flow of air that return to AHU (kg/h)
- G return2 :
-
mass flow of air that mixed with air from AHU (kg/h)
- Gsupply :
-
mass flow of supply air (kg/h)
- h AHU :
-
specific enthalpy of air from AHU (kJ/kg)
- h out :
-
specific enthalpy of fresh air (kJ/kg)
- h i :
-
enthalpy of state point i (kJ/kg)
- h mix1 :
-
specific enthalpy of the mixed air, which consist of the fresh air and the returned air (kJ/kg)
- h mix2 :
-
specific enthalpy of the mixed air, which consist of the returned and the air from AHU (kJ/kg)
- h return1 :
-
specific enthalpy of the air returned to mixed with fresh air (kJ/kg)
- h return2 :
-
specific enthalpy of the air returned to mixed with air from AHU (kJ/kg)
- h supply :
-
specific enthalpy of the supply air (kJ/kg)
- k :
-
turbulent kinetic energy (m2/s2)
- P :
-
mean static pressure (Pa)
- P f :
-
total pressure of the fan (Pa)
- Q :
-
airflow rate (m3/s)
- Q fan :
-
airflow rate of the fan (m3/s)
- q s :
-
source term
- S k, S ε :
-
source term (kg/(m·s3), kg/(m·s4))
- t :
-
time (s)
- u i :
-
mean velocity in the ith direction (m/s)
- u ip :
-
particle velocity (m/s)
- W terminal :
-
energy consumed by terminal devices (kWh)
- W AHU :
-
energy consumed by air handling unit (kWh)
- W fan :
-
energy consumed by fan (kWh)
- W hp :
-
energy consumed by heat pump (kWh)
- W total :
-
total energy consumed by the ventilation system (kWh)
- x i :
-
spatial coordinate in the ith direction (m)
- y + :
-
non-dimensional wall distance
- Y :
-
probability that the particle size is larger than d
- δ ij :
-
Kronecker delta
- ε :
-
turbulence dissipation rate (m2/s3)
- η :
-
fan efficiency
- μ :
-
dynamic viscosity (kg/(m·s))
- μ t :
-
turbulent viscosity ratio (kg/(m·s))
- ν :
-
kinematic viscosity (m2/s)
- ρ :
-
fluid density (kg/m3)
- ρ p :
-
particle density (kg/m3)
- σ ε, σ k :
-
model coefficients
- ϕ :
-
transported quantity
References
Aganovic A, Cao G, Stenstad LI, et al. (2017). Impact of surgical lights on the velocity distribution and airborne contamination level in an operating room with laminar airflow system. Building and Environment, 126: 42–53.
Allegranzi B, Bagheri Nejad S, Combescure C, et al. (2011). Burden of endemic health-care-associated infection in developing countries: Systematic review and meta-analysis. Lancet, 377: 228–241.
Alsved M, Civilis A, Ekolind P, et al. (2018). Temperature-controlled airflow ventilation in operating rooms compared with laminar airflow and turbulent mixed airflow. Journal of Hospital Infection, 98: 181–190.
Amiraslanpour M, Ghazanfarian J, Nabaei H, et al. (2020). Evaluation of laminar airflow heating, ventilation, and air conditioning system for particle dispersion control in operating room including staffs: A non-Boussinesq Lagrangian study. Journal of Building Physics, 45: 236–264.
ANSYS (2011). Fluent A. Ansys fluent theory guide. Ansys Inc., USA.
Bolten A, Kringos DS, Spijkerman IJB, et al. (2022). The carbon footprint of the operating room related to infection prevention measures: A scoping review. Journal of Hospital Infection, 128: 64–73.
Buchberg H, Lilly GP (1974). Model studies of directed sterile air flow for hospital isolation. Annals of Biomedical Engineering, 2: 106–122.
Bulitta C, Vasiuk S, Vasylchyshyn Y, et al. (2020). Clinical validation and efficacy of a temperature-controlled ventilation system (TcAF) in the OR to reduce surgical site infections. Current Directions in Biomedical Engineering, 6: 301–303.
Cacciari P, Giannoni R, Marcelli E, et al. (2004). Cost evaluation of a ventilation system for operating theatre: An ultraclean design versus a conventional one. Annali di igiene, 16: 803–809.
Caknis N (1975). Prevention of hazardous pollution in hospital operating theatres with the use of mechanical systems. South African Medical Journal, 49: 2255–2264.
Cao G, Kilpeläinen S, Sirén K (2018a). Experimental study of the transverse diffusion of pollutants through a downward plane jet in a room. International Journal of Ventilation, 17: 81–92.
Cao G, Storås MCA, Aganovic A, et al. (2018b). Do surgeons and surgical facilities disturb the clean air distribution close to a surgical patient in an orthopedic operating room with laminar airflow? American Journal of Infection Control, 46: 1115–1122.
Cao G, Nilssen AM, Cheng Z, et al. (2019). Laminar airflow and mixing ventilation: Which is better for operating room airflow distribution near an orthopedic surgical patient? American Journal of Infection Control, 47: 737–743.
Chow TT, Lin Z, Bai W (2006). The integrated effect of medical lamp position and diffuser discharge velocity on ultra-clean ventilation performance in an operating theatre. Indoor and Built Environment, 15: 315–331.
DIN (2008). DIN 1946-4:2008-12 Ventilation and air conditioning - Part 4: Ventilation in buildings and rooms of health care. Deutsches Institut für Normung, German.
Fan M, Cao G, Pedersen C, et al. (2021). Suitability evaluation on laminar airflow and mixing airflow distribution strategies in operating rooms: A case study at St. Olavs Hospital. Building and Environment, 194: 107677.
GB (2013). GB 50333-2013 Architectural technical code for hospital clean operating department. Ministry of Housing and Urban-Rural Development, China.
Gholami Motlagh V, Ahmadzadehtalatapeh M (2022). Optimization of air distribution patterns by arrangements of air inlets and outlets: Case study of an operating room. Journal of Applied and Computational Mechanics, 8: 809–830.
Hansen D, Krabs C, Benner D, et al. (2005). Laminar air flow provides high air quality in the operating field even during real operating conditions, but personal protection seems to be necessary in operations with tissue combustion. International Journal of Hygiene and Environmental Health, 208: 455–460.
Hinds WC, Zhu Y (2022). Aerosol Technology: Properties, Behavior, and Measurement of Airborne Particles, 3rd edn. New York: Wiley.
Hoffman PN, Williams J, Stacey A, et al. (2002). Microbiological commissioning and monitoring of operating theatre suites. Journal of Hospital Infection, 52: 1–28.
Holmer H, Bekele A, Hagander L, et al. (2019). Evaluating the collection, comparability and findings of six global surgery indicators. British Journal of Surgery, 106: e138–e150.
Howorth HF (1987). Prevention of airborne infection in operating rooms. Journal of Medical Engineering & Technology, 11: 263–266.
HTM 03-01 (2007). Specialised ventilation for healthcare premises. Part B: The management, operation, maintenance and routine testing of existing healthcare ventilation systems. National Health Service, UK.
Hu N, Lans J, Gram A, et al. (2024). Ventilation performance evaluation of an operating room with temperature-controlled airflow system in contaminant control: A numerical study. Building and Environment, 259: 111619.
Jiang J, Hu B, Ge T, et al. (2022). Comprehensive selection and assessment methodology of compression heat pump system. Energy, 241: 122831.
JTC (2000). Control and prevention of tuberculosis in the United Kingdom: Code of practice 2000. Joint Tuberculosis Committee of the British Thoracic Society. Thorax, 55: 887–901.
Kovalenko M (2013). Comparative analysis of European and Russian standards for ventilation of operating rooms in hospitals. Bachelor Thesis, Mikkeli University of Applied Sciences, Finland.
Lai ACK, Chen FZ (2007). Comparison of a new Eulerian model with a modified Lagrangian approach for particle distribution and deposition indoors. Atmospheric Environment, 41: 5249–5256.
Lidwell OM, Lowbury EJ, Whyte W, et al. (1982). Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: A randomised study. British Medical Journal (Clinical Research Ed), 285: 10–14.
Mackintosh CA, Lidwell OM, Towers AG, et al. (1978). The dimensions of skin fragments dispersed into the air during activity. Journal of Hygiene, 81: 471–479.
Mangram AJ, Horan TC, Pearson ML, et al. (1999). Guideline for prevention of surgical site infection, 1999. American Journal of Infection Control, 27: 97–134.
Matida EA, Nishino K, Torii K (2000). Statistical simulation of particle deposition on the wall from turbulent dispersed pipe flow. International Journal of Heat and Fluid Flow, 21: 389–402.
Moukalled F, Mangani L, Darwish M (2016). The Finite Volume Method in Computational Fluid Dynamics: An Advanced Introduction with OpenFOAM® and Matlab. Springer International Publishing.
Rotheudt H, Lichtner E, Brockmann G, et al. (2022). Distribution of microbial contaminants in operating theatres and healthcare environments. In: Proceedings of the 24th International Symposium on Contamination Control and Cleanroom Technology, the Hague, the Netherlands.
Rouaud O, Havet M, Solliec C (2004). Influence of external perturbations on a minienvironment: Experimental investigations. Building and Environment, 39: 863–872.
Sadeghian P, Bi Y, Cao G, et al. (2022a). Reducing the risk of viral contamination during the coronavirus pandemic by using a protective curtain in the operating room. Patient Safety in Surgery, 16: 26.
Sadeghian P, Duwig C, Sköldenberg O, et al. (2022b). Numerical investigation of the impact of warming blankets on the performance of ventilation systems in the operating room. Advances in Building Energy Research, 16: 589–611.
Sadrizadeh S, Tammelin A, Ekolind P, et al. (2014a). Influence of staff number and internal constellation on surgical site infection in an operating room. Particuology, 13: 42–51.
Sadrizadeh S, Tammelin A, Nielsen PV, et al. (2014b). Does a mobile laminar airflow screen reduce bacterial contamination in the operating room? A numerical study using computational fluid dynamics technique. Patient Safety in Surgery, 8: 27.
Sadrizadeh S, Afshari A, Karimipanah T, et al. (2016). Numerical simulation of the impact of surgeon posture on airborne particle distribution in a turbulent mixing operating theatre. Building and Environment, 110: 140–147.
Schumann L, Lange J, Cetin YE, et al. (2023). Experimental analysis of airborne contaminant distribution in an operating room with different ventilation schemes. Building and Environment, 244: 110783.
Sehulster L, Chinn RYW, Arduino MJ, et al. (2003). Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Chicago: American Society for Healthcare Engineering/American Hospital Association.
Srebric J, Vukovic V, He G, et al. (2008). CFD boundary conditions for contaminant dispersion, heat transfer and airflow simulations around human occupants in indoor environments. Building and Environment, 43: 294–303.
Tan H, Wong KY, Lee CT, et al. (2023). Numerical assessment of ceiling-mounted air curtain on the particle distribution in surgical zone. Journal of Thermal Analysis and Calorimetry, 148: 3005–3018.
Wang C, Holmberg S, Sadrizadeh S (2018). Numerical study of temperature-controlled airflow in comparison with turbulent mixing and laminar airflow for operating room ventilation. Building and Environment, 144: 45–56.
Wang W, Jiang J, Hu B, et al. (2022). Performance improvement of air-source heat pump heating system with variable water temperature difference. Applied Thermal Engineering, 210: 118366.
WHO (2018). Global guidelines for the prevention of surgical site infection, 2nd ed. World Health Organization.
Xie Y, Wang Y, He J, et al. (2024). Human emissions of size-resolved fluorescent bioaerosols in control situations. Science of the Total Environment, 926: 171661.
Zhai Z, Osborne AL (2013). Simulation-based feasibility study of improved air conditioning systems for hospital operating room. Frontiers of Architectural Research, 2: 468–475.
Zhao B, Zhang Y, Li X, et al. (2004). Comparison of indoor aerosol particle concentration and deposition in different ventilated rooms by numerical method. Building and Environment, 39: 1–8.
Acknowledgements
The authors greatly appreciate the collaboration with the Operating Room of the Future at St. Olavs Hospital, Norway. The authors are grateful to the China Scholarship Council for the financial support to Yang Bi (CSC student ID: 202009210006).
Funding
Funding note: Open Access funding enabled and organized by NTNU Norwegian University of Science and Technology (incl St. Olavs Hospital - Trondheim University Hospital).
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All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yang Bi and Marina Asuero Von Munthe Af Morgenstierne. Nan Hu and Parastoo Sadeghian contributed to the study’s validation of the simulation model. The first draft of the manuscript was written by Yang Bi, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Bi, Y., Hu, N., Sadeghian, P. et al. Numerical study on the application of low-turbulence air curtain surrounding laminar airflow distribution in operating rooms. Build. Simul. 18, 601–617 (2025). https://doi.org/10.1007/s12273-024-1229-7
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DOI: https://doi.org/10.1007/s12273-024-1229-7