A CCRE DI TA TI ON STANDARD S
Infection Prevention & Control
HEATING, VENTILATION AND
AIR-CONDITIONING SYSTEM
(HVAC)
Class 1 Facility: General Anesthesia
Heating, ventilation and air-conditioning system standards are a primary infection prevention
and control strategy whereby contaminants are diluted and expelled through the
high-frequency replacement of standing room air with clean filtered air.
The Canadian Standards Association (CSA) Special requirements for heating, ventilation and airconditioning (HVAC) systems in health care facilities (CAN/CSA Z317.2-10) standard is not based
on the type of room but on the functions that are expected to occur within the room. Where
several functions apply in a given area of a facility, the more stringent requirements take
precedence.
Both health-care facility classification and area classification, as per CSA, determine the design
requirements.
The information contained in this document provides a general overview of the requirements.
CAN/CSA Z317.2 Special requirements for heating, ventilation and air-conditioning (HVAC)
systems in health care facilities shall be referenced in addition to this document. CAN/CSA
Z317.2 represents the detailed requirements for HVAC in non-hospital medical/surgical facilities.
ABBREVIATIONS
AIA
CSA
DOP
HEPA
HVAC
MDR
MERV
PAR
PD
RH
T
American Institute of Architects
Canadian Standards Association
Dispersed oil particulate
High-efficiency particulate air
Heating, ventilation and air-conditioning
Medical device reprocessing
Minimum efficiency reporting value
Post-anesthetic recovery
Pressure differential
Relative humidity
Temperature
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
Page 1 of 8
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
ACCREDITATION STANDARDS
Infection Prevention & Control
DEFINITIONS
CSA health-care facility classifications
Class A-2 health-care facility
A health-care facility in which patients are
•
accommodated on the basis of medical need
•
provided with continuing medical care and
•
provided with supporting diagnostic and therapeutic services that can extend beyond 12
hours, and
•
does not meet the other requirements of a Class A-1 health-care facility.
Examples include:
•
outpatient surgical services
•
cosmetic surgical offices
•
dental surgical offices
•
laser eye clinics
•
other office surgical facilities
Class C health-care facility
A health-care facility in which ambulatory patients are
•
accommodated on the basis of medical need
•
provided with supportive, diagnostic, non-invasive interventions and treatment services
and
•
stay for no more than 12 hours, and
•
remain capable of self-preservation.
Examples include:
•
laser eye clinics
•
cosmetic surgical offices
CSA area classifications
Type I
A patient care area where the invasiveness of procedures, the level of risk of morbidity and
mortality to patients and the level of risk of adverse outcomes to care providers necessitate
more stringent HVAC and environmental requirements. Examples include:
•
minor surgical procedures
•
endoscopy
•
cystoscopy
•
dental minor procedures room
•
operating rooms
•
recovery rooms
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
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HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
ACCREDITATION STANDARDS
Infection Prevention & Control
Type II
A patient care area of an area that is intended for the provision of services that provide direct
support to patient care areas. Examples include:
•
decontamination/soiled room
•
preparation and packaging/clean room
•
sterilizer room
•
scope reprocessing room
•
sterile storage
NHMSFP Facility Classifications
Class 1
Provides general anesthesia and major regional anesthesia (epidural, spinal nerve blocks) and
may include use of IV sedation and/or analgesia, or local anesthesia only.
Class 2
Provides use of IV sedation and/or analgesia where the patient remains responsive and breathes
without assistance.
Class 3
Provides local anesthesia only. May provide oral sedation but not IV sedation/analgesia or
inhalants.
New facilities, additions to existing facilities and/or replacement or addition of
HVAC equipment in existing facilities are in compliance with CAN/CSA Z317.2-10
INDICATORS:
 HVAC system functions in accordance with design criteria
 HVAC system monitoring parameters are in accordance with design criteria
 Parallel air-handling units are present in CSA Class A-2 facilities for any areas that
accommodate the following critical functions including but not limited to:
•
surgery, operating rooms
•
surgery, sterile core
•
post-anesthetic care or recovery
•
storage of sterile materials and supplies
 The position and type of supply and exhaust registers promote the movement of air within
the rooms or spaces from clean to less clean areas
 Airflow is directed from supply to breathing zone to exhaust outlets1, 2
 All filters are clean and sealed
 Air supply is from:
•
non-aspirating ceiling outlets near the center of the work area1, 2
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
Page 3 of 8
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
•
ACCREDITATION STANDARDS
Infection Prevention & Control
ceiling outlets3
 Each operating/procedure room or area where anesthesia might be exhaled (PAR) has a
minimum of two return air inlets1, 2
 Return air inlets are placed:
•
whereby the bottom of the return air inlet is 75–500 mm above the floor1
•
whereby the bottom of the return air inlet is at least 75 mm above the floor2
•
near the floor3
 Rooms with inhalation anesthesia and/or inhalation analgesia have a scavenging system in
compliance with ISO Z7396-21, 2 or CAN/CSA Z168.83
 Minimum levels of HVAC are maintained for type I areas when the space is not occupied:
 Minimum of six air exchanges per hour of recirculated air1, 2
 Pressure differential across separations is maintained (7.5 Pa)1, 2
 Temperature is maintained1
 Relative humidity is maintained1
 HVAC heating plant, cooling plant and controls are connected to the essential electrical
system
1. CAN/CSA Z317.2-10
2. CAN/CSA Z317.2-01
3. CAN/CSA Z317.2-M91
Existing facilities are in compliance with the CAN/CSA Z317.2 at time of build
INDICATORS:
 HVAC system functions in accordance with design criteria*
•
2010–present
Z317.2-10
•
2001–2009
Z317.2-01
•
1991–2000
Z317.2 M91
•
Before 1991
American Institute of Architects
*Facilities not in compliance with CAN/CSA Z317.2 standards from time of build may be
required to upgrade their existing system to be in compliance with current CSA Standards.
 HVAC system monitoring parameters are in accordance with design criteria
 The position and type of supply and exhaust registers promote the movement of air within
the rooms or spaces from clean to less clean areas
 Airflow is directed from supply to breathing zone to exhaust outlets1, 2
 All filters are clean and sealed
 Air supply is from:
•
non-aspirating ceiling outlets near the center of the work area1, 2
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
Page 4 of 8
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
•
ACCREDITATION STANDARDS
Infection Prevention & Control
ceiling outlets3
 Each operating/procedure room or area where anesthesia might be exhaled (PAR) has a
minimum of two return air inlets1, 2
 Return air inlets are placed:
•
whereby the bottom of the return air inlet is 75–500 mm above the floor1
•
whereby the bottom of the return air inlet is at least 75 mm above the floor2
•
near the floor3
 Rooms with inhalation anesthesia and/or inhalation analgesia have a scavenging system in
compliance with ISO Z7396-21, 2 or CAN/CSA Z168.83
 Minimum levels of HVAC are maintained for type I areas when the space is not occupied
•
minimum of six air exchanges per hour of recirculated air1, 2
•
pressure differential across separations is maintained (7.5 Pa) 1, 2
•
temperature is maintained1
•
relative humidity is maintained1, 2
 HVAC heating plant, cooling plant and controls are connected to the essential electrical
system
1. CAN/CSA Z317.2-10
2. CAN/CSA Z317.2-01
3. CAN/CSA Z317.2-M91
The HVAC system is maintained in accordance with CAN/CSA Z317.2-10
INDICATORS:
 Filters and seals are visually inspected monthly to verify the presence of the filter and seal
and to ensure proper physical condition
 Primary filters with a MERV rating less than 9 are replaced every 12 months or when loaded
(based upon measurements of pressure drop across the filter bank)
 Primary filters with a MERV rating greater than or equal to 9 are replaced every 24 months
or when loaded (based upon measurements of pressure drop across the filter bank)
 Secondary filters are replaced every 24 months or when loaded (based upon measurements
of pressure drop across the filter bank)
 HEPA filters are replaced every 36 months or when loaded (based upon measurements of
pressure drop across the filter bank) whichever occurs first
 Fan coils, drain pans and induction and finned units are inspected and cleaned at minimum
semi-annually (usually spring and fall)
 Ducts are inspected at minimum annually
 Supply ducts are cleaned when deemed necessary by annual inspection
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
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HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
ACCREDITATION STANDARDS
Infection Prevention & Control
 Return ducts are cleaned every 10 years or when deemed necessary by annual inspection,
whichever occurs first
 Exhaust ducts are cleaned every 10 years or when deemed necessary by annual inspection,
whichever occurs first
 Diffusers (supply, return or exhaust) are cleaned every six months
HVAC Design Criteria
The information contained in this document provides a general overview of the requirements.
CAN/CSA Z317.2 Special requirements for heating, ventilation and air-conditioning (HVAC)
systems in health care facilities shall be referenced in addition to this document. CAN/CSA
Z317.2 represents the detailed requirements for HVAC in non-hospital medical/surgical facilities.
Minimum filter efficiency
Operating room
Procedure room
Specialized operating
room*
Z317.2-10
Filter # 1 MERV1 8
Filter # 2 MERV 14
Filter # 1 MERV 8
Filter # 2 MERV 14
Filter # 1 MERV 8
Filter # 2 MERV 14
Filter # 3
HEPA2
Filter # 1 MERV 8
Filter # 2 MERV 14
Endoscopy /
bronchoscopy
*Specialized operating room, e.g. transplants, orthopedics
1.
2.
3.
4.
Z317.2-01
Filter # 1
50%3
Filter # 2
90%
Filter # 1
50%
Filter # 2
90%
Filter # 1
50%
Filter # 2 99.97%4
Filter # 3
N/A
Filter # 1
50%
Filter # 2
90%
Z317.2 M91
Filter # 1
30%
Filter # 2
95%
Filter # 1
30%
Filter # 2
95%
Filter # 1
30%
Filter # 2
95%
Filter # 3
N/A
Filter # 1
30%
Filter # 2
95%
Minimum efficiency reporting value (MERV)
High-efficiency particulate air (HEPA)
Dust spot efficiency
Dispersed oil particulate (DOP)
Minimum outdoor air changes/total air changes per hour
Z317.2-10
Z317.2-01
Operating room
6/20
6/20
Procedure room
5/15
6/20
Recovery room
6/20
6/20
Endoscopy / bronchoscopy
5/(15/20)
6/20
Dirty room (MDR)
2/10
2/8
Clean room (MDR)
3/10
3/10
Sterile storage
0/4
0/4
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
Z317.2 M91
6/20
6/20
6/20
6/20
3/12
3/12
3/12
Page 6 of 8
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Relative pressurization
Operating room
Procedure room
Recovery room
Endoscopy / bronchoscopy
Clean room (MDR)
Sterile storage
Dirty room (MDR)
Z317.2-10
Positive
Positive
Positive
Negative
Positive
Positive
Negative
Z317.2-01
Positive
Positive
Positive
Positive/Negative
Positive
Positive
Negative
Pressure-critical spaces: minimum pressure differential
Z317.2-10
Z317.2-01
Operating room
+ 7.5 Pa
+ 0.762 mm
Procedure room
+ 7.5 Pa
+ 0.762 mm
Recovery room
+ 7.5 Pa
+ 0.762 mm
Endoscopy / bronchoscopy
- 7.5 Pa
+ 0.762 /- 0.762 mm
Clean room (MDR)
+ 7.5 Pa
+ 0.762 mm
Sterile storage
+ 7.5 Pa
+ 0.762 mm
Dirty room (MDR)
- 7.5 Pa
- 0.762 mm
ACCREDITATION STANDARDS
Infection Prevention & Control
Z317.2 M91
Positive
Positive
Positive
Positive/Negative
Positive
Positive
Negative
Z317.2 M91
+
+
+
+/+
+
-
7.5 Pa = 0.03wc = 0.762 mm of water pressure
Temperature
Operating room
Procedure room
Recovery room
Endoscopy / bronchoscopy
Clean room (MDR)
Sterile storage
Dirty room (MDR)
Relative humidity
Z317.2-10
18–23oC
18–22oC
22–24oC
18–22oC
18–23oC
20–23oC
18–20oC
Z317.2-01
17–27oC
17–27oC
24oC
20–24oC
20–23oC
20–23oC
18–20oC
Z317.2 M91
20–26oC
20–26oC
22–24oC
20–26oC
22–26oC
22–26oC
22–26oC
Z317.2-10
40–60%
30–60%
30–60%
30–60%
30–60%*
30–60%*
30–60%*
Z317.2-01
45–55%
45–55%
50–60%
30–60%
30–60%
30–60%
30–60%
Z317.2 M91
50–60%
50–60%
50–60%
50–60%
40–50%
40–50%
40–50%
Operating room
Procedure room
Recovery room
Endoscopy / bronchoscopy
Clean room (MDR)
Sterile storage
Dirty room (MDR)
*As per the Ministry of Health Best Practice Guidelines for Cleaning, Disinfection and Sterilization of Critical and Semi-Critical
Medical Devices relative humidity of 40–50% is preferred
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
Page 7 of 8
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Parameter monitoring: monitored, alarmed central readout
Z317.2-10
Z317.2-01

Pressure differential (PD)


Temperature (T)


Relative humidity (RH)
Parameter monitoring: local readout
OR/procedure room
Dirty room
Clean room
Sterile supply
Parameter monitoring: calibration
OR/procedure room (PD, T, RH)
Dirty room (T, RH)
Clean room (T, RH)
Sterile supply (T, RH)
Z317.2-10
PD, T, RH
T, RH
T, RH
T, RH
Z317.2-10
Monthly
Annually
Annually
Annually
Z317.2-01
T, RH
T, RH
T, RH
T, RH
Z317.2-01
-
ACCREDITATION STANDARDS
Infection Prevention & Control
Z317.2 M91

Z317.2 M91
T, RH
-
Z317.2 M91
-
REFERENCES
Canadian Standards Association. Special requirements for heating, ventilation, and air
conditioning (HVAC) systems in health care facilities. Mississauga, ON: Canadian Standards
Association; 2010. 70 p. CSA Standard No.: Z317.2-10.
NHMSFP – College of Physicians and Surgeons of British Columbia
March 2013
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