JUNE/JULY 2018 VOLUME 1/ISSUE 2
The official journal supplement for CIBSE Australia and New Zealand region
A snapshot of modern slavery â&#x20AC;&#x201C;
What you need to know
Healthcare Feature A multi-disciplinary approach
Pita te hori
District Energy Scheme, Christchurch
Refresh & restore your ceiling The smart, cost-effective alternative to acoustic ceiling tile replacement
People 10 Every journey starts with a single step 14
Engineers empowering teachers
19 A snapshot of modern slavery
Opinion 24 Planning an effective career 27 The ICA Role â&#x20AC;&#x201C; 10 years on Can engineers deliver all that is required? 30
Healthcare Feature 32 Prevention is better than the cure 36 Isolation room mechanical design â&#x20AC;&#x201C; Are we getting it right as an industry? 41 Air quality in harmony with infection control 48 Staying alive 50 Lighting in hospitals 54 Steam for sterilisation in healthcare
Innovation 58 Love thy NABER 60
vision for the future, built on the values of A the past
Continued Learning 64
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EDITORIAL Editor & ANZ Chair: Paul Angus Tel: 0488 210 447 Email: email@example.com Business Development Manager: Sharon Pestonji Tel: 0435 979 400 Email: firstname.lastname@example.org CIBSE ANZ ONLINE Website: www.cibse.org.au https://twitter.com/cibseanz https://www.facebook.com/CIBSEANZ https://www.linkedin.com/in/cibse-anz https://www.instagram.com/cibse_anz
CIBSE ANZ Committee
Chartered Institution of Building Services Engineers Australia and New Zealand Region Tusculum PO Box 671, Gladesville, NSW 2111, Australia Engineering Buildings is the official magazine for the CIBSE ANZ region for engineers, written by engineers.
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t's been three months since the launch of ENGineering Buildings, our quarterly online publication and the feedback from you all on the first issue has been amazing. We appreciate your opinion and do encourage you to get in touch, let us know what interests you and encourage you all to contribute - especially if you have an interesting insight, topical debate or perhaps you were involved in a challenging project. We are continuing to develop and harness the ever advancing social media methods of communication to ensure the Australia and New Zealand region is adapting to reflect you, our members needs. In this bumper issue, we cover a variety of topics, kicking off with an inspiring article on how you can get involved with encouraging and developing our children and the future generation into the art and science that is building services engineering. In stark contrast, still focussing on the children, we delve into harsh reality of modern day slavery, which has never really ended in some countries. In this hard hitting article, you'll find we all can all make a change towards the global supply chain and rethinking purchasing power to combat modern slavery. Paul Jackson reflects on the leaps and bounds the role of the Independent Commissioning Agent's (ICA) - 10 years on and the need for change to progress and improve upon the process. Our action packed healthcare feature, focuses on an array of topics, including infection control, legionella, lighting, plumbing in central sterile service departments (CSSD), plus an interesting evaluation on isolation suites to avoid
cross contamination, delving into practises overseas that could be implemented here in the ANZ regions. Paul Bannister provides the latest in NABERS in regards to residential properties and the next step to keep you informed of what's coming! In New Zealand, the recent devastating earthquakes have provided a unique opportunity to rebuild and harness geothermal energy on a grand scale. This technical article examines the use of district network schemes, describing the approach and challenges that makes it such a success. To assist with your Certified Professional Development, the multiple choice questions at the rear of the publication covers multiple articles to assist with your continued learning across multiple disciplines. Enjoy the publication at your leisure and please get in touch with any feedback, suggestions or if you are interested in contributing towards future editions. PAUL ANGUS, EDITOR & CIBSE ANZ CHAIR email@example.com
Victorian Engineering Registration Legislation
The Victorian Government made a commitment to work with relevant stakeholders on the introduction of a mandatory, statutory registration scheme, and work with other jurisdictions to develop a nationally consistent registration scheme for engineers. The Engineers Registration Bill 2018 is currently being considered by the Victorian Parliament. Be sure to have your say by contacting: firstname.lastname@example.org
Video Interview with Damian Armour, Chief Executive Officer at Epworth Geelong
In this exclusive video, Damian shares details of Epworth HealthCare's new the $270m hospital and explores how they're striving to deliver patient-centric services.
Building in Australia â&#x20AC;&#x201C; how does the cost compare internationally?
Sydney, Melbourne and Brisbane are in the 25 most expensive cities for construction according to the International Construction Costs report from Arcadis.
Read More >
Construction activity is strongest in over a decade, according survey
For the first time in over a decade, the future is looking very bright for global construction markets with synchronised activity upswing in Australia, the USA, Europe, Japan and China, according to Turner & Townsend's International Construction Market Survey 2018.
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Rising star takes centre stage
Building Services needs innovative young engineers, willing to challenge the boundaries of human comfort and efficiency in the way buildings are designed and operated. From the vantage point of the distinguished industry judges of the 2018 CIBSE ANZ Young Engineers Awards, the future of building services has never looked brighter. Entries across all three categories were received from Adelaide, Perth, Melbourne and Sydney, for this Australia and New Zealand CIBSE region-wide competition. Take a look at the line-up:
Click here >
Performance-based design for NCC compliance One of the ways that the ABCB is trying to assist practitioners in raising awareness and competent use of performance-based design is through developing case studies to meet the NCC Performance Requirements.
Don't miss this excellent article, written by Marianne Foley ABCB Subject Matter Expert (fire safety), Fellow and Principal Fire Engineer, Arup.
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Every journey starts with a single step 2018 ARBS Hall of Fame welcomes unsung hero on the APEC Monitoring Committee (2002-07) managed by The Institution of Engineers, Australia on behalf of the Commonwealth of Australia. Stephen was also a Member of the Accreditation and Disciplinary Committees (20092012) of the New South Wales Building Professionals Board and Member of the Certifier Accreditation Committee (2000-04) of The Institution of Engineers, Australia.
Family celebration: L-R Steve, Mary and Callum Gilchrist
Stephen Gilchrist FCIBSE, FIEAust, CEng, CPEng
Stephen Gilchrist is a passionate building services practitioner that has played a key role in developing the professionalism of the industry in Australia and New Zealand. He has been an active member of The Chartered Institution of Building Services Engineers, and was a Foundation Member (1987) Honorary Treasurer (1992-95) and Chairman (1995-98) of the Australia and New Zealand Region.
He has also had a long association with ARBS where he was involved at its conception in 1997, though to being a Director (2011-2016) and participating as one of the Awards Judge for the ARBS Industry Awards (2012-18). Never one to seek the limelight, Stephen has given generously of his time to make our industry a better one, all whilst holding senior positions in a number of major companies. People like Stephen tend to be the unsung heroes of professions like building services engineering â&#x20AC;&#x201C; so his induction into the ARBS Hall of Fame is recognition from his peers that his efforts are greatly appreciated.
Career Episode to Date
Foundation Member (1987) Honorary Treasurer (1992-95) and Chairman (1995-98) of the Australia and New Zealand Region of The Chartered Institution of Building Services Engineers.
He has represented Engineers Australia â&#x20AC;&#x201C; Sydney Division (1996-2016) on the Building Regulations Advisory Council, under the auspices of the New South Wales Department of Planning and Environment, and was Chairman (1998) and Treasurer (1999-2007) of the Society for Building Engineering Services (a technical society of Engineers Australia, which he helped create).
Property Representative on the National Mutual Life Association Occupational Health and Safety Committee (1987) assessing the implications of the then newly proclaimed legislation, framing Association policy and being responsible for the design and implementation of emergency evacuation procedures, education, training and practice in all owned or managed properties.
From a professional standards perspective Stephen was instrumental in having Building Services recognised as an Engineering discipline on the National Professional Engineers Register in Australia, and played a major role in the drafting of the APEC Engineer Manual (he also sat
Member of the Technical Committee of the Property Council of Australia - NSW Division, (1987-1997) participating in the formulation of policy in regard to matters of concern to the property industry including the building and construction, government policy and
legislation, standards and codes of practice, indoor air quality, energy management and conservation. Represented The Chartered Institution of Building Services Engineers (1996) in negotiations with The Institution of Engineers, Australia on mutual recognition in accordance with the rules of the Washington Accord, leading to the signing of the Heads of Agreement for Mutual Recognition between the Institutions. Represented the Australia and New Zealand Region of The Chartered Institution of Building Services Engineers on the Air Conditioning and Refrigeration Industry Exhibition Advisory Panel at its inaugural meeting on 27 June 1997 where the participating organisations signed the Heads of Agreement which established the first successful industry exhibition and the organisation known today as ARBS Exhibitions.
(Hall of Fame inductees from left: Stephen Gilchrist, CIBSE; John Bosci, AIRAH; Mark Padwick, AREMA; David Seedsman, AMCA; Warren Cole,
Represented the Australia and New Zealand Region of The Chartered Institution of Building Services Engineers (1998) in negotiations with The Institution of Engineers, Australia to establish its technical society, the Society for Building Engineering Services. Represented Engineers Australia – Sydney Division (1996-2016) on the Building Regulations Advisory Council, under the auspices of the New South Wales Department of Planning and Environment, to provide input into the deliberations on amendments to the National Construction Code Series. Chairman of the Judging Panel (1998) for the Technical Excellence Award in Property Management presented by the New South Wales Division of the Property Council of Australia. Chairman (1998) and Treasurer (1999-2007) of the Society for Building Engineering Services, a technical society of Engineers Australia. Interviewer (2000-To Date) of Applicants for Membership of The Chartered Institution of Building Services Engineers. Member of the Certifier Accreditation Committee (200004) of The Institution of Engineers, Australia – Sydney Division giving consideration to issues arising from private certification of members under the then NSW Environmental Planning and Assessment Act and Regulations. Represented The Chartered Institution of Building Services Engineers on the Committee of the APEC Monitoring Committee (2002-07) managed by The Institution of Engineers, Australia on behalf of the Commonwealth of Australia (DETYA) in the original drafting The APEC Engineer Manual which recognised Building Services Engineering as a professional engineering endeavour.
(Stephen Gilchrist, right, receiving Award from ARBS President, Ian Harwood)
Member of the Accreditation and Disciplinary Committees (2009-2012) of the New South Wales Building Professionals Board. Director of ARBS Pty Ltd (2011-2016) elected to the Board to represent the interests of shareholder The Chartered Institution of Building Services Engineers – Australia and New Zealand Region. Awards Judge for the ARBS Industry Awards (2012-18) held in conjunction with the ARBS Exhibitions. On behalf of the CIBSE ANZ Region, congratulations to Steve, very well deserved recognition.
ARBS facts: Total Exhibition space: 20,000 m2 (Halls 1-4) Number of Exhibitors: 306 Daily (once per day) visitor figures:Tuesday - 3427 Wednesday – 3965 Thursday – 2362 Dinner attendees approximately 450
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Engineers empower teachers
Bringing real world engineering practic The STEM Professionals in Schools program partners engineers (and other experts in science, technology, and mathematics), with primary and high school teachers around Australia. Through these partnerships teachers and their students are able to learn more about modern engineering and how scientific principles taught in the classroom are applied in todayâ&#x20AC;&#x2122;s engineering workplaces. The volunteer engineers who participate in the program are also given the opportunity to share their knowledge with the next generation of potential engineers â&#x20AC;&#x201C; and have a lot of fun in the process.
mathematics (STEM)’1. However, student participation in year 12 maths and science subjects is declining, and for science it is at the lowest rate in 20 years2. As a result, two objectives of the Australian government are to engage all Australians in science, and build our scientific capability and skills.3
Give a little. Change a lot.
Sharon Allen is the Surface Engineer Manager at Origin Energy, and she has volunteered with the STEM Professionals in Schools program for more than a year. Partnering with Ashgrove State School in Brisbane, QLD, Sharon and her partnered teachers arranged for Sharon to visit the school on six occasions in 2017 to run a variety of activities based on the needs of the teacher and the age of the students. “I worked with the school to identify areas of the curriculum that I had interest and expertise in, so that by simply sharing some of my most fundamental knowledge from my work, I’m able to give examples of how the science lessons taught in the classroom come into play to make an impact in real world situations,” said Sharon.
ce to the classroom
he purpose behind the program is not all fun and games however, as it strives to address the issue that in Australia there is a decline in the number of students participating in science, technology, engineering and maths (STEM) at school and who are considering careers in STEM. For example, the National Innovation and Science Agenda states that ‘over the next decade an estimated 75 per cent of jobs in the fastest-growing industries will need skills in science, technology, engineering and
“The students love to see someone from outside of the school and were very receptive to what I presented to them. By working with the teacher I could build on what they had already learned in class to extend their knowledge and understanding.” Some of the activities included a viscosity experiment with grade three students (measuring the time it takes for a marble to fall through liquids of different viscosities, or the same liquid at different temperatures), making models of molecules with grade five students (creating water, methane, nitrogen, and salt from the elements from the periodic table), and Sharon also gave a presentation on energy and electricity to grade six students. “The preparation for these visits only takes up a fraction of my time, and the visits themselves can be arranged to suit
my schedule, so I find the program quite flexible and easy to be a part of. More than that – it’s a welcome change of pace from my usual work. I’m fortunate in that my employer is very supportive of voluntary work and offers employees paid leave to undertake voluntary activities. For me, the sense of accomplishment in inspiring young people, particularly girls, to be interested – fascinated even! – by science has been very rewarding.” Despite research showing the females and males perform at a similar level of ability in maths and science subjects4, there is a higher proportion of male graduates in STEM related fields than female graduates5. Gender imbalance presents a concern for the development of a more robust STEM career path and ultimately STEM related industries. Sharon said that although there seems to have been a shift in recent years in the historically male-dominated engineering fields, more change is needed to put engineering on the radar of young girls. “I always enjoyed maths, science and problem solving, and fortunately I had a great maths teacher who made maths fun and inspired me to work hard. Long story short, I find myself today in a job that has taken me all the way around the world and across a number of industries from
the pharmaceutical sector to the energy sector, the oil and gas industry, defence and university sector,” said Sharon. “Engineering is a fabulous career option full of interesting challenges and problems. Women have a lot to offer in this space and I think standing in front of these girls (and boys) and telling them where engineering can take you does a lot to break down any misconceptions they might have about the job, as well as showing them what it has to offer.” Run by CSIRO since 2007, the STEM Professionals in Schools program is the largest STEM education skilled volunteer program for STEM professionals and teachers in Australia. There have been thousands of partnerships created since the program began – but there is always room for more! Apply today or visit our website for more information: https://www.csiro.au/en/Education/Programs/ STEM-Professionals-in-Schools
About the Author
Amy Macintyre is the Communication Advisor, STEM Professionals in Schools (formerly Scientists and Mathematicians and ICT Professionals in Schools) and CSIRO Education and Outreach.
3. Australiaâ&#x20AC;&#x2122;s National Science Statement, 2017. Page 4. https:// assets.documentcloud.org/documents/3527706/National-ScienceStatement.pdf
2. Office of the Chief Scientist, Science and Maths in Australian Secondary Schools Student performance and participation in maths and science July 2016 http://www.chiefscientist.gov.au/wp-content/ uploads/2-Science-and-Maths-in-Australian-Secondary-Schoolsdatasheet-Web.pdf
4. Science and maths in Australian Secondary Schools 2017 pg 2. http://www.chiefscientist.gov.au/wp-content/uploads/2-Science-andMaths-in-Australian-Secondary-Schools-datasheet-Web.pdf
5. Department of Education NSW A science, technology, engineering and mathematics (STEM) review of the research https://education. nsw.gov.au/teaching-and-learning/professional-learning/scan/media/ documents/vol-35/Research-a-STEM-literature-review.pdf
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A snapshot of modern slavery YANYAN XIAO I KENDALL BENTON-COLLINS
Slavery has never ended. In modern times, it continues to persist in the form of servitude, forced labour, debt bondage, human trafficking, child slavery, and forced marriage. The 2016 Global Slavery Index showed that there are over 45.8 million people across 167 countries in some form of modern slavery.
ndia, China, Pakistan, Bangladesh, and Uzbekistan are the countries with the highest absolute numbers of people suffering from modern slavery, while the more economically developed countries, Luxembourg, Ireland, Norway, Denmark, Switzerland, Belgium, the
US, Canada, Australia and New Zealand are showing less prevalence of modern slavery. It’s not surprising then, that modern slavery can feel like an issue that’s far away from the lives of most Australians. Having said that, it’s important to note that while Australia
may have fewer instances of modern slavery than developing countries, it is still very much a factor in our products and services and we are certainly not excluded from risk here on our shores. Developed countries are importing large numbers of goods and services from developing countries, and modern slavery can exist along the complicated global supply chains. In this regard, modern slavery is related to everyoneâ&#x20AC;&#x2122;s daily life through global supply chains. You might own a diamond ring that was exploited by forced labour in Africa; you might wear a T-shirt that was made
by bonded labour in Bangladesh; you might work on a computer that was assembled by exploited workers in Malaysia; you might use a phone battery that contains minerals mined by child slaves in the Congo; you might even eat prawns that were fished and processed by trafficked workers in Thailand. Modern slavery has increasingly attracted attention from governments, non-government organisations (NGOs), business communities and civil society worldwide. In 2003, the Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and
includes establishing a Modern Slavery Act. The crimes of slavery, forced labour, and human trafficking would then fall under a single law. The Australian anti-modern slavery model would be improved based on the UK one. It would have specific requirements in modern slavery in supply chain reporting, such as making the voluntary criteria of reporting modern slavery in supply chain mandatory and setting a lower threshold for including more business companies to take the responsibility of reporting modern slavery. In line with government leadership in anti-modern slavery, many NGOs are playing a significant role in this field through research, policy development, professional practice, technology provision, data analysis, and education. NGOs are making a concerted effort to raise the awareness of businesses on the need to be proactive when it comes to modern slavery, making them realise that anti-modern slavery actions are not only an obligation but is also a good thing to do for their businesses. Currently, NGOs are cooperating with companies to help them identify and remedy modern slavery hotspots in their supply chains. This is part of a trend to move the businesses toward proactive checking.
Children entered into force in the US, and until 2016, 124 countries ratified this protocol. Regarding the specific legislation in modern slavery, the UK was the first country in the world to publish the Modern Slavery Act 2015. This Act requires the companies with the total turnover threshold at ÂŁ36 million in the UK to make a Slavery and Human Trafficking Statement with modern slavery information on their supply chains, policies, and mitigation steps. In 2017, Australia proposed to build a comprehensive suite of new laws for combatting modern slavery, which also
The agriculture, construction, manufacturing, mining, utilities and domestic services sectors, appear to be modern slavery hotspots. Thus, if the big companies in these sectors or the companies that have close interactions with these sectors take initiatives in combatting modern slavery, it would be demonstrating leadership and may have a bigger impact on civil society. In theory, we are all connected to modern slavery through complicated supply chains. As consumers, we could also become active participants in anti-modern slavery campaigns. We have the ability to use our purchasing power. If we know that certain goods and services are free of modern slavery, while others are not, we can choose the ones without modern slavery to support the manufactures or providers to sustain economic
prosperity. Everyone’s purchasing power is tiny, but collectively, this power can never be underestimated. We still have a long way to go, however, before we’re at the stage of knowing whether every individual consumer product is indeed modern slavery-free. The good news is there are already a variety of independent environmental certifications available that help customers to make good choices when purchasing goods and services. Robustness, credibility, and impartiality are what build the reputations of good ecolabels so that suppliers and consumers can come to trust them. GECA’s standards, for example, consider the social impacts of the products it certifies, including safer and more ethical working conditions, not only for employees, but also those involved along the entire supply chain. With so many certified products available, there has never been a better time for organisations and businesses to start their positive procurement journey.
While it doesn’t currently exist, a certification for ‘modern slavery-free’ in the future could give transparent and reliable information to customers and make good use of this purchasing power to combat modern slavery. At the same time, this type of certification would increase the customers’ satisfaction by letting them feel the sense of participation in these campaigns. Thankfully, organisations can – and should – start taking steps to remove modern slavery from their supply chains today. The key is to start looking! GECA’s Positive Procurement Pledge, for instance, is asking organisations to identify the hotspots across their supply chain, create a framework for monitoring and evaluating these risk areas and implementing a procurement policy that is good for people and planet. The free online Slavery Footprint Calculator is another great place to begin the journey that we all need to be taking.
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Planning an Effective Career Why people at all stages of their career should stop and think about where they are headed…..
GILES KEAY I MANAGING DIRECTOR, CONSTRUCTIVE, MRICS, FRCSA
Do I have a career path? Have you ever asked yourself this question? Can anyone really plan their future accurately? Or, do you just let chance take you on its ride?
lanning your own career should be a crucial decision for everyone, no matter your role or level. It is often only really thought of as important for those entering the workforce as apprentices, graduates and school leavers but it is important to consider at every stage of your career. There are many factors including market demands, skill mismatch, changes in personal situations and overall engagement and enjoyment that can alter the path along the way and that can often mean that you have more than one vocation on your journey, but each step takes you to the next.
How Important Is a Defined Career Path? Employee
Obtaining a great career does not happen by sheer luck. Careers that are truly satisfying are often obtained because of hard work, strategy, the right attitude and by having a plan. A “career path” refers to the invisible road that will involve growth and development leading you towards your ultimate objective. That’s why, it is very important that you have a clear track in your mind – future positions, responsibilities, remuneration – and to identify the areas where you need to improve, build skills and competencies to be able to obtain your goals.
Although the stage in which you are at may affect career path decisions, creating a plan early will help you to be able to continually re-evaluate your career path. Most employees, if not all, envision a stable and meaningful career until retirement. It enables employees to accomplish the steps needed in the
Employer Retaining the best talent and developing skills is a challenge for all businesses. As competition for quality employees heats up, prioritising employees’ career development has become a crucial role for employers to play. Companies must provide opportunities for employees and work with them to develop a Professional Development Plan so that they can help them to achieve their own career objectives. Some companies give too much focus on recruiting and onboarding new talents, often leaving the existing staff unsure. A lack of opportunities can demotivate employees and a clear sense of purpose is also known to be a factor for employees having a sense of wellbeing. The best way to retain employees is to give them a realistic picture of what their positions will be in the future.
How Do I Start?
there. We see individuals that are successful in either approach however, in both cases your skills need to be consistently nurtured to match future work demands and opportunities. It is important to focus on your skills and not be content on what you currently possess. If you’re aiming high, then keep constantly learning. Your interests motivate you. Knowing what you love and what you don’t, gives you ease of identifying which jobs may suit you. By considering what you are most passionate about, could put you in a job that can guarantee you satisfaction.
present and understand career options for the future and highlights progress and growth over the years.
Sadly, you often really don’t know which roles are most interesting until you have experienced several positions and so you mustn’t be disheartened if some decisions do not always go to plan. Your long-term goals serve as a roadmap. Your future job prospects will lead you in the right direction while you walk your path. No one’s career path is straight – there are curves with many options along the way. You need to be clear around your objectives and goals in the long term, taking into consideration financial aspirations, seniority, flexibility and work life balance to name a few. Having a defined career path benefits both employees and employers. A clear career path will give employees broader understanding as to where they are heading, and employers, at the same time, can provide the training relevant to escalate deserving employees. It happens like this – employees plan while employers provide the opportunities for employees to take. A lack of a defined career path is one of the key reasons that individuals will leave a business (alongside poor management). This is often considered much more important to employees, as opposed to salary, benefits and bonuses.
Planning your career begins by identifying three important elements; • Skills
• Long term goals Your skills are your strength. You may have acquired skills from your education, but what you learn in the workforce is paramount and ongoing. If you are a growing professional, you may choose to follow your career path in one company where you know what your opportunities are, or some may wish to move to a new employer and try to climb the ladder
Most importantly, the best person who can curate and understand your career path is you. Take time to consider it carefully, money is not the only aspect to consider. Choose a career path that will bring out the best in you, motivate you, and give you enjoyment and satisfaction. For example, this may be a career that focuses on the technical aspects of the building services industry, so a technical project route would suit you to reach these goals. However, if you excel at building relationships you may be more suited towards a career path in management or business development. The great aspect of our industry is the opportunities are varied and endless, so make sure you do something that you love.
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The ICA Role – 10 years on PAUL JACKSON I COMMISSIONING MANAGER, IBMS
It is now over ten years since the Green Building Council of Australia acknowledged the importance of “proper” commissioning for buildings in Australia in the form of the MAN-4 Credit. Which was incorporated into the rating scheme.
his recognition has significantly lifted the bar and has lead to the successful commissioning of a large number of commercial buildings throughout Australia. Properly commissioned buildings are generally of a much higher quality and are typically far more energy efficient than a building/project that has not achieved or adopted the MAN-4 credit. However, over this period of ten years the process has become a little watered down and we are now seeing a lot of “tick and flick” or what I call “drive by” commissioning processes in place. Some of this is due to budget constraints, where the true value and importance of the ICA or Commissioning Managers role has not been fully understood. There are many definitions for commissioning, I particularly like this one: “Process by which equipment, facility, or plant (which is installed, or is complete or near completion) is tested to verify if it functions according to its design objectives or specifications” As always the devil is in the detail.
So as mentioned a couple of paragraphs earlier we are beginning to see a few projects defaulting back towards the old times i.e. get to Practical Completion then spend the Defects Liability Period (DLP) completing the commissioning of services and systems, the DLP should be exactly that, rectification of defects and warranty issues, not basic commissioning. Fine tuning or seasonal testing accepted. Some of the above is not the fault of the individual teams, unreal budgets, poor planning and constrained project timelines all play their part. The landscape has changed significantly over the last ten years, we are seeing the arrival of “Smart” buildings, Big Data and Analytics, and the need for superior levels of energy efficiency. For example if we just look at the Data and Analytics side of things the need for fully functional and commissioned systems comes right to the forefront otherwise “rubbish in, rubbish out” this also applies to the development and setup of whatever reporting package has been implemented. Part of the emphasis should be on developing a process for the project team to follow but the real “work” for the Commissioning Manager is in the onsite verification or
The full set of CIBSE Commissioning Codes is made up of the following: CIBSE Commissioning Code A: Air Distribution Systems CIBSE Commissioning Code B: Boilers CIBSE Commissioning Code C: Automatic Controls CIBSE Commissioning Code L: Lighting CIBSE Commissioning Code M: Management CIBSE Commissioning Code R: Refrigeration CIBSE Commissioning Code W: Water Distribution Systems validation of commissioning results. This should also be coupled to integration testing between the many services and technologies within modern buildings that need to interact together – for example one of the most important tests in my opinion is the integrated fire test in both normal, out of hours and emergency mode both with and without all utility’s available. We have seen systems where essential services have not been on essential power for example. In most cases no individual service provider/installer goes out of their way to poorly commission their scope of work but therein lies the problem. Invariably the gap is in the interaction with other works as individual components or services do get commissioned but are not tested as a system. So in essence there is a need for the Commissioning Manager along with his or her team to focus on following the process that has been documented during the design, procurement and construction stages of the project in detail, and to spend a significant amount of time on site during the commissioning phase of the project to verify that the systems have been commissioned as intended. There is also a need for the original project design team to remain involved. On a lot of projects the only consultant still involved during the commissioning phase is the ICA or Commissioning Manager. This can lead to a disconnect between the original brief, design intent and how the building or system is setup, resulting in a very different project outcome to what was originally intended. Normally this is due to the fact that the consulting team have run out of fee’s to cover attendance at the most important phase of the project. There are a lot of lessons learnt during the commission phase, some good, some bad, and this information would be of considerable value and benefit to the design team not only for the current project but also for future projects. The message here is keep the team engaged and active on the project. Worth noting is that the role of the ICA or Commissioning Manager, has become far more complex and there is a
need for a commissioning team on projects so that the ICA/CM can draw on the right expertise. In summary the usual suspects are still there: • Lack of integration testing. Not just limited to Life Safety.
• Lack of Validation of metering systems.
• Lack of Verification of control loops, typically BMS or DDC.
• Lack of Onsite Verification of commissioning results or witness testing.
• Lack of Validation of Data acquisition (Rubbish in = Rubbish out)
Finally, there needs to be a quantum shift in how projects are procured and delivered to overcome the poor delivery outcomes of some projects – in the commissioning space this may require a Standard or Guideline to nudge industry in the right direction.
About the Author
Paul Jackson is Associate Director of IBMS. With over 35 years’ experience in the building services industry, Paul has a varied skillset encompassing mechanical, electrical, airconditioning, associated control systems and BMS systems. Having entered the industry as a service engineer, Paul has been involved in field diagnostics and commissioning of a wide variety of building services plants, with extensive involvement in commissioning and project completion. The numerous projects Paul has been involved with ranged from very simple minor systems serving residential or commercial through to large central plant systems in the resource sector in many parts of the world.
Can engineers deliver all that is required? Nothing is more certain than time, change and innovation CRAIG UNDERWOOD I BEng (HONS), BUILDING SERVICES ENGINEERING NATIONAL EXECUTIVE: BUILDING CONSULTANCY AND ENGINEERING | MBM
Recently, I attended a seminar on how the 4th industrial revolution will change our futures. You’ll be no doubt happy to know that only 18% of an Engineers role is going to be undertaken by Artificial Intelligence...
y working life has crossed continents, passed through design, facility management, software and is currently in a Building Consultancy with more and more projects sitting in the asset management arena. There is one thing that traverses all disciplines and is consistently a question that I am asked... What’s the cost? Design processes, Revit, BIM and modeling revolution are well established. Collaboration through the design process that allows the design to move-on in real time, when efficiently managed, brings the results expected a relatively new role for our industry. I still recall the ink drawings and the razor blade used to fix the mistakes.. How did the clients pay the fee? This revolution has been the catalyst for entire precincts to be established to provide computer-based design and drawing support in various locations around the world. Makes total sense when there is a market. This approach allows companies to provide a service while contending with the costs of doing business.
It feels like none of the businesses undertaking largescale projects have a service that is hosted purely in one country or even continent. It’s seems very hard to value add through both the traditional and Design and Construct procurement routes when the cost are scrutinised by all involved. Competition for projects is very strong and often the lowest price wins the tender with varied results. I know of smaller team's struggling to bring the value on the ground for the fee anticipated. The amalgamation of businesses to gain larger and larger market share is something that will continue. The boutique provider must try and find a new way to deliver; the entrepreneurial spirit is the foundation of the Australian business.
Dollars are the driver and often the deliverer of good and bad news. All businesses are aspiring to innovative new approaches to deliver the service they can offer.
We are continually bombarded, through social media platforms, by new options to use technology with most of us simply trying to merely keep up! Most of the roles in this industry are challenged on a daily basis around keeping up. I wonder if an engineer’s background and training now needs to also transcend software development and code? How do we ensure that we are influencing the future expectations of our profession? So, in the future. What’s a given and what’s an extra? What’s provided and what’s added value? As I see it it, the cost is always going to be the common denominator flowing through all that an engineer does and when. Is it realistic that a design engineer considers the cost of ownership when working as quickly as we do for the fee that we can charge? Whole Of Life (WOL) costs are an area that I have become more aware of over my career, but feel that this is not necessarily as considered in too much detail. I believe that developing a future detailed model around the WOL costs has many facets, with input from maintenance cost, life cycle position, property and project complexity, property strategy, asset condition, energy use as well as return on investment, tax returns and funding mechanisms. An engineer cannot provide all of these inputs, and nor should they. 1.5% capex allowance per annum based on construction cost is a number that I have encountered when considering Life Cycle Cost (LCC) in Quantity Surveying. So, if a project costs $100m to Construct, every year $1.5m should be assigned to spend on that same property over its life. The complexity of the project and its operating parameters will affect this value but as a theoretical LCC approach. this is considered a reasonable starting position. I envisage that the future WOL costs relies on input from several industry professionals working together initially in a manual way. Expectations are moving so quick that I wonder how we will all align. Even the well-established businesses struggle with silos, Profit and Loss Key Performance Indicators, client conflicts and cross-pollination of ideas and solutions when busy delivering project outcomes. Technology will bring the solution but only with input from engineers and other specialists to ensure that the IT wizkids provide a solution that meets the need. In new developments, we can already mine data sets from the BiM model and map this information. The continuous use of this data is reliant on the level of sophistication adopted by the management team's involved with the property together with appetite of the owners to continually review and inform a live LCC and WOL
approach. In time the technology will provide an answer. The questions that need to asked can only be set through an engineering based approach. In existing property, the WOL approach is still very relevant and needed. Not only an investment tool, it’s a way of managing service delivery and dollars for forward thinking companies and government. There are tools available that can scan a space within a building and produce an image – with some work this becomes a 3D model.
Technology, it’s our backbone and may be our crux.
There are systems available that can create life cycle costs and provide ''what if'' modeling to help shape budgets relying on data sets. Remembering that systems can only deliver outputs based on the quality of the data it holds, the systems rely on qualified skills to inform development paths and challenge the reports. Application Program Interfaces (APIs) between systems are said to exist but in reality are fairly limited. APIs will become much more prevalent allowing the various tools to talk to each other supporting the needs of the clients. A growing number of systems are available to use in this field but these are reliant on the users training and skills. Building Services Engineers are instrumental in the future of our industry. We shape the built environment and will continue to do so. Our depth of knowledge and input into future software solutions needs to be considered to ensure that the tools that are developed provide the best results. Who knows where Artificial Intelligence will take us and how the engineering profession will progress. What is important is that we all, not just the 18% continue to adapt and embrace change for the better.
About the Author
Following a holiday to Australia I decided that a change in location was needed and subsequently packed my bags and returned to Sydney. Within my career I have worked in design consultancy, property advisory and Facility Management into CRE. Utilising my BSE honours degree to help clients understand their property investment and portfolio is a passion of mine. My family and I are lucky to live in a Northern suburb of Sydney and enjoy all that this has to offer with outdoors focussed activities. The beach and the local mountain bike trials are a staple for us providing balance in our busy lives. Nothing better than a day out and an ice cream with my children.
prevention is better than the cure DAVE DICKSON I UK & AUSTRALIA SPECIFICATION DIRECTOR FOR CONEX BANNINGER
The quality of our water is strongly dependant on good pipework design and maintenance. Dave Dickson, UK & Australia Specification Director for Conex Banninger, discusses the potential risk factors and how to minimise the risk of legionella and other waterborne diseases.
t is well understood across the globe that legionella, a bacillary germ with an empatholigy similar to pseudomonas causes severe health issues for immune suppressed people. We can trace the Legionnaires disease problem back to 1976 where at the time it was described as the greatest ‘epidemiogical puzzle of the century’. We now know many decades on so much more however due to it’s potentially life threatening capabilities it continues to pop up in the news on a regular basis with the Herald Sun only just recently reporting the death of a man and several other people taken ill. As our understanding grows almost daily and our recognition of at least 60 species some with a worryingly high mortality rate of around 40 per cent of the infected hosts – no wonder! Keeping things in a little perspective, the recoded and confirmed cases of legionella seems to be stable nowadays and we are much more likely to come into contact with another form of the same bacterial family but not life threatening known as Pontiac fever. Whilst legionella and Pontiac fever share similar symptoms incl coughs, shortness of breath & high fever Pontiac, unlike
legionella, normally resolves itself within a week or so without treatment. Recent cases of legionella outbreaks across the globe remind us of our responsibilities and strong legal frameworks, standards and codes of practice are in place to ensure business’s that receive the public include in their corporate health and safety policy water hygiene arrangements. The updated AS/NZS 3896:2008 Water Examination for legionella spp.incl Legionella pneumophila is helpful in the methodology of calculating, recording and reporting. In addition many of the Australian states Department Of Health are adopting the ‘Guidelines for Legionella Control enhealth’ an Australian Government document developed to assist health and aged care understand the arrangements to ensure adequate and effective control of water systems so far as reasonably practicable (freely available on the net).
Safety in Design
This issue of prevention of these dangerous pathogens in fact runs much deeper – right back to the initial system design stage in many cases, and a fundamental part of
Remedial modifications or builder’s works taking place on or near plumbing networks within a building or indeed on the municipal supply lines are known areas of potential bacteria ingress. On large installations (sometimes many Km’s modifications or extensions), inappropriate leak testing and/or commissioning can all contribute to the bacterial repopulation requiring detailed isolation and planning to ensure defective or poor installation does not contribute to the situation. Biolfilm consisting of bacterial, fungal and algal cells caused by system components and pipe materials releasing exploitable nutriments, can all facilitate a build up of iron or lime scale deposits. These build ups create crevices, and the covering layer of biofilm are able to use these to their advantage, and in many cases the ad hoc measures such as chlorine shock, cannot reach the deeper lying bacteria, resulting in reinfection of the system from the un touched bacteria.
good water network design as well as understanding the thermal and fluid dynamics is rooted in understanding the common sources of system infection. As Designers, Installers and maintainers of the network you are faced with conflicting realities. It’s pretty much understood that the hot water should be stored and circulated as close to possible at >60ºC allowing for a 5 Kelvin drop over the system. We do this as at 30-48ºC we can see a massive proliferation within days of harmful bacterial growth. However we are also faced with the potential issue that hot water scalds (water at 60ºC can cause second degree burns after 3 seconds! These type of burns are amongst the most common presentations to the adult burn centres of many hospitals). National legislation on hot water delivery (AS/NZS 3500.4:2015) clearly states the following:
‘All new heated water installations shall, at the outlet of all sanitary fixtures used primarily for personal hygiene purposes, deliver heated water not exceeding (a) 45 Degrees C for early childhood centres, primary and secondary schools and nursing homes or similar facilities for young, aged, sick or people with disabilities: and (b) 50 degrees C in all other buildings’ So knowing Legionella bacteria will proliferate between 30-48ºC yet safety demands to avoid scalding we must never deliver hot water at a temperature greater than 50ºC with an ideal 45ºC the optimum, a narrow temperature band indeed. However over the last years the introduction
of high quality thermostatic mixing valves (TMV’s – AS 4032.2) fitted to every tap and shower fixture greatly assist in solving this issue.
Traditionally we have relied on a chemical shock process (normally carried out as a fill and flush process using Chlorine based chemicals at an initial 50 ppm for a contact period of 1 hour measured in success by a free chlorine level not less than 30ppm at the end of the process). As indicated above this treatment potentially can only ever be a short term solution especially if there are areas of corrosion and bio film. In many European states we now see advanced treatment techniques and equipment with promising results, however we know for sure a tandem approach using chemical shock with pasteurisation is gaining in popularity, with the option of creating a bypass system and solar radiation as the heat source.
The Air that we Breathe
The principal route of human legionella contamination is through inhalation of the bacteria, which enters through fine aerosol water droplets with a particle size of around 5-10µm, the very size of this allows efficient transfer deep into the host’s lungs making treatment difficult. Commonly showers and the highly encouraged environmental and economical misting type taps actually can make the problem a little more complex and become inadvertent channels of misting infection. But it is also worth noting that other auxiliary equipment such as softeners, filters and dosage devices have all been implicated in previous outbreaks. For Design Engineers it is vital to avoid at all cost inappropriate design such as over sizing of storage vessels. Irregular used sections of pipework (dead legs) that create areas of stagnant water should always be avoided, especially long runs capped off for future extension of the network. Installers should make readily available 'as built' drawings, mapping of redundant
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pipework and insist on removal of any dead legs including shower valves not in regular use. Clearly, good design, construction & maintenance of a pipe network are key to optimum system functionality, yet the choice of materials used has been found to substantially improve the health benefits too. Numerous antimicrobial efficiency and mechanical studies have been conducted over the past 10 years concerning coppers ability to destroy a wide range of bacteria, including legionella. All piping materials naturally develop biofilm over time, and current data shows that there is no sustentative difference in the formation of biofilms between copper and many of the synthetic plumbing pipe materials that have entered the market over recent times. Where copper does come into its own, though, is its ability to withstand high thermal shocks whilst maintaining its installed and mechanical characteristics. This high temperature benefit is particularly useful when pasteurisation is required to combat deep lying bacterial growth within the network.
Optimal Maintenance Regime Implementation
Choice of materials aside, good maintenance practice and liaison between Engineers and Healthcare practioners is paramount, without it bacterial growth in the network can increase. A robust and rigorous maintenance programme must be implemented to ensure all breakdowns in the network are minimised, which in turn will reduce the risk of bacterial growth developing in the pipes for extended periods. Once installation is complete, it is essential that those charged with maintenance understand how to complete checks and report quickly and easily any concerns. Whilst we have to accept currently that the disease cannot be completely eradicated at this stage, if we take these points on board as an industry we can truly minimise the threat of legionnaires and many of the other dangerous pathogens in our water networks.
About the Author
www.cetec.com.au Melbourne | Sydney | Brisbane | Perth | London
In his role as Specification Director at IBP Conex Banninger, Dave Dickson looks to reinforce the understanding of water microbiology in premise plumbing of large buildings. After many years involved with both synthetic and metallic plumbing systems, Dave explains how factors promoting growth and persistence of bacteria in plumbing systems are strongly influenced by hydraulics’, material choices , disinfection and device choices.
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Isolation Room Mechanical Design – Are we getting it right as an industry?
BEN COOK, MCIBSE I ASSOCIATE DIRECTOR AT AECOM
- Isolation suites within hospitals play a key role in reducing the risk of cross contamination associated with both the airborne and physical contact routes. Typically in the order of 30m2 both negative and positive suites tend to comprise an anteroom, isolation room and ensuite.
ver the past two decades, mechanical design of isolation rooms have been subject to varying guidelines throughout different states and has continued to evolve at the national level albeit somewhat less. With the latest version of the New South Wales ’NSW’ Health Infrastructure Engineering Services Guidelines (August 2016), it is clear that NSW have adopted more stringent criteria in line with the Victorian Guidelines, however, are we getting the fundamental concept right? Or are there more flexible alternatives available used elsewhere across the globe, which better address user error and thus infection control? This article sets out to challenge the status quo and identifies a possible alternative approach to better protect staff, patients and visitors alike, both within the isolation room and throughout the hospital. Mechanical Pressure Regime Overview – The following three isolation room strategies are generally applied throughout Australia; Negative Pressure Isolation Rooms – Patients with an air communicable contagious disease are accommodated in a negative isolation room to protect others throughout
the hospital. The general consensus throughout Australia surrounding these rooms suggest a cascading flow from the corridor (Base line) to the Anteroom (-Ve) and to the isolation room/ensuite (--ve) as illustrated In Figure 1. Positive Pressure Isolation Rooms – Patients who are considered immunocompromised are designated into a positive pressure isolation room for their own protection against other diseases. The general consensus throughout Australia surrounding these rooms suggest Figure 1
into any one isolation room without the risk of human error due to the primary reasons as listed below. 1. C linicians unable to appropriately locate an undiagnosed patient - When a patient enters a hospital their illness or immune system strength is unknown, as such, they cannot be allocated with 100% accuracy until diagnosis is undertaken which can take some time.
a cascading flow to the corridor (Base line) and the Anteroom (+Ve) from the isolation room/ensuite (++ve), as illustrated in Figure 2. Standard Isolation rooms – Patients capable of transmitting infection by droplet or contact routes are accommodated in a standard isolation room. No pressure gradients are suggested for this type of isolation. A Case Study & Alternative Suggestion – In 2016 my organisation was engaged to complete a survey of the existing isolation rooms throughout a large hospital within NSW. The scope of the assessment was to identify any shortfalls of the current isolation room mechanical design in accordance with both the Australian Standards / Codes & applicable Guidelines at the time. Any identified legislative shortfalls were to be addressed as a mandatory measure whilst Guideline shortfalls were to be addressed by establishing an agreed cost effective baseline to which all isolation rooms would be required to achieve through refurbishment. Through this process, we unexpectedly found that the most challenging issue was not to establish benchmarking criteria for performance to be agreed with by the users, rather the key challenge was associated with achieving user consensus re the type of isolation rooms to be implemented throughout the differing departments. It was noted that an alternating pressure arrangement (switchable +ve to –ve rooms) were discouraged by all parties due to the potential for human error associated with incorrect switching between room types. Acutely aware of the limited number of isolation suites throughout the hospital, the users struggled to agree on the type for implementation due to the varied nature of illnesses suffered at different times by the local population. While the above posed a contentious issue, it was quite evident that all parties unanimously agreed that the isolation rooms should be designed mechanically, if possible, to enable the placement of an immune compromised, contagious or the combination of the two,
2. C linician unable to appropriately locate a patient emitting a contagious disease whilst also immune compromised – As discussed above, a positive isolation suit is design specifically for an immuno compromised patient while a negative isolation room is design specifically for a patient emitting an air communicable contagious disease, therefore, a patient subject to both cannot be placed appropriately without compromising infection control. 3. A llowance for a Pandemic Scenario – During a pandemic, it is typically found that all patients will be immune compromised or emitting an air communicable contagious disease, and as such, it would be the preference that all isolation rooms are of a positive or negative arrangement. 4. G eneral Clinician error in allocating a patient to the incorrect isolation room type – Unfortunately human error does occur in this high pressured environment. Placing a patient in the incorrect room has significant AECOM Wollongong - -Isolation WollongongHospital IsolationRooms Rooms- -CriteriaCommercial-in-Confidence infection control issues asAssessment itHospital promotes the Assessment spread of Isolation - Criteria Assessment Criteria Rooms Illawarra Shoalhaven Local Health disease throughout theCommercial-in-Confidence hospital, or hinders District D the R A immune FT 01-Jul-2016 D supressed RAFT patient. Doc No. RPT_MECH_001
Table 1 – Legislation and Guidelines applicable Origin
The Australian Building Codes Board - National Construction Code 2016 – Volume One – Building Code of Australia Class 2 to Class 9 Buildings
Standards Australia – Australian Standard 1668.2-2012 – The use of ventilation and air conditioning in buildings – Part 2; Mechanical Ventilation in buildings
Standards Australia – Handbook HB 260 – 2003 – Hospital acquired infectionsEngineering down the risk
Australia NSW Government Health Infrastructure – Engineering Services Guidelines – August 2016
NSW Health - Engineering Services and Sustainable Development Guidelines – Technical Series TS 11 Version 2.0– December 2005
TS – 11
Guidelines for the classification and design of isolation rooms in health care facilities – Victorian Advisory Committee on Infection Control - 2007
UK - Department of Health – Heating & Ventilation Systems – Health Technical Memorandum 03-01; Specialised ventilation for healthcare premises – November 2007
UK – Department of Health – Health Building Note 04-01 – Supplement 1 Isolation facilities for infectious patients in acute settings – 2013
ASHRAE – HVAC Design Manual for Hospitals and Clinics – Second Edition
ASHRAE HVAC DM
USA ASHRAE/ASHE Standard170-2013 – Ventilation of Health Care Facilities
As part of our engagement, we suggested our literature review cover those guidelines applicable to isolation rooms within the United Kingdom and United States of America. In doing so, we were able to provide an insight into how other countries overcome such issues, and also seek to validate the Australian approach. Legislation and guidelines reviewed is listed in Table 1. An order of precedence was highlighted to the client thus managing the expectation associated with establishing D Rbenchmark AFT the criteria as illustrated in Figure 3. AECOM
Wollongong Hospital - Isolation Rooms - Criteria Assessment Isolation Rooms - Criteria Assessment Commercial-in-Confidence
Second stage Legislation
Referred in NCC 2016 as a requirement
Referenced Information Document
The main down side of the alternative arrangements outlined within HBN 04-01 & ASHRAE HVAC DM occur if the patient enters the anteroom, thus jeopardising infection control however, this can be easily addressed through the implementation of interlocking doors (see figure 4).
ASHRAE HVAC DM
We produced mechanical design criteria matrices which cross referenced all standards and guidelines to further assist the clinicians in establishing the bench mark criteria. It was found that there was general consistency throughout the guidlelines associated with positive and negative isolation rooms, however, both HBN 04-01 and ASHRAE HVAC DM addressed the concerns listed above through the suggestion of a fundamentally different arrangement. ASHRAE HVAC DM classed the alternative as a combined Airborne Infectious Isolation (AII) and Protective Environment (PE) room. Two options are suggested for room pressurisation, 1) the room is negative to the anteroom with the anteroom positive to the adjacent corridor, or 2) the room is positive to the anteroom with the anteroom negative to the corridor. HBN 04-01 referred to the isolation suite as a Positive Pressure Ventilated Lobby (PPVL), the principle being that the anteroom is nominally 10pa greater than the corridor, the isolation room is nominally 0pa greater than
the corridor and the ensuite is negative in relation to the isolation room. This arrangement has been illustrated below.
A better Way?
It is clear that the PPLV approach has the potential to address the four main user concerns noted above. It also comes with minimal disadvantages, and it enjoys the support of health professionals in a number of countries including the UK and USA. It does however challenge the way we approach mechanical services pressurisation regimes in Australian hospitals, and to make the necessary changes will also require legislative changes. Whether there is an appetite for change amongst the Health Regulators remains to be seen, but as engineers we should always question the status quo, and when a seemingly better approach presents itself, it would be remiss of us to not at least canvas the ideas.
About the Author Ben Cook is a Chartered Engineer and Member of CIBSE, as an Associate Director at AECOM he leads the New South Wales Health Care Team, and has worked on a number of major healthcare projects including Lismore, Byron Bay, Saint George, Gosford & Randwick Hospital.
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Infection control in healthcare facilities is dependent on indoor air quality â&#x20AC;&#x201C; past outbreaks of hospital acquired infections have been shown to be caused or spread by air handling systems. How can hospitals stretch their limited maintenance and engineering budgets to ensure adequate air quality performance? This whitepaper showcases a risk management schema developed by QED to assist hospitals to prioritise maintenance spend according to infection control risk and observed air quality outcomes.
ED has for many years carried out a comprehensive air quality monitoring and management inspection function for commercial buildings, such as high rise multiple occupancy office blocks. This annual inspection and testing aids compliance with the Australian Standards AS1668.2 (2012) The use of ventilation and airconditioning in buildings, Australian Standards AS 3666 (2012) Air handling and water systems of buildings, Australian Standard SAA/SNZ HB 32 Control of microbial growth in air-handling and water systems in buildings and other relevant legislation and standards. Similar programmes are also in place in several commercial buildings as tenants require the knowledge that the air in the building is of a high standard, as this might impact upon productivity and profitability. Inspection of the air handling units, along with testing for various air quality parameters in the occupied areas gives a good indication of the overall quality of the system in place, and any rectification works that are required to improve the air quality in the building.
Hospitals are however, much more complex than commercial buildings. A commercial building usually has a healthy population, with no extremes of age present, and the presence of very few pre-existing health conditions. The use of space in the building is mostly confined to office use,
with usually only the server room having specialist heating and cooling needs. The building usually has fit outs that are all of a similar age, and a few, large air handling units are present. In comparison, hospitals have a much more diverse population of users of all states of health and ages, areas of use that vary from offices to laundries, operating theatres, commercial sized kitchens, sterile areas, imaging and radiation bunkers. Additional to this, hospitals usually are sites that have developed and evolved over many years, with many stages of construction and development, and reuse of often very old buildings. Air handling units are also of vastly differing ages, manufacturer and type, depending on the needs of the area. Specialist ventilation and heating requirements are also present with HEPA (High Efficiency Particle Arrestance) filtration for isolation rooms, theatres and cleanrooms, along with positive and negative pressure isolation rooms. Provision of safe air within a hospital environment is of vital importance. Hospital acquired infection
is a major cost burden for hospitals, and also a significant burden on the patients affected. Mortality of the patients is increased, and increased length of stay in hospital of between 7-10 days on average are noted. At a cost in WA of a hospital stay of nearly $2200 average per day per patient in 2013-141, the costs associated with this are significant. Outbreaks have previously been associated with the air handling systems within hospitals – examples include an MRSA outbreaks associated with dirty supply registers and ducting2; an outbreak of fungal infections in cardiac surgery patients3, and an outbreak associated with old air conditioning systems that were poorly maintained which resulted in 6 deaths from 6 infections4. There can also be a problem with ‘pseudo-outbreaks’. This is where the laboratory air supply is contaminated, and the air supply introduces contaminants into specimens5. This means that infection can be found in the samples when none is present in the patient – situation which can lead to unnecessary surgery and treatment with antibiotics. NHMRC Australian Guidelines for the Prevention and Control of Infections in Healthcare6 highlight the role of the air handling systems within a hospital of reducing airborne transmission of pathogens, and in contributing to the health of the population within the hospital. The NHMRC guidelines state that many studies indicate that infection rates are lower when there is very good air and water quality. In addition to this, the Australasian Health Facilities Guidelines7 and the WA Health Facilities Guidelines8 state that ventilation should “Provide breathing air free from contamination harmful to building occupants or processes undertaken in and around the building”. With the importance of providing good quality air into the hospital environment being of paramount importance, we undertook to develop a programme specifically for hospitals, that took into account not only the physical condition of the air handling units, but the quality of the air at the point of supply, and the individual risks present in the areas that the air is supplied to. Taking into account the three critical areas of: • Risk of the population supplied with air
• Condition of the Air handling Units
• Quality of the air supply in a particular area
A risk matrix was developed that, if any rectifications to systems were required, could risk assess each individual problem present and rank this according to the impact it could potentially have on patients and other users within the building. Examination of both the air handling units and the air quality in unison with each other is vital. Problems beginning in the air handling units may not yet have had an impact upon the air quality within the area supplied, and also, there may be other problems within the hospital, for example moisture ingress or use of chemicals that can impact upon the air quality, without necessarily being related to the air handling unit.
MEASUREMENT OF INDOOR AIR QUALITY
A number of parameters are measured to determine the quality of the air inside the hospital. Carbon Dioxide
Carbon Dioxide (CO2) is a gas that occurs naturally in the earth’s atmosphere, and is generally accepted as a surrogate indicator of ventilation within buildings and occupied premises. At normal concentration levels carbon dioxide exerts an important regulatory effect in the body; it can however become an asphyxiant at high concentrations. Historically, the most common complaint expressed about indoor air quality is that of “stale air”. Typically, complainants claim symptoms of headache, stuffiness, upper respiratory tract irritation, drowsiness, lethargy and fatigue etc. Research has shown that these symptoms tend to worsen during the course of the day, often peaking in the mid to late afternoon, but abate after vacating the premises in question. Moderately raised levels of carbon dioxide have also been shown to reduce productivity, decision making performance, basic activity levels, information levels and crisis response - all
The National Environmental Protection Council (NEPC)10 stipulates a standard for ambient particulate matter of <10 microns in size (PM10) of 50 µg/m3 (0.05 mg/m3) measured over a 24 hour period, with five allowable exceedances per year. QED has adopted the guideline level of 50 µg/m3 for indoor air. Raised levels of particulate matter, especially the PM10, PM2.5 and PM1 fractions have clear associations with increasing respiratory distress and hospital admissions, and also with worsening cardiac function and cardiac events at raised levels. Mortality in cardiac, cancer and respiratory patients is also increased when levels of airborne particulates are high11. Particulates should be controlled to prevent the worsening of these conditions within the hospital. Carbon Monoxide
In high concentrations, carbon monoxide can be fatal. At lower concentrations, headache, dizziness and other symptoms can be present. It is usually found when combustion products enter the airstream, for example from plant exhausts or vehicle fumes. Carbon monoxide is an odourless gas, and can only be detected using a specialist monitor. Any detection of carbon monoxide must be investigated. Temperature
Air temperature is one of the parameters that are known to influence the thermal balance of the human body as a whole, which in turns affects the perceived comfort of the individual. This can often be a contentious area in a hospital, as there are so many different levels of activity, from the busy staff to the bed bound patient. Even within well maintained office spaces, temperature is one of the factors that building managers have the most complaints about. Humidity
A level of RH (Relative Humidity) below 35% exacerbates and sensitizes an individuals’ response to airborne pollutants, and the following problems have been known to occur;
• Dryness and irritation of eyes, nose, throat • Increased allergic response by asthmatics • Increased static electricity shocks
• Increase rates of ozone generation
High humidity can also provide conditions favourable to the growth of micro-organisms such as fungi or mould and bacteria. Elevated levels of these micro-organisms may then have negative health effects, and also cause damage to property and assets. Volatile Organic Compounds
Volatile organic compounds (VOCs) are measured as a total for the air quality monitoring programme, and act as an indicator that a problem may be present. In an office environment sources of VOCs are usually from furniture, paints, and new building products. Within a hospital, there are many more sources of VOCs, from alcohol hand rub to more toxic chemicals used for disinfection and cleaning. High levels of VOCs usually indicate the need for more targeted investigation, and for measurement of Occupational Exposure12 to the chemicals in use in the area. VOCs are a wide group of compounds, some of which can have quite serious health effects at low concentrations, and some of which are relatively harmless at the concentrations usually found in a hospital day to day12.
essential for staff within a hospital9, who make life and death decisions every day.
Microbial Air Quality
The levels of microbial contamination within the air of the hospital are sampled using an active sampler. No specific guidelines exist for the levels of microbes within the air that are acceptable within a building, except for those within Operating Theatres13. It is however very useful to build up a picture of the usual levels for the different areas of the hospital over time, and then deviations from this can be investigated. Comparison of the levels within the building with those in the outside air are also extremely useful. Levels of microorganisms should usually be lower inside a building than outside a building, and be of a similar species mix. Higher levels of microbes inside than outside, or inside air readings that show a predominance of a problem species of fungus for example, is a cause for concern and would require investigation. Results should always be interpreted by a person
experienced in interpreting microbial air testing results.
basis. This is then used to produce a risk rating for each AHU.
INSPECTION OF AIR HANDLING UNITS
Functional Area Sensitivity Status
Air handling units should be inspected by experienced staff to ensure that they are clean, functional and that no problems are present that may impact upon the air quality supplied. A condition report should be produced detailing the condition of the unit, corrosion, condition and cleanliness of the coils, condition, specification and change dates of the filters, along with the condition of the plant rooms and any external factors that may impact upon air quality. Inspection of the maintenance records should also be carried out to ensure that the monthly inspections required under AS366614 have been carried out.
Microbial culture of the heat exchange coils is also possible at inspection, to give an early indication of if there may be a problem with microbial contamination.
Specific AHU Risk Groupings, XXX Building
RISK GRADING OF AREAS AND AHUS FOR FUNCTIONAL AREA SENSITIVITY STATUS
Each area and the AHU it serves should be graded according to a risk assessment tool based upon guidelines from Queensland, Western Australia, New South Wales and the Northern Territory15, with additional knowledge from consultants. The term â&#x20AC;&#x2DC;Functional Area Sensitivity Statusâ&#x20AC;&#x2122; is used instead of a term that is more focussed on patients, as sometimes, for example in the case of Pathology laboratories, the Cyclotron or pharmaceutical preparation areas, the persons present in the area are of good health, but the use of the area requires a higher grade risk classification. AHUs and areas that are grouped in Groups three and four for functional area sensitivity status should be examined and air quality testing carried out on a six monthly basis, to ensure that problems are dealt with in a timely manner and do not reach the levels where patients are put at risk. The areas grouped into Groups one and two should be inspected and tested on an annual
RISK ASSESSMENT OF THE AHU OR INDOOR AIR QUALITY PARAMETERS
Each noted exceedance from the expected air quality guidelines, or each rectification that is required for an AHU should be graded as to the potential impact to the area that is served using the following table. AHU Hygiene Assessment
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These two pieces of data should then be used to calculate a Maintenance priority rating, using the following matrix. Maintenance Priority Rankings
The maintenance priority ranking is used to produce a list of maintenance and other rectifications and investigations that are required to improve the system and ensure that it is up to standard and providing safe and clean air to the hospital. This provides both the Engineering and Infection Control and Prevention Departments with a targeted list of actions, in the order that they need to be done, to ensure maximum patient safety within the hospital with regard to the supply of air. A full report should be produced, along with a searchable and sortable spreadsheet of recommendations. This ensures that maintenance can then either target a particular air handling unit, or sort by the most important rectifications first. With only limited budgets for maintenance and repairs, and limited staff to carry out works this ensures that all of the available resources are directed in the most effective, efficient and safest manner.
EXAMPLES OF ISSUES UNCOVERED IN AHU’s
QED carries out this audit scheme for many hospital and commercial buildings, and the following are examples of problems that have been discovered with the air quality testing: • Formaldehyde and VOC exposures
• Dampness and mould issues
• Fungal growth within critical AHUs
• Bird faeces contaminating outside air intakes
• Negative pressure room vents adjacent to outside air intakes • Decomposing air handling units
FOLLOW UP PROCEDURES AND REPORTING PROTOCOLS
A comprehensive report of all of the issues, graded as to their importance to patient/staff health and safety should be produced. Once these issues have been investigated or rectified, a reinspection service shopuld be undertaken to ensure that rectifications have been carried out and are to standard.
About the Author
Sarah has years of experience in medical facilities where she specialised in microbiology and infection control, drawing on her postgraduate studies in medical microbiology. She leads QED’s infection control practice which includes hospital air quality, mould investigations and legionella risk management.
1. IHPA National Hospital Cost Data Collection Australian Public Hospitals Cost Report 2013-2014 Round 18. https://www.ihpa.gov. au/sites/g/files/net636/f/ publications/nhcdc-round18.pdf accessed 15 February 2017 2. www.esta.org.uk/documents/20130205VentilationHospitalsIAQ. pdf Accessed 15 February 2017 3. T. Peláez, P. Muñoz, J. Guinea, M. Valerio, M. Giannella, C. H. W. Klaassen and E. Bouza Outbreak of Invasive Aspergillosis After Major Heart Surgery Caused by Spores in the Air of the Intensive Care Unit Clin Infect Dis. (2012) 54 (3):e24-e31. doi: 10.1093/cid/ cir771 4. Lutz BD, Jin J, Rinaldi MG, Wickes BL, Huycke MM. Outbreak of invasive Aspergillus infection in surgical patients, associated with a contaminated air-handling system. Clin Infect Dis. 2003 Sep 15;37(6):786-93. Epub 2003 Aug 28. 5. Hajime Kanamori, William A. Rutala, Emily E. Sickbert-Bennett, and David J. Weber Review of Fungal Outbreaks and Infection Prevention in Healthcare Settings During Construction and Renovation Clinical Infectious Diseases 2015;61(3):433–44 6. NHMRC Australian Guidelines for the Prevention and Control of Infection in Healthcare 2010
8. Australasian Healthcare Faciltity Guidelines https:// healthfacilityguidelines.com.au/ accessed 15 February 2017 9. https://thinkprogress.org/exclusive-elevated-co2-levelsdirectly-affect-humancognition-new-harvard-study-shows2748e7378941#.3hr61la9s accessed 15 February 2017 10. National Environment Protection (Ambient Air Quality) Measure https://www.legislation.gov.au/Details/F2016C00215 accessed 15 February 2017 11. Terzano C1, Di Stefano F, Conti V, Graziani E, Petroianni A. Air pollution ultrafine particles: toxicity beyond the lung. Eur Rev Med Pharmacol Sci. 2010 Oct;14(10):809-21. 12. SafeWork Australia Workplace exposure standards for airborne contaminants 2013 13. WA Government Department of Health Microbiological sampling of operating rooms in Western Australian Healthcare Facilities. 2015 14. AS/NZS 3666 (2011) Air Handling and water systems of buildings – microbial control 15. NSW Department of Health Infection prevention and control during construction, renovation or maintenance SESLHDPR/374 September 2015
7. Western Australia Health Facility Guidelines for Engineering Services 2006, WA Department of Health
Staying Alive JONATHAN MOUSDELL I ENGINEER - HYDRAULIC, WARREN SMITH & PARTNERS
Central sterile service departments (CSSD) are integral parts of acute services healthcare buildings, an area that is often referred to as the heart of the hospital due to their function of providing the operating theatres with the tools to operate on patients. The question is, where do we go to understand the hydraulic services requirements for such an important, specialised area? An area where an incorrect pipe size or an unsuitable material can have such a significant impact on a hospital’s revenue, public health, and people’s lives.
am still looking for the answer to the above; however, through experience and the lessons learnt from peers, this is the brief and compiled information we work with at Warren Smith & Partners to successfully design and deliver fit for purpose hydraulic services to a CSSD.
What is a CSSD?
Being able to answer this question is critical to a successful design. You must understand the area, the process flows, the operation of the equipment, operating hours of the area, and the way the area functions. The main items you will take out of this and apply to your hydraulic design is that the CSSD is mainly split up into two areas – a dirty side and a clean side, that there are specific water quality requirements, and that the waste water discharge from the equipment will be well in excess of the 60°C.
Ensuring the Correct Water Supply
Working with the CSSD consultant you need to determine what water services you are required to supply to the equipment. Reverse osmosis (RO), chilled water, hot water, and cold water will generally always be required.
There is also becoming an increased desire for softened hot and cold water due to the associated increased performance with detergents. A dedicated RO plant will be required and located as close to the CSSD as possible to supply these specialist services. AS4187 identifies the risks associated with excessive pathogens able to developed in pure RO water and therefore sets out the sanitation requirements for the RO pipe work, storage tank and general reticulation system. Generally, there should be little to no diversity applied to the water supply flow rates for the equipment when determining the pipe sizing. This is due to the requirement for all equipment to run simultaneously during the test cycle prior to each major shift. A low flow supply will extend the equipment cycle times and therefore slow down the supply back to the operating theatres.
Counteracting Mineral Hungry Water
The main consideration when working with RO water is to understand how to counteract its nature. It is paramount to a successful design for the RO ring main to run directly above the equipment, that the dead legs to the equipment
It is necessary for the RO ring main to run at such a high velocity and with minimal dead legs as the water is mineral hungry and wants to ‘eat away’ at the pipework. Keeping the velocity high reduces the biofilm build-up in the pipes and as the loop is pasteurised each night, keeping the dead legs minimal whilst minimising seams at the joints is key to reducing the areas for this potential build-up. It is important to be mindful of the above and the required pipe properties when specifying the material.
Sterility of a CSSD
Due to the sterility of a CSSD, the delineation between the dirty and clean side is very important and the hydraulic services design needs to respect this. The hot and cold water supply is to be split up between the two sides with backflow prevention to stop cross contamination during the cleaning, disinfecting, and sterilising of the medical equipment. Additionally, in the clean side it is key that there are no areas or items which allow the potential for infections to harbour and spread, in turn floor wastes and the like are not permitted as these are proven to be a main source of pathogens.
as the pipe has been selected based on only needing to handle 60°C. This could be said to leave the hospital in hot water. In addition to the high temperature waste water, the waste pipe needs to be able to cater for the mineral hungry discharge. Cast iron is a commonly selected material for this application; however, during installation should the epoxy coating not be relined when the pipe has been cut, the joints will ‘fur’ over time and may cause blockages and leak. This has been a fairly common issue in the hospitals we visit throughout New South Wales.
Finding the Glove that Fits
So, where do we go to understand the hydraulic services requirements for such an important, specialised area? I hope the information I have shared assists with the high level requirements and contributes to future projects. However, as everyone in the industry knows, each project presents its own challenges and it is important to keep up to date with the ever evolving technology and standards whilst communicating with manufacturers and experts in the industry to get the best outcome in each application.
CIBSE Guide G - Public Health and Plumbing Engineering Design Guide provides guidance on hydraulic services in healthcare and can be downloaded here:
Equipment Waste Water Discharge Complexity
From the outlet of the equipment, the temperature of the waste water discharge can frequently exceed 90°C for extended durations. Consequently, a cooling pit is required. The most common mistake we come across with cooling pits is that they are sized for the first hour of the shift only; to cool from ambient temperature to the maximum outlet temperature as required by the local authority. However, this does not take into account the operation of the CSSD throughout the day, when the body of water in the cooling pit is no longer at ambient temperature but is still required to cool the same incoming mass of discharge. This results in an undersized cooling pit and a non-compliant system. The other function of the cooling pit is to protect the uPVC or HDPE on the cooling pit outlet from damage due to high temperatures of which both materials are susceptible to. To prevent a cooling pit, some manufacturers supply drain coolers with their equipment to reduce the outlet temperature to below 60°C. These drain coolers can cost a lot in wasted energy, wasted water, and extend the run times of the equipment which in turn decreases the productivity of the area. Due to the decrease in productivity, the drain cooling part of the cycle can be bypassed should the CSSD be busy – this can have a catastrophic effect on the pipe and in turn the hospital
are kept to an absolute minimum, and for the pipes to be sized up to a 3m/sec velocity. Failure to do this will leave you with a system that has a design life far less than the client’s expectations.
CIBSE Guide G For more information on joining the Society of Public Health Engineers, follow this link: https://www.cibse.org/Society-ofPublic-Health-Engineers-SoPHE
About the Author
Jonathan is a Hydraulic Engineer at Warren Smith & Partners. Since graduating with a building services degree in the UK, Jonathan moved to Sydney and has taken a specialised focus in the healthcare sector. Jonathan’s aim for the future is to be involved in innovative, positive changes in the industry for both sustainable and technological advances.
Reflecting on the Conventions of
Lighting in Hospitals
SIMM STEEL I PRINCIPAL LIGHTING DESIGNER, STEENSEN VARMING
Our specialist lighting work covers a lot of sectors at Steensen Varming, but one common factor is that our approach does, by necessity, focus on the welfare of occupants and visitors which is, in turn, predicated on upholding, constantly questioning, and setting benchmarks of design against the ever-changing industry and social background.
ospitals are also environments that have to function as critical workspaces, centres for patient well-being and recovery as well as assist with intuitive wayfinding for transient patient visitors, and sterility. Uniting aesthetics with functionality is crucial to the optimum habitability of any environment and seeking savings without diminishing quality of design or materials delivers a structure and institution of longevity and sustainability. These principles should be the focus and the true meaning and responsibility of value management. Recently there was a call for comment on AS/NZS 1680.2.5:2017 Interior and workplace lighting Hospital and medical tasks (a revision of AS/NZS 1680.2.5:1997) relating to safety and task performance efficiency within hospitals and medical premises. Three changes were recommended to this standard. All are pertinent, but the most thought provoking relating to the welfare of occupants is the topic of cyanosis observation lighting. The review highlights the importance of colour discrimination and the importance of specification of light sources with an appropriate Cyanosis Observation Index
(COI) under the current thinking. But in light of why the standard was created and the quality of new technologies should we instead be calling into question the relevance of cyanosis observation lighting altogether? As we are mandated by the Codes of Conduct of most engineering and design institution to stay within our sphere of expertise, Steensen Varming acknowledges that we do not possess clinical or medical expertise to conduct the necessary research or scientific evaluations however our input into Engineering Services Guidelines does advise that clinical staff should decide on the locations where COI is to be specified. Of course, recommending â&#x20AC;&#x153;... that all members of the health care team discuss and decide upon those areas where provision should be made for the visual detection of cyanosis.â&#x20AC;? places the onus of responsibility on the staff and the likely conclusion is that it would be specified everywhere. How relevant are the methodologies used to decide the value of COI? How is cyanosis observation affected by the presence of anaemia, genetic skin pigmentation or colour deficient observers? It is certainly becoming clear that
Until these factors are understood the value of cyanosis lighting is unknown and it would be beneficial to develop an approach of undertaking academic/clinical studies where the decisions/conclusions are made by qualified experts/scientists with assistance from unbiased lighting consultants to interpret and recommend based on the data provided. Which brings us to the question of the use of colour tuneability, and its use to reduce sleep disorders such as Seasonal Affective Disorder (SAD) and the support of circadian rhythms of shift working in the Australian context. The intrinsically photosensitive retinal ganglion cell (ipRGC’s) of which there are currently 5 types, were discovered in 2002 and play a part in influencing biological rhythms (even in the blind), pupil constriction and some image forming vision, and are particularly responsive to the wavelength of 480nm (toward cyan)4-5.
Although there is much talk about how blue light from LED light sources can play a part in sleepless behaviours, and as evidenced by a sample Spectral Power Distribution (SPD) graph from a Cree datasheet 2008-20186, the blue spectrum between 400-490 nm peaks at approximately 450nm and drops significantly at the 480nm, the wavelength associated with circadian rhythm response. So, if we suggest this peak lies outside the zone of influence are there other factors we are not paying enough attention to such as illuminance levels, mental focus and exhaustion? Assuming “tuneable” lighting does have an impact on circadian rhythms, how does “tuning” to a circadian responsive level where a CCT may be as low as candle light (resulting in low rendering of colours) impact on the shift worker who is carrying out detailed work within a hospital? And how does circadian lighting make a lasting difference if occupants still have to navigate the value managed lighting of restrooms, corridors, elevators, entry foyers and street lighting, not to mention daylight when they might be expecting to go home and sleep?
colour vision deficiency is an issue1. Advice also exists regarding skin colour evaluation where cyanosis “may present as grey or whitish (not blueish) in dark skinned patients2 but it does not relate to LED technology lighting itself and it hard is to find significant scientific research pertaining to light and cyanosis detection since the J.O, Morgan Hughes paper of 19683 when the increased use of fluorescent lighting brought about recommendations in the use of fluorescent with appropriate Spectral Power Distributions, and it is not clear if skin pigmentation was even considered, proving to be historically and societally outdated both in its western bias and embedded cultural myopia. There is also reasonable argument that areas where pulse oximeters are not in use, such as emergency waiting areas, there is equal justification for high colour rending to aid in cyanosis observation.
Are there other ways to support circadian rhythms? Outside trying to emulate a balanced diurnal cycle in environments where the solar day can be extremely long or short there is little evidence that trying to control or support circadian rhythms of shift workers is entirely effective. There are simply too many variables, however it has been noted that a reduction in illuminance is equally effective and this allows for specific task areas to have a focussed lighting that does not impact on the ambient light levels or CCT. With a considered design approach, the role of focussed lighting may also play a dual role in wayfinding for visitors and patients alike. In wards it is also possible that the application of paint colour that absorbs the higher energy spectrum of higher
Samer Hattar and Anna Matynia Journal of Neuroscience 9 November 2011, 31 (45) 16094-16101; DOI: https://doi.org/10.1523/JNEUROSCI.4132-11.2011 5. Berson DM, Dunn FA, Takao M (Feb 2002). "Phototransduction by retinal ganglion cells that set the circadian clock". Science. 295 (5557): 1070–3. doi:10.1126/science.1067262. PMID 11834835. 6. http://www.cree.com/led-components/media/documents/ XLampXPE.pdf
CIBSE has numerous Lighting Publications for various sectors and situations, in particular for healthcare:
LG02 Lighting Guide 02: Hospitals & Health Care Buildings - LG2 CCT ward task lighting employed at night would reduce the ambient colour temperature and reduce the assumed impact of blue light. During the day direct daylight penetration would trigger the daytime circadian response of patients looking out through windows while controlling the circadian spectrum when privacy curtains are closed. So how does this then relate to the importance of value management in the hospital and should we be honest and admit that “value management” is a term mis-used to make the act of “cost saving” more palatable rather than managing value. It’s not entirely clear how “colour Tuneable” and COI lighting is of benefit to clients. It’s a simplified question, but if circadian rhythms can be supported by other means and Cyanosis observation is being superseded by the use of pulse oximeters, why would we specify these light sources when the standardisation of high quality light would enhance the welfare of patients, staff and visitors within our hospitals?
1. Color changes in cyanosis and the significance of congenital dichromasy and lighting Stephen Dain. First published: 15 October 2007 https://doi.org/10.1002/col.20353 https://onlinelibrary.wiley.com/doi/pdf/10.1002/col.20353 2. Color awareness: A must for patient assessment https://www.americannursetoday.com/color-awareness-a-must-forpatient-assessment/ 3. LIGHTING AND CYANOSIS J.O. MORGAN-HUGHES. https://doi.org/10.1093/bja/40.7.503 4. Melanopsin-Positive Intrinsically Photosensitive Retinal Ganglion Cells: From Form to Function Tiffany M. Schmidt, Michael Tri H. Do, Dennis Dacey, Robert Lucas,
The SLL represents the interests of all those interested in the application of light. It is open to everyone with an interest in lighting.
About the Author
Simm Steel is the Principal Lighting Designer at Steensen Varming specialising in Museum lighting, and as part of the Steensen Varming holistic lighting approach, considers electric lighting and daylighting as intrinsically linked. He has worked on major projects with acclaimed international artists and leading architects on projects that have received numerous awards from the Illuminating Engineering Society of Australia and New Zealand and the International Association of Lighting Designers. Simm teaches the Subjective Analysis in Lighting Design unit for the Illumination Design Master’s program at The University of Sydney, is a member of the judging panel for the Illuminating Engineering Society LiSDA and LiDA awards, and has authored a number of articles in lighting magazines and publications, and presents at various international lighting conferences and technical seminars.
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Steam for Sterilisation in Healthcare SPIRAX SARCO
Steam is a vital component in the sterilisation process of most modern day hospitals and needs to be of a certain quality and purity to ensure the sterilisation process is not compromised. This article explores the standards that deal with steam quality and purity for sterilisation and how to ensure the steam system is able to deliver what is required for compliance with the standards.
he standard that governs steam quality and purity for large healthcare sterilisers is AS/NZS 4187:2104 Reprocessing of reusable medical devices in health service organisations. This standard in turn references: • EN 285 Sterilisation – Steam Sterilisers – Large Sterilisers
• ISO 17665 Sterilisation of health care products – Moist heat – Part 1: Requirements for the development, validation and routine control of a sterilisation process for medical devices Part 2: Guidance on the application of ISO 17665-1 • CFPP 01-01 Part C* *CFPP 01-01 Part C has been replaced by Health Technical Memorandum (HTM) 01-01: management and decontamination of surgical instruments (medical devices) used in acute care, Part C Steam sterilisation.
The requirement of steam supplied to a steriliser to be of a certain quality has long been recognised with testing for steam dryness, non-condensable gases and superheat being well established. To enable the steam quality to be tested there must be suitable test points installed in the
steam system and these points need to be such that they enable the steam testing to be undertaken as described in the standards.
load) and at the operating pressure required, particularly if producing steam at lower pressures, as is often the case with clean steam generators or dedicated generators.
A brief explanation of the steam quality parameters tested and factors which can affect these parameters follows.
For plant steam boilers, high levels of Total Dissolved Solids (TDS) can cause foaming, which can be drawn into the steam outlet. This will not only affect the dryness of the steam, but will also affect the steam purity. Good TDS control is thus required when plant steam boilers are providing the steam to the sterilisers.
• Steam Purity and Quality Testing to AS/NZS 4187:2014 • Analysis by NATA/IANZ Certified Laboratory • ISO 9001 Accredited Dryness The steam dryness test measures the moisture in the steam. Excess moisture in the steam supply to the steriliser can lead to failed wet loads. There are many factors that affect the dryness of the steam. Starting at the boiler or steam generator there is the need for good steam disengagement. The steam disengagement is determined largely by the boiler or generator design and is influenced by the water surface area, the distance between the water surface and the steam outlet and effective droplet and moisture separation. It is important that the boiler or generator has a water surface area designed for the maximum steam load (peak
From the boiler the steam must be conveyed to the point of use. Effective and efficient condensate removal from the steam distribution pipework is required and must also allow for the higher condensate loads that occur when the system is started up from cold. The pipework should be sized to carry the sum of the peak loads and have adequate drain points to remove the condensate (typically this is every 30 to 50m). Each drain point should have a pocket to collect the condensate and be fitted with a steam trap. Pipework should slope in the direction of flow, at a gradient of 1:100, towards the drain points. The slope will aid the flow of condensate towards the drain pocket, particularly when there is no steam being used and there is no steam flow to help move the condensate along the pipe. As condensate will always collect at any low point, it is important to either design out any low points, or if they can’t be avoided to ensure they have a collection point and trap to remove the condensate. As such a drain point should be fitted at the base of all vertical risers.
Steam Quality and Purity Test
A separator with trap set should be installed at each steriliser or point of use. Non-Condensable Gases Air is a good insulator, therefor excess non-condensable gases in the steam supply can retard the heat transfer to the items being sterilised, particularly where gases can collect in hollows etc. This can result in failed loads, similar to a failed air detector test. The removal of non-condensable gases is best done by heating the feedwater in a vented feedtank tank to 85°C or higher. This requires a feedtank that is large enough to heat the water and allow the gases to escape from the water and be vented from the tank. How the cold make-up water is introduced to the feedtank and how the water is heated can also effect gases in the feedwater. A small heat exchanger is sometimes used to heat the feedwater, and while this will get the feedwater above 85°C, it is in a closed loop and so does not allow the gases to be released and vented before entering the generator, so does not provide the degassing required. In the steam distribution system it is important to have air vents that will quickly vent (remove) air when the system is
brought on line. The air vents should be placed such that they allow the air, which will be pushed forward by the steam flow, to be vented. As such they are typically at the end of pipework, on headers etc. Superheat Superheated steam, while hotter than saturated steam at the same pressure, is slow to give up its heat energy and the enthalpy of superheat is very low compared to the enthalpy of evaporation. Thus superheated steam will slow down the heat transfer rate and items may not reach the required sterilisation temperature. Also the moist properties of saturated steam aid the heat penetration,
and this moist heat property is of course not present in superheated steam. Steam generated from a standard boiler or generator, where the steam is in contact with the water it is produced from, will be saturated steam. The presence of superheat is usually due to having steam, with a high dryness value, going through a large pressure reduction. To avoid superheat it is recommended that pressure reduction be limited to a maximum 2:1 pressure turndown per station and that there is a distance between pressure reducing stations if more than one is required.
Steam Purity and Clean Steam
While the requirements for steam quality have been in place for some time, there is also now an increasing focus on steam purity as well. The latest revision of AS/NZS 4187 requires annual testing of steam purity (testing of contaminates in the steam supply to the steriliser). Traditionally steam supplied to sterilisers has come from plant steam boilers, which can still be used, but with a limit on the allowable contaminates it becomes harder to constantly deliver the steam purity required from a plant steam boiler. In general the plant steam boiler, and associated equipment (i.e. make-up water supply, feedtank etc.) will need to be designed, operated and maintained within strict parameters to maintain the minimum steam purity required. Where the existing plant steam system is not able to constantly deliver the steam purity required, or when a major upgrade or new plant is to be built, then clean steam is recommended using a clean steam generator to produce the steam supply to the steriliser (HTM 01-01).
means that the factors that influence steam quality are compromised and steam quality declines as a result. A steam to steam generator will maintain the speed of response required for the pulse loads of the sterilisers and it also means that the plant steam is also available for heating of washers etc. The all new Australian Healthcare Clean Steam Generator – AG-CSG • Clean Steam to AS/NZS 4187:2014
• Clean Steam operational pressure of 3 to 5 barg
• Delivers up to 300kg/hr of clean steam • Typically supplying up to 3 sterilisers • Efficient compact design
• On-board water degassing and heating
• Designed and built in Australia
When considering clean steam it is important that the steam quality requirements are not forgotten. Often the desire to produce a compact clean steam generator
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Love thy Naber DR PAUL BANNISTER BSC (HONS) PHD I FAIRAH, FIEAUST, MIPENZ, MCIBSE
Apartment buildings represent one of the fastest growing sectors in the built environment and yet remarkably little is known about their efficiency. NABERS has created NABERS Energy and Water ratings for Apartment Buildings to help address this problem. In common with other NABERS ratings, the NABERS for Apartment Buildings is an operational rating, in that it rates how the building (or buildings within a strata scheme) actually performs, as opposed to the design intent.
partment buildings are challenging from an efficiency perspective for many reasons. In design and construction, they rather awkwardly straddle both Volume 1 and Volume 2 of the National Construction Code. In operation, most are governed by strata management schemes, which are notorious for having limited skills and appetite to manage the complex technical systems that exist in larger buildings. Furthermore, the sector is immensely diverse, ranging from small buildings of only a few apartments through to large complexes consisting of multiple towers, often integrated with other building types and managed through complex tiered arrangements of strata management and community associations. This diversity becomes even more challenging when taken down to the level of how energy and water use are measured and paid for. The NABERS for Apartment Buildings rating addresses the energy and water paid for by the strata management, typically covering common services provided centrally to all apartments, but excluding the energy use within the apartments. For both energy and water, the scope of these central services can vary dramatically, ranging from little more than a light bulb in the corridor through to full air-conditioning services being provided to all apartments, mechanically ventilated car parks, heated pools, gyms, and other facilities. Furthermore, metering arrangements can vary,
Energy Action, working with Green Strata, were engaged by NABERS to unravel these challenges and create the rating. Data from over 200 apartment complexes was gathered, ranging from 4 apartments to over 600; average size was around 50 apartments. Benchmarks were created using detailed statistical analysis of the data, allowing for the following features: • Energy: Extent of central air-conditioning provided to apartments (none, condenser water, full AC); presence of lifts; extent of pool facilities (none, unheated, heated); number of car parks a nature of servicing (naturally ventilated, mechanically ventilated); and presence of a gym.
• Water: Water metering arrangement (single water meter, apartment water meters); presence of central domestic hot water; presence of central air-conditioning services. The energy and water ratings are both indexed on a per apartment basis. Given the complexity of data, the analysis process to determine the benchmarks across such a large range of factors was complex, but there was sufficient resolution in the data to create statistically based adjustments for each of the listed features. Other features were tested for statistical significance and were found either to have
Beyond The 6 Star NABERS Barrier, Melbourne, Australia – Energy Action
Tower 3, 747 Collins Street, Melbourne Docklands, Australia
Building Services Engineer: Energy Action Building Owner: CIMB Contractors: Automated Logic/AG Coombs/Programmed Facilities Manager: Collins Square Management
no statistically significant impact or an impact too small to merit inclusion, once the listed features had been accounted for. In common with other NABERS ratings, the scale has been set with 3 stars at the mid-point of the market and an extrapolated 7 star at zero emissions. The rating was launched at the NABERS conference on 5 June 2018, and there is already a high level of interest in ratings, with Melbourne and Sydney city councils already working on significant roll-out projects for the rating. The intent of the rating is simple: prospective apartment owners can use the rating to easily understand how efficient the building they are interested in purchasing into is. This may influence purchasing decisions, and will also help strata management understand the efficiency issues associated with their buildings and direct investment appropriately. For building services engineers, the rating will open up new possibilities in the design of leading edge apartments as well as a myriad of opportunities for refurbishment and upgrade.
with some buildings using a single meter to measure all water use in the building, while others measure common area water use and apartment water use separately. For a rating based on measured and billed consumption, this variability in configuration represents a significant challenge.
About the Author
Dr Paul Bannister is an international authority on energy efficiency in the built environment and is well known for his role as the primary technical author of the NABERS Energy and Water ratings. Paul is currently working on projects in Australia, New Zealand, Dubai and the UK and has over 100 publications in the field of energy use and the built environment.
Energy Action smashed it at the 2018 CIBSE Building Performance Awards, winning Energy Management Initiative of the Year This is the second time Energy Action has been short-listed for a Building Performance Award in the last 2 years. Matt Dopheide, Energy Action project manager of the Collin Street Precinct had this to say of their win earlier this month: “It strengthens our relationship with our client, and will help us to promote our services to other potential clients. We take this award quite seriously as it reflects upon one of our major strengths and was awarded by a key industry body in CIBSE” Read more about this project on page 25 of the 2018 Building Performance Awards winners’ brochure or find out more about the other winners and how to enter the competition for 2019.
A vision for the future, built on the values of the past HEATH TURNBULL I ASSOCIATE/SENIOR ENGINEER
After the 2010/11 Christchurch Earthquakes, one of the ideas supported by the community as part of a successful city rebuild was a district energy scheme. Ngāi Tahu Property had the vision to get on board with this idea and partnered with global engineering and infrastructure advisory company Aurecon and the Christchurch District Energy Company (CDEC) to provide a centralised District Energy Scheme (DES) for the Pita Te Hori Centre the former site of the historic King Edward Barracks. The DES solution is a high-quality, efficient and cost-effective centralised energy supply to replace traditional distributed building services systems.
A vision for the future, built on the values of the past
n 2012, Ngāi Tahu Property, the property development company owned by the Ngāi Tahu iwi, approached Aurecon with the vision of creating a flagship development in the heart of the Christchurch CBD. The idea of an innovative commercial DES capable of providing cost-effective and sustainable heating and cooling to the Pita Te Hori Centre was brought to life at a thought leadership event, when Aurecon engaged with Ngāi Tahu Property and took them on a journey that would reimagine the development (and Christchurch’s) energy future. Ngāi Tahu Property had previously dipped its toes into this arena with a joint venture development with the Christchurch City Council in 2010. The jointly owned Christchurch Civic Building (Te Hononga) uses landfill gas to provide heating for both itself and the adjacent art gallery. The position of the Pita Te Hori Centre directly
alongside the Civic Building presented the opportunity to link three city blocks with one pipe connection across the road.
At the forefront of sustainable development
The ambitious Pita Te Hori District Energy Scheme aimed to supply energy to six buildings within one city block. Here a key consideration was the use of the natural resources on the site. The team quickly identified an abundance of water flowing below the site in the form of aquifers ranging in depth from 30m to 140m. The abundant supply of clean fresh water, deep underground at the right temperature, proved the ideal source for harvesting energy, cool in the summer and warm in the winter. While an aquifer-sourced heat pump solution was not a new idea for Christchurch, the scale of the project was, as the scheme would ultimately be supplying energy to six buildings. The team started to look at how these buildings
would be able to share their energy resources, which led to the idea of a DES.
Borehole and building in the background
Resilience and environmental sustainability
The DES boasts a number of sustainability benefits, including: • Using over 75% hydro-electricity bolstered by on-site photovoltaic generation
• A global efficiency of over 700% (COP 7.1)
• Saving 215 000 kWh of energy per annum when compared with a conventional variable refrigerant flow (VRF) system • Using heat from the council offices tri-generation plant which is powered from waste landfill gas • Using a 15 000 litre thermal store to even out the load profile, reducing the need to rely on thermal electricity generation plants during peak periods
The business case for DES
The centralised aquifer heat pump solution was benchmarked against an air-sourced VRF system which is a common solution for similar scale buildings in
• Transferring waste heat and cold from adjacent buildings
Plantroom, water storage
Christchurch. For a single building, the cost of the aquifer heat pump solution could not be justified. However, when grouped together, the life-cycle costs significantly came down and showed a break-even situation for the first two buildings and a significant advantage for each additional building added thereafter. The use of waste heat from a landfill gas boiler in the adjacent Civic Building was not factored into the original business case, but may assist in achieving further operational and environmental benefits. As the landfill gas is predicted to run down over the next 5-10 years, Pita Te Hori will be positioned to enable heating and cooling to be fed back to the Civic Building and Art Gallery.
Electricity not gas
The South Island of New Zealand lacks natural gas resources that are common in the North Island and across the Tasman Sea in Australia. As a result, reticulated gas in Christchurch has been imported via the local port. On the other hand, electricity produced locally uses largely hydropower, making it a far more sustainable source and cost competitive with gas. The site also has a significant roof area which has been used to supplement imported electricity with on-site photovoltaic generation.
Local electrical network limitations
Due to the reliance of the built environment on electricity for heating in the South Island, the peak demand period for the local electrical network is in the winter; particularly on cold mornings and evenings. Both these peak demand periods occur at times not ideal for producing solar energy and occur at a time of the year when hydro lake flows can be low. This arises because the typical power generation situation in New Zealand is that the majority of
power for the country is produced by hydro lakes in the South Island. For short periods in the winter, a reversal of the net flow of electricity between the islands can occur. When this happens, hydropower is supplemented with thermal power in the North Island. To manage these peak periods the local network operator uses a pricing structure to incentivise reduction of load during peak times. In response to this, the DES included a 15 000 litre thermal store allowing off-peak generation of heat to be stored. This thermal store has sufficient volume to enable the complete shutdown of the electric heat pumps for up to two hours during peak demand periods.
Plant configuration to maximise resilience, redundancy and efficiency
The tenants within the Pita Te Hori Centre include consulting engineers Aurecon and various governmental agencies. Both tenants had high requirements around resilience and redundancy. In addition, the development was proposed to be staged over a number of years. This pushed the design towards a modular arrangement in which the loss of any piece of equipment results in no more than 25% reduction in capacity. The secondary pumping arrangement used two pumps each sized at 75% of Stage 1 capacity. In the future stages, the capacity will be increased by adding a third pump of the same size. The final configuration will be three pumps each having 50% of the Stage 2 capacity.
A similar approach was taken to the sizing of the heat pumps with three at 50% each for Stage 1 but space for a further three if needed. Space was also allowed for a further 15 000 litre thermal store. The pre-insulated pipework, which connects the central plant room to each of the buildings, incorporates electronic leak detection. The incorporation of valved connections will facilitate the easy extension of the system to future buildings.
Aquifer bores at other sites were demonstrated in the 2010/11 earthquakes to be very resilient with the vast majority continuing to operate. Bores that were damaged often related to mass land movement or damaged
headworks. Both risks were addressed in the design of this site. Above ground stainless steel headworks were installed to celebrate the aquifer system and allow for public engagement and education. Other measures to improve the life of the bores were high quality filtration and accurate control of the pumps to prevent rapid change in aquifer velocity (sudden change in aquifer pressure can result in the release of sediment). Both measures aim to reduce filling the injection aquifer with silt and sand, and reduce the chance of needing to redevelop the bores in their expected 50-year life. The use of surface mounted pumps for the aquifer circuit enabled multiple pumps to be located in the plant room for ease of maintenance over the alternative of using submersible pumps. This also reduced the pressure of the aquifer circuit and enabled a very high free flow between the two aquifers selected. The result being that the first stage of heating or cooling can be achieved without the need to run the aquifer pumps, improving the system efficiency even further. The selection of the heat pump technology was subject to rigorous analysis with traditional four-pipe systems compared to six-pipe technology, designed explicitly for ground-sourced applications. The final selection was a six pipe heat pump, which achieved a high coefficient of performance and also hydraulically separated the heating circuit, cooling circuit and aquifer circuit. One benefit of this is an inbuilt pressure regime to guard against leaks into the aquifer.
Collaboration for the future
Aside from the technical wizardry, a major achievement of the project was collaboration. The project successfully brought together a wide range of stakeholders including developers; Ngāi Tahu Property and CDEC; funding agencies CAFÉ, EECA; and major tenants; Aurecon, EY, Ministry of Education and Ministry of Health. The collaboration between these parties has created a DES that is resilient, efficient and has significant social benefits. The Pita Te Hori DES provides a working private sector example that can inspire similar solutions across the Christchurch CBD and New Zealand. “Working with the Aurecon team has been an incredible experience. The idea of a DES that was brought to us responded to our core values, and has helped us to stay at the forefront of sustainable development in the city,” said Gordon Craig, Senior Development Manager, Ngāi Tahu Property.
1. What is the blue spectrum wavelength frequency associated with circadian rhythm response? o
C: 490nm - 520nm
2. Which standard is referenced that is pertinent to Central Sterile Service Departments (CSSD) within the healthcare sector? o
C: BS EN 12056
3. What was the depth that an abundance of water flowing beneath the Pita Te Hori Centre was recorded? o
A: 3m to 14m
B: 30m to 140m
C: 14m to 30m
D: 130m to 180m
4. In steam applications, which three items should be incorporated within the design? o
A: uPVC pipework
B: Condensate drain, typically every 40 to 50m
C: Trace heating
D: Pipework gradient 1:100
E: Waterless trap
F: Drain points at the base of all risers
5. According to the 2016 Global Slavery Index, how many people across 167 countries are involved in some form of modern slavery? o
A: 4.58 million
B: 45.8 million
C: 8.54 million
D: 5.84 million
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6. Which problems are known to occure when the level of RH (Relative Humidity is below 35%?
A: Increase rates of ozone generation
B: Dryness and irritation of eyes, nose, throat
C: loss of sight and memory loss
D: Increased static electricity shocks
E: Increased allergic response by asthmatics
7. Which three isolation room strategies are generally applied throughout Australia?
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A: Negative Pressure
B: Dry Bulb
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D: Positive Pressure
E: Wet Rooms
8. When considering whole of life costs, what percentage of CAPEX per annum based on construction costs is generally applied? o
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