Healthcare Facilities Winter 2018

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HEALTHCARE INSTITUTE of HEALTHCARE ENGINEERING AUSTRALIA

FACILITIES REGISTER NOW!

EARLY-BIRD STILL AVAILABLE Great sponsorship opportunities still exist

INTERNATIONAL CONGRESS THEME: Healthcare Engineering – Building on Sustainable Foundations POOL HEATING – Diving into Efficiency FEATURED INSIDE:

AIR FILTERS – Maintaining Air Quality & Efficiency SECURITY – Benefits of an Independent Audit

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CONTENTS REGULARS 5

Editor’s message

44 Water special interest group forum

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National President’s message

48 Sewage leaks in hospitals

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CEO’s message

Air filters – Considerations 56 in maintaining air quality & energy efficiency

82 News

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63 Hydrotherapy pools and legionella

BRANCH REPORTS 10 WA

69 Diving into efficiency in pool heating

12 VIC/TAS 14 QLD

64 Burning issues affecting the healthcare industry

16 NSW/ACT 20 SA

INTERNATIONAL STORIES FEATURE ARTICLES 28 St Andrews Hospital – The start of the Site Services Sustainment Plan

72 Complex M&E for new orthopaedic centre

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34 The ravage and annihilation of rust, bugs and other nasties in HVAC cooling tower systems

Visit the Institute of Healthcare Engineering online by visiting www.ihea.org.au or scanning here ➞

IHEA NATIONAL OFFICE Direct: 1300 929 508 Email: info@ihea.org.au Address: PO Box 6203, Conder ACT 2900 Website: www.ihea.org.au Conference: http://IFHE2018.com IHEA NATIONAL BOARD National President Peter Easson National Immediate Past President Brett Petherbridge National Vice President Jon Gowdy National Treasurer Mal Allen Communications Darryl Pitcher Membership Registrar Peter Footner

Standards Coordinator Brett Nickels Directors Michael McCambridge, Greg Truscott, Mark Hooper

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IHEA ADMINISTRATION Secretariat/Website Administrator Heidi Moon Finance Jeff Little Membership Wendy Clayton (FMA), members@ihea.org.au Editorial Committee Darryl Pitcher, Mark Hooper IHEA MISSION STATEMENT To support members and industry stakeholders to achieve best practice health engineering in sustainable public and private healthcare sectors.

Melbourne: Neil Muir T: (03) 9758 1433 F: (03) 9758 1432 E: neil@adbourne.com Adelaide: Robert Spowart T: 0488 390 039 E: robert@adbourne.com PRODUCTION Emily Wallis T: (03) 9758 1436 E: production@adbourne.com ADMINISTRATION Tarnia Hiosan T: (03) 9758 1436 E: admin@adbourne.com

The views expressed in this publication are not necessarily those of the Institute of Healthcare Engineering Australia or the publisher. The publisher shall not be under any liability whatsoever in respect to the contents of contributed articles. The Editor reserves the right to edit or otherwise alter articles for publication. Adbourne Publishing cannot ensure that the advertisers appearing in The Hospital Engineer comply absolutely with the Trades Practices Act and other consumer legislation. The responsibility is therefore on the person, company or advertising agency submitting the advertisement(s) for publication. Adbourne Publishing reserves the right to refuse any advertisement without stating the reason. No responsibility is accepted for incorrect information contained in advertisements or editorial.

The editor reserves the right to edit, abridge or otherwise alter articles for publication. All original material produced in this magazine remains the property of the publisher and cannot be reproduced without authority. The views of the contributors and all submitted editorial are the author’s views and are not necessarily those of the publisher.

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REGULARS

EDITOR’S MESSAGE

I

t’s exciting to place into your hands the Winter 2018 edition of “Healthcare Facilities” in which we share with you a collection of useful technical articles to support engineering outcomes in the healthcare environment.

Planning and program development is well and truly underway for our IHEA National Conference in October, which as you no doubt are aware incorporates the IFHE Congress in Brisbane. I highly recommend you take action while the early bird registrations are available, and if you are interested to promote your organisation as a sponsor or exhibitor partner get in touch at www.ifhe2018. com. You will find the program outlined inside this Journal, but be aware this is subject to change, and we will be expanding this out to include concurrent sessions on day 2 with an additional 10 speakers incorporated into the program.

If you haven’t already found the IHEA on Facebook take a look for us now and connect so we can keep in touch with you and communicate the good things that are happening around the world of healthcare engineering.

We would love to hear from you on social media or via email (editor@ihea.org.au) with any feedback and ideas you’d like us to follow up or pursue on your behalf.

You will see that there has been considerable activity around all the state branches with some great technical and professional development seminars happening.

If you are interested to get involved please contact our member services at members@ihea.org.au or 1300 929 508.

Thank you to all of our contributors and business partners who have supported the production of this technical journal.

Regards Darryl Pitcher

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NATIONAL PRESIDENT’S MESSAGE

As the professional organisation for engineers and engineering facility managers employed in both the private and public health care sectors, and with our strategic intent for the Institute “to lead the way for our members to excel in providing state of the art health care facilities and leading-edge management services to support the health and wellbeing of all Australians” it is important that we promote ongoing and Continued Professional Development (CPD) for our members.

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ontinuing Professional Development (CPD) is a means by which individuals can fulfil their professional obligation to themselves, their clients, the public and their professional colleagues.

CPD can be used as supporting evidence of continuing competence and is about keeping hardearned skills and knowledge completely up to date.

The IHEA currently provides professional development opportunities in the form of workshops, seminars, and conferences, allowing the opportunity to learn from other members. The peer-to-peer learning and potential mentorship opportunities that the IHEA provides, allows members to combine their knowledge and take advantage of each others’ experiences.

Personal CPD is not only about attending various professional forums and seminars. Workplace learnings, self-directed learning, workshops, structured learning activities as well as the more obvious tertiary, vocational and other accredited courses, all contribute to an individual’s professional development.

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CPD although recognised as important is not always actively pursued by individuals. Participation in our own CPD programmes varies from State to State and between metro and country areas. There are of course many reasons why our members may not able to participate in CPD seminars or presentations.

Logistical problems, lack of awareness, and workplace demands all impact on an individual’s ability to attend scheduled CPD activities A key objective of our 2018/19 strategic plan is “to enhance and increase education and offerings to members”, one component of which is to develop and implement a structured National professional development program.

It is some ten or so years since the IHEA introduced the Certified Healthcare Facilities Manager (CHCFM) programme to “promote healthcare facility management through the certification of qualified individuals”. It is recognised that during the early years of its inception, a number of members did participate in the programme although more lately a decline in interest, coupled with the lack of contemporary

REGULARS

learning resources to support the program has prompted the Board to rethink its strategy towards delivering a recognised certification of competency within Healthcare facilities Management.

The Board certainly has an appetite to revise the Certified Healthcare Facilities Manager (CHCFM) programme and is exploring opportunities to work with others in restructuring the programme, placing an emphasis on learning pathways, driven by work integrated learning activities which can be mapped to a capability framework.

From personal experience, keeping track of the wide and varied professional development learnings and experiences attained during my own career has been particularly challenging. With our increasingly demanding schedules, it takes a certain amount of self-regulation to recognise, capture and log all of those ‘educations’ attained during our busy day.

These are certainly exciting times for our Board and membership, and I look forward with anticipation as we develop and implement forward looking strategies that underpin our commitment “to cultivate and maintain the highest possible standards of knowledge, skill, ethics and efficiency for those involved in the design, construction and maintenance of health care facilities”.

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REGULARS

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REGULARS

CEO’S MESSAGE

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018 continues to produce significant achievements for IHEA. Our new website is now complimented by a vibrant social media presence on Facebook, Twitter and LinkedIn. Our partnership with FMA has not only improved service to members and potential members but is growing the strength of and opportunities for both organisations. IHEA is increasingly recognised as a credible voice for Healthcare Engineering with opportunities for advocacy becoming more regular.

It was with this backdrop that the National Board met in Adelaide in June for its last meeting before the next most significant event for 2018, the IFHE Congress in Brisbane in October. Along with the usual board business of risk, finance, strategy and governance two particular items are important to highlight.

The Parliament of Victoria, Engineers Registration Bill 2018, has been introduced to Parliament on 6th March, 2018. The bill is based on the Queensland legislation, were there are nine bodies registered to accredit engineers, to ensure qualified engineers are engaged in continuous professional development (150hrs / annum).

Regulations to underpin the bill are yet to be developed, these will however, go through thorough consultation.

The board and myself have been reviewing the CHCFM program and are looking to relaunch a version of this professional development/CPD program. A presentation was made to Directors on an exciting and innovative approach for a broader, more inclusive offering for members. One that will encourage ongoing training and professional development but in addition will record and acknowledge the learning that occurs in your job each and every day. It is still early days and we are continuing to work through the options. It is exciting to note however, that once launched this will be a significant addition to your member benefits. Stay tuned!

d) Electrical Engineering

Secondly, the board were updated on an important piece of advocacy work undertaken by Michael McCambridge and Mark Hooper from Victoria. Michael and Mark brought to my attention the introduction of a draft Bill into the Victorian Parliament designed to mandate the registration of engineers in Victoria. After approaching the Victorian Treasurer, a meeting was held at the Victorian Treasury with Simon Mulcahy, Advisor, Parliamentary Secretary for Treasury and Finance, Daniel Mulino, Member of Parliament, Mark Hooper, IHEA and Michael McCambridge, IHEA.

The initial tranche of the bill only covers the core engineering practices a) Structural Engineering b) Civil Engineering c) Mechanical Engineering

e) Fire Safety Engineering Future tranche’s may cover other areas of Engineering, such as Healthcare Engineering.

IHEA will continue to monitor and review the passage of the bill and participate in the consultation phase of the regulations underpinning it and of course keep members informed of its progress and any possible implications.

All eyes now are firmly fixed on IFHE 2018 in October in Brisbane. This international congress is an exciting opportunity for IHEA members to hear from and network with healthcare engineering professionals from around the world. Incorporating the IHEA annual National Conference, this really is a rare opportunity for members to interact on the international stage. If you haven’t registered and booked accommodation I urge you to do so at www.ifhe2018.com I look forward to seeing you all there!

Karen Taylor – CEO

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BRANCH REPORTS

WA BRANCH REPORT Branch Meeting March 2018, Bethesda Hospital

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his meeting was held at Bethesda Hospital, an independent private hospital with 68 overnight beds, 20 day procedure beds and 9 operating theatres situated on the stunning shores of Perth’s picturesque Swan River.

The Hospital’s Engineer, Phillipe Tercier, hosted the 35 members present. Phillipe, a qualified Electrician by trade, secured this position a year ago, having worked for an Electrical contractor who focuses on the Health sector. As part of the proceedings a short Q & A session was conducted, to get the perspective of Phillipe, a young Facility Manager, starting his career as a Healthcare Engineer.

Members then inspected a project he recently completed, using the firm TPS as Project Managers.

It was the replacement of the Main Site Electrical Switchboards. TPS also spoke about the project and provided the refreshments during the networking session.

Photo 1 Host Philippe Tercier addressing the members

Photo 2 The team from WACHS Telehealth, Kylie Bosich, Alan Hamilton & Jim Tunsch

The second facility was constructed for Emory Healthcare, which operates the largest health care system in the state of Georgia, USA. Perth was selected as the best city for this facility because of its 12 hour time difference with Atlanta, Georgia USA. From this Emory eICU facility at RPH, Emory Clinicians who travel to Perth in 3 months rotations are monitoring, real time, the vital signs of up to 140 ICU patients being cared for in hospitals in Atlanta, Georgia. These include a 733 bed (including 93 ICU beds), a 529 bed (including 86 ICU beds) and a 410 bed hospital run by Emory Healthcare. This allows Doctors in the Perth day time zone to be monitoring patients during the 8pm to 8am night time of Atlanta, USA. This is the only such facility in Australia.

The builder of the Emory eICU facility, Kwikfit Building Solutions, sponsored the evening and provided refreshments at the end of the tours, which members enjoyed while networking.

Branch Meeting April 2018, Royal Perth Hospital New IHEA member Boris Veljanoski, of the EMHS Projects Office, hosted 39 attending members. The evening commenced with guided tours, including operational presentations and demonstrations of two new facilities constructed at RPH. The first was an Emergency Telehealth Service facility constructed for the WA Country Health Service. This is a telemedicine service provided by Perth based emergency medicine specialists, using videoconferencing equipment from this facility, to support regional clinicians, treating very acute emergency patients. This is the only facility of its type in WA.

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At the meeting former Fellow, now retired member, Roy Aitken, who has held many official positions in IHEA, at both State and National level, was presented his 40 year IHEA Membership Certificate by, WA Branch President, Greg Truscott. Greg mentioned what a privilege it was to present this to Roy who many years early was his boss and who encouraged him to join the IHEA nearly 10 years ago. Roy spoke briefly about the great joy and the benefits he has received from being a member of IHEA and that he is looking forward to many more years of involvement.

Photo 3 Greg Truscott (L) presenting Roy Aitken with his Certificate for 40 years membership.

BRANCH REPORTS

Branch Meeting and professional development presentation, May 2018, St John of God Hospital.

This was part 2 of the medical gases PD (part 1 was in February), with a great turnout of 46 members.

Hosts, Fred Foley and John Bose, gave a run down on this 511 bed private hospital, which includes the only private Emergency Department in WA. It included a tour of the MURTEC teaching facilities, which has life like simulators of an adult, a child and a pregnant woman patient, including demonstrations of the simulators.

The medical gases PD, was then conducted by Garry Smith from Lifelines WA and Sue Done from A & M Medical Services. Gary provided a detail presentation around the requirements of AS2896-2011 & the WA Health Facility, Engineering Guidelines covering compliance, quality and workmanship. Sue provided details on their servicing and maintenance of Medical gas equipment.

Photo 6 Brontie – displaying her chest compression technique

Greg Truscott WA Branch President

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BRANCH REPORTS

VIC/TAS BRANCH REPORT Activities

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he first professional development day for 2018 was held at Aurecon, Docklands on Friday 23 March the agenda was geared around passive building design. Thanks to Simon Roberts, for coordinating the day.

We had a number of entertaining presenters covering three core topics; Medical Gases Systems, presented by Paul Rogers & Wayne Williams, from Special Gases Enterprises, this was a general discussion around safer commissioning of medical gases

Hospital Operating Theatre Design, presented

by Abraham Corona, from TECHIN Technology & Innovation Abraham is a member and presented his research topic on theatre design, with simple tests for air flows in theatre clean zones.

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An Introduction to Passive House (Passivhaus) Building Design as Applied to Hospitals, presented by Johanna Trickett and Jeffrey Robinson from Aurecon, an interesting presentation on leaky buildings and the opportunities for ensure tight facilities during building and techniques for testing and certifying compliance Professional Development Day two - Environmental Seminar in conjunction with CHHA at Western Health, Sunshine Campus on Monday 21st & Tuesday 22nd of May 2018.

Day one was organized by Peter Crammond, and facilitated by IHEA. There were 11 presenters discussing sustainability for healthcare; • Aurecon, Johanna Trickett, Passivhaus in Health (Frankfurt Germany).

• Efficiency Matrix, Joseph Cheund, Building Air Tightens Testing.

• LCI Consultants, Jack McGuire, National Constructions Code - Section J Changes.

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BRANCH REPORTS

• Victorian Health and Human Services Building Authority - Sarah Bending, Climate Change Adaptation Strategy.

• Environment & Climate Change / Department of Environment, Land Water and planning - Andrew Rothberg, Senior Policy Officer, Update on the former Victorian Energy Efficiency Target (VEET) Now - Victorian Energy Upgrades Program (VEUP).

• ShineOn, James Johnson, Sponsor presentation, LED Lighting and Energy Audits.

• Dr Forbes McGain PhD - Anesthetist, Western Health, Research presentation, Sustainability in a Healthcare Setting.

• Environmental Technology Solutions, Rick Edwards, SHARC Energy Systems.

Actions To enable all members to benefit from professional development Vic/Tas has been charged with trialing a process of recording a PD and uploading to YouTube/ linking to our website, also looking at the Vox Vote technology to interactively stream the PD live for members who are unable to attend.

Branch Committee of Management With committee members from all across the State the Committee of Management meet monthly via teleconference and at the end of PD days. If you want to be part of the planning feel free to join into the conversation, email me for the details on how to get involved.

Michael McCambridge – VIC/TAS Branch President

• AECOM, Pablo Sepulveda, Beyond Environmental labels: A Holistic Sustainable Approach.

• Out Performer, Phil Goodfellow & Doug Russell, Project Based Activities.

• Environmental Programs Advisor, Manager Sustainability Uniting Care Queensland Judene Andrews, Case Study: Uniting Care, Queensland.

Look Ahead Activity The next professional development opportunity, will be the trial of webinar technology, to assist member with professional development without leaving their office Membership We have had a number of new members join in the first quarter of 2018; if you’re a new member, please make sure you let us know when attending one of our function just like we caught up with Andrew D’Silva at PD1 this year.

Branch President

Michael McCambridge

michael.mccambridge@mh.org.au Melbourne Health

Branch Secretary

Peter Crammond

peter.crammond@whcg.org.au Wimmera Health Care

Branch Treasurer

Steve Ball

steve.ball@epworth.org.au Epworth Geelong

CoM

Howard Bulmer

howardjbulmer@gmail.com Macutex Property

CoM

Sujee Panagoda

sujee.panagoda@monashhealth.org Monash Health

CoM

Simon Roberts

wavenhoe@labyrinth.net.au CETEC Consultants

CoM

Mark Hooper

mhooper@erh.org.au Echuca Regional Health

CoM

Roderick Woodford

rwoodford@castlemainehealth.org.au Castlemaine Health

National Board Reps

Michael McCambridge Mark Hooper

michael.mccambridge@mh.org.au mhooper@erh.org.au

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BRANCH REPORTS

QLD BRANCH REPORT

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t has been a fairly quiet quarter after the decision was taken not to have our usual country meeting in Toowoomba; however we did hold a Professional Development Seminar on changing Technologies in Facility Management in March at the Pineapple Hotel.

An afternoon discussion on the concepts of changing technologies in facilities, BIM modelling for architect’s, and a new generation of drawing / CAD software.

Systems with building intelligence platforms, including advanced analytics, fault detection, smart alerts and inbuilt reporting capabilities. The sponsor, NHP, also discussed Automatic Transfer Switches (ATS) that provide connection of backup power supplies to health facilities and aged care centres. Systems for maintaining power, whilst retaining the comfort and safety of patients and staff within the building and allow critical processes to continue by quickly restoring power during a mains failure.

Also included was some useful information in relation to new standards in compliance for emergency power management systems used in hospitals. Ellis Air provided a presentation on BIM, an intelligent 3D model-based process that gives architecture,

EMERGENCY DEPARTMENT X-RAY REPLACEMENT PROJECT Start 5th February 2018 BE&MS Handover 22nd February Official Opening 7th March

THE PROJECT In 2017 the ED X-ray unit at Redcliffe Hospital was found to be unreliable and was adversely affecting delivery of timely X-ray services to patients. This would mean that the room required mayor renovation works prior to the installation of the new Siemens imaging unit.

A replacement unit was approved and the challenges then became apparent that the department had to ensure the maintaining of a 24 hour service during the demolition, rebuilding of the X-Ray room inclusive of the actual x-ray unit replacement.

The most important component of the demolition and build was to ensure that the desired outcome of the project also gave flexibility and strong consideration to a concentrated methodology of minimising any X-ray service disruption and the daily operation of the Emergency Department services provided to

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engineering, and construction (AEC) professionals the insight and tools to more efficiently plan, design, construct, and manage buildings and infrastructure with a digital representation of physical and functional characteristics of a facility. BIM provides an opportunity for shared knowledge resource for information about a facility forming a reliable basis for decisions during its life-cycle; defined as existing from earliest conception to demolition.. It was exciting to see a full house at the Professional Development seminar; it was well attended. Our congratulations and many thanks to our sponsors NHP, Ellis Air and the Staff and Management of the Pineapple Hotel for the provision of excellent meeting facilities and their continued support.

Membership of the QLD Branch continues with slow growth In 2017/18, we welcome the following members to the Institute: Angela Yabsley from the Gold Coast University Hospital; Jawad Syed part of a National Corporate membership from Alerton; Tim Weber from New Life Restorations; Jamie Hayes from Norman Disney Young; And from across the ditch Mick Neil also from the NZ office of Norman Disney Young.

the attending patients during replacement. Another component addressed was the risks associated with the infection prevention and control issues that arise during a project build within a healthcare facility from dust, fumes and contamination of areas during access and egress from the areas by workers. Once again this was achieved by regular monitoring of the area by BE&MS management to ensure there was no complacency in any processes.

The success of the project was achieved through a continuous collaborative planning and stakeholder engagement from the initial stages of the project with the BEMS, X – Ray, the Emergency Department and Executive Team members of the hospital. Stakeholders were recognised as invaluable source of information and through ongoing consultation empowered staff, involved early on in the change process, and maintained the drive of enthusiasm for the new installation. This gave assurance that all were aware of the desired outcome and timelines to be achieved.

Project Outcome BE&MS Redcliffe Hospital Demolition, build and final fitout of x-ray room was under budget and on time with a high quality of

BRANCH REPORTS

Welcome to you all.

Sunshine Coast Country Meeting.

The Branch Committee has decided to hold our Country meeting this year on 21st/ 22nd June on the Sunshine Coast at the Maroochydore Surf club and it includes a tour of the new Sunshine Coast University Hospital (1 hour from Brisbane). We hope this will be well attended and look forward to reporting on this in the next Journal.

Just to make my usual report a bit more interesting I’ve included a small project in a very busy Emergency Department at the Redcliffe Hospital – the replacement of an X Ray machine.

Brett Nickels President, QLD Branch

Official Opening. from left to right: ED Nurse Unit Manager – Fiona Packwood, Radiography Team Leader – Stuart Ameron, Director of MED Imaging – Tanya Oliver, FMC BE&MS & IHEA Member – Jeff Briggs, Siemens Project manager – David Howard, Director ED – Dr Doug Morel

professionalism and workmanship displayed during and on hand over of the room inclusive of no defects.

The project ran without any disruptions to the normal running of both ED and X-ray services. This was mentioned by both the director of emergency and the director for the Imaging department at the official opening held on the 7th march 2018 Project Outcome X-Ray Department The department imaging services saw 2000 people being attended to during the one month down time of the x-ray room which gave validation to the continuing services being maintained as per project build prerequisites.

• Reduce downtime of ED X-ray service by replacing ageing equipment • Reduce patient turnaround times through improved technology / room layout • Deliver safe X-ray service through improved image quality and lower radiation doses • Faster X-ray exam times • New digital X-ray room will support increasing demand for emergency services • Standardised equipment within medical imaging

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BRANCH REPORTS

NSW/ACT REPORT

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SW/ACT branch annual meeting was held on the 23rd and 24th March 2018 at the Sage Hotel in Wollongong. The event was well attended with upwards of 40 delegates and 30 sponsor displays. A comprehensive program of presentations was delivered covering a range of diverse issues.

These included the latest technology in nurse call communications, the new regulations for helipads in NSW and an interesting talk given by IHEA member Marcus Stalker on the challenges in managing and preserving heritage listed trees.

An active decision by the Committee of Management (CoM) to provide a broader scope in the range of presentation topics than usual was well received by members with a high level of audience interaction taking place.

The technical tour was held at the newly redeveloped Wollongong Hospital and gave the attendees some insight on some of the challenges faced when constructing and maintaining a healthcare facility in an active operational environment. Many thanks to Greg Showell and the hospital Engineering team for being tour guides.

The annual awards function and ceremony was held at the City Beach Reception Centre which is a fantastic venue on the Wollongong beachfront.

Recognised in this year’s awards were; Manager of the Year – Jack McMillan Sydney Local Health District Engineer of the year – Grant Noakes, Murrumbidgee Local Health District

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Tradesperson of the year – Tom Rabbit, Hunter New England Local Health District A big congratulations to all our well deserving winners.

A massive thank you to all of our corporate partners in particular our platinum sponsor Titan Services and gold sponsors Rauland (Australia) and Ecosave for supporting the event.

Membership Membership interest from both industry groups and health facility management practitioners is increasing and it’s been great to see some new corporate members joining this month. The CoM will be discussing strategies on an ongoing basis how to ensure that this pattern of growth continues.

Actions Planning for the 2019 national event to be held in Sydney is now well underway with a short list of dates and locations to be discussed at the committee meeting in early June - the outcome of which will be presented to the National Board for their June meeting.

Professional development days are planned for November 2018 and March 2019. We are strengthening the educational delivery of these events with an emphasis on the themes being relevant to the day to day challenges that the members face in their working environment Themes chosen for the two upcoming events will be height safety/confined spaces and practical sustainability measures.

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BRANCH REPORTS

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BRANCH REPORTS

Name

Position

Phone

Email

Jon Gowdy Robin Arian

President

0411 040 834

Jon.Gowdy@health.nsw.gov.au

Vice President

0423 170 114

Rob.arian@sswahs.nsw.gov.au

Mal Allen

Treasurer

0467 761 867

mal.allen@hnehealth.nsw.gov.au

Darren Green

Secretary

0418 238 062

darren.green@health.nsw.gov.au

John Miles

CoM

0408 403 025

John.miles@health.nsw.gov.au

Peter Allen

CoM

0408 869 953

peter.allen@hnehealth.nsw.gov.au

Jason Swingler

CoM

0423 299 221

Jason.swingler@health.nsw.gov.au

Marcus Stalker

CoM

0409 157 870

Marcus.stalker@health.nsw.gov.au

Brett Petherbridge

CoM

0418 683 559

brett.petherbridge@act.gov.au

Peter Lloyd

CoM

0428 699 112

peter.lloyd2@health.nsw.gov.au

Greg Allen

CoM

0467 711 715

Greg.allen@swsahs.nsw.gov.au

Ashwin Singh

CoM

0459 896 171

Ashwin.singh@swsahs.nsw.gov.au

Chris Tarbuck

CoM

02 6244 3186

Chris.tarbuck@act.gov.au

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BRANCH REPORTS

• upgrades to the main entrance and public amenities • a new pathology unit.

Enabling works, to facilitate construction to begin on Stage 3, commenced late 2017

Industry News The NSW Government has committed $170 million towards the Wagga Wagga Rural Referral Hospital Redevelopment – Stage 3.

Thanks to NSW / ACT CoM member Peter Loyd Jon Gowdy – NSW State President Director Engineering Services SLHD MIHEA

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19

BRANCH REPORTS

SA BRANCH REPORT Activities

D

uring April SA members were invited to a tour of the St Andrews Eastern Clinical Development site, which opened recently and was a feature of the 2017 IHEA Conference program, and recent Healthcare Facilities articles. The tour was arranged

by CIBSE Young Engineers Network and IHEA members appreciated the opportunity of a behind the scenes tour of the new building on the fringes of the Adelaide CBD. This included the opportunity to see the recently commissioned Tri-Gen plant that supports on-site power generation, and provides steam and water for heating and cooling processes.

SA Member Vince Russo inspecting services in patient rooms

The “young engineers” involved in this project were happy to share their experiences and learning associated with the plant and equipment needed to support the surgical, clinical and ward area demands of the project. The alignment of the new building floor plates with the existing facility created some challenges that resulted in “low-headroom” plant areas and squeezed the available space for air handling units and other equipment – something that most Healthcare Facilities specialists are very familiar with.

In May, IHEA hosted a Professional Development event and site visit to the new Remote Retrieval & Aviation Services (RRAS) facility located on the western fringe

St Andrews Tri-Gen installation IHEA and CIBSE YEN site tour delegates

20

BRANCH REPORTS

of the Adelaide Airport. Attendees were given an excellent insight into this niche section of healthcare delivery which is South Australia’s single emergency medical retrieval service. SA Ambulance Service (SAAS) MedSTAR provide critical care retrieval as well as 24/7 clinical support and advice to country and metropolitan health services and SAAS clinicians.

Utilising a wide range of transport platforms 40% of all tasks have been performed by helicopter, 30% by fixed wing turbo-prop or jet aircraft and the remaining 30% by road ambulance. SAAS also operates its Special Operations Team, comprised of highly-trained rescue paramedics, from this base.

Andrew Fraser, lead architect from Walter Brooke and Associates, spoke to the assembled IHEA members about the constraints that went into the design considering its adjacency to the airfield.

That proximity with aircraft literally passing overhead dictated the careful acoustic design. An open layout facilitating operational aspects as well as training and administration all overlaid a design to reduce ‘call to activation’ time and promote single pass through where possible.

Pat Stevenson, A/Director of RRAS walked us through the demands and benefits of the new facility. With a 24/7 service and on call adult and paediatric teams, the co-location of the service with the helicopter service has been able to reduce response times by

10 minutes which translates into significant health cost savings and improvement in patient outcomes.

The RRAS facility has a strong focus on simulation and training with the northern ground floor “hangar space” dedicated to this including a fitted-out chopper and space for abseiling and ropes training to simulate aerial rescue and recovery.

Backed up by a diesel generator and an efficient design (meets iGRAT - SA Health’s ESD/green tool requirements), this facility with its operational, simulation/training and impressive meeting area, conference and teleconferencing capabilities is a versatile asset to the State’s healthcare.

The evening concluded with an opportunity for networking over nibbles and the feedback from participants was positive Arising from our joint planning efforts with CIBSE and other partners, a number of other PD opportunities have been offered to our members over the last few months, covering topics such as: • Forum on current responses to combustible cladding issues • Building Enclosure Testing and HVAC Air & Hydronic Balancing • Adelaide University Health Innovation Building (Mechanical Services) site visit

Rescue chopper awaiting tower clearance before heading off to site

21

BRANCH REPORTS

SA Ambulance Tactical Support vehicle

• Electrical Storage through Hydrogen

Planning for future events is underway with a number of exciting events being scheduled and are likely to include:

Membership:

• Emergency Power and Diesel Fuel Management

It has been pleasing to resolve a number of outstanding memberships with long-standing members recommitting to IHEA, including SA Health Infrastructure Directorate and Lyell McEwin Hospital.

• Tri-Gen Development at St Andrews Hospital

• Planning for Emergency Response in a radical mixed use high rise environment

It is also pleasing to note the recent membership taken up by prominent building automation and controls company, Alerton. The SA Branch Committee of Management has recently met with the senior staff from Alerton and discussed mutually beneficial opportunities that might arise to support our members.

Watch this space for more information on a sponsored PD event.

We continue to actively pursue potential new Branch members as we work hard to enhance the presence of IHEA in SA. Actions: The CoM meets on a monthly basis to pursue planning around PD events, membership initiatives, financial management and other matters. Either Darryl Pitcher or Peter Footner from the CoM also attend regular monthly coordination meetings with CIBSE and affiliated organisations to plan and promote joint PD activities. Events arranged by these “like-minded” organisations are a beneficial exercise in shared learning and development.

22

• Electrical Infrastructure Developments for Electric Vehicle Uptake • State Corporate member presentations – details still TBC Committee of Management: The current Branch Committee of Management is as follows: State President: Peter Footner Vice President: John Jenner Secretary: John Jenner Treasurer: Peter Footner National Board Nominee: Peter Footner Committee Members: Darryl Pitcher, Tony Edmunds, Vince Russo Planning has commenced for the State Special Meeting to confirm Branch roles and responsibilities for the coming year. The Branch CoM always welcomes the assistance, contributions and suggestions of members, who are encouraged to contact any member with feedback.

Peter Footner President, SA Branch

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FEATURE ARTICLES

24

The Institute of Healthcare Engineering, Australia (IHEA) invites you to FEATURE ARTICLES register for the 25th Congress of the International Federation of Hospital Engineering (IFHE) to be held on 6-11 October 2018 at the Brisbane Convention and Exhibition Centre.

CONGRESS PROGRAM The IFHE 2018 organising committee have put together a diverse, challenging, rewarding and enjoyable program. Under the broader theme of ‘Healthcare Engineering – Building on Sustainable Foundations’, the program includes presentations across a range of streams such as: • • • • • •

Healthcare Planning, Design and Construction Management and Operation of Healthcare Facilities Safety Sustainability Technology and Case Studies

The congress will be joining with the 42nd World Hospital Congress 2018 for a joint plenary session focused on Disease, Disaster and Destruction: Providing Health Services in Times of Catastrophe, Epidemic and Conflict.

IFHE 2018 will feature two engaging keynote speakers: PROFESSOR DAVID HOOD AM is a civil and environmental engineer with vast experience across major civil and military projects, professional development in emerging economies, senior management in both the public and private sectors and in education.

TIM LONGHURST works with business leaders to identify opportunities and seize them. He combines the latest data, powerful case studies and entertaining anecdotes to bring possibilities to life.

TECHNICAL SITE TOURS

The congress will feature four technical site tours as part of the program: • The Lady Cilento Children’s Hospital • Gold Coast University Hospital • Royal Brisbane & Women’s Hospital • Queensland Emergency Operations Centre

SOCIAL PROGRAM The congress will also offer an exciting social program including: • Welcome Reception – chance to get up close and friendly with Australian native animals • Trade Night – opportunity to network with IFHE congress partners and exhibitors • Congress Gala Dinner at Brisbane City Hall • Partners Program • Optional Dinner & Show at the Australian Outback Spectacular • Optional Social Day at Australia Zoo

The full congress program is now available at www.ifhe2018.com

25

IFHE 2018 FEATURE ARTICLES BRISBANE, AUSTRALIA

6-11 OCTOBER 2018 BRISBANE CONVENTION & EXHIBITION CENTRE

Plenary sessions will be held in Plaza Auditorium, Plaza Level, Brisbane Convention & Exhibition Centre

Sunday 7 October 2018 5.00pm - 8.00pm

Welcome Reception Location: Plaza Terrace Room, Plaza Level, Brisbane Convention & Exhibition Centre Enjoy an Aussie BBQ networking function and get a photo with a wombat!

Partnered by YEARS STRONG

Monday 8 October 2018 7.00am - 5.30pm

Registration Desk Open

8.30am

Official Congress Opening & Housekeeping Emcee: Madonna King

8.45am

Welcome To Country Songwoman Maroochy

9.05am

IHEA & IFHE Welcome Address Peter Easson, IHEA President & Douwe Kiestra, IFHE President

9.15am

Official Conference Address & Opening

9.45am

KEYNOTE ADDRESS Professor David Hood AM

10.45am - 11.15am Morning Tea & Exhibition

Location: Plaza Ballroom

10.15am - 5.00pm Partners Program: Mt Cootha Lookout, Lunch & Lone Pine Koala Sanctuary Concurrent Session 1 - Healthcare Planning, Design and Construction Plaza Auditorium, Plaza Level

Concurrent Session 2 - Sustainability P6 & P7, Plaza Level

A Model of Appropriate Operating Theatre Size associated with High Satisfaction Hiroshi Yasuhara, University of Tokyo Hospital

More sustainability in hospital wastewater management – a case story about a decentralized wastewater treatment plant at the Herlev Hospital in Denmark Jakob Søholm, GRUNDFOS BioBooster A/S

11.45am

The Rehabilitation and Upgrading of Mulago National Referral Hospital, Uganda Sam SB Wanda, Isaac Ilukor & Joel Aita, Uganda National Association for Medical and Hospital Engineering (UNAMHE)

Low-tech Solutions to mitigate Environmental Conditions: a South African Case Study Jehan Bhikoo & Ulrike Kuschke, Department of Transport and Public Works (Western Cape)

12.15pm

IHEA Annual General Meeting

11.15am - 1.15pm

11.15am

12.15pm - 1.45pm

Lunch & Exhibition

1.45pm - 3.30pm

Concurrent Session 3 - Healthcare Planning, Design and Construction Plaza Auditorium, Plaza Level

Concurrent Session 4 - Safety P6 & P7, Plaza Level

1.45pm

Precinct-based Energy Trigeneration - the large hospital experience at Lady Cilento Children’s Hospital, Brisbane Queensland Michael Campbell, Children's Health Queensland

Electrical safety acc. to the new edition of IEC60364-7-710 and AS/NZS 3003 & AS/NZS 4510 Matthias Schwabe, Bender GmbH / WGKT

2.15pm

Engineering Queensland’s $1.1B Health Infrastructure Project Mark Reardon, Metro North Hospital and Health Service

Safety Case Study - Clinical Waste Management Onsite at a Large New Hospital for Compliance and Infection Control Peter Atherton, AWS Clinical Waste

2.45pm

Is Change Management in Hospital Projects a Necessary Evil? The case of a Publicly-Funded Hospital Project in the City of Kampala – Uganda Ruth Sengonzi, Ministry of Health Uganda

Risk management within technical department of the largest University Hospital of Belgium Eddy De Coster, UZ Leuven

3.05pm

Healthcare Infrastructure Planning & Design in the Standard of Care - Compliance for Hot Water Western Cape Province, South Africa – Finding Systems appropriate solutions to inappropriate problems Marcel F. van Dijck, Armstrong International Duncan Rendall, Western Cape Government

Location: Plaza Ballroom

3.25pm - 4.00pm

Afternoon Tea & Exhibition

4.00pm - 5.20pm

Concurrent Session 5 - Energy Efficient Plaza Auditorium, Plaza Level

Concurrent Session 6 - Case Studies P6 & P7, Plaza Level

New ways to provide Emergency Power for Healthcare: Fuel Cells and Microgrids Walt Vernon, Mazzetti

Doctors Without Borders (MSF), much more than field hospitals Elvina Motard, Medecins Sans Frontières / Doctors without Borders

4.00pm

26

Location: Plaza Auditorium

Location: Plaza Ballroom

Continued over the page...

Improving the Steam Plant through Maintenance Denton Smith, Western Cape Government: Department of Health

Designing the ICU for the Future

5.00pm

10kV Transformer Replacement Preben Byberg, Copenhagen University Hospital

Chronic Cladding Disorder: Assessing and Treating the Risk of Hospital Facade Fires Oat Tukaew, RED Fire Engineers Pty Ltd

5.20pm

Congress Sessions Conclude

4.30pm

5.30pm - 7.30pm

Tiina Yli-Karhu, South Ostrobothnian Hospital FEATURE ARTICLES District

Trade Night Location: Exhibition Area, Plaza Ballroom, Plaza Level, Partnered by Brisbane Convention & Exhibition Centre Networking function in the exhibition area. Drinks and canapes will be served.

Tuesday 9 October 2018 7.30am - 5.00pm 8.00am

Registration Desk Open Welcome & Housekeeping Emcee: Madonna King

8.20am

KEYNOTE ADDRESS Tim Longhurst

9.20am

International Building Award Presentation

9.45am

IFHE General Assembly Meeting

9.45am - 2.00pm

Partners Program: Brisbane City River Cruise & Lunch Tour

10.15am - 10.45am Morning Tea & Exhibition

Location: Plaza Ballroom

10.45am

Healthcare Facilities and Medical Equipment Maintenance Modeling Tool for Policy Makers Claudio Meirovich, Meirovich Consulting SL

11.05am

Remote Health Engineering: Implementing Proactive Maintenance and Compliance Methods to Meet Continued Demand Andrew White, DMA Engineers

11.25am

Sustainable Management of the National Health Service England's Assets: Strategies for Backlog Maintenance and Critical Infrastructure Risk Reduction Efthimia Pantzartzis, Loughborough University

11.55am

Certified Healthcare Facility Manager (CHFM), the Malaysian Experience Khairul Azmy Kamaluddin, Ministry of Health Malaysia

12.15pm - 1.15pm

Lunch & Exhibition

1.15pm - 2.15pm

Mercy Ships John & Sue Clynes, New Zealand

2.15pm - 3.00pm

Presentation to be confirmed

3.00pm - 3.30pm

Afternoon Tea & Exhibition

Location: Plaza Ballroom

Location: Plaza Ballroom

3.30pm

Cloud Computing - facilitating excellence in the Health Care Sector Ryan Milne, Ecosafe International

3.50pm

Taking control of your Building Management and Control Systems and delivering the ‘new digital promise’ David Oakeshott, A.G. Coombs

4.20pm

Closing Remarks & Awards Peter Easson, IHEA

4.40pm

IHEA National Conference 2019 Presentation Jon Gowdy, NSW/ACT Branch President

4.45pm

IFHE Congress 2020 Presentation Daniella Pedrini, SAIAS

5.00pm

Congress Concludes

6.30pm - 11.30pm

Congress Gala Dinner Location: Brisbane City Hall, 64 Adelaide Street, Brisbane City

Partnered by

Wednesday 10 October 2018 8.30am - 10.00am

Joint Plenary Session & Morning Tea with the 42nd World Hospital Congress 2018 Disease, Disaster and Destruction: Providing Health Services in Times of Catastrophe, Epidemic and Conflict

Optional Technical Site Tours: Technical Site Tour 1: Lady Cilento Children's Hospital 10.00am - 4.00pm Technical Site Tour 2: Gold Coast University Hospital Technical Site Tour 3: Royal Brisbane & Women's Hospital Technical Site Tour 4: Queensland Emergency Operations Centre 4.30pm - 11.00pm

Optional Dinner: Australian Outback Spectacular Dinner & Show

Thursday 11 October 2018 7.30am - 5.30pm

Optional Social Day: Australia Zoo

Please note the IFHE Congress program will be presented and printed in English. This program is an outline only and the organisers reserve the right to change the topics, times and presenters if necessary. For the most up-to-date version of the program, view the congress website: www.IFHE2018.com

27

FEATURE ARTICLES

ST ANDREWS HOSPITAL

THE START OF THE SITE SERVICES SUSTAINMENT PLAN

By Tony Edmunds

At the beginning of 2008, St Andrews Hospital started to look at the future direction of the services throughout the site by commissioning System Solutions Engineering to produce an overview of the services on site, this initially consisted of little more than a walk through and a simple summary of the overall condition of the services.

F

urther to that report, a number of additional surveys were conducted to identify individual issues, which heightened the hospitals awareness of the age and condition of the services generally throughout the site.

In 2012, a full overall site services audit was conducted including the development of a 5 year future plan for the upgrade of services which had reached their

28

end of life expectancy, with the overall condition of all services being factored in, so services which were aged but still in good condition were given an extension to their serviceable life.

This plan was then further developed into a 7 year, then a 10 year plan to spread the proposed expenditure so that the annual upgrade expenditure

FEATURE ARTICLES

and the associated disruption to the site were more manageable.

Without talking about the myriad of services which were programmed for upgrade over the next 10 years, we are specifically here to talk about the new Trigen plant which has evolved from the need to replace the existing Cogen plant and the need to provide more site heat, steam and power for the new Eastern Clinical Development (ECD).

VIABILITY OF THE OLD COGEN ENGINE The old Cogen engine was identified as being at the end of life and only having a few years left, but when inspected it was operating within the limitations of the cooling infrastructure by having its capacity reduced and according to the service agents it was in reasonable condition and expected to continue to operate reliably in the short to medium term (2 to 5 years).

BUT it failed prematurely and at that stage the options for repair of the old plant were assessed and the assessment identified that even if the engine was repaired the associated infrastructure would limit its future life and viability.

Photographs of existing radiator

The heat rejection radiator was corroded and unable to reject the jacket heat and therefore the engine had not been able to operate at full load for a number of years.

The electrical controls for the Cogen were at the end of life and due for upgrade.

All of the electrical componentry in the cogen switchboard was original equipment and although it had been regularly maintained it was showing its age and was in need of an upgrade.

The room ventilation was in poor condition and not expected to last for much longer.

The room ventilation was provided by a pair of evaporative coolers mounted on a mezzanine level above the engine room. These evaporative coolers were in a difficult position to maintain and they were in poor condition. Although they were NOT poorly maintained and were NOT at end of life in terms of age, their condition was due to the extreme duty and the poor environment they were subjected to along with the long hours of operation.

The intercooler radiator was fouled and in need of replacement.

29

FEATURE ARTICLES

The intercooler radiator was mounted above the engine with evaporative cooler air blowing through the intercooler radiator directly down over the engine, which is a standard arrangement, which created an unworkably hot environment in the engine room.

Immediate engine repairs were estimated at $600,000 With the list of repairs for associated items being additional to the $600,000 and the fact that at the end of this expenditure the hospital was still left with an old technology plant, the viability of a new fully maintained plant looked more desirable.

When looking forward, the efficiency of the old plant was not competitive against the newer technology options now available in the market place and as the old existing components started to fail its available hours would be reduced by increased break down and maintenance time.

The old plant never really used its heat properly with the only sources of heat export being steam and hot water for the mechanical services hot water loop. The steam boiler was not able to produce enough steam to totally provide steam for the site and the hot water to the mechanical services loop was only utilised in cool weather.

(10%) of the maximum demand. So we needed to estimate what the minimum site demand would be with the new ECD building operational and limit the size of the generator to ensure that the engine did not unload below the engines minimum continuous operational load, which in this case is 50%, but in our design estimations we used 60% as the engine minimum load point.

The heat sources identified were: Combined hot water and STEAM which is utilised for • Sterilisation; • Steam and Heat for CSSD processes; • Steam for air conditioning where steam coils are used; • Hot water for the main air conditioning boiler loop; • Heat recovery for domestic hot water; • Hot water for the absorption chiller.

A large Domestic Hot Water Calorifiers 30,000 litres. Max. load 170 kW

CONCEPT & SIZING FOR THE NEW TRI-GEN PLANT System Solutions Engineering recognises that the Hospital is not in the business of producing electricity and exporting it to the grid for the benefit of electricity providers to buy at a reduced rate and resell to others at a profit, so the option of exporting electricity was not considered.

The power produced was not the main driver, because the viability of the whole concept relies on being able to effectively use as much heat as possible and the electricity that is produced by this process is a bonus (electricity for free). This notion of electricity for free often entices designers to upsize the engines and associated generators to provide more electricity because in reality it costs almost no more to build a 1.0 MW engine and generator than a .6 MW generator.

30

Heat for new absorption chiller 347 kW min 738 kW max

C

Hot Water Circuit:

1.

Hot water flow (+- 3%)

m3/hr

60.1

Considering that the old plant never exported its heat properly we had to look at where heat would be utilised in the new concept so that the time that the engine produced excess heat was minimised.

2.

Hot water inlet temperature

ºC

85.0

3.

Hot water outlet temperature

ºC

80.0

4.

Generator passes

No.

6

5.

Hot water circuit pressure loss

mLC

5.3

We also had to look at the site maximum demand as we can only reduce the site incoming demand to

6.

Hot water connection diameter

DN

100

7.

Glycol Type

NA

FEATURE ARTICLES

The total of all possible loads was assessed as being between 2019 and 2410 kW if all of the peaks are combined, but this can never happen, because the loads are all variable. At times the combined demand for steam and hot water will exceed the capacity of the engine to produce heat and during these periods some top up from the gas boilers and steam boilers will be required. At other times when little or no site heating, cooling or steam is required the heat will be used by the absorption chiller only, and even the relatively small engine heat output of 729 kW may not be fully utilised.

There is an almost total absence of energy metering throughout the site and therefore there’s very little history with regard to how the loads are distributed across the site.

We know from the site BMS records that there is always some cooling demand on site so the absorption chiller will always take some heat, and some requirement for domestic hot water make up will be present, so at no time will all of the heat be wasted.

OPTIMISING HEAT PRODUCTION When site demands for hot water are in excess of the engine jacket heat available and the demand for steam is not at 100%, the excess heat from the exhaust heat boiler can be utilised to add additional heat to the hot water loop.

This will also enable the plant to produce hot water temperatures in excess of the normal jacket temperature to feed the absorption chiller with hot water and this will actually allow the absorption chiller to produce more capacity than its nominal 250 kW. The chiller was selected at a relatively low generator entering hot water temperature (80C entering and 85C leaving), and with a small increase in generator entering temperature to 90C entering with a small flow increase a cooling capacity (316 kW) will be achieved.

SITE LIMITATIONS & DIFFICULTIES When the old Cogen plant was built it was contained within a specifically built plant room with the room

St Andrews Hospital

/

TRIGENERATION CRACKED. By replacing its ageing cogeneration plant with a new trigeneration solution that produces electricity, steam, hot water and cooling in one process, St Andrews Hospital is not only less dependent on the grid, it will reduce its energy costs by 30% and its carbon footprint by an equal amount. Three nuts, one cracker.

How does your building perform? Call SSE and find out.

08 8333 1855 31

FEATURE ARTICLES Proposed radiator and exhaust location

Proposed Trigen package location

cooling incorporated into a mezzanine level, but with current boiler codes, OHW&S requirements and safety in design regulations the space available in the original plant area was not sufficient and new solutions needed to be found.

Initially a concept was developed with suppliers who were planning to install the exhaust heat boiler inside of the container but when it came to actually producing a drawing of this concept they found that it just could not be made to comply.

System Solutions Engineering then worked with Clarke Energy to produce a concept which met the site space limitations resulting in the engine, generator and controls package being mounted in a fully ventilated and attenuated container, with the exhaust heat steam boiler, engine silencer and heat exchangers mounted on the roof of the container.

The boiler feed water tank and associated water treatment systems and the heat dump radiator are to be mounted on the roof of the Gilles wing, so that the required head for the feed water is available and the fan noise from the heat dump radiator is dispersed above the building and will not add to the overall plant noise at ground level.

NOISE LEVELS The noise levels produced on site are a consideration which must be managed and the purchase of the Jenbacker engine package contained within an attenuated and ventilated container provides an extremely low noise level of 65 (dBA) at 10 metres. To put this into context, it’s about the same noise level as a 90 kW packaged air conditioning unit.

DUAL FUNCTION DURING POWER FAILURE The Trigen plant will be interlocked with the site diesel generators so it will be capable of operating and producing hot water, electricity and steam for the operation of essential services within the hospital as long as a gas supply is available.

In the case of a power failure, the Trigen unit will stop, the emergency generators will power up to establish power to all UPS units and essential medical and patient services and when the diesel generators have stabilised their load the Trigen engine will start.

32

FEATURE ARTICLES

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FEATURE ARTICLES

THE RAVAGE AND ANNIHILATION OF

RUST, BUGS AND OTHER NASTIES IN HVAC COOLING TOWER SYSTEMS

By Allwater Technologies

RUST, BUGS AND OTHER NASTIES

T

echnically, the term “rust” refers specifically to iron oxide generated by the corrosion of iron bearing metals (steel chiller tube sheets, some pipe work and condenser pump housings, as examples).

“Corrosion” is the umbrella label referring to the oxidation of all metals, the most common of which are copper and its alloys (some pipe work, chiller tubes), stainless steel and galvanized (zinc) coatings often used to protect the internal surfaces of chiller isolation valves.

problems of cooling tower water, chilled water, steam, or other HVAC and plumbing piping may produce a loss of service, inconvenience, property damage, shutdown, and even millions of dollars in monetary losses, but the failure of a fire sprinkler line always threatens the loss of human life.

THE RAVAGE TO HVAC COOLING TOWER SYSTEMS The Cost of Excessive Corrosion All metals, with the exception of some classified as “rare earth elements” are found in nature as the oxide – the electromagnetic stability of the metal oxide is much lower than that of the refined metal. Mining the oxide and reducing it in a blast furnace produces the pure metal ready to be put to use. However, because the metal is in an “excited” state by comparison to whence it came, a never ending battle commences – the metal has an unrelenting driving force to revert to the oxide form, and man tries his best to stop that process.

“Bugs” is a slang term referring to microscopic organisms and certainly includes Legionella bacteria.

It also includes the Total Bacteria Count (TBC) also known as Heterotrophic Colony Count (HCC) and any other organisms found in cooling systems. Micro organisms such as Pseudomonas bacteria are more often found in water fountains and features, the management of which is also the responsibility of the HVAC Facilities Manager.

“Other Nasties” refers primarily to the threat of high corrosion to fire sprinkler lines. The most critical piping of any building, property or plant operation is unquestionably the fire sprinkler system. Corrosion

34

Corrosion is a chemical process which can be interfered with, but can’t be totally stopped. The best science can do is to slow down the inevitable

FEATURE ARTICLES

process to enable an acceptable service life of items made from metals. The cost of the “inhibition” to global industries is astronomical. The corrosion inhibitor market in the US alone is expected to exceed $US8.8 billion by 2023 and predicted to grow at a rate of 4.7% per year.

Within an HVAC condenser water system the most costly single piece of equipment is the chiller, and a close second is the associated pipe work. A single small chiller unit may cost $1.3 million, but in a multistorey building an additional $1/4 million may be needed to remove the outgoing chiller and install the incoming unit!!

Most mechanical service companies agree an acceptable service life of a cared-for chiller is 25 years. Non-destructive testing can establish the life expectancy of the remaining metallurgy and depending on the age of the building, this information is of great interest to the building management, and the owner or prospective buyer!!

The Cost of Biological Excursions Legionnaires’ disease (LD) is a serious, and often deadly, lung infection (pneumonia).

People usually get it by breathing in water droplets containing Legionella germs.

People can also get it if contaminated water accidentally goes into the lungs while drinking.

Many people being treated at health care facilities, including long-term care facilities and hospitals, have conditions that put them at greater risk of getting sick and dying from LD.

Key points include: • People definitely got Legionnaires’ disease from a health care facility in 76% of locations reporting exposures.

• Legionnaires’ disease kills 25% of those who get it from a health care facility.

• Most problems leading to US health care-associated outbreaks could be prevented with effective water management.

THE ANNIHILATION PROCESS To go into any battle – especially those where annihilation is on the agenda, preparation is vital.

Project planning should include industry specific items such as Critical Control Factors which include: • EFFECTIVE HVAC CORROSION MONITORING • REYNOLD’S NUMBERS [NRe] and EROSION • LEGIONELLA IRON INDEX [NLII] • SUPPLEMENTARY APPLICATION OF AZOLE “As a requirement under AS/NZS 3666.3:2011; all cooling tower systems shall be provided with automatically regulated water treatment systems for effective management of corrosion, scaling, fouling and microbial growth. Consequently, it is important that the effectiveness of such programmes be monitored on a regular basis. Protection of the assets within the cooling tower system is a Key Performance Indicator and monitoring provides an indication of the performance of the Water Treatment Service Provider. Corrosion is also regarded as a risk factor because any corrosion of mild steel components within the system will release iron, thereby providing nutrients for the growth of Legionella. Therefore, the provision of reliable monitoring of the corrosion rates of the various metallurgies within the cooling tower water systems is an important component of a cooling tower management program.”

• EFFECTIVE HVAC CORROSION MONITORING HVAC Plant Longevity The accepted method of monitoring condenser water corrosivity in the interests of equipment longevity is the use of mild steel and copper corrosion coupons.

However, meaningful results of practical value can only be obtained by the use of equipment compliant with the industry standard (ASTM D2688-15), and operated by its guidelines.

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Legionella HVAC condenser system corrosion is regarded as a risk factor because any corrosion of mild steel components within the system will release iron, thereby providing nutrients for the growth of Legionella. Therefore, the provision of reliable monitoring of the corrosion rates of the various metallurgies within the cooling tower water systems is an important component of a cooling tower management program.

STEP 1: Install an ASTM Compliant Rack and use Compliant Corrosion Coupons

IMC provide ASTM compliant corrosion coupons, and racks. There are 14 different rack design criteria imposed by ASTM to duplicate water-side chiller conditions as closely as possible.

STEP 2: Measure and Set the Rack Water Flow Rate to 0.4 to 1.8 m/sec (refer to Reynolds Numbers below) ASTM D2688-D15 specifies an acceptable water flow rate range to ensure that soft metal erosion (of metals such as copper and its alloys) is not confused with, and interpreted as corrosion.

The acceptable flow rate range is 0.4 to 1.8 m/sec.

Upon installation the water flow through the rack is calibrated ultrasonically and the flow regulating valve set and locked accordingly, and then fitted with tamper evident security items. Flow rate is checked ultrasonically every six months, and should also be done after major plant operational disruptions.

Too low a flow rate can enhance under-deposit corrosion, often leading to pitting metal wastage.

General metal loss over a large surface area inhibited to an acceptable level is the aim of water treatment corrosion inhibition. Control of pitting attracts special attention because it is often the cause of premature equipment failure such as weep holes in pipes.

Too high a flow rate can readily cause erosion and therefore metal loss of coupons, especially copper and its alloys. As coupon weight loss over specified exposure periods considers all weight loss to be corrosion, it is desirable to set the flow at the low end of the ASTM flow rate specification.

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STEP 3: Laboratory Analyse the System Water for Critical Control Factors and Azole Base line water chemistry conditions are needed to compare results after chemical or operational changes are made.

Azoles are incorporated into many water treatment blended corrosion inhibitors.

International technology indicates that a continuous free and available concentration of 4 ppm of azole is needed not only to protect copper containing metals, but to greatly reduce mild steel corrosion which is enhanced by excess soluble copper. Supplementary azole must be added by a separate dedicated peristaltic pump and timer as a 5 to 10% solution diluted with water. (Refer Supplementary Application of Azole below)

The compliant rack accommodates the probe and the self contained unit displays and logs corrosion rates every 30 minutes. This is Ideal for quick and accurate assessment of system operational changes.

• REYNOLD’S NUMBERS [NRe] and EROSION Depending on velocity, water flow in a pipe may be defined as Laminar, Transitional or Turbulent.

Reynolds Number [NRe] is a dimensionless value that describes flow type; NRe = [DVLρ]/µ where D = pipe diameter, VL = Linear Velocity, ρ = density of water and µ = viscosity of water. In a corrosion coupon rack the pipe diameter and water properties are constant so the Reynolds Number is directly proportional to water flow rate i.e. NRe α VL NRe <2300 = LAMINAR FLOW NRe 2300-4000 = TRANSITIONAL FLOW NRe >4000 = TURBULENT FLOW

STEP 4: Temporarily Install a Data Logging Corrosion Monitor

• LEGIONELLA IRON INDEX [NLII] The Corrosion – Legionella Bacteria Relationship Iron is an essential nutrient to Legionella bacteria.

Corrosion is regarded as a risk factor because any corrosion of mild steel components within the system will release iron, thereby providing nutrients

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FEATURE ARTICLES

for the growth of Legionella. Therefore, the provision of reliable monitoring of the corrosion rates of the various metallurgies within the cooling tower water systems is an important component of a cooling tower management program.

It is interesting to note that laboratory culturing and measurement of Legionella bacteria concentrations in water samples requires the addition of iron to the agar. Iron is an essential nutrient to Legionella bacteria and under these ideal conditions, 84 ppm is specified. This is known as the Legionella Iron Index, NLII. This concentration of available iron would not be found in circulating condenser waters but would be exceeded under biofilm which often blankets “rust spots”. Legionella bacteria live in bio film.

• SUPPLEMENTARY APPLICATION OF AZOLE Overview Azoles are used by most water treatment suppliers in their corrosion inhibitor blends designed for open condenser water systems, such as chiller cooling. It is well known that azoles are the popular choice for protecting yellow metals in such systems, but they also protect mild steel by virtue of their ability to chelate soluble copper. Chelation simply means that when soluble copper and azole react together, the end product does not precipitate as an insoluble copperazole complex – it remains soluble and able to be removed from the system by bleed. Without chelation, soluble copper seeks a galvanic “home” and mild steel is plentiful and available! The copper readily films on the steel creating a galvanic cell, and the mild steel becomes the “sacrificial anode” leading to rapid iron wastage both as general metal loss and more seriously, pitting at an accelerated rate.

Why is azole testing so important?

Most suppliers generally formulate cooling system inhibitors with azole. When fed correctly at the stoichiometric dose rate, they supply enough azole to the recirculating water to protect all copper metallurgy in the system. Copper is relatively corrosion resistant and a little azole goes a long way. However, chelation of soluble copper requires a reserve of azole to be available over and above base metal protection! Copper concentrations as low as 0.1 mg/L can deposit on steel surfaces, accelerating localised attack.

Please note that many suppliers have “one size fits all” products when it comes to a geographic area.

Special plant problems, like high mild steel corrosion rates including pitting especially, need “designer chemistry” not commodity product approaches. You should test for azole in open recirculating cooling systems which include chillers. Never assume that a particular product contains the proper amount of azole even for the yellow metal inhibition required, let alone for chelation of soluble copper!

The Do’s and Don’ts of copper AND mild steel corrosion control: • Don’t assume that enough azole is in a particular formulation to meet every condition • Don’t rely on copper corrosion coupons as an indication that results are good • Do run copper tests and identify the demand for azole • Do make sure azole residuals in the recirculating water exceed base metal protection demand by 0.5 – to 1.5 mg/l • Do add on at least another 2.0 mg/l for chelation.

A continuous residual of 4 ppm free and available is preferable • Do routinely test for confirmation of the required residual for both base metal and chelation requirement • Do feed supplemental azole as needed • Don’t use azole containing inhibitor to provide the chelate demand – pH excursions may result

A WORD OR TWO ABOUT CLOSED SYSTEMS Closed System Corrosion Monitoring evaluates the corrosivity of the recirculating water.

Our independent laboratory analyses provides a “snapshot” of water chemistry base-line conditions in systems where it is difficult to satisfactorily use corrosion monitoring equipment such as corrosion coupons and/or data logging monitors. Without regular system water analyses, the appearance of “weep holes” and other equipment failures are often the first signs of serious metal wastage. Regular analyses for corrosion products and other Critical Control Indicators are therefore recommended.

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FEATURE ARTICLES

Regular system water analyses can indicate preventative action requirements, before equipment failures, by monitoring absolute levels and trends of corrosion products and other Critical Control Indicators.

Achieving ASTM standard water flow rates of 0.4 to 1.8 m/sec through coupon racks requires significant differential water pressure and volumetric flow.

Suitable locations for these requirements are not always readily available in closed systems such as Chilled Water (CHW) and Heating Hot Water (HHW) circuits.

The alternative and/or complementary method of monitoring closed system water corrosivity and Critical Control Indicators is to regularly analyse the recirculating water. This means that a once-off system analysis establishes “base line” conditions for comparison with future analysis to indicate satisfactory absolute values and trends of Critical Control Factors over time, or not.

INFLUENCE OF HEAT As a general rule, corrosion rates double with every 8oC rise in temperature.

Therefore HHW systems are more vulnerable than CHW systems. In open systems corrosion rates drop at about 80oC as oxygen is dispelled from the system – NOT SO with HHW circuits!

SUMMARY COMMENTS The four steps for effective HVAC corrosion monitoring discussed in this article are evidence proven over more than three decades, and is now internationally accepted technology. The chemistry of the corrosion cell will forever remain unchanged and mankind’s continuing efforts to control the reaction rate have come a long way in that period. Controlling corrosion with chemistry is not an art – it is a cold blooded science; get it right (but not at the expense of

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biological tardiness – oxidizing biocides are corrosive) and achieving simultaneous continuous corrosion and biological critical balance will reward you handsomely. Get it wrong and you will be jerked into remedial action very quickly, financially embarrassed and if Legionella is involved stamped with a stigma which you could well do without.

Steve Powell is a Chemical Engineer specialising in industrial water treatment processes.

He has held senior research and sales/ marketing positions in multinational water treatment and speciality chemical companies operating within Australia and he brings considerable practical experience to address clients risk management security. Based in Sydney he is currently the Principal Corrosion Engineer of Allwater Technologies (AWT) the specialist Corrosion Management Solutions Division of Independent Monitoring Consultants (IMC).

Steve says, “AWT and IMC are aware of all of the impairments to quality service and servicing. As a privately owned Australian company providing quality services since 1992, IMC was the first to introduce fully independent sampling and testing to help clients manage the control of Legionella, system corrosion, Risk Management, Audits, indoor air quality, OH&S and duty of care obligations. These securities are all important to international hotel chains, major shopping centres, hospitals, and key Property Managers and Owners. IMC was the first major microbiological laboratory in Malaysia. It was also the first to be accredited

by Standards Malaysia for both sampling and testing of environmental waters, indoor air quality, and food.

IMC technical expertise and proficiency has been perfected during the past 20 years through our national and international experience. With a combined total of more than 150 years of water treatment knowledge and experience in our senior staff IMC is the perfect partner”.

Allwater Technologies CORROSION MANAGEMENT SOLUTIONS is a Division of Independent Monitoring Consultants Head Office: 23-25 Daking Street, North Parramatta NSW 2151 Australia Tel: 1300 131 405 or +612 9800 5067 Fax: +612 9630 1256 Website: www.imclive.com

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WATER SPECIAL INTEREST GROUP FORUM

IN-PREMISE WATER SYSTEMS AS A SOURCE OF WATERBORNE HEALTHCARE ASSOCIATED INFECTIONS 19 March 2018, The Alfred Hospital, Melbourne, Australia

Within Hospital buildings, water can stagnate and its temperature increase. It passes through complex internal distribution systems consisting of narrow pipes, valves, tanks, TMV’s, all with possible corroded inner surfaces and dead ends. This environment can provide optimal conditions for the formation of biofilm from which bacteria and other microorganisms may continuously be released into the water, and compromise the safety of vulnerable patients.

N

oel Cleaves, Manager, Environmental Health Regulation & Compliance, Victorian Department of Health & Human Services (DHHS); “Regulation of In-premises Water Delivery Systems”. The current Victorian Public Health & Wellbeing Regulations (2009)1 define a water delivery system as that which ‘includes any shower plumbing, bath, pipes, water heaters, bathing facilities, water storage tanks or vehicle washing equipment used to store, deliver, transmit, treat or mix water’, and applies to premises supplying aged care, health services, health service establishments, registered funded agencies, correctional services and commercial vehicle washes. While these regulations provide for a ‘responsible person’ to take ‘reasonable steps to manage the risks of Legionella in any water delivery system’, the responsible person has to ensure the system be disinfected within 24 hours of receiving a report that Legionella has been detected within the system. However, it does neither cover requirements to register the system or take samples, as with cooling towers, nor to have a water management plan and/ or an outlet flushing program, nor provide DHHS or the responsible person discretion over regulating other than to ‘manage the risks’.

As all Victorian regulations lapse after 10 years, DHHS is conducting a sunset review of these regulations to determine what changes to incorporate into the new regulations before the sunset of the current regulations

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on 15 December 2019. To that end, a discussion paper will be released within the next few months with options to consider: allow lapse (do nothing, no regulations), keep ‘status quo’ (current regulations), or tighten regulations (new regulations). Up for debate is everything related to water delivery systems, including its definition.

Reported Legionnaires’ disease cases attributed to in-premise building water systems in Victoria are far lower than counterparts in USA and Europe; is this due to under-diagnosis or under-reporting, or some other reason? Should the regulations have a narrower focus e.g. to only cover hospitals and aged care facilities (currently covers other premises including commercial car washes), or should they be linked to classes of buildings following the Building Code? Should these systems/premises be registered? Who should the responsible person be? Could there be practical guidance of what constitutes ‘reasonable steps’, such as provided within the enHealth Guidelines?

A current strongly discussed topic is that the regulations require the entire system be disinfected upon detection of Legionella; is this excessive and should it be changed to disinfection of only the branch where detected?

Should a risk management plan be required, and if so, should it be independently audited? Should mandatory reporting be required, with a defined threshold and

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perhaps limited to certain species, like Legionella pneumophila (the current disinfection threshold is for any Legionella species.)? One benefit to mandatory reporting would be that the Legionella team would be able to follow up and help with ensuring that it is cleared up, and provide a clearer picture of the landscape.

Elizabeth Hartland, Director & CEO, Hudson Institute of Medical Research; Head of Department, Molecular & Translational Science, Monash University; “Legionella Biology and Environmental Persistence”. Research performed is in basic discovery, in this instance, understanding the biology of Legionella bacteria, how they interact with host cells and how Legionnaires’ Disease develops. Alveolar macrophages (immune cells) in the lung are generally able to kill bacteria, but engulfed Legionella start to replicate within the macrophage, going from a single cell to multiple cells within 24 hours. How this is achieved is of fundamental interest.

Legionella is an environmental bacterium with no selection for virulence in humans and does not appear to follow the normal rules of pathogenic spread.

Dirty water creates an environment called a biofilm (appears as sludge in pipes). In their normal habitat, Legionella are not free-living organisms, but closely associate with environmental protozoa (amoebae), in which they are included in a vacuole, replicate in the vacuole and finally emerge. This association is critical for environmental persistence.

Legionnaires’ Disease occurs when contaminated water containing Legionella is aerosolised and inhaled into the lungs; susceptibility depends on various factors including immune deficiency, increase in age, preexisting pulmonary diseases, chronic smoking and being male. Upon entering the lungs, in addition to being engulfed by macrophages and creating a vacuole within, the presence of Legionella stimulates the immune systems which releases killer immune cells (such as phagocytes) which are usually good at eliminating bacteria. Legionella, however, is very efficient at evading the normal killing pathways, which would end in the lysosome, where the bacteria are digested.

Instead, a robust inflammatory response is required to be rid of Legionella, including cytokines (like TNF and interferon gamma) and phagocytes (like neutrophils).

Amoebae may contribute to the emergence of new environmental pathogens by selecting for bacteria that replicate within amoebae and therefore also replicate within macrophages, leading to the environmental persistence of Legionella. Taking out some of the genes in Legionella, then comparing replication to the wild type strain, provides information on what bacterial

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factors allow replication in amoebae. This knowledge may be used to selectively target these gene products to inhibit replication. In order to contain Legionella, we need a rapid phagocyte response to control the infection.

Anne-Rita Vleugel, Business Manager, Pall Medical ANZ; “Healthcare Water Filtration from POE to POU”. Water from the source is transported through water plants to domestic/commercial premises, where it is provided “fit for purpose”. Cold water systems within complex hospital buildings can experience temperature increases, through plant rooms, heated roof spaces, and risers shared with warm water pipes, which provide excellent conditions for biofilm growth.

Within a water pipe, biofilm develops in several phases; “conditioning” occurs when low water flow near the surface of the pipe allows particulate matter to adsorb to the surface. Bacteria attach to the inner pipe surface and start releasing a sticky extracellular matrix, the so called Extracellular Polymeric Substance (EPS).

The formation of microorganisms surrounded by EPS is called biofilm. Within the biofilm bacteria reproduce quickly and are protected from mechanical, thermal and chemical stress. When a stable biofilm has been established, the force of the water flow can break off sections, propagating the development of biofilm downstream.

Bacteria exist in either a culturable, active state, or a Viable But Non Culturable (VBNC), dormant state.

Maintaining water system hygiene may include heat and chemical treatment, creating a stress environment for the bacteria forcing some into a dormant state, in which they may survive, and emerge, perhaps resistant to future similar treatment. The emerged culturable cells reproduce and rebuild the biofilm. In examining levels of chemical treatment Mustapha et al. tested Legionella pneumophila survival under increasing ClO2 concentrations in vitro.2 Whereas medium concentrations (4-6 mg/L ClO2) may have limited effect killing culturable cells, many VBNC cells could survive.

High concentrations (such as 10 mg/L ClO2) have been shown to lead to cell lysis, but are perhaps less practicable for long periods of time. Heat treatment (such as 70 °C for 30 min) appears to kill culturable cells, but VBNC cells may survive and resuscitate after the treatment.

Testing samples from the water network provide differing results depending on when and where the samples are obtained. Resultant false negatives may not be just because of dormant cells within the system, but also because of when and how the sampling is done.

Samples taken early in the morning before the increased

46

activity of showering and kitchen preparations might provide a truer indication of what the system holds than those taken later during the day. Samples taken immediately upon opening the faucet (pre-flush samples) will provide the water within the faucet; those taken at 1 minute or longer (post-flush) will provide that within the system. Each sample may provide a different reading.

New antibiotics are being investigated for a range of strains of microorganisms no longer sensitive to current treatment options, many of which are found in water.

One of the more prevalent is Pseudomonas aeruginosa, accounting for a large number of Healthcare Associated Infections (HAI).

Filtration from Point of Entry (POE) to Point of Use (POU) can help control the bacteria which give rise to HAI, and the resultant savings from reduced length of stay and antibiotic usage, could be put toward maintaining/ upgrading water systems. POE systems can help reduce particulate levels, turbidity and microorganisms. Inpremise, inline prefiltration banks help protect inlet water to washers and protect assets. POU filtration is a well-documented and validated method to prevent transmission of bacteria from the water system to the patient, either through tap outlets or showers. Their robust design allows them to withstand chemical and heat treatment regimes employed by hospital engineering, providing protection to highly vulnerable patients.

Pall Corporation is a global leader in high-tech filtration, separation, and purification, offering products and services to Life Sciences and Industrial markets worldwide. Pall Medical Point-of-Use Water Filters are well established and documented as efficient barriers against water pathogens such as Legionella spp. and Pseudomonas aeruginosa deriving from water systems within healthcare facilities. Pall Medical organises and supports educational events relevant to in-premise water hygiene, enabling the audience to access information on current scientific findings, and raising their overall awareness of in-premise water hygiene.

This forum was made freely available by Pall Medical.

We look forward to seeing you at the Congress of the International Federation of Hospital Engineering (IFHE) in Brisbane, 06-11 October 2018.

REFERENCES 1. Public Health and Wellbeing Regulations 2009, S.R. No. 178/2009 2. Mustapha et al., Research in Microbiology 166: 2015

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FEATURE ARTICLES

SEWAGE LEAKS IN HOSPITALS

By Brad Prezant

A previous article addressed water leaks in hospitals, and the consequences that can result, including fungal growth. This article will focus on sewage leaks, including the importance of pre-planning and timely response.

S

ewage is a mixture of liquid water and greater or lesser amounts of heavy organic matter; it sometimes contains chemical contaminants.

When sewage contains little heavy organic wastes, it might appear as clean water, though it would still be classified as biologically-contaminated liquid. For example, clean water passing through sewage pipes would be classified as sewage, due to presumed microflora (viral, bacterial, & parasitic invertebrate) contamination. In the cleaning and restoration industry, sewage is referred to as “black water” (Category 3 as per IICRC S-500). It represents an infectious hazard to patients, staff, and clean-up personnel.

Sewage can originate outside the facility (floodcontaminated waters) or inside, from internal leaks, such as might occur if a sewage line gets clogged with foreign material, and overflows.

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One item regarding external leaks bears mentioning.

Some institutions use backflow protection to prevent sewage from flowing inward from sewage main lines.

Absence of backflow protection can result in toilets overflowing with sewage if flooding occurs in other locations in the region connected via sewer lines, as the flooding waters seek equilibrium. Do you have this “one-way” valve, and is it properly operating? Some institutions avoid these valves because their failure can result in backup of sewage into the facility, and they perceive that this risk is greater than the risk of external entry of sewage.

The remainder of this article will focus on the appropriate planning and management of a largescale indoor internal sewage leaks, for which no current Australian guidance document exists. Small leaks such as overflow of waste in a bathroom with a tile floor are probably already addressed by your hospital’s protocols for spillage of bodily fluids or

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and cracks in a concrete slab to floors below, and vastly expanding its impact from the point of release.

Collecting this released liquid, in whatever physical form it is in (liquid or vapour) and wherever it is located, e.g., sitting on surfaces or absorbed into solid porous materials, behind wall assemblies, in pipe conduits, is a secondary consideration in managing a large-scale sewage release; it is typically an integral part of the response effort from the beginning of the response.

Many indoor building materials are porous, such as concrete. They will absorb and release large quantities of moisture. Many indoor building materials are constructed from organic material such as wood or was-wood products. They will rather quickly begin to support fungal growth after wetting. A significant percentage of materials we choose to use as indoor building materials are both porous and organic, such as paper-faced gypsum wallboard (think sponge with food glued to each side), MDF skirting, furnishings of plywood, and solid wood structural members.

wastes in clinical settings (for example, see sections B1.4.3 & Table B1-12 in the Australian Guidelines for the Protection & Control of Infections in Healthcare).

Inappropriate management of a large-scale sewage release by well-meaning but untrained custodial or other personnel can create unacceptable risks to public health by creating unnecessary exposures of sewage-associated biological agents to patients, providers, clean-up personnel, and the general public. While these exposures are of greatest risk in the period immediately following release, they continue for an extended period at a lower level, as infectious organisms contained in sewage can persist in the environment.

The first goal in sewage management is to neutralise the infectious potential of the spill and mitigate or eliminate potential hazardous biological exposures.

The secondary goal is to manage the large release of liquid. Buildings are not well-designed to manage large release of liquids.

Released water will follow gravity horizontally and vertically, penetrating wall cavities and other normally inaccessible spaces, traveling through penetrations

Organic materials used in buildings are not designed to get wet, remain wet for extended periods, or get wet repeatedly, without supporting fungal growth and eventually breaking down and losing their functionality. Generally the fungal growth begins rapidly; loss of functionality requires chronic moisture and takes more time. Sewage-borne organic materials may enhance fungal growth.

Porous non-organic materials that will not support fungal growth, such as concrete walls or floors, can function as reservoirs for large quantities of water, retaining and releasing it in liquid or vapour form, creating high humidities that would permit growth in adjacent vulnerable building materials that have not become directly wetted.

Sewage is no different than any other major water release within a health care institution; these guidelines as they pertain to these secondary considerations are also consistent with what would be required to manage large-scale clean water releases.

The measures employed by professionals to collect the easily accessible water, and extract the more difficult-to-access moisture absorbed into porous building materials must be adequate to rapidly identify and remove even hidden moisture so as to prevent microbial growth on materials and contents.

A partial job of collecting the easily accessible released moisture, but not collecting all the moisture is not adequate.

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Inadequate measures by untrained personnel can result in serious unintended consequences, such as indoor mould growth and resulting dispersion of fungal particulate.

When a sewage spill occurs, the following is a summary of the tasks to address. Many of the items in the list will overlap in time with others, e.g., drying activities may begin early in the process and continue through to the very end. The sequence of operations, however, is important for other groups of items. For example, gross removal, spray, cleaning (drying), and disinfection must occur in that exact order to be effective.

1. Notify and Initiate a spill response plan. Designate an incident commander. If a contractor has been

pre-qualified for clean-up activities, get them on-site immediately to begin mitigation efforts.

2. Identify the source or sources of the spill. If in-house personnel might function as first responders, make sure they have the training and personal protective equipment (PPE) for this task. If immediate cessation is not possible, minimise the quantity emanating from the source or re-direct sewage to areas outside the facility, away from occupied areas; or to areas that would be easier to contain, easier to clean, and/ or have fewer porous materials. Such efforts could minimise risk and/or the extent of eventual clean-up required. Verify cessation/correction.

3. Define the farthest boundaries. Moisture mapping is the term used in the cleaning and restoration industry to determine the extent of water movement. Measure

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FEATURE ARTICLES

the absorption into porous building materials. Liquids will flow around objects; the absence of water outside a wall does not preclude the possibility that flow has occurred into that cavity from a different direction, or along the wall interior.

4. Evacuate sensitive populations and/or unprotected populations to prevent direct contact with sewage or other exposure. Until such time as initial disinfectants have been sprayed, unprotected populations unable to be isolated, particularly vulnerable populations, should be promptly removed from the area, transiting through non-impacted areas.

5. Isolate traffic flow in order to prevent primary and secondary (transport of sewage-associated microflora) contamination. Barrier tape, warning signs, or other isolation barriers can minimise transference of sewage liquid to previously uncontaminated areas, and/or direct skin contact.

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6. Deactivate and isolate the HVAC system serving the impacted area as appropriate. HVAC returns may go to a common return and could potentially redistribute sewage-contaminated air not just back to the impacted area but throughout the facility.

Thus the potential for wide dispersion of sewagecontaminated aerosol from contaminated areas to non-impacted areas exists.

7. Isolate airflow Minimise or eliminate airborne distribution of sewage-derived aerosols by constructing critical barriers, typically of plastic. A small hand-held manometer and several meters of vinyl tubing measures the pressure relationships between zones and/or rooms. A map of pressure relationships will illustrate air movement from one zone to another. Control using existing HVAC resources or via introduced air moving equipment can then be achieved. A minimum of -5 pascals is considered appropriate for containment of aerosol-generating activities. It is not acceptable to erect plastic isolation barriers without controlling, verifying, and maintaining appropriate pressure control. More than 99% of the open space between two zones can be closed in with plastic, but if there is no pressure control to insure air is flowing into the contaminated area, significant airflow with associated contamination will flow outward through even a small opening from the contaminated zone to non-contaminated areas. Both structure and verified functionality (negative pressurisation) need to be present to truly isolate; structure alone is meaningless.

8. Protect assessment and remediation personnel using appropriate PPE; utilise other health and safety tools. Containment, assessment, and remediation activities will likely create inadvertent direct contact and/or splashing. Eating, cigarette smoking, and hand-to-mouth behaviours create ingestion exposures. Sewage-contaminated aerosols present inhalation exposure risk: all individuals so exposed should be properly protected. Special consideration should be given to excluding workers with breaks in the skin, eczema, or other conditions placing individuals at increased risk; protection against puncture wounds or other skin wounds while working should be included in the safety hazard analysis.

Appropriate PPE includes respiratory protection (minimum half-facepiece or full-facepiece silicone or rubber), impermeable boots, and for persons involved directly in activities with risk of contact, spill protection (gloves, typically inner and outer, protective suits, face shield and splash-proof goggles).

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9. Spray a disinfectant solution to initiate reduction of organisms as rapidly as possible. The effectiveness of the disinfectant will be compromised by the organic materials present , but will effect a significant reduction in the aerosolised microorganisms when the cleaning and other disruptive processes begin.

10. Suck Conduct gross removal of water and solids (suck liquids and solids). Conduct air scrubbing (suck air). Prior to initiating work, the impacted area should be isolated and under negative pressure, as the work activities will be creating aerosols containing sewage organisms; airflow from this area to non-contaminated areas should be prevented. When aerosols containing sewage organisms are created, such as during gross removal, HEPA-filtered air filtration devices (negative air machines) should be set up and activated as work commences to both minimise worker exposure (via general work area HEPA scrubbing) and provide secondary protection against breach of containment (the primary protection against cross-contamination is negative pressurisation). The remediator may also recommend the use of dehumidification equipment

at this stage as every technique and effort possible will ultimately need to be made to collect all of the released liquid present within the building (both in liquid form and in vapour form), an important goal of the secondary considerations described above.

Sewage wastes can be disposed in functional toilets or collected in a specialty tanker truck located outdoors. It should never be disposed of in the street or storm drains.

11. Assess the impact on building materials, destructively open hidden areas as required, conduct further moisture measurements/survey, and determine the scope of remediation. First, complete a safety check: Though these issues may have been resolved during pre-planning activities or the initial hazard survey, assessment activities have the potential to dislodge and/or disrupt building materials, or expose other safety or electrical hazards. Asbestos-containing building materials, lead paint, or other potential hazards should be identified to protect workers and occupants. The scope and extent of remediation for a sewer clean-up is highly influenced by the migration

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FEATURE ARTICLES

of sewage (and any other liquids used for the first cleaning) into building components. Destructive access into otherwise sound wall cavities or nonimpacted furniture assemblies may be necessary to conduct the assessment, as sewage may be behind or within these assemblies. At the completion of the assessment phase, potentially contaminated areas will have been accessed (some easily, some destructively), and the presence of liquid water or moisture in inaccessible areas, such as behind walls, cabinets, attics, crawl spaces, or other locations, will have been determined.

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12. Sort based on porosity and feasibility of remediation of the building materials. Materials are generally categorised as porous, semi-porous, or nonporous. Porous materials include carpeting, padding, porous wall surfacing such as wallboard, (particularly cut or unsealed edges, and regardless of surface paint, vinyl covering, etc.). Solid wood, hardwood or vinyl tile floors, grouting are examples of semi-porous material, and tile, stainless steel, or galvanized steel are examples of non-porous materials.The general approach is to designate for removal and disposal any and all porous materials which have been directly impacted by sewage, e.g., wet, saturated materials that have directly contacted liquid sewage. Semiporous materials are evaluated on a case-by-case basis. Non-porous materials can typically be cleaned.

Porous materials subject to light spray or touching during the clean-up may only need cleaning.

13. Dispose of porous materials and furnishings that have contacted liquid sewage.

14. Clean using a surfactant based cleaner intended to remove soil that would prevent proper disinfection.

Rinse the cleaner from the surfaces, as some residual cleaners can inhibit disinfection. Dry prior to disinfectant application. Hot water, at â&#x2030;Ľ43°C, followed by rinsing, using standard surfactant-based detergents and clean water, is considered to be the definition of cleaning.

Mechanical agitation is necessary to remove organics.

15. Disinfect using an appropriate disinfectant. The choice of disinfectants is not critical, and will likely be determined by the standard procedures used in the facility. Almost all disinfectants require a minimum contact time. Certain disinfectants require rinsing.

16. Dry all impacted areas as well as any building materials requiring special techniques. Generalised air movement as is typical of restorative drying operations can now proceed with reduced concerns of aerosolising and/or transporting microbial particulate in air.

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and/or promotional require the supplied vector file artwork(s) supplied to Voda Communications and must be accurately reproduced from the authentic artwork.

FEATURE ARTICLES Any deviation, either freehand

interpretation or renderings with similar fonts, should not be considered or used.

The Primary Master Logo on the right should be used on all applications.

17. Test to verify compliance with work practices and effectiveness of remediation measures. The primary quality assurance/quality control technique is proper communication and execution of the cleaning/ disinfection protocols by the Remediation Contractor.

Protect your assets and people

This is accomplished by thorough cleaning follow by disinfection. Specific testing, as described below, is limited to small locations intended to © Copyright Voda Communications 2015 be representative of much larger areas, and can therefore never substitute for proper remediation technique and equipment, verified to have been applied to the entire impacted area.

A consultant such as a Certified Occupational Hygienist can provide quality control measures including development of a scope of works, and testing to verify the effectiveness of cleaning. Unfortunately there are not tests available for many of the specific organisms of infective interest. Also, the large numbers of potential organisms of concern is so great that it would not be feasible or cost-effective to test for all simultaneously.

Indirect test methodologies therefore use coliform, faecal coliform, enterococcal bacteria, and E. coli swab tests to verify that sewage-associated bacteria are no longer present. These tests usually require a minimum of several days, quicker tests such as ATP testing of surfaces can be used as screening tests, but final project close-out is best accomplished using a suite of the tests listed above.

While sewage leaks provide challenges to hospital maintenance personnel, pre-planning can reduce the likelihood of further contamination, and ensure proper infection control within the facility.

ABOUT THE AUTHOR: Brad Prezant is a Certified Occupational Hygienist with experience addressing water, mould, and hospital-specific infection control issues resulting from these risks.

Mr. Prezant is Chief Scientific Officer of VA Sciences, providing consulting and microbiology laboratory services throughout Australasia.

Contact: www.VASciences.org

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FEATURE ARTICLES

AIR FILTERS

CONSIDERATIONS IN MAINTAINING AIR QUALITY & ENERGY EFFICIENCY

By Shannon Roger, Airepure Australia

INTRODUCTION

T

o some, the humble air filter is commonly misunderstood as just “a thing in the duct that blocks air flow”. Whilst that is in part true; the primary function of the air filter is nobler – to protect the people and facility components that are downstream of it.

If the filter blocks or is allowed to collect too much particulate material – excessive amounts of fan energy will be consumed and the amount of air being pulled through the filter will reduce – affecting the health and comfort of the occupied space.

In short - air filters are a critical component in maintaining the air quality and energy efficiency of a facility.

FILTER FUNCTIONS Air filters used for “pre-filtration” have two main functions; • Improve indoor air quality • Protect downstream equipment These pre-filters are designed and manufactured to be cost-effective to purchase and be energy efficient. Protecting downstream components such as secondary air filters and cooling coils, allows for better long term performance and further energy savings.

When it is doing its job – a filter becomes clogged with particulates over time. So these pre-filters must be replaced, to maintain air-flow for efficiency and performance of the system.

In general HVAC it is considered more cost effective (and environmentally safe) to replace and dispose of these pre-filters than clean them on-site (washable air filters).

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Washable filters still remain most relevant for kitchen exhaust hoods and some “mist eliminator” applications in sea-side areas.

COMMON FILTER TYPES Flat panel filters are the most basic type of air filter, whereby a flat panel of air filtration media is enclosed within a metal frame. They serve to prevent very large particles “rocks” from entering the system and are typically made to order.

Flat Panel Filter

Pleated panel filters are really the start of effective particle removal to generate higher indoor air quality.

They have a significantly greater surface area and dust holding capacity than flat panel type filters due to the pleated air filtration media. The higher the number of pleats, the larger the working surface area the filter has. Ultimately, the higher useful surface area maximises the filtration capability of the filter, and reduces its resistance to air-flow. Metal V-form and cardboard disposable are the most common type of pleated panel filters.

Metal V-form filters. These rugged filters have pleated air filtration media inserted into a channelled metal frame. A number of methods are typically used to create the pleats within the air filtration media, including galvanised mesh adhered to one side of the media and zig-zagged steel cage supports within the frame channel.

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Standard Metal V Form Filter

Some suppliers offer a premium version metal V-form, whereby the pleated filter media is â&#x20AC;&#x153;pottedâ&#x20AC;? or bonded (e.g. hot melt sealed) into the metal channel frame to eliminate potential contaminant bypass.

In general, V form filters offer respectable dust holding, moderate performance and a useful life. The more advanced forms are very resistant to by-pass, so work at the rated value for all their working life time.

Metal V form filters are typically available in standard sizes, with custom sizes made to order.

Premium Metal V Form Filter

Cardboard disposable filters are constructed from pleated air filtration media bonded to a cardboard frame (typically moisture resistant beverage grade cardboard). Diagonal cardboard supports across the filter face are included for rigidity and durability.

Cardboard disposable filters are available in a number of rated efficiencies and standard sizes.

Non-standard sizes are typically made to order, with some being modified (cut-down) from a larger size.

Cardboard Disposable Filter

What are the Characteristics of a Quality Disposable Cardboard Pleated Air Filter?

Surface Area Pleated air filters have a greater surface area and dust holding capacity, as compared to flat panel type filters. The higher the number of pleats, the larger the surface area it can contain.

Ultimately, the higher surface

area maximises the filtration capability of the pleated air filter and reduces the energy consumption.

Filter Media Quality Synthetic filter media are resistant to moisture build up and ideal for preventing the proliferation of mould and mildew. Pleated air filters must be able to sustain a high-efficiency performance, with a relatively low-pressure drop, to be effective in air filtration, so premium quality media should be used.

Quality Cardboard Frame Strong, durable cardboard frames should withstand the force of the air stream and support the filter media. Beverage board grade cardboards are resilient against water infiltration that can lead to premature structural deterioration. A stable housing module helps to achieve a longer service life. Poorly designed filters, can collapse prematurely, creating major problems for downstream equipment.

Quality Media Bonding Pleated air filters should be safely and tightly bonded to the cardboard frame to prevent air bypass (where contaminants can escape through the small gaps on the sides of the filters).

The combination of all of these design considerations helps to achieve an appropriate airflow static and load capacity that maximises energy efficiency, change out periods of disposable filters and loading.

What is the Impact of Selecting Quality Disposable Cardboard Pleated Air Filters over Cheaper Alternatives?

There are many cheap cardboard pleated air filters available in the market today, which use inferior quality components and construction methods.

These cheaper alternatives often provide poorer performance, risk product deterioration and mould (a known health risk) and have a shorter service life that requires more frequent change-outs.

The long term costs associated with inferior quality product include increased energy consumption, more frequent product replacement, increased load on more expensive downstream filters and potential contamination of expensive equipment or components. There is also potential for poorer air quality or health risks associated with product deterioration and mould.

Buying sub-par disposable air filters might be a tempting idea because of lower upfront charges.

However, it does not lower energy costs or guarantee

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FEATURE ARTICLES

QUALITY AIR FILTERS COMPREHENSIVE RANGE STOCKED AND SUPPORTED NATIONALLY

PANEL FILTERS Wide Range In Stock Australia Wide

COMPACT FILTERS High Efficiency Quality Construction Australia Wide

BAG FILTERS

HEPA FILTERS

High Efficiency Quality Media Australia Wide

Essential Air Quality Filters & Housings NATA Testing Services

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Quality Materials Various Configurations Australia Wide

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longer service life, high-quality performance, protection of expensive components or better air quality.

Bag Filters have excellent dust holding capacities and reasonable pressure resistance. They are bulky, and take a significant duct length to house them. Some design versions are tricky to install and remove, and they are available in a vast number of configurations, ratings and sizes. The most common types of bag filters include: Peaked bag filter – Four peak (full size) or two peak (half size) deep bed style bag filter mounted to a metal outer frame and inner basket assembly.

Four Peak Bag (Full Size)

Two Peak Bag (Half Size)

Pocketed bag filter – Three pocket (full size) or two pocket (half size) deep bed style bag filter mounted to a metal outer frame and inner basket assembly.

COMBINATION FRAMES Many commercial HVAC applications require staged filter sequencing such as a combination frame assembly. This typically includes a cardboard disposable pre-filter and pocketed bag or multipocket bag filter installed within a metal holding frame. Corner clips or P-clips are commonly used to secure the filters in place.

Combination Frame Assembly (Cardboard disposable pleated filter and multi-pocket bag filter secured to 100mm holding frame with corner clips)

Filter sequencing works like a set of sieves – the first stage (cardboard disposable) collecting larger particles and the second stage (bag filter) collecting finer particles. Special applications that require ultra-clean air quality, such as cleanrooms, would require a third stage (HEPA).

AIR FILTRATION MEDIA HVAC Air filtration media is available in cottonpolyester blends or pure synthetic blends. Filter media manufactured from 100% synthetic fibres are recommended for use within HVAC applications, as they are resistant to moisture build up and will prevent the proliferation of mould and mildew.

Quality air filtration media will ideally sustain a highefficiency performance, with a relatively low-pressure drop, to be effective at air filtration.

More advanced filters, which are used in special applications (HEPA filters), are carefully constructed from “silica” based materials and binders to form a “paper” like surface for removal of very fine particles.

Any of these specialty filters require special handling methods and processes.

Top: Three Pocket Bag (Full Size) Right: Two Pocket Bag (Half Size)

Multi-pocket filter – Typically six / eight pocket (full size) or three / four pocket (half size) deep bed bag filter bonded to a metal header frame.

Multi-Pocket Bag (Full Size)

FILTER SIZE AND RATINGS Nominal filter dimensions can vary by manufacturer, so when dealing with replacement filters, it is essential to know actual filter dimensions and the quantity required before you re-order.

Accepted filter performance rating systems are EN779:2012 (G1 to F9) and ASHRAE 52.2 (MERV 1 to 16). Based on the successful removal of airborne particles by size, these ratings provide a relative measure of filter effectiveness; whereby lower rated

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filters remove larger sized particles and higher rated filters remove smaller sized particles.

Higher rated filters will remove more airborne particles; however this is almost always at the cost of energy and more frequent filter changes. Similarly, lower rated filters will impact air quality, duct cleanliness, heat exchanger performance and in some cases safety.

Inspection of your current filters will reveal their rating, and you should replace these filters with (at minimum) a comparable rated filter. With large installations, it is worth checking the original filter specifications to confirm the right filters are still installed.

Over time, it is worth consulting with a knowledgeable and trustworthy filter manufacturer, to see if higher performance filters can result in higher IAQ and lower energy costs. Often by making a change to a modestly more expensive filter that provides lower pressure drops and larger dust holding capacities, you can actually reduce total costs of your clean air equation.

FILTER CAPACITY Whilst nominal dust holding capacities obtained from controlled laboratory testing are useful when comparing similar filters within a manufactures range, comparisons between different filters or manufacturers can be misleading due to differences in test conditions, dust ranges and other factors.

Similarly, real world dust, temperature, humidity and other contaminations are difficult to directly relate to this laboratory test data. As such, you should seek advice from suppliers with reputable technical knowledge and experience. Ultimately, with replacement filters, actual historic data will be your best guide.

Finally, all filters have a finite capacity and benefit from staged filter sequencing i.e. pre filters followed by higher efficiency final filters. Staged filter sequencing allows inexpensive filters to be sacrificed to maximise the life of the more valuable final filter.

As mentioned before – if the filter looks “dirty” with collected dust, it’s far beyond the cost effective change out point.

FILTER LIFETIME In a well-designed system, static pressure is a recognised measurement to indicate appropriate filter change out times.

For example, if the static pressure across a G4 filter was measured above 175Pa, it is demanding to be

60

changed. While this filter is still providing good air quality improvements, the excess energy used in airflow would cost more than the filter is worth to change.

The appropriate static change-out value for filters change significantly depending on the airflow rate, type of filter, grade of filter, hours of use per day and the dust concentration of the air being filtered.

A common rule of thumb for when to change a filter is 2-2.5 times the original pressure drop of the filter. Magnehelic gauges or other sensor methods connected to the BMS are worthwhile additions to a filter housing to give an indication on filter performance.

In general, it’s always better to change filters early – rather than late.

ENERGY EFFICIENCY With steady increases in energy costs, and priorities to decrease energy usage for greener buildings, effective air filtration is an increasingly critical component of the energy efficient facility. Accurate tracking of static pressure via a software or manual system will be a significant component in the overall energy assessment.

With older buildings, an overall review of the filter types and ratings, fan settings and system construction will reveal valuable opportunities for energy savings that would be comparable to LED lighting conversions.

FINAL THOUGHTS Buying decisions should start with obtaining the right filter, and then conducting service changes at the appropriate time. Supplier considerations should include stock availability, breadth of range, credible support, warranty and overall cost. Similarly, local and knowledgeable support is an important factor, when changes or upgrades are being considered.

The humble filter is often a forgotten part of the facility – but the people and equipment that it protects are critically important.

So – when did you last check your filters?

Written by Airepure Australia 2017 For more information, visit www.airepure.com.au or call 1300 886 353 Originally published in the AIRAH publication HVAC&R Nation, April 2017, Issue 100, pages 15-17.

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Don’t wait for your pool to have a health emergency!

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We ensure that your pools and spas are healthy and comply with legislation to fulfill your duty of care. Our services include: • Professional problem solving and advice • Same day response and breakdown service • Service all year round, with options to suit your requirements • Reductions in pool operating cost with energy saving equipment • System improvements and water chemistry efficiencies Poolwerx can do as much or little of the work you require. We can also provide training for work you wish to be performed in house. Starting with a complementary on-site visual inspection, Poolwerx will then tailor a solution, keeping your current resources and budget in mind.

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HYDROTHERAPY POOLS AND LEGIONELLA

By Lyn Wicks

HYDROTHERAPY POOL BENEFITS

H

ydrotherapy pools are widely used in hospitals and aged care facilities for patient recovery and rehabilitation activities. Sports centres, gyms and educational institutions use them for injury recovery and injury prevention for athletes. The benefit of near weightless exercise can aid in vastly improved mobility recovery and ultimately aid pain reduction plus offer faster healing/strength recovery. Hydrotherapy pools also offer comfortable warm water (normally 30oC to 35oC) to exercise in that promotes relaxation and patient comfort.

HEALTH RISKS AND TRANSMISSION Illnesses that may be transmitted in hydrotherapy and spa pools from pathogenic micro-organisms such as bacteria, viruses and protozoa.

Cryptosporidium is easily transmitted as oocysts are highly resistant to standard levels of chlorine and

bromine used for pool disinfection, transmission of the micro-organism can pose a serious health risk.

Other documented outbreaks that have been linked to swimming pools include: the skin infection folliculitis (caused by P. aeruginosa), respiratory illnesses (caused by Legionella and adenovirus), gastroenteritis (caused by Giardia, echovirus, norovirus, hepatitis A virus, E. coli and Shigella), haemolytic-uraemic syndrome caused by E coli O157 and pharyngo-conjunctivitis caused by adenovirus.

Pool operators should never allow disinfectant concentrations to fall below recommended levels and should anticipate high bather loads and raise disinfectant levels in advance.

POOL MANAGEMENT REQUIREMENTS Reliable pool operation depends on regular maintenance of filtration equipment, probes, electrical and hydraulic equipment. Hydrotherapy

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and spa pools are categorized as high risk under state health legislation and guidelines. A management program must include frequent water analysis with an approved water testing equipment such as a photometer not test strips and results recorded in a log book. Analysis of Microbiological testing regime NATA lab approved, management of TDS levels and biofilms, control of body oils and faecal matter that collect in the recirculation system. Chemical management must include safe storage, handling and use a chemical register and SDS. Signage to include pool rules. Most states it is a requirement that management of these pools must be by an approved technical operator.

Testing Frequency in most states or local laws is a mandatory requirement that the following disinfection criteria and pH levels are checked frequently. Refer to your states specific Health legislation. Extracted from NSW Health for hydrotherapy HIGH risk pools:

TESTS Minimum Daily*

TESTS Weekly

TESTS Monthly

Free chlorine / bromine

Turbidity and or / clarity

Total Dissolved Solids TDS

Total / combined chlorine

Ozone

Dimethylhydantoin (BCDMH systems)

pH

Cyanuric Acid

Microbiological

Alkalinity

Water balance

The *manual daily testing frequency is based on automatic control dosing system. Non-automatic continuous dosing / metering, tests must be conducted prior to opening and thence every two hours.

LEGIONELLA FACTS Legionella is a continuing major health concern and focus for hospitals, aged care facilities and institutions. Since discovery in 1976 in the US, Legionella has been researched often and the well proven facts regarding legionella briefly are:

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â&#x20AC;˘ Legionella is carried in water droplets â&#x20AC;˘ Legionella is easily aerated entering the human body via the nose and airways â&#x20AC;˘ Persons with compromised respiratory systems are higher risk

LEGIONELLA PREVENTION IN HYDROTHERAPY POOLS

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It is worth noting legionella outbreaks in hydrotherapy pools are rarer than in commercial cooling towers where outbreaks are relatively common. Documented cases most commonly occur when: â&#x20AC;˘ The water being used is not adequately treated â&#x20AC;˘ There is poor chemical or disinfection control â&#x20AC;˘ There is no regular testing or monitoring of the hydrotherapy pool water â&#x20AC;˘ There is infrequent or no replenishment of water contained in the hydrotherapy pool â&#x20AC;˘ There is inadequate or no cleaning process for the hydrotherapy pool filter and pipework systems â&#x20AC;˘ Bathers/users do not shower before entering and using the hydrotherapy pool â&#x20AC;˘ Cross contamination from air conditioning units, warm water loops and cooling towers occurs There is no absolute guarantee even a treated hydrotherapy pool will never get a legionella issue but the likelihood is significantly reduced by addressing the above issues.

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ADVERTORIAL

Modern technology and electronics allows the BAXX to achieve the aim of eliminating airborne pathogens by using cold plasma to strip a hydrogen atom from some of the natural water molecules (H20) contained in the air around us, leaving them as unbalanced hydroxyl clusters (-OH). These clusters seek and attach to airborne bacteria and virus cells and recover their missing hydrogen atom from the cells wall to return to a natural water molecule again (H2O).

I

n that instant, the bacteria/virus metabolism and cell wall is disrupted and the cell dies. Thus nature’s way of eliminating airborne pathogens has been reproduced.

Hydrogen Peroxide was the most effective airocell spray in dealing with the spread of the SARS outbreak on the turn of the century. It was in fact this finding that prompted Dr Allan Chua to investigate further and invent the cold plasma method of producing natures hydroxyls.

Hydroxyl knowledge had already been advanced earlier out of investigating methods of combating germ warfare by the British Ministry of Defence who had a remit to assess the risk of bacterial attack on the British Isles in the 60/70’s. This in turn had been initiated by observations over a hundred years prior by Louis Pasteur who had documented that the atmosphere in high altitudes and sunny days reduced the incidence of infection and effectively killed bacteria and viruses.

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• The only moving part is a resin-packed motor attached to a fan. These type motors can cope with dry & dusty conditions to wet and clammy environments and so the Baxx can be employed in steamy kitchens or cold wet chillers just as easily as dry powder mixing rooms and anything in-between.

Brackets on the Baxx unit also facilitate wall or ceiling mounting. It’s usual to hard wire the Baxx unit to a continuous power circuit as the Baxx unit should never be turned off. Not overnight, not for weekends, not for holidays – it’s always working for you to eliminate pathogen contamination in that room.

A single Baxx unit is capable of covering up to a 360 cubic metre room, although air losses such as exhaust fans, hoods, permanently open doorways etc may require additional units to compensate.

Applications encountered so far include – • Hospital kitchens.

He found the answer lay in the natural occurrence of airborne Hydroxyl Clusters.

• Aged Care meal kitchens.

The use of stripping away hydrogen atoms from airborne water molecules to form hydroxyl clusters by a cold plasma field is unique to the BAXX which naturally kills all airborne pathogens including MRSA, C.Diff(Spore Form), Norovirus and Bacteria.

• Backpackers accommodation to remove smoking odours.

• Medical centres.

• Smallgoods manufacturing.

• Lettuce leaf washing & packing to remove Listeria.

• Export Game meat facility boning room.

BAXX introduces several technological breakthroughs and advantages –

• Yogurt cooking and rapid cooling rooms.

• It doesn’t require any consumables other than electricity. No filters to clean, no chemicals or liquids to replenish, no service required allows the Baxx to be mounted high in the room for the most effective circulation and coverage. Install it and leave it to do its work. Electrical consumption is a mere 120watts – the equivalent of two 60watt light-globes.

• Chicken meat processing plants.

• The casing of the Baxx is in 316 stainless steel which makes it ideal for food manufacturing plants, health care facilities, retail outlets, and any other moist environments where a germ free environment is paramount.

• Meat wholesalers.

• Flour mill storage rooms to eliminate flour moulds.

• Seafood processing plants.

• Cold storage rooms.

Several large meat and other food industry users of BAXX have also noted a reduction in sick leave by staff working in the areas covered by the Baxx units. After all, BAXX is killing flu and cold virus just as efficiently and effectively as any other pathogen.

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Fast facts.

Destroys Bacteria

Baxx is an environmental pathogen and air-borne pollutant removal system.

The Baxx cold plasma technology kills Bacteria, Virus, Moulds & Fungus spores by disrupting the metabolism of their cell walls – no toxins, no chemicals, no radiation.

There are neither filters to replace nor consumables – no servicing and requiring only an occasional clean. Install it and let it do the work. Ceiling or wall mounted. 220v -240v.

3 year 24/7 warranty - continuous running.

As used in UK and European hospitals, and now fast being adopted in stainless steel versions with resin fan motor for the food manufacturing industry as well.

Unique cold plasma technology to create Hydroxyl Clusters which naturally kill all airborne pathogens.

These groups also react with odour causing chemicals such as ammonia and methane gas to produce neutral compounds such as Co2, Nitrogen and Water. The harmless way to create a safer and cleaner environment.

Protection for Residents & Staff.

Hydroxyls are the single most important cleansing agent in our environment. * 33% more effective at oxidizing pollutants than ozone. * 2.5 times more germicidal and fungicidal than liquid chlorine * Perfectly safe to breathe and use in occupied spaces In a room of 28m2 at 27ºC the Baxx reduced bacteria levels by 99.9% within 90 minutes, and viral traces were reduced by 88.96%. Ammonia levels reduced from 100% saturation down to zero in 30 minutes - without Baxx intervention the levels are 48%. Decomposition and ethylene gases are also effectively reduced/eliminated by Hydroxyls produced by Baxx.

TESTS INDICATE EFFECTIVE ELIMINATION OF THE FOLLOWING ESCHERICHIA COLI (E COLI) STAPHYLOCOCCUS AUREUS LISTERIA MONOCYTOGENES PSEUDOMONAS and ASPERGILLUS NIGER CAMPYLOBACTER BACILLUS SUBTILIS SPORE SALMONELLA SACCHAROMYCES CEREVISIAE MRSA, C.DIFF(SPORE FORM) AND NOROVIRUS

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FEATURE ARTICLES

DIVING INTO EFFICIENCY IN POOL HEATING

By Mark Crowther

T

he therapeutic benefits of hydrotherapy are well established but the heating of high volumes of water is energy intensive and so the potential impact on a hospital or health care facility in terms of energy usage and costs is also significant. There is a clear onus on facility developers and managers to understand the technology options in swimming pool heating. This applies not only to the initial selection of the heater type. Post-installation, there is clearly potential to achieve significant savings via the control strategy, tariff choice and by the introduction of complementary technologies such as solar-PV. The body of this article is a great example of how a proactive approach can provide substantial rewards in energy and cost reduction.

Prior to any other action, the first step of the facility manager is to understand the heat loss characteristics of their pool and instigating measures that lower the rate of loss.

LOWERING HEAT LOSS Lowering heat loss is an imperative as it provides a lasting change which has a flow on benefit to the efficiency and effectiveness of the heating system regardless of the heating technology chosen.

Important measures include the use of a pool blanket, the chosen water temperature and/or changing target range by time-of-year, increasing wind protection of outdoor pools and controlling space for indoor pools. Factors in the initial pool design are also clearly important such as the wind exposure of negative edge or waterfall features.

HEATING TECHNOLOGY However, our focus in this article is the second aspect, i.e. in considering the choice and operation of the heating technology. To assist this discussion we will look at the example of the Dive In Swim Academy.

Dive In provides an excellent case study for the health care sector as its experience is directly parallel to a busy hydrotherapy pool.

CASE STUDY – DIVE IN The Dive In Swimming Academy is located near Penrith, NSW and offers state-of-the-art facilities for learn to swim classes. The centre includes a 25M indoor pool heated to 32°C during winter and a 2-lane 50m outdoor lap pool.

Driven to reduce operating cost, the centre owners moved quickly at the end of 2017 to focus on heating efficiency. The cost of heating of the 25M pool easily represented the single largest component of the total energy cost, being some 70% of the average total monthly energy cost which includes other uses such as showers, lighting, space heating and pump loads. Heating costs for the pool varied from $3,000 to $6,000/month in summer and winter. The existing heating was natural gas.

The first phase of Dive In’s response was to break apart its energy costs and understand its pattern of use. This requires a detailed review of their gas and electricity billing, looking at both their consumption data and the structure of gas and electricity pricing. Next, they looked for detail on the heat loss characteristics of the pool. In Australia, such information is often derived from a heating simulation created by the University of New South Wales, known as Poolheat. This program examines the hourly heat loss characteristics of a pool taking into account multiple variables of design such as wind and sun exposure for outdoor pools and enclosure R-value and approach to space condition in indoor pools.

It is vitally important that facility managers understand the data available from such modelling and also verify the design assumptions upon which the predictive results are based. Such data is essential in allowing a comparison of the relative economics of heating technology options and will also allow a review of the impact of differing energy price options on heater sizing and overall heating costs.

Ultimately, Dive In determined that they would convert to high efficiency electric heat pump, with the existing gas heater retained for redundancy and temperature

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FEATURE ARTICLES

boosting. The anticipated saving in heating costs of this change is some $20,000 per annum.

HEAT PUMP TECHNOLOGY The characteristic of the heat pump of absorbing heat value from air means that the unit has a low electrical input relative to its heat transfer. Heat pumps output heat at a rate of around 5:1, relative to their input, greatly reducing total usage. This factor is called the heat pump’s co-efficient of performance or COP. The capture of solar energy from air means that the heat pump’s performance will vary with air temperature.

Higher efficiency is gained in more temperate locations but heat pumps are capable of maintaining pool temperatures year-round in nearly all areas of Australia.

MAXIMISING SAVINGS WITH TARIFF CHOICE Dive In’s decision to introduce heat pumps as their primary heating source was an economic one as this equipment is clearly more expensive as an initial investment. So their action reflected the predicted comparative heating cost between the existing gas and the new heat pumps based on the breakdown of their specific energy costs. The parallel for the healthcare sector is important but the analysis will not be the same in all States nor for all sites as electricity and gas pricing varies by supplier and by State and Region. For example, Melbourne has considerably lower gas pricing than say Perth and likewise, Canberra has substantially lower electricity pricing than Adelaide. The economics of the pool heater technology selection will vary accordingly.

Dive In’s breakdown of their electricity billing showed that their usage is metered on a time-of-use basis with peak, shoulder and off peak rates. This is significant as tariff sensitive control of the heat pumps does allow a level of manipulation of run hours to achieve a lower average input price for electricity by favouring off peak and shoulder periods. For example, the peak time price for electricity is 33.2c/kWh with this applying from 2PM to 8PM Mon-Fri. The overall modelled price for operation of the heat pump set is 22.2c/kWh. The lesson here is that this one-third reduction in the electricity cost achieved doesn’t reflect anything other than the clever management of the plant by its owner relative to how they are billed for energy costs.

Dive In’s electricity pricing is somewhat old-fashioned in the sense that it is based solely on metered usage (kWhs). While it is time-of-use based, their electricity price structure does not include any kVA or demand charges. For hospitals it can be expected that the electricity price structure will include these Network

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charges and this introduces the need to consider the demand profile of any new plant relative to the load of the total building. Ideally, any increase in the total recorded maximum demand would be avoided. The role of Power Factor is another consideration.

OFFSETTING NEW DEMAND WITH SOLAR POWER (PV) Dive In is now considering the use of a solar power system (also known as photovoltaic or solar-PV) as the next step in their reduction of energy costs. A photovoltaic system or solar-PV converts light into electricity and so it can directly offset the new electricity demand of the heat pumps and other electrical demand. While the heat pumps provide a cheaper heating option to gas at all times of the day for the centre, they will add significantly to electricity usage. As was the case with the gas heater, the demand of the new heat pumps will become the major use of electricity in the centre by a factor of around 2.

So an investment in solar-PV provides an opportunity to substantially lessen the P&L impact of this new electricity usage. The bottom-line in this decision is the rate of return of the investment.

Reputable suppliers of solar-PV will provide detailed calculations of solar generation and will further plot this against an assumed load profile allowing a detailed consideration of the portion of load which is met from in-house produced power and what remains unused for feedback to the grid.

The graphs below show a sample of the performance estimates which can be derived.

Electricity Offset in Summer

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profile of the client. The breakdown of this information would merit another whole article in its own right and is beyond the scope that we can cover today but the key lessons are in understanding and gaining confidence in the predictive data for the solar-PV and being able to overlay this to your own load profile, inter-laid with the detailed breakdown of your electricity price.

Electricity Offset in Winter

What can be seen from these graphs is the gap between predicted solar-PV output and the load

For Dive In, the solar generation covers periods of shoulder and peak priced electricity usage so its value is high and equates to between 28 – 33c/kWh. Given the estimated total kWhs provided by solar-PV for the year, the further reduction in electricity costs is some $10,000 per annum. With the total energy cost savings made between the two efficiency projects (conversion to heat pump and solar-PV offset), Dive In will have reduced its total annual energy cost by above 40%, with a payback on the capital cost of around two years. This is a fantastic result and is testimony of the benefit of a management which is committed to understanding the cost base of its business and looking for more efficient approaches to energy.

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COMPLEX M&E FOR NEW ORTHOPAEDIC CENTRE

By Paul Briars, North West regional director for independent engineering, IT, and facilities services business, NG Bailey

Paul Briars, North West regional director for independent engineering, IT, and facilities services business, NG Bailey (pictured), discusses the company’s part in a major redevelopment at one of the UK’s top orthopaedic hospitals, Wrightington Hospital in Lancashire – famous as the site, in the early 1960s, of first ever hip replacement operations, by pioneering surgeon, Professor Sir John Charnley (HEJ – April 2013).

O

ne of the UK’s leading centres for orthopaedic surgery, Wrightington Hospital near Wigan, has recently seen the completion of a new £18.1m Orthopaedic Centre that incorporates one of the country’s first ‘barn theatre’ operating complexes.

Barn theatres – with multiple operating bays separated by privacy screens and each with its own clean air enclosure – are known to provide increased safety, improved clinical practice, and greater efficiency, compared with the more ‘traditional’ onebay operating theatre.

Wrightington Hospital – which carries out more orthopaedic activity than any other hospital in the North West of England – already has one of the lowest infection and readmission rates in the region, and generates excellent clinical results. The Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust says the new Orthopaedic Centre will enhance patients’ experience even further – with a much improved environment for both patients and staff, more single room accommodation, increased safety, improved clinical practice, and reduced length of stay.

The Centre’s completion is the latest in a series of developments at Wrightington Hospital which is run by an NHS Trust formed in 2001 following the merger of the former Wrightington Hospital NHS Trust with the Wigan and Leigh NHS Trust. The Trust, which achieved Foundation Trust status in 2008, currently has around 4,600 staff, supported by over 500 volunteers, and provides both district general hospital services for a local population of around 320,000, and the specialist

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orthopaedic services at Wrightington, which are offered to a much wider regional, national, and international, catchment area.

A CENTRE OF EXCELLENCE Wrightington Hospital is a Centre of Excellence for orthopaedic surgery and in the treatment of musculoskeletal disease. It has its origins in the seminal work of Professor Sir John Charnley, a pioneer in hip replacement surgery, who performed the first ever such operations there in the early 1960s.

Professor Charnley, who joined Wrightington in 1949, published ‘The Closed Treatment of Common Fractures’ in 1950 – still regarded as the key reference material for practising trauma surgeons. By the early 1960s, he had established a full-time practice in hip replacement surgery at Wrightington Hospital, and it is consequently widely regarded as the ‘birthplace’ of the hip replacement. The Professor’s contribution to orthopaedic surgery was recognised both nationally and internationally with numerous awards, including a knighthood in 1977.

DEVELOPMENT OF THE CLEAN AIR ENCLOSURE Total dedication to all aspects of this type of surgery consumed Professor Charnley’s time. He oversaw the development of the clean air enclosure, total body exhaust suits, and the instrument tray system – all

INTERNATIONAL STORIES

One of the four new barn theatres within the new Orthopaedic Centre at Wrightington Hospital.

essential elements in modern-day surgery designed to reduce the risks of deep infection in this type of procedure.

Today Wrightington Hospital has more than 30 orthopaedic consultants, many with an international reputation for surgical excellence. It carries out more orthopaedic procedures than any other hospital in the North West, including more than 1,000 hip and knee replacements each year. The hospitalâ&#x20AC;&#x2122;s reputation for excellence attracts highly talented orthopaedic consultants, who specialise in hip and joint surgery, as well as rheumatology and rehabilitation. This multidisciplinary approach produces important

synergies, particularly in the field of inflammatory arthritis.

Wrightington Hospitalâ&#x20AC;&#x2122;s development as a key orthopaedic centre reached a further milestone in 1979, when a separate upper limb unit was opened.

Although there were very adequate facilities at that time for the treatment of patients with lower limb problems, there were no such services for the upper limbs. The next important development was in 2012, when the WWL NHS Foundation Trust invested ÂŁ6m to create two modular theatres, taking the total number of theatres to 10, and increasing annual patient capacity by 2,500. The investment also covered

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The project was a pilot for P21+ Repeatable Rooms and Standardised Components programme. As a result, the time clinical staff had to commit to the developing room layouts was considerably reduced, and the overall capital costs cut.

Off-site manufacture The sinks were also pre-plumbed and insulated at NG Bailey’s offsite facility in West Yorkshire, while the panels for the integrated plumbing systems (IPS) were built offsite by its partners at Inscape.

additional car parking facilities, as well as enabling works for a new access road.

COMPREHENSIVELY EQUIPPED Each of the new modular theatre suites includes an operating room with integral scrub-up, a sterile pack preparation room, dirty utility, and staff rest area.

Within one of the operating theatre suites is a threebed recovery suite, office space, and staff changing areas. Each theatre suite has a linkway corridor connecting it to the main hospital building, and each also has a dedicated, standalone plant room installed at first floor level.

This was the precursor to the latest £18m redevelopment over three storeys, which includes two new wards with 56 beds, a new admissions and recovery unit, and a four-bay ‘barn theatre’ complex – one of the UK’s first of its kind. The significant improvements in patient environment include a large increase in the provision of single rooms in each of the new ward areas. These improvements have been developed with the full involvement of patients and hospital staff throughout each step of the design process.

REDUCING LENGTH OF STAY The design of the new unit will assist in the reduction in length of stay, as Wrightington’s therapy teams will have the opportunity to work with the patients immediately after their surgery within the new ward environment. The main contractor for the redevelopment was Integrated Health Projects (IHP) – a joint venture between VINCI Construction UK and Sir Robert McAlpine, under the NHS ProCure 21+ (P21+) framework.

The significant improvements in patient environment include a large increase in the provision of single rooms in each of the new ward areas.

Work began on site in June 2014, and the new facilities are now fully operational. An opening event – featuring long-term staff members at the hospital – took place in December, with an official opening set for later this year. Patients are now happily receiving treatment and undergoing operations in the stateof-the-art building. The first operational day was highly successful, with a total of 13 joint replacements completed, as well as other minor operations being performed.

NG Bailey – the UK’s largest independent engineering, IT, and facilities services business – was contracted by IHP to deliver the full installation and commissioning of the mechanical, electrical, and public health services to the new hospital extension. The company also oversaw the delivery of the design for the mechanical and electrical (M&E) works, and provided technical assistance to ensure that the project deliverables were met.

Although this was the first barn theatre complex NG Bailey had been involved in, as a company we have extensive experience in healthcare, including having worked alongside IHP on a number of hospital developments in the North West of England.

EXPERIENCE ON THE HARBOUR One of those IHP developments was the £40m, 154bed mental health inpatient unit in Blackpool, The Harbour. NG Bailey delivered the mechanical and electrical, public health, information management, and technology services to The Harbour, which was built as part of a modernisation programme by the Lancashire Care NHS Foundation Trust. The unit – which became operational in early 2015 – replaced facilities

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at three other hospitals in the Blackpool, Lytham, and Fleetwood areas.

With this experience under its belt, NG Bailey offered to take responsibility for the fit-out works for the barn theatre at Wrightington, which had been earmarked for a turnkey company. This brought a number of benefits to the project in terms of overall costs and delivery timescales, but this had to be balanced against the added risk to NG Bailey of ensuring that the theatre complex met expectations and challenging commissioning criteria in line with Health Technical Memorandum (HTM) guidance.

Key challenges included ensuring that the deliverables – in terms of quality, client expectations, and the timetable for bringing the facility into operation – were all met.

The single biggest challenge we faced at NG Bailey was ensuring that the stringent air quality standards required in a theatre environment were complied with within an ultra-clean barn theatre, where there needs to be scope for multiple operations to be carried out simultaneously.

ULTRA-CLEAN CANOPIES To help achieve this, our engineers installed an ultraclean air ceiling canopy, which affords protection against airborne bacteria by ensuring a constant supply of fresh, filtered clean air into the theatre. Two of the theatre bays have body exhaust systems that remove bacteria-carrying particles emitted by the surgical team, diverting it away into an adjacent plant room.

The heating and ventilation system is designed to be flexible and controllable, allowing temperatures within different parts of the barn theatre to be adjusted to meet surgeons or patients’ individual needs. The surgeons can use the theatre control panel to access real-time information on the ventilation and heating systems, and adjust accordingly.

The NG Bailey IT Services team installed the data and telephone systems and cabling, and all electrical equipment was built by its off-site manufacturing division. Having the electrical equipment built offsite saved around four weeks on the project.

OFF-SITE MANUFACTURE The sinks were also pre-plumbed and insulated at NG Bailey’s offsite facility in West Yorkshire, while the panels for the integrated plumbing systems (IPS) were built offsite by its partners at Inscape. Other electrical

work included CCTV; bedhead trunking; nurse call, fire alarm, and damper systems; access control, and LED surgical lighting. There is also a picture archiving and communications system (PACS) connected to a 42inch screen, which allows surgeons to scan, store, and view, patient X-rays within the clinical environment.

EARLY BIM ADOPTER The scheme was a Department of Health early adopter of Building Information Modelling (BIM) to Level 2, which assisted collaborative working, with all parties sharing data through a common model. The project was also a pilot for P21+ Repeatable Rooms and Standardised Components programme. As a result, the time that clinical staff had to commit to the process of developing room layouts was considerably reduced, and the project’s overall capital costs cut.

The £5.4 m mechanical and electrical works had been scheduled to take 52 weeks, but were completed in less than 47 weeks, partly because NG Bailey was able to pre-fabricate the electrical distribution equipment and IPS, but also because the team worked closely with its supply chain partners to ensure correct product selection in line with user requests. Despite the significant challenges of the construction programme, completing the work around five weeks ahead of schedule meant the building could be delivered in time to meet the high potential winter demand.

SIZEABLE ON-SITE TEAM We had an on-site team of more than 40 people, supported by sub-contractors, and a total 30,000 engineering hours were put in without a single reported accident.

The new facilities are a step-change from what the staff, patients, and visitors, had been used to, and it is rewarding to know we have helped create a fantastic facility that will benefit the local community for many years to come.

LEADERSHIP AND COLLABORATION The project would not have been successful without the excellent leadership of the team at IHP, with whom we enjoyed a positive and collaborative working relationship throughout the design and construction process.

For NG Bailey, Wrightington Hospital is the latest in a long line of successful healthcare sector projects.

We have a rich heritage in delivering such projects, including the award-winning St Helens and Whiston PFI scheme, which we helped to deliver six months early

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INTERNATIONAL STORIES

The Midland Metropolitan Hospital has been designed to meet the best international and national standards to make it truly patient focused, and to support the efficient delivery of high quality clinical services.

As part of the contract, NG Bailey will manage the design and installation of the full MEP installation, worth approximately £80m, which will incorporate a fully digital integrated IT platform.

NG Bailey was recently appointed as building services partner to Carillion’s joint venture, The Hospital Company, to help deliver the new 670-bed Midland Metropolitan Hospital for the Sandwell and West Birmingham Hospitals NHS Trust. (Photo courtesy of Sandwell and West Birmingham Hospitals NHS Trust).

and on budget, due to the level of innovative off-site manufacturing techniques used.

The benefits of off-site manufacture do not centre solely on reducing costs and accelerating project delivery. They also act as a sustainable method of construction by reducing waste, lowering transport emissions, and improving health and safety. It is a process which adds an extra dimension to our growing portfolio of NHS clients.

One of those NHS clients is the Sheffield Children’s Hospital, where a £40 m extension is due to be completed in summer 2016. The project, a mix of new-build and refurbishment of existing facilities, includes the creation of a three-storey wing that will become home to three existing wards. NG Bailey’s building services contract includes the off-site build of all corridor modules, risers, and plantroom services.

Maximising the offsite work will enable the hospital to remain operational throughout the redevelopment.

MIDLAND METROPOLITAN HOSPITAL More recently, we were appointed as building services partner to Carillion’s joint venture, The Hospital Company, to help deliver the new state-of-the-art Midland Metropolitan Hospital – a public-private partnership scheme – for the Sandwell and West Birmingham Hospitals NHS Trust. As part of the £430m construction and support services contract, NG Bailey will work alongside Carillion to help create the new hospital, which will have around 670 beds and 15 operating theatre suites.

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The new hospital will also have a number of innovative design features, including a fully enclosed Winter Garden, car parking within the hospital building, and full separation of clinical activities and journeys from the public and non-clinical services.

Construction of the new hospital has recently started, with completion scheduled for mid-2018.

The achievement of the project timeframe will be facilitated by the extensive use of NG Bailey’s specialist off-site manufacturing division.

ABOUT THE AUTHOR Paul Briars, NG Bailey’s North West Regional Director, joined the company in 2015 from Warrington-based engineering services business, Rotary Building Services, where he had been group managing director and North West MD since 2000. He led Rotary through several acquisitions and challenging trading times. Among recent projects he was involved with at Rotary were Media City UK in Salford, and the Cooperative Group’s new headquarters in Manchester.

Presented with the RoSPA Order of Distinction Award in 2013, Paul Briars leads NG Bailey’s Engineering division in the North West. His recent projects have included the complex transformation of Manchester Town Hall and Central Library, Manchester Metropolitan University’s new Birley Fields campus, and the Ministry of Defence’s Beacon Barracks in Staffordshire.

NG Bailey is one of the UK’s leading independent engineering, IT, and facilities services business. The £400m turnover company, based in West Yorkshire and operating nationwide, says it is ‘committed to offering tailored and innovative solutions across a range of sectors, including health’.

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eyWatcher is a modular, scalable integrated key control and management solution that’s designed for interoperability with access control and other systems such as Contractor Management Kiosks and Fleet Management platforms. With a builtin 7” touch screen and up to 10,000+ assignable user codes with PINs (Personal Identification Numbers), KeyWatcher provides unmatched flexibility. The system allows administrators the discretion to appoint one of five different levels of access for each employee.

SMARTKEYS Key Control Data from Smart Keys Keys are secured to a SmartKeys which features an identification microchip and 1/8” stainless steel locking ring for additional security and functionality. Available in several different colours (black, brown, white, grey, red, yellow, blue, and green).

This allows for keys to be organised by colour, which can be useful when utilising several KeyWatchers in a facility, or designating one group of keys from another within the system.

THE INTEGRATED ACCESS CONTROL SOLUTION KeyWatcher is designed for complete interactivity with your other business systems. For example, by intergrating your KeyWatcher system with your access control system, your

For more information email: sales@astpl.com.au

KeyWatcher

®

Key Control and Management Solutions

MORSE AUSTRALIA

> Are you tired of lost time looking for keys? > Do you need to restrict access? > Do you want to control high risk areas? > Do you need to know if a key isn’t returned on time?

If the answer is YES then Morse Watchmans KeyWatcher Touch is the solution.

Contact Australian Security Technology on

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1300 539 928 for further information

FEATURE NEWS ARTICLES

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NEWS

ULTRAMAX – HOSPITAL AND MEDICAL AIR SPECIALISTS Ultramax understands the requirements of hospitals and medical facilities for clean, dry and reliable sources of medical air, delivered at consistent pressure levels and flow rates. We have a complete medical air filtration product range for both breathing and tool air configurations. We also offer personalised service and specialised expert knowledge in filtration products for compressed air and gas purification.

Our medical clean air packages are customised

to suit your specification for flow and space requirements.

Clean air medical filtration skid packages can be included with medical air compressors to create standalone medical air and gas, and our breathing air systems use medical desiccant compressed air dryers as standard.

With our extensive range of medical air and gas filtration products, we can help you pick the right products for your replacement filter or maintenance needs to meet the requirements of AS 2568-1991 Medical gases – Purity of compressed medical breathing air. All our products meet the highest Australian standards and use high quality materials in their construction.

We have warehouses in both Brisbane and Perth, making Australia-­wide delivery quick and easy.

For more information on products, packages or solutions, please contact us or to see our range of over 2,000 products visit our ecommerce website at www.ultramax.net.au/medical.

THE MARKET LEADING POOL WATER TESTING METER, WATERLINK SPIN TOUCH NOW TESTS ALL TYPES OF WATER: INDUSTRIAL WATER, POTABLE, POOL AND SPA LaMotte have developed the most advanced system for the precise use of wet chemistry ever. Water analysis no longer has to rely on time consuming tests and clean-up procedures. It’s almost idiot-proof, with no vials to fill, no prep time or guessing involved. The test results are available quickly and with the release of the testing of potable and industrial water is now made just as easy as pool and spa water.

All the user has to do is fill a sealed reagent disc which contains the precise amount of reagent needed to run a complete series of tests. The user places the disc in the meter, taps “start” and all results are shown via the touch screen. All that is needed is less than 3 ml of water and the vital tests are done automatically—in just 60 seconds!

With a built in lithium ion battery, there’s no need for a power connection, either, The meter is truly portable for out in the field

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Test results are displayed on the touch screen, which can also be transferred via Bluetooth to mobile apps and then to WaterLink Solutions or DataMate Web software for instant analysis, with step-by-step treatment instructions supplied.

Test history is then stored via Cloud database for real time monitoring.

Reagent discs have up to 11 test parameters per disc.

Parameters cover Chlorine/Bromine, Chlorine/Bromine plus Phosphate, Chlorine/Bromine plus Borate and Biguanide plus Borate, as well as pH, total alkalinity, total hardness, Cyanuric Acid, Copper and Iron. The new industrial discs also test for total iron, ferrous and ferric iron, plus more test follow in the very near future.

REGULARS

Port Douglas

CAIRNS MACKAY

BRISBANE Armidale

South Pacific Laundry specialises in the provision of quality linen and supplies for the customer service, hospitality and healthcare industries

Coffs Harbour

PERTH

PORT MACQUARIE Newcastle

ADELAIDE

SYDNEY

ALBURY Colac

Geelong

MELBOURNE

Currently, the South Pacific Group is establishing a strong network of modern laundries across Victoria, New South Wales, Queensland, Western Australia and South Australia with plans for several more facilities up the East Coast of Australia.

The relocation of our Sydney operations to a new larger facility in Bankstown together with the relocation of our Brunswick plant to Broadmeadows will establish South Pacific Laundry as the single largest privately owned laundry in Australia and in the Southern Hemisphere.

Contact Robert Teoh National PR & Marketing P: (03) 9388 5300 M: 0421 716 888 Coverage Australia wide

• A 365 day service to all its clientele with a 24 hour turnaround (depending on location).

Sale

Warrnambool

South Pacific Laundry (SPL) has been a provider of commercial laundry and linen services to the hospitality industry in Melbourne for the last 20 years.

SPL provides:

Pricing Information Contact supplier direct Delivery Free daily delivery within 25km city metropolitan areas Minimum Order Contact supplier direct

• A leading edge technology in RFID to assist housekeeping and managerial staff in time reduction and efficiency.

• Dedicated account managers and experienced support staff who are available 7 days a week.

• A dedicated software design package and centralised billing system enables seamless transactions, paperless and customised reports.

• Delivery rationalisation systems, providing and streamlining efficient delivery routes which will reduce the company’s carbon footprint.

• Building of partnerships and sharing benefits with the customers from savings made through its constant laundry process innovations and group purchasing power of linen products.

• Dry cleaning and uniform cleaning services.

• Provision and supplying of corporate uniforms/work wears and customised hotel room amenities.

Full Contact Information South Pacific Laundry 9-23 King William St Broadmeadows VIC 3047 P: (03) 9388 5300 F: (03) 9387 2399

*Melbourne, Albury only

E: customerservice@southpacificlaundry.com.au robert.teoh@southpacificlaundry.com.au

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AH-CSG Clean Steam Generator

■ Clean Steam to AS/NZS 4187:2014 4 ■ 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

Spirax Sarco offers installation and turnkey solutions available for clean steam generation including clean steam distribution systems, plant steam modifications and steam quality testing to AS/NZS 4187:2014. Providing tailored maintenance and service agreements for your business. Contact us for more information on the AH-CSG. 

1300 774729 (SPIRAX)



info@au.spiraxsarco.com



spiraxsarco.com/global/au