Deployment and Use of HEPA/UV Air Purifiers

Policy

Category: Control of Infectious Diseases
Subject: Deployment and Use of HEPA/UV Air Purifiers
Division: Health Protection
Policy Number: CA.82.01.208
Effective Date: February 26, 2016

POLICY STATEMENT

It is the policy of Wellington-Dufferin-Guelph Public Health (WDGPH) to provide HEPA/UV air purifiers to new tuberculosis (TB) clients starting treatment in order to reduce the risk of transmission to others while allowing clients to remain in their home/room when institutional isolation is not available or not in their best interest. HEPA/UV filters may also be lent to community partners (hospitals, long-term care homes) if requested, and with manager approval. HEPA/UV air purifiers will also be used at WDGPH during TB clinics when active or suspect cases are being seen.

Preventing the Spread of TB – Hierarchy of Controls

The Canadian Tuberculosis Standards (CTS) recommends a hierarchical approach to TB controls including the following:

  • Administrative controls, such as rapid isolation, diagnosis and treatment of patients  suspected of active TB;
  • Engineering controls, such as improved ventilation in patient care areas; and
  • Personal controls, such as tuberculin skin testing of workers and use of particulate respirators (e.g. N95 masks) (Canadian Tuberculosis Standards, as current).

A HEPA/UV air purifier is a supplemental engineering control that will reduce the risk of TB transmission when used in addition to administrative and personal controls.

Ultraviolet Germicidal Irradiation (UVGI)

There is good evidence that ultraviolet germicidal irradiation (UVGI) has excellent germicidal activity against M. tuberculosis and can reduce infectious droplet concentrations by an amount equivalent to ventilation with 20 air exchanges per hour (ACH), depending upon the room volume and type of lights used. (Canadian Tuberculosis Standards, as current).

Portable air cleaning units are considered safe and effective for the use of UVGI. (Canadian Tuberculosis Standards, as current).

HEPA Filtration

HEPA filtration can be used to filter the exhaust from airborne isolation rooms.

Small HEPA units may also be used to filter re-circulated air in a room to increase the germ-free ventilation without the need for an increase in the amount of outdoor air supplied. The HEPA filters require careful monitoring and must be changed regularly, as clogged filters will result in a decrease in effective germ-free ventilation. (Canadian Tuberculosis Standards, as current).

With both UVGI and HEPA filtration environmental controls, regular maintenance and documentation of changes to UV light and/or filter is necessary. (Canadian Tuberculosis Standards, as current).

The Sanuvox HEPA/UV Air Purifier

The HEPA/UV air purifier is comprised of a ventilator, speed selection switch, two stages of filtration, and the cabinet enclosure system.  The ventilator pulls air through the prefilter and pushes the same air through the HEPA filter, which removes 99.97% of particles that are 0.3 µm or larger in size. 

The HEPA/UV Purifier is designed to kill bacteria, viruses, odour causing mold and fungus, as well as chemical odours and volatile organic compounds (VOC’s) that pass through the unit. The ultraviolet band light inhibits and kills mold, fungus, bacteria, viruses, and microbial growth on 100% of the air flowing through the unit. The actual percentage of destruction depends on the velocity of the air, and the pollutant(s) treated. (Sanuvox Model S300 HFX Operation Guide)

SCOPE

This policy applies to all WDGPH employees on the Control of Infectious Diseases (CID) team, including managers, supervisors, public health nurses, public health inspectors, and students.

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Procedure:  CA.82.02.208 Deployment and Use of HEPA/UV Air Purifiers
Canadian Tuberculosis Standards (as current). Canadian Lung Association. 
www.respiratoryguidelines.ca/tb-standards-2013
Sanuvox HEPA UV S300 HFX Operation Guide  www.sanuvox.com/en/pdf/sanuvox_HFX_HEPA_UV.pdf

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases 

APPROVED BY

Director, Health Protection 


Procedure

Category: Control of Infectious Diseases
Subject: Deployment and Use of HEPA/UV Air Purifiers
Division: Health Protection
Procedure Number: CA.82.02.208
Effective Date: February 26, 2016

PROCEDURE

This procedure provides guidance to the CID team around the deployment, use, and cleaning of HEPA/UV air purifiers. 

THE USE OF THIS EQUIPMENT DOES NOT REPLACE ROUTINE PRACTICES FOR INFECTION CONTROL.

DEPLOYMENT:

The Control of Infectious Diseases (CID) Manager will direct staff when the HEPA/UV air purifier will be deployed and arrange for transportation. CID staff will review safety warnings in the user guide before deploying, cleaning or returning the unit.

1. CID staff will inspect the HEPA/UV unit for damage (e.g. dents, loose parts, broken bulb) that may have occurred during transport or storage.

2. The unit may be transported by two staff persons or by courier. The unit is heavy and cannot be transported by one staff.

3. CID staff will select the best location for the unit. CID staff will look for the following:

  • Low traffic area to avoid bumping into or tripping over the cord;
  • If possible, locate the unit near the room’s air vents;
  • A standard three-prong plug is required (it is not recommended that it be connected with an extension cord); and
  • Confirm the air vents will not be obstructed to ensure proper air flow.

4. CID staff will verify the HEPA/UV unit was cleaned and disinfected prior to setting up in a new location – refer to “Reprocessing” section.

5. CID staff will test the unit by plugging it in to a standard three-prong plug and ensure the fan and UV lamp are working.  The two indicator lights on the front panel (LED Status display) should be on.

6. CID staff will select “operation mode 2” as this will provide the highest air exchange per hour.

7. The UV light functions when the blower is in operation. The blue LED indicates the UV lamp is on; the green LED indicates the ballast is functioning.

Note: The UV lamp must be replaced every three years. Dates of lamp changes must be noted on the unit itself.

8. CID staff will educate the client, residential staff, and family about the unit using the attached fact sheet.  The client, staff, and family will be advised of the following:

  • Do not change settings on the HEPA/UV air purifier;
  • Do not turn off (unplug) the HEPA/UV air purifier, unless a malfunction is suspected;
  • If a malfunction is suspected, report this immediately to CID staff from WDGPH; and
  • ​Provide contact information for WDGPH including after hours numbers.

9. Risks of UV light exposure:

  • Do not open the HEPA/UV air purifier;
  • Do not look at the lamp;
  • Do not tamper with the lamp/unit. If the lamp requires replacement, please refer to the operation manual attached as a guidance document; and
  • Do not touch lamp without gloves (Note: the lamp contains mercury. If a lamp breaks, dispose of it with care and according to WHMIS).
REPROCESSING:

Cleaning and disinfection of the unit needs to be done prior to transportation in a vehicle.  The client and family will be asked to leave the room or be a minimum of two metres away during the reprocessing process.

CID Staff will:
  • Conduct hand hygiene;
  • Get supplies ready (two garbage bags and PPE);
  • Unplug unit before cleaning;
  • Don appropriate PPE which includes gloves, gown and fit-tested N95 mask;
  • Open the front panel of the unit to remove the used filters (pre-filter and the HEPA filter).  Be careful to touch the rim of the filter only (do not touch the filter media).  Pull the filters out one at a time and place the used filters in the first garbage bag and close the bag immediately;
  • Place the first bag into the second bag (KEEP THIS OPEN);
  • Clean the accessible internal and then external surfaces of the unit with mild soap and water or the surface cleaner/disinfectant to remove dirt (isopropyl or propanol alcohol recommended by manufacturer).  Dispose of wipes in the second garbage bag;
  • Disinfect the internal and then external surfaces of the units with the surface cleaner/disinfectant.  Ensure contact time for the cleaner/disinfectant has been observed;
  • Doff PPE in the appropriate order (gloves, gown, mask). Dispose of gloves, gown and mask in the second garbage bag and close the bag;
  • Conduct hand hygiene; and
  • Dispose of the garbage bag in regular trash.

Upon return to the office, CID staff will restock the HEPA/UV kit and note on the unit the date of cleaning or equipment replacement. An order for additional supplies will be placed as needed. A minimum supply of five filters, one UV light should be in supply at all times.

MAINTENANCE:

Detailed maintenance information is located on the front decal on the motor plate and in the operation manual attached as a guidance document.

10. As outlined in the procedures above, the pre-filter and HEPA filter will be replaced after every deployment.  The HEPA/UV air purifier will be reprocessed after every deployment. Install new filter according to air flow direction.

11. For proper cleaning of the unit, the manufacturer (Sanuvox Technologies) suggests the following two chemicals be considered: Isopropyl Alcohol or Propanol. Once each year, or after each deployment, clean the interior of the unit with a mild and non-abrasive soap (see operation guide).

12. Important Note: The UV lamp must be replaced every three years.  A sticker on the unit will indicate the month and year the lamp must be replaced.  This sticker will be checked prior to each deployment and the CID Manager will be notified when a bulb needs to be replaced.

NOTE:

Discontinuing use of the HEPA/UV filter air purifier will occur when the TB case is no longer infectious at the discretion of the Medical Officer of Health or based on need and high risk nature of household contacts (e.g., children under 5 years).

 

REFERENCES AND RELATED FORMS, POLICIES AND PROCEDURES

Corresponding Policy CA.82.01.208 Deployment and Use of HEPA/UV Air Purifiers
Sanuvox HEPA UV S300 HFX Operation Guide http://www.sanuvox.com/en/pdf/sanuvox_HFX_HEPA_UV.pdf

CONTACT FOR INQUIRIES

Manager, Control of Infectious Diseases

APPROVED BY

Director, Health Protection