A CCRE DI TA TI ON STANDA RD S
Infection Prevention & Control
HEATING, VENTILATION AND
AIR-CONDITIONING SYSTEM
(HVAC)
Class 1 Facility: General Anesthesia
Heating, ventilation and air-conditioning system standards are a primary infection prevention
and control strategy whereby contaminants are diluted and expelled through the
high-frequency replacement of standing room air with clean filtered air.
The Canadian Standards Association (CSA) Special requirements for heating, ventilation and air-
conditioning (HVAC) systems in health care facilities (CAN/CSA Z317.2-10) standard is not based
on the type of room but on the functions that are expected to occur within the room. Where
several functions apply in a given area of a facility, the more stringent requirements take
precedence.
Both health-care facility classification and area classification, as per CSA, determine the design
requirements.
The information contained in this document provides a general overview of the requirements.
CAN/CSA Z317.2 Special requirements for heating, ventilation and air-conditioning (HVAC)
systems in health care facilities shall be referenced in addition to this document. CAN/CSA
Z317.2 represents the detailed requirements for HVAC in non-hospital medical/surgical facilities.
ABBREVIATIONS
AIA American Institute of Architects
CSA Canadian Standards Association
DOP Dispersed oil particulate
HEPA High-efficiency particulate air
HVAC Heating, ventilation and air-conditioning
MDR Medical device reprocessing
MERV Minimum efficiency reporting value
PAR Post-anesthetic recovery
PD Pressure differential
RH Relative humidity
T Temperature
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December 30, 2017
ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
DEFINITIONS
CSA health-care facility classifications
Class A-2 health-care facility
A health-care facility in which patients are
accommodated on the basis of medical need
provided with continuing medical care and
provided with supporting diagnostic and therapeutic services that can extend beyond 12
hours, and
does not meet the other requirements of a Class A-1 health-care facility.
Examples include:
outpatient surgical services
cosmetic surgical offices
dental surgical offices
laser eye clinics
other office surgical facilities
Class C health-care facility
A health-care facility in which ambulatory patients are
accommodated on the basis of medical need
provided with supportive, diagnostic, non-invasive interventions and treatment services
and
stay for no more than 12 hours, and
remain capable of self-preservation.
Examples include:
laser eye clinics
cosmetic surgical offices
CSA area classifications
Type I
A patient care area where the invasiveness of procedures, the level of risk of morbidity and
mortality to patients and the level of risk of adverse outcomes to care providers necessitate
more stringent HVAC and environmental requirements. Examples include:
minor surgical procedures
endoscopy
cystoscopy
dental minor procedures room
operating rooms
recovery rooms
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ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Type II
A patient care area of an area that is intended for the provision of services that provide direct
support to patient care areas. Examples include:
decontamination/soiled room
preparation and packaging/clean room
sterilizer room
scope reprocessing room
sterile storage
NHMSFAP Facility Classifications
Class 1
Provides general anesthesia and major regional anesthesia (epidural, spinal nerve blocks) and
may include use of IV sedation and/or analgesia, or local anesthesia only.
Class 2
Provides use of IV sedation and/or analgesia where the patient remains responsive and breathes
without assistance.
Class 3
Provides local anesthesia only. May provide oral sedation but not IV sedation/analgesia or
inhalants.
New facilities, additions to existing facilities and/or replacement or addition of
HVAC equipment in existing facilities are in compliance with CAN/CSA Z317.2-10
INDICATORS:
HVAC system functions in accordance with design criteria
HVAC system monitoring parameters are in accordance with design criteria
Parallel air-handling units are present in CSA Class A-2 facilities for any areas that
accommodate the following critical functions including but not limited to:
surgery, operating rooms
surgery, sterile core
post-anesthetic care or recovery
storage of sterile materials and supplies
The position and type of supply and exhaust registers promote the movement of air within
the rooms or spaces from clean to less clean areas
Airflow is directed from supply to breathing zone to exhaust outlets1, 2
All filters are clean and sealed
Air supply is from:
non-aspirating ceiling outlets near the center of the work area1, 2
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December 30, 2017
ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
ceiling outlets3
Each operating/procedure room or area where anesthesia might be exhaled (PAR) has a
minimum of two return air inlets1, 2
Return air inlets are placed:
whereby the bottom of the return air inlet is 75–500 mm above the floor1
whereby the bottom of the return air inlet is at least 75 mm above the floor2
near the floor3
Rooms with inhalation anesthesia and/or inhalation analgesia have a scavenging system in
compliance with ISO Z7396-21, 2 or CAN/CSA Z168.83
Minimum levels of HVAC are maintained for type I areas when the space is not occupied:
Minimum of six air exchanges per hour of recirculated air1, 2
Pressure differential across separations is maintained (7.5 Pa)1, 2
Temperature is maintained1
Relative humidity is maintained1
HVAC heating plant, cooling plant and controls are connected to the essential electrical
system
1. CAN/CSA Z317.2-10
2. CAN/CSA Z317.2-01
3. CAN/CSA Z317.2-M91
Existing facilities are in compliance with the CAN/CSA Z317.2 at time of build
INDICATORS:
HVAC system functions in accordance with design criteria*
2010–present Z317.2-10
2001–2009 Z317.2-01
1991–2000 Z317.2 M91
Before 1991 American Institute of Architects
*Facilities not in compliance with CAN/CSA Z317.2 standards from time of build may be
required to upgrade their existing system to be in compliance with current CSA Standards.
HVAC system monitoring parameters are in accordance with design criteria
The position and type of supply and exhaust registers promote the movement of air within
the rooms or spaces from clean to less clean areas
Airflow is directed from supply to breathing zone to exhaust outlets1, 2
All filters are clean and sealed
Air supply is from:
non-aspirating ceiling outlets near the center of the work area1, 2
NHMSFAP – College of Physicians and Surgeons of British Columbia Page 4 of 8
December 30, 2017
ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
ceiling outlets3
Each operating/procedure room or area where anesthesia might be exhaled (PAR) has a
minimum of two return air inlets1, 2
Return air inlets are placed:
whereby the bottom of the return air inlet is 75–500 mm above the floor1
whereby the bottom of the return air inlet is at least 75 mm above the floor2
near the floor3
Rooms with inhalation anesthesia and/or inhalation analgesia have a scavenging system in
compliance with ISO Z7396-21, 2 or CAN/CSA Z168.83
Minimum levels of HVAC are maintained for type I areas when the space is not occupied
minimum of six air exchanges per hour of recirculated air1, 2
pressure differential across separations is maintained (7.5 Pa) 1, 2
temperature is maintained1
relative humidity is maintained1, 2
HVAC heating plant, cooling plant and controls are connected to the essential electrical
system
1. CAN/CSA Z317.2-10
2. CAN/CSA Z317.2-01
3. CAN/CSA Z317.2-M91
The HVAC system is maintained in accordance with CAN/CSA Z317.2-10
INDICATORS:
Filters and seals are visually inspected monthly to verify the presence of the filter and seal
and to ensure proper physical condition
Primary filters with a MERV rating less than 9 are replaced every 12 months or when loaded
(based upon measurements of pressure drop across the filter bank)
Primary filters with a MERV rating greater than or equal to 9 are replaced every 24 months
or when loaded (based upon measurements of pressure drop across the filter bank)
Secondary filters are replaced every 24 months or when loaded (based upon measurements
of pressure drop across the filter bank)
HEPA filters are replaced every 36 months or when loaded (based upon measurements of
pressure drop across the filter bank) whichever occurs first
Fan coils, drain pans and induction and finned units are inspected and cleaned at minimum
semi-annually (usually spring and fall)
Ducts are inspected at minimum annually
Supply ducts are cleaned when deemed necessary by annual inspection
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December 30, 2017
ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Return ducts are cleaned every 10 years or when deemed necessary by annual inspection,
whichever occurs first
Exhaust ducts are cleaned every 10 years or when deemed necessary by annual inspection,
whichever occurs first
Diffusers (supply, return or exhaust) are cleaned every six months
HVAC Design Criteria
The information contained in this document provides a general overview of the requirements.
CAN/CSA Z317.2 Special requirements for heating, ventilation and air-conditioning (HVAC)
systems in health care facilities shall be referenced in addition to this document. CAN/CSA
Z317.2 represents the detailed requirements for HVAC in non-hospital medical/surgical facilities.
Minimum filter efficiency
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room Filter # 1 MERV1 8 Filter # 1 50%3 Filter # 1 30%
Filter # 2 MERV 14 Filter # 2 90% Filter # 2 95%
Procedure room Filter # 1 MERV 8 Filter # 1 50% Filter # 1 30%
Filter # 2 MERV 14 Filter # 2 90% Filter # 2 95%
Specialized operating Filter # 1 MERV 8 Filter # 1 50% Filter # 1 30%
room* Filter # 2 MERV 14 Filter # 2 99.97%4 Filter # 2 95%
Filter # 3 HEPA2 Filter # 3 N/A Filter # 3 N/A
Endoscopy / Filter # 1 MERV 8 Filter # 1 50% Filter # 1 30%
bronchoscopy Filter # 2 MERV 14 Filter # 2 90% Filter # 2 95%
*Specialized operating room, e.g. transplants, orthopedics
1. Minimum efficiency reporting value (MERV)
2. High-efficiency particulate air (HEPA)
3. Dust spot efficiency
4. Dispersed oil particulate (DOP)
Minimum outdoor air changes/total air changes per hour
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room 6/20 6/20 6/20
Procedure room 5/15 6/20 6/20
Recovery room 6/20 6/20 6/20
Endoscopy / bronchoscopy 5/(15/20) 6/20 6/20
Dirty room (MDR) 2/10 2/8 3/12
Clean room (MDR) 3/10 3/10 3/12
Sterile storage 0/4 0/4 3/12
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December 30, 2017
ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Relative pressurization
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room Positive Positive Positive
Procedure room Positive Positive Positive
Recovery room Positive Positive Positive
Endoscopy / bronchoscopy Negative Positive/Negative Positive/Negative
Clean room (MDR) Positive Positive Positive
Sterile storage Positive Positive Positive
Dirty room (MDR) Negative Negative Negative
Pressure-critical spaces: minimum pressure differential
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room + 7.5 Pa + 0.762 mm +
Procedure room + 7.5 Pa + 0.762 mm +
Recovery room + 7.5 Pa + 0.762 mm +
Endoscopy / bronchoscopy - 7.5 Pa + 0.762 /- 0.762 mm +/-
Clean room (MDR) + 7.5 Pa + 0.762 mm +
Sterile storage + 7.5 Pa + 0.762 mm +
Dirty room (MDR) - 7.5 Pa - 0.762 mm -
7.5 Pa = 0.03wc = 0.762 mm of water pressure
Temperature
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room 18–23oC 17–27oC 20–26oC
Procedure room 18–22oC 17–27oC 20–26oC
Recovery room 22–24oC 24oC 22–24oC
Endoscopy / bronchoscopy 18–22oC 20–24oC 20–26oC
Clean room (MDR) 18–23oC 20–23oC 22–26oC
Sterile storage 20–23oC 20–23oC 22–26oC
Dirty room (MDR) 18–20oC 18–20oC 22–26oC
Relative humidity
Z317.2-10 Z317.2-01 Z317.2 M91
Operating room 40–60% 45–55% 50–60%
Procedure room 30–60% 45–55% 50–60%
Recovery room 30–60% 50–60% 50–60%
Endoscopy / bronchoscopy 30–60% 30–60% 50–60%
Clean room (MDR) 30–60%* 30–60% 40–50%
Sterile storage 30–60%* 30–60% 40–50%
Dirty room (MDR) 30–60%* 30–60% 40–50%
*As per the Ministry of Health Best Practice Guidelines for Cleaning, Disinfection and Sterilization of Critical and Semi-Critical
Medical Devices relative humidity of 40–50% is preferred
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ACCREDITATION STANDARDS
Infection Prevention & Control
HEATING, VENTILATION AND AIR-CONDITIONING SYSTEM (HVAC) – CLASS 1 FACILITY
Parameter monitoring: monitored, alarmed central readout
Z317.2-10 Z317.2-01 Z317.2 M91
Pressure differential (PD)
Temperature (T)
Relative humidity (RH)
Parameter monitoring: local readout
Z317.2-10 Z317.2-01 Z317.2 M91
OR/procedure room PD, T, RH T, RH T, RH
Dirty room T, RH T, RH -
Clean room T, RH T, RH -
Sterile supply T, RH T, RH -
Parameter monitoring: calibration
Z317.2-10 Z317.2-01 Z317.2 M91
OR/procedure room (PD, T, RH) Monthly - -
Dirty room (T, RH) Annually - -
Clean room (T, RH) Annually - -
Sterile supply (T, RH) Annually - -
REFERENCES
Canadian Standards Association. Special requirements for heating, ventilation, and air
conditioning (HVAC) systems in health care facilities. Mississauga, ON: Canadian Standards
Association; 2010. 70 p. CSA Standard No.: Z317.2-10.
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