Part E: Engineering Services

2. Mechanical (HVAC) Engineering Design

This HVAC design guideline written for DHA healthcare facilities, is a consolidated document listing

out the design requirements for all new construction and major renovation healthcare projects,

within the emirate of Dubai, under the licensure of DHA.

Compliance to this document, which stipulates minimum performance design standards for DHA,

ensures that DHA facilities will be of the highest quality.

Substantial variance from this Design Manual may be proposed by the design consultant to

promote new concepts and design enhancements. Variance shall not conflict with Federal

Regulations, Local Municipality Laws, Executive Orders, or the needs of the end users. Substantial

variance shall be reviewed by the DHA.

This document is intended for the Architect/Engineer and others engaged in the design and

renovation of healthcare facilities within the Emirate of Dubai. Where direction described in

applicable codes are in conflict, the AE shall comply with the more stringent requirement. The A/E

is required to make themselves aware of all applicable codes and ordinances and assure compliance

thereto.

The document should be read in conjunction with other parts of the Health Facility Guidelines (Part

A to Part F) & the typical room data sheets and typical room layout sheets.

2.1 Key Objectives

The HVAC systems should be designed to achieve the following key objectives.

• Mechanical services that deliver the anticipated levels of comfort and functionality.

• A zero-tolerance approach to patient safety and infection control.

• Compliance with the applicable codes and standards.

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• Appropriate pressure differentials between adjacent spaces and departments in clinical facilities.

• Adherence to air changes per hour requirements as per code.

• Reliable operation at the extreme outside design temperatures experienced in Dubai.

• Reducing operating and maintenance costs shall be a key component in all new constructions.

• Flexibility for future modification and expansion.

• Energy efficiency & Dubai Al Sa’fat Green Building System compliance.

• An appropriate level of consistency across facilities, within the emirate of Dubai, recognizing the

specific demands of each facility and clinical specialty.

2.2 Abbreviations & Reference Standards List

2.2.1 Abbreviations List:

Abbreviation Description

ΔT Delta T

A/E Architect Engineer

ACH Air Changes Per Hour

AHU Air-Handling Unit

AII Airborne Infection Isolation

BMT Bone Marrow Transplant

BSC Biological Safety Cabinet

C Celsius

CAPEX Capital Expenditure

CD Construction Documents

CFC Chlorofluorocarbon

cfm Cubic Feet Per Minute

CO2 Carbon-dioxide

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Abbreviation Description

CRAC Computer Room Air Conditioner

CT Computerized Tomography

CV Constant Volume

DB Dry Bulb

DD Design Development

DOAS Dedicated Outside Air System

DX Direct Expansion

EEG Electroencephalography Laboratory

EER Energy Efficiency Ratio

EMG Electromyography

ERCP Endoscopic Ultrasound Procedure

ETO Ethylene Oxide

fpm Feet Per Minute

fps Feet Per Second

GE General Exhaust

Gpm Gallons Per Minute – US

GWP Global Warming Potential

HCFC Hydro chlorofluorocarbons

HEPA High-Efficiency Particulate Arrestance

HFC Hydrofluorocarbons

HFO Hydrofluoro-Olefins

Hp Horsepower

HVAC Heating, Ventilation and Air Conditioning

HX Heat Exchanger

ICU Intensive Care Unit

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Abbreviation Description

IAQ Indoor Air Quality

IMRT Intensity-Modulated Radiation Therapy

I/O Input/output

IR Infrared Radiation

IT Information Technology

kg Kilograms

kPa Kilopascal

kWh kilowatt hour

L/s Liters per Second

LCC Life Cycle Cost

LCCA Life Cycle Cost Analysis

m/s Meters per second

MERV Minimum Efficiency Reporting Valve

MRI Magnetic Resonance Imaging

NC Noise Criteria

NICU Neonatal Intensive Care Unit

OA Outdoor Air

ODP Ozone Depletion Potential

OPEX Operational Expenditure

OT Occupational Therapy

OR Operation Room

Pa Pascal

PACU Post Anesthesia Care Unit

PE Protective Environment

PET Positron Emission Tomography

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Abbreviation Description

ppm Parts Per Million

QA/QC Quality Assurance/Quality Control

RA Return Air

RDS Room Data Sheets

RH Relative Humidity

SA Supply Air

SE Special Exhaust

TB Tuberculosis

TAB Testing, Adjusting and Balancing

UPS Uninterruptible Power Supply

VPS Variable Primary System

VSD Variable Speed Drive

2.2.2 Reference Standards List:

Local/international regulations, guidelines or standards as listed below are required to be followed

while designing healthcare facilities in the Emirate of Dubai. The requirements given in these

regulations or standards are not repeated generally in this document; however specific additional

healthcare specific requirements emphasised in the following sections will take precedence over

referenced standards. Local standards will always take precedence over international standards. The

editions mentioned are current editions and latest editions of the documents, at the time of

registration of the project shall apply.

Items marked with * indicate optional compliance.

Summary of Key Design Codes, Standards and Reference Documents for HVAC Design

SUBJECT DOCUMENT EDITION OR LATEST

General HVAC Design ASHRAE 170 - Ventilation of Healthcare 2017

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Summary of Key Design Codes, Standards and Reference Documents for HVAC Design

SUBJECT DOCUMENT EDITION OR LATEST

Facilities

ASHRAE HVAC Design Manual for Hospitals 2013

and Clinics Second Edition*

ASHRAE 62.1 Ventilation for Acceptable Indoor 2016

Air Quality

Pharmacy HVAC Design USP 795 - Pharmaceutical Compounding - 2015

Reference Non-sterile preparations

USP 797 - Pharmaceutical Compounding - 2015

Sterile preparations

USP 800 – Hazardous Drugs – Handling in 2014

Healthcare Settings

Refrigeration Systems ASHRAE 15- Safety standard for refrigeration 2013

systems

ASHRAE 34 Designation and safety 2013

classification of refrigerant

Thermal Comfort ASHRAE 55 Thermal environmental conditions 2017

for human occupancy

Ventilation for Catering NFPA 96- Ventilation control and fire 2014
Facilities protection of commercial cooking operation

Sustainability ASHRAE 189.3 Construction, and Operation of 2017

Sustainable High-Performance Health Care
Facilities *

Dubai Al Sa’fat Green Building System 2017

Laboratory HVAC ANSI/AIHA Z9.5 - Laboratory Ventilation* 2012

Design
ANSI/NSF 49 - Biosafety Cabinetry: Design, 2014
Construction, Performance and Field
Verification

ASHRAE laboratory Design Guide: Planning and 2015

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Summary of Key Design Codes, Standards and Reference Documents for HVAC Design

SUBJECT DOCUMENT EDITION OR LATEST

Operation of Laboratory HVAC Systems second

edition*

Laboratory Safety Guidance – OSHA* 2011

Fire Safety NFPA 45 - Standard on Fire Protection for 2015

Laboratories Using Chemicals

NFPA 90A - Installation of Air Conditioning and 2018

Ventilating Facilities

NFPA 90B- Standard for the Installation of 2018

Warm Air Heating and Air-Conditioning
Systems

NFPA 92 - Standard on Smoke Control 2018

Systems

NFPA 99 - Health Care Facilities Code 2018

NFPA 101 - Life Safety Code Handbook 2018

NFPA 5000 - Building Construction and Safety 2018

Code

UAE Fire and Life Safety Code 2017

Access and ASHRAE 180 - Standard Practice for Inspection 2012

Maintenance and Maintenance of Commercial Building HVAC
Systems*

UL Standards UL 1995 Heating and Cooling Equipment 2015

UL 555 Fire Dampers 2013

UL 705 Standard for Power Ventilators 2017

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2.3 Infection Control & HVAC

It is important to note the below mentioned functions desired from the HVAC system serving a

healthcare facility, as compared to other building types for which the HVAC system is simply

designed for thermal comfort.

Infectious diseases are spread by several different routes. Tuberculosis and in some cases influenza,

the common cold, and other diseases are spread by the airborne route. The spread can be

decelerated or controlled by heating, ventilating, and air-conditioning (HVAC) systems. The

designer must keep these aspects in mind & consider it an ethical responsibility to comply with all

relevant codes and standards.

For healthcare facilities, HVAC systems play a very important role in reducing airborne infections by

Air Change Rates to reduce the residence time of particles in the air.

Filtration to remove microbes.

Ultra Violet Germicidal Irradiation (UVGI) to in-activate the viable agents and prevent

growth.

Pressurization of spaces to move air from clean to less clean and dirty area.

Temperature and humidity control to reduce propagation.

100% exhaust from designated high-risk spaces to remove the particles from the space.

Proper air distribution to reduce the deposition of particles and provide a designed path to

the exit.

Pressurization of the entire building to reduce air infiltration from outside.

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2.4 Life Safety & HVAC

The HVAC systems should follow design requirements stated within UAE Fire and Life Safety Code,

2017 & other relevant referenced NFPA standards. Points to note are listed below.

Fire Dampers, Smoke Dampers and Combination Fire and Smoke Dampers should be

provided in accordance with the local code and in line with the Fire and Life Safety Drawings.

Mechanical smoke management should be provided for atriums, corridor and open

circulation spaces.

Mechanical pressurization should be provided for egress stairs, lift hoist ways & lift lobbies

for fire lifts.

If the air handling units return ducting is utilized for smoke control, the system design zoning

should be carefully matched with the smoke zones, which in turn should line up with fire

alarm and fire sprinkler zones. All other requirements related to duct construction and fan

rating should be adhered to., as per UAE Fire Life Safety Code, 2017.

It is recommended to install dedicated extract air ducts for corridor and open circulation

spaces smoke management, where required by code, rather than utilizing AHU ducts which

would complicate AHU control and operation sequences, especially for typical in-patient

floors. Using AHU return duct would also warrant replacement of ducting, post fire incident.

Makeup air can however, be provided through the AHU supply fans.

2.5 HVAC Services Reliability, Redundancy & Resiliency Requirements

The HVAC system designed for a healthcare facility is providing mission critical filtration, cooling,

humidification & dehumidification as well as pressure regime management to the various critical

healthcare spaces within the hospital.

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Thus, the failure of an HVAC system component can lead towards a loss of pressurization which

could be life threating to an immune-compromised patient and can also result in a spread of viral

infections.

The following section will list out the key requirements for an HVAC system to meet these

challenges.

2.5.1 Reliability

Reliability of an HVAC system is the quality of the system components, installation, commissioning

and facility maintenance.

To ensure reliable construction and operation, the DHA health facility guidelines aim to introduce a

prequalification system for the design consultants. Part A of these guidelines provide more

information on the proposed system.

It is encouraged that owners and facility operators get involved early in the design process and

provide feedback on the system components and operational aspects of the design.

For future healthcare projects in Dubai, HVAC equipment manufacturers that have a strong local

presence and full-service support shall be selected. All applicable components should be tested at

the Dubai Central Laboratories or other equivalent facilities worldwide and test certificates

provided for record. Witness testing is encouraged for all major HVAC system components.

2.5.2 Redundancy

In simple terms, redundancy can be thought of the amount of standby equipment that is available to

cover a system or component in the event of a partial system failure.

Standby equipment requirement should always be aligned with the owner’s facility operation plan.

Key system components in healthcare facilities must be configured in N+1 configuration. A guidance

is provided below.

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Redundancy Requirements for Healthcare Facilities

SYSTEM COMPONENT DESIRED OPTIMAL ALTERNATE ALLOWED

REDUNDANCY LEVEL

Water Cooled Chillers N+1 Deviation allowed for smaller

hospitals & clinics if loss of one
chiller does not affect critical
cooling.

Air Cooled Chillers N+1 Deviation allowed for smaller

hospitals & clinics if loss of one
chiller does not affect critical
cooling.

Central Steam Boilers N+1 Deviation allowed for smaller

hospitals & clinics if loss of one
boiler does not affect critical
cooling.

Hydronic Heat Exchangers N+1

Chilled Water & Hot Water N+1

Pumps

Operation Theatre Air Handling N+1 AHU’s with dual fans with each
Units sized at 100% of the airflow or fan
arrays with one additional fan are
allowed as an alternate to N+1
AHU’s.

Air-Side Equipment – Hygienic N+1 (Fans) Each sized Fan Coil Units can be used for
Air Handling Units (Critical Care, at 100% airflow & Emergency, Imaging, Oncology, in
LDR, Emergency, Diagnostic Critical Cooling. patient pharmacy, Radiotherapy
Imaging, Laboratory, Oncology, and renal departments but their
In-patient pharmacy, use is highly discouraged.
Radiotherapy, Renal Unit, CSSD,
Surgical Suite, Isolation Rooms)

Server Room N+1 N+1 Precision Control Units or

single indoor unit with dual coils &
dual fans backed up by

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Redundancy Requirements for Healthcare Facilities

SYSTEM COMPONENT DESIRED OPTIMAL ALTERNATE ALLOWED

REDUNDANCY LEVEL

independent heat rejection

equipment.

Critical Rooms Dedicated Exhaust N+1

Fans (Isolation Rooms,
Bronchoscopy, Nuclear Medicine
Hot Labs, Emergency and
Radiology Waiting Rooms, Lab
Fume Hoods, CSSD Sterilizers &
Washers, Pharmacy hazardous-
drug exhausted enclosures)

Fire & Life Safety / Smoke N As per local Fire and Life Safety
Control System / Pressurization code requirements
System Fans

2.5.3 Resiliency

For the HVAC system, resiliency can best be thought of how much of the total system continues to

operate in the event of a failure of one part of the system. Resiliency is critical to business

continuity which is essential for public hospitals operating under disaster management and helps

mitigate revenue losses in case of system failures for private hospital operators.

Resiliency must be built into the design, during the concept design stage. The consultant must

evaluate the risks associated with the failure of a system component, engage in an effective

dialogue with client/owner/operator and determine ways and means to mitigate the risks.

External risks associated with climatic conditions such as Sand Storms & heavy rainfall

should also be evaluated and intake and exhaust louvers should be positioned & sized so that

they can handle an extreme event.

Major equipment located below grade must be evaluated for flash flood risk.

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Operating weights of equipment’s should be considered for structural design. Critical

weights of equipment’s such as absorption chillers should also be considered to ensure that

the structure can handle the HVAC equipment loadings.

Redundant systems should be routinely operated through BMS and tested at design

conditions.

Some of the major equipment risks are mitigated by the table in the previous section on

redundancy, but distribution systems such as ductwork and pipework should be configured

in a way that eliminates a single point of failure.

Ring mains, multiple risers, dual connections to larger AHU coils, bypass over major control

valves with proper isolation, Individual VFD’s per fan, bypass for VFD’s, manifolded air

handling unit configuration are some of the measures that can be adopted for better system

resiliency.

2.6 HVAC System Zoning & Emergency Operation

2.6.1 HVAC System Zoning

HVAC systems for clinical buildings shall generally be zoned to match the smoke control

compartments for the building. The intention is to ensure that the impact of one zone being shut

down is minimized. If this approach results in an excessive quantity of air handling units, more than

one zone can be combined with fire and smoke dampers to separate them. In this case designers

shall consider arranging the distribution ductwork so that only part of the system has to be shut

down in a fire alarm condition.

By zoning the system using smoke control compartments it is unlikely that the capacity of a single

air handling unit would exceed 16,500 L/s (60,000 m3/hr). If it does the designer should consider

dividing the air volume between two air handling units.

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It is encouraged that consultants prepare zoning diagrams during the concept design stage to

clearly demarcate HVAC zones for coordination & clarity.

2.6.2 HVAC Systems Emergency Operation

Emergency generators are to be provided for the buildings to supply power to the HVAC system in

a loss of power supply from the DEWA grid.

As described in the Electrical section, the capacity of the generators is determined using a risk

classification process. The HVAC designer shall work with the electrical designer for the building to

determine which HVAC systems are to be provided with emergency power through this process.

The result of this analysis should also be used to assess how systems are zoned.

As a minimum all critical areas identified within ASHRAE 170 (SSU(CSSD), Surgical Suite, Labour &

Delivery Suite/Birthing Unit, Recovery, Emergency, Intensive Care, Nursery & Inpatient Rooms)

should be provided with backup cooling fed from emergency power. The space ventilation and

pressure relationship requirements for Isolation rooms, Operating rooms including Caesarean

section, should be maintained, via backup power. Refer to the electrical section, detailing the

requirements for different risk categories within the hospital.

It is encouraged that mechanical consultant table the electrical power requirements (normal power

or emergency power) in the mechanical equipment schedules in order to obtain clarity for the

electrical engineer.

2.7 HVAC Services Acoustic Requirements

The HVAC system shall be designed to be compliant to HTM 08-01: Acoustics, as mandated by

Dubai Al Sa’fat Green Building rating system. Specific requirements for HVAC system components

should be obtained from ASHRAE HVAC Applications Handbook Chapter 48: Noise and Vibration

Control.

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Lining of ductwork is not allowed in healthcare facilities after final filtration, as per ASHRAE

170 except in terminal units, sound attenuators and air distribution devices (plenum boxes

etc.). Such lining should be provided with an impervious cover, or carry certifications citing

no vapor absorption and be acceptable to local civil defence requirements. CAV/VAV boxes

which cannot meet acoustic requirements, should be provided with downstream attenuators

in critical areas.

Backup power generator’s if installed within hospital buildings should be provided with

critical hospital grade silencers.

Car park exhaust and make up air fans should be provided with sound attenuators to reduce

the sound during normal mode operation.

Acoustic Ratings for plant room doors should be carefully specified with detailed

coordination between trades.

2.8 HVAC Services Future Proofing & Spare Capacities

Due to the nature of medical facilities, changes to internal layouts and upgradation of the medical

equipment is quite common, which results in HVAC cooling load variances. The designer should

engage in an effective dialogue with the owner/operator to determine the allowance to be kept for

future expansion as well as retrofitting and modifications within departments.

As a strong recommendation this guide asks for 20% extra useable area allocated for mechanical

shafts for additional pipework and ductwork. It is also recommended that mechanical AHU rooms

for medium to large hospitals should allow for space for an additional air handling unit for every 10

air handling units. Mechanical Pump rooms should be provided with space for 1 additional pump for

both primary and secondary systems.

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2.9 HVAC System Selection – Distribution

The intent of this section is to provide a guidance for HVAC systems selection process for

healthcare facilities as well as list out acceptable and unacceptable HVAC systems. Specific Room

design guidance is provided at the end of this document in a separate section, which should be read

in conjunction with this section.

2.9.1 Acceptable HVAC Systems-Distribution

All-air systems shall be used for all new facilities and major renovations of existing facilities where

above ceiling clearance is available to accommodate HVAC air distribution systems. All-air systems

designs shall provide for the admittance of minimum required outdoor air in all operating

conditions. The use of constant volume (CV) systems shall be carefully considered and only utilized

if proven more cost effective through a Life Cycle Cost Analysis (LCCA), or if required due to the

area served.

The following list of systems is acceptable for air-distribution systems within healthcare facility.

2.9.1.1 Variable Air Volume with terminal reheat

This distribution system is acceptable in all facilities and is considered as the preferred solution for

general clinical areas.

• VAV terminal units shall be in a pressure independent configuration to maintain airflow under

fluctuating upstream duct pressures as system flow changes.

• Supply air VAV terminals shall be provided with integral hot water reheat coil or electrical reheat

coil for areas with permanent occupancy as deemed necessary through heat load calculations.

• Supply air temperature differential to room temperature shall not exceed 10°C in heating mode

to prevent stratification.

• Terminal units shall be equipped with sound attenuators as necessary to meet acoustic

requirements.

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• Supply air temperatures shall be reset based on demand to minimize cooling and reheat loads.

• VAV terminal units shall be provided for both supply and return/exhaust air systems for areas

where mandated pressure control is required as per ASHRAE 170.

• Terminal humidification is discouraged expect in operating theatres.

• Minimum air volumes for VAV boxes shall be in accordance with the room air change rate specified

in ASHRAE 170. This will generally be higher than the typical 30% minimum for a conventional

commercial VAV system. The tender drawings & specs should indicate minimum value for each

VAV box.

2.9.1.2 Fan Coil Units

Chilled water-based Fan Coil Units are an acceptable solution for administration and support areas

as well as clinical areas where ASHRAE 170 does not prohibit recirculation by room units.

For Larger facilities, use of FCU is discouraged due to higher energy consumption, maintenance

issues and the need to access clinical spaces to replace components such as filters, fan motors and

control valves.

In specific cases fan coil units may also be used in circulation spaces, if there are high sensible

cooling loads from heat gain through the building envelope or in spaces where there are localized

heat gain from electro-mechanical equipment’s; such as plant rooms, electrical and telecom rooms.

Care must be taken to place FCU’s outside of the electrical/telecom rooms to avoid chilled water

piping within the room as per DEWA regulation.

Fan coil units shall not be used to dehumidify the outdoor air as Dubai’s outdoor air has a high

moisture fraction. A dehumidified outdoor air supply should be ducted to the Fan coil units through

a dedicated 100% outdoor air handling unit, utilizing energy recovery as per DM regulation.

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DX or VRF based Fan coil units are also acceptable where there is no centralized source of chilled

water for smaller installations.

2.9.1.3 Displacement Ventilation

Displacement ventilation is an acceptable solution for non-clinical areas only. It is not recommended

in clinical areas due to the restrictions created by the fixed location of the supply diffusers. Where

displacement ventilation is used, the designer shall co-ordinate locations of terminals carefully with

the interior design proposals to ensure thermal comfort is achieved and future flexibility is not

compromised.

Displacement ventilation can be particularly effective in spaces with lofty ceilings such as entrance

areas atriums or spaces with high occupancy levels such as lecture halls.

If utilizing displacement ventilation, the designer shall refer to the ASHRAE standards and

handbooks with consideration for space temperature gradients.

2.9.2 Unacceptable HVAC Systems – Distribution

The following systems are unacceptable and should not be used in future healthcare projects within

the emirate of Dubai.

• Chilled beams or chilled ceilings due to concerns over potential condensation and associated

infection control risks.

• Dual duct VAV systems.

2.10 HVAC Systems Design Criteria & Relevant Applicable Codes

The following section aims to provide a general brief for the HVAC systems for new construction

and major renovation healthcare projects within the Emirate of Dubai, governed by the DHA.

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2.10.1 External Design Criteria

The following minimum design conditions shall be used for all healthcare projects within the

Emirate of Dubai. These have been developed from the ASHRAE Fundamentals Handbook 2017 &

the Dubai Al Sa’fat Green Building Evaluation System.

Design Criteria Value to be utilized

Outside design conditions for cooling load 46°C DB, 29°C WB

calculation (as per DM)

Outside design conditions for fresh air (as per 34°C DB, 32°C WB
DM)

Outside design conditions for heating load 11.2°C DB, 7.5 °C WB

Outside design conditions for humidification 29.8°C DB, 14.22°C WB

Outside design conditions for selecting air 47.6°C DB (ASHRAE Projected Dry Bulb for
cooled HVAC equipment (Recommended) next 20 years)

Outside design conditions for selecting cooling 32°C WB (ASHRAE Projected Wet Bulb for
towers (Recommended) next 20 years)

2.10.2 Envelope Design Criteria

The envelope design parameters, as a minimum should meet the prescriptive requirements listed

out in Dubai Al Sa’fat Code 501 Chapter 1- Conservation and Efficiency: Building Envelope & Dubai

Municipality Circular 214/2016.

As a best design practice, the following values are suggested to be used for future healthcare

projects within the emirate of Dubai.

Component Recommendation (U- W/m2. K)

Roof U-0.3 (Insulation entirely above the slab)

Solar Reflectance Index (SRI) > 78

External Wall U-0.4 (Mass Walls)

Floors As per project requirements

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Component Recommendation (U- W/m2. K)

Doors Swinging U-0.74

Non-Swinging U-1.45

Vertical Fenestration (Full Assembly) Window to Wall Ratio 40%

Thermal Transmittance U-1.9 (min)
Solar Heat Gain Coefficient 0.25 (max)
Light Transmittance 0.15 (min)

It is encouraged to improve upon the recommended values for medium to large healthcare facilities

as they are operational round the clock and consume the most energy as compared to any other

building type.

2.10.3 Internal Design Criteria

The internal design criteria for DHA facilities is split up into two categories, clinical and non-clinical

spaces. All spaces identified within ASHRAE 170 shall be treated as clinical spaces.

The below tables would identify the performance level for internal spaces and the associated ceiling

with respect the heat gain from internal sources for both spaces.

Non-clinical ancillary support buildings that are part of the development shall follow the guidelines

for non-clinical spaces.

2.10.3.1 Non-Clinical Spaces:

Criteria Requirements

Temperature The internal temperature requirement for non-clinical spaces shall be set
at 24 °C DB.

Relative Humidity General non-clinical spaces would not be provided with active relative
humidity control, unless it is a requirement related to specialist
equipment within the space. The designer to ensure that maximum
relative humidity is kept within 60% by employing BMS control

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Criteria Requirements

algorithms.

Electrical Lighting Lighting loads shall be based on an average watts/m2 figure for each
type of room based on a representative lighting layout. General guidance
can be obtained from ASHRAE 90.1.2016 Lighting Power Density. The
maximum overall limit set by Al Sa’fat 502.04 Lighting Power Density-
Interior should be adhered to.

Electrical Small Power Where there are specific equipment rooms, the heat loads shall be based
on the ‘worst case’ values from the potential range of suppliers.
Where are there no specific equipment layouts, allowances for small
power loads shall be made on an average watts/m2 basis as appropriate
for the space type. Refer to ASHRAE Handbook Fundamentals 2017
Chapter 18 Non-Residential Cooling and Heating Load Calculations.

Occupancy The design shall be based on the furniture layout or ASHRAE 62.1,
whichever is the more onerous.

Infiltration The building should be designed to be at positive pressure with respect to

the atmosphere, always. Infiltration load should only be considered for
high rise as defined by UAE FLS Code, 2017.

Ventilation The minimum requirements for ventilation shall be as specified in the

ASHRAE Standard 62.1.2016.

Acoustic The design for HVAC system should follow the acoustic requirements
Requirements listed out in HTM 08-01 which is referenced in the Dubai Al Sa’fat Code.

2.10.3.2 Clinical Spaces

Criteria Requirements

Temperature Internal design temperatures shall generally be in accordance with

ASHRAE Standard 170 & HVAC room design segment in this document.
If there is an equipment specific space temperature requirement listed in
the Room Data Sheets (RDS) it will supersede ASHRAE requirements.

Relative Humidity Internal relative humidity shall generally be in accordance with ASHRAE
Standard 170. If there is an equipment specific temperature requirement
listed in the Room Data Sheets (RDS) it will supersede ASHRAE

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Criteria Requirements

requirements.

Electrical Lighting Lighting loads shall be based on an average watts/m2 figure for each
type of room based on a representative lighting layout. General guidance
can be obtained from ASHRAE 90.1.2016 Lighting Power Density. The
maximum overall limit set by Al Sa’fat 502.04 Lighting Power Density-
Interior should be adhered to.

Electrical Load Due to Medical equipment heat dissipation loads shall be based on the Room
Medical Equipment Data Sheets (RDS) listed values. RDS values should represent actual
equipment heat dissipation values using ‘worst case’ manufacturer’s
published data from the range of potential suppliers.

Occupancy Design occupancy for each space shall be as specified on the room data
sheets. If no occupancy is provided, the design shall be based on the
furniture layout or ASHRAE 62.1, whichever is the more onerous.

Infiltration The building should be designed to be at positive pressure with respect to

the atmosphere, at all times. Infiltration load should only be considered
for high rise as defined by UAE FLS Code, 2017.

Ventilation The minimum requirements for ventilation shall be as specified in the

ASHRAE Standard 170.2017. For spaces not listed under ASHRAE 170,
utilize ASHRAE 62.1.

Acoustic The design for HVAC system should follow the acoustic requirements
Requirements listed out in HTM 08-01 which is referenced in the Dubai Al Sa’fat Code.

2.10.4 Air Intake & Exhaust

The air intake and exhaust louvers/vents positions should be carefully planned for healthcare

facilities to ensure that there is no recirculation of air. Minimum separation distances mentioned in

ASHRAE 62.1 should be adhered too. ASHRAE 170 lists out the perspective requirements for

outdoor air intakes and exhaust discharges which will be enforced via this guideline.

Dubai’s harsh climatic conditions warrant special attention to the air intake air louvers. As a

minimum the intake outdoor air should be drawn into the system through sand trap louvers sized at

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1m/s across the face area of the louver to provide an 80% or higher filtration efficiency at coarse

sand grain size (355-425 microns).

For bigger healthcare facilities providing a central air intake to the 100% outside air energy

recovery air handling unit it is recommended to utilize a self-cleaning inertial air cleaner. The air

cleaner provides 99% efficiency at a sand grain size of 10 to 100 microns. Due to the high velocity

intake it also overcomes the constraints regarding the large face area, which are a problem for the

standard sand trap louver.

Washable aluminium filters can be provided at the rear of the sand trap louver. If provided, designer

should ensure access for proper maintenance. If proper access cannot be guaranteed, enabling the

removal of the filters without shutting down the AHU, the filters should not be provided for the air

intake louvers as dirty filters would clog the air steam providing higher pressure drop and in turn

reduced air volume.

Based on the ambient acoustic levels, determined through a survey conducted at the site by a

professional acoustic consultant, if required the outdoor air intake & exhaust should be provided

with a sound attenuator.

Buildings shall maintain a positive pressurization (5-10% net positive). Tighter buildings are eligible

for less net pressurization. Designers should ensure enough outside air is provided for adequate

pressurization. It is encouraged to undertake blower door testing for facility integrity as part of the

testing and commissioning process.

2.10.5 Filtration

Mechanical filtration plays a very important role in ensuring that the hospital continues provide

best in class care & is fit for occupancy. Mechanical filtration is one of the key elements to

healthcare HVAC design and is of primary significance regarding air quality & infection control.

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All air handling units directly serving the spaces & outside air handling units serving downstream

terminal units, should be provided with a 1st stage filtration of no less than MERV 8/ePM10 60%

rating and a final filter downstream of all wet-air cooling coils and supply fan according of no less

than MERV 14/ ePM1 70% rating.

ASHRAE 170 Table 7.1 & 8.1 provide a list of healthcare spaces which do not allow recirculation

through room units. Majority of the spaces are highly critical departments [Critical Care, OT, NICU,

Procedure rooms, Recovery Rooms, Isolation Rooms, X-Ray Rooms (surgery/critical care &

catherization/angiography ), Endoscopy Rooms, Autopsy Room, etc.] where cleaning difficulty and

potential building of contamination has led to this requirement. DHA for all future projects would

therefore not allow terminal cooling or heating units for these spaces as identified by ASHRAE 170.

Ultraviolet (UV-C) disinfection (also called ultraviolet germicidal irradiation [UVGI]) is used to

inactivate microorganisms. The use of UV-C is encouraged for healthcare projects specially for

cooling coil surfaces to avoid fungal amplification. The peak effective wavelength range for

inactivation of microorganisms is near 254 nm.

Alternative filtration techniques such as electronic filters and air cleaners using photocatalytic

oxidation (PCO) are not encouraged to be used because of negative health effects that arise from

exposure to ozone and its reaction products. Substantial technical evidence is required on the use of

these techniques, validated by international agencies, test standards and standard engineering

bodies such as ASHRAE, CIBSE etc. If utilized, they are not considered a replacement for mechanical

filtration but can be considered as aides to achieve better indoor air quality . Refer to ASHRAE

position document on Filtration and Air Cleaning, 2015.

2.10.6 Materials

The table below provides basic information on reference design standards for core HVAC system

components. It is highly recommended that the materials and system components carry

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certifications citing compliance to the following standards for all new construction and major

renovation healthcare projects within the Emirate of Dubai. Latest versions of the following will

apply at the time of the project registration.

Certification & Design Standards for All Facilities

SUBJECT DOCUMENT EDITION

Ductwork DSP DW/144 Specification for sheet metal ductwork. 2016

Third edition

DSP DW/172 Specifications for kitchen ventilation 2018

systems.

SMACNA HVAC Systems Duct Design 2006

SMACNA HVAC Duct Construction Standards-Metal & 2005

Flexible

Pipework ASME B31.9 Building Services Piping 2014

ASTM A53 Pipe, Steel, Black and Hot-Dipped, Zinc

Coated (Galvanized), Welded and Seamless.

ASME B31.5 - Refrigeration Piping 2016

Filter Standards ASHRAE 52.2 - Method of Testing General Ventilation 2017

Air-Cleaning Devices for Removal Efficiency by Particle
Size

ISO Standard 16890 Air Filters for General Application 2016

HEPA Filter Standard EN 1822 High efficiency air filters (EPA, HEPA and 2009
ULPA). Aerosol production, measuring equipment,
particle counting statistics

ISO 29463 High efficiency filters and filter media for 2017
removing particles from air

Fan Coil Units & Eurovent RS 6/C/002-2017 Rating Standard for 2017
Package Units Certification of Non-Ducted Fan Coil Units

Eurovent RS 6/C/002A-2017 Rating Standard for 2017

Certification of Ducted Fan Coil Units

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Certification & Design Standards for All Facilities

SUBJECT DOCUMENT EDITION

AHRI 340/360 Performance Rating of Commercial and 2015

Industrial Unitary Air-Conditioning and Heat Pump
Equipment

AHRI 310/380 Standard for package terminal AC and 2017

Heat Pump

AHRI 410 Forced-Circulation Air-Cooling and Air- 2001

Heating Coils

AHRI 440 Performance Rating of Room Fan-Coils 2008

ANSI/AHRI 1230 Performance Rating of VRF Multi Split 2010

AC & Heat Pump Equipment

Standard Air Handling Eurovent RS 6/C/005-2017 Rating Standard for 2016

Unit Construction Certification of Air Handling Units

AHRI 1350 Mechanical Performance Rating of Central 2014

Station Air-handling Unit Casings

AHRI 430 Performance Rating of Central Station Air- 2014

handling Unit Supply Fans

Hygienic Air Handling VDI 6022 - Ventilation and indoor-air quality - Hygiene 2011
Unit Construction requirements for ventilation and air-conditioning systems
and units

DIN 1946-4 - Ventilation and air conditioning - Part 4: 2008

Ventilation in buildings and rooms of health care

Eurovent RS 6/C/011-2017 Rating Standard for 2017

Certification of Hygienic Air Handling Units

Boilers & Chillers ANSI/AHRI 1500 Performance Rating of commercial 2015

Space Heating Boilers

ARI 550/590 Performance Rating of Water Chilling 2017

Packages Using the Vapor Compression Cycle

Cooling Towers CTI (Cooling Technology Institute) STD-201 Certified 2013

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Certification & Design Standards for All Facilities

SUBJECT DOCUMENT EDITION

Ventilation Equipment AMCA 210 Laboratory Methods of Testing Fans for 2016
Certified Aerodynamic Performance Rating

AMCA 300 Reverberant Room Methods for Sound 2014

Testing of Fans

AMCA 301 Methods for Calculating Fan Sound Ratings 2014

from Laboratory Test Data

2.10.7 Hydronic System Design

Hydronics refers to the science of heating or cooling with water. Open systems are open to the

atmosphere at least one location, such as cooling towers. Closed systems on the other hand are not

open to the atmosphere.

Piping systems distribution scheme can be direct or reverse return. With the advent of Pressure

Independent control valves (PICV), direct return systems outweigh the advantages offered by

reverse return both in terms of cost and system simplification, so they are encouraged for new

healthcare facilities.

All new facilities using hydronic cooling or heating system, should utilize pressure independent two-

way control valves.

Hydronic piping distribution schemes should either be constant primary / variable secondary

pumping or variable primary pumping. For Variable Primary Flow the chillers must be provided with

automatic isolation valves and the decoupler line provided with a control bypass actuated by a flow

meter ensuring that the minimum flow through the chiller is guaranteed. Care must be taken in

correct sizing of expansion tanks and air separators especially for heating hydronic systems.

Variable Primary Flow pumping systems are the preferred choice for future medium to large scale

healthcare projects because they offer

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• Low installed cost

• Reduced Mechanical room footprint

• Higher system efficiency

• Best response to Low Delta T syndrome.

Constant primary / variable secondary systems are also acceptable. Pumps should be in headered

configuration and located in a controlled environment.

Refer to the Figure 2.1, 2.2. 2.3 for illustrative example of the various distribution schemes.

Pipe material should be Black Steel Schedule 40 with welded or grooved joints.

2.10.8 HVAC Insulation Requirements

All insulation shall have a system fire and smoke hazard rating as tested by procedure ASTM-E-84,

NFPA 255, and UL 723 not exceeding: Flame Spread 25 and Smoke Developed 50. The system

rating shall be based on insulation, jacket, adhesives, coatings, fittings, and cements. Any treatment

of jackets or facings to impede flame and/or smoke shall be permanent.

Refer to Dubai Al Sa’fat Green Building Code for relevant insulation thickness. Refer to Dubai

Municipality Circulars for applicable materials. All insulation should be approved for use by the

Dubai Civil Defence.

The selection of insulation should look at not only thermal characteristic but also ensure no

condensation occurs in high humidity climate of Dubai.

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Figure 2.1

Figure 2.2

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Figure 2.3

2.11 HVAC System Location Access & Maintenance

2.11.1 Major Equipment

2.11.1.1 Location

All significant HVAC equipment such as FAHU’s, AHU’s shall be located in enclosed mechanical

plant rooms. Mechanical rooms shall be provided with air-conditioning & ventilation. The only HVAC

equipment which may be located externally is the following:

• Exhaust Fans.

• Heat Rejection Equipment. (e.g. Air-cooled chillers, Air cooled condensers, Cooling Towers, etc)

• Staircase & Lift core Pressurization Fans.

• Smoke Management Fans.

Rooftop/Exposed air handling units are not recommended due to the high humidity conditions in

Dubai.

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2.11.1.2 Access

Mechanical rooms and roofs with mechanical equipment shall be provided with staircase and

preferably lift access to facilitate maintenance and equipment replacement. Access to mechanical

rooms and roof mechanical areas shall be directly from cores or main corridors. It is not acceptable

for the access to mechanical rooms to be through treatment or patient care areas.

Clear access routes through mechanical rooms and roof areas shall be provided from the ls and

staircases. Routes shall be clearly and permanently marked on the mechanical room floor. The

minimum clear height for access routes shall be 2000mm or higher if dictated by the dimensions of

equipment.

Steps on access routes are not acceptable. If changes of level are needed, or if services must be run

at low level across an access route, a ramp must be provided.

2.11.2 Service Shafts

2.11.2.1 Location

Service shafts shall be strategically located to provide rational and flexible services installations and

minimize the size of the distribution ductwork and pipework on each floor. It is recommended that

main ductwork shafts are located away from stair cores and elevator shafts to allow ducts to enter

and leave the shaft on all sides.

Pipework shafts are most suited to locations adjacent to structural cores.

In clinical facilities, shafts shall not be located inside surgery suites or critical care areas. If the

designer encounters a specific situation where a shaft is needed in one these spaces it should be

discussed and agreed with DHA during the schematic designs stage, through architectural design

submission.

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2.11.2.2 Access

Pipework shafts shall be provided with access doors at each floor level to allow for inspection and

maintenance and installation of additional pipework in the future. Removable floor gratings are

recommended to be provided where clear openings exceed 450mmx450mm.

Ductwork shafts shall be provided with access doors as needed to enable cleaning. It is anticipated

that installation of additional ductwork would require the removal and replacement of wall finishes.

2.11.3 Terminal Equipment Locations

Locating HVAC equipment in ceilings above patient, staff and public areas shall be avoided where

possible. Where it is necessary, its location shall be carefully selected to minimize the disturbance

during maintenance and limit the infection control measures which are required to access it.

In clinical facilities it is not acceptable under any circumstances to have HVAC equipment accessed

from the space in any of the areas listed below. Terminal units should be located outside the rooms

in corridor spaces or other back of house spaces.

• Surgical Suite/ Zone

• Treatment Room

• All Critical Care Areas (ICU, CCU, NICU, PACU)

• Patient Rooms (permitted over ensuite)

• Sterile Store

• Fire Escape Horizontal Exit Passageway

The only exception is room side accessible terminal HEPA filters and fan filter units (FFU), where

access is obtained through special housing’s allowing quick replacement. All HEPA filters should be

located at terminal locations.

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2.11.4 Maintenance Strategy

It is strongly suggested that the designer develops an access and maintenance strategy document.

This document shall clearly describe the access and maintenance strategy for all mechanical

systems, including HVAC, plumbing and medical gas. Document shall be made available during the

90% stage inspection by DHA. The document must identify the strategy for plant maintenance and

replacement including the following considerations:

• Locations with Accessible ceilings for terminal units (VAV, FCU etc.)

• Access and Maintenance clearances for major equipment.

• Major plant removal routes with mechanical rooms.

• Infection control and patient safety implications.

2.12 Design Considerations - HVAC Equipment’s

The following section outlines the important design considerations that should be kept in mind

while selecting HVAC equipment for healthcare facilities.

2.12.1 Central Plants

If the project is significantly large, it is beneficial to locate all major MEP equipment at a central

location. This will help optimize the cost and increase the overall efficiency of all the systems.

District cooling availability for the project should also be ascertained at an early stage and if

approved by the local district cooling provider the building should be designed to be hooked up to

district cooling system. The building still must provide critical cooling (SSU(CSSD), Surgical Suite,

Labour & Delivery Suite/Birthing Unit, Recovery, Emergency, Intensive Care, Nursery & optionally

Inpatient Rooms) in case of failure of the district cooling network, by means of local heat rejection

equipment owned by the building owner.

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Remotely located central plant may use directly buried piping or use trenches/tunnels to connect to

hospital building. When utilizing service tunnels, a minimum of 2000mm clear depth should be

considered with a 900mm access passageway in between pipes to allow for sufficient space for

maintenance.

2.12.1.1 Central Chilled Water Plant Considerations

The following recommendations are for central chilled water plants.

Select cost-effective and optimum central chilled water plants and/or small chilled water

systems to meet the project-specific requirements. Each installation shall consist of multiple

(minimum two) chillers.

For central plants and small systems, it is recommended to conduct a comprehensive study

to evaluate and define the lowest life-cycle cost performance of the chilled water system.

The study shall address both CAPEX and OPEX.

Chillers shall be rated and certified as per AHRI conditions.

Where a central plant serves more than one air handling system, the capacity of the central

plant shall be calculated based on the peak simultaneous load, not the sum of the individual

loads. In addition, the following diversity factors are reasonable when calculating central

cooling plant capacity. The actual calculated central plant capacity shall be specific to the

nature and size of the system(s) however and should be determined via computer simulation.

Lighting 0.9

Equipment 0.85

People 0.8

For air cooled chiller in noise-sensitive locations, include chiller manufacturer’s standard

acoustic options in the design.

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Imaging systems such as MRIs, PET, CT Scanners, LINAC require chilled water for equipment

process cooling. Central plants should be sized to cover process loads, if use of plant central

chilled water use is approved by the imaging equipment manufacturer, otherwise a dedicated

chiller plant must be provided. Typically, the chiller, buffer tanks, and pumps for these

applications are provided by the manufacturer of the imaging equipment for installation by

others.

Potable water cooling should be provided as per the hydraulics engineering section of this

report.

Adequate space should be provided for equipment removal and maintenance. Replacement

routes should be marked on the design drawings. Design for non-disruptive access to all

chillers, pumps, cooling tower, and cooling tower components without the need to

disassemble or remove other equipment or systems and/or building components such as

piping, doors, walls etc.

Higher delta T should be utilized to obtain energy savings by lowering pumping costs.

Consider VFD driven equipment for further energy savings for any pump consuming over

7.5kW.

Arrange piping, especially piping in hydraulic decoupler to ensure that all water flow meters

have ideal flow conditions for accurate measurement. Follow worse case flow meter

recommendations.

Cooling Towers should be provided with an automatic basin cleaning system considering the

sand storms prevalent in Dubai & the risk of legionella associated with manual cleaning.

Cleaner environment friendly refrigerants should be utilized. ODP value should be 0 and

GWP value should be less than 2500. HFO’s are being developed which have much lower

GWP values <10 and are encouraged for use.

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2.12.1.2 Central Hot Water Plant Considerations

The following recommendations are for central hot water plants.

Select cost-effective and optimum central hot water plants and/or small hot water systems

to meet the project-specific requirements. Each installation shall consist of multiple

(minimum two) boilers/calorifiers etc.

For central plants and small systems conduct a comprehensive study to evaluate and define

the lowest life-cycle cost performance of the hot water system. The study shall address both

CAPEX and OPEX.

Adequate space should be provided for equipment removal and maintenance. Replacement

routes should be marked on the design drawings.

Higher delta T should be utilized to obtain energy savings.

VFD driven equipment should be utilized, for further energy savings.

2.12.1.3 Energy Benchmarking

All new projects within the emirate of Dubai must obtain full compliance with the Dubai Al Sa’fat

Green Building System Section Five: Resource Effectiveness: Energy 500. The values mentioned in

section 2.10.1 and 2.10.2 shall supersede the requirements from the Al Sa`fat code.

Medium to Large scale healthcare projects are encouraged to apply the principles mentioned in

ASHRAE 189.3 Construction, and Operation of Sustainable High-Performance Health Care

Facilities.

In addition, LEED v4 for Healthcare guiding principles are also encouraged to be utilized for a

sustainable healthcare building.

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2.12.1.4 HVAC Major Source Equipment’s

The following section lists out the specific requirements for major HVAC source equipment’s to be

utilized for healthcare projects. The aim is not to create an equipment specification list but to

highlight essential elements of design related to each equipment which must be considered due to

the critical nature of the healthcare facilities & the challenging climatic conditions of Dubai.

2.12.1.5 Water Cooled Chillers

Water cooled chillers can be centrifugal/screw or absorption type. Most common water-

cooled chillers utilized in the UAE market are centrifugal chillers with single compressor or

dual compressors based on the tonnage.

Chillers should be in air-conditioned environment, with adequate clearance space for

maintenance.

Consultant is encouraged to undertake an LCC study for VFD chillers vs. standards chillers.

Refrigerants with 0 ODP and less than 2500 GWP should be utilized for future healthcare

projects within the emirate of Dubai.

Provide emergency chilled water flanged piping connections covered with blind flanges and

isolation valves for emergency chilled water service where redundant chillers are not

installed.

Chillers should adhere to the performance metrics listed in the Dubai Al’ Sa’fat Code as a

minimum.

2.12.1.6 Air Cooled Chillers

Air cooled shall be screw type for tonnage over 100 tons. Scroll type chillers can be utilized

for smaller installations. Reciprocating chillers are not allowed to be installed in future

healthcare projects.

Consultant is encouraged to undertake an LCC study for VFD chillers vs. standards chillers.

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Provide emergency chilled water flanged piping connections covered with blind flanges and

isolation valves for emergency chilled water service where redundant chillers are not

installed.

Chillers should adhere to the performance metrics listed in the Dubai Al’ Sa’fat Code as a

minimum.

2.12.1.7 Cooling Towers

Induced draft-type, counter-flow, factory-fabricated, and factory-test cooling towers are

preferred choice for new construction and major renovation projects for DHA. The cooling

towers shall be certified by the Cooling Tower Institute (CTI) and shall meet OSHA safety

requirements.

It is recommended that the Cooling Tower structure should be stainless steel, with FRP

removable louvers and an FRP or Stainless-Steel basin.

Consultant is encouraged to undertake an LCC study for VFD cooling tower fan motors vs.

standard motors.

Cooling Towers should be provided with a Basin cleaning system.

Legionnaires Disease: When a new hospital building is constructed, place cooling tower(s) in

such way that the tower drift is directed away from the hospital’s air-intake system and

design the cooling towers such that the volume of aerosol drift is minimized.

2.12.1.8 Heat Exchangers

Heat exchangers used for HVAC applications for district cooling systems should comply with

the regulations from the relevant district cooling provider Empower, Palm District Cooling,

Emicool etc.

For potable water pre-conditioning and other applications plate and frame type heat

exchangers should be utilized. It is recommended that two heat exchangers as a minimum

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are provided, each sized at 50% of the load.

For low temperature hot water circuit for heating, heat exchangers can either be plate &

frame type or shell & Tube type. It is recommended that two heat exchangers as a minimum

are provided, each sized at 50% of the load.

2.12.2 HVAC Major Airside Equipment’s

The following section lists out the specific requirements for major HVAC air side equipment’s to be

utilized for healthcare projects. The aim is not to create an equipment specification list but to

highlight essential elements of design related to each equipment which must be considered due to

the critical nature of the healthcare facilities & the harsh climatic conditions of Dubai.

2.12.2.1 Outside Air Energy Recovery Air Handling Units

Outside air units should employ means of energy recovery. Approved methods include

Air to Air Plate Type Heat Exchangers. Preferred choice for areas where no cross

contamination is permitted such as OR’s.

Heat Pipes. Allowed for all areas but offer lower energy savings.

Total Energy Recovery Wheels. Allowed & encouraged for all areas except OR’s. Must have

a cross contamination limit of less than 0.04% by particulate count and have a purging

section.

Run around Coils. Allowed for all areas but offer lower energy savings.

Outside air energy recovery should not be employed for the following air streams. These

should be directly exhaust to ambient with dedicated exhaust.

Exhaust from all fume hoods and bio-safety cabinets.

Kitchen Exhaust (Range hood and wet exhaust).

Autopsy Exhaust.

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Isolation Room Exhaust.

Wet Exhaust from cage and cart washers.

ETO- Ethylene Oxide Sterilisers Exhaust.

Refer to the Figure 2.4,2.5,2.6 for outside air handling unit approved configurations.

Refer to the AHU section for other applicable notes.

Figure 2.4

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Figure 2.5

Figure 2.6

2.12.2.2 Air Handling Units

The capacity of a single air-handling unit shall not exceed 50,000 m3/hr [16,500 L/s].

Air handling units shall be AHRI or Eurovent certified, factory-fabricated, and the standard

product of one manufacturer. All air-handling units shall be constructed in modular and

draw-through configuration. Use of blow-through air-handling units are not permitted, as

fully saturated air leaving the cooling coil causes damage to the downstream filters and

sound attenuators.

Air handling units serving clinical areas should be hygienic type units. Refer to the materials

section for required certifications and standards.

To prevent cross contamination, separate AHU’s should be provided as a minimum for the

following spaces.

Operating Theatres

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Mortuary

Main Kitchen

Each air-handling unit shall be installed as a standalone entity without any physical interface

with another air-handling unit. Selection of stacked (one on the top of another) air handling

units is not permitted. Use of a common return air fan for two or more air-handling units is

also not permitted.

Use of a single or multiple plenum fans (fan array) is permitted & encouraged over housed,

air-foil centrifugal fans. Fan motors shall be premium efficiency.

Where room air can be returned to the system, provide a dedicated return or relief air fan

for each air-handling unit to facilitate room-by-room air balance, economizer cycle, and

intended volumetric air balance. Provide a direct digital control (DDC) interlock between the

supply and return or relief air fans.

Variable frequency drives (VFD) shall be utilized in all air handling units and rooftop units.

Building type (e.g., hospital, outpatient facility, etc.) will determine level of redundancy

required for VFDs. VFDs shall include either a bypass switch or be configured in a manner

that failure of one VFD does not disable the entire unit. Fan motor shall be high efficiency.

Each cooling coil shall not exceed six (6) rows and ten (10) fins per inch (FPI). Design two

(2) coils in a series arrangement if the cooling coil capacity requirement exceeds the

capability of an 6 row, 10 FPI coil. Chilled water shall be piped in series through both coils,

and a 42-inch access section shall be provided between the two equally sized coils

Maximum cooling coil discharge face velocity shall not exceed 450 fpm. Heating coil

discharge face velocity shall not exceed 800 fpm.

Ultra violet (UV) lamps shall be located on the leaving air side of the cooling coil.

Access doors (or panels) on the air handling unit sections shall always open against the

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positive side of the door and shall not be blocked by internal filter casings or internal

equipment components. Micro switches or safety switch interlocks need to be provided at

access doors or panels on UV sections to protect maintenance personnel from possible

injuries.

Refer to Figure 2.7 for general AHU approved configuration.

Figure 2.7

2.12.2.3 Fan Coil Units

All Fan Coil Units must be provided with a source of treated precooled dehumidified fresh

air through the DOAS systems. Direct injection of outside air dumped over the ceiling void

or ducted to units is not allowed.

Fan coil unit systems served by chilled water with hot water or electric heating are an

attractive solution for areas requiring special control or out of hours operation. Such areas

include computer/communication rooms, lift machine rooms, distribution communications

and electrical rooms, PABX rooms and administration areas. Fan coil units are not allowed

for areas where ASHRAE 170 prohibits room side recirculation.

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Fan Coil unit’s usage is highly discouraged for new constructions for areas other than

mentioned above, where adequate space for distribution ductwork can be provided.

Select fan coil units that deliver the required capacity at medium speed.

For new construction and major renovation, PICV should be provided for each FCU.

FCU shall be located outside of patient occupied spaces/rooms for ease of maintenance.

2.12.2.4 Terminal Units (VAV, CAV)

All terminal units shall be pressure-independent type and equipped with DDC controls. All

air terminal units (constant volume or variable air volume) serving perimeter or interior

spaces with permeant occupancy & mandated ASHRAE 170 air change requirements, shall

be equipped with integral reheat coils.

The maximum and minimum air volume settings shall be factory set, but field adjustable. The

minimum setting for each space should be dictated by the air change requirement, the

ventilation requirement for multi zone VAV’s based on ASHRAE 62.1 and the makeup air

requirement for exhaust. The designer should list out minimum settings for each VAV box

in the detailed design drawings.

All rooms requiring acoustic treatment according to HTM 08-01 should be provided with

terminal sound attenuators.

Variable Air Volume (VAV) boxes shall be located outside of patient occupied spaces for

ease of maintenance.

2.12.2.5 Air Valve Terminals

If VAV systems are specified, Venturi Air Terminals or Air Valves with high speed actuators

are highly recommended to be utilized for all new construction and major renovation for the

following space types in lieu of VAV boxes due to their higher reliability and stable airflow

control.

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Operation Theatre

Pharmacy Clean Rooms

Isolation Rooms

Laboratories with Fume Hoods ( Should be equipped with a 3 sec or faster response

actuator)

Additional rooms as identified by the building end user that have strict pressure control

requirements due to infection control issues.

Venturi air terminal should be programmed as using the variable air volume approach with

maximum energy savings. Usage based controls can also be employed at the facility owner’s

discretion. Each airflow control device shall be factory characterized on air stations NVLAP

Accredited.

Venturi Air Valves shall be located outside of patient occupied spaces for ease of

maintenance.

For an AHU provided with downstream venturi air terminals, it is preferable to utilize all

venturi’s instead of a combination of venturi terminals and VAV/CAV terminals due to

varying pressure drops. Low speed venturis and constant air venturis can be used for non-

critical areas, for cost savings.

2.12.2.6 Humidifiers

Considering the climatic conditions in Dubai, it is not anticipated that active humidification

would be required expect for critical spaces such as OT’s.

Depending on the scale of the project humidification can be achieved by package electric

humidifiers served by DI or RO water or jacketed type steam humidifiers.

The humidifier should be located prior to the cooling coil and fed with clean steam (steam

generated from RO or DI water and piped using stainless steel).

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If duct mounted humidifiers are used 304 stainless steel ducting should be provided for a

minimum of 1.5m downstream and 0.5m upstream of the humidifier. Designer Team to verify

the absorption distance for each application and adjust the length of stainless steel

accordingly. Duct sections downstream of steam humidifiers shall be sloped to a low point

with drain valve and cap.

2.12.2.7 Diffusers, Registers and Grilles

Diffusers, Registers and grilles should be specified as per the project requirements and in alignment

with the clinical and interior design. Air Diffusion Performance Index (ADPI) shall conform to

selection criteria given in ADPI table of the “Room Air Distribution” chapter of the ASHRAE

Handbook – HVAC Applications 2015.

Terminal HEPA filters for all spaces other than OT’s served by dedicated AHU’s should be Fan

powered type, catering for the entire pressure drop of the filter, allowing for the AHU supply fan to

be sized for only the pressure drop of the secondary filtration.

2.12.2.8 Ductwork

Rectangular galvanised steel has consistently been shown to be more cost effective as

compared with rigid circular ductwork which is both less efficient in its space requirements

and normally more expensive because of the excessive costs of fittings.

All clinical areas shall be provided with a fully ducted system. Use of the ceiling void, for air

delivery (supply or return) is not allowed, only back of house areas and admin areas can use

return air plenum but should be provided with appropriate sealing and smoke sensors.

Duct sizing is to be based on the recommended velocity and pressure drop ranges in the

current version of ASHRAE ‘Fundamentals’.

Air handling duct systems shall be designed to be accessible for duct cleaning, generally by

the provision of access panels. Access panels shall be fitted at each reheat coil and fire and

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smoke damper to allow annual Essential Services inspection.

Commercial dishwasher exhaust, steam sterilizer, and sterile washer exhaust shall be type

304 stainless steel with welded joints.

Laboratory hood exhaust ductwork shall be 304 stainless steel with welded joints.

Kitchen hood exhaust shall be 16-gauge black steel where concealed and 18-gauge, type 304

stainless steel, welded and polished to a No. 3 finish, where exposed.

2.13 HVAC Services Instrumentation and Control

HVAC Instrumentation and Control systems which are commonly part of the BMS systems are

integral to the proper operation of a healthcare facility. BMS Control systems form the backbone of

the operation and maintenance system for HVAC and provide the facility management team with

information regarding equipment life & operational performance.

The following points should be kept in mind while designing a BMS system for healthcare

applications.

The BMS system shall be suitable, compatible, scalable and flexible to meet the demands

imposed by healthcare facilities. The system shall have spare capacity at field level to allow

for departmental changes and equipment changes.

All actuation shall be electronic.

Specific requirements related to control actuators, control valves, control dampers, end

switches, safeties and safety alarms, control wiring, air flow measuring stations, room

temperature & humidity sensors, DDC control systems servers & tablet displays should be

detailed within the project drawings and specifications.

A detailed Input/output point list should be prepared by the consultant in consultation with

specialist solution providers and included as part of the project tender documentation.

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BMS systems should be configured to optimize energy usage.

Control algorithms should be programmed to utilize the data collected and allow for effective

energy recovery, air-side filter diagnostics, critical alarms and sensor calibration checks.

Ensure system is capable of robust metering. Separate sub-meters should be allocated for

lighting, HVAC plant, HVAC distribution, general power, service water heating, renewables

and whole building power & water as a minimum. Energy use should be benchmarked every

month. Facility managers should be trained on continuous benchmarking.

2.14 HVAC Systems Commissioning & Handover

The HVAC systems commissioning is an important phase in the project timeline and is critical in

confirming that the design parameters are met by the installed system and the system meets the

minimum code requirements related to air changes, filtration effectiveness and infection control.

For medium to large scale healthcare projects an independent commissioning agent (CxA) should be

employed the facility owner/client to oversee the commissioning process.

The following points should be kept in mind while preparing for commissioning of HVAC systems

for healthcare facilities.

Method Statements should be provided by the contractor during the commissioning phase

for all HVAC equipment.

Testing and Commissioning plan should be developed by the contractor in consultation with

the CxA to provide a clear and concise roadmap for the implementation of the commissioning

process and to provide a record of the results of the commissioning process.

The design consultant should engage with the owner and the facility management team and

develop the Owner’s Project Requirements (OPR). Furthermore, these should be formulated

in a report along with the design narrative, submitted as part of the construction

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documentation submitted to the contractor.

As a minimum space pressurization report is required for the following spaces:

Class N & Class Q -Airborne Infection Isolation Rooms

Class P- Protective Environment Rooms

Bone Marrow Transplant

IVF Labs and Procedure Rooms

Operating Rooms

Interventional Imaging Rooms

Pharmacy Clean Rooms

Laboratory Clean Spaces

Sterile Processing Rooms

Sterile Storage Rooms

Vivarium Areas

Operating Rooms and other clean rooms should be tested for particle counts as per

international standards.

The commissioning agent (CxA), Testing Adjusting and Balancing Contractor (TAB), MEP

Contractor, Controls Contractor (BMS Contractor) should work together on the

commissioning of systems and provide all reports and test results as well as arrange for

witness testing for agreed systems for the owner’s representative and the supervision

consultant.

Functional Testing for all critical systems should be included in the scope of works.

O&M Manuals for all HVAC equipment should be provided by the contractor.

Training on the systems installed should be conducted by the contractor’s team for the

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owner’s facility management team.

FM Team should keep a record of all O&M activities on site, preferably through an electronic

record keeping system.

2.15 HVAC- Room Side Design

The intent of this section is to identify key design elements related to the various spaces found

within a healthcare environment and provide a checklist that must be adhered to for approval of

new construction and major renovation projects under the umbrella of DHA within the emirate of

Dubai.

2.15.1 Operating Rooms

Following requirements must be adhered too for Operating Room HVAC systems.

Proper temperature (18-22°C), humidity (20-60% RH) and ventilation control for the

comfort of surgical personnel and patients & to environmentally discourage the growth and

transmission of microorganisms for general operating rooms.

Operating-room ventilation systems should produce a minimum of about 20 ACH of MERV

17 HEPA (99.995% MPPS as per EN 1822) filtered air for thermal control, 4 ACH (20%)

of which must be outside air. Air should be introduced at the ceiling and exhausted near the

floor.

Each operation theater should be provided with a dedicated air handling unit.

Air Handling units for operation theater should be provided with VFD’s to allow for variable

speed to cater for HEPA filter loading.

Air handling units should supply constant volume (20 ACH) airflow. Constant volume

systems are common and should be the basis of design as complicated systems lead to

operational issues during operation and maintenance.

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Variable systems are permitted for use “only if” they continue to provide a positive room

pressure (normally +0.01-0.04 in. wg or +2.5-10 Pa differential) with respect to the corridors

and adjacent areas and the required ACHs are maintained when the room is occupied. This

can be achieved by communicating fixed offset air-valves. Active Monitoring of pressure is

required through a pressure display monitor, connected to the BMS system. Space

temperature , humidity and air change rate shall be displayed simultaneously. Pressure

monitor should have an IP-54 rated housing, resistant to spray washdown &

decontamination chemicals. Accuracy RSS of at least +/-0.25% full scale . This guide

recommends an air differential of 10 Pa. Refer to figure 2.8.

HEPA-filtered airflow should be dissipated through laminar airflow diffusers. Laminar airflow

must be designed to move clean air over the aseptic operating field at a maximum face

velocity (0.15–0.3 m/s), sweeping away particles in its path. All laminar flow diffuser should

be room side accessible. Laminar flow array should entirely cover an area equivalent to the

footprint of the surgical table plus 305mm on each side as a minimum.

UVGI (Ultraviolet Germicidal Irradiation) should be provided as additional measure to reduce

SSI (Surgical-Site Infection) risks.

Medical plume evacuation system should be provided for OR’s using lasers and other

instruments generating plumes. This equipment should be part of the medical equipment

package as a standalone equipment.

Amount of reheat should be minimized, through supply air temperature reset, if humidity

conditions can be met, and through reduced airflow when the operating room is not occupied.

Special low temperature requirements, related to heart and orthopedic surgery should be

ascertained early in the design process and a corresponding low temperature chilled water

circuit be provided to meet the surgeon’s desired temperature (if required). It is to be noted

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that temperatures as low as 16 C DB can be required in operating rooms. Special elevated

temperature requirements related to burn and pediatric units should also be ascertained,

and systems designed to suit with space heating & humidification.

Surgeons should only be allowed to set the dry bulb temperature. Humidity display should

be provided.

Humidity and temperature sensors should be provided in the return air duct for system

control.

In general, operating room air handling units should be designed at 2 m/s air velocity at the

coil to allow for lower leaving air temperatures.

In general, operating room chilled water pipes to the AHU should be designed at higher

velocities in the range of 1.8 m/s to 2 m/s to allow for better heat transfer.

Refer to Figure 2.8 for operating room airflow configuration and pressure relationship.

Figure 2.8

2.15.2 Imaging Rooms

Following requirements must be adhered too for Imaging Room HVAC systems.

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Imaging rooms can be grouped into 4 types as mentioned below, each having their respective

requirements.

X-Ray (CT, Radiography, Fluoroscopy)

Ultrasound (Diagnostic Treatment)

Magnetic (MRI)

Nuclear (PET Scan, Linear Accelerator LINAC, Nuclear Camera, Gamma Knife)

In general Imaging rooms fall under diagnostics which according to ASHRAE require 6 ACH

of supply air with 2 ACH of outside air & a Temperature requirement (21-24°C), humidity

(<60% RH).

Imaging rooms do not require dedicated air handling units and can be served from the same

air handling unit serving the rest of the radiology suite.

Imaging rooms designed for treatments such as fluoroscopy (e.g. vascular, cardiac

catherization, interventional lab, cystoscopy, electrophoresis(EP)) carry a prescriptive

requirement for treatment rooms 15 ACH of supply air with 3 ACH of outside air but are

recommended to be designed to operating rooms standard as mentioned in section 2.15 for

future flexibility. All relevant clauses applicable should be adhered to.

Data should be obtained from Room Data sheets for the control room, procedure room and

equipment room heat dissipation.

Wherever possible water cooled medical equipment should be preferred. Process water

cooling can be provided via dedicated medical grade chillers backed up by central chilled

water system or with the central chilled water system backed up by chilled potable water.

Discussion on the system and its criticality should be brought up by the designer to the

facility owner during concept design.

MRI rooms must be designed to cater for the heat load produced by the equipment. As a

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minimum 6 ACH of supply air and 2 ACH of outside air should be provided. Following key

considerations should be accounted for.

All materials in the room should be nonferrous.

No rotating equipment (motors, fans) should be placed within the 1 gauss field.

Chilled water requirements as per point 6 above.

Provide an insulated stainless-steel quench pipe with proper thrust restraints sized as per

manufacturer guidelines and vented to outside with the exclusion zone clearly marked.

Provide an emergency exhaust fan sized at 12ACH to exhaust helium. This can also be used

to purge clean agents in case of fire.

Provide an overpressure relief grille.

PET & SPECT Scan rooms are diagnostic rooms requiring 6 ACH SA/2 ACH OA. All air

should be exhausted via the general exhaust system from the scanning rooms. Chilled water

requirements as per point 6. Hot labs, Radio pharmacies provided with PET and SPECT scan

rooms normally house BSC II Hoods and should be provided with dedicated hood exhaust

with bag-in bag-out filtration for isotopes and general exhaust from the space.

LINAC rooms are also diagnostic rooms with no invasive procedures being carried out.

Regular requirements of 6AC SA/ 2 ACH OA will suffice. Humidity should be kept less than

50%. Chilled water requirements as per point 6. Modern day LINAC’s are often coupled with

MRI’s within the same suite. Care should be taken to accurately calculate the heat dissipation

and cater for all requirements of MRI room as per point 7.

2.15.3 Laboratories

Following requirements must be adhered too for Laboratories HVAC systems.

Proper temperature control (21-24°C), maximum 60% RH with 6 ACH SA/ 2 ACH OA

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should be provided for all labs.

All Laboratory work areas should be 100% exhausted to outside through general exhaust

passed through heat recovery.

Fume hoods and Bio Safety cabinets located within the labs should be exhausted to the

ambient through high plume dilution fans through proper filtration. Exhaust from BSC

cabinets can be combined into a single manifold, provided they carry the same class of air

and exhausted through N+1 exhaust fans. Similar approach can be adopted for Fume

cupboards. Engineer should minimize the number of fans for operational efficiency and

maintainability of the system.

Labs containing Fume Hoods or BSC cabinets should be provided with laminar flow diffusers

located at appropriate locations.

Flammable cabinets should be provided with ventilation with dedicated exhaust fan and

discharge.

Variable systems are permitted for use “only if” they continue to provide a negative room

pressure (normally -0.01-0.04 in. wg or -2.5-10 Pa differential) with respect to the corridors

and adjacent areas and the required ACHs are maintained when the room is occupied. This

can be achieved by communicating fixed offset air-valves for the supply, general exhaust and

hood exhaust (one per BSC). Active Monitoring of pressure is required through a pressure

display monitor, connected to the BMS system. Space temperature , humidity and air change

rate shall be displayed simultaneously. Pressure monitor should have an IP-54 rated housing,

resistant to spray washdown & decontamination chemicals. Accuracy RSS of at least +/-

0.25% full scale.

Laboratory sterilizing areas should be provided with 10 ACH SA/ 2 ACH OA.

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2.15.4 Pharmacy

Following requirements must be adhered too for Pharmacy HVAC systems.

As a minimum Pharmacy spaces should be provided with temperature control (21-24°C),

maximum 60% RH with a 4 ACH SA/ 2 ACH OA.

Pharmacy should be kept at positive pressure. VAV systems are permitted without

compromising on the pressure requirement.

In-patient pharmacy providing compounding facilities should be designed according to USP

797.

Vault, if designed for controlled substances should be provided with cooling with supply and

return air.

Pharmacy clean rooms ( if required by clinical planning) should be designed to ISO Class 7

Standard according to ISO 14644, unless stated otherwise for the project by the operator ,

providing a minimum of 40 ACH of HEPA filtered air , with a ceiling coverage between 30%-

40%, keeping the maximum face velocity under 0.15 m/s and providing low level return.

These should be provided with an ISO Class 8 ante room , providing a minimum of 20 ACH

of HEPA filtered air.

HEPA filters modules should be fan filter type to reduce central fan size.

Clean rooms should be kept at positive pressure except when used for hazardous drugs which

should be negative pressure with associated ante room at positive pressure. Clean rooms

should be certified to ISO 14644 standard.

Hazardous drugs compounding clean rooms are provided with BSC cabinets. The exhaust

from these cabinets should be filtered with a carbon filter and a hepa filter before being

discharged through a high plume dilution fan or an exhaust stack.

Clean room personal are wearing heavy protective clothing so lower temperature should be

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considered as a design requirement, 20 C.

2.15.5 Patient Rooms

Following requirements must be adhered too for Patient Room HVAC systems.

As a minimum Patient rooms should be provided with temperature control (21-24°C),

maximum 60% RH, with a 6 ACH SA/ 2 ACH OA.

Each patient room should be provided with a thermostat linked with the BMS system (if

available).

2.15.6 Intensive Care Rooms- Critical Care Rooms

Following requirements must be adhered too for Intensive Care Room HVAC systems.

Intensive Care rooms include specialized rooms such as Surgical Intensive Care (SICU),

Medical Intensive Care (MICU), Cardiac Care Unit (CCU), Paediatric Intensive Care Unit

(PICU), Neonatal Intensive Care Unit (NICU), High Dependency Unit (HDU) etc. All these

rooms require a minimum of 6 ACH SA/2 ACH OA with temperature range of 21- 24°C, and

30-60% RH.

ICU areas should not be served with recirculating type units such as FCU’s.

Reheat should be provided to each ICU room/bay. Thermostat should be linked with the

BMS system (if available).

2.15.7 Morgue & Autopsy

Following requirements must be adhered too for Morgue & Autopsy HVAC systems.

As a minimum Morgue & Autopsy spaces should be provided with temperature control (20-

24°C), maximum 60% RH with a 12 ACH SA/ 2 ACH OA.

Air should be supplied via uni-directional flow diffusers.

Exhaust grilles should be located at both high level and low level.

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All air should be exhausted outside through dedicated ductwork.

Direct exhaust connection to the autopsy table should be provided. Exhaust air should be

HEPA filtered, UV treated, and carbon filtered for odours and discharged at a high velocity,

preferably using a stack. Since autopsy is normally not carried out at private facilities, this

requirement will not apply.

Body Holding refrigerators should be designed by the specialist manufacturer. Designer to

take the heat dissipated for the refrigerators into account while designing the HVAC system.

Negative room pressure (normally -0.01-0.04 in. wg or -2.5-10 Pa differential) with respect

to the corridors and adjacent areas is required. Active Monitoring of pressure is required

through a pressure display monitor, connected to the BMS system.

2.15.8 Isolation Rooms

Isolation rooms can be classified into 3 categories.

Class N- Airborne Infection Isolation Rooms (AIIR) – Negative Pressure Isolation Room

Class Q – Quarantine Isolation – Negative Pressure Isolation Room with Clean and Dirty

Utility.

Class P- Protective Environment Isolation Rooms (PE)- Positive Pressure Isolation Room.

Class S- Standard Isolation Room - Contact Isolation Room- Neutral Isolation Room.

Switchable Pressure Isolation Rooms – No longer allowed by FGI/ASHRAE.

2.15.8.1 Class N- Negative Isolation Room

Proper temperature (21-24°C), humidity (<60% RH) and ventilation control, minimum 12

ACH SA/ 2 ACH OA, anteroom 10 ACH SA.

Use of negative pressure rooms with close monitoring and control of airflow direction

(normally -0.01 to -0.03 in. wg or -2.5 to -8 Pa differential). Negative pressure to be

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maintained during un-occupied mode by communicating Air Valves. Provide differential

pressure monitor with alarm points to building automation system. Space temperature ,

humidity and air change rate shall be displayed simultaneously. Pressure monitor should

have an IP-54 rated housing, resistant to spray washdown & decontamination chemicals.

Accuracy RSS of at least +/-0.25% full scale.This guide recommends a negative pressure of

10 Pa for the class N room. Refer to figure 2.9.

Seal room below 0.5 ft2(465 cm2) of air leakage (called Effective Leakage Area under 4 Pa

pressures differential test)

Exhaust air grille should be placed over the patient head or at low level near the head. Air

from negative pressure rooms is to be HEPA-filtered with a bag in bag out filter and

exhausted directly to the outside with dedicated N+1 high plume dilution exhaust fans

discharged 10 feet above roof level. Recirculation is not allowed. Air from other AIIR rooms

can be mixed provided each room is provide with a VAV or Air Valves prior to connection.

UVGI fixtures may be placed in upper room, or inside the ducts as an additional measure ,

but are not a mandatory requirement.

Pressure relationship should be negative with respect to the ante room with the ante room

negative with respect to the corridor.

Refer to Figure 2.9 for AIIR room airflow configuration. Room exhaust and supply air valves

should be VAV type while the remaining valves for ante room and toilet can be CAV types.

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Figure 2.9

2.15.8.2 Class Q- Negative Isolation Room

All the requirements for Class N rooms must be adhered too for Class Q rooms.

In addition, supply should be provided with HEPA filters similar to Class P rooms.

Class Q isolation suite will contain a dirty utility as well. That should also be exhausted to

outside, similar to the bed room, ante room and toilet.

2.15.8.3 Class P-Positive Isolation Room

These rooms are to be designed for high-risk, immuno-compromised patients (BMT, organ

transplant, leukemia, burn, late-stage HIV) and to minimize fungal spore counts in air.

Proper temperature (21-24°C), humidity (<60% RH) and ventilation control, minimum 12

ACH SA/ 2 ACH OA, anteroom 10 ACH SA.

Incoming air through HEPA filters or fan powered HEPA filters mounted in laminar flow

diffusers, supply air on top of the patient bed and exhaust out through the opposite side of

the room, preferably at low level.

Pressure of +2.5 Pa (0.01" w.g.) relative to the corridor as a minimum. Provide differential

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pressure monitor with alarm points to building automation system. Space temperature ,

humidity and air change rate shall be displayed simultaneously. Pressure monitor should

have an IP-54 rated housing, resistant to spray washdown & decontamination chemicals.

Accuracy RSS of at least +/-0.25% full scale. This guide recommends a positive pressure of

10 Pa for the isolation room. Refer to figure 2.10. Room return and supply air valves should

be VAV type while the remaining valves for ante room and toilet can be CAV types.

Seal room below 0.5 ft2(465 cm2) of air leakage (called Effective Leakage Area under 4 Pa

pressures differential test)

UVGI fixtures can be placed in upper room, or inside the ducts as an additional measure.

Pressure relationship should be positive with respect to the ante room with the ante room

positive with respect to the corridor.

Refer to Figure 2.10 for PE room airflow configuration.

2.15.8.4 Class S-Contact Isolation Room

These isolation rooms are used to provide physical isolation for patients having a

communicable disease which is not airborne as chicken pox, etc. Requirements for regular

patient rooms apply.

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Figure 2.10

2.15.9 SSU(CSSD)

Following requirements must be adhered too for SSU(CSSD) HVAC systems.

SSU(CSSD) can be broken down into 3 areas.

Dirty Area – 6 ACH SA/2ACH OA with 100% dedicated exhaust and negative pressure.

Temperature 16-23°C

Clean Area- 4 ACH SA/2 ACH OA with positive pressure. Temperature 20-23°C

Sterile Store – 4 ACH HEPA filtered SA/ 2 ACH OA with positive pressure. Temperature

24°C

Means of recording daily temperature and humidity should be provided via the BMS system

for all spaces.

Exhaust ductwork should be stainless steel for durability.

Direct exhaust from washers, disinfectors and sterilisers should be provided as per the Room

Data Sheets.

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Where ethylene oxide (ETO) sterilizers are used and ETO is stored system shall be designed

to provide 100% dedicated exhaust to outside. Upon loss of exhaust system airflow, an

audible and visual alarm shall activate in the steriliser work area, and at a location that is

continually staffed.

2.15.10 Renal Dialysis & Chemotherapy

Following requirements must be adhered too for Renal Dialysis Patient Bays systems.

Room/Bay can be considered as having the same requirements as standard patient room.

Consider radiant heating panels directly over the patient chair/bed for radiant heating as

dialysis/chemo patients are frequently cold & anaemic & immobile for the duration of the

treatment.

Consider low design velocities of below 0.25 m/s at the treatment bed/chair, preferably

through laminar flow diffusers.

2.15.11 Recovery (Post Anaesthesia Care Unit)

Following requirements must be adhered too for PACU Recovery area HVAC systems.

As a minimum PACU rooms should be provided with temperature control (21-24°C), 30-

60% RH, with a 6 ACH SA/ 2 ACH OA.

Low level return should be provided with stainless steel grilles to capture the anaesthetic

gasses being exhaled by the patients and allow for better flushing of the space.

Each room/bay should be provided with a thermostat linked with the BMS system (if

available).

2.15.12 Emergency

Following requirements must be adhered too for Emergency area HVAC systems.

Decontamination Room: Temperature control (21-24°C), with a 12 ACH SA/ 2 ACH OA,

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negative pressure. All air should be 100% exhaust with dedicated ducting.

Exam/Treatment Room: Temperature control (21-24°C), maximum 60% RH, with a 6 ACH

SA/ 2 ACH OA, positive pressure.

Resuscitation (Trauma) Room: Temperature control (21-24°C), 20-60% RH, with a 15 ACH

SA/ 3 ACH OA, positive pressure. If Trauma is to be utilized as emergency Operating room

under the hospitals disaster management scheme, operating room requirements should be

imposed.

Triage: Temperature control (21-24°C), maximum 60% RH, with a 12 ACH SA/ 2 ACH OA,

negative pressure. All air should be 100% exhaust with dedicated ducting.

Emergency Department Public Waiting Area: Temperature control (21-24°C), maximum

60% RH, with a 6 ACH SA/ 2 ACH OA, negative pressure. All air should be 100% exhaust

with dedicated ducting.

2.15.13 Burn Units

Following requirements must be adhered too for Burn Unit Room HVAC systems.

As a minimum Burn Units rooms should be provided with temperature control (21-32°C),

40-60% RH, with a 6 ACH SA HEPA Filtered with laminar flow diffusers / 2 ACH OA. Room

should be at positive pressure.

Each patient room should be provided with a thermostat linked with the BMS system (if

available).

Each patient room should be provided with an individual humidifier and a humidistat to

control the humidity level in the room.

Each patient room should be provided with reheat sized to raise the temperature to 32°C

inside the room.

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2.15.14 Bone Marrow Transplant Rooms

Requirements for Protective Environment PE Isolation rooms should be applied for Bone Marrow

Transplant rooms.

2.15.15 Hydrotherapy & Therapeutic Pools

Following requirements must be adhered too for Hydro-Therapy Pool HVAC systems.

Should be provided with temperature control (26-28°C), with the ability to reheat up to

32°C, with a minimum of 10 ACH SA / 100% exhaust from the space. Space should be at

negative pressure.

Provide a dedicated or common wet exhaust system with welded stainless-steel ductwork.

To allow for energy saving, VAV system can be employed via supply and exhaust terminal

during unoccupied mode.

The Spinal cord injury patient requires 33˚C (92˚F) water temperature, while the patient

with multiple sclerosis requires 28˚C(84˚F) water temperature. The pool equipment should

be designed to accommodate rapid water temperature change, where both patient types can

use the same pool on a given day based on schedule. Humidity control should be

appropriately designed to cater for the water evaporation from the pool surface.

2.15.16 Psychiatric Rooms

Requirements for standard patient rooms apply, in addition

Care must be taken that all grilles/diffusers and other HVAC devices must be suicide and

vandal resistant.

Use duct mounted sensors and allow for heavy-gage construction to resist damage and

vandalism and reduce injury.

Special Anti-Ligature devices should be used.

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2.15.17 Procedure Rooms

Following requirements must be adhered too for Procedure Room HVAC systems.

As a minimum procedure rooms should be provided with temperature control (21-24°C),

20-60% RH, with a 15 ACH SA with laminar flow diffusers / 3 ACH OA. Room should be at

positive pressure.

If aesthetic gasses are administered all requirements related to operating rooms should be

applicable.

2.15.18 Endoscopy Procedure Rooms

Following requirements must be adhered too for Endoscopy Procedure Room HVAC systems.

Gastrointestinal Endoscopy procedure room:

As a minimum should be provided with temperature control (21-23°C), 20-60% RH, with

a 6 ACH SA with laminar flow diffusers / 2 ACH OA. Room shall have no mandated

pressure requirement, but its preferable to be under negative pressure.

Endoscopy/Bronchoscopy:

As a minimum should be provided with temperature control (20-23°C), 20-60% RH, with

a 12 ACH SA with laminar flow diffusers / 2 ACH OA. Room shall be negative pressure

with dedicated 100% exhaust ducting to outside.

This is more common scenario and endoscopy rooms should be designed as a worse case to

this requirement, unless noted otherwise by the operator.

Endoscopy ERCP procedure room:

If specifically designed by the clinical planning team as a dedicated ERCP (Endoscopic

Retrograde Cholangio-Pancreatography) room the following requirements shall

supersede the previous requirements.

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As a minimum should be provided with temperature control (20-23°C), 20-60% RH, with

a 15 ACH SA with laminar flow diffusers / 3 ACH OA. Room shall have positive pressure

requirement.

Endoscope Cleaning Rooms:

As a minimum should be provided with temperature control (21-24°C), 20-60% RH, with

a 10 ACH SA / 2 ACH OA. Room shall have negative pressure requirement. All air should

be exhausted to outside with dedicated ducting.

2.15.19 Outpatient Clinics & Support Spaces

The HVAC systems for outpatient clinics & support functions are often not designed to the same

level of redundancy as in-patient facilities. It is encouraged that the consultant engages with the

owner/facility manager early in the design process to figure out the requirements for the clinics and

day surgery units, endoscopy & imaging procedures if present.

Any particular low temperature requirements for day surgery units should be advised by the

owner’s representatives and the consultant should undergo an analysis of whether the requirements

are achievable by the proposed system design.

2.15.20 IVF Clinics/ Fertilization Centres

Following requirements must be adhered too for IVF HVAC systems.

IVF Clinics typically contain the following spaces.

Procedure Room & Embryo Transfer Room: The procedure room & embryo transfer room

should be treated as an OR and all requirements for operating room should be complied.

Recovery Room/Bays: Recovery bays should be treated as PACU rooms and all

requirements should be taken for PACU rooms.

Laboratories (Embryology, Andrology, Cryo etc.): Labs for IVF centre represent ultra clean

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labs. In addition to the requirement for laboratory mentioned in the previous section all

air should be HEPA filtered with laminar flow diffusers. Pressure requirement should be

positive pressure (+0.01-0.02 in. wg or +2.5+5 Pa differential). ISO Class 7 certification

testing is highly recommended.

Infectious Labs: Infectious labs should be provided with the same systems as other IVF labs,

but the air pressure regime should be negative. (-0.01-0.02 in. wg or -2.5-5 Pa

differential)

Sample Collection Rooms: Sample collection rooms should be kept at negative pressure via

the adjoining shower area exhaust.

HVAC air handling units serving the laboratories, procedure and embryo transfer rooms

should be provided with carbon filters, with activated alumina impregnated with potassium

permanganate & HEPA filters in the air handling unit. HEPA filters can also be installed at

the terminal locations instead of the air handling units if dedicated air handling units are not

used.

2.15.21 Data Centre

Following requirements must be adhered too for Data Centre/Server Room HVAC systems.

As a minimum Server rooms should be provided with temperature control (19-22°C), 30-

60% RH, with supply air governed by the heat load for the servers but not less air required

to cool 0.5 kW/m2 of data hall of heat load, to cover for future expansion.

Server Room should be cooled by precision ac units or close control ac units, providing

cooling and humidity control, located within the server room with adequate clearance space

or preferably adjacent to the server room in a dedicated mechanical room.

A minimum of two close control units should be provided for each server room in N+1

arrangement, one fed from the central chilled water circuit and one fed from a dedicated DX

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machine for medium to large scale healthcare facilities. For smaller facilities and outpatient

facilities one close control unit can be provided with dual coil arrangement and dual fans.

Close control units shall be fed from emergency power.

Server Rooms rack should be arranged in hot aisle and hot cold arrangement, where

applicable.

Server Rooms should be conditioned through raised floor arrangement, with perforated floor

tiles provided for up to 6kW rack load and fan powered tiles or rack containment provided

for higher heat loads.

Use of Fan coils to provide backup cooling is not permitted

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