Low-cost interventions to improve ventilation in long-term care facilities

Abstract

Residents of long-term care facilities are particularly vulnerable to communicable diseases. Low-cost interventions to increase air exchange rates (AERs) may be useful in reducing the transmission of airborne communicable diseases between long-term care residents and staff. In this study, carbon dioxide gas was used as a tracer to evaluate the AER associated with the implementation of low-cost ventilation interventions. Under baseline conditions with the room’s door closed, the mean AER was 0.67 ACH; while baseline conditions with the door open had a significantly higher mean AER of 3.87 ACH (p < 0.001). Subsequently opening a window with the door open increased mean AER by 1.49 ACH (p = 0.012) and adding a fan in the window further increased mean AER by 1.87 ACH (p < 0.001). Regression analyses indicated that the flow rate of air entering through the window, both passively and through the use of a fan, was significantly associated with an increase in AER (p < 0.001). These results indicate that low-cost interventions that pull outside air into resident rooms were effective in improving the air exchange rates in these facilities. While implementation of these interventions is dependent on facility rules and isolation requirements of residents with airborne communicable diseases, these interventions remain viable options for long-term care facilities to improve resident room ventilation without requiring costly ventilation system upgrades.

Keywords:

• Air exchange rate
• airborne communicable diseases
• indoor air quality
• occupational hygiene

Acknowledgments

The researchers acknowledge the two long-term care facilities studied in this work for their collaboration, and the University of Washington DEOHS Field Research and Consultation Group for their collaboration in the experimental procedure of this study.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclaimer

The findings presented here do not necessarily reflect the opinion of the CDC.

Disclosure statement

The authors have no conflicts of interest to report.

Additional information

Funding

Funded by the Centers for Disease Control and Prevention’s CK19-1904 “Nursing Home & Long-term Care Facility Strike Team and Infrastructure Project” through the American Rescue Plan Act of 2021. Research reported was also supported by the National Institute for Occupational Safety and Health (NIOSH) under Federal Training Grant T42OH008433. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIOSH.