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Volume 10, Number 7—July 2004

Perspective

Environmental and Occupational Health Response to SARS, Taiwan, 2003

Eric J. Esswein*Comments to Author , Max Kiefer†, Ken Wallingford‡, Greg Burr‡, Lukas Jyhun-Hsiarn Lee§, Jung-Der Wang¶, Shun Chih Wang#, and Ih-Jen Su**
Author affiliations: *National Institute for Occupational Safety and Health (NIOSH), Denver, Colorado, USA; †NIOSH, Atlanta Field Office, Atlanta, Georgia, USA; ‡NIOSH, Cincinnati, Ohio, USA; §Department of Health, Taipei, Taiwan; ¶National Taiwan University, Taipei, Taiwan; #Institute of Occupational Safety and Health, Taipei, Taiwan; and; **Taiwan Center for Disease Control, Taipei, Taiwan

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Table 2

Environmental findings from southern Taiwan hospitals and medical centers in Kaohsiung, Tainan, and Chia-Yia

Hospital IRs Single pass AHU HEPA UV Pressure monitorsb BP review Negative pressure in IRs? Recommendations and notes
A
10 (S)
Y
N
N
N
Y
Y
1c
B
6 (s)
N
N
N
N
Y
N
2d
C
4 (S)
2 (s)
Y
Y
N
Y
Y
Y
3e
D
3 (S)
9 (s)
Y
Y
N
Y
Y
Y

E
29 (s)
Y
N
N
Y
Y
N
4f
F
2 (S)
72 (s)g
N
N
N
N
Y
N

G
20
Y
N
N
Y
Y
Y
5h
H
20
Y
N
N
Y
Y
Y
6i
I
2 (S)
20 (s)
Y
N
N
Y


7j
J 8 (S)
19± (S) Y N N Y Y Y 8k

aIR, isolation rooms; AHU, air handling units; UVGI, ultraviolet germicidal irradiation; BP, blueprint or engineering designs plans available for review; S, standard isolation room; s, simple isolation room; Y, yes; N, no.
bPressure monitors were either digital or analog manometers installed outside patient room.
cRepair collapsed rooftop exhaust stack.
dInspect isolation rooms for leakage; four rooms not negatively pressurized.
eEnsure outdoor air intakes are not in proximity to exhaust fans for simple isolation rooms.
f32% isolation rooms were not negatively pressurized, no ICU, not recommended for SARS patients.
gProposed for construction as of 5/2003.
hVentilation system needs balancing/modification (negative pressure varied from –1.4 to –22 pascal). Extend rooftop exhaust stacks, establish standard operating procedures for personal protective equipment use, require handwashing for all hospital contractors.
iModify 2-way switches in simple isolation rooms so that fans cannot operate in reverse, replace wooden doorknobs with metal on SARS patient ward.
jModify 2-way switches in simple isolation rooms so that fans cannot operate in reverse, position patient beds with head of bed near source of room exhaust for increased isolation, seal wall, window, and ceiling penetrations in simple isolation rooms.
kModify 2-way switches in simple isolation rooms so that fans cannot operate in reverse, seal windows in simple isolation rooms to enhance negative pressure.

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