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Indoor Air Quality Assurance In A
Dental Environment
www.somamedical.net
Fundamental Principle Of Dental
I.A.Q.( Indoor Air Quality).
Environmental Surfaces
Contaminated patient care items and surfaces pose different degrees of risk for infection
transmission based on their location and potential to transmit pathogens. With regard to
environmental surfaces, the latest precautionary dental guidelines also provide a better
understanding of how to discriminate between the two categories of environmental
surfaces: clinical contact surfaces and housekeeping surfaces
Categories of Contaminated Environmental Surfaces
Category Definition Examples
Clinical contact Surfaces that are directly
contacted by contaminated
instruments, devices, hands,
or gloves
Dental unit surfaces, laboratory
equipment, reusable containers of
dental materials, drawer handles,
heavily used countertops, pens,
telephone handles, doorknobs
Housekeeping Surfaces that require regular
cleaning to remove soil and
dust but that rarely contact
dental personnel or patients
Floors, walls, lightly used
countertops
Environmental Decontamination In Dentistry
“A high level of general cleanliness must be maintained in dental surgery.
Working surfaces, bracket tables and countertops should be disinfected. The
use of sterilize-able trays or disposables are recommended. Floors, walls and
sinks must be routinely cleaned. All spilt blood or body fluids must be
attended to immediately.“
The phrase “risk of aerosols contamination“ means :
1. “General cleanliness”, “routinely cleaned” are not enough.
2. “Spilt blood and body fluids” might not be attended too immediately.
3. Aerosol dispersal is not completely prevented by Using high-volume
suction and dental dam.
4. How many of dental clinics follow the exact IAQ preventive instructions?
5. Air conditioners make the air dryer (higher risk of droplet nuclei formation
because of fluctuating humidity levels)
Why is I.A.Q important in a
dental environment?The execution of dental work and the use of various chemical compounds leads to
exposure levels for dentists, staff and patients to a range of potentially harmful airborne
contaminants. Especially for dental staff this exposure to potentially harmful air pollutants
can be significantly higher than that of individuals in most indoor environments.
Microorganisms
The use of high-speed drills and ultrasonic scaling equipment generates fine droplets which
are light enough to stay airborne for hours. Bacteria and viruses, which are contained in
these micro-droplets, are easily inhaled and constitute a potential source of infection.
Mercury
Numerous studies show that dentists and their staff have higher than average levels of
inorganic mercury (Hg) in their blood and urine. Mercury vapours can be released by the
placement and the removal of amalgam fillings. They may also be released from indoor
surfaces, where they may have accumulated over years of usage.
Disinfectants
Chemical disinfectants in a dental environment are responsible for a generally unpleasant
odour. Some disinfectants may also cause irritation and may have a sensitising potential
especially for staff.
Journal- ExtractIndoor air quality in a dentistry clinic.Helmis CG, Tzoutzas J, Flocas HA, Halios CH, Stathopoulou OI, Assimakopoulos VD, Panis V, Apostolatou M, Sgouros
G, Adam E.
Source
Division of Applied Physics, Department of Physics, University of Athens, University Campus, Build.Phys-5, Athens 157 84,
The purpose of this work is to assess, both experimentally and theoretically the status of air quality in a dentistry clinic of the
Athens University Dentistry Faculty with respect to chemical pollutants and identify the indoor sources associated with dental
activities. Total VOCs, CO(2), PM(10), PM(2.5), NO(x) and SO(2) were measured over a period of approximately three months
in a selected dentistry clinic. High pollution levels during the operation hours regarding CO(2), total VOCs andParticulate Matter were found, while in the non-working periods lower levels were recorded. On the contrary, NO(x) and
SO(2) remained at low levels for the whole experimental period. These conditions were associated with the number ofoccupants, the nature of the dental clinical procedures, the materials used and the ventilation schemes, which lead tohigh concentrations, far above the limits that are set by international organizations and concern human exposure. The indoor
environmental conditions were investigated using the Computational Fluid Dynamics (CFD) model PHOENICS for inert gases
simulation. The results revealed diagonal temperature stratification and low air velocities leading to pollution stratification,
accompanied by accumulation of inert gaseous species in certain areas of the room. Different schemes of natural ventilation
were also applied in order to examine their effect on the indoor comfort conditions for the occupants, in terms of air renewal and
double cross ventilation was found to be most effective. The relative contribution of the indoor sources, which are mainly
associated with indoor activities, was assessed by application of the Multi Chamber Indoor Air Quality Model (MIAQ) to the
experimental data. It was found that deposition onto indoor surfaces is an important removal mechanism while a greatamount of particulate matter emitted in the Clinic burdened severely the indoor air quality. The natural ventilation of the
room seemed to reduce the levels of the fine particles. The emission rates for the fine and coarse particulates were found to be
almost equal, while the coarse particles were found susceptible to deposition onto indoor surfaces.
PMID:
17434576 [PubMed - indexed for MEDLINE]
The Dental I.A.Q. Solutions
Temporary Solutions:
Using of disinfectants on surfaces. (Time
consuming and costly )
Long-lasting preventive solutions :
Slow releasing active chemicals (Titanium
Dioxide, TiO2), air filters, UV-C light and
negative ions.
Legend:
Titanium
Dioxide
Cleanature
SM767B
Uvmax
SM212
Medilite GFL
So what is IAQ ?
Indoor Air Quality as defined by OSHA Malaysia,
OSHA Singapore and ASHRAE standard 62-1989.
“Wherein it is stated that air in which there are
no known contaminants at harmful
concentrations”. So quality air is always related
to fresh air.
3 main causes of IAQ problems
• Source of contamination
• Susceptible occupants
• Mechanism transport of contaminants
Gases
� Volatile Organic Compounds (V.O.C).
� Potential VOC’s come from gases of building furnishings i.e. carpets,
furniture etc. and life cycle byproducts of micro-organism that lives in
the building (or its HVAC system).
� Aldehyde vapors are typical byproducts of both off gassing and
chemical processes, that occur inside or outside the building.
Particles
� Mostly counted in the diameter range from 0.1 micron or greater.
� Bio-aerosol are defined as airborne particles, which are living
organisms, spores and fragments of organisms released from living
organisms.
� These include pathogens (disease causing viruses), fungi (mold) and
bacteria.
Type of IAQ contaminants
What I.A.Q problems should we be
concerned about?
1. How can people eject flu viruses into the air.
2. What different forms can airborne viruses take.
3. How far can those viruses travel & how can theycirculate within buildings and inside their HVACunits.
4. What conditions increase airborne flu virussurvival.
5. What systems are available to sterilize, captureand/or kill airborne flu viruses.
Airborne transmission depends on people to
launch viruses into the air. People can shed
this many flu virus into the air:
1. Coughing 3,000+
2. Sneezing 3,000+
3. Breathing 200+ natural sterilization , nose hair & mucus.
4. Talking/Singing 1,000+
5. Vomiting 1,000+
6. Diarrhea *20,000+
How far can Airborne Viruses Travel?
Large/Small Droplets Droplet Nuclei
1. Coughing 1-5 feet 160+ feet
2. Sneezing 8-15 feet 160+ feet
3. Singing, Talking 1-3 feet 160+ feet
4. Mouth Breathing 1-3 feet 160+ feet
5. Diarrhea* 5 feet+ 160+ feet
*As a result of toilet water aerosolization, air contamination in toilets
need to be effectively sterilized and contained.
Stages of Infectious Droplets
& Droplet Nuclei
Infectious Droplets & Droplet
Nuclei Travel Lengths
Droplet Nuclei Viruses are 0.3μ or less, it can
penetrate deeply into the human lungs
A μm is a micron or 1/1,000,000 of a meter.
The smallest particle you can see is 30μm.
Let’s not forget the detrimental effects of swine
flu!
How do Occupant Droplet Nuclei travel both within indoor
spaces and then throughout a building?
Source
So, is there a flu season?
Does flu take a vacation?
Why are there flu epidemics?
The answer is found in
HUMIDITY LEVELS
Optimum Humidity
For optimum air quality, Indoor Relative Humidity should always be
maintained between 40% and 60%!
Low indoor humidity increases
Droplet Nuclei Levels
• Viruses evaporate faster in low humidity levelsthus creating More Droplet Nuclei.
• Low humidity allows droplet nuclei to stayairborne longer as the droplets do not absorbwater weight which would cause them to fall tothe ground.
• Indoor Air currents both created by HVACsystems and people movement assure thatdroplet nuclei will remain airborne Indefinitely.
• This allows HVAC systems to remove andredistribute droplet nuclei throughout thebuilding to infect more occupants.
and gaseous pollutants into harmless products by a
process called photo catalytic oxidation (PCO).
• When applied as a coating and exposed to ultra-
violet or ambient light, Nano-TiO2 produces hydroxyl
radicals and superoxide ions that will neutralize
biological and gaseous contaminants in indoor air.
• We now know IAQA problems exist!
• We now understand the
recommendations by EPA for effective
sterilization!
• So, what kind of equipments and
technologies does Soma Medical have to
resolve these IAQA problems?
Benefits
• Cost efficient
• Long lasting
• Low maintenance
• Good indoor air quality
Cleanature SM767A
Ultraviolet light (UVC)
MERV filter + TiO2
Bipolar ionization
Electrostatic
All 5 EPA recommended
solutions.
Medilite GFL
Bipolar ionization
TiO2
Medilite GML
Bipolar ionization
TiO2
UVmaxTM Series
Ultraviolet light (UVC) for
various applications
UvmaxTM SM14-H
UvmaxTM SMT8
UvmaxTM SM40W
UvmaxTM SM14
UvmaxTM SM313
UvmaxTM SM212
Customized UVC Series
Ultraviolet light (UVC) for
projects based applications
Double Ended UVC
Single Ended UVC
UVC SM15C Submersible UVC
SM Nano 1152 Titanium Dioxide
The proof is in the pudding!!
Our recommended sterilization
solution protocol and products
can be effectively tested through a
pre and post microbial challenge
test, VOC count test and
particulate testing
Our equipments used for testing
Particle Scanner
IAQA VOC Tester
Negative Ion Tester
The importance of testing for
Volatile organic compounds (VOC)
Volatile organic compounds (VOCs) refers
to organic chemical compounds which have
significant vapor pressures and can affect the
environment and human health.
The importance of testing for
negative ions
Negative ions help freshen and purify the air by
neutralizing allergens such as pollen, mold
spores, dust, and animal dander floating in the
air. Negative ions will cause floating particulates
to be attracted and stick to each other, forming
'clumps', this eventually falls to the ground and
thus purifies the air.
The importance of testing for
Particulate count
Particle counters are used to determine the airquality by counting and sizing the number ofparticles in the air. This information is useful indetermining the concentration and micron size ofparticulates since it has a direct relationship tohuman well being and IAQA.