Better Air, Better Care: The Filtration Upgrade Indian Hospitals Must Make
By Arunima Rajan
Deepak Nanaware is the head of marketing and business development at American Air Filter International AAF International - Middle East and India. In an interview with Arunima Rajan, he talks about how smarter air filtration and simple retrofits can sharply cut infection risks in Indian hospitals without major shutdowns.
For Indian hospital leadership teams, what single air handling change would cut infection risk fastest in wards and ICUs, and why should it be funded first?
Most Indian hospitals don’t use centralised AHUs for wards & ICUs, hence using portable healthcare-grade air purifiers with true HEPA filter shall be recommended to use in such critical areas and upgrade to minimum MERV 15 / ePM1 grade of filters in existing AHUs serving these areas. Most infections in wards/ICUs spread via aerosolized particles and unfiltered recirculated air, affecting patients as well as making them easy targets for HAIs. Adding or upgrading final-stage filtration with validated sealing and pressure monitoring can cut airborne pathogen load by up to 90% within days, without major structural changes. This will create immediate impact on patient as well as healthcare professionals’ safety, national regulatory compliance (NABH), and the hospital's reputation.
Where does contaminated air most often originate inside hospitals, which zones leak the most, and how should leaders prioritise fixes by clinical risk and footfall?
OPD areas generate most contaminated air due to higher footfall & unknown risk of infection from patients/ visitors, followed by the pathology department where samples are tested. Cross-leakage between isolation, ICU, and ward zones through unsealed ceiling voids, inadequate pressurization of areas, common elevators also add to contamination. Leaders need to define the zones and should have the best possible isolation along with sterilisation when crossing the zones. ICUs, NICUs, transplant & oncology wards should get more attentions where risk of infection to in house patients is very high. Minimum MERV 15 air filtration should be used in OPD areas and safe handling / containment systems should be used in a pathology department to avoid spread of contamination to other areas during the exhaust of air.
Give a stepwise upgrade plan for a mid-sized Indian hospital that starts this quarter, continues at six months, and at one year, without shutting Ots?
Quarter 1 (Immediate Start):
Conduct airflow, pressure, particle & microbial counts for all critical zones. Seal leakage points in ducts, AHU plenums, and ceiling voids. Replace/upgrade prefilters and fine filters to restore rated pressure differentials &
efficiency. 6-Month Milestone:
Retrofit terminal HEPA modules or Fan Filter Units (FFUs) in ICUs and transplant wards. Introduce room pressure and airflow monitoring sensors. Optimize AHU balancing for positive/negative pressure zoning.
1-Year Target:
Extend HEPA retrofit to all OTs and recovery rooms. Integrate Building Management System (BMS) control for filtration, humidity, and alarms. Validate with third-party testing (DOP scan, microbiological count). (OTs remain functional via phased night/weekend installation and portable filtration support.)
Beyond saying “HEPA,” what three proof points should procurement demand to verify cleaner air at the bedside, not just inside ducts or on paper?
Procurement should demand performance verification beyond datasheets: On-site PAO/DOP integrity test (per ISO 14644-3) — ensures zero leakage at terminals. Airborne particle and microbial count at patient level before & after handover. Filter certification traceability (EN 1822 H14 or ISO 29463) — serialized filter test reports with scan data.
What is the business case for better filtration and airflow control in terms of reduced HAIs, shorter length of stay, fewer cancellations, and reputational risk?
Reduced Hospital-Acquired Infections (HAIs): 20–30% potential reduction through improved air quality. Shorter Length of Stay: Each prevented infection saves 3–5 ICU bed-days helping to generate revenue from new patients. Lower Procedure Cancellations: Stable airflow prevents OT shutdowns during audits. Reputational Gains: NABH readiness and patient trust lead to higher occupancy and insurance tie-ups. ROI: Typical payback within 12–18 months via infection cost avoidance and energy optimization.
With power costs rising, which design choices and maintenance practices deliver cleaner air with flat or lower energy bills over 12 to 24 months?
Design Choices: Use multi-stage filtration (MERV 11 + MERV 15 + H14) with low-pressure-drop media / technology. Install EC motors and Variable Frequency Drive (VFDs) for dynamic airflow control.
Apply pressure-based fan modulation reduces fan energy up to 25%.
Maintenance Practices:
Regular filter replacement before clogging threshold (150–200 Pa). AHU coil cleaning for improved heat transfer. Calibrate sensors quarterly.
Result: Cleaner air with up to 10–15% lower energy cost over 12–24 months.
In older Indian facilities with tight ceiling voids and high humidity, what retrofits work while keeping pressure, airflow, and noise within safe bands?
In older facilities we review implement tailor-made: solutions:
Use slim HEPA modules or FFUs with integrated fans. Install dehumidification coils or desiccant wheels upstream. Use vibration-isolated plenums and acoustic ducts to maintain <50 dB(A). Pressure and noise remain stable with proper zoning and diffuser layout along with lower operating velocities.
India faces high PM2.5 outdoors and fungal spikes during repairs and festivals. Which controls handle these peaks without disrupting OPD and emergency services?
Use two-stage filtration (MERV 8 + MERV 11) at fresh air intake along with dehumidification to reduce RH from fresh air. Maintain pressurized clean corridors to block outside air ingress. Deploy portable HEPA scrubbers in OPDs and ERs during construction or repair and use negative pressurization on construction area. Regularly sanitize AHU condensate pans to prevent fungal amplification. Continuous monitoring keeps operations uninterrupted during peak pollution or repair periods.
What are the three most common failure points in hospital air systems, and what simple monthly audits will catch them early with clear ownership?
Failure Points:
Bypassed or leaked filters due to damaged gaskets or loose clamps or improper handling. Pressure loss or reversal from unbalanced airflow. Sensor drift causing false alarms or silent failures.
Monthly Audit Checklist:
Visual inspection of filters and seals. Record room pressures with manometers / differential pressure sensors. Review differential pressure & room temperature + RH trends via BMS. Assign ownership to Facility Engineer → report to Infection Control Committee (ICC).
For procurement teams, what should a one page brief include so bids are comparable, including test methods, certifications, on site validation, warranty, and AMC terms? Each tender should include:
Performance test as per international standards: ISO 16890 / EN 1822 / ISO 14644-3. On-site validation: PAO integrity test + particle count at occupancy. Certifications: CE / UL / ISO 9001 / NABL-accredited testing reports. Warranty & AMC terms: Minimum 1 year with defined response time. Energy and performance data: Initial pressure drop, rated airflow, and service interval. This ensures technical parity and transparency across bidders.
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