To Keep Docs Cool, Dry and Happy

David N. Schurk DES., CEM., LEED-AP., CDSM., SFP., CWEP.

Director of Healthcare Accounts for Heat Transfer Solutions in Houston, TX.
 Learning Objectives
1. Understand the roll that both temperature and humidity play in proving doctor and patient comfort.

2. Learn what “dew-point” temperature is, how its measured and maintained, and why its key to producing
satisfactory operating room conditions.

3. Discover how to reference a psychrometric chart (or App) to quickly determine space temperature and
humidity conditions.

4. Learn to assess existing HVAC systems and determine if they are capable of producing space
temperature/humidity conditions needed.

5. Understand the “pros and cons” of all three common cooling and dehumidification equipment types
installed in hospitals today, DX cooling, medium and low-temp chilled water and desiccant dehumidification
systems.

6. Learn of available retrofit and upgrade solutions that can supplement existing HVAC systems to help deliver
the performance necessary to satisfy new demands.
 Complaints?
Why can’t I properly control humidity in my OR?
1. Lack of understanding of basic psychometrics.

2. The HVAC systems are being designed without consideration of

“real world” space condition requirements.

3. Inappropriate HVAC systems are being designed and installed for

the task.
Why do we Dehumidify ORs?

“I’m cold & clammy”

“I’m hot & sticky”

“I’m mad as hell”

Surgeon and staff

comfort
 Why do we Dehumidify ORs?

“Drier” “Wetter”
makes makes
us feel us feel
cooler warmer

An environment with excessive humidity will make it feel

warmer than it really is
 Why do we Dehumidify ORs?
1. The combination of temperature & relative humidity is the
primary component of perceived human comfort.

2. Increased levels of humidity restrict the body's evaporative

processes.

3. The result of increasing humidity on human comfort is an

perceived increase in air temperature.

4. This results in a decrease in human thermal comfort.

Why else do we Dehumidify ORs?

 Therapeutic reasons

 Instrument “fogging”

 Orthopedic adhesives

 Microbial growth

 Droplets of condensate
 Definitions

High

Cool & Dehumidify Heat & Dehumidify

Low

Low High
 Definitions
Dry bulb temperature °F (dbt): Is the temperature of air
measured by a thermometer.

Relative humidity % (rh): the amount of water vapor

in the air, expressed as a percentage of the maximum
50%
amount that the air could hold at the given 100%
temperature

Dew point temperature °F (dpt): Is the temperature at

which the air is saturated with water (100%rh). Once
air is cooled to its dew point temperature, any further
cooling of the air will condense moisture from it.
 Basics

This may help moving forward………

1. When air-conditioning to keep a space cool we must

supply conditioned air to the space that is colder than
the space.

2. When air-conditioning to keep a space dry we must

supply conditioned air to the space that is dryer than
the space.
 Basics
o People are accustomed to describing the space “temperature” in
terms of dry bulb temp (dbt) and relative humidity (%rh)

o Dew point temperature is an indication of the amount of “moisture”

(water) in the air.

o Knowing the dew point temperature requirement of the space allows

the HVAC designer to calculate how much “moisture” must be
removed to provide proper dehumidification.

o The space dew point temperature will establish the SAT required to
maintain the desired “humidity” in the space.

o Knowing the space dew point temperature allows “simple”

troubleshooting of space humidity issues.
 Basics

100% rh

% rh
dpt
dbt
 Basics

Plotting any TWO known

air conditions on the
Psych Chart allow all the
remaining conditions to
be identified
 Operating Room Design
If I cool the air below
50°Fdbt (50°Fdpt)
moisture will condense
from the air

50°F Space (dpt)

Dew Point Temperature
*(required)*

50% Space Relative Humidity (rh)

100% rh

70°F Space (dbt)Temperature

50°Fdbt
 Basics

This may help moving forward………

1. This means (cooling based) I need to maintain my SAT below

50°F dbt (50°Fdpt) and I need chilled water cold enough to get
the air (coil) to this temperature, if I want to dehumidify the
air and the space?
 Basics

o If air above (warmer than) this is supplied to the

space, no dehumidification will occur.

o Any surface in the space below (colder than) this

will condense moisture from the air ……..WHAT?
 Basics
Can surface cools the air surrounding it from
70°Fdbt (50°F dpt) to 45°Fdbt
and moisture in the air next to the
can will begin to condense

“Coke Bottle Effect”

45°F
dbt Sweating (condensation)
will form on a surface
which has reached the
“dew-point”
70°Fdbt / 50% rh
50°F Dew Point temperature of the air
Temperature
(dpt)
which surrounds it.
 Operating Room Design
 The purpose of the HVAC system in an operating room
(OR) are to minimize infections, maintain patient
comfort, and help facilitate patient health and recovery
and maintain staff comfort.

 Requirement for 20-air change per hour (ach) which

includes 4-ach outdoor air (20% outdoor air).

 Maintain positive pressure in space.

 Operating Room Design
Table 3: Ventilation Requirements for Hospitals and Outpatient Facilities
Area Air Minimum air Minimum All air Recirculated Relative Design
Designation movement changes total air exhausted to by means of humidity temperature
relationship outdoor air changes per outdoors room units (%) (degrees F)
to adjacent per hour hour
area
Operating Out 4 20 ----- No 30-60 68-73
Surgical

Texas Hospital Licensing Rules Effective June 21, 2007

Note 8: Where temperature ranges are indicated, the system shall be capable of maintaining the rooms at any
point in this range. Nothing in these rules shall be construed as precluding the use of temperatures lower than
those noted when the patients comfort and medical conditions make lower temperatures desirable.

Note 17: Some surgeons may require room temperatures that are outside of the indicated range. All operating
room design conditions shall be developed in consultation with surgeons, anesthesiologists, infection control
and nursing staff.
 Operating Room Design

Orthopedic and cardiac operating room surgeons frequently

request very low temperatures, often as low as 60°F @ 50%rh.
Operating Room Design
 Operating Room Design

Outdoor Air Load

Sensible
+
Latent

SPACE = 64.5°Fdbt @ 60% rh (50°Fdpt)

 Operating Room Design
Item Load Sensible Latent
Lights 1-kW 3,412 Btu/hr 0
Equipment 1-kW 3,412 Btu/hr 0
6-People 3000 Btu/h 1,500 Btu/hr 1,500 Btu/hr
Ventilation 440 cfm (20%) 24,330 Btu/hr 18,839 Btu/hr
TOTAL 32,654 Btu/hr 20,339 Btu/hr

 52,993 Btu/hr = 4.42 tons (no safety)

 Air reheated to 61°Fdbt (35,640 Btu/hr)
 Reheat is (always) required
 ACH drives the size of the HVAC system, not the internal
loads.
Operating Room Design
Does Reheat Matter?
Thermal (Nat Gas) Energy Use

Outside Air Htg 7%

Reheat 65%
Space Htg 15%
DHW Htg 3%
Dietary/Sterilizers 5%
Distribution Losses 5%

In order to maintain low humidity's in the space the SA

Must be overcooled in order to deeply dehumidify it
 Operating Room Design

O/A: 97.2°Fdbt/68.6°Fdpt

MAT = 71.1°Fdbt/54.8°Fdpt
50.3°Fdpt
∆ = 4.3°F
S/A: 46.0°Fdbt/46.0°Fdpt
Reheat: 61.0°Fdbt SPACE : 64.5°Fdbt/50.3°Fdpt 46.0°Fdpt
 Operating Room Design “MATRIX”
Texas Hospital
OR OR OR dpt°F SAT
Licensing Rules # temp°F rh% dpt°F ∆ dpt °F
1 72 60 57.4 4.3 53.1
2 72 50 52.4 4.3 48.1
3 68 60 53.6 4.3 49.3
4 68 50 48.7 4.3 44.4
Example 5 64.5 60 50.3 4.3 46.0
6 64.5 50 45.5 4.3 41.2
7 62 60 48.0 4.3 43.7
8 62 50 43.1 4.3 38.8
9 60 60 46.1 4.3 41.8
10 60 50 41.3 4.3 37.0
 System Types
Supply Air
dpt °F
Texas Hospital Licensing Rules

ASHRAE Example
System Types
Direct Expansion Cooling (DX)

I. Packaged Roof Top Units

II. Packaged Self Contained Units
III. Packaged Split Systems

 Refrigerant based, R-410a

 Typical SAT 55°Fdpt
 Lowest SAT around 48°Fdpt
 System Types
Direct Expansion Cooling (DX)

Pros Cons

 Relatively inexpensive  Limited equipment life 10-12 yrs.

 Easily understood  Inefficient at low SATs
 Fairly easy to service & maintain  On/off capacity staging & control (unless
 No pumps or cooling towers required VSC)
 Part load control is very difficult
 Requires reheat
 Not capable of “deep” dehumidification
 System Types
DX
Supply Air
dpt °F
55 F
dpt
48 F
72/60 dpt
72/50

60/60
60/50
System Types
Traditional Chilled Water System (CWS)

I. Indoor Water-Cooled
II. Outdoor Packaged Air-Cooled

 Refrigerant/water based
 Large tonnages available
 Typical LWT 44°F (coldest 40°F)
 Typical SAT around 53°Fdpt
 Lowest SAT around 45°Fdpt
 Lowest DPT around 43°F
 System Types
Traditional Chilled Water System (CWS)

Pros Cons

 Most large hospitals have CW  Requires pumps & piping

systems  May require a cooling tower/water and
 Easily understood chemical consumption
 Fairly easy to service & maintain  More maintenance required
 15-25 year lifespan  Inefficient at lower LWT
 lower SATs than DX  Requires reheat
 Not capable of “deep” dehumidification
 System Types
CW
Supply Air
dpt °F
53F
dpt
72/60 45 F
72/50 dpt

60/60
60/50
System Types
Low-Temperature “Glycol” Chiller (LTCW)

I. Indoor Water-Cooled
II. Indoor Air-Cooled
III. Outdoor Packaged Air-Cooled

 Refrigerant/water based
 Use glycol as anti-freeze
 Lowest SAT around 38°Fdpt
 System Types
Low-Temperature “Glycol” Chiller (LTCW)

Cons
Pros
 Higher first cost expense
 Same as traditional chillers
 May be in addition to traditional DX or CW
 Capable of lower dew point
system
temperatures
 Require glycol (antifreeze)
 Inefficient at lower LWTs
 Condensate freezing (frost)
 Additional duct/pipe insulation for low LATs
 Requires reheat
 System Types
LTCW
Supply Air
dpt °F

72/60
72/50 38 F
dpt
60/60
60/50
System Types

Desiccant Dehumidification (DDHS)

I. Indoor
II. Outdoor

 Adsorbent: different from traditional

cooling/dehumidfication system
 Required regeneration source
 Very low space dew point control
 System Types
Desiccant Dehumdification (DDHS)

 Different from cooling

based dehumidification

 Attracts moisture based

on vapor pressure
differential
 System Types
3. Then the wheel rotates into the reactivation airstream, the
desiccant is heated by the hot reactivation air, and the
desiccant releases its moisture to the reactivation air.

4. The wheel then

rotates back into the From Outdoors To Outdoors
process air, so it can
collect more moisture WARM
from the process
airstream. From Indoors
To Space or
Outdoors

2. The process air flows

through the wheel and
the desiccant adsorbs the
1. The wheel rotates slowly moisture from the air.
between the process and
reactivation airstreams.
 System Types
Desiccant Dehumidification (DHW)

Pros Cons

 Commercial & industrial grades  Not easily understood

(durable)  Requires skilled maintenance
 Very stable dew point space control  Controls may be more complex
 Extremely low dew point temps  May require traditional pre-cooling
 Can be very energy efficient system
 Can reduce or eliminate reheat
 System Types
Desiccant
Supply Air
dpt °F

72/60
72/50

60/60
20 F
60/50 dpt

OR LESS
 Operating Room Design “MATRIX”
OR temp °F OR rh% OR dpt°F dpt°F ∆ SAT dpt °F DX CW LTCW Des
72 60 57.4 4.3 53.1
72 50 52.4 4.3 48.1
68 60 53.6 4.3 49.3
68 50 48.7 4.3 44.4
64.5 60 50.3 4.3 46.0
64.5 50 45.5 4.3 41.2
62 60 48.0 4.3 43.7
62 50 43.1 4.3 38.8
60 60 46.1 4.3 41.8
60 50 41.3 4.3 37.0
 System Types
Process & Capacity Low-Temp Desiccant
Requirements Chiller Dehumidification
Stage-1 cooling or YES YES
Desiccant pre-cooling (MBH)
Stage-2 cooling or YES YES
Desiccant post-cooling (MBH)
Reactivation (MBH) NO YES

Reheat (MBH) YES NO

Standard-chiller nominal-tons YES YES

Low-temp chiller nominal tons YES NO

Standard chiller cost to operate $ 1,809 $ 4,789
Low-temp chiller cost to operate $ 6,701 $0
Reactivation cost to operate $0 $ 5,092
Reheat cost to operate $ 8,631 $0
Total cost to operate $ 17,141 $ 9,881 (-42%)

For each 50-tons of low-temp chiller capacity replaced by desiccant

dehumidification a hospital may save $5000/year or more in utility cost.
Assumptions: Standard chiller COP=3.0, low temp chiller COP=2.4, operation 6-am to 6-pm M-F,
3120 hr/yr, cost of electricity = $0.07/kWh, cost of gas (reheat or regeneration) = $10/MMbtuh,
boiler efficiency= 80%.
Retrofit Solutions
 Retrofit Solutions
DX Rooftop Unit

Source of Operating Room Cooling Loads

Light/Equip 10%
Staff/Patient 4%
Reheat 43%
Minimum OA 43%

 Limited O/A capability = 15-20% (or less)

 Limited latent (dehumidification) capacity
 Typically no reheat capabilities
 Typically on-of capacity control (no cooling modulation)
 Typically doesn’t work!
 Retrofit Solutions
Existing (10,000 cfm) DX Rooftop Unit “Decoupled” Desiccant (2000 cfm) Pre-Treat

10,000 cfm 20% OA

100% MA
70°F dbt
40°F dpt
2000 cfm 2000 cfm
100% OSA 100% OSA
97°F dbt 83°F dbt
3𝟒𝐅 𝐝𝐩𝐭 7𝟓°𝐅 𝐝𝐩𝐭
100% SA

10,000 cfm
100% SA
57°F dbt 80% RA Handle the OA
40°F dpt 60°F
55%rh and space latent loads
44°Fdpt 8000 cfm
Zero 100% RA
62°F dbt
Reheat
45°F dpt
Quick Help
Quick Help
Please visit Questions?
our HTS
booth at
TAHFM David N. Schurk
Director of Healthcare Accounts
Cell: 920-530-7677
[email protected]
Heat Transfer Solutions
Houston, TX