Green Schools Attributes for Health and Learning (2007) / Chapter Skim
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7 Building Characteristics and the Spread of Infectious Diseases
7 Building Characteristics and the Spread of Infectious Diseases
Pages 105-119
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From page 105... ...
7 Building Characteristics and the Spread of Infectious Diseases T ransmission of infectious diseases among school children is frequent and probably inevitable. Although most such cross-infections are transient and not serious, they may have concentric circles of repercussions for other students, teachers, parents, and educational achievement.
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From page 106... ...
. Current green school guidelines typically contain few measures related to these building characteristics, although they may address filter efficiencies.
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From page 107... ...
0 BUILDING CHARACTERISTICS AND THE SPREAD OF INFECTIOUS DISEASES ï Ventilation rates • ï Internal mixing • effectiveness effectiveness ï Air cleaning & disinfection and disinfection • effectiveness effectiveness • ï Humidity Airborne transmission by small droplets Direct skin Direct Direct Direct skin contact; contac contact contact; self t self inoculation inoculation Surfaces Inactivation Personal hygiene • Doorknobs ï Door Knobs (sneezing, coughing, • ï Cleaning • ï Bathroom fixtures hand washing) • ï Humidity • ï Keyboards Proximity • ï Surface material; material • Desktops ï Desk tops • ï Sunlight • ï Objects FIGURE 7.1 Transmission modes for spread of infectious diseases.
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From page 108... ...
Understanding the role of airborne transmission is further complicated by the fact that the human infectious dose will vary substantially among viruses. Dilution in the indoor air supply may make concentrations far too low for transmission to occur.
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From page 109... ...
0 BUILDING CHARACTERISTICS AND THE SPREAD OF INFECTIOUS DISEASES of high concentrations might persist for longer than would be predicted by the calculated air exchange rate for the room. Reports on the transmission of respiratory infections, including SARS, in places like airplanes, office buildings, and hospitals also suggest the potential importance of an airborne component (Moser et al., 1979; Roy and Milton, 2004; Reichert et al., 2001; McLean, 1961; Riley et al., 1978)
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From page 110... ...
MEASURES FOR CONTROLLING THE SPREAD OF INFECTIONS IN SCHOOLS Two of the most effective measures for controlling the spread of infection in schools are immunization and the exclusion of children and adults with infectious cases. Because these are policy measures unrelated to school buildings, they are not discussed further in this report.
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From page 111... ...
BUILDING CHARACTERISTICS AND THE SPREAD OF INFECTIOUS DISEASES Hand and Personal Hygiene The use of hand sanitizers or hand rubs for infection control has been evaluated in health care facilities, at home, and in day care centers and schools (Meadows and Le Saux, 2004; Lee et al., 2005; Girou et al., 2002; CDC, 2002; Rochon-Edouard et al., 2004; Master et al., 1997; Early et al., 1998; Zaragoza et al., 1999; Turner et al., 2004; Sandora et al., 2005)
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From page 112... ...
GREEN SCHOOLS: ATTRIBUTES FOR HEALTH AND LEARNING readily available, including disposable tissues, no-touch waste receptacles, conveniently located dispensers of alcohol-based hand rub solutions, and, wherever sinks are available, supplies for hand washing. Similar measures could be implemented in green schools; ongoing maintenance would be required if such measures are to be effective.
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From page 113... ...
VENTILATION AND AIR CLEANING Three building characteristics are relevant to the survival, dispersal, and removal of airborne pathogens -- the relative humidity of the room air,
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From page 114... ...
Humidifiers are not routinely installed in schools. Although humidification carries its own health concerns, a lack of it in school buildings can result in low relative humidity (RH)
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From page 115... ...
However, there may be practical limitations to this effect, since not all the air is completely replaced with each air exchange. Typically only two-thirds of the air is removed per air exchange because of the size and location of supply and exhaust ducts, short circuiting, and obstructions (blocked unit ventilators)
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From page 116... ...
GREEN SCHOOLS: ATTRIBUTES FOR HEALTH AND LEARNING Indeed, in a recirculated air system, viable airborne pathogens could be distributed to other classrooms by the mechanical ventilation system. Riley et al.
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From page 117... ...
. The exposure of building occupants to UVC used in upper room installations is very low.
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From page 118... ...
Evidence from studies in nonschool environments suggests that interventions which interrupt the known modes of transmission of common infectious agents may decrease the occurrence of such illnesses in schoolchildren and staff. Finding 7b: The best way to control infections, especially gastroenteritis, appears to be instituting procedures that promote good hand cleansing.
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From page 119... ...
Recommendation 7a: Future green school guidelines should include measures for the regular cleaning of commonly touched surfaces and the availability of hand sanitizers at sinks. The use of "no-touch" faucets, receptacles, equipment, and egress from bathrooms should be considered, taking into account the age of the children in the school.
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