Ventilation Air Pressure Relationship Requirements: Endoscopy Procedures

Are there specific air pressure relationship requirements for rooms in which endoscopy procedures are performed?

Any examples are for illustrative purposes only. 

Organizations that use The Joint Commission for deemed status purposes are subject to, at a minimum, the ventilation requirements in ANSI/ASHRAE/ASHE Standard 170 - 2008 (as referenced in NFPA 99-2012, Chapter 9) for facilities that are built, altered, or renovated effective July 5, 2016 .  State rules or regulations may mandate more restrictive requirements.  This document requires endoscopy procedure rooms to have positive airflow to adjacent areas, with a minimum of 2 outdoor air changes and 15 total air changes per hour. Humidity shall be between 30-60% and temperature shall be between 68-73 degrees Fahrenheit.  Recirculating air units are not allowed.  

For new, altered, or renovated space in non-deemed organizations, facilities are expected to comply with either state rules or regulations (if applicable), or the 2018 Guidelines for Design and Construction of Healthcare Facilities (EC.02.06.05).  The 2018 Guidelines contain ANSI/ASHRAE/ASHE Standard 170 -2017 edition. In the 2017 document, gastrointestinal endoscopy procedure rooms may be either positive or negative, either is permitted. The total air changes per hour has been revised to 6 and the humidity requirement has been lowered to 20-60%.  The other ventilation requirements for endoscopy remain the same. 

Facilities that were built, altered, or renovated prior to July 5, 2016, shall meet the requirements that were enforced by their state rules and regulations, CMS, and/or Joint Commission at the time of construction.  The different editions of design guidelines have varied dramatically in the requirements for pressure relationships from endoscopy procedure rooms to adjacent areas:
  • 1984 (and prior) DHHS Minimum Requirements of Construction and Equipment for Hospital and Medical Facilities – no requirement (N/R)
  • 1987 AIA Guidelines for Construction and Equipment of Hospital and Medical Facilities – N/R
  • 1992-93 AIA Guidelines for Construction and Equipment of Hospital and Medical Facilities – N/R
  • 1996-97 AIA Guidelines for Design and Construction of Hospital and Health Care Facilities – N/R
  • 2001 AIA Guidelines for Design and Construction of Hospital and Health Care Facilities – Negative
  • 2006 FGI Guidelines for Design and Construction of Health Care Facilities – N/R
  • 2010 FGI Guidelines for Design and Construction of Health Care Facilities – Positive
    • References ANSI/ASHRAE/ASHE Standard 170 - 2008 edition
  • 2014 FGI Guidelines for Design and Construction of Hospitals and Outpatient Facilities – N/R
    • References ANSI/ASHRAE/ASHE Standard 170 - 2013 edition

The key to compliance with EC.02.05.01 for existing facilities is to know what design standard your endoscopy room was built to, and to maintain the requirements of that standard.
Last updated on June 10, 2020
Manual: Hospital and Hospital Clinics
Chapter: Environment of Care EC

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