COVID-19: Managing Infection Risks During In-Person Dental Care includes Air Quality Circulation
The Royal College of Dental Surgeons of Ontario, has published on May 25, 2020, several recommendations pertaining to air circulation and sterilization cleaning times.
If Dentists have not had the rate of air changes (indoor air testing) for their office confirmed by an air quality professional, dentists must assume a rate of 2 air changes per hour and adhere to a minimum fallow time of 3 hours following an AGP (Aerosol Generating procedure), before cleaning and disinfection.
In order to reduce this fallow time (as per Table 2) of publication, Dentists should consult an air quality professional to assess the existing HVAC system and calculate the actual ACH for the dental practice. Dentists may use the actual ACH to calculate a fallow time using Table 2.
a. Dentists should retain copies of any documentation supporting the HVAC assessment and any need for engineering controls.
Options to improve ACH (and further reduce the fallow time) may be explored, including:
b. Consulting an HVAC professional to determine whether changes to the existing HVAC system are possible to improve ACH for the dental practice.
c. If changes to the existing HVAC system are not possible or adequate, dentists may consider the use of an in-operatory air cleaner (e.g. HEPA filtration) to increase the effective air changes per hour (eACH) for a specific operatory.
d. If an in-operatory air cleaner (e.g. HEPA filtration) will be used to increase the effective air changes per hour (eACH) for a specific operatory, the HVAC professional must also take into account several additional factors, including:
i. any structural changes that may be necessary to contain the spread of aerosols (e.g., the addition of floor to ceiling walls or barriers),
ii. the type of unit being considered (e.g. fixed versus portable), iii. the cubic feet of the operatory and airflow rate of the unit, and iv. the optimal placement and operation of the unit.
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