Page 27 - GP fall 2023

The Effectiveness of Room Air Purifiers in Dental Practices

Authors: Ramin Rezaei, MSC Mechanical Engineering; Igor Krichtafovitch, Ph.D.; and Normand Long, MSC, PE
Tonya N. Bellamy-Bissoon, DDS, Roslyn, NY

Hector B. Bernabe, DDS, Secaucus, NJ One outcome of the COVID-19 pandemic Using a layered approach with HVAC sys- (https://www.energystar.gov/productfinder/
is an elevated awareness of the dangers of tems, high-quality in-room air purifiers can product/certified-room-air-cleaners/results)
Christopher Bialko, DDS, New York, NY airborne, aerosolized particulate matter— bridge healthy indoor air, removing air-
Matthew Calaigian, DDS, New York, NY pathogens and toxins—in healthcare envi- borne pollutants in dental offices. In-room Ozone safety:
The health issues related to ozone are
ronments, including dental offices. Recent air purifiers are highly effective in removing
Jamie Renald Carter, DMD, Brooklyn, NY studies have detailed how dental healthcare pollutants at the source. They can also re- well-established. Select an air purifier that
is certified as ozone-safe by the Califor-
Peter D’Elia, DDS, Fairport, NY workers experience multiple exposures to a move pollutants such as smog and wildfire nia Air Resources Board (CARB), which
large range of airborne contaminants, leading smoke that can infiltrate offices every time
Sharon Deng, New York, NY to a wide range of occupational diseases. 1,2 the door opens. has the strictest standards in the country.
(https://ww2.arb.ca.gov/list-carb-certi-
Juan B. Espaillat, DDS, Spring Valley, NY The occupational diseases that result from When selecting room air purifiers, there are fied-air-cleaning-devices)
Laura Gennaro, DMD, Tonawanda, NY indoor pollution increase due to materials five important considerations: size, energy Effectiveness over time:
use, ozone safety, effectiveness over time,
and dental equipment services. Indoor par-
Pierangelo Antonio Ghisalberti, Ridgefield, NJ ticles are a complex mixture of extremely and maintenance costs. It’s important to choose an air purifier that
removes fine and ultrafine particles (look
3
Dean E. Glasser, DDS, Melville, NY small particles and liquid droplets. Dental Size: for independent test results) and that will
aerosols contain viruses, bacteria, and fun-
4
Philip Grecco, New York, NY gi, representing a cross-infection risk factor To select air purifiers at the proper size, it is remain at peak performance between filter
changes. The two leading technologies dif-
5,6
Umair Hassan, DDS, Huntington Station, NY for dental professionals. Important bacte- helpful to understand two key terms: fer significantly in performance over time.
rial pathogens are Mycobacterium tuberculo-
Marta Herin, DDS, Hauppauge, NY sis, Streptococcus pyogenes, Corynebacteri- Clean Air Delivery Rate (CADR) is an Mechanical (HEPA) air purifiers, using a
Caitlin Hewitt, DDS, Rochester, NY um diphtheriae, and Neisseria meningitidis, industry-standard set by the Association of technology little changed since the 1940s,
Home Appliance Manufacturers (AHAM)
all transmitted by an airborne route. Dental
physically block and trap particles in a fil-
Justin Huang, New York, NY aerosols have been found to contain viruses to compare the cleaning power between ter. As the filter fills with particles, it clogs,
new air purifiers. CADR ratings between
Carmen Hung, DDS, Staten Island, NY associated with dangerous diseases, such as zero and 450 are provided for each of the and the clean airflow drops. As clean airflow
the influenza virus, cytomegalovirus, hepati-
drops off, effectiveness also drops. As a re-
Nicole Jackson, DMD, Irvington, NY tis virus, herpes simplex virus, and Epstein– three pollutants: smoke, dust, and pollen. sult, HEPA air purifiers require frequent fil-
The CADR needed depends on room size ter changes to remain at peak performance
7,8
Ankit A. Jain, DDS, Port Jefferson Station, NY Barr virus, along with fungi. and desired air changes per hour. (within 10% of the original Clean Air De-
Daniel Janash, DDS, Rego Park, NY In determining how best to minimize these Air Changes per Hour (ACH) refers to the livery Rate).
exposures, recent studies recommended a
Jane Jiang, DDS, Brooklyn, NY multi-mode approach, including the use number of times the air in a room circulates Electrostatic APART technology of-
TM
Ankur Kadakia, Sayreville, NJ of in-room air purifiers to supplement per- in a one-hour period. The more air changes fers a different approach. Developed by
per hour, the faster an air purifier will clean research scientists and air quality experts
sonal protective barriers and the use of a
Harnoor Kaur, Buffalo, NY well-maintained HVAC system. In deter- the room. In most office settings, an ACH of at the University of Washington, and used
1
3 (every 20 minutes) is a good target when in patented Agentis Air room air purifiers,
Hira Khan, Lake Grove, NY mining how to choose and deploy air pu- combined with HVAC-system filtration and APART removes all particles, including the
rifiers for this purpose, one can learn from
Juhee Kim, New York, NY recent guidance on this topic that was gen- other ventilation. If in-room air purifiers most dangerous ultrafine pathogens, using
non-clogging electrostatic technology so
are the only air filtration source, the ACH
Caroline Soyoung Kim, DDS, New York, NY erated in response to the pandemic. should be increased to 4 or 5, filtering the clean air can flow freely, and effectiveness
Noah Lebovitz, White Plains, NY Spurred by the pandemic, the EPA has cre- volume of air every 12 to 15 minutes. stays constant between filter changes.
ated a voluntary action plan for businesses,
Chasen Lee, Buffalo, NY The Clean Air in Buildings Challenge, to A common formula can be used to see if Maintenance costs:
Due to clogging, HEPA air purifiers may
Melissa Elizabeth Mathews, Long Island City, NY provide guidance on improving indoor air the air purifier will deliver the desired air need filter changes every two to three
changes per hour. The estimated ACH is
quality. The complete document includes
Richard Murphy, New York, NY detailed steps and resources: epa.gov/in- calculated as [CADR x 60 minutes]/Room months. With multiple operatories over
many years of use, this can get expensive.
Astha Patel, DDS, Woodside, NY door-air-quality-iaq/clean-air-buildings- Volume in cubic square feet. For example, It is important to pay attention to this ongo-
an air purifier with a CADR of 250, in a
challenge. Assessment, the first step in the
ing cost and find a purifier that can maintain
Sobia Rafiuddin, DDS, Syosset, NY Challenge, can happen quickly, but long 500-square-foot room, with 8-foot ceilings the desired effectiveness without frequent
Alina Robbiano, DMD, Latham, NY lead times and considerable capital expen- will deliver an estimated ACH of 3.75. changes. This is where Brio comes in, ac-
diture may be needed to make system-level
cording to Agentis Air: “All HEPA air puri-
Cornelia Alice Sallar, DDS, Sioux Falls, SD adaptations. And, particularly for environ- This calculation should be done for each fiers use older, mechanical technology. The
room in the dental practice, as each separate
Sarah Sherman, DDS, New York, NY ments such as dental practices with heavy room will require an air purifier. Agentis air products, including Brio, offer
concentrations of toxic aerosols, central
a more effective solution than HEPA, with
Khalida K. Stutman, DDS, Massapequa Park, NY HVAC systems, which were not designed to Energy use: less filter expense and waste, and near-zero
maintenance.”
11
Ashfak Uddin, DDS, Mount Vernon, NY remove fine and ultrafine particulate matter, With several air purifiers in use, energy
may still fall short.
For this reason, the
9,10
James Yun, New York, NY EPA, along with the American Society of consumption can become significant, so it is Considering the damaging effects of aero-
important to limit your search to air purifiers solized pathogens and airborne toxins,
Heating, Refrigerating and Air Condition-
Maritere Zamora, DMD, Brooklyn, NY ing Engineers (ASHRAE), the NIH, and the that are Energy Star certified. This website healthy indoor air at work should be a base-
Antony Zeng, DDS, Long Island City, NY CDC, recommend the addition of in-room provides a directory of Energy Star-certified line requirement for dental practices. When
air purifiers.
selected carefully, in-room air purifiers can
air purifiers.
be an effective tool to meet that requirement.
www.nysagd.org l Fall 2023 l GP 27