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Research Article Open Access

The Study of Sustainable Green HVAC Systems in Health Care Facilities

Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H and Milyani H*
Architecture Student, Effat University, Saudi Arabia

Abstract
The amount of energy used up in healthcare buildings by traditional types of Heating, Ventilating and Air
Conditioning systems is about 40% of the total building energy consumption. It also accounts for a large number of
harmful emissions released into the environment. Therefore, we need to implement the use of green systems that
will help in not only improving indoor comfort and quality but also in reducing energy consumptions and harmful CO2
emissions. HVAC is defined as a system that is responsible for controlling and maintaining the thermal comfort of
indoor rooms.
The purpose of this research paper is to identify sustainable Heating, Ventilating and Air Conditioning systems
that can be used in healthcare facilities. The research also focuses on identifying different methods and technologies
to help understand how they can be used with maximum efficiency.
First we discuss types of heating ventilation and air conditioning systems and their manufacturing process.
Then we analyze the different criteria and technologies for systems specific to healthcare facilities and green
technologies. The final process of this research paper involves the study of different case studies where we use
several assessments to confirm the most appropriate type of green systems to be used for healthcare buildings. In
conclusion, every healthcare building has a different set of requirements but new and green technologies are the
most environmentally and economically beneficial.
This paper is divided into six main parts: (i) Introduction (ii) Literature Review (iii) Manufacturing Process (iv) New
Systems and Technology (v) Green HVAC Systems and (vi) Conclusion.
Hence, by identifying the several types of green HVAC systems in this paper, we will now be able to understand
the most appropriate and efficient type that we can use in health care facilities. This will allow for a great reduction in
energy consumption, harmful emissions and provide a more thermally comfortable environment for patients.

Keywords: Sustainable; HVAC; Manufacturing; Green; Healthcare may need to be colder than a lobby for example and a morgue may have
buildings specific ventilation needs from a ward. Hospital ventilation also needs
to account for infection control, because there are so many pathogens
Introduction in the air. Additionally, since the systems are running around the clock,
it is necessary to make sure the systems are energy efficient.
Heating ventilating and air conditioning (HVAC) is the technology
that provides environmental comfort inside of a building. However, With the many requirements of hospitals, which also include energy
in hospitals they have numerous functions, including: improving the and cost­saving concerns, sustainable HVAC systems that are most
indoor air quality, maintaining diseases from transmission, conserving suitable for hospital buildings will be discussed in this paper. Possible
energy that also leads to controlling energy costs, providing life alternate energy sources to power large scale systems, along with the
safety, low maintenance requirements and meeting safety standards. different methods of implementing these systems to benefit from
Maintaining disease transmission is what the American Society of maximum efficiency, will also be addressed. Thus this paper will explore
Heating, Refrigerating and Air­Conditioning Engineers' calls infection the research questions of “What heating ventilation air conditioning
control. An example would be, places that deal with substances that systems are most suitable for hospitals and how can they be used in
are hazardous to our health, such as pharmacies and laboratories. They the best, most sustainable way?” The significance of this research is
require specific air distribution systems that will ensure the protection of to gain a cohesive understanding and spread awareness about HVAC
people and medicines. It not only has to follow the ASHRAE criteria for systems, how they are manufactured, and the best options for hospitals
infection control but it also has to be of good quality and be sustainable. that allow them to run smoothly, efficiently and sustainably twenty-four
The newly released ASHRAE criteria manual describes how to meet the hours a day in order to keep patients comfortable and sensitive medical
standards and details how and why engineers and hospital owners may equipment operating correctly at all times.
want to design systems that exceed the standards. This is why hospital
HVAC systems are different from all others where environmental
comfort is the predominant and usually sole objective [1-5].
*Corresponding author: Milyani H, Architecture Student, Effat University, Jeddah
Hospital buildings are one of the few types of building that run 22332, Saudi Arabia, Tel: +966 2 636 4300; E-mail: [email protected]
at full scale twenty-four hours a day. Unlike other buildings, HVAC
Received December 09, 2015; Accepted February 11, 2016; Published March
in hospitals require not only comfort but also safety and hygiene.
15, 2016
Hospitals need to maintain the temperature, air quality, air flow, and
humidity to create the most comfortable environment possible for Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016)
The Study of Sustainable Green HVAC Systems in Health Care Facilities. J Archit
the patients. Ventilation in hospitals also work to control hazards,
Eng Tech 5: 160. doi:10.4172/2168-9717.1000160
because there are frequently fumes and chemicals in the air that could
cause harm if not properly dealt with. Different areas of a hospitals Copyright: © 2016 Abdul FSM, et al. This is an open-access article distributed
under the terms of the Creative Commons Attribution License, which permits
have different air conditioning systems, depending on the function. unrestricted use, distribution, and reproduction in any medium, provided the
Different parts of a hospital have different needs ­an operating room original author and source are credited.

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 2 of 10

Healthcare building HVAC system requirements

Heating, ventilating, and air conditioning system have a very
important role in health care facilities. They not only maintain good
air quality and create comfortable atmospheres for the patients,
but they also help staff members remain productive at all times. It
is very critical for an HVAC system to be flexible to all the different
needs in a healthcare facility such as; operating rooms, patient rooms,
administrative offices, meeting rooms, etc. Healthcare building
specifically require these systems to be able to filter the air coming in
and out of it from airborne contaminants along with bacteria to prevent
infections spreading or harming patients. Those systems should also
meet the minimum standards for healthcare ventilation, air changes,
temperature, humidity, filtration and design. The most important
HVAC system needs in hospitals include: design, size, and energy
efficiency.
HVAC systems should create quiet environments for patients and
minimize disruptions. The design of the system has to have a different
environment inside the building as critical care spaces, operating rooms,
Figure 2: Split system illustration of component and work (source: Cyclone
recovery rooms, and intensive care units all have different atmospheres Contracting, 2015).
and each environment should be controlled separately according to its
temperature and humidity requirements. According to studies, patients
Droplet transmission take place when an infected person makes
are proven to show slower recovery in uncontrolled environments
droplets containing microorganisms which are transferred at a short
opposed to controlled environments. Its size must be of enough
distance within air and lands on the conjunctivae, nasal mucosa or
functional capacity to meet the needs of heating, cooling and ventilation
mouth of a host. Droplets do not stay hanging in the air, therefore
in the building. Moreover, it must be consistently good in quality and
no particular air handling and ventilation are needed to stop droplet
performance not to breakdown and endanger the health and safety of
transmission. They are generated by coughing, sneezing and talking.
the patients. It should be easily accessible for routine maintenance to
achieve achieving maximum productivity with minimum wasted effort Airborne transmission occurs when either airborne droplet nuclei
or expense. Hospitals are working 24 hours a day which means HVAC or dust particles disseminate infectious agents. Droplet happens
systems are constantly consuming energy. Therefore, energy efficient through nuclei or dust. Nuclei smaller droplets of bacteria or viruses
system are especially important in such facilities [6-10]. caused by the high velocity with which coughing and sneezing. In this
case the control of ventilation and air handling is very needed to prevent
In a hospital environment, large amounts of harmful microorganisms nosocomial airborne transmission of microorganisms (Figure 1).
tend to cluster. The most important rule of hospital design from an
infection control point of view is not to expose the patient to harmful Types of HVAC systems
infections while in the hospital. Hygiene, reliability, safety and energy­ The Four HVAC System Types include:
related are some unique technical demand issues.
Heating and air conditioning split system: The most traditional
Contact transmission is the most crucial and common type of and most used system it has parts both inside and outside the building
infections transmission (nosocomial). It is further subcategorized into and mainly would include (Figure 2):
direct and indirect contact transmissions. Direct­contact transmission
happens by direct contact between two bodies that transfer the micro­ • An air conditioner that cools the refrigerant,
organisms from the infected body to the other. However, Indirect­ • Furnaces and a fan or evaporator coil to convert the refrigerant
contact transmission transfers microorganisms from a person to and circulate the air,
another through instruments.
• Ducts that carry air all through your building,
• A control panel/thermostat to manage the system,
• The occasional optional accessories for quality indoor air such
as air cleaners, purifiers, humidifiers, UV lamps and so on.
Hybrid heat split system: This system is an advanced and more
energy efficient version of the traditional HVAC split system. A Heat
pump addition to this system will allow it to become an electrically
fueled HVAC (Figure 3). An ideal hybrid heat split system that is cost
effective will have:
• A heat pump that heats or cools the refrigerant
• Furnaces plus the evaporator coil for conversion of the refrigerant
Figure 1: Thermal loads tend to be dominated by HVAC system due to the and circulation of air
heavy use (24/7) as it's shown in the chart (source: Commercial Energy Library,
2013). • The ducts to channel the air around your building

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 3 of 10

• Your interface for adjusting and controlling the system

• Optional accessories for more quality indoor air
Duct­Free split heating and air conditioning system: A duct­free
HVAC is easy to install for places that conventional systems with ducts
can’t fit into. These systems also complement the existing ducted types
of HVAC systems. Duct­free systems will have the following;
• The heat pump or an air conditioner to heat\cool the refrigerant
• A fan coil that is compact
• Wires and tubing for the refrigerant, connecting the outdoor
unit to the fan coil
• The thermostat or control panel
• Optional accessories to clean the air and make it more pleasant
before its distribution through the house
Packaged heating and air conditioning system: A packaged HVAC Figure 5: Mechanical ventilation type (source: Studio B Mechanical ventilation).
system is for smaller homes and offices that don't have the space for the
split units (Figure 4). Packaged heating and air conditioning systems
forced, natural and mixed types. A building ventilation system that uses
will sort out confined spaces that range from entire homes to the one­
powered fans or blowers to provide fresh air to rooms when the natural
roomed units, all in one package. Packaged HVAC systems will contain:
forces of air pressure and gravity are not enough to circulate air through
• The air conditioner/heat pump together with the evaporator/fan a building.
coil in one unit
Mechanical ventilation is used to control indoor air quality, excess
• Thermostat/control interface for a complete control of the system humidity, odours, and contaminants can often be controlled via dilution
or replacement with outside air. However, in humid climates specialised
• Optional air quality improvers. Things like the air purifiers, ventilation systems can remove excess moisture from the air (Figure 5).
cleaners, ventilators or UV lamps, which gear towards making
the air extra clean before it circulates your home or office. Ceiling fans are commonly seen as ventilation systems as they are
usually the most visible mechanical system in a building; however
Manufacturing Process ceiling fans do not provide real ventilation, as there is no introduction
of fresh air. Ceiling fans only circulate air within a room for the purpose
Ventilation types
of reducing the perceived temperature by method of evaporation of
Methods for ventilating a building may be divided into mechanical/ perspiration on the skin of the occupants. Also hot air rises therefore;
ceiling fans may be used to keep a room warmer in the winter by
circulating the warm from the ceiling to the floor [11-13].
Types of mechanical ventilation
1. Window AC, Split AC, Packaged AC, Central AC
2. Natural Ventilation
It is the ventilation of a building with outside air without using fans
or other mechanical systems. It is normally openings being positioned
strategically around the space in order to produce a healthy air flow.
The plans, cross sections and pictures below provide insight into
Figure 3: Heating and cooling hybrid system illustration (Source: Ductless
four styles of natural ventilation. The blue ribbons represent fresh airflow
Heating and Cooling Systems).
whilst the red represents the stagnant air. In order to be successful natural
ventilation must take some key factors into consideration (Figure 6).
• Passive Cooling
• Shading of the building
• Geometry of the building
How HVAC is made
High quality HVAC systems are high in demand in not only
healthcare but almost all buildings nowadays. Air conditioning
manufacturing companies play a significant role in making AC units
more affordable by enhancing efficiency, improving components, and
Figure 4: Packaged HVAC System. technology. With demands increasing, competition is rising between

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 4 of 10

different companies to provide the best quality yet most affordable AC

units and systems.
Generally in terms of raw materials, AC is composed of different
types of metals, such as copper, aluminum and Finstock that are
considered to be significant to create an outstanding thermal properties
and a positive effect on system efficiency (Figures 7-10).

Figure 10: All aluminium heat exchanger,that is made by aluminum heat­transfer

tubes with aluminium fins; enables improvement of the heat conductivity
efficiency of the heat exchanger (Source: sumisho metalex, 2015).

Figure 6: Natural ventilation (Source: Autodesk university,2015).

Figure 11: Portable air conditioner(Source: royal sovereing, 2013).

Figure 7: Copper coil tube for air conditioner (Source: sumisho metalex,2015).

Figure 12: Window type AC (source: Energy Land, 2015) [11].

Many components or parts of Air­Conditioning are diverse due to

the application, but usually they are composed of stainless steel and
other ​ corrosion​­resistant metals.
Also, Air conditioners shares basic parts which are:
1. Main parts: Compressor, Condenser, Evaporator, Fan, Expansion
Valve, Refrigerant and Tubes.
Figure 8: Various copper tubes for air conditioner (Source: sumisho metalex,2015).
2. Supporting parts: Tube insulation, Muffler, Filter, Filter dryer
and receiver.
3. Control parts: Thermostat, Contactor, Damper, Humidistat and
hygrometer
The following pictures illustrates the parts of different AC types
• Portable Air Conditioner (Figure 11)
• Window type AC (Figure 12)
• Central AC system (Figures 13 and 14)
• Split/Ductless AC system (Figures 15 and 16)

Figure 9: Coated hydrophilic aluminum foil for ac condenser and heat exchanger HVAC requirements in hospitals
are excellent in workability, hydrophilicity and corrosion­resistance (Source: sumisho
metalex, 2015). Before designing a proper HVAC system there are few problems

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 5 of 10

that needs to be solved. we should consider whether it is planned for the

isolation rooms, surgical suite, the patient rooms, or the administration
offices.
First, the suitable ambient design conditions should be selected.
usually, only the peak cooling design conditions are put into
consideration for sizing the capacity requirements of the system.
In the research of A. Bhatia about the HVAC Design for Healthcare
Facilities he explains that. In the ASHRAE Handbook – Fundamentals
these ambient conditions are called the dry­bulb temperatures with
mean coincident wet­bulb temperatures, representing conditions on
hot, mostly sunny days. Cooling equipment such as chillers or package
equipment for cooling control are sized by these conditions. This might
work good on some climates, however in higher humidity climates
considering only the cooling condition might not be efficient. High
relative humidity and peak absolute moisture loads from the weather is
the result of Extreme dew­point temperature conditions may occur on
days with moderate dry­bulb temperatures.
Some helpful humidity control applications values found in tables

Figure 16: Split Ductless AC system (Source:Gowers house, 2015).

found in the Fundamentals Handbook, such as desiccant cooling

and dehumidification, cooling­based dehumidification, and fresh air
ventilation systems. When analyzing the behavior of cooling systems
at part load conditions these values can also be used as a checklist
Figure 13: Central AC system. especially for systems that are used for humidity control as a byproduct
of temperature control.
Isolation rooms and critical examination rooms
Bhatia points out in his research are For the critical areas such
as isolation rooms, intensive care units and operating rooms, critical
diagnostic and examination rooms, consider only the centralized
HVAC system encompassing “all air systems”. In all air systems, the
outdoor air enters the system via a low ­efficiency or "roughing" filters,
which removes the large particulate matter. It is mixed with the return
air and is made to pass the fine filters, which removes small size particles
and many microorganisms. The air is than conditioned and delivered
to each zone of the building. After the conditioned air is distributed
Figure 14: Central air conditioning units two main components are condenser and
evaporator (source: Homestuffworks, 2015). to the designated space, it is withdrawn through a return duct system
and delivered back to the HVAC unit. A portion of this "return air" is
exhausted to the outside while the remainder is mixed with outdoor air
and filtered for dilution and removal of contaminants” [6].
However in other critical areas HEPA filters that are located under
the cooling/heating coil or at the terminal end of the duct filter the air
again. All air systems can be classified as single­zone, multi­zone, dual­
duct and reheat systems (Figure 17).
Single­zone systems: Single­ zone systems work on special
temperature humidity and pressure requirements for one zone.
This system is very simple and basic. For this type of system to work
efficiently, the load must be equal all through the zone, otherwise there
may be a large temperature differences.
Multi­zone systems: Multi­zone systems are used for a small number
Figure 15: Split/Ductless AC system (Source: Airesrve,2015). of zones with just one central air handling unit. The air handling unit

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 6 of 10

Figure 17: Operating room—sectional view of air distribution system.

for multi­zone systems consists of heating and cooling coils in parallel to is increasing pressure to reduce energy consumption while maintaining
get a hot deck and a cold deck. This system is energy efficient because a safe environment.
hot and cold deck temperatures are automatically changed to meet the
No two hospitals are alike, and while the facilities often contain
maximum zone heating (hot deck) and cooling (cold deck) needs. Zone
the same program, varying size, location, priorities or goals can lead to
thermostats control mixing dampers to give each zone the right supply
completely different HVAC systems. The goal, then, is not to designate
temperature.
a universal HVAC system for all health care facilities, but rather
Dual­duct systems: Dual­ duct systems are similar to multi­ zone to identify the various factors and general processes that need to be
systems, however it does not mix the hot and cold air at the air handling considered when selecting HVAC systems for health care.
unit. Rather the hot and cold air are both brought by ducts to each zone
• Identify project goals
where they are then mixed to meet the needs of the zone. It is usual for
dual­duct systems to use high­pressure air distribution systems with the • Identify program requirements
pressure reduced in the mixing box at each zone.
• Identify constraints.
Reheat systems: Reheat systems supply cool air from a central air
• Identify facility desires and expectations.
handler as required to meet the maximum cooling load in each zone. A
heater is located in each zone’s duct that re-heat the air supply to keep • Thermal and ventilation loads.
the space temperature as needed.
• Identify HVAC systems.
Type of HVAC system
New Systems and Technology for HVAC for Healthcare
Normal patient care rooms administrative and noncritical areas:
Buildings
For the patient rooms and other non­basic regions, any of the listed
HVAC frameworks can be utilized. With the continuous advances in technology, new and improved
systems are being developed. This part of the study will present systems
• All air systems as talked about above.
that can be applied in medical institutions.
• Terminal heating and cooling units, such as fan coil units or
radiant ceiling panels.
Gatorduct ductwork system
Gatorduct is a company that has developed ducts made from a new
• Radiant heating and cooling system.
material, called tri­wall, which is essentially a very strong, reinforced,
The amount of outside air and how it is supplied to the indoor corrugated cardboard. The raw materials are obtained from managed
spaces would depend on the sort of HVAC framework utilized. At the forests, so that two trees replace one that is cut down, preserving the
point when the fan coil units or radiant ceiling panels are utilized, the forest environment. Tri­wall has been used for a while for other heavy­
rooms are conditioned by a central ventilation unit. duty purposes but Gatorduct has combined tri­wall with a special
coating to keep it dry and protected.
HVAC selection for healthcare facilities
It can be flattened and packed for transportation, allowing more of
Identifying a healthcare facility’s specific goals in patient care and it to be transported in one truck than steel ducts. This reduces energy
energy efficiency is critical in choosing the right HVAC system. and cost on transportation, making it environmentally friendly. In
Hospital HVAC system designs present unique challenges to facility addition to this, it is about 80% lighter than traditional ducts [3], and
managers due to the sensitivities of the hospital environment. The easy to install. Gatorducts can also be relatively flat, reducing floor­to­
selection process is not straightforward, because in healthcare facilities floor height.
there is an increased level of demand, a variety of required thermal A school has already implemented these new duct systems with
conditions, and codes regarding reliability and hygiene. On top of that an exposed ceiling style. They have altered the colour of the material

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 7 of 10

to their aesthetical preferences. The image below shows the gatorduct controlled using an electronic card. This system reduces cost by 30%
system in place (brown ducts). due to its design of the heat exchange circuit. It also reduces the carbon
dioxide emissions by more than 30%. This is done by the use of specific
High performance HVAC system type of refrigerant that is harmless to the environment, known as
Generally, the heating, ventilating and air conditioning accounts R410A. This refrigerant is a thermodynamic fluid which allows the
for a large portion of energy consumption within a building. With the great reduction in the carbon dioxide emissions.
introduction of the high performance HVAC unit we will be able to save Finally, the third unit known as Mitsubishi Electric Heat Pump
between 10% to 40% of cost and energy emissions according to Graham System is a highly intelligent HVAC unit. It is equipped with the
[8]. “Extended comfort includes employing concepts such as providing technology of zoning capabilities. With this system, it can recognize
warmer, but drier air using desiccant dehumidification in summer, different needs, occupancy, usage and parameters of solar gain. It also
or cooler air with warmer windows and warmer walls in winter. In has the ability of measuring temperature at any location within the
addition, high­performance HVAC can provide increased user thermal room which allows for a more controlled air flow. Through this system
comfort, and contribute to improved indoor environmental quality energy efficiency is achieved and the cost of air conditioning the room
(IEQ).” is heavily reduced.
The difference between a traditional hvac unit and a high
performance one would be in the addition of a new discipline to the Green HVAC systems
overall name and meaning which is known as, Control. This refers to In this modern time, there is an obvious and strong focus on
the ability of providing user comfort, energy saving and consumption providing sustainable solutions. There are several HVAC systems that
by the implementation of operating the HVAC unit (Figure 18). can be implemented in a green and sustainable way. This part of the
There are specific design fundamentals to be considered in order study will present systems that are sustainable.
to achieve high performance hvac. According to the Whole Building Displacement ventilation systems
Design Guide (2014) they are as follows:
Displacement Ventilation (DV) Systems are more energy­friendly
• Decide on the goals of the design as early as possible alternatives to the traditional HVAC systems. They offer alternative
• Select the correct size of the hvac unit for efficiency methods to distributing air around a room. Outdoor air is cooled and
pumped in at floor level at a low velocity. The cool air then warms and
• Take into consideration the several aspects of the building that rises, creating convection currents within the room. It offers several
could affect it. advantages:
• Take into account future expansion • Lower energy costs are achieved in general, although multiple
• Think of part load performance factors affect this such as thermal mass, building usage etc.
However, because air is pumped in at a lower velocity, there is
• Have a maintenance and operation program lower pressure drop and smaller fans so less energy is required.
• Have the hvac system commissioned. Ventilation air change per hour (VCH) is also reduced.
• With the rising warm air, contaminants are also carried with
Alternative HVAC solutions Inc units
it from heat sources, providing cleaner air. Because fresh air is
The company, Alternative HVAC Solutions Inc provides several supplied at floor level, contaminants like carbon dioxide, odour
different types of units that are sustainable, green and energy efficient. and such are limited from permeating throughout the space.
The first one being Messana. This is a suitable system for a healthcare
• Less ductwork is needed, which can help minimize floor ­to­
building as it is highly efficient, quiet and is easily attached to the ceiling.
floor height as well as cost.
It can be easily repaired and can be used for renovations. It eliminates
dust particles and provides a more clean atmosphere. This unit has the There are some disadvantages to this system too:
R value of 9.65 and is extremely light weight.
• Rooms must “be higher than 9 ft for the displacement effect to
The second unit is the Aermec unit system. This is a reversible take place” [4] and for DV systems to be effective. The taller the
heat pump that produces hot water in an efficient way. It can be easily room, the better the circulation.
• Indoor temperatures tend to be warmer than if a traditional
HVAC system is used. There is also a noticeable temperature
difference sometimes, where below a certain height, the
environment is cool and above that height it is warm.
Increasing rate of air flow may help in these situations but this
can also result in draughts. If colder temperatures are desired,
these systems can be paired with radiant chilled ceilings, which
also help balance out temperature differences. In temperate
climates, DV systems are most effective.
• DV systems cannot be applied as vastly as a traditional system
at the moment. Their diffusers are more expensive and supply
air ducting is more complicated.
Figure 18: Lampton school. Displacement ventilation systems are great for public spaces in

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 8 of 10

hospitals such as lobbies and cafeterias. They can be used in other places This system is especially suitable for healthcare buildings because
too such as wards and patient rooms, but if cooler temperatures are it has optimum humidity control, which as a result “nearly eradicates
needed, they must be paired with another cooling method or system. microbial problems and related sick­building issues” [2]. With the aid of
However, overall, they still reduce energy consumption and as a result radiant cooling ceiling panels, DOAS eliminates transfer of biological
energy costs, which is doubly advantageous. Not only are they green and chemical substances between different parts of a building,
technology but they offer the benefit of cleaner air, which is especially removing them from each individual space. Thereby, spread of any
essential in healthcare buildings. harmful substance or contaminant is prevented.
Desiccant­Enhanced evaporative air­conditioning systems Sustainable methods
Desiccant­enhanced evaporative air­ conditioning systems, also While the demand for energy­efficient systems rises and HVAC
known as DEVap Systems are currently being developed by the National companies strive to meet demands and requirements, they cannot
Renewable Energy Laboratory (NREL) and are very promising for provide energy efficient systems to their absolute potential alone.
the energy industry. Business Insider states that DEVap systems are Architectural and social techniques are required to aid systems to
capable of reducing energy costs by 40­80%. This efficiency is due to provide the best­quality, most sustainable environment possible. Some of
the relationship between the desiccant and evaporative cooler. The these techniques are discussed below, pertaining to different situations.
former dries humid air while the latter cools it simultaneously, unlike
traditional systems that perform this process slower and step by step, General
using a dehumidifier first. Smart, interactive systems are becoming increasingly popular today
This system was initially constructed for commercial buildings for many building systems, including HVAC. HVAC can maintain
(although it is starting to make an appearance in residential buildings temperature by switching on and off when needed, be remotely
with smaller­scale systems), making it appropriate for use in both small controlled, learn and operate according to user habits, and even make
scale healthcare facilities to larger hospitals (Figure 19). suggestions on improving energy efficiency. Each of these options
can be made use of in healthcare buildings. For example, maintaining
Other benefits, according to Tucker, include: temperature by switching on and off can be used in patient rooms,
• Removal of refrigerants that are more harmful to the while learning user habits can be implemented in offices.
atmosphere than CO2 Rainy, humid regions
• Temperature and humidity control are of higher standards For very rainy areas, providing some kind of rain screen or shield
because DEVap systems treat each of these separately on the facades of buildings can aid in moisture control, which will
• Indoor air quality is better and spaces do not feel stuffy reduce loads on HVAC systems to dehumidify air, thus saving energy.
An example of this can be seen in the case study that is explored in this
Dedicated outside air systems paper: Kiowa County Memorial Hospital.
Dedicated Outside Air Systems (DOAS) is a new HVAC technology Windy regions
making waves in the industry, replacing the old system of Variable Air
Volume (VAV), which was the most energy­efficient system of its time. If possible, the creation of wind farms near large, highly energy­
Today, DOAS offers more potential in multiple aspects. consuming buildings provides a source of renewable energy that can
be harnessed to power HVAC systems, as well as other electrical needs.
It works by wholly using outside air in interior spaces through a
“constant­volume outside air unit” [2], recovering 100% of energy used Sunny regions
with an enthalpy wheel that cools and dehumidifies outdoor air in hot
If feasible, the use of solar panels on rooftops, facades and, recently,
environments. eases the outside air load on the cooling coil by up to
even as glass curtain wall panels can produce electricity to power HVAC
80% and also substantially lessens the required size of the building
systems, as well as serving other electrical needs.
refrigeration plant, often by over 40%”.
Case Study: Kiowa County Memorial Hospital
On May 4, 2007, a massive tornado destroyed or severely damaged
95% of Greensburg, Kansas. The Kiowa County Hospital got destroyed
in the tornado and rebuilt sustainable. the design team of the hospital
transformed one of the most energy consuming building type and
turned it into an energy efficient hospital but still following the
functional and safety requirements.
The hospital which is 50,000 square­foot has 15 acute­care beds,
rural health and specialty clinics, and emergency department with
two trauma rooms, physical/occupational therapy and radiology
departments, a laboratory, and other support areas (Figure 20).
The new hospital in Greensburg is expected to perform with more than
40% energy savings more than a standard code due to features such as an
on­site wind turbine it is 100% renewable energy, 100% of the time.
Figure 19: Illustration of how displacement ventilation works (source: MEBS6008
Environmental Services II, 2005). The Kiowa County Memorial Hospital was completed in March

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 9 of 10

farm helping to provide power, the hospital was able to eliminate the
need for an expensive boiler backup system, as well as the gas service,
piping, and equipment flues associated with natural gas fired heating
equipment. These savings offset the cost of the heat recovery system and
high­efficiency equipment and make the hospital an electricity­only site.

Conclusion and Recommendations

HVAC systems are crucial mechanical systems in buildings,
especially in a healthcare building for the following reasons:
• Healthcare buildings are first and foremost places of healing and
the people within require a thermally comfortable environment
to recover and function well.
• Typically, healthcare buildings have many different functions
that may require different thermal environments and types of
ventilation.
• Proper ventilation is very important because healthcare
Figure 20: Annual energy cost saving diagram (source: US department of buildings contain people that may have contagious diseases
energy, 2010). and labs that deal with biological and chemical substances that
could possibly be harmful if spread. This is why ventilation
20120 to become the U.S. Green Building Council’s Leadership in systems for healthcare buildings are designed specifically to
Energy and Environmental Design (LEED®) Platinum designation. monitor the air and control substances from spreading.
In order to reach their LEED Platinum certification goal, the hospital The above needs must be met but as many of these buildings are
design team had to put in mide and add some energy conservation large and require HVAC systems to run around the clock, efficiency is
and efficiency measures, which include lighting; insulation; heating, also necessary. With today’s need for a more environmentally conscious
ventilation, and air conditioning (HVAC); and renewable power approach to living and functioning, we are constantly striving to make
sources. our mechanical systems more environmentally friendly as well as
economically and physically sustainable, which is why it is imperative
Air Quality and Indoor Environment to do the following:
With the majority of patients, visitors, and staff inside the hospital, • Architectural design is key in order to aid HVAC systems; good
an environment that is safe, sanitary, and comfortable is imperative. To design and technologies such as responsive screening on facades
create this environment, the hospital utilizes a ventilation system that will lessen the load on air­conditioning, thus saving energy and
prevents air exchange between emergency and isolation areas and the money. Design must be responsive to local environmental
rest of hospital, and demand­control ventilation to ensure continuous conditions.
fresh air and appropriate carbon dioxide levels. Since Kansas weather
can become very humid, a rain screen system on the hospital’s exterior • Healthcare buildings should make efforts to incorporate new
provides moisture control. The hospital uses a filmless x­ray, which and green technologies in their systems. Purchasing from green
eliminates the need for dangerous chemicals, and seamless countertops factories that hav sustainable practices also aids in the going
and floors to help reduce infection rates.” green effort.

HVAC • Setting up ways to harness renewable energy for new or existing

healthcare buildings will allow the building to become more
1. Ultra high­efficiency magnetic bearing chiller with secondary energy­friendly and economically friendly in the long run.
unit reclaims waste heat for reheat and domestic water heating.
Because each health­care building will be slightly different and thus
2. Ventilation air is pre­conditioned via energy recovery wheels, have slightly different requirements, it is necessary to run an individual
reducing the load on heating and cooling systems. assessment for each building to understand the best HVAC options
3. Variable air volume system provides air distribution and to use as well as what problems can be treated with design and what
dynamically adjusts airflow to meet loads while maintaining opportunities can be utilized. This can be seen in our discussion of the
pressurization. case study of Kiowa County Hospital. The hospital was located in a
place that experienced a lot of wind and thus used this opportunity to
Results harness wind energy as a renewable source of energy for the hospital’s
HVAC system. To lessen the load on the HVAC system, a rain screen
According to energy analysis modeling results, the new hospital
was also used on the facade to control the amount of moisture coming
is 32% more energy efficient than an ASHRAE­compliant building of
into the building.
the same size and shape. Applying the savings from the 50 kW wind
generator, the hospital achieves an additional 8% in annual electrical In conclusion, healthcare buildings need to be individually analyzed
savings for a total savings of approximately 40%. as their functions can vary from one to the other and their locations are
always different. With so many HVAC options for different requirements
Due to the high­efficiency HVAC and heat recovery system, the
and environmental conditions, being developed and emerging in the
efficient building envelope, and the City of Greensburg’s 12.5 MW wind
market, any healthcare building can improve its HVAC efficiency,

J Archit Eng Tech

ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160
Citation: Abdul FSM, Mofarhi S, Abdulwahab Y, Ali Z, El­Borombali H, et al. (2016) The Study of Sustainable Green HVAC Systems in Health Care
Facilities. J Archit Eng Tech 5: 160. doi:10.4172/2168-9717.1000160

Page 10 of 10

become more energy friendly and lower costs by understanding what 6. Tucker E (2015) Air conditioner ready to change industry. National Renewable
Energy Laboratory.
suits their needs best. In the long­run, new and green technologies will
be both environmentally and economically sustainable. 7. HVAC Design for Health care Facilities. Editor Bhatia A, Continuing Education
and Development, Inc.
References
8. What Are the Different Types of HVAC Systems? (2015, September 14).
1. Alternative HVAC Solutions Inc. (n.d.). Green HVAC Solutions.
9. Graham CIPE (2014) High Performance HVAC. Viridian Energy &
2. Arabe KC (2003) New HVAC technology to transform the industry. Industry Environmental, LLC.
News.
10. Health Facilities Management, Modular services company.
3. Gatorduct (2015) Gatorduct.
11. HVAC systems for hospitals. Applied System Solutions.
4. HVAC Web Connection (nd) Top 3 trends for the HVAC industry in 2015.
12. Making Life more comfortable. Importance of a Hospital HVAC system.
5. Schultz RW (2012) When, where to use displacement ventilation. Consulting­
Specifying Engineer. 13. Air conditioner. Industrial Vaccum pump 3.

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ISSN: 2168-9717 JAET, an open access journal Volume 5 • Issue 1 • 1000160