「英中对照」医院设施如何为野火烟雾空气质量事件做好准备

Wildfire smoke puts pressure on mechanical systems already working hard to maintain controlled indoor environments.野火烟雾给本已全力运转以维持受控室内环境的机械系统带来了压力。

Over the past several summers, wildfire smoke events have become more frequent, more geographically widespread and more likely to overlap with other environmental stressors, including extreme heat. 过去几个夏天，野火烟雾事件变得更加频繁、地理分布更广，并且更有可能与包括极端高温在内的其他环境压力因素叠加出现。 

For example, in mid-July of this year, the New York City Air Quality Index peaked at 289 — very unhealthy — in its worst smoke event since June 2023. The smoke stemmed from wildfires burning in Ontario, Canada, and it blanketed the city in the middle of an active heat emergency. For the first time, New York was forced to run its heat plan and its air quality response at full strength simultaneously. 例如，今年7月中旬，纽约市空气质量指数峰值达到289——属于非常不健康级别——这是该市自2023年6月以来最严重的烟雾事件。烟雾源自加拿大安大略省燃烧的野火，并在高温紧急状态持续期间笼罩了整座城市。纽约市首次被迫同时全力运行其高温应急预案和空气质量响应措施。 

In early August, emergency room visits in Oregon surpassed seasonal norms due to wildfire smoke, with adults 18-44 making up the largest share of patients. For hospitals, these demographics suggest that more recurrent smoke events also might impact patient volume in unexpected ways: People with chronic conditions already might be accustomed to taking precautions, while younger, otherwise healthy adults might not yet factor smoke exposure into their routines. 8月初，俄勒冈州因野火烟雾导致的急诊就诊人数超过了季节正常水平，其中18至44岁的成年人占患者的最大比例。对医院而言，这些人群特征表明，更频繁发生的烟雾事件还可能以意想不到的方式影响患者数量：慢性病患者可能已经习惯了采取防护措施，而年轻且原本健康的成年人可能尚未将烟雾暴露纳入日常考量。 

For healthcare facilities managers and their staffs, this convergence of conditions and factors puts mounting pressure on mechanical systems already working hard to maintain controlled indoor environments that doctors and patients depend on. 对于医疗设施管理人员及其团队来说，这些条件和因素的叠加，给本已全力运转以维持医生和患者所依赖的受控室内环境的机械系统带来了越来越大的压力。 

Standards supporting patient care 支撑患者诊疗的标准 

Much of the infrastructure for managing indoor air quality (IAQ) in healthcare facilities is already built into the code. Healthcare HVAC systems are governed by FGI guidelines and ASHRAE standards that set a high baseline for IAQ, with filtration requirements that scale with the clinical environment. 医疗设施中用于管理室内空气质量（IAQ）的大部分基础设施已经写入规范之中。医疗暖通空调系统受FGI指南和ASHRAE标准的约束，这些标准为IAQ设定了较高的基线，其过滤要求随临床环境的不同而相应提高。 

For spaces serving respiratory or cardiac patients, those requirements go even higher and for isolation rooms higher still. Filtration rates, air change needs and pressure relationships are well established and rigorously maintained. 对于服务呼吸系统疾病或心脏病患者的空间，这些要求还要更高，隔离病房的要求则更为严格。过滤等级、换气次数需求和压差关系都有明确规定，并得到严格执行和维护。 

Healthcare facilities also must have built-in redundancies, such as backup equipment, to ensure these systems do not fail when stretched beyond normal operating conditions.  医疗设施还必须具备内置冗余，例如备用设备，以确保这些系统在超出正常运行条件时不会失效。 

But during a smoke event, that infrastructure comes under unique strain. Filtration is the most immediate failure point because filters rated for normal particulate loads clog significantly faster when outdoor air carries concentrated fine particulate matter from wildfire smoke. A filter expected to last one month might need replacement within a week, depending on the amount of time the conditions linger. Clogged filters restrict airflow, which affects the system performance that healthcare facilities depend on to maintain infection control sequences and life safety. 但在烟雾事件期间，这套基础设施会承受独特的压力。过滤是最直接的故障点，因为按正常颗粒物负荷选型的过滤器，在室外空气携带野火烟雾产生的高浓度细颗粒物时会明显更快地堵塞。一个预计可使用一个月的过滤器可能需要在一周内更换，具体取决于这种状况持续的时间。堵塞的过滤器会限制气流，从而影响医疗设施赖以维持感染控制流程和生命安全保障的系统性能。 

The difficulty in this scenario is that upgrading filtration is not as straightforward as installing a higher-rated filter. Higher-efficiency filters create more resistance. If the existing air handling equipment was not sized to accommodate that additional friction, the pressure relationships that rely on certain directional airflow — such as the difference between a positive-pressure clean environment and a negative-pressure containment zone — can be disrupted to the detriment of patient care. 在这种情况下，难点在于升级过滤并不像安装一个更高等级的过滤器那么简单。高效率过滤器会产生更大的阻力。如果现有的空气处理设备在选型时没有考虑容纳这种额外的摩擦阻力，那么依赖特定定向气流的压差关系——例如正压洁净环境与负压隔离区域之间的差异——可能会被破坏，从而损害患者诊疗。 

HFT Recommends: IAQ and Infection Mitigation: Plans Into ActionsHFT推荐：IAQ与感染防控：从规划到行动

ASHRAE Guideline 44-2024, Protecting Building Occupants from Smoke During Wildfire and Prescribed Burn Events, addresses building preparedness, filtration, ventilation and air cleaning strategies across the full lifecycle of a smoke event. ASHRAE 指南 44-2024《在野火和计划性烧除事件期间保护建筑内人员免受烟雾侵害》涵盖了烟雾事件全生命周期中的建筑准备、过滤、通风和空气净化策略。 

That guidance, combined with the forthcoming 2026 FGI Facility Code, which separates enforceable minimum requirements from best practices for the first time, creates a timely opportunity for healthcare designers and facility managers to revisit the way early design decisions shape a facility's ability to respond when conditions exceed baseline assumptions. 该指南与即将发布的2026 年 FGI 设施规范相结合——后者首次将强制性最低要求与最佳实践区分开来——为医疗设计人员和设施管理者创造了一个及时的机会，重新审视早期设计决策如何塑造设施在条件超出基准假设时的应对能力。 

The impact of design decisions 设计决策的影响 

The most effective strategies for managing wildfire smoke in healthcare facilities often are determined during the schematic design phase, where decisions about mechanical infrastructure, building envelope and spatial planning set the ceiling for the way a facility can respond. These decisions also tend to be the least visible in practice. 管理医疗设施中野火烟雾的最有效策略，往往在方案设计阶段就已确定：关于机械基础设施、建筑围护结构和空间规划的决策，为设施的应对能力设定了上限。这些决策在实践中也往往是最不引人注意的。 

A zoning strategy that allows different sections of the hospital to be managed independently gives operators more precise tools during an event than one building-wide response can provide –– such as the ability to adjust outdoor air ratios or activate supplemental filtration in high-acuity zones without disrupting the rest of the facility. That level of granularity requires intentional planning because it also needs to account for the way clinical staff move through the building, not just how air moves. 一种允许医院不同区域独立管理的分区策略，在事件发生期间能为运营人员提供比整栋楼统一响应更精确的手段——例如能够在高重症监护区调整新风比或启动补充过滤，而不影响设施的其他部分。这种精细程度需要有意识的规划，因为它还需要考虑医护人员在建筑内的通行方式，而不仅仅是空气的流动方式。 

The building envelope deserves equal attention because smoke enters through the same pathways as any other infiltration: loading dock configurations, entrance vestibule design, gaps around piping and ductwork penetrations and any area where the envelope is not fully sealed. 建筑围护结构同样值得重视，因为烟雾进入的通道与任何其他渗漏途径相同：装卸区的构造、入口门斗的设计、管道和风管贯穿处周围的缝隙，以及围护结构未完全密封的任何区域。 

The location and design of outdoor air intakes also plays a role. Intake placement relative to grade, prevailing wind exposure and proximity to vehicle traffic or loading areas all affect the amount of particulate that reaches the system before filtration even begins. Addressing these architectural decisions during design helps prevent them from ultimately becoming vulnerabilities during a smoke event. 新风取风口的位置和设计也起着作用。取风口相对于地面的高度、盛行风的暴露情况以及与车辆交通或装卸区的距离，都会影响在过滤开始之前进入系统的颗粒物数量。在设计阶段解决这些建筑层面的决策，有助于防止它们最终在烟雾事件中成为薄弱环节。 

At the equipment level, specifying air handling units with enough fan capacity to accommodate higher-rated filters gives facilities teams room to respond without sacrificing air change rates or pressure relationships. Designing ductwork with accessible filter housings that allow rapid changeover makes this process easier operationally. 在设备层面，选用风机容量足以容纳更高等级过滤器的空气处理机组，可以让设施团队在不牺牲换气次数或压力关系的情况下保有应对余地。设计带有便于快速更换的可检修过滤器箱体的风管系统，可以使这一过程在操作上更为简便。 

Particularly for older hospitals, where the opportunities for capacity interventions might be more constrained, integrating IAQ monitoring into the building's automation system can help inform response priorities before conditions become noticeable to patients or clinicians, and it can create a data trail that supports clinical decision-making and long-term capital planning. 特别是对于老旧医院，其进行容量改造的机会可能更为有限，将室内空气质量（IAQ）监测集成到楼宇自动化系统中，有助于在患者或医护人员察觉到状况之前确定响应优先级，并且还能形成支持临床决策和长期资本规划的数据记录。 

Wildfire smoke ultimately does not demand a fundamentally new approach to healthcare facility design. The filtration, ventilation and pressure management principles that govern these buildings are sound, and the standards that codify them are rigorous. 归根结底，野火烟雾并不要求医疗设施设计采用全新的方法。支配这些建筑的过滤、通风和压力管理原则是可靠的，将其编纂成文的标准也是严格的。 

But what healthcare facility managers are learning is that as these events occur more frequently, those systems will be tested under conditions they were not designed to anticipate originally. The consequences of being caught without a plan fall on patients, staff and the clinical operations that depend on those environments. 但医疗设施管理者正在认识到，随着这类事件发生得越来越频繁，这些系统将在其最初设计时未曾预料的条件下经受考验。毫无预案地遭遇此类事件，其后果将由患者、员工以及依赖这些环境的临床运营来承担。 

The facility managers who manage these events most effectively are the ones that treat them as an operational likelihood during design and planning rather than a rare emergency. 最能有效应对这类事件的设施管理者，是那些在设计规划阶段就将其视为大概率运营事件、而非罕见紧急情况来对待的人。 

Al Thompson is managing executive at TPG Architecture, an interior design firm. Jerry Stramowski is senior associate with the firm.Al Thompson 是室内设计公司 TPG Architecture 的执行主管。Jerry Stramowski 是该事务所的高级合伙人。