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308 CHAPTER 27 1962 Guide And Data Book Maintenance The accessibility, good illumination, and the ease of main tenance of air-conditioning equipment ts vital. The larger the building, tiie more complex is the total aggregate 0f equip-: ment and controls, and the more there is a need for compre hensive and vigilant overseeing of the installation. The wn^lW the building ia, the mote automatic and should the system be. Misoperatioa of a good air conditioning system, if bad enough, can turn it into a destructive agent. Hence a plan of operation should be carefully worked Out and the actual per formance monitored with recording instruments. Every large museum should have several temperature-humidity recorders located at strategic points. In all cases a good operating and maintenance guide should be a part of the installation. Certain members of the museum's staff should be familiar with the operation of the system. However excellent is the air conditioning installation and its operation, it is not the final solution. The operating staff of the libraries and museums must exercise continuously watch ful guardianship and practice all the other measures known to the conservation and preservation art to protect .the quality and life of a book, painting, natural history mn^nm or other exlubit. REFERENCES 1 L- L. Lewis: Air conditioning for museums (Museum, VoL X. No. 2^1957).-(UNESCO quarterly publication in Rngi;> and * A. A. Kimberley and A. L. Emley: A Study of Deterioration of Book Papert in bOmnes {National Bureau of Standards Misedlaneous Publication No. 140, April 1933). * A. A. Kimberley and A. L. Emley: A Study of the Removal of Sulphur Dioxide from Library Air (National Bureau of Stand ards Miscellaneous Publication No. 142. October 1933). 4 Air conditioning of libraries essential to preservation of books `"^records (Heating, Piping and Air Conditioning, July 1934, BIBLIOGRAPHY. A. Bures: Anligues, Their Restoration and Preservation (Edward Arnold A Co., London, 1924). D. R Brewster: Air conditioning as applied to furniture fixture^ and other interior woodwork (ASHVE Joubnai. Se<> Neofmff, Piping and Air Conditioning, January 1931, p. 65). H. B. Meller: Air pollution from the engineer's standpoint (ASHVE Joubnai. 8ectio.v, Heating, Piping and Air Conditio tng, January 1931, p. 70). w,71' A E. Kimberley and J F. G. Hicks, Jr.: A Survey of Stora* Conditions in Libraries Relative to the Preservation of Rer^S*. lK^^OctobeMO^I) ^anc^an^s Miscellaneous PublicaiionliQ 8. R. Lewis: Heating and humidifying art museums (Heali Piping and Air Conditioning, November 1931). M. McCabe: Air humidification and ventilation in museum. (Afonseion, Vol. 15, No. 3, 1931). UQJ3 . Cotyado Ricci: Effect of atmospheric agents on the conserv. tion of art objects (Afonseion, VoL 15, No. 3, 1931). ^ 15^N^3N<^-^Conservation of precious metals (Afonseion, Vol H-King: Air conditioning South Hull, Columbia UuiTC,,*. (The LibraryJournal, April 1935). * J. McIntyre: Air conditioning of museums (Refhigbratt**. ENGiNsewNo, August 1935, p. 85). F. J. Cumming: Air conditioning modernizes library; promote, efficiency; protects books (Heating, Piping and Air Condition^ December 1935). J. F. McCabe: Museum mechanics, air conditioning solve* museum s major problems (The Aerologist, April 1936). . A. E. Kimberley and B. W. Scribner: Summary Report of No- Bureau cf Standards Research of Preservation of Records t^taonanJureau of Standards, Miscellaneous Publications MI54, B. W. Scribner: Air treatment for preservation of records in libraries (ItEFEraEBATiNa Engineeeing, April 1937, p. 233). A. S. Crocker and R. E. Cheme: Air conditioning and me chanical equipment for a modem library building (Rep-bigehatLNG Encineesuno, July 1938, p. 13). Advantages of air conditioning (Heating, Piping and Air Conditioning, November 1939). New Gallery of Art in Washington has 21 zone air conditioning systems (Heating and Ventilating, April 1941). G. K. Sauerwein: Air conditioning for. protection (Heatina Piping and Air Conditioning, May 1941). J- F. Kooistra: Highlights of air conditioning for museums (The Museum Aetna, May 1941). H. L. Alt: Air conditioning for books and people (Architectural Record, November 1946). Air conditioning to kill bookworms, Howard Tilton Memorial Ulguy of Tulane University (Domestic Engineering, August, Preserving books by air conditioning (Heating, Piping and Air Conditioning, August 1943. Contains alist of 37 references). Air conditioning as a means of preserving books and records (Amavan Archivist, July 1949. Also has a Ust of 47 references). , - How 40 ventilate art galleries (Healing, Piping and ` Air Conditioning, May 1951). What causes book pages to crinkle? (Heating, Piping and Air Condtltanvng, July 1955). Ian Grad and Alfred Greenburg: Air conditioning for books and people (Architectural Record, June 1957). CHAPTER 28 HOSPITAL AIR CONDITIONING fnfedion Problem! Air Quality; Air Cleaning} Zoning; Air-Conditioning Systems} Design Criteria: Administration Deportment, Diagnostic and Treatment facilities, Nursery, Nursing, Surgical, Obstetrical, Emergency, and Service Departments HE rapid advances in medical knowledge have resulted able limits and as the sulfonamides and antibiotics became Tin the need for providing more complex hospital facilities available the problem appeared to be solved. Not long after to implement the application of this knowledge. Outstanding these drugs came into common use, however, an alarming in gfn^ng the many innovations in hospital design over the past crease in the number of infections was noted in many hos decade is the wide application of air conditioning. Although pitals In this country and abroad. Investigations revealed that ail of this increased use cannot be attributed solely to medical among the many organisms responsible for infections in the purposes, there is medical evidence that it is beneficial in the hospital, the previously relatively innocuous staphylococcus treatment of many conditions (see Chapter 9 of the 1961 organisms bad developed a resistance to the antimicrobial ` Guide And Data Book). drugs. Prior to this time, these drugs had been effective both The application of air conditioning to hospitals presents as preventstives and cures for the diseases caused by the many problems not encountered in the usual comfort con organisms. Because of this immunity, these organisms are ditioning system. The basic differences result from: (1) the probably responsible for more infections contracted in the restriction on air movement, ventilation, and filtering to hospital and for more complications of existing infections control odors and to maintain aseptic conditions, tempera than any other organisms with which the hospital must tures, and humidities required for certain areas and (2) the presently contend. Although they are relatively harmless to seed for a design that will facilitate accurate balancing of the the person in good health, these organisms do tend to manifest system. themselves among the well in the form of pimples, boils, and Many of these basic differences have been accentuated by carbuncles which are difficult to cure. An increase in incidence the relatively new and acute problem of staphylococcal in of such minor infections has been reported among hospital fections common to most hospitals today. To provide the personnel.1 The organisms are a serious hazard to debilitated engineer with a better understanding of these differences, the persons, to those having upper respiratory infections, to the infection problem will be discussed first and followed by newborn and their mothers, and to patients during surgery.1 other factors involved in the desigu of air-conditioning sys The organisms create problems because they can be carried tems. by a person on the hair, skin, clothing, and in the nose and THE INFECTION PROBLEM may be dispersed to the environment during normal activi ties. The shedding of these bacteria to the air of the environ . Particular emphasis is placed upon the staphylococcus or ganisms because they represent a serious recent development in hospitals and because air handling systems designed to as ment may account for the relatively high percentage of hos pital personnel who become nasal earners of these organisms. These organisms are approximately I micron in size and may sist in preventing their spread and in removing them from * the environment will also be effective against other airborne organisms such as those causing tuberculosis and gas gangrene. The modern hospital is unique among building types in many respects, but in no way is it more unique than in its design requirements as they affect the maintenance of an aseptic environment. Among the design features that concern the engineer, and are receiving considerable' attention from investigators in the medical and hospital fields, are those exist as single cells or in fairly large microscopic clumps, and like other organisms, can be airborne,' usually attached to dust or other particulates and thus carried by air currents from one hospital area to another as well as from oue patient to another.* They have been identified bacteriologically as the cause of many infections, a number of which have been fatal.1 Owing to the ubiquitousness of the organisms, it is impossible, in most instances, to state with authority the exact or direct means by which they come in contact with the relating to airborne bacterial contamination and its effects on patient.* the incidence of infection. Current research of airborne con The current problem of these recent infections was first tamination stresses the importance of bacteriological quality identified with surgeries and nurseries but now involves most of the air, air cleaning, air movement, and zoning of the sys- all hospital areas. Due to the acuteness of this problem, the tems by departments. American Hospital Association in 1958 recommended to the Infection has always been a primary concern to hospitals. Surgeon General of the Public Health Service that the na To minimize its incidence, stringent techniques must be tional professional groups interested in the control of infec dhered to in all operations ranging from those involving tion look into this problem. In September 1958, a conference ngical procedures to those of housekeeping. These prac sponsored by the Public Health Service and the American ks were sufficient to keep the infection rate within reason Academy of Sciences was held and has been followed up by 309