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Hospital and health care providers face substantial challenges in engineering innovative ways to regulate water consumption while not impacting on the functionality of their systems or increasing health and safety risks.
But innovative architects, plumbers and building managers can find effective ways to stem industries’ appetite for water - and energy to heat it - without compromising their shared need to ensure safety, clean hands and the prevention of cross-contamination.
“We know there is no single simple answer to the issue of water conservation and the inter-related issue of hot water energy consumption. You can’t just cut flow rates across the board to industry or say one technology fits all - it is much more complex than that,” says Enware Australia Managing Director Paul Degnan.
“You really have to approach it on a case-by-case basis, but many of the tools are already there. Big advances in water and energy conservation are already possible by selective and site-appropriate uses of existing good technologies, such as thermostatic mixing valves, electronic water monitoring systems, electronic and mechanical automatic water regulation, flow control technology and hands-free tapware that both reduces water use and helps prevents cross contamination from the hands.”
Enware is particularly active in the hospital and healthcare markets, which are among the biggest water users in Australia. While it champions initiatives such as the WELs water conservation measures, it sees major challenges presented by some suggested water use constraints that may be either impractical or not feasible.
Some sectors of the building industry, heavily influenced by Green Building targets, have expressed the need for hospitality and healthcare facilities to further curtail their water usage and became even more water efficient. What has been intimated is that they would prefer new projects and buildings to be installed with fixtures and outlets that help conserve greater amounts of water than what may be practical or clinically proven as acceptable, especially when the consideration of cross infection control is factored in. In several instances these fixtures have been provided targets around 4L/min in an effort to simply reduce water consumption, says Enware’s Innovation & Marketing General Manager Tim Fisher.
Such blanket targets may be at odds with good sanitation practices, which are one major cause of higher water consumption. Research published by health authorities, for example, shows that with patients and staff susceptible to infection and disease, hand washing has been proven as the most important and basic sanitisation technique to prevent the spread of infection.
“The problem with different hand washing methods and needs is that they do not take into consideration the amount of water required for this vital function and, as a result, the process may be seen by the uninitiated as unnecessary or simply wasteful.
The result can be – as has been recently mooted – to simply mandate minimum flow rates at hand washing fixtures in an effort to be seen to be water efficient without due consideration of such an action.
(For example, some critical surgical hand washing procedures take up to five minutes to complete, and with the standard flow rate from water outlets in health care facilities being around 9L/min, this equates to approximately 45L being used in a single wash. Is this excessive given the risk?)
“What we’re seeing are well intentioned attempts to enforce targets upon health care and hospital facilities in an effort to conserve water. However, a significant flow rate reduction should not be attempted without due consideration to the possible negative impact on cross-infection control is factored in.
“While lowering water usage is desirable, controlling infection takes precedence for hospitals as otherwise they could potentially be facing a situation where infection rates spiral out of control!”
Challenges can also arise where, in addition to saving water, consideration must also be given to the desired type of flow stream demanded by the particular facility. It is generally considered that laminar flow outlets should be used instead of aerated outlets for clinical hand washing, for example, because laminar flow does not draw ambient room air into the water stream, avoiding any possible introduction of airborne bacteria. But laminar flow technologies - and aerated ones, for that matter - have limitations as to the minimum flow rate at which they perform, which, with Neoperl PCAs flow regulators, is 5 l/min.
“Any prescriptive application of significantly lower flow rates would result in laminar flow outlet technology – the industry standard for these clinical applications – becoming unavailable,” says Mr Fisher.
“Further we must also look at the heated water source that supplies warm water to these fixtures within healthcare and hospital facilities. TMV’s are the preferred source of delivering controlled temperature heated water in healthcare and hospital facilities, where they both save energy and prevent burn accidents (and in NSW health facilities may only be substituted where a cost advantage can be demonstrated after consideration of capital cost and maintenance routine costs are taken into account according to NSW Health’s Engineering Services and Sustainable Development Guidelines).
TMV’s as mechanical devices have a minimum flow rate of 4 l/min at which they must comply with AS4032.1 – 2005. This value then becomes the benchmark for minimum flow rate settings at fixture outlets where stable temperature warm water is required to be delivered.
“What is highlighted here is that guidelines seeking to achieve greater levels of water efficiency cannot be viewed in isolation because they have to take into account compatibility with the particular technology required to achieve particular outcomes for particular applications (such as clinical hand washing, or TMV hot water efficiency and safety).
Tim Fisher says greater levels of water efficiency can also be significantly advanced by technology such as electronic or self closing tapware that controls the time a fixture runs without the need for manual intervention to shut off the supply. This type of technology has a significant impact on water usage, which it achieves in ways other than by simply reducing flow rates.
A further soon to be released innovation from Enware is the Australian made Aquablend SQX sequential thermostatic mixing valve tap range. The combination of thermostatic control into an energy and water efficient sequential mixer shall assist in minimising heated water wastage with the safety of Aquablend’s thermostatic control. These point of use thermostatic taps shall further assist in minimising risk where Legionella control is paramount in high risk healthcare applications.
“Looking at flow rate alone does not have an impact on the duration a person uses a manually operated fixture outlet. Solutions for particular facilities should consider a range of factors, including flow rates, time control, the application need and actual number of usages at those facilities or fixtures within a day. This holistic approach will provide far greater efficiency gains,” says Mr Fisher.
“When all the factors are considered it becomes obvious that amending flow rates alone may not have the desired impact in seeing water efficiency gains and that a comprehensive overhaul and greater level of understanding of the interplay of the technologies and handwashing requirements is needed. As designers and builders look to obtain a ‘green-star’ building ratings in healthcare establishments, simply ignoring vital cross infection control considerations of the intended facility cannot occur without increasing risk.”
Enware Australia’s water conservation, safety and hygiene-oriented products include Australian-made Aquablend TMVs (thermostatic mixing valve systems), anti- vandal tapware, bubblers, laboratory tapware, lever tapware for hospitals and health care, and food service tapware designed for hygiene and water conservation including the FS729 Ultra Rinse food service gun. Enware ranges also include electronic water monitoring systems, electronically activated toilets and urinals, hands-free tapware options and healthcare associated products.
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