The Facility Manager's Guide to Healthcare Air Quality and Safety

Air quality is near the top consideration for any facility, and even more so for healthcare facilities. Often open extended — or all — hours, housing patients in various degrees of health and staffed by workers whose own health is critical to operations.  

Indoor air quality (IAQ) can’t be compromised and, for a facility team already strapped with time and budget, a misstep in air filtration solutions can have a ripple effect. 

IAQ was a large topic of conversation at the recent ASHE Health Care Facilities Innovation Conference. Brian Abel, healthcare segment manager with AAF International, presented tips and solutions for facilities managers to have confidence in their air filtration solutions.  

The cost of healthcare-associated infections 

In July, the Centers for Disease Control and Prevention reported that about 1 in 38 hospitalized patients in 2023 had at least one healthcare-associated infection (HAI), with airborne infections, pneumonia and surgical site infections among the most common. In fact, 61 percent of HAIs weren’t associated with medical devices or procedures. 

“They lead to extended stays, and the cost for the treatment of these is not covered. Your hospital is eating the extra cost to treat these infections,” Abel warns. 

This strengthens the importance IAQ plays in health and safety, where Abel stresses that the hospital facilities team is the first line of defense against these airborne contaminants. 

ASHRAE’s Guideline 43, published June 2025, calls for a Ventilation Management program, and efforts are underway to tie it to ASHRAE Standard 170, where it could become a requirement for new systems, remodeling and repurposing projects. 

“Adding a filter efficiency certification every six months is not required, but would be a positive addition to promote air quality and reduce airborne transmission at your facility,” Abel says. 

He presented this chart showing different filter efficiency needs by healthcare function, comparing Minimum Efficiency Reporting Value (MERV) by year. 

For context, the smallest air particle size, Range 1 — .3 to 1 micron particle — including air particles containing bacteria viruses, aren’t controlled under a MERV 10 or lower filter. 

“When we look at the long-distance spread of these aerosols that are carrying your viruses and your small bacteria, that is of particular concern because these smaller particles can travel farther,” Abel warns. 

Strategies to extend HVAC life 

In his presentation, Abel recognized that times are tight for facility managers dealing with budget constraints, funding cuts or facilities losing money. The cost of deferred maintenance, however, isn’t worth the wait. He warns that energy costs can be up to 81 percent higher in facilities with deferred maintenance plans, where 71 percent of that increase is related to HVAC. 

Able provides recommendations to extend the life of HVAC systems for air quality: 

• Ensure gaskets aren’t letting bypass around the system. A quarter-inch of bypass around a pre-filter could lead to a drop in filter efficiency by a few MERV ratings. 
• Ensure air handlers are clear of biofilms, which can harbor bacteria, mold or fungus, and could break loose into the airstream. 
• Schedule time to clean scale buildup on coils, as obstruction reduces heat transfer efficiency. 

“We find with facility directors that time is their scarcest resource. Their No. 1 challenge is that they don’t have enough to get all their work done,” he says. 

How to measure your air filter performance 

As a result, Abel encourages considering some longer-life air filter options to free maintenance personnel time. Higher-end products now last longer than they did previously, and can perform better and maintain performance, Abel notes. 

For added assurance and understanding of your air filtration, Abel recommends engaging in a six-month filter performance analysis. In this test, you pull a sample of one of your final filters out of a critical unit and send it for an initial filter efficiency baseline measure to better understand how your air filtration system performs.  

“You can make a difference. Your staff can make a difference,” Abel encourages. “If they choose to walk by some of the situations they see in the air handler, somebody’s mom or dad may not be coming home. Help your facility achieve the highest health grade they can.” 

Valerie Dennis Craven is a freelance writer based in Plymouth, Minnesota.

Next

---

Read next on FacilitiesNet