Transition to Green Plumbing in Healthcare

The plumbing system is fundamental to a healthcare facility's success. Probably no other built facility places more demands and complex requirements on plumbing than the hospital.

Because in most cases healthcare facilities are 24/7 operations, requiring lots of water and energy, this is reason enough for green design considerations for healthcare facilities. On average, a hospital uses nearly 125,000 gallons of water every day, based on facilities with bed capacities between 130 and 550.

Proper plumbing fitting designs can meet sustainable objectives while reducing germ transmission, and careful planning can give professionals interested in achieving sustainable healthcare facilities the best of both worlds.

According to the Environmental Protection Agency's Energy Star statistics, more than 40% of hospital water use is for bathrooms and sanitary facilities. Therefore, while the plumbing system is vast in a healthcare facility, the common points of contact in the water delivery system are the fittings: faucets, showers and flushometer components. These common points warrant a closer look in order to achieve greater water efficiency.

That said, the role of plumbing products is evolving, along with design considerations for patient rooms and restrooms. As green design and construction strengthens its traction in the healthcare market, water, energy and money can be saved with plumbing systems, while gaining additional benefits that align with the overall objectives: Sustainable healthcare strategies can promote healthier, more hygienic environments for patients and staff.

Low-flow plumbing fixtures and fittings have traditionally been relegated to the commercial and residential market. However, availability of products that will work in healthcare installations has increased dramatically in the U.S. Green-building programs, such as LEED for Healthcare and Green Guide for Healthcare™, identify ways to reduce water consumption while maintaining a healthy environment for patients, visitors and staff.

Green Options
Facilities have a wide range of toilet and urinal technology choices, which run the gamut from the standard 1.6 gpf water closet models to dual-flush technologies to waterless urinals. High-Efficiency Toilets and High-Efficiency Urinals are becoming more popular as professionals increasingly recognize how much they have to gain by using less water. Urinals flushing at 1/8 to 1/2 gpf can save 50-80% of the water used by conventional fixtures.

The best case scenario is achieved when the flushometer and fixture are optimized to work together to guarantee the intended flush volume is maintained while fully evacuating the fixture. Flushometers and vitreous china fixtures are available both separately and as engineered combinations from many manufacturers, and professionals need to choose which approach best suits their needs.

It is not all about cost; performance is really the key issue, and professionals need to do their homework. The research and testing division of the International Association of Plumbing and Mechanical Officials Professionals (IAPMO), for instance, tests and certifies plumbing products to ensure they are in compliance with industry standards and applicable plumbing codes. The IAPMO Web site, among others, lists plumbing fixtures and fittings that have passed its testing (see the product listings at www. iapmo.org). Such listings give insight into mix-and-match or packaged combination decisions.

Some of these water-efficient options, such as pressure-assist toilets and waterless urinals, require complete fixture changeovers. Dual-flush technologies, sensor-activated flushing and lowerconsumption flushometers are available as retrofit kits for converting existing manual units into intelligent, automatic appliances or higher water-consuming fixtures into more water-efficient versions.

The options are many when it comes to faucet selection. Water efficiency goes hand-in-hand with hygiene and cleanliness, which are top considerations when reviewing the type and flow rate of faucets available.

According to the Centers for Disease Control and Prevention, hygienic hand-washing is the single-most effective measure for preventing the spread of pathogens that can cause everything from the common cold to more serious, even life-threatening, diseases. Proper hand-washing is critical to reduce the transmission of pathogens to food, water, other people and inanimate objects, such as hand railings and other surfaces.

A 2.2 gpm flow rate is necessary in foodservice areas, nurses' stations and patient rooms, for example, where employees are washing foods, filling containers or rinsing equipment. Additionally, laminar flow spray heads that typically operate at 2.2 gpm are suitable for critical care applications in healthcare, such as for surgical scrub sinks.

Unlike "aerated"-type flow controls, laminar flow does not draw ambient room air into the water stream, avoiding any possible introduction of airborne bacteria. Flow control in some models is located in the base of the faucet, which permits the elimination of the spray head that could be a breeding ground for bacteria in areas of the hospital housing severely immune-compromised patients.

Basic hand-washing faucets, however, can operate effectively at a much lower flow rate. The U.S. Green Building Council specifically recommends lavatory faucets with 0.5 gpm outlets for public restrooms and other general hand-washing stations in LEED for Healthcare. Low-flow faucets offer an easy way to cut water consumption, while allowing users to properly clean their hands and reduce germ transmission, which is especially critical in healthcare environments.

Touch-Free Operation
How fittings are powered is another consideration. Many different types and styles of sensor-activated faucets address different purposes and environmental requirements, and water consumption is a major area to consider.

Low-flow, sensor-activated faucets are available with tempered or hot/cold water operation. Although most sensor-activated faucets are powered by batteries or plug-in transformers, power harvesting technologies allow electronic plumbing fittings to save energy by extending the service life of the battery, while using water more efficiently. In some cases, greater energy efficiency is gained by harvesting the light energy. In other cases, harvesting hydraulic power by turning a turbine impeller with flowing water is more advantageous. Either scenario enables facilities to save both water and energy.

The overall convenience and ease of use of sensor-activated faucets transcends into placement and design of sinks—further encouraging healthcare professionals to wash their hands.

This was the case at West Chester Hospital near Cincinnati, where instead of traditional nurses' stations overseeing multiple patient rooms from one central position, it was designed with a nurses' work space between each patient room. This type of work space set-up gives nurses greater flexibility and patient visibility, and the sensor-activated faucets allow for hands-free operation for infection control purposes, which was the main goal.

Furthermore, according to a study published in Journal Watch, 80% of healthcare workers reported that easy access to sinks and availability of hand-washing facilities led to increased hand-washing compliance. Similarly, research conducted by the Virginia Commonwealth University's Department of Internal Medicine found that easily accessible waterless antiseptic dispensers significantly improved hand-washing rates among healthcare workers than infection-control education alone. The compliance rate rose from 19% after education about the need to wash to 41% after installing one dispenser for every four patient beds.

Thus, healthcare facility planners can benefit by combining the advantages of touch-free plumbing with the sustainable benefits of systems that are specifically engineered for lowconsumption applications. Sensor-activated faucets, for example, can offer greater water savings by not only being low-flow, but also by automatically turning water on only when needed and then promptly turning off when users' hands leave the sensor range.

Design of other plumbing fixtures and fittings can also reduce germ and bacteria transmission. Installing electronic, touchless water closet and urinal flushometers cuts down on the number of contaminated touchpoints in the restroom where users can leave or pick up various sorts of germs.

Proper plumbing fitting designs can meet sustainable objectives while reducing germ transmission. Careful planning can give professionals interested in achieving sustainable healthcare facilities the best of both worlds: plumbing systems that reduce costly and wasteful water and energy usage while providing healthier, more hygienic environments.

Rick Nortier is Faucet Product Line Manager at Sloan Valve Company, a leading manufacturer of water-efficient solutions dedicated to promoting a healthy environment through water conservation.


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