Microclimate- a complex of physical factors of the internal environment of the premises, influencing the heat exchange of the body and human health. Microclimatic indicators include temperature, humidity and air velocity, surface temperature of enclosing structures, objects, equipment, as well as some of their derivatives (air temperature gradient along the vertical and horizontal of the room, the intensity of thermal radiation from internal surfaces).

The impact of a complex of microclimatic factors is reflected in the human sensation of heat and determines the characteristics of the physiological reactions of the body. Temperature influences that go beyond neutral fluctuations cause changes in muscle tone, peripheral vessels, sweat gland activity, and heat production. Moreover, the constancy heat balance is achieved due to a significant tension of thermoregulation, which negatively affects the well-being, performance of a person, his state of health.

The thermal state in which the stress of the thermoregulatory system is negligible is defined as thermal comfort. It is provided in the range of optimal microclimatic conditions, within which there is the least stress of thermoregulation and comfortable feeling of heat. The optimal microclimate standards have been developed, which must be ensured in medical and prophylactic institutions, residential, administrative buildings, as well as at industrial facilities, where optimal conditions are necessary according to technological requirements. The sanitary norms for the optimal microclimate are differentiated for the cold and warm seasons ( tab. 1 ).

Table 1

Optimal norms of temperature, relative humidity and air velocity in residential, public, administrative premises

Indicators	Period of the year
		cold and transient
Temperature
Relative humidity,%
Air speed, m / s	No more than 0.25	No more than 0.1-0.15

For the premises of medical and prophylactic institutions, the calculated air temperature is normalized, while for premises for various purposes (wards, offices and treatment rooms), these standards are differentiated. For example, in wards for adult patients, rooms for mothers in children's departments, wards for tuberculosis patients, the air temperature should be 20 °; in wards for burn patients, postpartum wards - 22 °; in wards for premature, injured, infants and newborns - 25 °.

In those cases when, for a number of technical and other reasons, the optimal microclimate standards cannot be ensured, they are guided by the permissible standards ( tab. 2 ).

table 2

Permissible norms of temperature, relative humidity and air velocity in residential, public, administrative and amenity premises

Indicators	Period of the year
		cold and transient
Temperature	Not more than 28 °
for areas with a design air temperature of 25 °	Not more than 33 °
Relative humidity,%
in areas with an estimated relative humidity of more than 75%
Air speed, m / s	No more than 0.5	No more than 0.2

Allowable sanitary standards microclimate in residential and public buildings is provided with the help of appropriate planning equipment, heat and moisture protection properties of the enclosing structures.

When carrying out the current sanitary supervision in residential, public, administrative and medical institutions, the air temperature is measured at the level of 1.5 and 0.05 m from the floor in the center of the room and in the outer corner at a distance of 0.5 m from the walls; relative air humidity is determined in the center of the room at a height of 1.5 m from the floor; air speed is set at 1.5 and 0.05 m from the floor in the center of the room and at a distance of 1.0 m from the window; the temperature on the surface of the enclosing structures and heating devices is measured at 2-3 points on the surface. When carrying out sanitary supervision in multi-storey buildings, measurements are made in rooms located on different floors, in end and row sections with one-sided and two-sided orientation of apartments at an outside air temperature close to the calculated one for given climatic conditions.

The air temperature gradient along the height of the room and horizontally should not exceed 2 °. The temperature on the surface of the walls can be lower than the air temperature in the room by no more than 6 °, the floor - by 2 °, the difference between the air temperature and the temperature of the window glass in the cold season should not exceed an average of 10-12 °, and the thermal effect on human body surface of infrared radiation flux from heated heating structures - 0.1 cal / cm 2 × min.

Industrial microclimate ... The microclimate of industrial premises is significantly influenced by the technological process, the microclimate of workplaces located in open areas is influenced by the climate and weather of the area.

At a number of industries, the list of which is established by industry documents, agreed with the state sanitary inspection authorities, an optimal production microclimate... Optimal microclimate values ​​should be ensured in cabins, consoles and control posts for technological processes, in computer rooms, as well as in other rooms in which operator-type work is performed: air temperature 22-24 °, humidity - 40-60%, speed air movement - no more than 0.1 m / s regardless of the period of the year. Optimum rates are achieved mainly through the use of air conditioning systems. However, the technological requirements of some industries (spinning and weaving shops of textile factories, individual shops Food Industry), as well as the technical reasons and economic capabilities of a number of industries (open-hearth, blast furnace, foundry, forging workshops of the metallurgical industry, heavy machine building, glass production and food industry) do not allow ensuring optimal standards of the industrial microclimate. In these cases, at permanent and non-permanent workplaces, in accordance with GOST, permissible microclimate standards are established.

Depending on the nature of heat input and the prevalence of one or another microclimate indicator, shops are distinguished mainly with convection (for example, food shops of sugar factories, machine rooms of power plants, thermal shops, deep mines) or radiation heating (for example, metallurgical, glass production) microclimate. The convection heating microclimate is characterized by a high air temperature, sometimes combined with its high humidity (dyeing departments of textile factories, greenhouses, sintering shops), which increases the degree of overheating of the human body (see. Overheating of the body). Radiant heating microclimate is characterized by the predominance of radiant heat.

If preventive measures are not followed, people who work for a long time in a heating microclimate may experience dystrophic changes in the myocardium, arterial hypertension, hypotension, asthenic syndrome, decrease the immunological reactivity of the body, which contributes to an increase in the incidence of workers with acute respiratory diseases, angina, bronchitis, myositis, neuralgia. When the body overheats, the adverse effect of chemicals, dust, noise increases, and fatigue sets in faster.

Table 3

Optimal values ​​of temperature and speed of air movement in the working area of ​​production of other premises, depending on the category of work and periods of the year

	Energy costs, W	Periods of the year
		cold		cold
		Temperature (° C)		Air speed, ( m / s)
light, Ia
light, Ib
moderate, IIa
moderate, IIb
heavy, III

The cooling microclimate in industrial premises can be predominantly convection ( low temperature air, for example, in separate preparatory workshops of the food industry), mainly radiation (low temperature of fences in cold rooms) and mixed. Cooling contributes to the occurrence of respiratory diseases, exacerbation of diseases of the cardiovascular system. With cooling, coordination of movements and the ability to perform precise operations deteriorate, which leads to both a decrease in performance and an increase in the likelihood of industrial injuries. When working in an open area in winter period there is an opportunity frostbite, it is difficult to use personal protective equipment (frosting of respirators when breathing).

Sanitary standards provide for the provision of optimal or acceptable parameters of the microclimate of industrial premises, taking into account 5 categories of work, characterized by different levels of energy consumption ( tab. 3 ). The standards regulate the temperature, humidity, air velocity and intensity of thermal radiation of workers (taking into account the area of ​​the irradiated body surface), the temperature of the internal surfaces enclosing the working area of ​​structures (walls, floor, ceiling) or devices (for example, screens), the temperature of the external surfaces of the technological equipment, air temperature differences in height and horizontal working area, its changes during the shift, and also provide for the necessary measures to protect workplaces from radiation cooling. emanating from the surface of the glass of window openings (during the cold season) and heating from direct sunlight (during the warm season).

Prevention of overheating of workers in a heating microclimate is carried out by reducing the external heat load by means of automation technological processes, remote control, the use of collective and individual protective equipment (heat-absorbing and heat-reflecting screens, air showers, water curtains, radiation cooling systems), regulation of the time of continuous stay at the workplace and in the recreation area with optimal microclimatic conditions, organization of the drinking regime.

To prevent overheating of those working in summer period in the open area, overalls made of air- and moisture-permeable fabrics, materials with high reflective properties are used, and recreation is organized in sanitary facilities with an optimal microclimate, which can be provided by using air conditioners or radiation cooling systems. Measures aimed at increasing the body's resistance to thermal effects, including adaptation to this factor, are of great importance.

When working in a cooling microclimate, preventive measures include the use of overalls first of all (see. clothing), shoes (see. Shoes), hats and mittens, the heat-shielding properties of which must correspond to meteorological conditions, the severity of the work performed. The time of continuous stay in the cold and rest breaks in sanitary facilities, which are included in work time... These rooms are additionally equipped with devices for warming hands and feet, as well as devices for drying overalls, shoes, gloves. To prevent the respirators from freezing, devices for warming up the inhaled air are used.

Bibliography: Hygienic regulation of factors of the working environment and labor process, ed. N.F. Measured by A.A . Kasparov, p. 71, M., 1986; Provincial Yu . D. and Korenevskaya E.I. Hygienic principles of microclimate conditioning for residential and public buildings, M., 1978, bibliogr .; Occupational Health Guide, ed. N.F. Izmerova, vol. 1, p. 91, M., 1987, Shakhbazyan G.Kh. and F. M. Shleifman. Hygiene of industrial microclimate, Kiev, 1977, bibliogr.

Microclimate parameters determine the heat exchange of the human body and have a significant impact on the functional state different systems organism, well-being, performance and health.

The microclimate of the premises of medical institutions is determined by a combination of temperature, humidity, air mobility, temperature of surrounding surfaces and their thermal radiation.

The requirements for the microclimate and air environment of the premises are established by SanPiN 2.1.3.1375-03 "Hygienic requirements for the placement, arrangement, equipment and operation of hospitals, maternity hospitals and other medical hospitals."

Heating and ventilation systems must provide optimal conditions microclimate and air environment in hospitals.

The parameters of the design temperature, the frequency of air exchange, the category for the cleanliness of the premises of medical institutions regulated by SanPiN 2.1.3.1375-03 are shown in Table 3.1.

Table 3.1 - Temperature, air exchange rate, cleanliness category in the premises of the central hospital and medical unit

Name of premises	Design air temperature, О С	Air exchange rate, m3 / h		Exhaust rate with natural air exchange
	Exhaust,%
Wards for adult patients		80 for 1 berth
Tuberculosis wards		80 for 1 berth
	Exhaust,%
Hypothyroid wards		80 for 1 berth
Wards for patients with thyrotoxicosis
Postoperative wards, intensive care wards		By calculation, but not less than 10 times the exchange		Not allowed
Doctor's offices		Inflow from the corridor
Functional diagnostics room
Cabinet of microwave and ultra-high-frequency therapy, thermotherapy, ultrasound treatment					Not allowed

Relative air humidity should be no more than 60%, air speed - no more than 0.15 m / s.

Heating devices for heating systems should have a smooth surface that allows easy cleaning, they should be placed against external walls, under windows, without fences. It is not allowed to locate heating devices in chambers against internal walls.

In operating rooms, preoperative, resuscitation rooms, anesthesia, electrotherapy and psychiatric wards, as well as in intensive care and recovery wards, heating devices with a smooth surface should be used as heating devices, resistant to daily exposure to washing and disinfecting solutions, excluding the adsorption of dust and accumulation of microorganisms.

As a heat carrier in systems central heating hospitals use water with a maximum temperature in heating devices of 85 ° C. The use of other liquids and solutions (antifreeze, etc.) as a coolant in heating systems of hospitals is not allowed.

Hospital buildings should be equipped with systems supply and exhaust ventilation with mechanical impulse and natural exhaust without mechanical impulse.

In infectious diseases, including tuberculosis departments, exhaust ventilation with mechanical induction, it is arranged by means of individual channels in each box and semi-box, which must be equipped with air disinfection devices.

In the absence of mechanical forced ventilation in infectious diseases wards, natural ventilation must be equipped with the obligatory equipping of each box and semi-box with a recirculation-type air disinfection device, ensuring the inactivation efficiency of microorganisms and viruses is at least 95%.

Design and operation ventilation systems should exclude the overflow of air masses from the "dirty" areas to the "clean" rooms.

Premises of medical institutions, except for operating rooms, in addition to supply and exhaust ventilation with mechanical induction, are equipped with natural ventilation (vents, folding transoms, etc.), equipped with a fixation system.

Outside air intake for ventilation and air conditioning systems is made from a clean area at a height of at least 2 m from the ground. Outside air supplied supply units, to be cleaned with coarse and fine filters in accordance with the current regulatory documentation.

The air supplied to operating rooms, anesthesia, resuscitation, postoperative wards, intensive care wards, as well as to wards for patients with skin burns, AIDS patients and other similar treatment rooms should be treated with air disinfection devices that ensure the effectiveness of inactivating microorganisms and viruses in the treated air at least 95% (high efficiency filters H11-H14).

Operating rooms, intensive care wards, intensive care units, treatment rooms and other rooms in which there is a release into the air harmful substances must be equipped with local suction or fume hoods.

The levels of bacterial contamination of the indoor air depend on their functional purpose and purity class are also regulated by the requirements of SanPiN 2.1.3.1375-03.

Table 3.2 - Maximum permissible concentration and hazard classes medicines in the air of hospitals

	The substance to be determined	MPC, mg / m3	Hazard Class
	Ampicillin
	Aminazine (demytylaminopropyl 3-chlorophenothiazine hydrochloride)
	Babzilpenicillin
	Diethyl ether
	Ingalan (1,1-difluoro-2, 2-dichloethyl methyl ether)
	Nitrous oxide (in terms of 02)	5 (in terms of 02)
	Oxacillin
	Streptomycin
	Tetracycline
	Ftorotane
	Florimycin
	Formaldehyde
	Ethyl chloride

Air ducts of supply ventilation systems after high efficiency filters (H11-H14) are made of stainless steel.

Split - systems installed in an institution must have a positive sanitary and epidemiological conclusion.

Air ducts, air distribution and air intake grilles, ventilation chambers, ventilation units and other devices must be kept clean, must not have mechanical damage, traces of corrosion, leakage.

Fans and motors must be free of abnormal noise.

At least once a month, the degree of filter contamination and the efficiency of air disinfection devices should be monitored. The filters should be replaced as soon as it becomes dirty, but at least as often as recommended by the manufacturer.

General exchange air handling units and local exhaust units should be switched on 5 minutes before the start of work and switched off 5 minutes after the end of work.

In operating and preoperative rooms, supply ventilation systems are first switched on, then exhaust systems, or supply and exhaust ventilation systems at the same time.

In all rooms, air is supplied to the upper area of ​​the room. Air is supplied to sterile rooms in laminar or weakly turbulent jets (air velocity< = 0,15 м/с).

Supply and exhaust ventilation (air conditioning) ducts must have inner surface, excluding the removal of particles of the duct material into the premises, or protective coating. Internal coating must be non-absorbent.

In the premises for which the requirements of aseptic conditions are imposed, a hidden laying of air ducts, pipelines, fittings is provided. In other rooms, it is possible to place air ducts in closed boxes.

Natural exhaust ventilation is allowed for detached buildings with a height of no more than 3 floors (in reception rooms, ward buildings, hydrotherapy departments, infectious buildings and departments). Wherein forced ventilation provided with mechanical induction and air supply to the corridor.

Exhaust ventilation with mechanical induction without an organized inflow device is provided from the premises: autoclaves, sinks, showers, latrines, sanitary rooms, rooms for dirty linen, temporary storage of waste and pantries for storing disinfectants.

Air exchange in wards and departments should be organized in such a way as to limit as much as possible the flow of air between ward departments, between wards, between adjacent floors.

The amount of air supplied to the ward should be 80 m3 / h per patient.

The movement of air flows must be ensured from the operating rooms to the adjacent rooms (preoperative, anesthetic, etc.), and from these rooms to the corridor. An exhaust ventilation device is required in the corridors.

The amount of air removed from the lower zone of operating rooms should be 60%, from the upper zone - 40%. Innings fresh air is carried out through the upper zone, while the inflow should prevail over the exhaust.

It is necessary to provide for separate (isolated) ventilation systems for clean and purulent operating rooms, intensive care, oncohematological, burn departments, dressing rooms, separate ward sections, X-ray and other special rooms.

Preventive inspection and repair of ventilation systems and air ducts should be carried out according to the approved schedule, at least twice a year. Elimination of current malfunctions, defects should be carried out urgently.

Monitoring of microclimate parameters and pollution chemicals air environment, the operation of ventilation systems and the frequency of air exchange should be carried out in the following rooms:

In the main functional rooms operating rooms, postoperative wards, intensive care wards, oncohematological, burns, physiotherapy departments, rooms for storing potent and toxic substances, pharmacy warehouses, rooms for the preparation of medicines, laboratories, the department of therapeutic dentistry, special rooms of radiological departments and in other rooms, in offices, using chemical and other substances and compounds that can have a harmful effect on human health - once every 3 months;

Infectious, incl. tuberculosis departments, bacteriological, viral laboratories, X-ray rooms - once every 6 months; - in other premises - once every 12 months.

For disinfection of air and surfaces of premises in hospitals, ultraviolet bactericidal radiation should be used using bactericidal irradiators approved for use in the prescribed manner.

The methods of application of ultraviolet bactericidal radiation, the rules of operation and safety of bactericidal installations (irradiators) must comply with hygiene requirements and instructions for the use of ultraviolet rays.

The assessment of the microclimate is carried out on the basis of instrumental measurements of its parameters (temperature, air humidity, speed of its movement, thermal radiation) at all places of the employee's stay during the shift.

Read: Anatomy of the congestive glands of the small intestine. Topography, purpose, specific features of domestic animals and birds. Innervation, blood supply, lymph outflow. Anatomy studies the structure of animals in 3 main aspects. b) The history of the development of the main directions of medical science and health care On an industrial scale, 5 main methods of water desalination are used: distillation, freezing, reverse osmosis, electrodialysis, and ion exchange. Ventilation of premises. Air exchange rate in children's groups. Air exchange, microclimate, lighting of the main premises of schools. Question 2. Pyramidal and extrapyramidal systems, their significance, centers and main pathways.

How much air does a person need for a normal existence?

Ventilation of premises ensures the timely removal of excess carbon dioxide, heat, moisture, dust, harmful substances, in general, the results of various household processes and people staying in the premises.

Types of ventilation.

1) Natural. It consists in natural air exchange between
premises and external environment due to the temperature difference between the internal and
outdoor air, wind, etc.

Natural ventilation may be:

Unorganized (by filtering air through cracks)

Organized (through open vents, windows, etc.) - ventilation.

2) Artificial.

Supply air - artificial feed outside air into the room.

Exhaust - artificial air extraction from the room.

Supply and exhaust - artificial supply and exhaust. Air enters through the supply chamber, where it is heated, filtered and removed through ventilation.

General principle ventilation is that

In dirty rooms, an exhaust hood should prevail (in order to exclude the spontaneous flow of dirty air into neighboring rooms)

V clean rooms the inflow should prevail (so that air from dirty rooms does not enter them).

How to determine how much clean air should be supplied to the room per hour per person for adequate ventilation?

The amount of air that must be supplied to the room per person per hour is called the ventilation volume.

It can be determined by humidity, temperature, but it is most accurately determined by carbon dioxide.

Methodology:

The air contains 0.4%<■ углекислого газа. Как уже упоминалось, для помещений, требующих высокого уровня чистоты (палаты, операционные), допускается содержание углекислого газа в воздухе не более 0.7 /~ в обыч­ных помещениях допускается концентрация до 1 Л«.

When people are in the room, the amount of carbon dioxide increases. One person emits approximately 22.6 liters of carbon dioxide per hour. How much air should be supplied per person per hour in order to dilute these 22.6 liters so that the concentration of carbon dioxide in the room air does not exceed 0.7% ° or 1 /<.. ?

Each liter of air supplied to the room contains 0.4% carbon dioxide, that is, each liter of this air contains 0.4 ml of carbon dioxide and thus can still "accept" 0.3 ml (0.7 - 0.4) for clean rooms (up to 0.7 ml per liter or 0.7 / ~) and 0.6 ml (1 - 0.4) for normal rooms (up to 1 ml per liter or 1 / ~).

Since every hour 1 person releases 22.6 liters (22600 ml) of carbon dioxide, and each liter of supplied air can "take" the above number of ml of carbon dioxide, the number of liters of air that must be supplied to a room for 1 person per hour is

For clean rooms (wards, operating rooms) - 22600 / 0.3 = 75000 l = 75 m 3. That is, 75 m 3 of air per person per hour must be supplied to the room so that the concentration of carbon dioxide in it does not exceed 0.7% *

For ordinary premises - 22600 / 0.6 = 37000 l = 37 m 3. That is, 37 m of air per person per hour must enter the room so that the concentration of carbon dioxide in it does not exceed.

If there is more than one person in the room, then the indicated numbers are multiplied by the number of people.

Above, it was explained in detail how the value of the ventilation volume is located directly on specific numbers, in general, it is not difficult to guess that the general formula looks like this:

B = (K * M) / (P - P0 = (22.6 l * 14) / (P - 0.4%.)

B - ventilation volume (m)

K - the amount of carbon dioxide exhaled by a person per hour (l)

N - the number of people in the room

Р - the maximum allowable content of carbon dioxide in the room (/ ")

Using this formula, we calculate the required volume of supplied air (required ventilation volume). In order to calculate the real volume of air that is supplied to the room per hour (real ventilation volume), you need to substitute the real concentration of carbon dioxide in the given room in ppm instead of P (MPC for carbon dioxide - 1 / C 0.7 U ") in the formula:

^ real-

- (22.6 l * 14) / ([С0 2] fact - 0.4 / ~)

B real - real ventilation volume

[REFactual - the actual content of carbon dioxide in the room

To determine the "concentration of carbon dioxide, use the Sub-Botin-Nagorsky method (based on reducing the titer of caustic Ba, the most accurate), Reberg's method (also using caustic Ba, express method), Prokhorov's method, photocolorimetric method, etc.

Another quantitative characteristic of ventilation, directly related to the volume of ventilation, is the ventilation rate. The ventilation rate shows how many times per hour the air in the room is completely exchanged.

Ventilation rate - The volume of the supplied (extracted 4) in the chyag. dry I am

The volume of the room.

Accordingly, in order to calculate the required ventilation rate for a given room, it is necessary to substitute the required ventilation volume in this formula in the numerator. And in order to find out what the real rate of ventilation in the room is, the real volume of ventilation is substituted into the formula (see calculation above).

The ventilation rate can be calculated by the inflow (the inflow rate), then the volume of air supplied per hour is substituted into the formula and the value is indicated with a (+) sign, or it can be calculated by the exhaust (exhaust ratio), then the volume of air extracted per hour is substituted into the formula and the value is indicated with a (-) sign.

For example, if in the operating room the ventilation rate is indicated as +10, -8, this means that every hour a tenfold volume of air is supplied to this room, and eightfold volume of air is extracted in relation to the volume of the room.

There is such a thing as an air cube.

An air cube is the volume of air required for one person.

The air cube rate is 25-27 m = 1.5).

The microclimate of hospital premises.

Temperature conditions.

Temperature changes should not exceed:

In the direction from the inner to the outer wall - 2 ° С

In the vertical direction - 2.5 ° С for each meter of height

During the day with central heating - 3 ° С

Relative humidity should be 30-60%

Air speed - 0.2-0.4 m / s

6. The problem of nosocomial infections; non-specific prevention activities, purpose and content.

INTERNAL INFECTIONS - any clinically recognizable disease caused by microorganisms that occurs in patients as a result of staying in a medical and prophylactic organization or seeking medical help, as well as arising from medical personnel as a result of their professional activities (World Health Organization).

Non-specific prophylaxis.

Architectural planning activities

· Construction and reconstruction of inpatient and outpatient clinics in compliance with the principle of rational architectural and planning solutions:

· Isolation of sections, wards, operating blocks, etc .;

· Observance and separation of flows of patients, personnel, “clean” and “dirty” flows;

· Rational placement of departments on floors;

Correct zoning of the territory

Sanitary measures

· Efficient artificial and natural ventilation;

· Creation of standard conditions for water supply and sewerage;

· Correct air supply;

· Conditioning, the use of laminar installations;

· Creation of regulated parameters of microclimate, lighting, noise regime;

· Compliance with the rules of accumulation, neutralization and disposal of waste from medical institutions.

Sanitary and anti-epidemic measures

· Epidemiological surveillance of nosocomial infections, including analysis of the incidence of nosocomial infections;

· Control over the sanitary and anti-epidemic regime in medical institutions;

· Introduction of a hospital epidemiologist service;

· Laboratory control of the state of the anti-epidemic regime in medical institutions;

· Identification of bacteria carriers among patients and personnel;

· Compliance with the norms of accommodation of patients;

· Inspection and admission of personnel to work;

· Rational use of antimicrobial drugs, primarily antibiotics;

· Training and retraining of personnel on the regime in health care facilities and prevention of nosocomial infections;

· Sanitary and educational work among patients.

Disinfection and sterilization measures.

· Use of chemical disinfectants;

· The use of physical methods of disinfection;

· Pre-sterilization cleaning of instruments and medical equipment;

· Ultraviolet bactericidal irradiation;

· Chamber disinfection;

· Steam, dry-air, chemical, gas, radiation sterilization;

· Carrying out disinsection and deratization.

institutions and pharmacies, with the exception of infectious diseases hospitals (departments), are equipped with supply and exhaust ventilation with mechanical induction. In infectious diseases hospitals (departments), exhaust ventilation is organized autonomously from each box, semi-box and from each ward section. In this case, the natural draft hood is equipped with a deflector, and the inflow is equipped with mechanical induction and air supply to the corridor.

Air conditioning is organized in operating rooms, anesthesia, delivery, postoperative wards, intensive care units, intensive care units, one- and two-bed wards for patients with burns, in wards designed to accommodate 505 beds, in wards for newborns and infants, as well as in all wards in the wards for premature and injured babies.

The air conditioning system must provide in operating rooms, anesthesia, postoperative wards, delivery rooms, resuscitation and intensive care units, a relative air humidity of 55-60%, an air speed of no more than 0.15 m / s.

Independent supply and exhaust ventilation systems are provided for operating units (separately for septic and aseptic wards), intensive care units, intensive care units (separately for those entering hospitals from the street and from hospital departments), delivery units - separately for physiological and observational wards; wards of obstetric departments of hospitals (maternity hospitals) - separately for physiological and observational departments, wards for newborns, premature and injured children; for X-ray rooms, laboratories, mud and hydrotherapy, hydrogen sulfide and radon baths, laboratories for the preparation of radon, sanitary facilities, refrigerators, self-supporting pharmacies.

Outside air supplied by supply ventilation systems is purified in filters. Recirculation of air is not allowed.

The air supplied to operating rooms, anesthesia, birth, postoperative wards, intensive care rooms, intensive care wards, to one- and two-bed wards for patients with skin burns, boards for newborns and infants, for premature and injured children is additionally purified in bacteriological filters. In this case, it is not allowed to install oil filters as the 1st stage of air purification and the device of air ducts that remove air after bacteriological filters made of galvanized sheet.

Heating... In health care and social services, only water heating is used. The heating power of the radiators should be calculated so that their surface temperature is no more than 90 ° C, otherwise the dust will burn. To facilitate cleaning, radiators should be mounted against the wall, not in niches. Better yet, use panel radiators that can be placed singly.

Microclimate is climatic conditions created in a limited space artificially or due to natural features. The indoor microclimate is created artificially in order to provide the most favorable conditions for people and protect them from adverse climatic influences (see Comfort zone). For this purpose, taking into account the climatic conditions of the area, the heat loss of the room is calculated and the calculation of heating (see) and ventilation (see) is made. The heat-shielding properties of external enclosures are of great importance: regardless of weather conditions, with normal fuel consumption, temperature, humidity and air speed must be maintained at a certain level. Temperature fluctuations during the day should not exceed 2-3 ° with central heating and 4-6 ° with stove. The air temperature in the premises should be uniform: its fluctuations in the horizontal direction should not exceed 2-3 °, and in the vertical direction 1 ° for each meter of the room height. The external enclosures of the premises must have sufficient resistance to heat transfer so that the temperature difference between their internal surfaces and the air in the premises does not exceed the permissible value.

With an increase in this difference, the loss of heat by the human body increases, a feeling of chilliness arises and colds are possible. Condensation of water vapor on cooled surfaces is also possible, causing dampness. The permissible values ​​of the temperature difference between the air of the premises and the inner surface of the fences depend on the humidity of the air and are standardized for premises for various purposes. So, for the outer walls of residential buildings, this difference should not exceed 3 °, for industrial premises 8-12 °, for attic floors of residential buildings -4.5 °, public buildings - 5.5 °.

The microclimate of living quarters - see Dwelling.

The microclimate of industrial premises is determined by the purpose of the premises and the nature of the technological process. To normalize working conditions, a number of measures are taken: heating and ventilation of industrial premises, mechanization of the production process, thermal insulation of heated surfaces, protection of workers from radiation sources, etc.

The meteorological conditions of industrial premises are standardized by SN 245-71 (Sanitary standards for the design of industrial enterprises).

The microclimate of hospitals should provide conditions for thermal comfort for patients. Special microclimatic conditions are desirable in operating rooms, wards, for patients with allergic reactions. In these rooms, it is advisable to air conditioning, radiant heating equipment. Air temperature in wards for adults, treatment rooms, canteens 20 °, wards for children 22-25 °, operating rooms and maternity wards 25 °.

The microclimate of the premises for children is standardized depending on the type of institution, the age of the children, the heating system, the climatic conditions of the area and the clothes of the children, as well as the purpose of the premises. The air temperature in the premises for newborns is taken at 23-26 °, for children under 1 year old 21-22 °, for children under 2-3 years old 19-20 °, in the common rooms of nurseries 20 °, in playrooms 16 °, in potties 22 °, in washrooms and 20 °.

The microclimate of the clothing space is determined by the properties of the clothing fabrics. The heat-shielding ability of the clothing must correspond to the conditions of wear and help maintain the thermal equilibrium of the body. The state of thermal equilibrium of the human body is maintained at an air temperature of the underwear space of 28-32 ° and relative humidity in the range of 20-40%. Clothing fabrics must provide such an air exchange so that the content of the underwear space in the air does not exceed 0.08% (see Clothes).

Microclimate of cities. In cities, during the hot season, the stone buildings heated by the sun and the asphalt pavement of the streets are an additional source of heat; due to air pollution with smoke in cities, the intensity of solar radiation decreases and biologically important ultraviolet radiation is sharply reduced. Therefore, in preventive construction, especially important hygienic importance are the issues of the correct use of the terrain, the distribution of green spaces throughout the city, the correct orientation in housing construction, natural lighting and street ventilation, the appropriate choice of material for covering streets, etc. (see) ...

Microclimate - the meteorological regime of closed premises (dwellings, medical institutions, production workshops). In addition, a distinction is made between the microclimate of populated areas and the microclimate of working sites during work carried out in an open area. The microclimate is determined by the following main meteorological components - the temperature of the air and surrounding surfaces, humidity and air velocity, as well as radiant energy. The microclimate of premises for various purposes, despite the fences, changes in accordance with the state of external atmospheric conditions and, therefore, is subject to seasonal fluctuations.

Human heat exchange is determined by the relationship between the generation of heat and the return or receipt of heat from the external environment. The study of human heat exchange in various microclimate conditions in all its diversity and versatility allows one to develop microclimate norms, determine the degree of adaptation of the body and develop protective measures against excessive exposure to heat, cold and radiant energy (see Thermoregulation).

Sanitary standards for microclimate have been developed on the basis of modern data on the physiology of heat exchange and human thermoregulation, as well as on the achievements of sanitary engineering. Sanitary standards for microclimate for objects of various purposes are usually developed for the cold and warm seasons, and in some cases for climatic zones (see Climate). Sanitary standards are divided into optimal (often called thermal comfort) and acceptable.

Optimal standards (see Thermal comfort zone) are used for objects with increased requirements for thermal comfort (theaters, clubs, hospitals, sanatoriums, children's institutions). In a number of industries, hygienic and technological requirements also require optimal microclimate conditions (electronic equipment, precision instrument making).

The permissible norms ensure the performance of a person at a certain voltage of heat regulation, which does not go beyond the limits of physiological changes. These standards are used in cases where, for a number of reasons, the level
modern technology still cannot provide optimal rates.

The microclimate of populated areas (cities, villages, towns, etc.) differs from the climatic conditions of the surrounding area. Various buildings are heated by the sun, tall buildings and streets alter the strength of the wind; green spaces create shade and reduce air temperatures. Therefore, the study of the climate of a particular area is of great hygienic importance for the planning of cities and settlements, as well as for the design of various heating, ventilation and air conditioning systems.

Microclimate of dwellings... The zone of thermal comfort for dwellings is defined as a set of conditions under which the thermoregulatory function of the body is in a state of least stress and the physiological functions of the body are carried out at the level most favorable for rest and recuperation of the body after a previous work load (see Dwelling).

Heating of dwellings according to the existing building codes and regulations must ensure the air temperature: for living rooms, corridors and lobbies - 18 °, kitchens - 15 °, showers and baths - 25 °, stairs and latrines - 16 °. Recently, it has been recommended for living rooms t ° 18-22 °, relative humidity 40-60%. The temperature of the inner surface of the walls should not be lower than the air temperature in the room by more than 5 °. In summer, in the southern regions of the country, it is necessary to protect dwellings from 1 excessive insolation by means of landscaping and watering of adjacent areas, through ventilation, the use of blinds and shutters. In addition, in the southern regions, in some cases, a radiation cooling system (using wall or ceiling panels with a lower temperature than the air temperature), as well as an air conditioning system, can be implemented. For the summer period, the recommended air temperature is 23-25 ​​°, relative humidity 40-60% and air speed 0.3 m / s.

The microclimate of industrial premises in most cases is determined by the technological process. The industrial microclimate can be conditionally divided into: 1) "heating" with mainly convection heat release; 2) "radiation" with a predominant release of radiant heat; 3) "wet" with the release of a large amount of moisture; 4) "cooling" in the presence of low air temperature and fences.

The microclimate of industrial premises must comply with the Sanitary Standards for the Design of Industrial Enterprises (SN 245-63), which are drawn up for the summer and winter periods. Optimal norms for the winter period of the year: air temperature - from 14-21 °, relative humidity - 40-60%, air speed - no more than 0.3 m / s; permissible norms - from 24 to 13 °, humidity - no higher than 75%, air speed - no more than 0.5 m / s. Optimal norms for the summer period: air temperature -25-17 °, humidity -40-60%, air speed - no more than 0.3 m / s; in permissible norms, the upper limit of air temperature is 28 °, humidity is no more than 55%, air speed is 0.5-1.5 m / s. The temperature of heated surfaces of equipment and fences at workplaces should not exceed 45 °.

The microclimate of the clothing space is also identified and studied, which largely determines the thermal state of the human body. Clothing creates an adjustable microclimate for a person, providing thermal comfort. This microclimate differs from the climate of the external environment and is characterized by relatively small changes in temperature, humidity and air mobility. The state of thermal comfort of a person corresponds to an air temperature under clothes of 29-32 ° and a relative humidity of 40-60% (in case of sedentary air).