Project Overview
Start date: 1 September 2017
End date: 31 May 2022
Funder: EPSRC — £1,025,622
Partners & Collaborators: Leeds Teaching Hospitals NHS Trust, NHS Lanarkshire, Monaghans, Apex 4D Ltd
Principal Investigator: Professor Catherine Noakes
Co-Investigators: Dr Marco-Felipe King, Dr Andrew Kemp, Dr Louise Fletcher, Dr Andrew Sleigh, Dr Amirul Khan
Around 6% of patients acquire an infection while in hospital, and roughly a fifth of those are attributed to the environment around them. Hospital buildings have not progressed at the same rate as medical advances: ventilation, layout and the surfaces people touch all shape how pathogens move through a ward, yet they are rarely designed with transmission in mind.
HECOIRA set out to change what designers, estates teams and clinicians can actually measure and predict. It brought together infection control, microbiology and respiratory medicine with engineers from the Schools of Civil and Electronic & Electrical Engineering, to understand the relationship between microorganisms on patient room surfaces, on patients' hands, on healthcare workers' hands, and in the air.
What the project did
The team recorded air quality in a surgical rehabilitation unit and a respiratory ward over 18 months, while taking microbiological samples from ward surfaces, from the air, and from the hands of patients and healthcare workers. Healthcare workers' surface contacts during patient care were observed and recorded, so that the pattern of touches could be modelled rather than assumed.
Those data fed mathematical infection risk models, which were used to explore how design parameters — room layout, ventilation — and the realities of clinical work affect the potential for a pathogen to reach the next person.
Computational tools
- Coupling physical, environmental, microbial and human parameters with sensor data, to model a hospital environment as it actually behaves rather than as designed.
- Linking sensors to real-time fluid dynamics simulation, so that an environment can be monitored live rather than surveyed once.
- Quantitative pathogen exposure models that compare airborne and surface routes, instead of treating either in isolation.
Approaches were tested on real wards with clinicians and industry partners, to see whether they could be deployed in design, estates management and clinical guidance rather than only in research.
Where it led
The modelling and measurement built here underpinned the group's contribution to the UK response to COVID-19, and the questions it opened — how to keep a building healthy without abandoning net zero — continue through the Healthy Buildings Network and the HESTIA network.
Five of the HECOIRA investigators are still in the group. The work continues in our aerobiology chamber and in the computational methods that came out of it.