1. mobile air applied science inc “Break the Chain Of Infection”©
ma2si
mobile air applied science inc
“Break the Chain Of Infection”©
CLEAN AIR

2. Misconceptions About Quality Air Filtration
The air looks clear so it must be clean
The air entering the room from the facility HVAC system is clean because your told so
Increasing the room air exchange rates will solve all air quality issues by itself
Where the filters are placed in the system flow is not critical to the air quality as it enters the room
The facility has installed HVAC filtration at a central location, so it ought be delivering ultra clean air to the connected rooms downstream
They always change out the dirty filters in a timely manner .
ma2si
mobile air applied science

3. mobile air applied science
What Is a Particle
A particle is defined as a small object that behaves as a whole unit in terms of its transport and properties.
Fine particles cover a range between .1 and 10,000 micrometers (µm)
Ultrafine particles are sized between and .1 µm
Airborne Particles range from to 10,000 µm
Particles >50 µm or larger are visible to the eye
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mobile air applied science

4. Why Are Particles A Concern
Particles are easily inhaled thru the mouth
or nose into the lungs
Particles <100 µm can be inhaled into the lungs (clay, silt, fine sand, smog, spores, pollen, viruses, bacteria, tobacco smoke, nebulized drops, metal fumes)
Ultrafine Particles <10 µm are capable of entering the deep part of the lungs (clay, silt, smog, viruses, bacteria, tobacco smoke, metal fumes)
Ultrafine Particles then have the ability to enter the bloodstream
Ultrafine Particles also have the unexplained ability to penetrate cells and impair cellular function
National Institute of Environmental Health Sciences report
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mobile air applied science

5. Misconceptions About Air Quality
Particle Settling Velocities in Still Air
Mean Particle Diameter (µm) Settling Velocity
Skydiver ,920 feet per minute
feet per minute
feet per minute
ft per minute
inches per hour
inches per hour
inches pre day
< negligible
Smaller airborne particles in an occupied room will resist
gravitational settling and will remain in suspension indefinitely
ma2si
mobile air applied science

6. Samplings Found In One Hospital HVAC System
On Anesthesia Diffuser
Soot, clothing fiber, skin flakes, pollen, hyphae, fern spores, insect parts, paint spheres, plant parts, cosmetics, rust, ink, bird feather barbules
Operating Room
Wear metals, dog and cat dander, shoe wear, floor wear, cleaning residues
On Sterile Core Diffuser
Calcite, skin flakes, clothing fiber, natural minerals, paint spheres, starch, fern spores, pollen, hyphae, cosmetics, insect parts, fungal spores, plant parts, charred wood, bird feather barbules, rust, and ink 
ma2si
mobile air applied science

7. Where Do Room Contaminated Particulates Originate?
Persons entering the room (patient, staff, or visitor)
- On their clothing and shoes
- On their body
- Dislodged from objects by air currents as they pass
Naturedly suspended in the room airflow currents
From the room HVAC air inlet registers
Displaced from equipment, food trays, equipment, etc., brought into room
From bedding, curtains, gowns, etc.
Shedding from wall/ceiling surfaces
Stirred from the floor while walking
ma2si
mobile air applied science

8. Sources of Wound Contamination & Routes of Transmission in the OR
Adjacent Areas
Floor
Personnel
Ventilation
Theater Air
Clothing
Mouth
Hands
Body
Patient’s Skin
Masks
Gloves
Body Incisions &
Wound Drapes
Instruments
Wound Site
ma2si
mobile air applied science

9. Duct Wall Friction And Why It Impacts Air Quality Negatively
Wall friction pulls along the sides of
the duct against airflow for the entire
duct
This causes contaminates from the
room to stick to the inside duct walls
Build-up occurs and eventually re-enters
the room more contaminated
Duct cleaning is in ineffective since it
cannot reach every nook and seam
Bacteria & virus pathogens are found in
ducts at heath centers
ma2si
mobile air applied science

10. A Facility HVAC Normal Airflow Diagram
Air blower & filter system on the area roof
Duct maze system with many twists, turns and jagged assembly joints
Simple air outlet registers
Room return air exhausts through ceiling
Room doors left open that upsets airflow
ma2si
mobile air applied science

11. mobile air applied science
Improved Facility Air Quality Using HEPA Filtration Located at Room Interface
Takes the duct contaminates out
of the equation
Places room air exhaust as far from air intake as possible
Utilizes “Cleanroom” air movement principals - Enter from the ceiling and exit near the floor
Each room is a island unto itself
and needs to be individually
addressed
ma2si
mobile air applied science

12. Particles Released from People
Particles Released Human Activity Per Minute (>0.3µ) Sitting at Rest ,000 Standing Still ,000 Neck Rotation ,100,000 Body Twisting ,000,000 Body Bending ,000,000 Stepping ,000 Standing & Sitting ,400,000 Knee Bending ,200,000 Arm Motion ,700,000
Camfil Farr Literature
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mobile air applied science

13. Postoperative Sepsis in the United States
Sepsis after elective surgery imposes both significant clinical and resource utilization burdens
Studies demonstrate sepsis increased significantly over last decade
As payers move to performance-based reimbursement, sepsis prevention becomes financially prudent
A 3.3-fold increase in hospital cost in cases with postoperative sepsis went from $17,229 (median) to $57,032
Postoperative Sepsis in the United States
Todd R. Vogel, MD, MPH; Viktor Y. Dombrovskiy, MD, PhD, MPH; Jeffrey L. Carson, MD; Alan M. Graham, MD; Stephen F. Lowry, MD
Authors and Disclosures
Posted: 12/13/2010; Annals of Surgery. 2010;252(6):  © 2010 Lippincott Williams & Wilkins
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mobile air applied science

14. mobile air applied science
Healthcare Acquired Infections (HAIs) Linked to Increased ICU Mortality
5% of hospital patients will develop an HAI; that
number increases to 30% for patients in ICUs
The added risk of infection to the antimicrobial resistance of pneumonia in the ICU was 20%
Healthcare-associated pneumonia doubles the risk for death and increases the length of stay
"Prevention of health-care-related infections needs to be reasserted and emphasized as an absolute priority."
Healthcare Acquired Infections Linked to Increased ICU Mortality
News Author: Laurie Barclay, MD CME Author: Penny Murata, MD
In intensive care units in Europe, bloodstream infections occur in 3% and pneumonia occurs in 6.2% of patients with more than a 2-day stay, according to the European Centre for Disease Prevention and Control. In the January 2009 issue of Intensive Care Medicine, Hanberger and colleagues reported that patients in the intensive care unit have a high risk for infection with pathogens resistant to antibiotics.
This prospective cohort study evaluates the association between bloodstream infection and pneumonia and the risks for mortality and extended length of stay in intensive care units.
ma2si
mobile air applied science

15. Breaking The Chain Of Infection© Follow the path
Surface Contamination
From furniture & equip. surfaces
Off dirty objects carried in
Brought in by patients, staff,
or visitors
Hands touching dirty surfaces
Off people’s clothing
Airborne Contamination
From facility’s HVAC system
Suspended in air currents
Blown off dirty surfaces
Created by people movement
From personnel in room
ma2si
mobile air applied science

16. The Incidence and Control of Airborne Healthcare Infection is Relevant
Abstracts Highlight the Reduction of Infectious Disease
Using HEPA Filter Technology
MRSA, now becoming a deadly visitor to healthcare facilities, can be
greatly diminished by portable HEPA filtration (Department of Microbiology, Nottingham City Hospital, UK.)
Establish effective management over spread of aspergillosis for severely immunocompromised patients using flexible (HEPA based) aerial control measures (Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263)
A clear, demonstrable, statistically significant reduction in microbial organisms followed the activation of an air filtration system in a hospital ward (Glasgow Caledonian University, Glasgow, UK)
One Virus Particle Is Enough To Cause Infectious Disease
ScienceDaily (Mar. 14, 2009) — Can exposure to a single virus particle lead to infection or disease? Until now, solid proof has been lacking. Experimental research with insect larvae at Wageningen University and Simon Fraser University in Canada has shown that one virus particle is theoretically enough to cause infection and subsequent disease.
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mobile air applied science
* The full abstracts for these and other studies are available

17. Recent Reports of Airborne Spread of Disease and Infection
Influenza & Respiratory Syncytial Virus Spread by Infectious Airborne
Particles (NIH/IDSA Vol 50 ISSN Mar)
Airborne Spread of Clostridium Difficile (Clin Infec Dis, Lindsey, et al, 2010 Feb)
Airborne Transmission of DS/DR TB Fueled by Risk of HIV (NIH/IDSA Vol 50
Sup 3 ISSN: May)
Growing Evidence of Linking Air Pollution with Cardiovascular Disease (American Heart Assoc, Circulation 2010 May)
Potential for Airborne Dispersal of C. Difficile from Symptomatic
Patients (Best et al, IDSA Vol 50 ISSN: Jun)
Significance of Airborne Transmission of MRSA in an Otolaryngology- Head & Neck Surgery Unit by Teeruo Shiomori, et al, Head Neck Surg. 2010; 127:
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mobile air applied science

18. Alert! Another New “Superbug”
A new “Superbug” (NDM-1) that is resistant to even the most powerful antibiotics has entered hospitals worldwide
NDM-1 enzyme has travelled back with patients visiting
who went abroad to countries like India and Pakistan
NDM-1 can exist inside different bacteria (E. coli)
NDM-1 Infections have already been passed from patient to patient in UK hospitals. Recommendation: “Patient Isolation”
International researchers say that NDM-1 could “produce dangerous infections that would spread rapidly from person to person and be almost impossible to treat”
Environmental Protection – Contending with Waterborne and Airborne Pathogens, Kris Ellis, Infection Control Technology, April 2006
ma2si
mobile air applied science

19. The Numbers Are Alarming
In the US there were 14,561 AIDs deaths in 2007
However …
In US hospitals overall, HAI’s account for an estimated
2 million infections and 99,000 deaths each year
at a total cost of over $30+ Billion dollars.
22% or 440,000 are surgical site infections (SSI)
15% or 300,000 are lung infections (Pneumonia)
CDC Stats
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mobile air applied science

20. * Viruses tend to clump together forming larger contaminants
Viruses Facts
Influenza virus particles are about 0.12 micron in size*
Airborne Influenza viruses are usually transmitted by droplet transmission
The average droplet nucleus is 5-10 microns
The average size sneeze/cough droplet is over 10 microns
Research has shown that one virus particle is theoretically enough to cause infection
* Viruses tend to clump together forming larger contaminants
ma2si
mobile air applied science

21. A Few of Today’s Airborne Virus Droplets
Pulmonary Tuberculosis (TB)
Chicken Pox and Measles
Disseminated Zoster
Small Pox
Severe Acute Respiratory Syndrome (SARS)
Swine Flues & Avian Flues
Viral Hepatitis (kills >1 million annually)
Environmental Protection – Contending with Waterborne and Airborne Pathogens, Kris Ellis, Infection Control Technology, April 2006
ma2si
mobile air applied science

22. A Bacteria To Be Very Concerned About In Clean Air Filtration Media
Pseudomonas Aeruginosa
Free-living bacterium, commonly found in soil and water
Occurs as a nosocomial pathogen
Antibiotic resistance is increasing in clinical isolates
An opportunistic & virulent pathogen
Studies show Bacterial growth thru the filtration media in six months even in low humidly
Environmental Protection – Contending with Waterborne and Airborne Pathogens, Kris Ellis, Infection Control Technology, April 2006
ma2si
mobile air applied science

23. Connecting Airborne & Blood Borne Infection Prevention
Biofilm-forming bacteria, different from planktonic bacteria, needs 1,000 times more antimicrobial agent to destroy
The best practice is to reduce migration of bacteria to the open wound before the protective biofilm completes
The best solution in controlling open wound infection requires both best Practice and best product combination
Protect open wounds until the biofilm completely forms by substantially reducing the number of airborne bacteria
ma2si
mobile air applied science

24. The Risk of Surgical Site Infection
Defining the risk of Surgical site Infection (all surgeries) Level of Contamination Risk Clean < 2 % Clean Contaminated < 10 % Contaminated ≈ 20 % Dirty ≈ 40 %
Cruse, PJ and Foord, R. The epidemiology of wound infection. A ten year prospective study of 62,939 wounds. Surg. Clin. Am (1980) 60:27-40
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mobile air applied science

25. Today’s Surgery Suites Are Contaminated In Many Ways
Duct contaminants increase over time due to standard building HVAC design verses cleanroom design filter placement
More surgery procedures are moving to clinics and outpatient surgery centers designed with restrictive building HVAC systems
The near-open wound site air is often contaminated with over 600,000 particles per ft3 by HVAC, staff and equipment
Laser & cautery fumes carry toxic and infectious contaminants
ma2si
mobile air applied science

26. How Do We Change This Picture and What Are the Results?
Remove the invisible airborne pathogens/contaminants that
contribute to the high infection rates
Create cleaner patient and staff environments transparently and targeted when and where needed
Reduce the infection incidence and resulting cost of hospital acquired infections from air contribution
Decrease patient suffering and high cost of treatment
Introduce “Focused Clean Air Zone” applications
ma2si
mobile air applied science

27. The Science of Air Contamination Control Can Effectly Reduce Infections
HEPA filtration can trap viral and bacterial pathogens
The use of a Focused Clean Air Zone© has been shown to reduce infections in surgery
Over 475 operations completed in a surgical suite over three years with < .01% infection rate*
Superior reduction of micro-organisms can be achieved
Upgrade existing facilities; converting most any space to a
cleaner and safer environment
* Both complex and routine plastic and reconstructive surgeries
From the white paper authored by Russ Crutcher, “MA2SI Focused
Clean Air In Surgical, Laboratory and Industrial Environments” 2/10/2009
ma2si
mobile air applied science

28. How HEPA Filters Function
The four processes of the HEPA filter media to capture particulates:
Sieving - 2 micron micron
Sieving, the most common mechanism in filtration
Inertial Impaction - 1 micron – .02
micron Inertia works on large, heavy particles
suspended in the air stream
Interception micron – .02 micron
The mid-range size that are not quite large enough to have inertia and not small enough to diffuse within the flow stream
Diffusion - .3 micron – .01 micron
Diffusion works on the smallest particles that disperse within the flow stream
This information is from Donaldson Filter paper on “How HEPA filter works”
ma2si
mobile air applied science

29. mobile air applied science
Cleanroom Proven Design Principals That Transfer To Healthcare Applications
Placing of final filtration at room air discharge
Utilizing certified HEPA filter with 100% gasket seal
technology
Regulating airflow velocity rates creating smooth, near- laminar airflow
Creating proven room airflow directional dynamics with
incoming and exhaust strategic placement
Controlling air volume to minimize external interferences
Per Federal Cleanroom Design and Operation 209E
ma2si
mobile air applied science

30. What Can This Technology Do?
Reduce new construction expenses for facility
HVAC systems both new and remodel
Provide cost effective airborne environmental
upgrades within existing facilities
Create immediate surge capacity for onsite and offsite surgery, patient isolation and staff safety
Upgrade hospital and private pharmacies to meet
USP797 requirements
ma2si
mobile air applied science

31. Welcome To Clean Air World From Mobile Air Applied Science
FDA accepted 1st mobile air filtration system
Mobile isolation systems for quick placement in
any potential setting; “Clean Air Anywhere”
Enhance site-specific HVAC conditions with
strategic installation of exclusive high-efficiency
filtered environments
Suites of follow-on devices to address specific applications in the operating theater, patient isolation, staff safety and more
ma2si
mobile air applied science

32. Mobile Air Applied Science’s Evidence Based Solutions
ma2si
mobile air applied science

33. The Mobile M100 Device Solution
A self-contained mobile air filtration solution that provides immediate infection and airborne contamination control wherever it’s needed
ma2si
mobile air applied science

34. M100 Flexibility And Airflow Output
90 FPM Velocity
120 FPM Velocity
M100 Adjustable Positions
Airflow Directional Operation
“Focused Clean Air Zone”
ma2si
mobile air applied science

35. mobile air applied science
M100 – What Does It Achieve?
Recirculates filtered room air at rates from
100 to 480 CFM
Totally adjustable hood projects “Focused Clean
Air Zone”© onto the desired target
Pulls & collects pathogens, odors & VOCs from
lower worksite level
Provides non-shadowing and variable intensity lighting
Plug it in, turn it on and in minutes you
have a “Focused Clean Air Zone©”
ma2si
mobile air applied science

36. Single Patient Isolation Versatility
Positive Pressure Configuration
Negative Pressure Configuration
Both patient isolation configurations from a single unit
ma2si
mobile air applied science

37. How Does A Single Patient
Isolation System Work?
The mobile M100 adapts to the patient isolation system to provide either a positive pressure (PP) or a negative pressure (NP) Isolation chamber unit
ma2si
mobile air applied science

38. PCF322 - Ceiling Room Incoming
Air Filtration Devices In A Clinic Surgery Room
(Red) Primary surgical site HEPA filtration creating the “Focused Clean Air Zone©”
(Blue) Secondary HEPA filtration operated 24/7 to maintain maximum room air quality at all times (< 4,000 particles per ft3)
Note: Outside of room over (1m PCF)
ma2si
mobile air applied science

39. PCF322 – Room Airflow Dynamics
“Focused Clean Air Zone” envelope gently projected downward
B. Extension of airflow downward until surface is encountered
C. Airflow outward after surface is encountered thereby gently moving room air outward
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mobile air applied science

40. Purging Room With Clean Filtered Air
A. Use clean filtered air to push contaminated air out
B. Airflow moves from the inlet filtered air register
toward the exhaust register creating a cleaner
environment
C. The exhaust outlet is placed at the opposite
side of the room to achieve best possible impact
Optimizing the placement of the PCF series, in relation to exhaust, creates better room airflow dynamics and increased effective room contaminate reduction
ma2si
mobile air applied science
Bill, I don’t like either of these two drawing showing
the exhaust in the ceiling especially with the next slide.
I realize retrofit often runs into this situation.

41. Maximizing Airflow Dynamics & Creating Positive Pressure in Room
PCF series placement is critical for very best airflow
dynamics while keeping the contaminates near
floor level
Maintain the airflow in this manner provides
maximum room clean air movement, once
contaminated, below patient and staff level
Balance the room positive pressurization by
restricting the exhaust air while maintaining
sufficient air changes
Install a pressure air pressure meter outside near
the entrance to assure room pressurization
ma2si
mobile air applied science
Placement of the PCF-322 is critical to assure
the best possible airflow throughout the room to
keep the contaminated air near the floor level.
The air outlet register when positioned across the
room and near the doorway keeps the airflow
going in the best possible direction so as to
purge the room and keep the room clean where
normally a patient would be placed.
Convert this room to a positive pressurized room
by restricting the amount of air that passes out of
the room but not closing it off. A manometer to
monitor the pressure differential should be
installed near the room entrance so the staff can
be confident the room air supply is sufficient.

42. Ineffective Airflow Dynamics Within Room
The airflow dynamics in this example is most
undesirable
Clean air coming into the room is pulled directly
toward the exhaust register thereby creating
unprotected zones in room
Little prospect exists for purging many
contaminates from the room
Creating a positively pressurized room is nearly
impossible with clean air throughout
ma2si
mobile air applied science

43. PCF322/422 – What Do They Provide? All at a Very Reasonable Price
Replaces incoming HVAC air register with HEPA filtered air
system
Produces a “Focused Clean Air Zone©” projection onto the worksite gently pushing contaminants down to the floor
Produces regulated amount HEPA clean air entering the room
assuring control of the number of air exchanges per hour
Positively pressurizes a site by limiting the exhaust rate will keep out contaminants entering the room during access
All at a Very Reasonable Price
ma2si
mobile air applied science

44. Healthcare Applications Needing Clean Air
Clean Air Clean Air Clean Air Clean Air
Surgery
Emergency
Intensive Care
Surge
Capacity
Burn
Units
Patient
Isolation
Pharmacy
Immune
Suppressed

45. Disaster Preparedness, Bio/Pharma, Research and Staff Safety
Surge Isolation/ Quarantine
Research Laboratories
Secure Environments
Surgical
Procedures
Pharmaceutical Admixing
Capture Airborne Pathogens
ma2si
mobile air applied science

46. Impacting Healthcare Critical Areas
Surgery Rooms
Clean the airborne environment surrounding the wound site
Push contaminated air away from and below the OR table
Reduce room environmental contamination
Pressurize the OR to keep contaminates out & fix exchange rate
Emergency Rooms
Precautionary isolation for undiagnosed Infection or disease
Open wound and staff protection
ma2si
mobile air applied science

47. Additional Healthcare Applications
Intensive Care
Reduce infections and length of stay and provide greater patient and staff protection
Surge Capacity
Add patient isolation (negative/positive) and portable surgical zones in-house or elsewhere in the community quickly and at low cost
ma2si
mobile air applied science

48. MA2SI Technology Positively Defends …
Open burn wounds from infections with minimal drying
Patients suffering from respiratory distress
Neonates once they’ve left the incubator
ERs by isolating those suspected of being contagious
Pharmacies during admixture of drugs & nutritional fluids
Laboratory specimens and those who handle them
Professional staff during performance of their duties
Facility HVAC systems from airborne pathogens
ma2si
mobile air applied science

49. mobile air applied science
Universal Benefits
Simple and affordable implementation
Easily transported to wherever needed
Counteracts the high costs associated with
infections
Proven reliability you can count on
Fewer infections and less patient trauma
ma2si
mobile air applied science

50. Facility Construction Solutions
Simplify design & construction with effective clean air systems
Upgrade facilities to create increased capability for patient care
Install clean air environments anywhere they are needed
Increase surge capacity quickly and at low cost
Add safety and airborne infection control to new and existing facilities
ma2si
mobile air applied science

51. The Real World of Dr. Partington
Nationally recognized plastic
and reconstructive surgeon
Over 475 nearly infection free (<1%) surgeries using a combination of two ma2si clean air systems
Captures cauterizing smoke particulates and odors with post- wound site system
ma2si
mobile air applied science

52. mobile air applied science
Cataract Surgery
A low velocity ultra clean air zone that does not produce dry-eye conditions during surgery
ma2si
mobile air applied science

53. Surgical Supplies Storage Room
Providing supply room with ultra-clean air reduces contaminant buildup on surgical supplies
Greatly reduces the transfer of collected
contaminates into surgical suite
ma2si
mobile air applied science

54. Pharmaceutical Research Lab
Creates secure laboratory and pharmacy environments easily and at low cost (USP-797)
ma2si
mobile air applied science

55. Physicians, Examination & Clinic Rooms
Dramatically reduces patient and provider chemical sensitivity reactions
Provides a clean environment for office surgeries
Removes toxic and potentially infectious plumes during electrocautery or laser surgery
ma2si
mobile air applied science

56. Premier US Particulate Analytical Lab
World recognized authority in
particulate identification
Verifiable contamination free
work environment
MA2SI E100 has worked flawlessly for eight years
ma2si
mobile air applied science

57. What Is Your Strategy For…
Airborne related infection reduction in your facility?
Staff and patient protection from spread of infections?
Overflow during local and national emergencies?
Protecting staff and facility’s air handling systems?
Quickly adding low cost isolation capacity during local and national disasters
Moving operations offsite successfully when needed?
ma2si
mobile air applied science

58. Clean Air Devices That Can “Break The Chain Of Infection”©
Mobile Air Applied Science, Inc.
Clean Air Devices That Can “Break The Chain Of Infection”©
ma2si
mobile air applied science