Potential airborne transmission between two isolation cubicles through a shared anteroom.

Full-scale experiments and CFD simulations were performed to study potential inter-cubicle airborne transmissions through a shared anteroom due to the hinged door opening. When doors are closed, current negative pressure designs are effective for the containment of airborne pathogens in the 'dirty' cubicle with an index patient. When the 'dirty' cubicle door is open, airborne agents can move into the other 'clean' cubicle via the shared anteroom. As the door being opened or closed, the door sweeping effect is the main source of the two-way airflow and contaminant exchange through the doorway. When the dirty cubicle door remains fully open, temperature difference and concentration gradient across the doorway induce the two-way buoyancy-driven flow and transport of airborne agents across the doorway. The longer the dirty cubicle door remains fully open (10 s, 30 s or 60 s) or the smaller the air change rate (34-8.5 ACH for each cubicle), the more airborne pathogens are being transported into the 'clean' cubicle and the longer time it takes to remove them after the door is closed. Keeping the door completely open is potentially responsible for the majority of inter-cubicle transmissions if its duration is much longer than the duration of door motion (only 3 s). Our analyses suggest a potential inter-cubicle infection risk if the shared anteroom is used for multiple isolation cubicles. Decreasing the duration of door opening, raising air change rate or using a curtain at the doorway are recommended to reduce inter-cubicle exposure hazards.