Objective: We substantiated a hygienic standard for air exchange multiplicity in the doctors’medical premises at the ambulances built into residential houses to preserve and strengthen their health.

Materials and methods: The analytical method was applied in the work (regulatory framework of sanitary and town-planning legislation, development of the hygienic standard by calculation method). The air exchange calculation for the working places of family doctors of the built-in ambulances was carried out in accordance with the NBS B.2.5-67:2013 Heating, Ventilation and Air Conditioning.

Results and discussion: The calculation of air exchange rate for the doctors’ working places of the healh care facilities built into the residential houses was carried out in accordance with the NBS B.2.5-67:2013 Heating, Ventilation and Air Conditioning (Annex X (mandatory) Minimum Outdoor Air Consumption) and corresponding formulas.
To calculate the air exchange in the doctors’premises, the category of the works of the doctors of the ambulance medical practice, which refers to light physical (office) work by the category I; the number of nurses at work at the same time and the potential number of visitors (2 persons - doctor and patient; 3 persons - doctor, nurse and patient and / or doctor, patient and accompanying person; 4 persons - doctor, nurse, patient and accompanying patient person); the minimum air consumption per 1 person - 60 m3 / hour; the regulatory size of the area of the medical premises (12 m2, 18 m2) and different types of housing estate with 2.5 m and 3 m premise high were taken into account.

Conclusions: To replace the current standard K = 1 (NBS B.2.2-10-2001 Health Care Facilities), the standards of optimal air exchange multiplicity K = 6.44 and K = 8.40 in doctors’ medical facilities with different sizes and the number of people staying simultaneously were substantiated on the basis of the conducted hygienic study of the conditions of the placement of modern health care facilities of ambulance type built into residential houses.
In order to ensure strengthening and preservation of the health of medical staff and patients and to create the proper sanitary and anti-epidemic working conditions for staff, the health care facilities, built into residential houses, need the mechanical plenum-exhaust ventilation according to the new reasonable standards of air exchange multiplicity for medical premises.

health care facilities of ambulance types built into residential houses; medical premises of different sizes and different types of buildings, rate of air exchange multiplicity, health of medical staff and patients

1. Machniuk V.M., Hopperia V.G., Polka O.O., Pavlenko N.P. and Ocheretyana G.V. Hygiene and Ecology in State Regulation of Urban Planning. Kyiv : Medinform ; 2020 : 131 p.

2. Makhniuk V.M., Serdiuk Ye.A., Chorna V.V., Harkavyi S.S. and Laptiev V.E. Novi hihiienichni pidkhody do suchasnoho mistobuduvannia v Ukraini [New Hygienic Approaches to the Modern Town-Planning in Ukraine. Monograph] / A.M. Serdiuk and N.S. Polka (eds.). Kyiv : Medinform; 2021 : 370 p. (in Ukrainian).

3. Kryvomaz T.I., Varavin D.V. and Sipakov R.V. Otsinka vplyvu system ventyliatsii na mikrobiolohichnu bezpeku ta mikroklimatychni umovy prymishchen [Assessment of the Impact of Ventilation Systems on the Microbiological Safety and Microclimatic Conditions of Premises]. Ventyliatsiia, osvitlennia ta teplohazopostachannia. 2020 ; 35 : 49-57 (in Ukrainian). DOI : https://doi.org/10.32347/2409-2606.2020.35.49-61

4. Makhniuk V.M., Melnychenko S.O., Mohylnyi S.M. et al. Do pytannia unormuvannia sani tarno-protyepidemichnykh vymoh pry budivnytstvi suchasnykh zhytlovykh kompleksiv [On the Issue of Standardization of Sanitary and Anti-Epidemic Requirements in the Construction of Modern Residential Complexes]. In : Fizychni faktory dovkillia ta yikh vplyv na formuvannia zdorovia naselennia Ukrainy (shistnadtsiati marzieievski chytannia) : mater. naukovoi konf. [Physical Environmental Factors and Their Impact on the Health of the Population of Ukraine (The Sixteenth Marzieiev`s Reading): Sci. Conf. Mater.]. Kyiv ; 2020 ; 20 : 73-73 (in Ukrainian).

5. Sanitarni normy mikroklimatu vyrobnychykh prymishchen : DSN 3.3.6.042-99 [Sanitary Standards of Microclimate of Production Areas : SSS 3.3.6.042-99 ]. (in Ukrainian). URL : https://zakon.rada.gov.ua/rada/show/va042282-99#Text

6. Radchenko O.Yu. and Feshchuk K.O. Zakhyst prav medychnykh pratsivnykiv v umovakh pandemii (COVID-19) v Ukraini [Protection of the Rights of Medical Staff in a Pandemic (COVID-19) in Ukraine]. Grail of Science. 2021 ; 2-3 :146-152. (in Ukrainian). DOI : https://doi.org/10.36074/grail-of-science.02.04.2021.029

7. Ocheretiana H.V., Chorna V.V., Makhniuk V.M. et al. Fizychni ta biolohichni (Covid-19) faktory vplyvu na sanitarno-protyepidemichni umovy sumishchenoho rozmishchennia zhytlovykh budynkiv ta vbudovanykh v nykh zakladiv okhorony zdorovia [Physical and Biological (Covid-19) Factors of the Impact of Sanitary and Anti-Epidemic Conditions of the Combined Placement of Residential Buildings and Built-in Health Care Facilities]. In : Fizychni faktory dovkillia ta yikh vplyv na formuvannia zdorovia naselennia Ukrainy (shistnadtsiati marzieievsky chytannia): zb. tez dop. naukovo-prakt. konf [Physical Factors of the Environment and Their Effect of the Formation of the Health of the Population of Ukraine (The Sixteenth Marzieiev’s Reading); Coll.Abs.Rep.Sci.-Pract. Conf.]. Kyiv ; 2020 ; 20 : 71-71 (in Ukrainian).

8. Guvernul Hotгrоre Nr. HG 696/2018 din 2018-07-11 pentru aprobarea Regulamentului sanitar privind gestionarea deșeurilor rezultate din activitatea medical. Monitorul Oficial (Republica Moldova). Nr. 295-308 (10.08.2018); art. 835. (in Romanian). URL : https://www.legis.md/cautare/getResults?doc_id=108829&lang=ro

9. Hotгrоrea Guvernului nr. 663 DIN 23.07.2010 pentru aprobarea Regulamentului sanitar privind condiюiile de igienг pentru instituюiile medico-sanitare. Monitorul Oficial (Republica Moldova). Nr. 131-134 (30.07.2010); art. 746. (in Romanian). URL : https://www.legis.md/cautare/getResults?doc_id=15505&lang=ro

10. Ocheretiana H.V., Makhniuk V.M., Chorna V.V. et al. Normatyvno-pravove rehuliuvannia hihiienichnykh pytan shchodo rozmishchennia vbudovanykh zakladiv okhorony zdorovia v yevropeiskykh krainakh [Regulatory-and-Legal Regulation of the Hygienic Issues on the Placement of Built-in Health Care Facilities in the European Countries]. Molodyi vchenyi. 2020 ;10 (86) : 272-278. DOI : https://doi.org/10.32839/2304-5809/2020-10-86-56

11. Prymirnyi tabel materialno-tekhnichnoho osnashchennia zakladiv okhorony zdorovia ta fizychnykh osib-pidpryiemtsiv, yaki nadaiut pervynnu medychnu dopomohu. Zatverdzheno nakazom Ministerstva okhorony zdorovia Ukrainy vid 26.01.2018 r. № 148 [Indicatory Report Card of Material and Technical Equipment of Health Care Facilities and Physical Persons-Emplyees Who Provide Primary Health Care. Approved by the Order of the Ministry of Health of Ukraine, January 26, 2018 № 148]. URL : https://moz.gov.ua/uploads/0/4141-dn_20180126_148.pdf

12. Zdaniya zhilye i obshchestvennye. Parametry mikroklimata v pomeshcheniyakh : GOST 30494–2011 (RF) [Residential and Public Buildings. Parameters of Microclimate in Premises : State Standard 30494-2011 (RF)]. (in Russian).

13. Erhonomika teplovoho seredovyshcha. Osnovni polozhennia i zastosuvannia vidpovidnykh standartiv. DSTU ISO 11399:2007 (ISO 11399:1995, IDT) [Ergonomics of Thermal Environment. Basic Provisions and Application of Corresponding Standards. NSTU 11399: 2007 (ISO 11399: 1995, IDT]. URL : http://online.budstandart.com/ua/catalog/doc-page?id_doc=52910

14. Dovidnyk kvalifikatsiinykh kharakterystyk profesii pratsivnykiv. Vypusk 78. Okhorona zdorovia [Handbook of qualification characteristics of employees' professions. Issue 78. Public Health (va117282-02)]. (in Ukrainian). URL : https://zakon.rada.gov.ua/rada/show/va117282-02

15. Ventyliatsiia hromadskykh budivel. Vymohy do vykonannia system ventyliatsii ta kondytsionuvannia povitria : DSTU B EN 13779:2011 (EN 13779:2007, IDT) [Ventilation of Public Buildings. Requirements to the Performance of the System for Ventilation and Air Conditioning : NSTU B EN 13779:2011 (EN 13779:2007, IDT)]. Kyiv ; 2012 : 142 p. (in Ukrainian).

16. Sustainability in Buildings and Civil Engineering Works — General Principles : ISO 15392:2019. URL : https://www.iso.org/standard/69947.html

17. Opalennia, ventyliatsiia ta kondytsionuvannia. Derzhavni budivelni normy DBN V.2.5-67:2013 (iz zminamy) [Heating, Ventilation and Conditioning. National Building Standards B.2.5-67;2013 (with alterations)]. (in Ukrainian). URL : https://zakon.rada.gov.ua/rada/show/v0024858-13#Text

18. Ventilation for Acceptable Indoor Air Quality: ASHRAE Standart 62–1989. Date of Access: 24.04.2016. URL : https://ashrae.iwrapper.com