Patient Presentation
A pediatrician was traveling on a long-haul train when it began to become very cold in the car. He overheard the train steward responding to a passenger complaint about the temperature who said, “This is the temperature we set it at to decrease the spread of diseases.” A half-hour later after the car had warmed up, he also heard the steward saying that, “The conductor had turned on the air conditioning airflow by mistake, but that we usually have a set temperature to stop the spread of diseases.” The pediatrician had no idea what temperature would decrease the risk of disease and wrote down the question to research later.
Discussion
Ambient comfort levels depend on many factors including the temperature, humidity, airflow, radiant heat, and clothing of the individual among others.
In the United States Department of Labor’s, Occupational Health and Safety Administration (OSHA) states As a general rule, office temperature and humidity are matters of human comfort. OSHA has no regulations specifically addressing temperature and humidity in an office setting…. OSHA recommends temperature control in the range of 68-76° F [20-24.4° C] and humidity control in the range of 20%-60%.”
In the United Kingdom, the temperature usually should be at least 16 deg C [60.8°F] and at least 13 [55.4°F] if much of the work is physical. Where it is not appropriate, such as a cold storage room, bakery, etc., reasonable accommodations should be provided rotating tasks, insulating of pipes, providing shading on windows, etc..
Learning Point
According to the Centers for Disease Control guidelines for environmental infection control in health care settings: “Cool temperature standards (68°F-73°F [20°C-23°C]) usually are associated with operating rooms, clean workrooms, and endoscopy suites. A warmer temperature (75°F [24°C]) is needed in areas requiring greater degrees of patient comfort. Most other zones use a temperature range of 70°F-75°F (21°C-24°C).”
Humidity “[f]or most areas within health-care facilities, the designated comfort range is 30%-60% relative humidity.” Ventilation and pressurization of rooms has many parameters that are outlined in the guidelines (see To Learn More below).
Questions for Further Discussion
1. What temperature related issues does an airline need to consider for its passenger compartment ambient temperature?
2. What environmental controls can decrease disease spread risk in contained areas such as a train, bus, plane?
Related Cases
- Disease: Ambient Temperature | Hypothermia | Heat Illness |
Infection Control | Occupational Health for Healthcare Providers
- Symptom/Presentation: Health Maintenance and Disease Prevention
- Age: Young Adult
To Learn More
To view pediatric review articles on this topic from the past year check PubMed.
Evidence-based medicine information on this topic can be found at SearchingPediatrics.com, the National Guideline Clearinghouse and the Cochrane Database of Systematic Reviews.
Information prescriptions for patients can be found at MedlinePlus for these topics: Hypothermia and Heat Illness.
To view current news articles on this topic check Google News.
To view images related to this topic check Google Images.
U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC). Guidelines for Environmental Infection Control in Health-Care Facilities.
Available from the Internet at http://www.cdc.gov/hicpac/pdf/guidelines/eic_in_hcf_03.pdf (rev. 6/6/2013, cited 4/2/2013).
United States Department of Labor. Occupational Health and Safety Administration. OSHA Policy on Indoor Air Quality: Office Temperature/Humidity and Environmental Tobacco Smoke.
Available from the Internet at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=24602 (rev. 2/24/2003, cited 4/2/2013).
Health and Safety Executive. What is the maximum/minimum temperature in the workplace?
Available from the Internet at http://www.hse.gov.uk/contact/faqs/temperature.htme (cited 4/2/2013).
ACGME Competencies Highlighted by Case
10. An investigatory and analytic thinking approach to the clinical situation is demonstrated.
11. Basic and clinically supportive sciences appropriate to their discipline are known and applied.
12. Evidence from scientific studies related to the patients’ health problems is located, appraised and assimilated.
13. Information about other populations of patients, especially the larger population from which this patient is drawn, is obtained and used.
Author
Donna M. D’Alessandro, MD
Professor of Pediatrics, University of Iowa Children’s Hospital
Pediatric Education 