Open Shafts in Mechanical Rooms
Accreditation Monthly
August 12, 2008
This month’s article was written by Brad Keyes, CHSP, a consultant at The Greeley Company.
I recently observed an open shaft in a mechanical room at a client’s hospital. The mechanical room was located in the penthouse, which housed an air-handler and elevator equipment. The vertical shaft extended more than four floors below and was used for ventilation ductwork, steam and chilled water pipes, and communication wires.
The Life Safety Code permits an open shaft in a mechanical room, as long as the room has a use related to the purpose of the shaft. The mechanical room also has to be separated from the rest of the building by appropriate fire-rated walls. (See LSC 8.2.5.3, 2000 edition.)
The problem that I saw was that this mechanical room, which didn’t have fossil fuel–fired equipment, had other items stored in it, including a separate storage room. With the constant problem that hospitals face of too little storage for too much stuff, the use of a mechanical room for storage is a common situation.
I wrote to the Standards Interpretation Group (SIG) at The Joint Commission and specifically asked if the following items were allowed to be stored in this situation:
- Cardboard boxes of filters
- Medical equipment, televisions, computer servers
- A separate room used for storage
Its answer was clear:
- Only one change of air filters is allowed in any mechanical room
- All storage must be confined with appropriately constructed barriers
- Any use of the mechanical room not primary to the function of the vertical shaft must be separated by appropriate constructed barriers
My recommendation is to inspect your mechanical rooms, especially the penthouse rooms, although open shafts in mechanical rooms can be found on the lower floors, and follow these suggestions:
- Leave only one set of filters for the air-handling equipment in that room; remove all others. Always keep new air filters clean in the boxes they came in or inside plastic bags. This is an infection control issue.
- Remove all items that are stored in mechanical rooms that are not related to the purpose of the shaft. Spare electric motors, drive shims, replacement belts, etc., are considered related to the purpose of the room. Televisions, computer servers, plumbing supplies, and medical equipment are not.
- Check the fire rating on any barriers separating a storage room from the mechanical room. The walls will need to be two-hour fire-rated if the shaft extends four or more floors, or one-hour fire-rated if the shaft extends three or fewer floors. The door will need to be fire-rated and must be fitted with positive latching and a closure. Look for unsealed penetrations in those walls also.
Finally, if you have no other place for storage and you want to continue to utilize the mechanical rooms for that purpose, you will have to construct storage rooms with appropriate fire-rated barriers. This is an expensive proposition, but it may be your best choice. Also, keep in mind that fire-rated storage cabinets are considered the same thing as fire-rated rooms. So consider using fire-rated cabinets for your smaller storage needs.
If you have any questions or comments regarding this information, please feel free to contact me at 815/629-2240 or 815/742-4367.
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