Ventilation guidelines for airborne infection isolation rooms (AIIRs) are highly variable in different countries indicating lack of actual knowledge about the guidance needed. However, US guidelines for AIIRs are extensive and have been widely adopted outside the US. AIIR performance has also been evaluated in numerous studies. For a long time, the aim has mainly been to evaluate how well the existing AIIRs meet US guidelines. For historical reasons, mixing-type ventilation has been emphasised and attention has been paid to air exchange rates, although the use of auxiliary devices, such as portable room-air cleaners and ultraviolet germicidal irradiation systems, has also been examined. Recently, the scope of the investigations has been widened. The most crucial issue is to minimise the potential for disease transmission and prevent the escape of contaminated air from the AIIR. Airflow direction inside the AIIR is also important and AIIRs minimise air leakage to save energy. On the other hand, it has been observed that efficient containment can be achieved even by using simple and inexpensive construction by considering pressure differential and air flow patterns. Nevertheless, additional research is needed to assist hospitals with improving their preparedness to cope with the threat of pandemics by building and using effective AIIRs.

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Airborne infection isolation rooms (AIIRs) house patients with tuberculosis, severe acute respiratory syndrome (SARS), and many other airborne infectious diseases. Currently, facility engineers and designers of heating, ventilation, and air-conditioning (HVAC) systems have few analytical tools to estimate a room's leakage area and establish an appropriate flow differential (DeltaQ) in hospitals, shelters, and other facilities where communicable diseases are present. An accurate estimate of leakage area and selection of DeltaQ is essential for ensuring that there is negative pressure (i.e., pressure differential [DeltaP]) between an AIIR and adjoining areas. National Institute for Occupational Safety and Health (NIOSH) researchers evaluated the relationship between DeltaQ and DeltaP in 67 AIIRs across the United States and in simulated AIIR. Data gathered in the simulated AIIR was used to develop an empirical model describing the relationship between DeltaQ, DeltaP, and leakage area. Data collected in health care facilities showed that the model accurately predicted the leakage area 44 of 48 times. Statistical analysis of the model and experimental validation showed that the model effectively estimated the actual leakage area from -39% to +22% with 90% confidence. The NIOSH model is an effective, cost-cutting tool that can be used by HVAC engineers and designers to estimate leakage area and select an appropriate DeltaQ in AIIRs to reduce the airborne transmission of disease.