The characteristics and capacity of the 33 assessed health centres in Jordan.
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In health facilities, IPC cannot be met without water, sanitation, and hygiene (WASH) services that provide the basis for adequate IPC. In the context of COVID-19, poor or inadequate WASH and IPC services and practices lead to transmission of the infection from healthcare facilities to communities and exacerbate the outbreak and spread of infections. The World Health Organization (WHO) in collaboration with the United Nations Children’s Fund (UNICEF) 2015 Report underlined the importance of adequate WASH in healthcare facilities for the prevention of infections and spread of disease and for protecting staff and patients’ health, dignity, and privacy [1]. WASH services strengthen the resilience of healthcare systems to prevent disease outbreaks, allowing effective responses to emergencies (including natural disasters and outbreaks), and bringing emergencies under control when they occur.
IPC has an immense role in reducing disease transmission generally and in healthcare facilities specifically; this fact has been well established in many studies. Madge et al. (1992) concluded that several IPC measures significantly reduced the incidence of nosocomial respiratory syncytial virus in the sample groups they observed [2]. According to Ershova et al. (2018), in middle-income countries, the employment of the IPC programme was highly effective in preventing nosocomial infection and in reducing antibiotic resistance [3]. Conducting evaluation studies for IPC in healthcare facilities helps find gaps and mistakes that should be corrected for the IPC programme to be more efficient and effective. In Jordan, this type of evaluation is seldom carried out. A survey of nosocomial IPC capacity among radiographers in Jordan reported moderate knowledge of IPC practices and that future training and improvement are needed [4]. Another study was conducted among nurses from 9 different hospitals in Jordan regarding safe injection handling. The study recommended focused and effective infection control educational programmes in Jordanian hospitals [5].
WASH is the acronym of Water, Sanitation, and Hygiene. It has a major impact on public health and its importance is recognized globally. In 2015 members of the United Nations agreed on 17 Sustainable Development Goals; these goals require urgent actions from all countries [6]. The first two targets in SDG 6 (Ensure availability and sustainable management of water and sanitation for all) are focused on the availability of clean affordable water and proper conditions of sanitation and hygiene [7].
Proper WASH conditions are essential for the protection of human health during all types of disease outbreaks including the ongoing COVID-19 pandemic. According to WHO, routinely applied WASH and waste management in homes, communities, schools, marketplaces, and healthcare facilities help to prevent the viral transmission that causes COVID-19 [8]. Prüss et al. (2002) have estimated the global disease burden from water, sanitation, and hygiene to be 4.0 per cent of all deaths and 5.7 per cent of the total disease burden (in DALYs) [9].
According to Khader (2017), despite the major advancement Jordan has made in IPC by providing access to drinking water and improving sanitation and health waste management, several areas are yet to be improved in the Jordanian healthcare setting. Also, it is advisable to establish and implement a WASH monitoring system for the healthcare system [10].
Water is essential to humans, not only for nourishment but also for better sanitation and hygiene. Each year, about 3,000 children under the age of 5 years old die from diarrhoeal disease resulting from lack of safe drinking water, hygiene, and sanitation; it also causes death to more than 829,000 humans each year [11]. The availability and quality of water are very strong factors in public health. According to the UNICEF, 663 million people do not have access to clean drinking water and nearly 60 million people use untreated water from unsafe sources like rivers [12, 13]. Jordan is ranked as the world’s-second most-water scarce country with 100 m3 per person, 400 m3 less than the severe water scarcity threshold, and more than 50 per cent receive water once every week [12]. Regarding COVID-19, clean water is very crucial in controlling the pandemic as about 1.8 billion people globally use fecal contaminated water; this water can serve as an alternative route of infection [14]. The Hospital Water Supply as a Source of Nosocomial Infections study by Anaissie et al. (2002) mentioned that an estimated number of 1,400 annual deaths in the United States due to waterborne nosocomial lung infections caused by Pseudomonas aeruginosa alone [15]. A recently published article in Infection Control and Hospital Epidemiology by Stuckey et al. (2020) reviewed the National Health care Safety Network annual reports from 4929 hospitals in the United States. They reported that 1 in 10 hospitals did not have a water management programme and some hospitals did not include some basic practices like water temperature and disinfectant monitoring [16]. Hospitals in Low- and middle-income countries suffer from water shortage. Chawla et al. (2016) reported in their study, a systematic review that included 22 hospital in the LMICs area providing surgical services, that more than one-third of the hospital did not have a reliable water source. They recommended that both governments and non-governmental organizations should direct more effort to enhance the water infrastructure of hospitals [17].
Medical waste is a dangerous pollutant that may contain viruses, bacteria, chemical substances, and even radioactive waste. It must not be taken for granted as it can act as a source of infection and limit the efforts in controlling an outbreak, not to mention its environmental impact. Since the beginning of COVID-19 pandemic medical waste has increased significantly and managing it became more difficult [18]. It is important to evaluate waste management for an accurate infection prevention assessment. In Jordan, less than 78 per cent of sanitation systems are managed safely and one-third of schools have basic sanitation services [12]. Several studies found that viral materials of the SARS-COV2 virus (RNA) can be found in human waste like blood and stool [19, 20, 21]. A recent study by Chen et al. (2020) tested human waste for SARS-COV2 viral shedding and found that fecal samples of COVID-19 patients remained positive for the virus after the pharyngeal swaps turned negative; this means that a patient that tests negative might excrete the virus by fecal route. The study also suggests that the fecal-oral transmission may be another way for this virus to be transmitted. Wastewater epidemiology is a relatively new discipline and it was mainly used to detect drugs in wastewater to estimate drug use in a population. However, it is now applied to detect pathogens including SARS-COV2 as the first report of its detection in an Australian study by Ahmed et al. (2020) was followed by a number of studies that all recommended a safe wastewater management to help fighting the pandemic [22].
Hygiene is a term used to describe the behaviors performed to achieve a level of cleanliness that can lead to good health and provide a range of infection prevention. It includes practices like hands and face washing, douching with water and soap, and other personal hygiene etiquettes. Good hygiene practices have an immense effect on public health. A simple act like hand washing can reduce the risk of foodborne diseases that spread by hand, and can reduce the mortality of diarrhoeal associated diseases by 50 per cent [23]. Hand hygiene has a great impact in preventing nosocomial infections especially multidrug-resistant infections. Yet, studies estimated global compliance with hand hygiene in healthcare to be only around 40 per cent [24]. Przekwas and Chen (2020) have mentioned that, besides hand washing, washing the face is also recommended to prevent COVID-19 transmission as they stated that the virus may accumulate in some areas of the face and can then be inhaled [25]. Using the WHO methodology, a recent study in Tanzania compared hospitals that received WASH training and hospitals that did not receive it. It was shown that the compliance rate of hand hygiene was significantly higher among hospitals with the WASH training programme [26].
Different studies have used different assessment tools. Recommendations on the suitability of different tools were made after the studies. A study was conducted by Tomczyk et al. (2020) to assess the WHO IPCAF at acute healthcare facilities in 46 counties. The study concluded that this is a necessary tool, and is effective for the improvement of IPC in health facilities [27]. Aghdassi et al. (2020) used the WHO IPCAF in their assessment and have stated in their paper that it was a useful tool that can detect shortfalls even in high-income settings at acute health facilities [28]. Maina et al. (2019) have reported in their paper, which examined WASH-FIT and WASH-FAST tools, that WASH-FIT is the tool of choice to assess WASH in smaller facilities. On the one hand, WASH-FAST is more suitable for hospitals at regional level [29]. On the other, a comprehensive study assessing different tools for WASH assessment has reported that none of the tools that they studied was comprehensive and concrete enough for assessing healthcare facility WASH activities [30].
A facility-wide WASH and IPC assessment is the cornerstone for designing, developing, and implementing specific WASH and IPC activities at healthcare facilities. This type of assessment helps identify and prioritize surveillance and prevention activities at the facility, based on the risk of acquiring and transmitting infections in the facility [1, 23, 31]. This report will provide healthcare policy makers at the national, district, and facility levels with the evidence and the action plans needed to strengthen WASH services and infection control policies, practices, and resources in health facilities and to motivate facilities to intensify efforts where needed to prevent, respond to, and control the spread of COVID-19. This report identifies areas for quality improvement in primary healthcare facilities, including strengthening WASH and IPC policies and standards that will lead to lower infection rates, better health outcomes for patients and improved safety and morale. It also identifies the strengths and gaps in the WASH and IPC practices, activities, and resources in the primary healthcare facilities in Jordan in the context of COVID-19.
A national assessment of WASH and IPC in primary healthcare facilities, including primary health centres and comprehensive health centres, was conducted in Jordan during the period October–November 2020. A multistage cluster-sampling technique proportional to the size of the facility was used for the selection of health centres. A sampling frame of all MoH health centres was obtained from the MoH and stratified according to region (North, Middle, and South), facility type (primary health centres and comprehensive centres). A random sample of health centres was selected from each stratum. A total of 11 primary healthcare centres and 22 comprehensive centres were selected.
A comprehsnive assessment tool was developed for healthcare centres a based on the review and adaptation of several tools, mainly the Water and Sanitation for Health Facility Improvement Tool (WASH FIT) [32]. WASH FIT covers four broad domains and comprises 65 indicators, aiming to achieve minimum standards for maintaining a safe and clean environment. WASH FIT is primarily designed for use in primary healthcare facilities that provide outpatient services. The assessment tools developed included more indicators and standards from other tools such as: ‘The Infection Prevention and Control Assessment Framework’ (IPCAF) [33]; the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care [34]; The Systems for Improved Access to Pharmaceuticals and Services (SIAPS) tool, and the coronavirus disease (COVID-19) technical guidance by WHO [8].
The health centre assessment tool covered eight broad areas (Domains): (1) Water, (2) Medical waste and sanitation facilities, (3) Hygiene, (4) Management, (5) Infection prevention and control programme, (6) Training and education, (7) Evaluation and feedback, and (8) COVID-19 precautionary measures. The Hygiene domain covered areas related to hand hygiene and facility environment, cleanliness and disinfection. The Infection prevention and control programme area was divided into subareas including (a) Basic indicators, (b) Guidelines in IPC unit, (c) Training and education for the Infection Prevention and Control Unit, (d) Healthcare associated infection monitoring, (e) Monitoring/auditing of infection control practices and outcomes, (f) Personal protective equipment, and (g) Availability of hygiene materials. Evaluation and feedback covered subareas including (a) Basic Indicators, (b) Respiratory safety, (c) Environmental cleaning, and (d) Sterilization of Reusable Devices.
Each area/subarea included indicators and targets for achieving minimum standards for maintaining a safe and clean environment. These standards are based on global standards as set out in the WHO Essential environmental health standards in health care [35] and the WHO Guidelines on core components of infection prevention and control programmes at the national and acute healthcare facility level [33]. The assessment tool included WASH-FIT indicators in addition to other indicators identified from available tools. Indicators were adapted to Jordan’s needs and local priorities and/or national standards in order to meet quality improvement cycles and mechanisms implemented to improve quality of care. Indicators that are not relevant were removed. Additional indicators were added as necessary to represent levels of services.
A committed team with leadership skills and who are familiar with and trained on WASH and IPC was formed. The assessment team was composed of 12 assessors who were divided into three teams; one team for each region. The team had support from the MoH leadership and from facility’s administration. A training workshop was held to train the assessment team on the assessment process, data collection, and use of assessment tools. During the workshop, the assessment team members were made aware of the assessment tools and their roles and responsibilities.
The assessment teams planed their visits to the health centres with the senior facility manager. During the facility visit, the assessment team worked the with facility team including those who have in-depth understanding and knowledge of WASH and IPC activities at the facility level to fill the assessment tool. If there were no professionals in charge of WASH and IPC or there was not yet an IPC programme established, the tool was completed by the team with the consultation with the senior facility manager. The IPC team consulted with other relevant teams in the facility to respond to questions accurately.
A comprehensive assessment of the facility was conducted using the agreed list of indicators and each indicator was recorded as whether it meets, partially meets, or does not meet, the minimum standards. The assessment forms were reviewed by supervisors to ensure all information is clear and correct and all members of the team agree on the findings of each assessment. As part of the assessment, hygiene promotion materials, WASH and IPC guidelines and budget were reviewed and observed.
The percentage of indicators, which meet or partially meet the standards, was calculated for each facility. The overall facility score (the percentage of all indicators meetings the standards) was calculated to make comparisons over time when future assessments are conducted. The mean percentages over all facilities were calculated. Data were described using means and percentages.
A total of 33 healthcare centres were assessed using WASH and IPC assessment tools. One-third of these centres (n = 11, 33.3 per cent) were primary healthcare centres and 22 (66.7 per cent) were comprehensive health centres. Of all assessed health centres, 39.4 per cent were in the North of Jordan, 33.3 per cent in the Middle and 27.3 per cent in the South of the country.
Table 1 shows the characteristics and capacity of the 33 assessed health centres in Jordan. Primary healthcare centres were more consistent in the number of the medical staff they have than comprehensive healthcare centres; the median number of medical staff in each category was two for most specialties, while the median number of medical staff in the comprehensive healthcare centres ranged from two to six.
Primary healthcare centre | Comprehensive healthcare centre | Total | |||||||
---|---|---|---|---|---|---|---|---|---|
Number | Min. | Max. | Median | Min. | Max. | Median | Min. | Max. | Median |
Doctors | 1 | 6 | 2 | 2 | 25 | 6 | 1 | 25 | 5 |
Nurses | 0 | 8 | 2 | 1 | 8 | 3 | 0 | 8 | 3 |
Midwifes | 0 | 6 | 2 | 1 | 6 | 2 | 0 | 6 | 2 |
Lab technicians | 0 | 4 | 1 | 1 | 11 | 3 | 0 | 11 | 2 |
Radiology technicians | 0 | 0 | 0 | 0 | 5 | 2 | 0 | 5 | 1 |
Pharmacists | 1 | 6 | 2 | 1 | 9 | 3 | 1 | 9 | 3 |
Ambulance | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 1 | 0 |
MoH health technicians/inspectors | 0 | 2 | 0 | 0 | 8 | 0.5 | 0 | 8 | 0 |
The characteristics and capacity of the 33 assessed health centres in Jordan.
Table 2 shows the mean percentage of WASH and IPC indicators over health centres that met the targets for each assessed area in both the primary and comprehensive healthcare centres. Each assessed area has a different number of indicators. The mean percentages of indicators that met the targets considerably varied among various WASH/IPC areas and type of health centres.
Area | Number of indicators assessed | Type of health centre | Total (N = 33) | ||||
---|---|---|---|---|---|---|---|
Primary (N = 11) | Comprehensive (N = 22) | ||||||
Mean % | SD | Mean % | SD | Mean % | SD | ||
Water | 14 | 55.2 | 15.7 | 64.9 | 20.2 | 61.7 | 19.1 |
Medical waste and sanitation | 16 | 39.2 | 20.2 | 54.0 | 24.3 | 49.1 | 23.8 |
Hygiene | |||||||
Hand hygiene | 5 | 54.5 | 37.0 | 69.1 | 27.4 | 64.2 | 31.1 |
Environmental cleanliness and disinfection | 11 | 61.2 | 19.5 | 66.9 | 12.4 | 65.0 | 15.1 |
Management | 10 | 27.3 | 28.0 | 49.1 | 31.3 | 41.8 | 31.6 |
Infection prevention and control programme | |||||||
Basic indicators | 7 | 29.9 | 30.3 | 45.5 | 30.4 | 40.3 | 30.8 |
Guidelines in IPC unit | 12 | 48.5 | 39.4 | 77.3 | 29.3 | 67.7 | 35.2 |
Training and education for the Infection Prevention and Control Unit | 3 | 30.3 | 37.9 | 42.4 | 41.4 | 38.4 | 40.1 |
Healthcare-associated infection monitoring | 3 | 24.2 | 36.8 | 53.0 | 33.6 | 43.4 | 36.8 |
Monitoring/auditing of infection control practices and outcomes | 8 | 51.1 | 32.3 | 73.9 | 16.3 | 66.3 | 24.9 |
Personal protective equipment | 9 | 46.5 | 24.8 | 70.7 | 21.3 | 62.6 | 25.0 |
Availability of hygiene materials | 5 | 52.7 | 33.8 | 57.3 | 29.8 | 55.8 | 30.7 |
Training and education | 4 | 34.1 | 35.8 | 50.0 | 40.1 | 44.7 | 38.9 |
Evaluation and feedback | |||||||
Basic indicators | 2 | 63.6 | 45.2 | 77.3 | 33.5 | 72.7 | 37.7 |
Respiratory safety | 5 | 14.5 | 20.2 | 50.9 | 34.2 | 38.8 | 34.6 |
Environmental cleaning | 2 | 31.8 | 33.7 | 56.8 | 41.7 | 48.5 | 40.5 |
Sterilization of reusable devices | 2 | 81.8 | 33.7 | 100 | 0.0 | 93.9 | 20.8 |
COVID-19 precautionary measures | 17 | 42.8 | 23.1 | 53.2 | 19.9 | 49.7 | 21.3 |
The mean percentage of indicators that met the targets in each assessed area.
Almost 61.7 per cent of water indicators in all health centres (64.9 per cent in comprehensive health centres and 55.2 per cent in primary centres) met the targets. However, only half of the medical waste and sanitation indicators (49.1 per cent) met the target. Almost two-thirds of hand hygiene indicators (64.2 per cent) and environmental cleanliness and disinfection indicators (65.0 per cent) met the target. Only 41.8 per cent of management indicators (27.3 per cent in primary centres and 49.1 per cent in comprehensive centres) met the targets. While two-thirds of indicators pertaining to guidelines in IPC unit met the target, only 40.3 per cent of basic indicators of IPC programming, 38.4 per cent of indicators of the training and education for the Infection Prevention and Control Unit, and 43.4 per cent of the targets for healthcare-associated infection monitoring indicators were met. Moreover, 66.3 per cent of ‘Monitoring/auditing of infection control practices and outcomes’ indicators, 62.6 per cent of ‘Personal protective equipment’ indicators, 55.8 per cent of the ‘Availability of hygiene materials’ indicators, 44.7 per cent of the ‘Training and education’ indicators, 38.8 per cent of the ‘Respiratory safety’ indicators, and 48.5 per cent of the ‘Environmental cleaning’ indicators met the targets. The mean percentages of ‘COVID-19 precautionary measures’ indicators (49.7 per cent) that met the target were relatively low in both types of healthcare centres.
As expected, the mean percentages of indicators that had met the targets were higher for comprehensive healthcare centres than that for primary centres in all assessed WASH/IPC areas. For example, the mean percentage of ‘respiratory safety’ indicators in primary healthcare centres (14.5 per cent) was much lower than the mean percentage of ‘respiratory safety’ indicators in comprehensive healthcare centres (50.9 per cent).
The percentage of primary healthcare centres that met the target for most water indicators were lower than comprehensive care centres, except for a few indicators, as demonstrated in Table 3. The percentage of health centres that met water indicators varied between 21.2 per cent and 100 per cent. Improved drinking-water supply and the availability of hot water was weak in both primary and comprehensive healthcare centres. Less than two-thirds of centres had clean drinking-water available and accessible to all at all times and in all locations, had drinking-water safely stored in a clean bucket/tank with cover and tap, had water tanks cleaned annually, had an emergency water tank available, and had hot water available in the health centres. On the other hand, meeting the target for indicators related to the availability and functionality of water supply was high in both types of healthcare centres, and even higher in primary care centres, reaching 100 per cent. Fortunately, the percentage of healthcare centres that fully met the target was greater than the percentage of centres that partially met the target for almost all the indicators related to water.
Water | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
2 | 18.2 | 1 | 9.1 | 4 | 18.2 | 6 | 27.3 | 6 | 18.2 | 7 | 21.2 | |
Water services available at all times and of sufficient quantity for all uses | 2 | 18.2 | 5 | 45.5 | 2 | 9.1 | 17 | 77.3 | 4 | 12.1 | 22 | 66.7 |
A clean drinking-water is available and accessible for staff, patients and healthcare providers at all times and in all locations/wards | 2 | 18.2 | 5 | 45.5 | 6 | 27.3 | 14 | 63.6 | 8 | 24.2 | 19 | 57.6 |
Drinking-water is safely stored in a clean bucket/tank with cover and tap | 5 | 45.5 | 5 | 45.5 | 7 | 31.8 | 14 | 63.6 | 12 | 36.4 | 19 | 57.6 |
Water tanks are cleaned annually | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 10 | 45.5 | 0 | 0.0 | 14 | 42.4 |
Emergency water tank is available | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 13 | 59.1 | 0 | 0.0 | 15 | 45.5 |
All water end points (i.e., taps) in the health centre are connected to an available and functioning water supply | 0 | 0.0 | 10 | 90.9 | 5 | 22.7 | 17 | 77.3 | 5 | 15.2 | 27 | 81.8 |
Water services are available throughout the year (i.e., not affected by seasonality, climate change-related extreme events or other constraints) | 0 | 0.0 | 11 | 100 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 33 | 100 |
Water storage is sufficient to meet the needs of the health centre for two days | 0 | 0.0 | 11 | 100 | 0 | 0.0 | 21 | 95.5 | 0 | 0.0 | 32 | 97.0 |
Water is treated and collected for drinking with standards that meet WHO performance standards | 0 | 0.0 | 8 | 72.7 | 3 | 13.6 | 15 | 68.2 | 3 | 9.1 | 23 | 69.7 |
Drinking-water has appropriate chlorine residual (0.2 mg/L or 0.5 mg/L in emergencies) or 0 | 0 | 0.0 | 7 | 63.6 | 3 | 13.6 | 17 | 77.3 | 3 | 9.1 | 24 | 72.7 |
The health centre water supply is regulated according to national water quality standards | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 21 | 95.5 | 0 | 0.0 | 30 | 90.9 |
Hot water is available in the health centre | 4 | 36.4 | 3 | 27.3 | 13 | 59.1 | 4 | 18.2 | 17 | 51.5 | 7 | 21.2 |
Water heating indicator is available | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 9 | 40.9 | 0 | 0.0 | 13 | 39.4 |
Percentage of health centres that meet the target for each indicator of ‘Water’ according to the type of health Centre.
The targets for many indicators related to toilet provision were met by very few primary healthcare centres and relatively few comprehensive healthcare centres. In addition to the low percentage of centres that met targets for indicators pertaining to the number, functionality, and monitoring of toilets, there were few, if any, toilets that serve people with special needs, or toilets designed to meet menstrual hygiene needs. The difference in the percentage of centres that met the targets for indicators pertaining to toilets was obvious between comprehensive and primary healthcare centres (Table 4).
Medical waste and sanitation | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Number of available and usable toilets in the health centre for patients | 1 | 9.1 | 5 | 45.5 | 2 | 9.1 | 16 | 72.7 | 3 | 9.1 | 21 | 63.6 |
Toilets are clearly separated for staff and patients | 4 | 36.4 | 2 | 18.2 | 6 | 27.3 | 12 | 54.5 | 10 | 30.3 | 14 | 42.4 |
Toilets are clearly separated for male and female | 2 | 18.2 | 1 | 9.1 | 3 | 13.6 | 14 | 63.6 | 5 | 15.2 | 15 | 45.5 |
At least one toilet provides the means to meet menstrual hygiene needs | 1 | 9.1 | 3 | 27.3 | 2 | 9.1 | 11 | 50.0 | 3 | 9.1 | 14 | 42.4 |
At least one toilet meets the needs of people with special needs (reduced mobility) | 0 | 0.0 | 0 | 0.0 | 2 | 9.1 | 10 | 45.5 | 2 | 6.1 | 10 | 30.3 |
Functioning hand-hygiene stations within 5 metres of the toilets | 0 | 0.0 | 4 | 36.4 | 2 | 9.1 | 8 | 36.4 | 2 | 6.1 | 12 | 36.4 |
Record of toilet cleaning is visible and signed by the cleaners each day | 5 | 45.5 | 1 | 9.1 | 6 | 27.3 | 6 | 27.3 | 11 | 33.3 | 7 | 21.2 |
Wastewater is safely managed through the use of on-site treatment (i.e., septic tank, followed by drainage pit) or sent to a functioning sewer system | 1 | 9.1 | 8 | 72.7 | 1 | 4.5 | 17 | 77.3 | 2 | 6.1 | 25 | 75.8 |
Greywater (i.e., rainwater or wash water) drainage system is in place that diverts water away from the health centre (i.e., no standing water) and also protects nearby households | 0 | 0.0 | 3 | 27.3 | 2 | 9.1 | 4 | 18.2 | 2 | 6.1 | 7 | 21.2 |
Toilets are adequately lit, including at night | 2 | 18.2 | 7 | 63.6 | 5 | 22.7 | 15 | 68.2 | 7 | 21.2 | 22 | 66.7 |
A trained liaison officer is responsible for the management of healthcare waste in the health centre | 2 | 18.2 | 6 | 54.5 | 7 | 31.8 | 10 | 45.5 | 9 | 27.3 | 16 | 48.5 |
There are functional waste collection containers in close proximity to all waste generation points for non-infectious (general) waste, infectious waste, and sharps waste | 4 | 36.4 | 5 | 45.5 | 9 | 40.9 | 13 | 59.1 | 13 | 39.4 | 18 | 54.5 |
Wastes are correctly sorted at all waste generation points | 1 | 9.1 | 9 | 81.8 | 5 | 22.7 | 14 | 63.6 | 6 | 18.2 | 23 | 69.7 |
Functional burial pit/fenced waste dump or municipal pick-up available for disposal domestic waste | 0 | 0.0 | 10 | 90.9 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 32 | 97.0 |
Protocol or standard operating procedure (SOP) for safe management of healthcare waste clearly visible and legible | 2 | 18.2 | 2 | 18.2 | 2 | 9.1 | 13 | 59.1 | 4 | 12.1 | 15 | 45.5 |
Appropriate protective equipment for all staff in charge of waste treatment and disposal | 6 | 54.5 | 3 | 27.3 | 10 | 45.5 | 5 | 22.7 | 16 | 48.5 | 8 | 24.2 |
Percentage of health centres that meet the target for each indicator of “medical waste and sanitation” according to the type of health Centre.
Some targets were met by most primary and comprehensive healthcare centres, such as wastewater management (72.7 per cent and 77.3 per cent, respectively), and disposal of domestic waste (90.9 per cent and 100 per cent, respectively). However, the percentage of primary centres that met the target for indicators like sorting of waste and the availability of a trained liaison officer for waste management were higher than comprehensive healthcare centres.
Hand hygiene indicators were generally good at both the primary and the comprehensive healthcare centres; there were more centres that fully met the target than centres that partially met the target (Table 5). Over 70 per cent of healthcare centres were reported to have functioning and adequately available hand-hygiene stations that were supplied with water and soap. However, almost half of the centres had clearly displayed sign boards for hand hygiene (posters), had functioning hand-hygiene stations in waste disposal areas, and had regular hand-hygiene compliance activities.
Hand hygiene | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Functioning hand-hygiene stations are adequately available at all care points | 2 | 18.2 | 8 | 72.7 | 2 | 9.1 | 20 | 90.9 | 4 | 12.1 | 28 | 84.8 |
Functioning hand-hygiene stations are adequately available at all care points and supplied with water, liquid soap, or alcohol-based hand rub | 1 | 9.1 | 8 | 72.7 | 4 | 18.2 | 18 | 81.8 | 5 | 15.2 | 26 | 78.8 |
There are sign boards for hand hygiene (posters) clearly displayed in an understandable manner in key areas | 4 | 36.4 | 5 | 45.5 | 5 | 22.7 | 13 | 59.1 | 9 | 27.3 | 18 | 54.5 |
Functioning hand-hygiene stations are available in waste disposal areas | 2 | 18.2 | 4 | 36.4 | 1 | 4.5 | 12 | 54.5 | 3 | 9.1 | 16 | 48.5 |
Hand-hygiene compliance activities are undertaken regularly | 1 | 9.1 | 5 | 45.5 | 5 | 22.7 | 13 | 59.1 | 6 | 18.2 | 18 | 54.5 |
Percentage of health centres that meet the target for each indicator of ‘hand hygiene’ according to the type of health Centre.
The target for many indicators for cleanliness and disinfection were met by most healthcare centres (Table 6). The percentage of primary healthcare centres that met the target was close to the percentage for comprehensive healthcare centres, but were quite different for centres that partially met the target. Two indicators—‘record of cleaning’ and ‘laundry facilities’—were met by few centres only, and one-third of healthcare centres provide at least two pairs of gloves, apron, and boots for each cleaning and waste disposal staff member.
Environmental cleanliness and disinfection in the health centre | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
The exterior of the health centre is well-fenced, kept generally clean (free from solid waste, stagnant water, no animal and human feces in or around the health centre premises, etc.) | 2 | 18.2 | 8 | 72.7 | 0 | 0.0 | 21 | 95.5 | 2 | 6.1 | 29 | 87.9 |
There is a container assembly area managed by the municipality | 0 | 0.0 | 10 | 90.9 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 29 | 87.9 |
General lighting sufficiently powered and adequate to ensure safe provision of health care including at night (mark if not applicable) | 5 | 45.5 | 6 | 54.5 | 5 | 22.7 | 16 | 72.7 | 10 | 30.3 | 22 | 66.7 |
Floors and work surfaces are clean | 1 | 9.1 | 10 | 90.9 | 1 | 4.5 | 20 | 90.9 | 2 | 6.1 | 30 | 90.9 |
Appropriate and well-maintained materials for cleaning (i.e., detergent, mops, buckets, etc.) are available | 3 | 27.3 | 8 | 72.7 | 2 | 9.1 | 19 | 86.4 | 5 | 15.2 | 27 | 81.8 |
At least two pairs of household cleaning gloves, one pair of overalls or apron, and boots in a good state are available for each cleaning and waste disposal staff member | 2 | 18.2 | 4 | 36.4 | 3 | 13.6 | 7 | 31.8 | 5 | 15.2 | 11 | 33.3 |
At least one member of staff can demonstrate the correct procedures for cleaning and disinfection and apply them as required to maintain clean and safe rooms | 1 | 9.1 | 8 | 72.7 | 2 | 9.1 | 14 | 63.6 | 3 | 9.1 | 22 | 66.7 |
A mechanism exists to track supply of IPC-related materials (such as gloves and protective equipment) to identify stock-outs | 1 | 9.1 | 7 | 63.6 | 1 | 4.5 | 15 | 68.2 | 2 | 6.1 | 22 | 66.7 |
Record of cleaning is visible and signed by the cleaners each day | 1 | 9.1 | 1 | 9.1 | 2 | 9.1 | 5 | 22.7 | 3 | 9.1 | 6 | 18.2 |
Health centre’s laundry is available to wash linen from patient beds between each patient | 0 | 0.0 | 2 | 18.2 | 2 | 9.1 | 7 | 31.8 | 2 | 6.1 | 9 | 27.3 |
The health centre has sufficient natural ventilation and, where the climate allows, large opening windows, skylights and other vents to optimize natural ventilation | 1 | 9.1 | 10 | 90.9 | 3 | 13.6 | 19 | 86.4 | 4 | 12.1 | 29 | 87.9 |
Percentage of health centres that meet the target for each indicator of ‘environmental cleanliness and disinfection in the health Centre’ according to the type of health Centre.
Less than half of healthcare centres met the target for indicators related to the management of WASH, except for the availability of ‘a dedicated WASH or IPC coordinator’ and ‘a written job description that is clear and legible for all staff’ which were achieved by 57.6 per cent of centres. An annual planned budget for the centre that includes WASH infrastructure and service was available at 15.2 per cent of centres only, with none of the primary healthcare centres having completely met the target. However, there was a higher percentage of healthcare centres that completely met the target than those that partially met the target, except for few indicators in the primary healthcare centres like the availability of an annual budget, a protocol for operation and maintenance, and the availability of cleaners and WASH maintenance staff (Table 7).
Management | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
WASH FIT or other quality improvement/management plan for the health centre is in place, implemented and regularly monitored | 1 | 9.1 | 3 | 27.3 | 3 | 13.6 | 10 | 45.5 | 4 | 12.1 | 13 | 39.4 |
An annual planned budget for the centre is available and includes funding for WASH infrastructure, services, personnel and the continuous procurement of WASH items | 2 | 18.2 | 0 | 0.0 | 4 | 18.2 | 5 | 22.7 | 6 | 18.2 | 5 | 15.2 |
An up-to-date diagram of the health centre management structure is clearly visible and legible | 0 | 0.0 | 4 | 36.4 | 2 | 9.1 | 12 | 54.5 | 2 | 6.1 | 16 | 48.5 |
Adequate cleaning and WASH maintenance staff are available | 7 | 63.6 | 3 | 27.3 | 9 | 40.9 | 12 | 54.5 | 16 | 48.5 | 15 | 45.5 |
There is a protocol for operation and maintenance, including procurement of WASH supplies, that is visible, legible and implemented | 3 | 27.3 | 1 | 9.1 | 1 | 4.5 | 8 | 36.4 | 4 | 12.1 | 9 | 27.3 |
Regular department-based audits are undertaken to assess the availability of hand rub, soap, single-use towels and other hygiene resources | 4 | 36.4 | 4 | 36.4 | 3 | 13.6 | 12 | 54.5 | 7 | 21.2 | 16 | 48.5 |
New healthcare personnel receive IPC training as part of their orientation programme | 3 | 27.3 | 2 | 18.2 | 2 | 9.1 | 13 | 59.1 | 5 | 15.2 | 15 | 45.5 |
Healthcare staff are trained on WASH/IPC each year (at least) | 2 | 18.2 | 2 | 18.2 | 4 | 18.2 | 9 | 40.9 | 6 | 18.2 | 11 | 33.3 |
The health centre has a dedicated WASH or IPC coordinator | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 13 | 59.1 | 0 | 0.0 | 19 | 57.6 |
All staff have a job description written clearly and legibly, including WASH-related responsibilities, and are regularly appraised on their performance | 1 | 9.1 | 5 | 45.5 | 1 | 4.5 | 14 | 63.6 | 2 | 6.1 | 19 | 57.6 |
Percentage of health centres that meet the target for each indicator of ‘management’ according to the type of health Centre.
One-third of primary healthcare centres (36.4 per cent) and two-thirds of comprehensive healthcare centres (63.6 per cent) have an IPC programme. Nonetheless, an IPC team or focal person was not available at most healthcare centres (Table 8). IPC objectives were clearly defined in 42.4 per cent of the health centres. Although the leadership in most healthcare centres shows full commitment to support the IPC programme in the centre, most centres lack the ability to support an appropriate IPC system, such as a microbiological laboratory (33.3 per cent) or an early-detection system (15.2 per cent).
Infection prevention and control programme: Basic indicators | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Have an IPC programme at the health centre | 0 | 0.0 | 4 | 36.4 | 4 | 18.2 | 14 | 63.6 | 4 | 12.1 | 18 | 54.5 |
The health centre has a full-time ICP team or a specialist | 3 | 27.3 | 3 | 27.3 | 10 | 45.5 | 7 | 31.8 | 13 | 39.4 | 10 | 30.3 |
IPC team or the focal person have dedicated time for IPC activities | 1 | 9.1 | 2 | 18.2 | 8 | 36.4 | 10 | 45.5 | 9 | 27.3 | 12 | 36.4 |
IPC objectives are clearly defined in the health centre | 2 | 18.2 | 2 | 18.2 | 6 | 27.3 | 12 | 54.5 | 8 | 24.2 | 14 | 42.4 |
Does the senior leadership team in the health centre show clear commitment and support for the IPC programme? | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 23 | 69.7 |
Does the health centre have microbiological laboratory support (either on or off site) for routine day-to-day use? | 1 | 9.1 | 3 | 27.3 | 1 | 4.5 | 8 | 36.4 | 2 | 6.1 | 11 | 33.3 |
The health centre has an early-detection system and deals with potentially contagious individuals at early meeting points | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 3 | 13.6 | 0 | 0.0 | 5 | 15.2 |
Percentage of health centres that meet the target for each indicator of ‘infection prevention and control programme: Basic indicators’ according to the type of health Centre.
A higher percentage of comprehensive healthcare centres met the targets compared to primary healthcare centres for all indicators of the IPC guideline (Table 9). Almost 48.5 per cent of health centres have policies and procedures for disease outbreak management and a preparedness system, 45.5 per cent have policies and procedures for antibiotic usage, 48.5 per cent of health centres had trained healthcare workers on the new or updated IPC guidelines, and 57.6 per cent of health centres regularly monitor the implementation of at least some of the IPC guidelines in the health centre.
Guidelines in IPC unit | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
The health centre has policies and procedures for standard precautions | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 26 | 78.8 |
The health centre has policies and procedures for hand hygiene | 0 | 0.0 | 8 | 72.7 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 27 | 81.8 |
The health centre has policies and procedures for transmission-based precautions | 0 | 0.0 | 5 | 45.5 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 24 | 72.7 |
The health centre has policies and procedures for outbreak management and preparedness system | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 12 | 54.5 | 0 | 0.0 | 16 | 48.5 |
The health centre has policies and procedures for prevention of infection during treatment | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 17 | 77.3 | 0 | 0.0 | 21 | 63.6 |
The health centre has policies and procedures for disinfection and sterilization | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 25 | 75.8 |
The health centre has policies and procedures for healthcare worker protection and safety | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 25 | 75.8 |
The health centre has policies and procedures for injection safety | 0 | 0.0 | 8 | 72.7 | 0 | 0.0 | 20 | 90.9 | 0 | 0.0 | 28 | 84.8 |
The health centre has policies and procedures for waste management | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 26 | 78.8 |
The health centre has policies and procedures for antibiotic usage | 0 | 0.0 | 3 | 27.3 | 0 | 0.0 | 12 | 54.5 | 0 | 0.0 | 15 | 45.5 |
Healthcare workers receive specific training related to new or updated IPC guidelines introduced in the health centre | 0 | 0.0 | 3 | 27.3 | 0 | 0.0 | 13 | 59.1 | 0 | 0.0 | 16 | 48.5 |
The implementation of at least some of the IPC guidelines in the health centre are regularly monitored | 0 | 0.0 | 3 | 27.3 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 19 | 57.6 |
Percentage of health centres that meet the target for each indicator of ‘guidelines in IPC unit’ according to the type of health Centre.
Further, there was a large difference between the percentage of primary healthcare centre and comprehensive healthcare centres that met the target for the following indicators: the availability of policies and procedures for transmission-based precautions (45.5 per cent versus 86.4 per cent), policies and procedures for prevention of infection during treatment (36.4 per cent versus 77.3 per cent), and monitoring the implementation of at least some of the IPC guidelines (27.3 per cent versus 72.7 per cent).
Although 60.6 per cent of health centres have an employee who leads the IPC training, healthcare workers, cleaners or other workers receiving training in IPC is reported by few centres (27.3 per cent); primary (18.2 per cent) or comprehensive (31.8 per cent). However, some centres were reported to have partially met the target; about one-third of centres met the target for receiving training regarding IPC for healthcare workers (39.4 per cent) and cleaners (33.3 per cent) (Table 10).
Training and education for the Infection Prevention and Control Unit | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
There are personnel with the IPC expertise (in IPC and/or infectious diseases) who lead IPC training | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 14 | 63.6 | 0 | 0.0 | 20 | 60.6 |
The number of times healthcare workers receive training regarding IPC in the health centre | 3 | 27.3 | 2 | 18.2 | 10 | 45.5 | 7 | 31.8 | 13 | 39.4 | 9 | 27.3 |
Number of times cleaners and other personnel directly involved in patient care receive training regarding IPC in the health centre | 4 | 36.4 | 2 | 18.2 | 7 | 31.8 | 7 | 31.8 | 11 | 33.3 | 9 | 27.3 |
Percentage of health centres that meet the target for each indicator of ‘training and education for the infection prevention and control unit’ according to the type of health Centre.
Surveillance was mainly conducted for epidemic-prone infections, as indicated by almost two-thirds of healthcare centres (60.6 per cent). Furthermore, surveillance for colonization or infections caused by multidrug-resistant pathogens was conducted by about one-fifth of healthcare centres (21.2 per cent), and about a half of them (48.5 per cent) conducted surveillance for infections that may affect healthcare workers in clinical, laboratory, or other settings, like the hepatitis virus (Table 11).
Healthcare-associated infection monitoring | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Surveillance is conducted for colonization or infections caused by multidrug-resistant pathogens based on the local epidemiological situation | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 5 | 22.7 | 0 | 0.0 | 7 | 21.2 |
Surveillance is conducted for epidemic-prone infections, e.g., norovirus, influenza, tuberculosis (TB), severe acute respiratory syndrome (SARS), and COVID-19 | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 20 | 60.6 |
Surveillance is conducted for infections that may affect healthcare workers in clinical, laboratory, or other settings, e.g., hepatitis B or C, human immunodeficiency virus (HIV), and influenza | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 14 | 63.6 | 0 | 0.0 | 16 | 48.5 |
Percentage of health centres that meet the target for each indicator of ‘healthcare-associated infection monitoring’ according to the type of health Centre.
The targets for some infection control practices were well met by most comprehensive healthcare centres. For instance, monitoring of cleaning and disinfection was performed in 100 per cent of comprehensive healthcare centres and monitoring alcohol-based hand rub was performed in 95.5 per cent of them. In contrast, a low percentage of primary healthcare centres met the target for any indicator, except for disinfection and alcohol-based hand rub monitoring indicators, which were at 81.8 per cent each (Table 12).
Monitoring/auditing of infection control practices and outcomes | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Hand-hygiene compliance (using the WHO hand-hygiene observation tool or equivalent) is monitored regularly | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 12 | 54.5 | 0 | 0.0 | 14 | 42.4 |
Transmission-based precautions and isolation to prevent the spread of multidrug-resistant organisms (MDRO) are monitored regularly | 0 | 0.0 | 3 | 27.3 | 0 | 0.0 | 5 | 22.7 | 0 | 0.0 | 8 | 24.2 |
Cleaning of the health centre is monitored regularly | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 29 | 87.9 |
Disinfection and sterilization of medical equipment/instruments are monitored regularly | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 31 | 93.9 |
Consumption/usage of alcohol-based hand rub or soap is monitored regularly | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 21 | 95.5 | 0 | 0.0 | 30 | 90.9 |
Waste management is monitored regularly in the health centre | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 18 | 81.8 | 0 | 0.0 | 24 | 72.7 |
Monitoring and feedback of IPC processes and indicators are performed in a “blame-free” institutional culture aimed at improvement and behavioral change | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 10 | 45.5 | 0 | 0.0 | 12 | 36.4 |
For all employees, there is an easily available, up-to-date list of reportable diseases (to the MoH) | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 20 | 90.9 | 0 | 0.0 | 27 | 81.8 |
Percentage of health centres that meet the target for each indicator of ‘monitoring/auditing of infection control practices and outcomes’ according to the type of health Centre.
Monitoring of transmission-based precautions to prevent the spread of multidrug-resistant organisms (MDRO) was conducted by about one-quarter of primary healthcare centres (27.3 per cent) and one-fifth of comprehensive healthcare centres (22.7 per cent).
There was a considerable wide range of difference for PPE indicators in the percentage of healthcare centres that met the target. Some indicators such as ‘HCP do not wear the same gown for the care of more than one patient’ and ‘wearing protection for the mouth, nose, and eyes during procedures that are likely to generate splashes or sprays of blood or other body fluids’ were met by 36.4 per cent and 39.4 per cent of centres, respectively. Comparatively, other indicators, such as ‘wearing gloves’ and ‘replacing gloves after each patient’ were met by 90.9 per cent and 81.8 per cent of centres, respectively, as illustrated in Table 13. A higher percentage of comprehensive healthcare centres met the target compared to primary healthcare centres for all indicators.
Personal protective equipment | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Healthcare providers (HCP) that use personal protective equipment (PPE) receive training on how to use them properly | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 14 | 63.6 | 0 | 0.0 | 16 | 48.5 |
Compliance in using PPE is routinely reviewed and monitored | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 13 | 59.1 | 0 | 0.0 | 15 | 45.5 |
Suitable and sufficient PPE is easily accessible by healthcare providers | 0 | 0.0 | 5 | 45.5 | 0 | 0.0 | 14 | 63.6 | 0 | 0.0 | 19 | 57.6 |
HCP wear gloves for potential contact with blood, body fluids, mucous membranes, non-intact skin, or contaminated equipment | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 21 | 95.5 | 0 | 0.0 | 30 | 90.9 |
HCP do not wear the same pair of gloves for the care of more than one patient | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 18 | 81.8 | 0 | 0.0 | 27 | 81.8 |
HCP wear proper gowns to protect skin and clothing during procedures or activities where contact with blood or body fluids is anticipated | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 19 | 86.4 | 0 | 0.0 | 25 | 75.8 |
HCP do not wear the same gown for the care of more than one patient | 0 | 0.0 | 1 | 9.1 | 0 | 0.0 | 11 | 50.0 | 0 | 0.0 | 12 | 36.4 |
HCP wear mouth, nose, and eye protection during procedures that are likely to generate splashes or sprays of blood or other body fluids | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 9 | 40.9 | 0 | 0.0 | 13 | 39.4 |
Percentage of health centres that meet the target for each indicator of ‘personal protective equipment’ according to the type of health Centre.
As seen in Table 14 only one-quarter of healthcare centres (24.2 per cent) reported the availability of a single-use towels at each sink. However, most healthcare centres of both types reported the availability of soap at each sink (81.8 per cent). Alcohol-based hand rub was available in 57.6 per cent of health centres. On the other hand, less than half of centres (42.4 per cent) have a dedicated budget for the procurement of hand-hygiene products (e.g., alcohol-based hand rubs) or any other way to ensure its availability.
Availability of hygiene materials | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Alcohol-based hand rub is available in the health centre | 5 | 45.5 | 6 | 54.5 | 9 | 40.9 | 13 | 59.1 | 14 | 42.4 | 19 | 57.6 |
Liquid soap is available at each sink | 2 | 18.2 | 9 | 81.8 | 3 | 13.6 | 18 | 81.8 | 5 | 15.2 | 27 | 81.8 |
Single-use towels are available at each sink | 4 | 36.4 | 2 | 18.2 | 11 | 50.0 | 6 | 27.3 | 15 | 45.5 | 8 | 24.2 |
There is a dedicated budget for the procurement of hand-hygiene products (e.g., alcohol-based hand rubs) or any other way to ensure its availability | 0 | 0.0 | 5 | 45.5 | 0 | 0.0 | 9 | 40.9 | 0 | 0.0 | 14 | 42.4 |
Supplies needed for adherence to hand hygiene (e.g., soap, water, paper towels, alcohol-based hand rubs) are readily available to healthcare providers in patient-care areas | 0 | 0.0 | 7 | 63.6 | 0 | 0.0 | 17 | 77.3 | 0 | 0.0 | 24 | 72.7 |
Percentage of health centres that meet the target for each indicator of ‘availability of hygiene materials’ according to the type of health Centre.
The targets for two training indicators are met by one-third of healthcare centres (33.3 per cent): receiving ‘training regarding hand hygiene’ and ‘training assessors to verify compliance with hand hygiene’. The target for the other two indicators are met by more than half of centres: ‘instructions on hand hygiene’ (54.5 per cent), and ‘safe injection training’ (57.6 per cent). In addition, comprehensive healthcare centres met the target at a higher percentage—partially or completely—than primary healthcare centres (Table 15).
Training and education | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Healthcare workers receive training regarding hand hygiene in the health centre | 1 | 9.1 | 3 | 27.3 | 12 | 54.5 | 8 | 36.4 | 13 | 39.4 | 11 | 33.3 |
Posters or instructions on hand hygiene in health care are displayed to all healthcare workers | 2 | 18.2 | 6 | 54.5 | 6 | 27.3 | 12 | 54.5 | 8 | 24.2 | 18 | 54.5 |
There is a system in place to train assessors to verify compliance with hand hygiene | 1 | 9.1 | 2 | 18.2 | 6 | 27.3 | 9 | 40.9 | 7 | 21.2 | 11 | 33.3 |
Healthcare providers who prepare and/or administer parenteral drugs receive training in safe injection practices | 1 | 9.1 | 4 | 36.4 | 4 | 18.2 | 15 | 68.2 | 5 | 15.2 | 19 | 57.6 |
Percentage of health centres that meet the target for each indicator of ‘training and education’ according to the type of health Centre.
Most healthcare centres reported that hand hygiene is performed correctly (84.8 per cent) and regular reviews are done to assess the availability of hand-hygiene materials (60.6 per cent), as shown in Table 16. One-quarter of centres reported that they review the availability of hand-hygiene materials (24.2 per cent), but not regularly.
Evaluation and feedback: Basic indicators and respiratory safety | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Hand hygiene is performed in the health centre correctly | 0 | 0.0 | 8 | 72.7 | 0 | 0.0 | 20 | 90.9 | 0 | 0.0 | 28 | 84.8 |
At department level, regular reviews are conducted (at least annually) in order to assess the availability of soaps, hand sanitizers, single-use towels, and other hand-hygiene resources | 2 | 18.2 | 6 | 54.5 | 6 | 27.3 | 14 | 63.6 | 8 | 24.2 | 20 | 60.6 |
The health centre has policies and procedures for dealing with people who exhibit signs and symptoms of respiratory infections, starting from the point of admission to the health centre and continuing for the duration of the follow up | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 11 | 50.0 | 0 | 0.0 | 13 | 39.4 |
Face masks are offered upon admission to the health centre to cough patients and other people with symptoms, at least, during periods of increased respiratory tract infection in the community | 0 | 0.0 | 1 | 9.1 | 0 | 0.0 | 5 | 22.7 | 0 | 0.0 | 6 | 18.2 |
Space is provided in waiting rooms, and people with symptoms of respiratory infections are encouraged to sit as far away from others as possible | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 14 | 63.6 | 0 | 0.0 | 14 | 42.4 |
The health centre educates healthcare providers on the importance of infection prevention measures to contain respiratory secretions to prevent the spread of respiratory diseases | 0 | 0.0 | 2 | 18.2 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 18 | 54.5 |
Signboards and posters are displayed on entrances with instructions for patients with symptoms of respiratory infection in order to practice respiratory hygiene/cough etiquette (covering the mouth/nose when coughing or sneezing, using and disposing of tissues), and perform hand hygiene | 0 | 0.0 | 3 | 27.3 | 0 | 0.0 | 10 | 45.5 | 0 | 0.0 | 13 | 39.4 |
Percentage of health centres that meet the target for each indicator of ‘evaluation and feedback: Basic indicators and respiratory safety’ according to the type of health Centre.
Less than half of healthcare centres met the target for indicators related to respiratory safety, except for educating healthcare providers on the importance of infection prevention measures, which was met by 54.5 per cent of the centres. This overall low percentage of meeting the target was attributed to the low percentage of primary healthcare centres that met the target, which was lower than 20 per cent for most indicators, as demonstrated. It is noteworthy to mention that none of the primary healthcare centres met the target for providing space in waiting rooms or encourage people with symptoms of respiratory infections to sit apart from others. However, the target for this indicator was met by 63.6 per cent of comprehensive healthcare centres.
About two-thirds of healthcare centres (63.6 per cent) met the target for using disinfectants according to manufacturer’s instructions, and one-third (33.3 per cent) met the target for wearing PPE by staff involved in cleaning. However, cleaning of devices and packaging after cleaning were properly done by all comprehensive healthcare centre (100 per cent) and 81.8 per cent of primary healthcare centres (Table 17).
Evaluation and feedback: Environmental cleaning and sterilization of reusable devices | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Cleaners and disinfectants are used in accordance with manufacturers’ instructions (e.g., dilution, storage, shelf-life, contact time) | 0 | 0.0 | 6 | 54.5 | 0 | 0.0 | 15 | 68.2 | 0 | 0.0 | 21 | 63.6 |
HCP engaged in cleaning wear appropriate PPE to prevent exposure to infectious agents or chemicals (PPE can include gloves, gowns, masks, and eye protection) | 0 | 0.0 | 1 | 9.1 | 0 | 0.0 | 10 | 45.5 | 0 | 0.0 | 11 | 33.3 |
Devices are thoroughly cleaned according to manufacturers’ instructions and visually inspected for residual dirt prior to sterilization | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 31 | 93.9 |
After cleaning, the tools are packaged appropriately for sterilization | 0 | 0.0 | 9 | 81.8 | 0 | 0.0 | 22 | 100 | 0 | 0.0 | 31 | 93.9 |
The health centre has an emergency team | 2 | 18.2 | 3 | 27.3 | 6 | 27.3 | 6 | 27.3 | 8 | 24.2 | 9 | 27.3 |
Percentage of health centres that meet the target for each indicator of ‘evaluation and feedback: Environmental cleaning and sterilization of reusable devices’ according to the type of health Centre.
The percentage of healthcare centres that met the target, partially or completely, varied widely among the different COVID-19 precautionary measures (Table 18). A low percentage of centres met the targets for some indicators, like emergency training of staff, or checking the temperature and breathing of staff or patients before entering the centre (18.2 per cent, each). On the other hand, a high percentage of centres met the targets for other indicators, like the requirements of washing hands frequently (81.8 per cent) or wearing masks (93.9 per cent). More comprehensive healthcare centres, compared to primary centres, met the targets for all indicators of COVID-19 precautionary measures, except for regular testing for COVID-19 and distancing and spacing the timings of appointments. However, these two indicators were met by only one-third (33.3 per cent) and one-quarter of healthcare centres (24.2 per cent), respectively. Moreover, three out of four healthcare centres (75.8 per cent) reported asking patients to wear masks and maintain distances, as shown in Table 18. It is interesting that only 60.6 per cent of healthcare centres reported COVID-19 cases to the Ministry of Health.
COVID-19 precautionary measures | Primary centres (N = 11) | Comprehensive (N = 22) | Total (N = 33) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Partially meet target | Meet target | Partially meet target | Meet target | Partially meet target | Meet target | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
All health-centre staff are trained in the emergency programme | 2 | 18.2 | 1 | 9.1 | 6 | 27.3 | 5 | 22.7 | 8 | 24.2 | 6 | 18.2 |
Health workers receive special training regarding COVID-19 | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 12 | 54.5 | 0 | 0.0 | 16 | 48.5 |
All employees are asked to distance themselves from the rest of the staff, unless treating patients requires closer proximity | 3 | 27.3 | 6 | 54.5 | 6 | 27.3 | 16 | 72.7 | 9 | 27.3 | 22 | 66.7 |
All employees are required to wash their hands frequently | 3 | 27.3 | 7 | 63.6 | 2 | 9.1 | 20 | 90.9 | 5 | 15.2 | 27 | 81.8 |
All employees are required to adhere to wearing masks at all times | 1 | 9.1 | 10 | 90.9 | 1 | 4.5 | 21 | 95.5 | 2 | 6.1 | 31 | 93.9 |
Health workers in the health centre receive regular tests for COVID-19 | 3 | 27.3 | 4 | 36.4 | 10 | 45.5 | 7 | 31.8 | 13 | 39.4 | 11 | 33.3 |
Patient appointment times are staggered and distances maintained, as a response to COVID-19 outbreak | 5 | 45.5 | 3 | 27.3 | 13 | 59.1 | 5 | 22.7 | 18 | 54.5 | 8 | 24.2 |
Patients are required to wear a mask when they are in the health centre | 2 | 18.2 | 7 | 63.6 | 4 | 18.2 | 18 | 81.8 | 6 | 18.2 | 25 | 75.8 |
Patients are required to maintain distance throughout their stay in the health centre | 2 | 18.2 | 7 | 63.6 | 3 | 13.6 | 18 | 81.8 | 5 | 15.2 | 25 | 75.8 |
Temperature and breathing problems are checked for all patients before entering the health centre | 1 | 9.1 | 3 | 27.3 | 3 | 13.6 | 3 | 13.6 | 4 | 12.1 | 6 | 18.2 |
Temperature and breathing problems are checked for all healthcare workers before entering the health centre | 1 | 9.1 | 3 | 27.3 | 3 | 13.6 | 3 | 13.6 | 4 | 12.1 | 6 | 18.2 |
Medical staff treating COVID-19 permitted to socialize with the rest of the health-centre staff | 1 | 9.1 | 4 | 36.4 | 6 | 27.3 | 12 | 54.5 | 7 | 21.2 | 16 | 48.5 |
Instructions given to health-centre staff with COVID-19 symptoms, like fever and coughing | 4 | 36.4 | 6 | 54.5 | 7 | 31.8 | 12 | 54.5 | 11 | 33.3 | 18 | 54.5 |
There is a monitoring and registration record for all workers infected with the virus | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 9 | 40.9 | 0 | 0.0 | 13 | 39.4 |
All cases with COVID-19 are transferred to the hospital assigned to treat them. | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 20 | 60.6 |
All cases of COVID-19 are reported to the Ministry of Health | 0 | 0.0 | 4 | 36.4 | 0 | 0.0 | 16 | 72.7 | 0 | 0.0 | 20 | 60.6 |
Percentage of health centres that meet the target for each indicator of ‘COVID-19 precautionary measures’ according to the type of health Centre.
Based on the findings of this assessment, we could identify health facilities that fully met the targets and those that partially met or did not meet the targets. A wide range of performance was noted, and clear differences between facilities in meeting the targets were observed. Thus, healthcare policy makers are urged to develop WASH and IPC national policies and guidelines that set targets for all public and private healthcare facilities in the country. It is essential that healthcare providers in Jordan translate local and national IPC policies into their daily and regular practice. However, IPC policies should be enforced during the COVID-19 pandemic to control the spread of the virus. Developing and implementing a national IPC Action Plan (2021–2024) will assist the integration of IPC practices into the Jordanian healthcare system, which also identify, amend, and correct non-compliance practices with IPC standards. The action plan should be supervised by a national IPC unit, affiliated with, or as part of, the Ministry of Health.
Furthermore, stakeholders and policy makers are urged to institute a quality surveillance system through which standard precautions and transmission-based precautions can be implemented. This surveillance system assists healthcare facilities across Jordan to manage infections through early detection of patients with infectious diseases, immediate implementation of containment measures including the use of PPE and isolation; and measures required to control the spread of COVID-19.
The implementation of the surveillance system and WASH/IPC standards are possible only through capacity building with proper training that is carried out, based on international recommendations, like the WHO recommended procedures for PPE and WASH, for example.
Digital health solutions to enhance healthcare providers’ skills and knowledge on WASH and IPC policies could be promising during the COVID-19 pandemic. Such digital health solutions can be designed to train healthcare providers to demonstrate evidence-based practices of infection control and to promote hygiene messages among patients to protect themselves and their families. However, the optimum benefits of precautionary measures and the sustainability of WASH and IPC targets are not achieved without the serious commitments from leaders and managers from all levels (national, provincial, and organizational). Skilful health management is necessary to officially mandate WASH and IPC practices and to provide and maintain necessary human and financial resources to conduct IPC activities. Moreover, medical leadership are expected to show tangible support and act as role models to drive a patient-safety culture, supporting WASH and IPC and all relevant subsequent actions.
Authors would like to acknowledge the technical and financial support from UNICEF Jordan Country office and Middle Eastern and Northern Africa Regional Office.
Light emitting diodes are rapidly developing in light output, color rendering, efficiency, and reliability. Achieving good level of maintenance-free in harsh environment, while keeping product competitive, is the largest challenge which only few manufacturers manage to achieve. The latest high quality LED technologies are already exceeding all other available technologies by all technical parameters. According to its numerous advantages, even higher initial cost quickly pays for itself due to vastly reduced cost of electricity and maintenance. But to fully benefit from the outstanding advantages it is important to educate and recognize the difference between low quality and latest state of the art LED technologies, since low quality LED alternatives have quickly spread all over the world [1, 2].
LED lights use 40–80% less electricity and have at least 5 times the life expectancy than regular High Pressure Sodium (HPS) fixtures. LED lamps are 7 times more energy efficient than incandescent and twice as efficient as fluorescent lamps.
LED lights with a lower lumen output can replace conventional lamps with a higher output. For example, a 30 W LED street light can often replace an 80 W High Pressure Sodium lamp. The reason for this is directionality. LED street lamps are very directional and the light output is much more than other street lamps. Also there is little or no hot spot under the LED lamp. The light emitted from the LED lamp is directed downwards, spread throughout the entire area it covers. This means that a lower amount of light is needed to properly illuminate the area. This also dramatically reduces glare and light pollution which affects the mood of human beings, navigation in birds and insects, mating behavior in animals and flowering in plants.
LED lights last much longer than conventional lamps (4 to 8 times longer). This result in less expense in replacing the lights themselves but also the labor to replace the lamp is needed less often. This provides a great cost savings by itself.
Also the loss of brightness or lumen depreciation is slower over the life of an LED lamp than that of sodium or other lamp. So not only does the LED have a longer life span than the conventional lamp, but it stays brighter longer than other lamps. The long life span reduces maintenance expenses and makes these bulbs particularly suitable for difficult to reach locations and for streetlights where maintenance costs can be significant.
Lifetime and Lumen maintenance compression between LED and HID lights is illustrated in Figure 1. The comparison shows that relamping of HID fixture is required to be done 5 times to achieved one base life time of LED, considering the relamping is required when the Lumen reduces to 70% of initial lamp Lumen [1].
Lifetime and lumen maintenance compression between LED and HID.
LED operates at efficiently at low and high temperatures, and unaffected by on/off cycling. This makes them safer and efficient in special indoor applications such as refrigerator lights, cold room lights, offices, industrial plants and better for applications requiring frequent switching on and off lights. These bulbs are shocks and vibrations resistant making them the best choice for places like offshore platforms, oil refineries, steel factors, skids and similar applications.
The light is easily controllable with intelligent systems. The light can be turned on and off instantly and can be dimmed for added energy savings at dawn, dusk, and also during hours of low traffic. Switching on–off and dimming does not affect the life-time of the luminaire as in the case of fluorescent lights.
The carbon footprint of LED street lights is smaller than other lights due to lower energy usage. Moreover, LEDs last 4 to 8 times longer than any other bulbs, further reducing the carbon footprint of manufacture over the life time. From another angle, wide range application of LED in a country my give better chance to sale there international quota in CO2 emission to other countries.
Because of the directional light, light is carefully distributed exactly where it is meant to go and therefore there is no or little light which is wasted by illuminating the night sky or very low background light contribution. This is a considerable plus especially if the local community has a Dark-sky Initiative.
It is worth to mention here that for example LED street lamps with color temperature 3.500–4.200 K are rendering more natural light than the yellow of sodium lamps or green of fluorescent streetlights. Also no UV or IR radiation is emitted from the LED street lamps. Color rendering index (CRI) is high (80–90) and displays natural colors of illuminated objects. This reflect actual color of the objects.
LED luminaires contain no harmful substances, like mercury, lead or other hazardous chemical and gasses. Spent LED lamps can be thrown away without any special handling or disposal requirement, since they are recyclable and environmentally friendly. Other lighting bulbs often have hazardous materials such as lead and mercury which require special handling and waste management procedures which have both economic and environmental costs.
European Commission issued the Regulations EC No. 245/2009 for tertiary lighting products on 18 March 2009. On the basis of these Regulations, about 1 billion lighting products have to be replaced by LED type by the year 2015 only in the area of the EU, which translates to 100 million street lamps for street lighting and industry. The remaining 900 million refer to neon lamps.
Similarly, the Energy Information and Security Act of 2007 began the process of restricting the sale of inefficient lamps in the US. By 2012, with a few exceptions, the result of the legislation will be that inefficient incandescent lamps cannot be sold [1].
High-intensity discharge lamps (HID lamps) are a type of electrical gas-discharge lamp which produces light by means of an electric arc between tungsten electrodes housed inside a translucent or transparent fused quartz or fused alumina arc tube. This tube is filled with noble gas and often also contains suitable metal or metal salts. The noble gas enables the arc’s initial strike. Once the arc is started, it heats and evaporates the metallic admixture. Its presence in the arc plasma greatly increases the intensity of visible light produced by the arc for a given power input, as the metals have many emission spectral lines in the visible part of the spectrum.
Many lighting application use HID bulbs for the main lighting systems, although some applications are now moving from HID bulbs to LED because of the LED advantages [2].
By about 2010 LED technology came to dominate the outdoor lighting industry; earlier LEDs were not bright enough for outdoor lighting. A study completed in 2014 concluded that color temperature and accuracy of LED lights was easily recognized by consumers, with preference towards LEDs at natural color temperatures [3]. LEDs are now able to match the brightness and warmer color temperature that consumers desire from their outdoor lighting system.
By comparing the power characteristics and lighting characteristics for LED verse traditional lighting, it can be concluded that using LED lighting to replace the traditional lighting devices are possible and recommended. However, still protection circuits such as current, voltage and temperature are still needed to be revised to increase the reliability. In order to make such mission become truth, the first important thing should be done is to lower the unit cost and secondary to have a proper and reliable power circuit with less loading and less electrical faults probabilities. Also suitable optics is needed to control the light pattern from the LEDs including focus, diffusion, reflection, and light amplification [4, 5].
For indoor Lighting, seven criteria are proposed to assess the technical and economic characteristics of LED luminaires and ensure their compliance with European Norms regarding office lighting. The proposed decision support system can be applied to any type of luminaire and can be used by professionals who want to evaluate different luminaire suppliers and determine the optimal luminaire tender for the lighting of any indoor space [6].
Other researches concentrated in Road lighting to compares mainly the life cycle costs (LCCs) of two typical alternatives in current road lighting: the HPS and LED luminaires. These studies have considered only the road lighting design criteria, but the esthetics and visual attractiveness are excluded from the comparison. The comparison and the results have considered only the direct energy operating cost [7]. Also an Economic cost analysis comparison between LED and HPS flood lights for an outdoor design, but using solar PV as a power supply, has been carried as a part of renewable energy design [8].
Feasibility study of LED lamp in replacing the conventional fluorescent lamp was conducted. Analysis and comparison have been carried out on the two lighting systems in terms of electrical and photometrical performance. The study did not cover any HID outdoor lighting [9].
Comprehensive techno-economic analyses that considered the Company and National economic benefits that can be achieved from the high service life of the LED light fittings (up to 100,000 Hours) and its low power consumption compared with HPS was carried out. However, this analysis is limited only for 400 W HPS lighting case.
For the above survey, it can be found that several efforts carried out economic analysis of replacement different light fittings with LED. But, none of these works has considered the economics for replacement the HID lamps by LED lamps in industrial plants. Moreover, none of these researches have presented any type of economic index to support such type of lighting projects, except [10], which limited the research the replacement of only HPS type used in access road of a gas production company.
Based on the above survey, the first goal of this chapter is to discuss the economic benefits of replacing outdoor different type of HID lights with different rating installed in an oil and gas plant, as typical “Case-Study” for industrial plant, with suitable equivalent number of LED lighting fittings, to provide even better lighting effect level, without changing the lighting poles. The second goal is to determine the global saving norm based on two main aspects. “Company Benefits”, in which the Company can gain it directly, and “National Benefits” that can be achieved by creating better gas sales opportunity for the county and by the reduction of the CO2 emission and hence the pollution.
In this section, firstly, comprehensive economic study is introduced to replace 241 pieces of 150 W Metal Halide, 103 pieces of 400 W HPS lighting, 20 pieces of 1000 W MH lighting and 162 pieces of 70 W Bollard lighting by equivalent number of LED lighting fittings. Next, economic discussion is to carried out to provide four important economic indicators. Finally, summary, conclusion and recommendation are given.
The methodology in this economic study is carried out to estimate the financial benefits of replacement of outdoor HID (High intensity discharge) lights in an oil and gas plant by the equivalent LED (Light Emitting Diodes) lighting fixture. The Study has considered the following factors:
Company (Direct) Benefits:
The initial cost of the replacement the lighting fixtures.
The energy saving.
The maintenance cost.
National (Indirect) Benefits:
Natural Gas Sales opportunity
Pollution Cost
In Company Benefits, calculation for “Luminaire Cost”, “Power Consumption” and “Maintenance Cost” are given based on offers and prices collected on 2015–2016 from different bidders, contractors and suppliers to find the lowest prices.
In National Benefits, two benefits are considered. First benefit is the gas sales opportunity that will be gained from the reduction of the power consumption in case LED light is used. Natural gas valued using the wholesale price of $4.618/MMBtu based on US Energy Information Administration Henry Hub/NYMEX futures prices; Equivalent energy rate of 5.6 ¢/kWhr is used to value the energy produced over 10 years, assuming 1% annual escalation factor and Euro to USD exchange rate of 1.2 [10, 11] Accordingly,
Where Δ kWhr is the reduction in the power consumption.
However, the second benefit is the cost saving due to the reduction of the CO2 emission, and hence less pollution. Carbon credits based on current market is typically 6 euro/ton. Where, CO2 emission is considered to be 0.83 kg/kWh. Assuming Euro to USD exchange rate of 1.2, the annual saving in pollution reduction can be calculated as following [10, 11]:
The economic study is categorized based on HID lamp type that is needed to be replaced in the plant under the study. Typical study is summarized in the following Table 1 for 150 W Metal Halide luminaire replaced by 65 W GREE LED luminaire. Where.
I. LUMINAIRE PRICE ANALYSIS | ||||
---|---|---|---|---|
S/N | Description | 150 W MH Metal Halide [12] | 65 W CREE LED [13] | Remarks |
1 | Initial Fixture cost | $227.52 | $449.59 | |
2 | Total quantity | 241 | 241 | |
3 | Total quantity Cost | 0 | 108351.4986 | |
4 | Cost/lamp manpower, crane, dumping etc.… | 108.9918256 | 108.9918256 | This estimate taking into consideration replacement cost, man power, vehicle, manpower to divert/block traffic, cost of loading/unloading & installation |
a | Therefore initial investment for LED | 0 | Additional investment for using LED luminaire. | |
1 | Wattage per fixture | 150 | 72 | System Wattage includes losses |
2 | No of fixtures in the lighting circuit | 241 | 241 | |
3 | Total power consumed (kW) | 36.15 | 17.352 | |
4 | Hence total Power consumed per year(kWHr) | 145142.25 | 69668.28 | Average daily operating time is considered 11 Hours |
5 | Cost per kWHr | 0.026948229 | 0.026948229 | As agreed with Utility |
6 | Annual cost | 3911.326574 | 1877.436755 | |
7 | Service Life Range | 16,000–20,000 | 60,000–100,000 | |
8 | Average Service life (Hrs) | 18,000 | 80,000 | |
b | Therefore the saving in 10 Years |
S/N | Description | 150 W MH Metal Halide [12] | 65 W CREE LED [13] | Remarks |
---|---|---|---|---|
Service Life Range | 16,000–20,000 | 60,000–100,000 | ||
1 | Average Service life (Hrs) | 18,000 | 80,000 | |
2 | Number of Lamps change cycle in 10 Year | 2.230555556 | 0 | LEDs have no downtime against MH lamps which fail arbitrarily |
3 | Total No. of Lamps | 538 | 0 | |
4 | Cost/lamp manpower, crane, dumping etc | 108.992 | 0 | The estimate take into consideration new lamp cost, man power, vehicle, manpower to divert/block traffic, cost of loading/unloading & installation. |
c | Therefore savings in lamp maintenance in 10 Years | |||
1 | Rated life (Hrs) | 15,000 | N/A | |
2 | Life in 10 years | 2.676666667 | N/A | |
3 | Total No. of Ballasts | 241 | N/A | |
4 | Thus component to be replaced in 10 Years | 645 | N/A | |
5 | Cost/lamp manpower, crane, dumping etc.… | 81.74386921 | N/A | This estimate takes into consideration new ballast cost, man power, vehicle, manpower to divert/block traffic, cost of loading/unloading & installation. |
c | Therefore savings in component maintenance in 10 Years | N/A | ||
a | ||||
b | ||||
c | ||||
d | Natural gas valued using the wholesale price of $4.618/MMBtu based on US Energy Information Administration Henry Hub/NYMEX futures prices; Equivalent energy rate of 5.6¢/kWh used to value the energy produced over 10 years, assuming 1% annual escalation factor. | |||
e | Carbon credits –based on current forward market @ 6 euro/ton, CO2 emission in kg/kwh: 0.83, Euro to USD exchange rate of 1.2. | |||
Summary of economic study for replacement of 150 W metal halide luminaire by 65 W LED luminaire.
Similar to the typical economic study that is carried out for 150 W Metal Halide lighting, economic study is done for the remaining types of lighting; 103 pieces of 400 W HPS lighting, 20 pieces of 1000 W MH lighting and 162 pieces of 70 W Bollard lighting. Summary Tables (Tables 2–5) are provided hereinafter to show the Total Benefit and the Economic Analysis for these luminaire types.
Total Benefits: | |
---|---|
Total Net Average Annual Saving | $14,899.66 |
Company Saving Norm = Annual Saving / kW (3) [10] | $184.02 |
Total Saving Norm = Annual Saving / kW (4) [10] | $360.29 |
Economic Analysis | |
Payback Period in Years | 4.632 Year |
Annual “ROI” in Percentage | 21.59% |
Replacement of 400 W HPS lighting with (100–130) W CREE LED.
Total Benefits: | |
---|---|
Total Net Average Annual Saving | $2543.09 |
Company Saving Norm = Annual Saving / kW (3) [10] | $ 107.15 |
Total Saving Norm = Annual Saving / kW (4) [10] | $127.15 |
Payback Period in Years | 10.93 Years |
Annual “ROI” in Percentage | 19.15% |
Replacement of 1000 W MH lighting with (426) W CREE XAX LED.
Total Benefits: | |
---|---|
Total Net Average Annual Saving | $9291.03 |
Company Saving Norm = Annual Saving / kW (3) [10] | $799.05 |
Total Saving Norm = Annual Saving / kW (4) [10] | $819.31 |
Payback Period in Years | 8.657 Year |
Annual “ROI” in Percentage | 11.55% |
Replacement of 70 W bollard lighting with (34) W CREE EDGE LED.
Project Total Investment | $339,550.41 |
---|---|
Project economics.
Base on the above techno-economic, following Table 5 is developed to summarize the main project economics indicators that can be used as good guide line for future similar projects that consider the replacement of HID lighting by LED Lighting.
Based on the Saving Norm calculated for individual luminaire type in the above from Tables 1–4 the Global Saving Norm can be calculated based on the following Eq.:
Where “n” is the number of replaced lighting types in the study.
Using Eq. (7), the calculated Global Company Saving Norm is (355.19$/kW).
From Table 2, it can be concluded that replacement of HPS lighting by LED lighting have the highest Total Net Average Annual Saving. Therefore, it is highly recommended to use LED lights instead of HID lights in industrial lighting applications.
It is also observed from Table 4 that replacement Bollard Light Lamps by LED Lamp has highest economic value because of the very short lifetime Bollard Light Lamps compared with LED lifetime.
In Table 4, project main economic indicators are illustrated with very attractive total payback period of 8.654 years and Project Annual Return on Investment of 11.55% which is higher approximately 10 times than the international bank rate for dollar deposit. This indicator supports the decision of investment in such scope of work.
In this Section, comprehensive economic study is carried out to calculate the Global Saving Norm for the replacement of High-intensity discharge lamps with different types by LED lamp in an Oil and Gas plant, which includes also the operational cost per year. The study considered Company direct benefits and National indirect benefits in evaluating project economic indicators and in calculating the Global Saving Norm as well. The result is compared and validated with previous research effort. Four important economic indicator were provided in this Section; Global Total Saving Norm ($433.37/kW), Global Company Saving Norm ($355.19/kW), typical total payback period of (8.654 year) and typical Project Annual Return on Investment of (11.55%). These four figures are important for both project decision makers and for cash-flow controllers.
In Section 2 of this chapter, comprehensive economic study is carried out to calculate the Global Saving Norm for the replacement of High-intensity discharge lamps with different types by LED lamp in an Oil and Gas plant as “Case Study” representing industrial plant. The analysis considered Company direct benefits and National indirect benefits in evaluating project economic indicators and in calculating the Global Saving Norm as well. Four important economic indicator were provided in this Section; Global Total Saving Norm ($433.37/kW), Global Company Saving Norm ($355.19/kW), typical total payback period of (8.654 year) and typical Project Annual Return on Investment of (11.55%). These four figures are important for both project decision makers and for cash-flow controllers.
Various road classifications are existed in terms of traffic flow. Principal arterials, minor arterials, rural collectors, local roads and very low-volume roads. The last is what our concern in this section. Statistically, for low-traffic roads the flow rate of the vehicles is assumed to be 400 vehicles per day [14]. In these roads, even simple lighting system is not installed mostly, and authorities rely on vehicle lights to illuminate the roads, which putting people life and valuable product passing in these roads under the risk. The main reason of non-lighting system is the desired of saving electrical energy. The main reason of non-lighting system is the desired of saving electrical energy. However, continuously lightened fully roads cause wastage of electricity, as only one vehicles may appear every three or four hours and even more during the night time. Each of these two scenarios are contradicting and are extremely significant issues.
Several researchers did some projects and published their work related to this topic, however, none of them has considered the lighting automation system on low traffic road. Articles are mainly related to smart or automated main street lighting systems or parking areas. In the following paragraphs, several researches’ results is discussed, and main points are drawn into attention.
Some studies proposed a suggestion to use two sensors in order to consume less power with maximized efficiency of a system [15]. Light Dependent Resistor (LDR) sensor is utilized to measure the sun light intensity to control the switching action of LED streetlights, and Passive Infrared Resistor (PIR) motion sensor is used for changing the intensity of LED light when there is no motion of object in the street at mid-night, then all the streetlights are dimmed. However, [16] indicates that LDR and PIR sensor are used for same purpose, but without dimming the light, just switched on or off. In [17], the author worked on this topic using Infrared Resistor (IR) sensors which measure the heat of an object as well as detects the motion, in contrast to previous researchers did. They developed the system using Arduino Uno R3 while [18] achieved the same by Raspberry Pi 3 micro controller.
Another research effort offered Zigbee Based Smart Street Light Control System Using LabVIEW. Here, movement is detected by motion sensors, communication between lights is enabled by Zigbee technology. So, when a passer-by is detected by a motion sensor, it will communicate this to neighboring streetlights, which will brighten so that people are always surrounded by a safe circle of light [19].
Another author developed Intelligent Street Lighting System Using GSM technology. The aim is to achieve the energy saving and autonomous operation on economical affordable for the streets by installing chips on the lights. These chips consist of a micro-controller along with various sensors like CO2 sensor, fog sensor, light intensity sensor, noise sensor and GSM modules for wireless data transmission and reception between concentrator and PC. The emissions in the atmospheres would be detected along with the consumption of energy and any theft of electricity [20].
Automatic street-light control system using wireless sensor networks is also proposed in some design. The system contains lamp station and base station [21]. Each lamp station consists of Arduino Uno board as microcontroller, PIR sensor, emergency switch, LDR sensor, nRF24L01 transceiver, ultrasonic sensor, relay, LED light and a solar panel as energy source. The base station consists of Raspberry Pi as processor, nRF24L01 transceiver, and a GSM module. The automatic streetlight turns on under three conditions. Firstly, when PIR sensor detects a human or a moving object vehicle LED light is turned on. Secondly, an ultrasonic sensor is used to detect distance objects and turn on the light accordingly. Lastly, a switch is included for manual operation in case of maintenance work. The LDR sensor is included to measure the light intensity for identification of the day and night. There nRF24L01 wireless transceiver transmits the sensor information and the light status to the Raspberry web server to upload on the web page. Also, it receives commands sent from the web page to turn on or off the light at a particular node. The entire system is powered using solar cells making it more energy efficient.
The problem of high operational cost of low traffic light that use HPS lighting is partially solve by using LED light fitting instead of HPS luminaries [10].
Many real projects and researches have been done on this area [22, 23, 24], but few of them are focused in this topic exactly. Most of them consider street, campus, parking, park or any small area lighting system. The rest of them is devoted to road light and control systems. Brief analysis, discussion and comparison will be introduced hereinafter.
From the above literature review, firstly, all systems mentioned above used LDR sensor to sense night-time to operate the control system itself. In the system prosed in this Section, the same day/night sensor idea is also use to know exact hours of night-time or any dark time during the day time due to heavy cloud or any other reasons.
Secondly, all systems above have used motion sensors to detect the object movement whatever this object is, even if it is not vehicle, and hence control the lights in terms of switching ON/OFF or dimming. IR sensors and PIR sensor were the preferred sensors used to detect the object. These type of sensors detect mainly warm object and their movement. But, for the suggested system in this Section that need to be used for low traffic road, movement of only vehicle is needed to be recognized and hence switch on the light or dim them. The proposed system need to be designed to avoid any other motion such as animals, birds, or other objects which may be detected by IR or PIR sensors as this unnecessary detection of motion can cause unjustified energy consumption. Therefore, it is needed to give new approach to tackle with such problems. New approach could be to add the night vision smart camera to the system in order to recognize only the vehicles among all other objects that the camera detects.
Thirdly, some systems control the illumination by measuring the intensity of the objects movement and change the dimming of the lights accordingly. But for illumination system of low traffic roads, the intensity of the vehicles is continuously very low, and hence dimming technique is not effective solution.
Fourth, using LED light continuously operate during the night for low traffic roads can reduce the cost of illuminating the road compared with any other HID lighting, but still this is not best solution because the utilization of this system by this operational philosophy is not an efficient utilization because most of the time the light is ON unnecessary.
Fifth, in general, previous researches have been done on lighting automation system for the roads which serve both pedestrians and vehicles. But, this Section tries to design automation lighting system for long road with low traffic, where no need to switch on the lights for movement of any object except the vehicles.
In this section, efficient, safe and cost effective solution to design automated lighting system suitable for long roads with low-traffic is provided. First, description of the entire system design is discussed. Then, methodology and the programing of vehicles recognition using camera images are illustrated. Economic analysis for the proposed system is carried out. Finally, conclusion is given.
Lighting automation system in low traffic roads is intended to implement in the illuminated roads. It is supposed to have source power supply, feeder pillar with controller, light poles with day/night sensor. Such conventional system can be upgraded by new automated system. The methodology of lighting automation system in low traffic roads is achieved by applying the moving object recognition technique using cameras. Firstly, the road is sectionalized into several zones. Each zone depends on how much distance is existed between two feeder pillars, typically 400 meters. So, light poles in each zone will be switch on/off together. It means that each zone will have its feeder pillar (control panel) with controller, day/night sensor, motion sensor, and camera. Night vision cameras are installed on the road in such way to detect the vehicle arrival-to and departure-from each zone. The controller is designed to illuminate only the zones in which the vehicle is detected. The type and span of the zone are calculated based on the road design considering straight spans and roundabout.
The control scheme of the automatic lighting system is illustrated in Figure 2. Day/night switch detects darkness status to start the controller and hence motion sensor and night vision cameras. Now, let us consider that there are two adjacent zones (Zone N) and (Zone N + 1), and vehicle enters to Zone (N + 1). Mainly, day/night sensor and motion sensors of (Zone N + 1) need to be installed before the camera of (Zone N + 1), while camera of (Zone N + 1) need to be installed in (Zone N) near to the end. This is because camera need to start capture the moving objects images only after motion sensor detects any object in advance and sends the signal to the camera to start operation, and hence the controller takes the proper decision for switch the light of (Zone N + 1) before the object enter the zone.
Automatic lighting system schematic.
For that, camera is installed on a light pole about 80 m before each zone. This distance provides approximately 2 seconds for data processing and control assuming maximum speed is approximately 60 km/hour. Figure 3 illustrates the installation location of (Zone N + 1) camera, day/night sensor and motion sensors in (Zone N).
Zone definition.
The software in the controller extracts the image from the camera and analyze it to determine whether the object is vehicle or not. If the object is not a vehicle, no action is taken by controller. In case the object is vehicle, signal shall be sent to Zone N + 1 lighting feeder pillar to switch on light of Zone N + 1 Simultaneously signal shall be sent to Zone N controller to switch off lightning system of Zone.
As we explained above, each Zone has its own lighting control system consists of Day/night switch, motion sensor, night vision camera, controller and feeder pillar.
When the controller of any zone detect “vehicles” the digital counter inside this controller counts the number of these detected vehicle (Nin). In the same time, the same controller receives from the digital counter inside the controller of next Zone updated number of the vehicle interring the next zone (Nout). The communication between the controllers can be achieved by Power Line Telecommunications method. or RS-485 cable. If the difference between the these to numbers (Nin- Nout) is zero, this means that no vehicles exist in this zone, and the controller switches “Off” the light. As long as (Nin- Nout) is not zero, the light of the zone will be kept “On”. This methodology insures that the lighting system for any zone is kept “On” if any vehicle(s) still in that zone for any reason such as accident, maintenance or temporary parking. Also, this methodology insures that the lighting system of the zone free of any vehicle is “OFF”.
In Figure 4, flow chart for two consequent lighting system control logic is illustrated.
Control flow chart for zone N and zone N + 1 lighting system.
Several researches are done to recognize the vehicle at night based on vehicle lamp detection [25, 26]. This method will not work in case the vehicle lights are switches off for any reason. Another researches are carried out to detect the information in vehicle number-plate using artificial intelligent methods [27, 28]. However, using artificial intelligent method is time consuming and not useful for the application of the proposed system. In this application, recognition of the number-plate rectangular frame is simple method and more than enough to confirm that the moving object is “Vehicle”.
The process of detection of vehicle number-plate consists of the following steps: capture of image, pre-processing, plate region extraction (Figure 5).
Vehicle recognition flowchart.
In this step, the image is captured by electronic devices such as infrared digital camera or any other camera suitable for night time. The image captured is stored in JPEG format. After that the captured image is converted into gray scale image.
The next step after capturing the image is the pre-processing of the image. When the image is captured a lot of noises present in the image. Reducing the noises from the image are required to obtain an accurate result.
The RGB image is then converted into a gray scale image for easy analysis as it consists of only two color channels.
The aim of this pre-processing is to improve the quality of the image. Image enhancement techniques are used in this step. Image enhancement techniques consists process of sharpening the edges of image, contrast manipulation, reducing noise, color image processing and image segmentation.
The most important stage is the extraction of number-plate from eroded image significantly. The extraction of number-plate can be done by using image segmentation method. Mathematical morphology is used to detect the region of interest and Sobel operator are used to calculate the threshold value.
In general, any vehicle has its own number-plate which is always in rectangular shape consists characters. Accordingly, the basic approach in the detection of a vehicle is to recognize its number-plate which is mainly frame with characters (Numbers and letters). So, it is necessary to detect two criteria: the edges of the rectangular plate and there are characters within the rectangular.
A morphology based approach for detection number-plates is used. Our proposed method applies basic mathematical morphology operations like dilation and erosion.
The software model using the image processing technology is designed. The programs are implemented in MATLAB. The algorithm is divided into following parts: capture image, pre-processing, plate region extraction, characters recognition.
The following MATLAB code is written to implement the above mentioned parts:
Image capturing from camera
% Read Image
Input_image = imread(‘Car.jpg’);
RGB to gray scale
% Convert the truecolor RGB image to the grayscale image
I = rgb2gray (Input_image);
The following steps are used:
Image capturing from camera
% Read Image
Input_image = imread(‘Car.jpg’);
RGB to gray scale
% Convert the truecolor RGB image to the grayscale image
I = rgb2gray (Input_image);
Edge detection
% Sobel Operator Mask
Mx = [−1 0 1; −2 0 2; −1 0 1];
My = [−1–2 -1; 0 0 0; 1 2 1];
% Sobel Masking for filtering image
S = imfilter (I, Mx,\'replicate’);
Vertical and Horizontal Dilation
% Vertical Dilation
Dy = strel(‘rectangle’, [80,4]);
Iy = imdilate (M,Dy);
Iy = imfill(Iy,\'holes’);
% Horizontal Dilation
Dx = strel(‘rectangle’, [4,80]);
Ix = imdilate(M,Dx);
Ix = imfill(Ix,\'holes’);
% Joint Places
JP = Ix.*Iy;
ID = imdilate(JP,Dy);
ID = imfill(ID,\'holes’);
Erosion
The process of erosion reduces removing unwanted details from a binary image.
% Erosion
E = strel(‘line’,50,0);
IE = imerode(ID,E);
Filtering of digits
By filtering, the unwanted substances or noise can be removed or filtered out that is not a character or digits. Small objects or connected components should be removed and then the frame line that is connected to the digits should be identified and separated.
Bwareaopen (Image Processing Toolbox) is applied for removing all the connected components from the binary image that have value less than P pixels.
image2 = bwareaopen(image, min(numberofpixel, 100));
Stats = regionprops (L, properties) is applied for measuring a set of properties for each labeled region in the label matrix L.
stats = regionprops (image2,\'all’);
Detect plate from image
The validation of the of the number-plate recognition program, and hence the detection of vehicle, is done by two tests.
In this first test it needs to insure that the program recognizes any object, that is captured by the camera, has number plat. Therefore, the test is carried out to detect the number plat for different vehicle models and types with different orientations. The test result is illustrated in Figure 6. The program succeeded to detect the number-plate as rectangular frame include characters. It is worth to highlight here that it is not part of the program function to “read” the number-plate.
The results for objects with number-plate.
The objective of the second test is to ensure that for any object that does not have number plat, the program shall detect no number-plate. The test is done using four images for different objects consist of peoples and animals - Camels and Dog- (Figure 7). The program also succeeded to detect no number-plate.
The results with non-car images.
Any moving object enters any zone of the road shall be subject to two steps of recognition process: the first recognition process is by the motion sensor which detects that there is a moving object leaving the zone (serves-zone) and enters the next zone. The second recognition process is carried out by the image processing software that detects the moving objects which has rectangular plate with characters (Vehicle). If the two condition is satisfied simultaneously, the intelligent lighting system puts ON the road lighting of the next zoon (vehicle entering zoon) and switch off the lighting of the service-zoon after short time delay (vehicle leaving zoon).
Comprehensive economic study is carried out with the same methodology discussed is Section 2, but to estimate the financial benefits of using the proposed lighting automation system for the low traffic roads. The Study considers also Direct Benefit and Indirect Benefits [10] in order to evaluate the entire economic value of the system.
Assuming for low traffic; the vehicle flow is 400 vehicles per day [14], vehicle speed is 60 km/hour, zone distance is 400 meter, lighting pole span is 40 meter, LED fixture consumption per pole is 75 Watts [30] and electricity tariffs is typically (0.053$) per kWh [29].
From the above assumptions, flow rate of the vehicle can be calculated to be 17 vehicles per hour. Considering worst road operation scenario, at which the 17 vehicles are driven with constant speed of 60 km/hour and equal distances from each other, it is obvious to conclude that one vehicle shall enter the first zone each 212 seconds and leaving the zone (400 meter) after approximately 24 seconds. Accordingly, the zone lighting fixtures shall be switched on for 29 seconds and switched of for 183 second approximately. From that, the percentage saving in power consumption using the proposed controller compared with the power consumption when road is illuminated continuously during the night is approximately 183 × 100/212 = 86% saving.
Considering 4 km low traffic road operating for typically 50 years, Direct benefits and Indirect benefits can be calculated as following:
Considering the cost of; camera (approximate number), day/night sensor, motion sensor, controller (simplest version) [31], signal transmission between zones by RS-485 network [32], and installation [10] (lamp, manpower, crane, dumping etc.…), Table 6 can be obtained. The table illustrates that approximately $26,662.88 is needed to provide the proposed automation lighting system for 4 km.
S. No | Definition (in 4 km) | With controller | Without Controller |
---|---|---|---|
1 | Total Quantity of LED | 100 | 100 |
2 | Quantity of Day/Night sensor, Motion sensor, Camera & Controller | 10 | 0 |
3 | Unit price for Day/Night sensor, Motion sensor, Camera & Controller including maintenance | $107.40 | $0 |
4 | Total cost for item 3 | $1074.00 | $0 |
5 | Signal transmission between zones | $14,698.88 | $0 |
6 | Total Cost of Installation | $ 10,890.00 | $0 |
Initial investment.
Table 7 illustrates the comparison of energy consumption between using the proposed automation lighting system versus conventional system which operates all night, considering that both systems utilize LED fixtures with 75-Watt as minimum consumption for the conventional system. The table shows reduction in the power consumption of 86.31%. This reduces drastically the electrical fault probability in the lighting electrical circuits [33, 34].
S. No | Description | With Controller | Without controller |
---|---|---|---|
1 | Wattage per fixture (Watt) | 75 | 75 |
2 | № fixtures in 4 km | 100 | 100 |
3 | Total power Consumed (Watt) | 7500 | 7500 |
4 | Operating hours (hour) per day | 1.643 | 12 |
5 | Daily operating cycle % | 6.8458% | 50% |
6 | Operating hours (hour) in 50 Years | 29990.83 | 219,000 |
7 | Power consumed per day (kWh) | 12.325 | 90 |
8 | Power consumed for 50 years (kWh) | 224931.25 | 1,642,500 |
9 | Total Cost for per day ($) | 0.65 | 4.77 |
10 | Total Cost in 50 years ($) | 11,921.36 | 87,052.50 |
Energy saving.
Table 8 indicates the maintenance cost saving [10] (in terms of light fixture) such as lamp, manpower, crane, etc. for 50 years’ operation of the proposed automation lighting system and the conventional system.
S. No | Description | With Controller | Without controller |
---|---|---|---|
1 | Rated Life (Hours) | 100,000 | 100,000 |
2 | Operating hours in 50 years | 29990.83 | 219243.33 |
3 | Rate of maintenance in 50 years | 0 | 2 |
4 | Maintenance Cost per lightening pole | 108.9 | 108.9 |
5 | Total Maintenance $ | $0.00 | 21,780.00 |
Saving in maintenance cost.
In indirect saving, two benefits of implementing the lighting system will be drawn into attention [10].
First benefit is natural gas sales opportunity (Table 9) gained from reduction of the power consumption calculated based on Eq. (1).
S. No | Description | With Controller | Without controller |
---|---|---|---|
1 | Annual Power consumption (kWh) | 4498.63 | 32,850 |
2 | Reduction in Power Consumption (kWh) | 28351.38 | |
3 | Annual Natural Gas Sale Opportunity | $1587.68 | |
d |
Natural gas sales opportunity.
Second benefit is the cost saving due to reduction of the CO2 emission, hence less pollution. (Table 10) calculate the related saving based on Eq. (2).
S. No | Description | With Controller | Without Controller |
---|---|---|---|
1 | Annual Power Consumption (kWh) | 4498.625 | 32,850 |
2 | Power Consumption in 50 years (kWh) | 224931.25 | 1,642,500 |
3 | Annual Saving in Pollution | $1694.2752 | |
Saving in pollution.
Table 11 summaries the calculations in direct and indirect savings. It is obvious that total saving for only 4 km road in 50 years is $ 234,238.47.
a | Initial Investment | $ 26,770.28 |
---|---|---|
Net saving analysis in 50 years.
To sum up, huge amount of money can be saved if such technique is implemented. In case that this system is applied to only 100 km road, total annual saving becomes about $117,119.24; total saving in 50 years becomes $5,855,961.75. It means that such system saves huge amount of energy and hence expenditure saving that can be utilized in other projects’ investment. From is discussion, it is also possible to calculates the “Saving Norm” for the proposed system to be $1171.19/km/Year (Eq. (3)).
This Section provided automation design for the illumination system for low traffic roads in order to solve the problem of operating the road not only economically but also safely. Image recognition techniques was used based on identification of vehicle number-plate to recognize the objects, is it vehicles or not? Image recognition algorithm was tested on different objects. The result from test has proved the validity of the algorithm that is used to detect different types of vehicle. Comprehensive techno-economic analysis was carried out and the result showed a great saving can be achieved, and hence, “Saving Norm” of $1171.19/km/Year was calculated for the proposed system too. This “Saving Norm” is a good index to supports project management for both project decision makers and for cash-flow controllers. The calculated value of this “Saving Norm” index encourages the implementation of this technique in any Low-Traffic Long-Roads. This index is expected to be much higher, and hence more cost saving, in case road lighting uses HID bulbs instead of LED bulbs.
The ways which are used today in order to light houses, offices, and most of indoor areas are inefficient as a lot of energy is consumed unnecessarily during the day time. This problem is also one of the design concern in Green Building. In this section, a solution to this problem and a method for people’s comfort is presented. Lights switch on automatically when there is somebody in the room and switch off when there is no occupancy. In addition to this known technique, adjustment of the brightness level of the lights will be possible via the personal computer or any other smart device. In this method, for the illumination of the lights in the area, where is needed to be controlled, light automatically is measured by sensor and considering the amount of background light coming from outside, the brightness of lights automatically controlled to reach the preset level. By the means of this method, it is possible to provide both user comfort and energy saving [35].
The energy wasting created by lighting is very significant in places where is multi-occupant, especially in offices. In Today’s world, a lot of companies provide methods in order to minimize energy consumption, because energy consumption becomes a significant problem in developing world. Many researches show that lighting system accounts for approximately 30% of energy consumption [36]. Especially, departmental stores and big offices located in city territories causes a lot of energy consumption. In offices, lighting system consume approximately twice more than printers and computers [37]. One of the main causes of this problem is that people leaves lights “on” in unoccupied places. In almost 23% of the daytime this event occurs [38]. Another problem that causes to waste of energy is called over-illumination. Over-illumination occurs when lights are brighter than needed to illuminate room. In addition to this, researches demonstrate that excessive lighting can give rise to negative health effects [38]. This problem, however, still occurs in many structures everywhere, particularly in offices. Researches indicates that lights are off for just 1 percent of daytime while the room is unoccupied [39]. And this fact shows that over-illumination occurs during daytime because of external daylight coming into the room. And, in order to overcome these problems, implementation of intelligent lighting system can be a great solution.
The direct advantage of automated lighting system is to reduce energy consumption and maintenance cost. Energy consumption is reduced, because intelligent lighting system considers external daylight coming into the room and occupancy status, hence reduce the amount of power consumed. And, maintenance cost is minimized, since lifetime of the light bulbs is better utilized and this factor extends the life span of light bulbs. In addition to this, indirect advantages of proposed solution are that it allows the country to export more oil and gas, since the consumption of fuel that is needed to generate electricity will be reduced due to the energy savings caused by intelligent lighting system. Also, a reduction in pollution can be considered as positive advantage as well, because when less energy is consumed, the amount of carbon dioxide emission released by power generation plants is reduced.
It is important to highlight that during the engineering phases of indoor lighting system, because of uncertainty of the amount of daylight and any other background light which penetrates the room, engineers ignore this factor in the design which consequently introduce several drawbacks in the operation and maintenance cost of lighting system. Typical level of illuminance for indoor lighting is given in Table 12 [35].
Facility type | Area or task type | Emin(lux) |
---|---|---|
general | Entrance halls or corridors | 100 |
offices | Typing,Writing, Reading | 500 |
offices | Technical drawing/Working on computer | 500–750 |
offices | Conference rooms/Archives | 200–500 |
restaurant | Kitchen/Dining room | 300–500 |
schools | Classrooms/Library and Laboratories | 300–500 |
hospital | Waiting rooms/Operating theater | 200–1000 |
Design average level of illuminance for various places.
It is clear from the minimum level of illuminance indicted in Table 12 for each application that the design engineer has to consider the given value as Minimum. This make the designer not only ignore any background lighting contribution, but also it considers “Minimum” illumination level that allows the designer to go to higher values to satisfy other design criteria such as symmetrical distribution of lighting inside the room. Also, this “Minimum” value of the illuminance level considered the worst calculation safety-factors that may not be applicable in all cases. Therefore, in general, most of the time in day extra unnecessarily lux level can be obtained inside the room, and hence additional money for operation and maintenance need to be spent.
For better control of the indoor lighting and reduce the operation and maintenance cost of the lighting system, there are many methods to implement intelligent lighting system in order to provide more efficient lighting [40]. First method is to use occupancy sensor in offices, homes etc. In this method, sensor is used to detect occupancy in order to control lights. If there is somebody in the room, lights switch on, otherwise lights switch off automatically. This is a good straight forward and easy method reduce energy consumption but it is not the optimum solution as the method still ignoring the contribution of background lighting, therefore it cannot be considered as high efficient way to control the indoor lighting intensity.
Second method is to utilize daylight to adjust brightness to a preset level. Energy savings are controlled by using dimming technique in which percentage of illumination of light bulbs change according to daylight coming into the room. Researches show that dimming technique reduces energy consumption up to 30% compared to non-dimmable light bulbs [41]. Daylight utilization can be accomplished by using light sensors which is used in order to detect level of illuminance inside the room and adjust brightness of the light bulbs on the basis of amount of daylight measured in the room and desired set-point. The energy saving can increase depending on the performance of light sensors used. It is reported by Electric Power Research Institute that daylight utilization can increase energy savings up to approximately 40% [42]. In addition, researches indicate that energy savings can enhance up to 76% by taking into account daylight and occupancy status [43].
In this section, both above mentioned approaches are considered to develop intelligent lighting system in order to minimize power consumption and provide sustainable lighting system. Economic analysis is required to be carried out to evaluate this new approach.
This integrated approach enables us to adjust brightness of lamps to a preset level, considering daylight coming into the room and also prevent unnecessary lighting in unoccupied places. In the economic analysis, LED lighting type is selected as its power consumption is the lowest among other types of light bulbs, and hence it is expected minimum energy cost saving to be achieved. In case, other type of bulb is used, such as fluorescent or incandescent bulb, the energy saving due to using this intelligent lighting system shall be much higher.
Energy consumption can be reduced significantly when light bulb’s output is controlled automatically. Two methods are commonly used for lighting control. First method uses individual lighting control system in which each light bulb’s output is adjusted independently according to light output level of its neighbor bulbs, the second method is networked lighting control system, which is more effective than the first method because all bulbs communicate intelligently with each other in order to achieve the required level for the room light intensity.
Networked lighting control system can be classified as DLCS (distributed lighting control system) for first method, or CLCS (centralized lighting control system) for second method. in DLC systems, each light bulb’s sensing data is received by the controller, and they can communicate with neighbors in order to adjust their output level according to each other’s state. However, in central unit CLCS which receives the status of each node based on information obtained from the sensors, and then performs control actions via actuators. In this system, central unit determines the output level of each light bulb on the basis of data obtained from sensors. In CLCS, many tasks are performed by central unit, such as, acquiring sensors’ data from each node, estimating the optimal state where each light bulb will meet light requirements of the room (Figure 8).
C LC system and DLC system.
PIR (Passive infrared) sensor is used to sense occupancy in places. PIR sensor detects occupancy at places and send commands to the controller to switch on or off lights. Light intensity sensor(s) is used to give the controller the required data. The control unit sends signal to light dimmer(s) to control the LED light imitation to achieve the preset Lux level required for the room considering daylight.
The term called intelligent luminaire is connected to a smarter level of illumination where devices are capable of creating lighting comfort, energy efficiency, and easy controllability. The concept which is named intelligent lighting system corresponds to a system that communicates and cooperates with many luminaires, creating a node that satisfies user requirements. The key goal of this kind of system is to save energy and, at the same time user comfort by the means of network communication. In Figure 9 the block-diagram of intelligent lighting system is illustrated. It is assumed that lighting system is dimmable (controllable) in order to provide intelligent method to tune the Lux level to the present value determined by the controller.
Block diagram of intelligent lighting system.
Firstly, this system checks for occupancy. If there is no occupancy, Arduino controller sends commands to AC light dimmer (which is controlling the intensity of light bulbs) to switch off lights. If there is somebody in the room, PIR sensor detects occupancy inside the room and activate Arduino controller. Consequently, the controller sends signal to the dimmer(s) to switch on the light and tune the lux of the room to achieve the preset value based on the input provided by the light intensity sensor(s).
The intelligent lighting system contains PIR sensor, BH 1750 light sensor, Arduino Mega, AC light dimmer, LED and light bulb.
PIR sensor is used to detect occupancy in the room. Light sensor is used to measure the amount of light in lux. Arduino Mega is used as a controller. Ac light dimmer is used in order to adjust the brightness of LED bulb. To monitor the amount of light (PV) and set point (SP), LCD is used. LED bulb is used to provide illumination in the room.
PIR sensor is one of the simplest and inexpensive type of occupancy sensors and this type of sensor is widely used around the world. It is capable of measuring various air temperatures in the room. When there is somebody in the room, sensor sends a signal to turn on or off lights. When object is moved in the sensor’s field of view, infrared lights which is radiating from the objects are measured by PIR sensor. People have a temperature that is higher than perfect zero and thermal energy is emitted from people in the form of radiation. During the day, the wavelength of radiation is approximately 9–10 micrometers. PIR sensor has capability to detect the wavelength of radiation which only arise when a person comes to sensor’s field of view. The radiation emitted by all objects which has temperature above absolute zero cannot be seen by human eye, since it is emitted at infrared wavelengths, however, electronic devices, such as PIR sensor, can detect it. This kind of sensors works totally by sensing the energy emitted by objects. When the amount of heat varies in intensity or position, sensor activates the controller.
PIR sensor which is used in this Intelligent Lighting System possesses pyro-electric sensor module that is designed for the detection of human body. This sensor has sensing range from 3 m to 4 m, and lens angle is about 140 degrees [44]. One of the advantages of PIR sensor compared with other types of occupancy sensor is that it is not complex, effortless to install, and it has compact size which is 28*28 mm. In addition to this, it is highly sensitive, power consumption is very low, and can perform under temperature from −15 to 70 degree. Most significantly, as contrasted with other sensors, it can penetrate walls in which motion can be anticipated and it is cheaper compared with other sensors. However, a constant and slight motion cannot be detected by PIR sensor and this sensor is sensitive to temperature. Another negative side of this sensor is that its field of view is smaller than other type of occupancy sensors. Moreover, this sensor cannot be mounted near the places where temperature changes commonly. But for application of indoor industrial building, this senior is adequate to be used.
BH1750 sensor is used in order to measure light intensity inside the room. This is a digital light sensor and it is used in the majority of mobile phones in order to adjust screen brightness, depending on lights coming from outside. This sensor has capability to measure directly lux value and there is no need to convert measured value to lux. This sensor uses I2C protocol to communicate with the controller. This protocol makes it easy to use with microcontroller. SCL and SDA pins which sensor have are required for I2C protocol. One of the advantages is that there is no need for calculation because we can get directly lux value by the means of this sensor. This sensor measures light intensity based on the amount of light which is hitting on it. The voltage between 2.4 V and 3.6 V and 0.12 mA current is needed to operate this sensor. The main component of BH1750 sensor is illustrated in Figure 10.
BH 1750 sensor circuit.
Arduino Mega is used as a master to control all slaves. It is the brain of this Intelligent Lighting System. It is a type of microcontroller board and uses ATmega 2560 microcontroller. Arduino Mega has 70 I/O pins. Fiftyfour (54) pins of Arduino Mega are digital I/O pin and 14 of them can be used as PWM pin. Other 16 pins are analog I/O. In addition to this, it consists of 4 UARTs, 16Mhz crystal oscillator, USB connection, power jack, ICSP header, and reset button. Arduino Mega can simply be connected to the computer and programmed. There are many types of shields used for several purposes can be added to the Arduino mega [13].
LED light bulbs are the best choice to use in energy saving lighting systems and they have great advantages over the fluorescent lamps and incandescent light bulbs. In these days, LED bulb technology has developed and this technology offer light bulbs which can be used for many applications. In addition to this, this type of light bulbs offer dimmable and non-dimmable options and it creates opportunity to be used in intelligent lighting systems. LED bulbs are very durable and no mercury is used in this type of bulbs. Although the initial cost of LED bulbs is higher than other types of bulbs, they are cheaper to use for overall life of the light bulb compared with fluorescent or incandescent light bulbs. For all of these reasons, it can be beneficial to use led bulbs instead of other types of bulbs in the Intelligent Lighting Systems [44].
AC Light Dimmer is used to adjust the light intensity by dimming the light bulb [45]. There are various methods for dimming, the usual way is to use variable resistor which change the voltage coming into the lamp. Nevertheless, when variable resistance is used in order to change the brightness of lamp, resistance converts some part of energy into the heat that is not used. An effective method for dimming is to turn off AC power regularly and provide only some portion of full wave to the light. It could sound strange at first, because it will produce flicker, however it is not visible by human eye, if the periodic light switches and phase of AC power are locked. In order to accomplish the dimming, two circuits are required, zero-crossing detector and pulse-controlled switch, respectively. This is used in order to maintain switching with the power source in phase. And, to deal with 220 V AC, safety precautions should be implemented. That is why, circuit should be mechanically and electrically isolated from outside by the means of metal box and optoisolators, accordingly. The zero-crossing detector is a full wave rectifier with high power resistors that is used to reduce voltage (Figure 11). And, the pulse-controlled switch contains a Diac or Triac.
Pulse control using AC light dimmer.
The response of system will be illustrated for three different preset values and three background in the room. The response of the system will be represented for occupied conditions. In unoccupied conditions, the intensity of light bulb will be set automatically to zero lux. In Figure 12, the response of the system is illustrated for preset value of 75 lux and external daylight with the amount of 25, 50, and 75 lux, ascending and descending. Another case is considered in Figure 13 represents the response of the system for setpoint of 150 lux and additional daylight with the amount of 50,100, and 150 lux, ascending and descending. And last test case is considered in Figure 14 shows the response of the system for setpoint 300 lux and external daylight with the amount of 100, 200, and 300 lux, ascending and descending. It is obvious from the results, the dimmer adjusts the light intensity of light bulb to achieve successfully to the present value, considering the external light coming into the room.
The response of system for 75 lux SP.
The response of system for 150 lux SP.
The response of system for 300 lux SP.
The transient state of the system response is not described in these graphs, only steady state is taken into account, since human’s eye does not recognize to the fast changes happen in the amount of light. Moreover, in general, the rate of the change in the daylight occurs slowly and gradually, consequently, the response of the controller will change the intensity of the light emitted from the controlled lighting system in small steps which are comfortable for the eye. Hence, the transient state is not concern for the proposed intelligent lighting system.
In this section, Techno-Economical evaluation is discussed that includes direct and indirect benefits obtained from using the proposed intelligent lighting system. As mentioned earlier in this Chapter, Direct benefits are categorized in two parts; operational and maintenance cost. However indirect benefit is categorized also into two parts, introducing more oil/gas sale opportunity and reduction of pollution. And, the cost of this intelligent lighting system is negligible compared with other lighting systems [46, 47].
Direct benefits of the proposed Intelligent Lighting System are explained as following:
This section determines the energy gains that intelligent lighting system can provide during the day. In order to achieve this, the response of controller is assumed to be maintained during the day. By considering occupancy status and level of illuminance during the day, energy savings which intelligent lighting system can provide may be calculated. Survey [37] illustrates that workers’ illuminance preference is approximately 300 lux, and energy waste is generated by over-illumination and turning on lights in unoccupied places.
In Figure 15, Data of illuminance and occupancy status during the day and workers’ illuminance preference in typical open-office are illustrated. In this survey, it is assumed that approximately 60% of daylight is coming into the room. From Figure 15, it can be observed that workers arrive at office at approximately 9:00 AM, occupies the working area and turn on the lighting system, because the level of illuminance is less than 300 lux (However, lighting system plus daylight coming into the room provides more than 300 lux). Thus, at the end of working hour, the lighting system was switched off about at 19:00. Also, from It can also be observed that workers leave working area at different times of the day, but lighting system turned on by causing the energy waste. In addition, between 15:00 and 17:00 the illumination which is generated by daylight is sufficient to satisfy the illuminance requirement at the office and lighting system is however switched on by causing over-illumination.
Data of illuminance and occupancy status in typical open-office.
This data represents that thanks to daylight utilization technique, energy can be saved significantly between 9:00 and 19:00 by controlling the amount of light provided by the lighting system. In addition to this, occupancy sensor will contribute us to save energy by switching off lighting system when there is no occupancy in the working area. Finally, the energy savings can be calculated from the Figure 15 by comparing the Areas under the curves. In order to find the energy savings, the area of curves, which are generated by the outputs of intelligent lighting system and Setpoint, should be calculated between 9:00 and 19:00. And, using the following equation, the percentage of energy savings accomplished from intelligent lighting system can be estimated.
From the equation above, it is calculated that in typical open-office energy savings can be approximately 81.7% by implementing proposed intelligent lighting system.
In Figure 15, it is clearly seen that operation hours of light bulbs reduce from 10 hours to approximately to 5.5 hours. So, implementation of proposed intelligent lighting system contributes also to reduce maintenance cost. The life span of light bulbs increases significantly, since lights are switched on at certain times of the day. From Figure 15, percentage of reduction of maintenance cost can be calculated by the means of following equation.
From the equation above, it is calculated that in typical open-office, maintenance cost can be reduced about 45% by implementing proposed intelligent lighting system.
Explanation of indirect benefits will be given in detail in the following paragraphs.
First benefit is that country can export larger amount of gas, since the consumption of gas will be reduced due to the energy savings caused by proposed intelligent lighting system. By using the selling price of $4.618/MMBtu on the basis of US Energy Information Administration Henry Hub/NYMEX, natural gas valued futures prices. Considering 1% annual escalation factor, equivalent energy rate of 5.6¢/kWhr used to measure the energy generated for one year. And, sales opportunity for the natural gas can be estimated annually by the means of equation Eq. (1) that can be used to calculate the annual gas sale opportunity for any project using this Intelligent Lighting System.
Second indirect benefit is that pollution caused by power plants can be reduced significantly. When the amount of power consumed is reduced, the amount of toxic fumes released by power plants will be reduced. The majority of power plants burn crude oil, coal, fossil fuel etc. Hence, this causes the emission of carbon dioxide that accounts for the majority of pollution. Carbon dioxide is released into the air and causes the absorption of sun’s warmth and heat in our atmosphere. When power plants burn more fuel in order to generate more energy, extra carbon waste traps cause too much heat. When carbon dioxide emission is reduced, it will cause less pollution. Eq. (2) can be used to calculate the Annual Saving in Pollution that can be gained in any project using this Intelligent Lighting System.
Nowadays, energy saving is one of the big problems, that is why energy-efficient lighting systems proceed rapidly over the past ten years [43]. Led light bulbs are the best choice to use in energy saving lighting systems and they have great advantages over the fluorescent lamps and incandescent light bulbs. In these days, led bulb technology has developed and this technology offer light bulbs which can be used for many applications. In addition to this, this type of light bulbs offers dimmable and non-dimmable options and it creates opportunity to be used in intelligent lighting systems. Led bulbs are very durable and no mercury is used in this type of bulbs. Although the initial cost of Led bulbs is higher than other types of bulbs, they are cheaper to use for overall life of the light bulb compared with fluorescent or incandescent light bulbs. For all of these reasons, it can be beneficial to use led bulbs instead of other types of bulbs in lighting systems.
One of the bunch of LED bulbs is diffused LED bulbs. It is covered by lens which have dimple shape, and this shape support to spread light around a big area. Nowadays, because of their tremendous efficiency, people increasingly use this type of bulbs. This type of bulbs is available in standard Edison bases, and they can be used for a lot of purposes, such as, reading lamp, lighting for rooms and offices, and some other applications in which light can remain on for a long time.
Flame Tip, Candelabra Base LED bulbs is another type of LED bulbs and it is used in many applications. The purpose of designing such type of light bulbs is to take the place of incandescent candelabra bulbs. This type of light bulbs is significantly effective because they can deliver corresponding light of 25 to 35 W and light does not spread top to bottom as far as typical lights, because of heat sink.
LED Tube Light bulbs is another type of LED light bulbs and it is used in a lot of applications. The purpose of designing this type of light bulbs is to replace typical fluorescent tube lights. They exist in 8 and 16 W. In commercial sites, fluorescent lights are frequently installed in high ceilings and using Led Tube Lights instead of fluorescent tube lights is extra saving, because the frequency of replacing bulbs is significantly decreased.
The life of LED bulbs is approximately 10 times more than incandescent and fluorescent light bulbs. The main reason why they are more effective is that they do not have filament and they are not destroyed under conditions in which typical incandescent and fluorescent light bulb can be damaged. This type of bulbs does not cause any heat, but common incandescent lamps heat and help to increase the room temperature. LEDs avoid this problem and contribute to reduce the air conditioning cost. In the manufacturing process of LED bulbs, no mercury is utilized and this kind of bulbs use approximately 2–17 W electricity. LED bulbs reduce electricity cost, remain cool and avoid the replacement cost, because they have long life.
Although, initial cost of LED bulbs is higher, this cost compensates over time in electricity saving. The use of LED bulbs commercially adopted, because maintenance and replacement cost was significantly higher. Maintenance and replacement cost in LED bulbs are considerably less compared with others and the initial cost of LED bulbs is continuing to decrease.
Consider standard office with dimension 3mx4m. As per Table 12, the design lux level is 500 lux. Using matrix distribution 2x2 with 60cmx60cm light fitting, each consists of 4 lighting tube Fluorescent (25 W) or LED (9 W), the office Traditional lighting load shall be 400 W or 144 W respectively. For 9 hours working duty, the annual consumption shall be 4730kWh and 1314kWh.
Applying Equation-9, the office annual energy consumption can be reduced to 865.59kWh and 240.462kWh for Fluorescent lighting and LED lighting respectively.
From Table 13, cost of electricity (0.10per KWh). Accordingly, from two the values, 865.59kWh and 240.462kWh, Annual Energy Saving Norm/Office for offices using Fluorescent lighting and LED lighting can be calculated to be 86.6 $/office and 24$/office respectively. For example, if this technique applied on 100 Administration Building with 50 room each, so the total Annual Saving can be 433,000 $ and 120,000$ for Fluorescent lighting and LED lighting consequently. This example gives good impression how much reasonable saving can be obtained by applying such technique in industrial buildings.
Conditions | Led Bulbs | CFL | Incandescent |
---|---|---|---|
Light bulb projected Lifespan | 50,000 h | 10,000 h | 1200 h |
Watts for per bulb | 10 | 14 | 60 |
Cost for per bulb | $35.95 | $3.95 | $1.25 |
KWh of electricity used over 50,000 hours | 300–500 | 700 | 3000 |
Cost of electricity (0.10per KWh) | $50 | $70 | $300 |
Bulbs needed for 50 k hours of use | 1 | 5 | 42 |
Equivalent 50 k hours bulb expense | $35.95 | $19.75 | $52.50 |
Total cost for 50 k hours | $85.75 | $89.75 | $352.50 |
Economic comparison between LED, CFL and incandescent bulbs.
To conclude this section, it can be highlighted that most places are over illuminated because background light is not considered in the design sage. In addition, light is switched on in unoccupied places which causes waste of energy. Therefore, Intellect Lighting System is very essential to overcome this problem to control indoor lighting intensity taking into account occupancy status and background light coming into the room in order to adjust level of illuminance in efficient way. As a result, it is worth to highlighted that Intelligent Lighting System uses properly selected LED bulbs not only reduces power consumption, but also reduces maintenance cost, pollution caused by power plants and increases opportunity for gas sales. Finally, typical Annual Energy Saving Norm (Energy Saving$/Office) is calculated for both cases, offices using Fluorescent lighting and LED lighting.
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\\n"}]'},components:[{type:"htmlEditorComponent",content:"In each instance of a possible Conflict of Interest, IntechOpen aims to disclose the situation in as transparent a way as possible in order to allow readers to judge whether a particular potential Conflict of Interest has influenced the Work of any individual Author, Editor, or Reviewer. IntechOpen takes all possible Conflicts of Interest into account during the review process and ensures maximum transparency in implementing its policies.
\n\nA Conflict of Interest is a situation in which a person's professional judgment may be influenced by a range of factors, including financial gain, material interest, or some other personal or professional interest. For IntechOpen as a publisher, it is essential that all possible Conflicts of Interest are avoided. Each contributor, whether an Author, Editor, or Reviewer, who suspects they may have a Conflict of Interest, is obliged to declare that concern in order to make the publisher and the readership aware of any potential influence on the work being undertaken.
\n\nA Conflict of Interest can be identified at different phases of the publishing process.
\n\nIntechOpen requires:
\n\nCONFLICT OF INTEREST - AUTHOR
\n\nAll Authors are obliged to declare every existing or potential Conflict of Interest, including financial or personal factors, as well as any relationship which could influence their scientific work. Authors must declare Conflicts of Interest at the time of manuscript submission, although they may exceptionally do so at any point during manuscript review. For jointly prepared manuscripts, the corresponding Author is obliged to declare potential Conflicts of Interest of any other Authors who have contributed to the manuscript.
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\n\nEditors can also have Conflicts of Interest. Editors are expected to maintain the highest standards of conduct, which are outlined in our Best Practice Guidelines (templates for Best Practice Guidelines). Among other obligations, it is essential that Editors make transparent declarations of any possible Conflicts of Interest that they might have.
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\n\nFINANCIAL AND MATERIAL
\n\nNON-FINANCIAL
\n\nAuthors are required to declare all potentially relevant non-financial, financial and material Conflicts of Interest that may have had an influence on their scientific work.
\n\nAcademic Editors and Reviewers are required to declare any non-financial, financial and material Conflicts of Interest that could influence their fair and balanced evaluation of manuscripts. If such conflict exists with regards to a submitted manuscript, Academic Editors and Reviewers should exclude themselves from handling it.
\n\nAll Authors, Academic Editors, and Reviewers are required to declare all possible financial and material Conflicts of Interest in the last five years, although it is advisable to declare less recent Conflicts of Interest as well.
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\n\nAuthors should declare if they were or they still are Academic Editors of the publications in which they wish to publish their work.
\n\nAuthors should declare if they are board members of an organization that could benefit financially or materially from the publication of their work.
\n\nAcademic Editors should declare if they were coauthors or they have worked on the research project with the Author who has submitted a manuscript.
\n\nAcademic Editors should declare if the Author of a submitted manuscript is affiliated with the same department, faculty, institute, or company as they are.
\n\nPolicy last updated: 2016-06-09
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