Ventilation Requirements for Endoscopy Procedure Rooms

I was asked recently if the ventilation requirements for Endoscopy procedure rooms have changed recently, and the answer is yes. But the changes only apply to new construction, meaning you are not required to go back and retroactively update the ventilation design of the Endoscopy rooms.

The following editions of the Guidelines for Design and Construction of Healthcare Facilities have the following air pressure relationship requirements:



  • (AIA) 1996-1997 edition                 Neutral                 6 ACH                    2 ACH (outdoor air)
  • (AIA) 2001 edition                           Negative               6 ACH                    2 ACH (outdoor air)
  • (FGI) 2006 edition                           Neutral                 6 ACH                    2 ACH (outdoor air)
  • (FGI) 2010 edition                           Positive               15 ACH                     2 ACH (outdoor air)

So, from 1996 to 2010, the air pressure relationship for the endoscopy procedure room, went from being neutral, to negative, back to neutral, then to positive, and the air changes per hour (ACH) went from 6 to 15.

These are guidelines, and are not standards, meaning these are meant to be followed at the time of new construction, unless there are other reasons not to follow them (such as state requirements). The good thing is, as long as you have documented what edition of the guidelines you designed your Endoscopy procedure room to, you are not required to go back and update the room to meet the newer edition of the guidelines.

Typically, most states have firm requirements on ventilation requirements in hospitals that frequently follow along with the guidelines, so in those situations the hospital would have to follow the state’s requirements. Joint Commission has currently adopted the 2010 FGI guidelines (see EC.02.05.01, EP 6) which applies to new construction, and is not enforceable to older designs (many surveyors are not fully aware of this). Again, the guidelines are just guidelines, not standards. In lieu of any other reason, TJC would expect compliance with the guidelines that apply at the time the Endoscopy room was constructed.

CMS has not adopted any specific edition of the Guidelines…. See §482.41(c)(4) [A-0726], which requires ‘proper ventilation’. The CMS interpretative guidelines for this standard just says acceptable standards from AIA should be incorporated. This is not a specific requirement to use the AIA (or FGI) Guidelines. [NOTE: AIA used to write the Guidelines for Design and Construction, but in 2006 they turned it over to FGI.]