Hospital doors with a cardboard honeycomb core: can they be used?

Requests for quotation for healthcare facilities often include hollow-core doors with a cardboard honeycomb core, the classic honeycomb. They are light, inexpensive and widely used in housing and offices. But are they suitable for a hospital ward? Let’s see what the regulations say and what happens in everyday use.

What the regulations say

No Italian standard explicitly forbids doors with a cardboard core in healthcare facilities. Internal doors must, however, meet two groups of requirements.

• Fire prevention. Ministerial Decree (DM) of 18 September 2002 as amended, or alternatively Vertical Technical Rule (RTV) V.11 of the Italian Fire Prevention Code, sets the reaction-to-fire classes of materials according to the area. Compartmentation doors must also have certified EI fire resistance. A hollow-core door with a cardboard honeycomb cannot be an EI door.
• Hygiene and accreditation. The minimum structural requirements (Presidential Decree (DPR) of 14 January 1997) and the regional accreditation manuals call for washable, disinfectable and durable surfaces, especially in critical areas.

Cardboard, therefore, is not banned. It is the combination of these requirements with real-world use that makes it unsuitable in a hospital setting.

The limits of cardboard honeycomb in hospitals

• Moisture and disinfection. In hospitals, doors are cleaned every day with water and disinfectants. A damaged edge or an unsealed fixing hole is enough for moisture to reach the cardboard. The cardboard swells, loses strength and the panel warps.
• Impacts. Beds, stretchers and trolleys hit doors constantly. With a honeycomb core the facing is supported only at points, so it dents and can be punched through.
• Hardware and automation. Hinges, pull handles, door closers and automation need solid backing. In a honeycomb panel the screws grip only a few millimetres of material and loosen over time.
• Service life. A door that warps or gets damaged has to be replaced sooner than expected. The initial saving turns into maintenance costs and disruption for the ward.

Our choice: a solid-core compound panel

Hospital Division doors are made with a 40 mm, 5-layer compound panel with a symmetrical structure:

• 0.9 mm plastic laminate on both faces, smooth, washable and resistant to cleaning agents;
• MDF under each face, providing rigidity and a solid base for hinges, pull handles and automation;
• self-extinguishing, flame-retardant expanded polystyrene core, class 1 reaction to fire, with a density of 25 kg/m³. It is solid and light and, unlike cardboard, does not absorb water.

The symmetrical structure balances the stresses between the two faces: the panel stays flat over time and does not warp. The result is a stable, impact-resistant door that keeps its hardware secure even after years of intensive use.

Antibacterial handle

The doors come with an antibacterial handle. The handle is the part of the door touched most often by staff, patients and visitors, and therefore one of the most critical points for the spread of infection. An antibacterial finish reduces the growth of bacteria on the surface, supporting standard cleaning and disinfection protocols.

In summary

Door with cardboard honeycomb core

• Core: cardboard honeycomb
• Moisture resistance: low
• Impact resistance: limited
• Hardware and automation holding: limited over time
• Long-term flatness: variable
• Suitable for intensive hospital use: no

Hospital Division door with 40 mm compound panel

• Core: self-extinguishing expanded polystyrene, class 1
• Moisture resistance: high
• Impact resistance: high
• Hardware and automation holding: solid MDF backing
• Long-term flatness: ensured by the symmetrical 5-layer structure
• Suitable for intensive hospital use: yes