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Material gains in healthier hospitals

Ninety per cent of our time is spent indoors and 90% of business costs are for staff salaries. However, the effect of the indoor environment on productivity is not considered in the same way as other aspects of the building, such as energy performance.

Few would deny the merits of healthy buildings, but momentum is slow, says sustainable materials leader Eszter Gulacsy. By identifying the challenges, we can get this stone rolling.

In recent years, we’ve seen a growing realisation among healthcare providers that although a building won’t cure you, it could contribute to the healing process. Or, at least, the building shouldn’t hinder the healing process. If we’re being honest, then that’s where we’re starting from: buildings shouldn’t get in the way of recovery.

Healthcare trusts are understandably keen to improve their environments, whether it’s air quality, access to daylight or setting temperatures and artificial lighting that suits both patients and clinicians. But they also have other factors to consider, most notably energy efficiency. 40% of energy production in the European Union is directed to the building sector. It’s little wonder that energy efficiency is therefore the primary focus of regulators and voluntary schemes in healthcare facilities.

The upshot of concentrating on energy efficiency is increased air tightness: eliminating leakiness reduces heat loss and improves energy efficiency, which again is a good thing. However, it also means that any air pollutants coming into the building or generated inside the building have less chance of escaping.

Balancing opposing priorities

Of course, in cities with poor outdoor air quality, opening the windows is not the healthy option anyway. It is proven the world over that a ‘bad air day’ will raise mortality inside as well as out. But using forced or recirculating ventilation systems instead of natural air supply presents an equal challenge – the risk of pollutants accumulating in the building.

With attention so fixed on vehicle pollution it may

surprise you that in hospitals the most likely source of pollutants is the chemicals that occur throughout surgery rooms, operating theatres, and laboratories. In this indoor environment, even everyday disinfectants such as rubbing alcohol can react with other chemicals inside the building to produce gases such as ozone, a common component in smog. Tests find the same compounds inside the building as you would in an outdoor traffic environment. Indeed, recent studies have shown that healthcare workers reported more indoor-related symptoms than people working in office buildings.

The fabric of buildings themselves, and their fittings and furnishings, are another major source of compounds that can make us ill. Designing and specifying healthier buildings is still a niche skill, and more prevalent in the office sector than healthcare. There is an increasing number of office owners who are determined to protect the wellbeing (and productivity) of their staff by minimising the use of construction materials that contain potentially harmful chemicals.

The challenge for designers is finding healthier materials, and then verifying these new products have been used in construction, with no substitutions made.

It asks for a new tactical approach, backed by education of suppliers. But the more projects that ask these questions, the less they become a novelty and the quicker the markets will emerge.

If you buy a bottle of shampoo in the EU, all the ingredients are listed on it. But not so in construction materials. Like a parent of an asthmatic child, who will be acutely aware of finishes and textiles, designers will need to act like ‘mom’ for their clients in the building process. In a recent office fit-out project, we developed a list of more than 300 products, with an assured ingredients list for each.

No perfect solutions

Designing with human-friendly materials and avoiding volatile compounds as far as practical in facilities management and clinical treatments helps solve the dichotomy of opposing outcomes for energy efficiency and air quality.

This is a complex area, and demonstrating quantitative metrics is hard. But when you consider the office environment, there’s an obvious business case for proactively safeguarding employee health: greater alertness, improved wellbeing, less absenteeism. In the life or death situations of healthcare, a positive indoor environment that affects productivity and improves performance also makes a lot of sense.

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