Indoor Air Quality and Healing Environments

2/4/2011
Indoor Air Quality and Healing
Environments
The GEI is a Registered Provider with the American Institute of Architects Continuing
Education Systems. Credit earned on completion of this program will be reported to CES
Records for AIA members.
This program is registered with the AIA/CES for continuing professional
education. As such, it does not include content that may be deemed or
construed to be an approval or endorsement by the AIA of any material
of construction or any method or manner of handling, using, distributing,
or dealing in any material or product. Questions related to specific materials,
methods, and services will be addressed at the conclusion of this presentation.
GREENGUARD Environmental Institute is an industry
independent non-profit organization focused on helping you
create healthy indoor environments.
GREENGUARD Environmental Institute
2010
GREENGUARD
Environmental Institute
Course Name :Indoor Air Quality
and Healing Environments
1
1
2/4/2011
Learning Objectives
• Discuss the factors driving sustainable
building practices of healthcare
facilities
• Understand issues impacting
healthcare construction and IAQ
• Demonstrate effective design
strategies to minimize indoor air
problems and control contaminants
• Identify resources for creating healthy
healing environments.
• Confirm understanding through verbal
quiz at course end.
The Changing State of Healthcare
• State of the facilities: refurbishment/improvement
• First Impressions: Facility, Organization, Type of Care
• Hospitals should provide flexibility
• Operations and Maintenance Costs impact on Life
Cycle costs
Populations in Sensitive Environments
• Children, older adults, people with chronic
illnesses or suppressed immune systems
• Hospitals, nursing homes: patients and
staff
Building Functions
Number of Buildings
Inpatient
8,000
Outpatient
121,000
Total US healthcare facilities
129,000
Total US Buildings
4,859,000
2003 Commercial Buildings Energy
Energy Information Administration,
Consumption Survey
Washington
DC
GREENGUARD Environmental
Institute
2009
2
2/4/2011
Issues Impacting Healthcare Facilities
Construction
• Shift in care settings
• Changes in patient
populations
• Changes and demand
for new technology
Issues Impacting Healthcare Facilities
Construction
•Competition: nontraditional healthcare
providers
• Medical tourism
•Nationalized Healthcare
loss of control/cost
escalation
Design Issues Impacting Healthcare Facilities
Construction
•Renovating aging facilities to High Performance Building
Guidelines
•Green Premium Issues
•Consumer needs driven facilities, e.g. “Healthcare Villages”
•Health and well-being of all patient care personnel
•Single patient rooms/ birthing suites
3
2/4/2011
Top Reasons for Deciding to Build
Green Health Care Facilities
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Enhanced staff and
patient well-being
Operational cost savings
Increased building
function efficiency
Most Important
Being part of the
Public relations benefits
healthcare sector that
of being a green leader
values the environment
Overall
Courtesy of McGraw Hill Construction
Green Building Smart Market Report – Health Care
Design from a Management Perspective
Business
Competitiveness
Societal Issues
Patient
Centered Issues
Evidence Based
Design
Principles
Case Study: Center for Health and Healing,
Portland, Oregon
• 400,000 square ft-- Cost $160Million
• Completed in October 2006
• Mixed use center;
healthcare/wellness/offices/research labs
• Sustainable attributes included:
•Radiant flooring
Energy reduction of 30%
Passive ventilation system
Green roofing
Day lighting
Water conservation
Low VOC finishes
On-site transportation provided
4
2/4/2011
Human Health Impact Asthma
Allergies
Eye Irritation
Headache
Upper Respiratory Irritation
Nausea, Dizziness
Fatigue & Lethargy
Sore/Dry Throat
Nose Bleed
Odor Complaints
Memory Impairment
Healthcare IAQ Concerns
Infectious
Diseases and
Biological Hazards
Chemical Hazards
Unique ventilation and
filtration standards—
adequate volumes of
outside air
Infectious Diseases and
Biological Hazards
5
2/4/2011
Chemical Hazards
• Volatile Organic
Compounds
• Cleaning chemicals
and disinfectants
• Outdoor
contaminants
• Lab tests
Unique Ventilation
Requirements
• CDC and ASHRAE
Guidelines
• ASHRAE 62.1 –
Ventilation/recirculation/
mixing
• Challenge: introduce
moisture without
contaminating the air.
Effective Design Strategy: Children’s Hospital,
Fort Worth, Texas
Waiting Room: air
sweeps through
No mixing of air
HEPA Filtration
Savings from not totally
exhausting to the
outside
Infectious Isolation
6
2/4/2011
Jersey Shore University
Medical Center, Neptune, NJ
Completed August 2009
Case Study: Center for Health Design
Design Strategies Included:
Use of 100% outdoor air in all
spaces
Use of low-emitting finishes
Outcomes:
90% of staff satisfied with air quality
and surface finishes
Caulks and
Sealants
Window
Coverings
Walls and
ceilings
Textiles
Furniture
Surfacing
Materials
Medical
Equipment
Flooring
Cleaning
products
GREENGUARD Environmental Institute
2009
So how do we create Healthier Care
Facilities?
We can help
you put the
pieces together
7
2/4/2011
IAQ Management Plan
Design Phase
Considerations
Construction Phase Issues
Operations and
Maintenance Procedures
IAQ Considerations in the Design Phase
• Site orientation and
preparation
• Room design: single
patient
• Pressurization:
Protective Isolation
v. Infectious Isolation
IAQ Considerations in the Design Phase
• Specify lowemitting materials
• Use of
antimicrobial
textiles
• Ventilation
procedures
8
2/4/2011
Material Considerations in the Design
Phase --Furniture
Furniture Finishes- durable; inexpensive
Avoid sharp corners
Wipe-out drawers; seat backs
Easily moved or permanently affixed to floor
Able to withstand at least 300 pounds
Material Selection in
Design Phase
Correct Pressurization And Airflow Design To Minimize
Contaminant Spread Through Adjoining Spaces.
-0.6
Pa
FCU
Outside
(0 Pa)
X





Closet
-0.5
Pa
Supply Air
Return Air
Corner Room
Individual
Bath Fan
Toilet
Area
-1.6
Pa
+0.5
Pa
9
2/4/2011
IAQ Issues during Construction Phase
• Precautions:
– Prevent Contaminant Spread—dust barriers
– Vigilance of HVAC- negative pressure
– Protection of building materials-moisture
– Commissioning of building systems
Maintaining proper IAQ during
Operations and Maintenance
• Biological pollutants: Mold and
bacteria
• Cleaning/maintenance of high
performance products/furnishings
• Cleaning products-source control
and low-VOC
• Cleaning time: traffic volume
A Study of Emissions:
Incubators
Environmental Testing Chambers used to study emissions from
neonatal unit for premature infants.
Results indicated emissions of formaldehyde, acetaldehyde and
methylmethacrylate as chemicals of concern.
Exposure concentrations elevate
risk for cancer and non-cancer
health effects
80
Formaldehyde/ppb
60
40
20
0
60
13
Measured
Recommend
10
2/4/2011
Resources for Building Healing Health
Care Facilities
• Green Guide for Health Care (GGHC)
• International Facility Managers Association
(IFMA)
• American Society of Healthcare Engineers
(ASHE)
• GREENGUARD Building Construction
• GREENGUARD Certification Children and
Schools—Products
• ASHRAE Standard 62.2007 and ASHRAE’s
Greenguide
Resources for Building Healing Health
Care Facilities
• Green Guide for Health Care
–
–
–
–
Healthcare specific challenges
Incorporates Design, Construction and Maintenance
Introduces health issues as component of each point
Evidence based Design -enhanced patient and staff well-being
Resources for Building Healing Health
Care Facilities
IFMA and ASHE
• Guidelines for energy use, air quality issues, and
cleaning/maintenance supplies standards
• ASHE’s Green Healthcare Construction Guidance
Statement (available online at
www.healthybuilding.net/healthcare)
11
2/4/2011
Resources for Building Healing Health
Care Facilities
Resources for Building Healing
Health Care Facilities
• GREENGUARD
Certification Program SM
– Voluntary program
– Low-emitting products
certification
– Product profiling and
testing
– Certification Test;
monitoring
– Comprehensive healthbased standard--Premier
ASHRAE 62.1-2007 Indoor Air
Quality Standards
Requirements for
ventilation, air-cleaning
system design, installation,
commissioning, and
operation and
maintenance.
Healthcare: ventilating
with 100% outside air, no
recirculation between
interior spaces,
dehumidification
requirements.
12
2/4/2011
What have we learned so far?
• The healthcare industry will
benefit from sustainable building
practices.
• Issues such as aging populations,
need for healthy, friendlier
environments, and increased
legislation are driving new
construction.
• Effective design strategies include
minimizing biological, chemical
pollutants and optimal
ventilation.
• An IAQ Management Plan is
essential to optimizing healing
environments.
• Moisture control and specifying
non-toxic, low-emitting products
is essential to success of the plan.
• Numerous resources provide
guidance for proper design,
construction ,and operations and
maintenance of facilities.
This concludes the AIA portion of
the presentation.
We will now discuss GREENGUARD
Certification and provide resources
for your use.
GREENGUARD Environmental Institute
Industry Independent non-profit organization
To improve public health and quality of
life through healthy indoor air quality
13
2/4/2011
Free Online
Resource
Guide
More than
10,000
products
featured
Resources:
Indoor Air Quality
www.greenguard.org
www.ashrae.org
www.aerias.org
www.epa.gov/iaq
www.lungusa.org/air/air_indoor
www.usgbc.org
Questions for Discussion
1. Name the standard which clearly
delineates IAQ ventilation rates.
2. Name three guidelines that available
when considering IAQ best practices
3. When considering healthcare design,
what are the three main considerations?
4. Are there other factors driving sustainable
building practices in Healthcare
environments?
14