Green building certification for healthcare facilities: Where, how and why did we get it wrong?

Indoor Air Cartoon Journal, December 2018, Volume 1, #37

Good indoor air quality (IAQ) enhances healthy living. Poor IAQ compromises healthy living. These are known facts. Risk assessment of IAQ condition effects on healthy living will provide an informed decision for IAQ improvement. Risk assessment is largely driven by concentration and nature of air pollutant(s), duration of exposure and inhalation and vulnerability of exposed human. Building type influences how these assessment factors are analysed and interpreted. For example, there are several sources of indoor air pollutants, especially microbial contaminants, with significant adverse health effects in healthcare facilities. Furthermore, the patients that the value of healthcare facilities centred on are more vulnerable than occupants of non-residential buildings – offices, schools, etc.

Value occurs if someone’s (consumer) problem is solved to satisfaction and required safety level with the least amount of investment – time, cost, manpower, etc. Poor attention to IAQ will compromise the primary value – health provision with no waste in investment – a healthcare facility gives its patients and other users. IAQ is central to the value. Therefore, one would expect that the attention given to IAQ in healthcare facilities to be stricter than those in offices, schools or the likes. Green building certification practice provides an opportunity for ensuring that IAQ in healthcare facilities is of very high quality. Why? Green building is a product of sustainable design. Sustainable design is a philosophy that seeks to respect – honour, protect and be a steward of – wisdom of natural system, people, place, the cycle of life, energy, and natural resources and process.

Sustainable design is a verb, not a noun. That this, the philosophy should guide our (green building certification) practices. Green building certification should, in addition to respecting the quality of the environment, ensure that respect for people and place are not compromised. In the context of healthcare facilities, the fundamental question is, will the healthcare facility in question make its users healthy? If attention is not given to IAQ, it will be difficult to answer this question favourably. It is important to note that attention to IAQ goes far beyond comparing measured IAQ parameters to IAQ standards.

Any green building certification practice that does not differentiate or have negligible differentiation between IAQ in healthcare facilities and any other building types should be revised to address the gap. Before doing this revision, interpretation of the perceived importance of IAQ in healthcare facilities should be addressed. Perception interpretation will determine the reaction to the interpretation, i.e. the extent to which IAQ is given priority in healthcare facilities.

37_Green Mark HCF_IAC 37

Do you want to know more about how poor IAQ could compromise value of healthcare facilities? Read Cole and Cook (1998), Leung and Chan (2006) and Obbard and Fang (2003) papers.

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