Whether the renovation is focused on healthcare or school buildings, each of these environments has unique characteristics and requirements that need to be taken into consideration when addressing indoor air quality.

Healthcare

According to “Greener Hospitals,” an article released by the Environment Science Center in Augsburg, Germany, healthcare facilities comprise roughly 3 percent of all U.S. buildings, yet they have far-reaching effects on so many people. What’s more, the average hospital uses more energy per square foot than any other commercial building, generates more waste than most other industries, and has the highest usage of water — making healthcare facilities a prime market for healthy, sustainable retrofits or new builds.

An article that appeared in Reuters on February 26, 2008, titled “Healthcare Construction Becomes High Stakes Game” looked at the many factors influencing healthcare facilities construction. Among those are the condition of existing buildings, the movement of the U.S. population to warmer climates creating additional stress on current facilities, and the maturation of the baby boomer generation requiring more health-related services as people live longer, healthier lives. The challenge at hand is modifying existing structures to bring them up to high-performance building standards. We are fortunate to have building programs and certifying authorities who can provide strategies to minimize failures and enhance the building while also reducing its impact on the environment.

Healthcare is a sensitive environment. This means people utilizing the space are especially susceptible to poor indoor air quality. In healthcare settings, the primary building occupants are patients who already may have weakened immune systems making them more vulnerable to harmful chemicals. While there are a number of contaminant concerns in the healthcare environment, not all of them affect indoor air quality while renovating. However, as noted by The Center for Health Design, airborne contaminants, as a result of poor or inadequate ventilation and filtration of indoor air, do impact indoor air quality and need to be considered when renovating a healthcare environment.

Ventilation requirements need to be addressed in healthcare environments as a way to promote good indoor air quality. Strict guidelines exist for hospitals and proper ventilation rates for spaces such as emergency room areas, intensive care units (ICUs), infectious disease control areas and operating rooms to name a few. The need for good indoor air quality is also stressed by requiring a specific volume of air to be exchanged per person. This may cause relative humidity to fall below optimum levels making it a challenge to introduce moisture without air contamination. When introducing moisture into a space to improve humidity, the chance of mold growth increases. This chance is normally increased due to the lack of maintenance of the system.

After ensuring good ventilation, it is important to minimize airborne contaminants, such as VOCs, by specifying low-emitting products. Indoor air quality issues can originate from a variety of items in a healthcare setting, specifically with the furniture and finishes in a typical patient area. Take, for example, an area where a patient may already be suffering from immunosuppression or a related disease. People with immunosuppressive diseases are at increased risk for adverse health effects from indoor air pollutants as their immune systems may be impaired, which severely limits their ability to fight off infections and disease and, in general, may make them more sensitive to irritants. Products with potential indoor air quality issues include:

• Furniture – Multiple components such as wood, plastics and fabric all may have issues related to formaldehyde content, phthalates and stain protection chemicals.
• Chemicals – Cleaning products (limonene, terpenes, etc.), disinfecting implements (glutaraldehyde), benzene and acetone may contribute to indoor air quality issues.
• Walls and Ceilings – Ceiling tiles, caulks and sealants, gypsum board, wallcoverings, and paints and coatings all may off-gas VOCs.
• Textiles – Formaldehyde, fire retardants and antimicrobials can all be found in textiles and impact IAQ.
• Window coverings – Window coverings have potential phthalate and VOC implications.
• Flooring – Resilient flooring and carpeting may emit VOCs.
• Cleaning Products – Floor cleaners, wax strippers, air deodorizers and surface cleaners may contain chemicals that can be released into the indoor environment.
• Medical Equipment – Medical equipment may contain plastics, which can emit phthalates, ozone or VOCs from materials.

Good indoor air is an essential component when remodeling educational facilities. Shown are HurricaneSL17: Special-Lite FRP Flush Doors.

While some of the sources of contamination may not be in the control of an architect, designer or builder, there is one simple way to have a positive impact on indoor air quality: Select low-emitting products to help diminish the amount of VOCs released into the air, which will improve IAQ and provide patients and healthcare workers with the cleanest air possible. Look for products carrying the GREENGUARD Certification mark, and know that they have been independently tested and meet strict chemical emission standards.

Schools

As with many green renovations, schools are focusing on green, energy-efficient design. However, in data collected by Air Quality Sciences Inc., of 200 schools over the past 15 years, staggering pollutant levels were discovered to be common — some 1,000-times higher than outdoor pollution — indicating that schools need to address indoor air quality.

Numerous VOCs in the air contribute to poor indoor air quality of schools emitted from items such as cleansers, art materials, carpeting, furniture and plastics to name a few. More than 55 million students (k-12) attend school anticipating a healthy learning environment, but that is not always the case. In fact, more than half of U.S. schools have poor indoor air quality, affecting attendance and productivity.

Because poor indoor air quality has a greater impact on children than adults, schools are considered a sensitive environment. Children are affected more so than adults by indoor contaminants for the following reasons:

• Children receive the majority of their environmental exposure to chemicals indoors.
• Their organs and respiratory, immune and neurological systems are still developing. Because of their lower body weight, they breathe in a relatively greater volume of air than adults.
• Newborns breathe through their mouths, as do many older infants and children — more so than adults. This difference in breathing may increase children’s risk of pulmonary exposure to particulates and fibers, which might otherwise be filtered out in the nose.
• Children’s breathing zones are much closer to the ground than adults, and as a result, heavier airborne chemicals pose more of risk to children than to adults. These factors combine to create a higher body burden of air pollutants for the same amount of exposure.

This data, added to the statistics below as reported in the Media Resources Media Kit, Asthma Statistics by the American Academy of Allergy, Asthma and Immunology (AAAAI) 2005 and Allergy and Asthma Facts and Figures by the Asthma and Allergy Foundation of America (AAFA) 2005, makes a compelling argument for the necessity of remodeling and renovating current schools for good indoor air quality.

• 50 percent of teachers report respiratory issues while in school facilities.
• Asthma rates have increased by 160 percent in the past 14 years.
• Asthma costs $16 billion in annual healthcare costs for children and adults.
• Asthma is the No. 1 disease affecting school children, the third leading cause of hospitalization, the leading cause of chronic illness and the leading cause of absenteeism (14.6 million lost U.S. school days a year).

Because it has a major impact on both students and teachers, good indoor air quality is an essential component when remodeling educational facilities.

For more information, visit www.greenguard.org.