Abstract
Indoor Air Quality (IAQ) is one of main topics of Public Health on which international institutions and countries are taking action. With regards to healing architectures, several studies have reported data analysis and case studies to improve users’ health (patients, and medical and administrative staffs), but there are not enough regarding volatile organic compounds (VOCs). Regarding chemical pollution of indoor air, the Scientific Community has highlighted that there are several factors that affect the IAQ, in particular the design and management, and energetic efficiency, of inpatient wards. Several stakeholders, from the designers to the managers, are responsible for the indoor air in healing environments. Supported by analysis of the State of the Art and the main factors that influence the heterogeneous scenario of inpatient wards, the paper presents three check-lists, designed for supporting the stakeholders during the design phase, or for the daily procedures and maintenance activities, for pre-assessment of factors that affect chemical pollution, and for the definition of strategies to be applied. In fact, in such environments IAQ assumes a particular meaning and importance, both for the vulnerability of the patients and for the long time spent by the sanitary staff. The multidisciplinary approach emphasizes the continuous need for interdisciplinary knowledge and skills aimed at finding solutions able to protect users’ health status (including patients, workers and visitors), especially in the field of the indoor air issue.
Highlights
Referring to the factors that affect the Indoor Environmental Quality (IEQ), the Indoor Air Quality (IAQ) is an issue already discussed in the 1980s [2,3,4,5], only in recent years has it become a strategic issue for all the countries [6], as one of the goals of the United Nations’ Sustainable Development
These check-lists aim to be useful tools for the pre-assessment and prior verification of strategies and decisions to be applied, and, when these cannot be verified, to have an awareness and take action for avoiding possible risks for the hospital users regarding chemical pollution. They become a preliminary tool to define a future and broad protocol for supporting the healthcare organizations in the strategies to be applied. These lists refer to several criteria, considered as factors that affect IAQ the State of the Art, several research projects and investigations, and the systematic reviews by scientific international researchers, supported by reports promoted by the research group Study for the Indoor Air Pollution of Istituto Superiore di Sanità (National Institute for Health) in Italy [54]
It is clear that IAQ is a very broad topic, in which any variable can affect the performance of air in indoor environments
Summary
Several stakeholders are responsible for health promotion in indoor environments, starting with the decision makers and the designers during the design process, to the managers and the users who will manage, work, use and live in the spaces [1]. As Joseph and Rashid sustained, the Scientific Community has shown that healthcare design may directly affect safety in hospitals, and it probably indirectly influences safety by triggering adverse events that cause harm to users (both patients and staff) [12] It may affect the safety in “Architectures for Health” to counteract risk factors and harmful events. The quality of the management and maintenance of engineering plants [15], the cleaning and disinfection activities, and the quality assessment plans are all relevant [15,17] It is well-known that some concentrations of outdoor pollutants (i.e., VOCs, benzene, formaldehyde, etc.) are lower than indoor ones, because of the internal sources, including HVAC systems, building and finishing materials, hospital staff, and medical activities [18]. The focuses of the check-lists are related, referring to the current trends in hospital design, and to facilities with mechanical ventilation and/or mixed systems (natural and mechanical ones)
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