Sick Building Syndrome: Healing Health Facilities

(page 3 of 4)

The building's location in the Mott Haven section of the South Bronx presented a number of challenges, as well as opportunities, for the designers to align Foundling's mission with the architecture. With one of the highest asthma rates in the city, air quality both inside and outside the building became a design focus. According to the Mott Haven Longwood Community Asthma Partnership, a sister project of Foundling, the Bronx has almost twice the childhood asthma death rates of the city as a whole. A study by the New York City Department of Health and Mental Hygiene concurs, pointing out that the asthma hospitalization rate for that neighborhood of the South Bronx in particular is higher than that of the entire city.

Foundling's team did not want the new building to contribute to the asthma burden, but rather aid the overall health of the community and be a catalyst for change in the local environment—one whose overall air quality has been degraded due to the presence of light industry and the heavily trafficked Major Deegan Expressway, which is immediately adjacent to Foundling's site.

To that end, the combustion-free building will not be a point source of pollution in the community—the new facility relies on a ground-source heat pump rather than a furnace. Its bore field contains three wells 1,500 feet deep; electricity is used to temper the ground water for both heating and cooling purposes. On the exterior, the design also calls for a large vegetative wall and two intensive roof gardens, as well as gardens both inside and out. These elements are meant to act as biofilters in a similar fashion as the flora in the courtyards at Dell Children's hospital.

Turning their attention inside, the designers relied on the Environmental Protection Agency's list of asthma triggers to determine which substances to avoid. While the list includes items such as cigarette smoke and mold, it also includes 17 chemical compounds that are common components in construction and building materials, which in addition to VOCs and formaldehyde, include styrene, isonates, and aerosols. "Wherever possible, we are going to avoid their use in the building so that the indoor environment doesn't trigger an asthmatic episode, or, in the long run, contribute to the eventual onset of asthma for someone," Syrett explains. "What goes into a building has a direct impact on the health and well-being of its occupants."

Another trigger the architects hope to avoid is dust, both during construction and within the finished building. The building's design calls for minimal overhangs, ledges, and exposed piping so that there is less opportunity for dust to accumulate and become a respiratory irritant. In accordance with what is becoming standard practice at most health care facility construction sites, air locks and walk-off mats will be used during construction of Foundling. Additionally, ducts will be capped and sealed as work progresses so that dust doesn't settle inside and get spewed out once the mechanical system is fired up. That system uses a HEPA filter with a MERV rating of 14—among the highest available, and commonly employed in hospitals.

One thing Foundling does that most hospitals do not do is incorporate operable windows. While opening a window to let in the fresh air is usually a no-brainer for improving IAQ, in Foundling's case, the poor air quality outside led the architects to weigh this decision quite heavily. "In the end, we still think it's important for people to be able to open windows," Syrett says. "And we thought about the building in a longer trajectory. It is our hope that the point-source pollution will become less of a problem in the future, which is something to consider when you're designing for a 50-year building. One of the biggest issues with hospitals and other hard-core health care environments is sealing people in."

While some older hospitals have retained their operable windows, you would be hard-pressed to find new hospital buildings in the U.S. that feature them. "Health care providers worry about infection control above almost everything else," explains Walt Vernon, principal at Mazzetti & Associates. "There are documented instances of airborne transmission of pathogens from one space to another in buildings that use natural ventilation." But after becoming frustrated with the current paradigm of hospital design, Vernon, a cocoordinator for the Green Guide for Health Care (available for download at www.gghc.org), began to research how natural ventilation and displacement-ventilation systems would affect IAQ in a health care setting.