Key Takeaways:
“Our goal could not be clearer – to make healthy indoor air the norm, not the exception in every building everywhere.” – Rick Fedrizzi, Executive Chairman, International WELL Building Institute
How many people, when they consider the biggest impacts on their health, would include the buildings they occupy on the list? Surely not many – yet the high-caliber experts presenting at the third Healthy Building Policy Summit held in late September in Washington, D.C., are seeking to change that.
The interdisciplinary collection of speakers and attendees – from academia, industry, government and non-governmental organizations – made a compelling case for treating the condition and management of institutional and commercial buildings as a major factor in human health with research, investment and practice geared accordingly.
“The building is the highest dose, longest exposure drug in human health and we need to engineer for it, prescribe it as if it is … a medicine,” says Marwa Zaatari, chief engineer for Poppy.
The idea of buildings as drugs was just one of many concepts presented at this event. Speakers made the case for coordinating across the buildings, health and national security sectors so that threats from childhood asthma to disease transmission and biowarfare may be safely detected and mitigated. They also presented substantial evidence that the healthy building movement they champion is reaching a tipping point.
Zaatari cited a recent large scale study from the United Kingdom of more than 500,000 people examining mortality risk, which found indoor and outdoor environmental exposures accounting for 10 times greater risk of untimely death than one’s genetic inheritance.
“The environment is the main event,” she says.
As indoor air quality (IAQ) experts like to point out, the indoors is where we spend 90 percent of our time. It’s also where the air frequently contains more concentrated toxins, gases and biological contaminants than outside. When outdoor air is polluted from wildfire smoke, preventing that bad air from infiltrating the indoors represents an additional facilities management challenge.
The dilemma of operations and maintenance shortcomings leading to the proliferation of indoor asthma triggers – from dust and mold to strong chemicals – was emphasized at this event as it was at the recent Healthy Schools for Healthy Kids Summit organized by several of the same organizations.
Asthma is particularly a problem for school kids with their sensitive, developing systems stuck in aging, underfunded school facilities. As Jenna Riemenschneider, vice president of advocacy & policy at the Asthma and Allergy Foundation of America, recounted, 1 in 15 children regularly suffer from asthma.
“Asthma is the leading cause of missed school days, (accounting for) about 1 in 6 absences in the United States,” she says.
Nsedu Obot Witherspoon, executive director of the Children’s Environmental Health Network, added that the annual price tag for combating this disease in the United States is about $118 billion.
Speakers also discussed the risks of dangerous chemicals in building and office products, such as PFAS or “forever chemicals,” so-called because they persist in the environment for years without breaking down. PFAS can be found in such products as upholstery, carpet, coatings and sealants – yet can be avoided with careful purchasing.
Two critical aspects of occupant health were emphasized. First, cognitive abilities and psychological health as well as physical health can be significantly impacted by the indoor environment. For example, high levels of carbon dioxide, a sign of poor ventilation, has been shown to impact worker productivity and judgement.
“Life expectancy in the south side of Chicago is 20 years less than in other parts of the same city,” says Eric Corey Freed, principal and sustainability director of CannonDesign, as example of how risks are not evenly distributed and that zip code is one of the most reliable indicators of your health prospects.
The group of experts that convened for the summit were not shy about reconceptualizing the problems of health in buildings to arrive at better solutions. This led to some truly mind-bending perspectives on the challenges confronting the building industries.
Eric Malmstrom, CEO of SafeTraces, framed the IAQ quandary by saying, “We’re breathing in 2,000 gallons of air per day.”
Dr. Joseph G. Allen, director of the healthy buildings program at Harvard’s T. H. Chan School of Public Health, says his program’s recent disturbing research found that air and dust in buildings is “Hormonally active … lighting up estrogen receptors, testosterone receptors (which can) interfere with our hormone systems,” introducing a whole new category of health risks.
Whereas we are used to thinking of humans as having five senses, Yiselle Santos Rivera, president-elect of the American Institute of Architects, cited research suggesting that “We have over 33 senses. Two of them, proprioception and interoception, are focused on how we sense space with our bodies.” These spatial senses affect our experience inside buildings in ways that few have taken into account.
Karen Alexander, director of outreach and education for the John Hopkins School of Medicine’s International Arts + Mind Lab, discussed the emerging discipline of “Neuroaesthetics … the science of how our brains and therefore our bodies are impacted by sensory inputs, arts and aesthetic experiences.”
A recurring event theme was the notion that buildings designed and operated for the disadvantaged can work best for everyone. Matthew Biel, director of Georgetown's Thrive Center for Children, Families and Communities, cited “an amazing initiative called Urban 95. It’s (looking at) cities from 95 centimeters (off the ground), which is the height of the average 3-year-old. And it’s thinking about, for the average 3-year-old — what is it like to get onto a bus? What is it like to enter a curb cut or walk into a park or building or stand in an elevator or walk into a house? If it works for a 3-year-old, it works for every human being.”
Rivera pointed out how the concept of “disability” had progressed from being considered “a personal attribute” to “a condition built by the built environment and technology” – that, in other words, it’s a facility’s problem, not a disabled individual’s problem, if they can’t navigate through it easily and safely.
Speakers pointed to many signs of progress that their healthy building message is breaking through, as evidenced by new technologies, programs, investments and commitments.
Of particular significance are recent advancements in sensor technologies making it increasingly practical and affordable to conduct continuous indoor air monitoring across facilities. Several speakers cited programs underway in large school districts.
Georgia Lagoudas, senior fellow and faculty at Brown University’s Pandemic Center, noted that both the Boston and Denver school districts have deployed thousands of such monitors.
In Boston, this investment has had many unforeseen benefits: “This dealt with issues of maintenance that might have not been able to be detected earlier,” she says. “They were able to do quick assessments of where mold is popping up, so they initially started with a case for health, and then they showed that it paid financially.”
There was much discussion of the investment of $150 million by the relatively new federal health research program ARPA-H in its BREATHE program — short for Building Resilient Environments for Air and Total Health — focused on developing intelligent building systems that sense, assess and protect.
Zaatari described the work her firm is doing under BREATHE’s SCALE program, which stands for “Strategic Control of Bioaerosols in a Learning Environment.”
The program’s parts include, Zaatari says, “Building a biosensor that can detect, in real time, multiple organisms such as viruses, bacteria, allergens and mold … building a risk decision engine … that takes all of this into account and decides what is the proper amount of clean airflow … and (implementation) … in this case we’re giving schools a building automation system that can respond appropriately with the measures we have inside buildings, for example ventilation and filtration.”
The focus on biological contaminants is no coincidence. While the COVID pandemic was a disaster for so many, one ultimate silver lining of that experience was the resulting attention it provided to the need to detect and address some of the greatest risks in the indoor environment. In addition to federal funding of ARPA-H’s IAQ work, the private sector has begun investing impressive sums in related research.
This includes a $500 million fund called Intercept financed by companies including Stripe and Anthropic, with a focus on protecting people from viruses with such solutions as better air filtration. A company called Pilgrim also managed to raise $25 million for its technology to detect airborne pathogens through real-time biological sensors.
Multiple speakers at the summit are heavily involved in recent efforts to bring together an international coalition to coordinate on healthy building issues. The new Global Pledge for Healthy Indoor Air is, in the words of Rick Fedrizzi, executive chairman of the International Well Building Institute, “A shared strategic road map, a global framework for action that brings together nine interconnected levers of market transformation, 40 strategic priority areas and nearly 180 recommended actions.”
The commission’s work is supplemented by a new Global Indoor Air Quality Policy Database that catalogues over 200 healthy building policies across 53 countries as well a scoring system by a coalition called the Air Club that evaluates different countries’ program across a five-part framework including, according to Lagoudas, “Who’s in charge, defining standards, measure, enforce and support.”
Fedrizzi, who, as former CEO of the U.S. Green Building Council was at the heart of the highly successful worldwide expansion of the green building movement, sees parallels in the current course of the healthy building field. As he described this process, “When awareness builds demand and demand attracts investment, investment accelerates innovation, then policy creates scale, standards build trust, education prepares a workforce and partnerships bring it all together.”
In other words, you’re likely to be hearing a lot more about healthy buildings before long, and to have an increasing number of opportunities to take advantage of their technologies, practices and benefits – a future in which we should all be able to breathe a little easier.
Ken Sandler, Ph.D., is a clean energy and sustainability analyst and thought leader who spent 35 years advancing green building and sustainability policies and programs across the federal government. In addition to being a FacilitiesNet sustainability columnist and Facility Influencer, he writes his own newsletter, Regenerative Futures at LinkedIn and Substack.
