‘Connected technology’maintaining healthy IAQ

We hear a lot about air quality and its undoubted impact on our wellbeing and health. But when we dig a little bit more on the subject, people are referring mostly to outdoor air quality. The general perception seems to be that we are exposed to outdoor pollution, but that once we are inside in the building, we are protected from air pollution. In a study made by French Consulting company, Elabe,1 52% of French, 60% of Belgian, and 62% of Shanghai residents were surprised to learn that we are exposed to more air pollution inside buildings than we are outdoors. According to the Environmental Protection Agency (EPA),2 indoor air quality is up to five times more polluted than outdoors

Indoor environments

Healthcare settings are complex spaces that are constantly in use, and have various air quality requirements. According to analysis from City Hall, London, in 2022,3 despite improvements in air quality, every hospital, medical centre, and care home in the capital is in a location that breaches the World Health Organization’s (WHO) guidelines for nitrogen dioxide (NO2) and fine particulate matter (PM2.5). The data showed that while 91% of hospitals and medical centres meet the legal limits set by the UK, they do not meet the stricter WHO guidelines for NO2, and all hospitals and medical centres fail for PM2.5. This reflects a 2018 study4 by the British Lung Foundation, which found that 2,220 GP practices and 248 hospitals in England were in areas where outdoor PM2.5 concentrations exceeded the WHO’s recommended average annual levels of 10 µg/m3 (in 2021 WHO revised the guideline value for PM2.5 down to 5 μg/m3). In hospitals and healthcare environments, air quality has been found to have a profound impact on patient health.

A Boston-based physician, Dr. Stephanie Taylor, has undertaken years of research after realising that her patients in hospital were getting new infections despite extensive surface hygiene efforts, while her patients in a hospital in Papua New Guinea, with less resources, were not. What was the reason? This is where Dr. Taylor began to extend her research into how building architecture and air quality can have an effect on patients.

In 2020, Dr. Taylor co-founded Building4Health (B4H),5 to create a building performance metric using occupant health data to become ‘the most important next advance in improving public health’. The B4H mission is to lead the transformation of indoor air quality management through our medically based, data-driven approach for better health and efficiency.

Pollutants found indoors and their effect on occupants

When it comes to the pollutants found indoors, carbon dioxide is a good place to start, as it exists naturally in the atmosphere, being a molecule produced by the human body through breathing. A high concentration of CO2 means that there’s lack of fresh air, which can have a significant impact on occupants — with effects including poor concentration, sleepiness, and potentially headaches. Overly high or low humidity levels can lead to mould and dust mites, which can provoke allergies, and trigger other respiratory problems like upper respiratory (nasal and throat) symptoms and general discomfort.

VOC (Volatile Organic Compounds) are emitted as gases from certain solids or liquids, and are found in items such as paints, cleaning supplies, pesticides, building materials and furnishings, office equipment, glues and adhesives, and permanent markers. These can cause eye, nose, and throat irritation, headaches, loss of coordination, and nausea.

Fine particles

Fine particles are a mix of tiny solid and liquid particles in the air we breathe — many so small as to be invisible. They are considered mainly as outdoor air pollution, but they can be generated from indoor activities like burning candles, use of fireplaces, use of unvented space heaters or kerosene heaters, and smoking. Exposure to fine particles can contribute to the risk of cardiovascular and respiratory complaints.

We are beginning to see standards catch up with the research. In a number of scientific studies conducted over the years, it has been found that the ideal indoor humidity level of between 40-60% RH will reduce the spread of respiratory infections.

In the US, ASHRAE published Standard 241, which 
has been developed to reduce the risk of infectious aerosol transmission in buildings. Standard 241 establishes minimum requirements to reduce the risk 
of airborne disease transmission and other pathogens 
in buildings such as single and multi-family homes, 
offices, schools, and healthcare facilities. The standard applies to new and existing buildings, and sets requirements for equivalent clean airflow rate target 
per occupant of pathogen free-air flow, reducing the 
risk of infection.

How can a building management system help?

More than ever, having a fully functional building management system (BMS) to ensure wellbeing in non-residential buildings is critical. An outdated, non-functioning, or inefficient system can have serious consequences for the health of patients and staff, by facilitating the transmission of viruses and bacteria. In all aspects of our lives, we expect the spaces we occupy to be healthy and trustworthy so that we can grow, learn, work, and consume, with peace of mind.

Occupants want to know that the building they are entering is safe, that measures have been taken to reduce the spread of infection, that the space is clean, that they will be alerted to any problems, and that they can have control over their own environment. This is particularly important in a healthcare environment, where patients might already feel vulnerable.

The preventative measures can be classified into the two following solution types — proactive solutions that reduce the risk of contagion, and reactive solutions that advance optimal risk management.

In the first instance, there are a number of proactive measures that we can put in place to make our buildings safer. These include managing indoor air quality, detecting occupied spaces, and providing contactless comfort management. Increased ventilation rates are also recommended to control airborne diseases, provided that these systems are used appropriately. Measuring and tracking indoor air quality as carbon dioxide (CO2) will generate proper rates of ventilation to extract and 
renew air.

Occupancy detectors located in operating theatres or wards make it possible to know, in real-time, if a room is occupied, and to keep a utilisation history of each room. This allows for the building’s cleaning routine to be optimised, concentrating on the spaces that have been used.

The growth of AI technology

AI technology is becoming an important part in the development of products that support occupancy wellbeing. AI has its share of enthusiasts and doomsayers, but its promise lies somewhere in the grey area between those saying it will solve all our problems, and those predicting disaster and chaos. For many, the technology cycle is early, and there will likely be much discussion and many upheavals as society figures out how laws will be created and applied.

AI learning can provide building owners and Facilities managers with more valuable data about their healthcare buildings so they can adapt systems and services such as HVAC and lighting system operation, cleaning rotas, and even catering services, to better serve staff and patients, as well as deliver performance and energy efficiencies. The ability to conduct people counting through an inbuilt thermal sensor in our Resense Move sensor would not be possible without the support of AI technology; the accuracy and learning which needs to take place would be limited without it.

Patient and staff wellbeing should be central to how the building operates, and human-centric solutions, such as the AI-powered Resense Move, are designed to enhance the comfort of people visiting, recovering in, and working in, the building. As an example, in a hospital — where bed space is at a premium, and there is a constant stream of visitors, it’s important to know who is using a space and when. Resense Move will count the number of people in a space, and provide a proactive solution which immediately renews the airflow in the building according to the occupancy levels, unlike a standard CO2 sensor — which needs to be sent a command. The integrated visual LED indicator on Resense Move provides reliable information about the space, letting occupants know if there is a problem with the air quality, such as a build-up of CO2 or VOCs.

Monitoring noise levels too

As a multi-sensor, Resense Move also has the capability to monitor dB levels (noise), which can be important in healthcare settings. For instance, dB readings could be taken at a nursing station within a NICU which is adjacent to construction activities — to monitor and address noise levels that may have an impact on patient outcomes, such as an infant’s heart rate and blood pressure. The solution that Resense Move offers will aid indoor air quality, save energy, and enhance the day-to-day operations in a building. It can also be installed in both a new-build or during renovation.

It is important to bring as much of the building data together, in one place, so changes can be made quickly and efficiently if required. This is where open protocols combined with APIs (Application Programming Interfaces), such as RESTful API, can be vital. With 
RESTful API and the open Internet Protocol (IP), communication between devices becomes easier, and you can achieve a fully integrated system. By using RESTful API interface systems, integrators can enable IT web services to easily interact with software applications. For instance, patients can even see their daily medical schedule when the building automation system is linked with third-party software via the open RESTful API. Doctors and clinical staff are empowered to easily make any hospital space comfortable with access to simple touchscreen controls, while IOT sensors help them quickly track key hospital equipment. Distech Controls has a RESTful API embedded into a range of its solutions, including the ECLYPSE series.

Human-centric and energy-efficient

When we enter a healthcare environment, we 
want to know that the air we breathe is as safe as possible. Building owners and Facilities managers have a duty to provide occupants with a comfortable environment, but they are also required to ensure that their buildings meet sustainability target and energy efficiencies. With new sensor solutions we can provide human-centric buildings without compromising on energy efficiency.

Maintaining indoor air quality is a necessity for hospital and healthcare facilities, but integrated systems and connected technology can also help provide healthy patient rooms, conducive to healing, as well as a better experience for patients’ families, and staff, by optimising comfort and improving workflow, while reducing stress and enhancing the healing environment.

References

1 Bedeau L. Public perception of indoor air quality in China, Belgium and France: the discovery of an invisible enemy. Elabe. The Veolia Institute Review — Facts Reports. https://tinyurl.com/4uhber87

2 Indoor Air Quality. What are the trends in indoor air quality and their effects on human health? United States Environmental Protection Agency. Last updated 8 July 2024.

3 All London hospitals in areas which exceed WHO toxic pollution limits. London Assembly press release, 3 February 2022. https://tinyurl.com/yc2f2n2s

4 Toxic air at the door of the NHS. British Lung Foundation. October 2018. https://tinyurl.com/3ykh26sw

5 Building4 Health (B4H). https://www.b4hinc.com/