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Greening the Design and Construction of Healthcare Facilities What we do to our environment, we do to ourselves, the saying

admin2010-05-26  36
问题              Greening the Design and Construction of Healthcare Facilities
    What we do to our environment, we do to ourselves, the saying goes. Nowhere is this principle played out more dramatically than in our hospitals, where doctors and nurses work in the front lines against environmental illnesses, treating patients for cancers caused by exposure to toxic materials, asthma triggered by breathing dirty air, and heat stroke brought on by heat waves made more severe by climate change.
    Sadly, the connection between hospitals and illnesses does not end with treatment. Even as Healthcare professionals go to heroic lengths healing the sick among us, the very buildings in which they work stop and erase their efforts. Burning fossil fuels to power Healthcare facilities contributes to climate change, allowing disease to invade new habitats. Relying on ozone-depleting refrigerants to cool them increases the potential for skin cancer. Using mercury-based instruments to measure body temperature and blood pressure contributes to air and water pollution, increasing rates of brain damage from mercury poisoning. Furnishing interiors with materials manufactured using carcinogens  (致癌物) perpetuates the spread of cancer; such materials are common even in radiation and chemotherapy treatment rooms.
    There is clearly room for improvement in the performance of our Healthcare facilities. By considering the environmental and health implications of design and construction decisions, we can bring the performance of Healthcare facilities more closely in line with the industry’s mission to restore and safeguard health. If we trust our doctors to "first, do no harm" as the Healthcare creed counsels, it seems only fair to expect the same of our hospitals.
    The History and Future of Greening the Healthcare Industry
    The connection between the Healthcare industry and the environment was illuminated in 1994, when the U.S. Environmental Protection Agency (EPA) identified medical waste burning as the largest source of dioxin, considered to be the most potent human carcinogen ever manufactured. The irony of this situation inspired the formation of Health Care Without Harm (HCWH), a nonprofit organization that now boasts more than 375 member groups in 40 countries.
    Another milestone in the push to green the Healthcare industry was the 1998 memorandum of understanding between AHA (the American Hospital Association) and EPA, which laid out three goals for the Healthcare industry: to eliminate mercury-containing waste, to reduce the overall volume of waste, and to identify hazardous substances for pollution-prevention opportunities. This agreement launched the nonprofit Hospitals for a Healthy Environment (H2E), a joint project of AHA and EPA, along with HCWH and the American Nurses Association.
    Within the last five years, interest in greening Healthcare has moved beyond operations to encompass the design and construction of Healthcare facilities themselves. To guide a new sustainable design category in its annual awards program, the American Society for Healthcare Engineering (ASHE) published the Green Healthcare Construction Guidance Statement in January 2002. It is considered the first document to incorporate health considerations into design guidance. Noting that preventing disease is preferable to treating disease, it advises that "a precautionary and preventive approach is an appropriate basis for decisions regarding material selection, design features, mechanical systems, infrastructure, and operations and maintenance practices".
    Prompted by an impending Healthcare construction boom in response to California’s new seismic (有关地震的) regulations, Gail Vinori. co-director of the Center for Maximum Potential Building Systems in Austin, Texas, met with a group of green building and health experts in 2003 to develop a more prescriptive set of design guidelines. This work was initially sponsored by the Merck Family Fund, with the New York State Energy Research and Development Authority (NYSERDA) and H2E subsequently joining as sponsors. The collaboration resulted in the Green Guide for Healthcare, which was released in pilot form in late 2004.
    And more than 30 Healthcare facilities are registered through Green Building Council’s LEED Rating System, and two have achieved certification: Boulder Community Foothills Hospital in Boulder, Colorado, became the first LEED-certified hospital when it earned a Silver rating in 2003, and the Patrick H. Dollard Discovery Health Centre earned Certification in 2004.
    Meanwhile, the next version of the AIA Guidelines for the Design and Construction of Healthcare Facilities is also under development and due out in 2006. Parts or all of the AIA guidelines have replaced individual state codes in 42 U.S. states, according to Guenther, who is participating in the revision. While the current version includes only one paragraph about green design--focused on energy conservation--the next version will include an entire chapter on therapeutic environments and sustainability issues. While the new text will not prescribe any minimum thresholds for green design, its attention to these issues indicates the growing recognition of the connection between design decisions and health.
    The Best Chance for Greening Hospital Building
    America’s last hospital building boom occurred just after World War Ⅱ, according to Guenther, and much of that building stock is in need of renovation. A range of other forces is further stressing our Healthcare facilities. "Rapid technological advances, advances in information systems, changes in medical practices, evolving regulatory mandates, decreases in financial resources, shortages in Healthcare professionals, aging baby boomers, worn-out facilities, and an increasingly competitive market have all impacted activities and demand on the physical infrastructure," says Dina Battisto, assistant professor of architecture and health at Clemson University in Clemson, South Carolina.
    As a result of these factors, a new construction boom is upon us. The U.S. is currently spending＄17 billion on Healthcare construction each year, according to Rosalyn Cama, FASID, president of the interior design finn Cama, Inc. By 2010, that number is expected to reach ＄25 billion, she says, so this is the time to rethink that we design and build our Healthcare facilities in a green way. "If we miss this golden opportunity, we’re going to have a lot of facilities built the wrong way," says Cama.
    What Makes Healthcare Unique?
    Healthcare facilities stand apart from other building types. First, they’re big. At 168,200 ft(上标)2 (15,626 m(上标)2), the average inpatient (住院病人) Healthcare facility is more than 11 times the size of the average commercial building, according to the Energy Information Administration’s 1999 Commercial Buildings Energy Consumption Survey. Healthcare facilities are also highly regulated and expensive to build. They often operate around-the-clock, and they experience long ownership. They use tremendous amounts of energy and need backup power for emergencies, they require a lot of water, and they create huge amounts of waste, some of it hazardous or infectious. They are stressful environments, and many of their occupants have depressed immune systems. Perhaps most important, they function expliciny to restore and protect health. Because of these characteristics, some green building strategies carry greater challenges, importance, or payback in Healthcare facilities than they do in other buildings.
America’s last hospital building boom was simply the result of rapid technological advances.
选项 A、Y
B、N
C、NG
答案B
解析
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