Smart Technologies and Design For Healthy Built Environments [1st ed.] 9783030512910, 9783030512927

Citation preview

Ming Hu

Smart Technologies and Design For Healthy Built Environments

Smart Technologies and Design For Healthy Built Environments

Ming Hu

Smart Technologies and Design For Healthy Built Environments

123

Ming Hu School of Architecture, Planning & Preservation University of Maryland College Park, MD, USA

ISBN 978-3-030-51291-0 ISBN 978-3-030-51292-7 https://doi.org/10.1007/978-3-030-51292-7

(eBook)

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Foreword: Smart Technologies for a Healthy Built Environment

As an architect and neuroscientist I consumed Professor Ming Hu’s new book, on smart technologies and the built environment, with interest and pleasure. The book proves timely and strategic on numerous fronts, including through its comprehensive coverage of pressing issues concerning public and population health as well as its thought-provoking connections between design and wellness. Professor Hu methodically crafts and unfolds a compelling story concerning the responsibilities of architects to meaningfully foster the health of users of the built environment, while revealing vital links between design, technology, and duties around societal well-being. Beginning with early historical actors such as Hippocrates (do not harm) and Vitruvius (site, wind, light water), and ending with remarkable case studies of seminal contemporary buildings, Prof. Hu takes us on a rich journey across the centuries as architects endeavored to connect the ways we design with the impacts on people’s lives. Along this path many stories are told that capture and convey the development of architecture, and architects’ roles, in the promotion of health as a key objective of building construction and community design. Through illuminating the major advancements in the science of building over the generations Professor Hu gives us an understanding of the critical function of architecture in the nurturing of our physical and psychological health, and the power of cities to improve us societally. Health and shelter are fundamental human rights. Ming explores the intersection of these two realms, demonstrating how the provision of shelter can and must promote the improvement of health. A stream of my own research considers systems theory and the positive consequences around holistic posturing in design and planning. In reviewing Prof. Hu’s book I was impressed with her strong arguments linking design of the built environment with enhanced health and improved quality of life. She highlights the recent rise of green building and sustainable design movements, then moves on to consider the largely untapped potential of information technology to demonstrably advance individual health and community well-being. In particular Prof. Hu presents state-of-the-art developments in technology that hold promise to move us from more predictable models of monitoring environments to more remarkable v

vi

Foreword: Smart Technologies for a Healthy Built Environment

means of responding to user needs, assessing human conditions, and facilitating better health. She correctly covers then transcends physical and physiological dimensions to crucially delve into the nurturing of our mental, social, and spiritual wellness via more thoughtfully designed worlds. Professor Hu challenges us to consider the potency of design, the deployment of advanced technology-based systems (intelligent buildings, smart cities), and the promise of emerging tools to dramatically alter the relationship between people and the environments they inhabit. In an increasingly turbulent world, where we confront unprecedented and unfathomable crises including climate change and global pandemics, Ming helps us to grasp how new ways of thinking about design can precipitate transformation and proffer hope. Churchill, in reflecting on the rebuilding of post-war Britain, mused that “We shape our buildings; thereafter they shape us.” In many ways our modern world is facing dire outcomes, on numerous fronts, if we cannot meaningfully and measurably alter our behavior, our architecture, and our built environments. Professor Hu, in her new book, sets her sights on connecting people, design, technology, and place, all with an eye to heightening our health, healing our world, and improving our future. Across this innovative voyage she explores economics, considers medicine, examines design, invokes science and highlights art—embracing an interdisciplinary perspective on advancing architecture, cultivating wellness, and improving our communities. Calgary, Canada

Dr. Brian R. Sinclair

Preface

Smart, Healthy, and Sustainable “Architecture is more than the art of constructing individual buildings, it is also the creation of environment. Buildings do not exist in isolation. They not only impose their character on their surroundings but also have an incalculable effect on the lives of human beings who inhabit them” [1]. In the past couple of decades, we have witnessed sustainable buildings bring about a market transformation, turning many sustainable building solutions into standard and expected minimal design criteria [2]. Many sustainable design principles and approaches had their origins in a desire for energy and water conservation, and in this way, the use of natural resources and the improvement of indoor environmental quality have become major concerns, if not standard practice. As the sustainable building movement becomes widely accepted, the benefits of sustainable design, such as improvements in occupants’ health, well-being, and productivity, are increasingly being recognized by building owners and tenants, and presumably could drive the market in the future. In recent years, as sustainable building solutions that conserve energy have become standardized, we have seen two further developments in the building industry. The first is a shift in the market toward designing, operating, and maintaining “healthy buildings” [2]. As people spend more than 80% of their time indoors, creating a healthy built environment is of critical importance. A healthy building is a building that not only meets its occupants’ physical and physiological needs but could also benefit their mental health and productivity. The second development is the transformation of today’s sustainable buildings into smart buildings, through ubiquitous computing and the Internet of Things (IoT) [3]. More and more buildings are being equipped with smart sensors, actuators, and nano-embedded systems, for the collection and analysis of data from occupants. Smart control systems then adjust the built environment through automatic commands, or commands made remotely by occupants to meet their particular needs.

vii

viii

Preface

If we identify the period from the 1990s to the present day as an era of sustainable building, then the next couple of decades could be the era of healthy and smart buildings. This book is about connecting smart technology to a healthy built environment that builds upon the sustainable building movement. We use smart technologies in our daily life (iPhones, smart sensors, and voice-activated systems), but we have no clear picture of a smart built environment. A smart built environment takes full advantage of the potential of smart objects and other innovative systems which adapt to the needs of occupants and changing external climatic events. Smart buildings can lead the transformation of the public health market by turning buildings into responsive, user-focused, health-conscious, and interconnected systems. These systems will provide better living and working environments. To apply smart technologies appropriately, where they are most needed, the first step is to describe them, including their advantages and disadvantages, and their potential applications to enhance occupant health. Firstly, this book provides a snapshot of state-of-the-art smart technologies being applied in the built environment. It covers a broad spectrum of smart technology categories, ranging from dynamic operability, energy efficiency, self-regulating and self-learning systems, to responsive systems. Secondly, this book provides in-depth analysis of the four primary components of health (biological, physical, physiological, and psychological); their effects on well-being and cognitive performance are introduced as well. Thirdly, it connects smart technologies to those health-influencing factors by reviewing three completed smart building projects. This book can also serve as a basis for education and discussion among professionals and students of diverse backgrounds who are interested in smart technologies, smart building, and healthy building. Chapter 1 sets the stage for understanding the built environment’s effects on human health in history, worldwide. It provides readers with a basis for understanding the relationship between the built environment and public health. It also introduces the diverse factors that play a critical role in forming the concept of healthy buildings. Chapter 2 establishes the context for understanding the synergies and disconnections between public health and built environment planning and design. It serves as a foundation, to transition to the in-depth analysis in Chap. 3 of the built environment’s effects on human health. Chapter 3 outlines the key factors of health problems emanating from the built environment: physical, physiological, biological, and psychological. It then examines how the current building codes and regulations address those factors. Chapter 4 investigates the indoor variables that contribute to the key factors outlined in Chap. 3. The detailed explanation builds a foundation for understanding the necessity to apply smart building technologies to solve built environment problems. Chapter 5 starts to connect smart building technologies to primary health causes in the built environment, then gives a brief history of smart building development and

Preface

ix

outlines three sets of key smart technologies that are critical for the improvement of occupants’ health. Chapter 6 points out the future shift in priorities and the effect on smart building technologies. It describes future smart building through a detailed explanation of five unique abilities the future smart building would possess. Chapter 7 closely examines the three most advanced smart and healthy buildings in the world: Edge in Amsterdam, the Gator-Tech Smart House (GTSH) in Florida, and the CASA smart home in Washington state, to demonstrate the five smart abilities introduced in Chap. 6. Chapter 8 synthesizes the preceding chapters to derive a final framework that integrates the healthy and smart building practices. The benefits and future potential of this integrated approach is outlined and emphasized. College Park, USA

Ming Hu

References 1. Conti F (1978) Architecture as environment (his grand tour). HBJ Press, New York 2. Cedeno-Laurent JG, Williams A, MacNaughton P, Cao X, Eitland E, Spengler J, Allen J (2018) Building evidence for health: green buildings, current science, and future challenges. Ann Rev Publ Health 39:291–308 3. Building Performance Institute Europe (BPIE) Is Europe ready for the smart buildings revolution? http://bpie.eu/wp-content/uploads/2017/02/STATUS-REPORT-Is-Europe-ready_ FINAL_LR.pdf. Accessed 14 Feb 2019

Acknowledgements

I owe a debt of gratitude to the many people who supported this book and helped me in a number of ways. First, I would like to thank Dr. Jennifer Roberts and Dr. Carl Bovill for reviewing my book proposal and providing me with invaluable suggestions from the onset of this book. I also want to thank my colleagues and students in the School of Architecture, Planning, and Preservation at the University of Maryland. In particular, Interim Dean Donald Linebaugh, Associate Dean Brian Kelly, and Associate Dean Madlen Simon offered support in the form of funding, guidance, and research assistance. Additionally, I truly appreciate the many suggestions contributed by colleagues and friends from UMD. I would also like to acknowledge research assistants Chris Pearce and David Milner for their involvement in the book, in helping to collecting data and produce drawings and diagrams. Thank you to those who provided fact-checking, took the time to answer my inquiries, offered interviews, provided me with information and images, and pointed me to resources, including Dr. Sumi Helai at the University of Florida, Dr. Diane Joyce Cook, and Dr. Araon Crandall at Washington State University, and researchers from Mapiq. I am indebted to Dr. Brian Sinclair from the University of Calgary and Dr. Howard Frumkin from University of Washington for contributing the Foreword. He generously offered his mentorship, support, and guidance during my first teaching endeavors. I am also grateful to Anthony Doyle, the executive editor at Springer Publishing, who accepted my book proposal and Megana Dinesh, also from Springer, who shepherded the writing and publication phases. Thank you also to all editors, the co-editor, and others who helped to bring this book to publication. In addition, I would like to acknowledge Janna Christie for her professional and excellent editing help and support. Finally, I would like to thank my dear family. To my parents, thank you for your unconditional support and love; to my brother and his family, thank you for being great role models and your support. I want to especially thank my husband, Kai Hu—my best friend and partner—for his love and support.

xi

Contents

1 A Brief History of Health and the Built Environment . . . . . . . . 1.1 The Pre-industrial Era: Vitruvius and Feng Shui—Western and Eastern Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.2 Renaissance Era: Not just Air (Fourteenth–Seventeenth Centuries) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3 First and Second Industrial Revolution (1760–1914): Healthy Buildings and Environmental Concepts . . . . . . . . . . . . . . . . . 1.3.1 Architecture and Engineering Field . . . . . . . . . . . . . . . 1.3.2 Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.3.3 Industrialists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.4 Post-war Rebuilding (1930–1970): Quantitative Measurement of Healthful Homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.5 Energy Crisis and Sick Building Syndrome (1970–1990) . . . . 1.6 Initiatives and Concepts for Healthy Homes (1990–2000) . . . . 1.7 Beyond Health (2000–Present) . . . . . . . . . . . . . . . . . . . . . . . 1.8 The Connection Between Sustainable and Healthy Buildings: Future Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.9 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Connections, Shifts, and Future Trends . . . . . . . . . . . . . . . . . . . 2.1 Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2 Shifting of the Focus (Twentieth Century to Present) . . . . . . . 2.3 Future Trends: Reconnecting Public Health and Built Environment Planning and Design . . . . . . . . . . . . . . . . . . . . . 2.3.1 A New Multi-disciplinary Approach: Human Ecology, Biology, Psychology, and Neurology . . . . . . . . . . . . . 2.3.2 A Multi-level Approach: Urban and Building Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.3.3 Multi-factor Assessment . . . . . . . . . . . . . . . . . . . . . . .

...

1

...

1

...

4

. . . .

. . . .

. . . .

6 7 8 9

. . . .

. . . .

. . . .

10 11 12 13

... ... ...

14 15 16

... ... ...

21 21 24

...

26

...

28

... ...

30 31

xiii

xiv

Contents

2.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Factors That Impact Human Health in the Built Environment . . 3.1 General Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1.1 Cluster One (Green)—Engineering Field: Biological, Physical, and Physiological Factors . . . . . . . . . . . . . . . 3.1.2 Cluster Two (Red)—Public Health and Public Policy Field: Physiological and Psychological Factors . . . . . . 3.1.3 Cluster Three (Yellow)—Public Health Field: Physical and Physiological Factors . . . . . . . . . . . . . . . . . . . . . . 3.1.4 Cluster Four (Blue)—Urban Planning/Design and Engineering Field: Physical and Physiological Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 Four Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3 Physical Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.3.1 Falls and Fire Hazards (Indoors) . . . . . . . . . . . . . . . . . 3.3.2 Safety and Security (Outdoors) . . . . . . . . . . . . . . . . . . 3.4 Physiological Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.4.1 Indoor Environmental Quality . . . . . . . . . . . . . . . . . . 3.4.2 The Outdoor Built Environment and Physical Activity . 3.5 Biological Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6 Psychological Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.1 The Connection Between Psychological Impact and Physiological Impact . . . . . . . . . . . . . . . . . . . . . . 3.6.2 Defining Mental Health Impact . . . . . . . . . . . . . . . . . . 3.6.3 Mental Health and Well-Being (Hedonic Well-Being) . 3.6.4 Cognitive Function and Productivity (Eudemonic Well-Being) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.6.5 Mediating and Moderating Factors . . . . . . . . . . . . . . . 3.7 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Indoor Environmental Impact on Human Health . 4.1 Indoor Observed Variables . . . . . . . . . . . . . . . 4.2 Indoor Air Quality (IAQ) . . . . . . . . . . . . . . . . 4.3 Indoor Thermal Quality (ITQ) . . . . . . . . . . . . . 4.4 Indoor Lighting Quality (ILQ) . . . . . . . . . . . . . 4.5 Indoor View Quality (IVQ) . . . . . . . . . . . . . . . 4.6 Indoor Sound Quality (ISQ) . . . . . . . . . . . . . . 4.7 Indoor Spatial Quality (ISPQ) . . . . . . . . . . . . . 4.8 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

32 32

... ...

37 37

...

39

...

39

...

40

. . . . . . . . . .

. . . . . . . . . .

41 42 43 43 44 44 44 45 46 48

... ... ...

48 49 49

. . . .

. . . .

. . . .

50 51 52 52

. . . . . . . . . .

. . . . . . . . . .

. . . . . . . . . .

57 57 59 61 64 65 67 68 69 70

. . . . . . . . . .

Contents

xv

. . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . .

75 75 75 77 78 79 80 81 83 84 84 86 87 87 88 89

6 Future Smart Technologies for Human Health . . . . . . . . . . . . . . 6.1 Smart Priority Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1.1 Shift One: Smart Versus Sustainable . . . . . . . . . . . . . . 6.1.2 Shift Two: Black Box Versus Digital Identity . . . . . . . 6.1.3 Shift Three: Product-Centered Versus Individual User-Centered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1.4 Shift Four: Failure Prevention Versus Responsive Building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.1.5 Shift Five: Smart Built Environment Versus the Individual Building . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2 Future Smart Building Technology: What Makes a Building Smart? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2.1 Collection of Raw Data Through IoT . . . . . . . . . . . . . 6.2.2 Learning from Past Experiences Through an Intelligent Control Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2.3 Artificial Intelligence: The Brain . . . . . . . . . . . . . . . . . 6.2.4 Customized Environment Through Biometric Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.2.5 Context Awareness: Consciousness . . . . . . . . . . . . . . . 6.3 Further Benefits of Smart Buildings: Health and Well-Being . . 6.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . .

. . . .

. . . .

93 93 94 95

...

97

...

98

...

99

5 Smart Building and Current Technologies . . . . . . . . . . . . . . 5.1 History of Smart Building . . . . . . . . . . . . . . . . . . . . . . . . 5.1.1 Automated Buildings (1980s–2000) . . . . . . . . . . . 5.1.2 Smart Buildings (2000–2015) . . . . . . . . . . . . . . . . 5.1.3 Cognitive Buildings (2015–Future) . . . . . . . . . . . . 5.2 Defining “Smartness” . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2.1 Smart Building Definitions Per Discipline . . . . . . . 5.2.2 Smart Building Development Per Region . . . . . . . 5.3 Current Smart Technologies for Healthy Buildings . . . . . . 5.3.1 Summary of Smart Technologies . . . . . . . . . . . . . 5.3.2 Physical Causes: Sensors, Devices, and Equipment 5.3.3 Physiological Causes: Sensors and Devices . . . . . . 5.3.4 Psychological Causes . . . . . . . . . . . . . . . . . . . . . . 5.4 Smart Building Components . . . . . . . . . . . . . . . . . . . . . . 5.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . .

... 99 . . . 100 . . . 102 . . . 104 . . . . .

. . . . .

. . . . .

107 109 110 112 112

xvi

Contents

7 The Nexus Between Smart, Sustainable, and Healthy Buildings: Three Case Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 The Edge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2.1 Collection of Data (IoT) . . . . . . . . . . . . . . . . . . . . . . . 7.2.2 Artificial Intelligence and Control Algorithm (Learning from the Past and Management of Information) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2.3 Context Awareness . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2.4 Adaptation to the Environment . . . . . . . . . . . . . . . . . . 7.3 The Gator Tech Smart House (GTSH) . . . . . . . . . . . . . . . . . . 7.3.1 Collection of Data (IoT) . . . . . . . . . . . . . . . . . . . . . . . 7.3.2 Artificial Intelligence and Control Algorithm . . . . . . . . 7.3.3 Context Awareness: Understanding of Surroundings . . 7.3.4 Adaptation to the Environment . . . . . . . . . . . . . . . . . . 7.4 Smart Home in a Box (SHiB) by CASAS . . . . . . . . . . . . . . . 7.4.1 Collection of Data (IoT) . . . . . . . . . . . . . . . . . . . . . . . 7.4.2 Artificial Intelligence and Control Algorithm . . . . . . . . 7.4.3 Context Awareness: Understanding the Building Occupants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.4.4 Adaptation to the Environment . . . . . . . . . . . . . . . . . . 7.5 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Look Ahead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.2 Smart Physical Technologies: Small and Adaptable . . . . . . 8.3 Smart Design Technologies: Affordable . . . . . . . . . . . . . . . 8.4 Emerging Issues: Epidemic and Aging . . . . . . . . . . . . . . . . 8.5 Looking Ahead: Ways the Built Environment Will Change Post-pandemic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . .

. . . . .

. . . .

. . . .

. . . .

117 117 119 121

. . . . . . . . . . .

. . . . . . . . . . .

. . . . . . . . . . .

121 123 124 125 125 131 131 132 133 134 135

. . . .

. . . .

. . . .

136 137 137 138

. . . . .

. . . . .

. . . . .

141 141 142 143 143

. . . . . 144 . . . . . 146

Chapter 1

A Brief History of Health and the Built Environment

This Chapter provides readers with a broad view of the relations between health concerns and the built environment through history. The purpose of this chapter is not to cover a detailed history of the development of healthy buildings but to instead illustrate the historical development from two perspectives: public health and building design and construction. It also outlines and explains the diverse factors that play important roles in shaping the concept of healthy buildings and a healthy built environment. This chapter is organized based on the chronological development of relations between the built environment and public health (Fig. 1.1).

1.1 The Pre-industrial Era: Vitruvius and Feng Shui—Western and Eastern Approaches Early evidence that links human habitation to health dates back to Greek and Roman times. Hippocrates (460–370 BC), “the father of modern medicines” [1], advocated the health implications of the wind, air, water, and other components of habitants in his book On Air, Waters and Places. Hippocrates believed each city’s unique setting in the landscape, and even its inhabitants’ areas, should be considered most attentively in order to protect the habitants’ health [2]. One of the oldest infectious diseases is malaria, which has a Latin origin meaning “bad air” and is based on the assumption that decaying vegetables in markets were responsible for the disease [3]. In response to the concerns that Hippocrates raised about unhealthy air and wind, hundreds of years later, Marcus Vitruvius Pollio (80–15 BC) suggested that not only the buildings’ orientation but also the street patterns should be laid at an oblique angle to break harsh wind [4] so that bad air would not be able to travel far through the wind. Marcus Vitruvius Pollio was regarded as the first architect and planner in history to address environmental health issues. Commonly known as Vitruvius, he was a military and civil engineer and architect who designed and built protective facilities, such as castles © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_1

1

2

1 A Brief History of Health and the Built Environment

Fig. 1.1 Historical development of the built environment and public health

and shelters. He described many technological and building innovations with the aim to improve people’s living conditions, some which are still applicable to today’s environment. For instance, in his famous book De Architctura, known today as The Ten Books on Architecture, Vitruvius described the development of the hypocaust, the prototype of ancient “central heating,” which supplied hot air through the floor and inside of walls to buildings and public baths. In the same book, he suggested several key environmental health concerns which are still applicable in today’s world and are considered the principles of modern sustainable design. The first key concern is site; Vitruvius suggested that cities could maximize their access to sea breezes, thus minimizing the health effects originating from foul-smelling swamps. The second concern is wind; he suggested the street layout should be designed in a way to prevent the wind from blasting dwellings. He also advised against placing alleyways parallel to the winds, which could bring in and spread odors and disease through the town [5]. The third key concern is light; Vitruvius recognized the “regenerative” quality of lights and, therefore, suggested that bedrooms should face east, presumably to help awaken inhabitants, while temples face west so that worshippers could behold the morning sun from the east. The purifying effect of light was later recognized by the medical community around the turn of the twentieth century, at the discovery that sunlight could kill bacteria [6]. The fourth key concern is water; there was an ancient belief that “all things depend upon the power of water.” In book seven, Vitruvius developed techniques to locate water resources and restore and filter rainwater in order to provide clean and healthy water to people. Vitruvius’s influence in architectural and engineering design was profound. In book five, he designated one chapter to climate influence on house design, stating, “If our designs for private houses are to be correct, we must at the outset take note of

1.1 The Pre-industrial Era: Vitruvius …

3

the countries and climates in which they are built.” This view can be considered as the predecessor of the passive design and sustainable design principles that promote the concept of design optimization in order to maximize their adaptability to natural environment. Another example of his influence, the drawing called Vitruvian Man (refer to Fig. 1.2), created by Leonardo da Vinci, demonstrates the fundamental geometric patterns of the cosmic order. Since then, it has been regarded as a symbol representing the blending of mathematics and art and of science and design. Another of Vitruvius’s significant theories was the three key qualities of architecture that he described in book five: stability, utility, and beauty, which are still perceived

Fig. 1.2 Vitruvian Man (This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License)

4

1 A Brief History of Health and the Built Environment

as fundamentals of design, even reaching beyond architecture. In particular, they were used to create the Design Quality Indicator (DQI) by the British Construction Industry Council in 1999 [7]. In the Western world, there has been continuous development in consideration of the relations between public health and the built environment, with most development rooted in Greek and Roman traditions. In the Eastern world, a variety of schools of thought were developed as guiding principles of design and healthy built environments for inhabitants. One of the broadly known theories is feng shui, a Chinese traditional environmental design theory for site selection, which provides a theory of building layout and design associated with residential buildings [8]. It consists of a set of empirical principles that integrate biophysical landscape features with cultural traditions and religious beliefs [9]. One of the key principles in the feng shui theory is the flowing of qi, or energy, between nature and manmade structures. Warm and moving qi is categorized as living qi that infuses life with energy and maintains inhabitants’ good health, while cold and stagnant dead qi brings an end to life [8]. Two essential conditions of accumulating living qi are wind and water, which mean feng and shui in Chinese. Wind represents energy, while water represents adaptability. There are two primary sub-schools of thought in feng shui: the compass school (理 ) [8]. The former is typically used for the buildings 气派) and form school ( located in remote areas surrounded by nature since its focus is on site selection. The latter, the form school, focuses on the exterior and interior layouts and is more often used for buildings located in densely populated areas with greater stringent site conditions. All schools of thought share common key concepts for site selection and building design: adequate water resources, building orientation, natural ventilation, day lighting, and indoor air quality. These key concepts serve one purpose, which is to design a dwelling that creates a healthy living space. Later, feng shui was introduced to other countries, such as South Korea and Southeast Asian countries, and was used not only by design professionals but also by engineers, developers, and ordinary citizens. Interestingly, when we compare the guiding principles of healthy site selection and healthy building design in Eastern and Western traditions, the key concepts are strikingly similar. This might indicate the existence of a set of universal principles that is applicable to different sites and cultural contexts in terms of guiding design and evaluating living conditions.

1.2 Renaissance Era: Not just Air (Fourteenth–Seventeenth Centuries) Throughout the medieval period (fifth–fifteenth centuries), there was limited knowledge to further understand the relations between buildings and human health. The general belief was that bad air was largely responsible for the spread of disease. Poorly ventilated rooms were part of the cause of polluted conditions, and appropriate ventilation designs were perceived as the solution. Following the medieval

1.2 Renaissance Era: Not just Air (Fourteenth–Seventeenth Centuries)

5

era, researchers in the early public health field discovered evidence linking health effects with habitants, especially that of indoor air quality and disease. Bernadino Ramazzini (1633–1714) explored the health conditions of workers, with a focus on women workers, such as breast illness (cancer) and exposure to polluted air caused by laundry materials and starch, among others. His discovery of environmental effects on human health remained as relevant research and a practice model [10] followed by public health researchers in later years. Bad ventilation was not the only problem studied; temperature and moisture were also noticed as factors affecting human health. Nicolas Gauger published a book in 1714 titled Fire improved: or, a new method of building chimneys, so as to prevent their smoking. Gauger indicated that it was not the warmth of a room but its inequality of temperature that caused numerous maladies [11], which may have been the first time the concept of mean radiant temperature was recognized. In the twenty-first century, this concept became one of the most important criteria in creating a comfortable indoor environment. In the architectural and engineering design field, the Renaissance era was a period that witnessed the revival of ancient Greek and Roman architecture, with an emphasis on proportion, geometry, and symmetry. Two influential documents related to the built environment design are The Four Books and Architecture by Andrea Palladio and De re aedificatoria (On Architecture) by Leon Battista Alberti. Following the traditions and principles Vitruvius had laid out in his book, Palladio reintroduced the importance of relations between the climate condition and location of cities and the layout or orientation of streets [12]. He further developed those principles and connected the physical built environment characters with occupant health and the beauty of design. For instance, in the third book, Chap. 2, “On Planning Streets in Cities,” he stated, “… in areas of cold or temperate climate, streets must be built wide and large because when they are broad the city will become more healthy, convenient, and beautiful since the thinner and more diffuse the air is, the less it offends the senses.” [14] Compared to Palladio, Alberti not only examined Vitruvian principles of healthy buildings to a much greater extent, but he also furthered the discussion and knowledge [13] in his influential book On Architecture. The book was written in 1452 and first published in Italian in 1546. It was described as being “perhaps the most significant contribution ever made to the literature of architecture” [14]. On Architecture also represented Alberti’s differing approach to design. While Vitruvius focused on practical engineering solutions, Alberti—as a Renaissance scholar—evaluated design and planning as a humanities profession. Alberti’s influence was transferred to later centuries, and the design principles of healthy buildings were repeatedly reiterated by other important architects and designers of the Renaissance era, such as Francesco di Giorgio Martini, Sebastiano Serlio, and Vincenzo Scamozzi. As a loyal follower of Vitruvius and Alberti, Scamozzi strongly believed that, through design, he could provide healtheri buildings for inhabitants. In his second book, The Ideal of a Universal Architecture, published in 1615 in Italy, he almost exclusively focused on climate, geography, the choice of healthy sites, and natural phenomena that included water, air, and winds [15]. Scamozzi had outstanding knowledge in medicine. Unlike his architect predecessor Vitruvius, who treated the health-related phenomenon as one of the elements of natural philosophy, Scamozzi believed that public health was a

6

1 A Brief History of Health and the Built Environment

terrestrial impact from the environment [17]. Interestingly, Scamozzi may have been the first architect to appreciate the medical benefits of fresh and pure air as well as its contribution to the “virtue of the soul,” in his words, and “wellbeing” in a modern sense [16] (refer to Chap. 2 for the definition of well-being). Overall, the Renaissance era established tradition in the field of architecture and engineering that respected the connection between human health and the built environment, which contributed to the birth of the healthy building concept in the late eighteenth century. Before the invention of modern heating, air-conditioning, and ventilating systems, the concerns of the built environment to human health mainly involved outside odors and polluted air from contaminated outside regions. Consequently, the design and planning solutions were centered around neighborhood, city, and street layouts; building orientation; building proportion; and other techniques that helped reduce odors. These principles and planning traditions have continued to date and have been integrated in urban design and planning principles.

1.3 First and Second Industrial Revolution (1760–1914): Healthy Buildings and Environmental Concepts Up to the nineteenth century, people’s concerns about the effects of buildings on human health had been mainly focused on indoor air quality affected by outside conditions. In early traditions and during the pre-Christian and Renaissance eras, the connection between health and building conditions belonged primarily in the realm of philosophy and humanities. Design guidelines were not easily understood nor followed. However, the industrial era experienced the development of design and practice guidelines based on scientific research and evidence. Academic research during the First Industrial Revolution (approximately 1760–1870) carried traditions from the pre-industrial era and focused on the human health impact from air and ventilation. Rooted in the Industrial Revolution, the rapid growth of modern public health issues (overcrowding, unsanitary conditions) evolved around the eighteenth century, particularly in some of the early industrialized countries such as England, as well as concerns of the impact of buildings to human health. This caused the study and focus to public health split into two separate tracks: (a) architecture and engineering and (b) public health and medicine. The former focused on the creation and engineering of the comfort level of the indoor environment, while, in the latter, physicians and public professionals examined the health outcomes of the indoor environment [17]. At that time, comfort was typically defined by temperature, humidity, and ventilation rates, whereas health outcomes concentrated on the physical well-being of occupants.

1.3 First and Second Industrial Revolution (1760–1914) …

7

1.3.1 Architecture and Engineering Field In the engineering and architecture field, there was much development to define what was required to provide adequate indoor air quality. The first book dedicated to studying indoor heating and ventilation requirements, written by English engineer and self-taught architect Thomas Tredgold, was titled Principles of Warming and Ventilating Public Buildings, Dwelling Houses, Manufactories, Hospitals, Hot Houses, Conservatories, etc. (the first edition was published in 1824) [18, 19]. In this book, he made the first estimation of the minimum quantity of fresh air needed for breathing and to remove exhaled moisture, which was 113 L (0.11 m3 ) per person, per minute [19, 20]. The number is very close to the modern-day requirement: for a typical office space, 141 L (0.14 m3 ) per person, per minute, of outside fresh air is needed for a typical office building based on ANSI/ASHRAE Standard 62.1 (2019 version) [20]. During the Second Industrial Revolution (1870s–1914), also known as the Technological Revolution [21], there were two very influential and fundamental studies that set the foundation for later mechanical system designs of buildings. In 1882, Professor Herman Reitschel (1847–1914) published the textbook Heating and Ventilation: A Handbook for Architects and Engineers. This book includes the guidelines of outdoor airflow and “natural” versus mechanical ventilation requirements [11]. Rietschel was considered as the founder of mechanical engineering, and his book is considered as the predecessor of modern-day mechanical system design standards. In 1895, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) recommended a minimum rate of ventilation of 30 ft3 per minute (CFM), per person, which was based on the work of John Shaw Billings, a physician and building designer [17]. This number, 30 CFM, is much higher than the current ASHRAE requirement. An important invention occurred during the late nineteenth and early twentieth centuries that had a significant impact on the building industry and triggered the healthy building movement: the invention of air-conditioning units. Following the invention of the air-conditioning system, the focus also shifted from outside to indoors. The first modern air conditioner was invented by Willis H. Carrier (1876– 1950), and an air-conditioning unit to control the air temperature and humidity in buildings was installed in 1902 in a printing plant in Brooklyn [22]. In 1911, Carrier presented his Rationale Psychrometric Formulae at a meeting for ASHRAE, which became the basis of calculation for modern air-conditioning systems. He studied and investigated the relations between temperature, humidity, and human comfort. The invention of a controlled indoor environment was aimed at the improvement of human living conditions; however, later on, the tightly controlled environment was often associated with disease induced by a lack of fresh air.

8

1 A Brief History of Health and the Built Environment

1.3.2 Public Health There were also new theories and studies in the field of public health (at that time, called “practical hygiene”). “The father of modern pathology,” German scientist Rudolf Ludwig Virchow (1821–1902) advised city leaders that poorly maintained, crowded housing was associated with higher rates of infectious disease transmission after he was sent to Upper Silesia to investigate a typhus epidemic in 1848 [23]. Around the same time period, Florence Nightingale (1820–1910), the founder of modern nursing, claimed “the connection between the health and dwelling of the population is one of the most important that exists” [24]. The connection between public health and the places where people lived and worked became more evident during the Industrial Revolution as a result of an increasing epidemic that was caused by horrific manufacturing conditions, unsanitary housing conditions, overcrowding, and lack of daylight, among others [25]. At that time, there were no environmental laws or zoning regulations to control where factories, houses, and other buildings could or should be built. The results of an unhealthy build environment were direct and disastrous. The nineteenth century alone (before 1890) had seen more than 60 epidemics [26]. Figure 1.3 illustrates the problems of nineteenth-century London. Around the Second Industrial Revolution, further theories and research in the field of public health were conducted by several academics, such as Max Joseph Pettenkofer (1818–1901) and Elias Heyman (1829–1889). Pettenkofer firmly supported the theory that there was a strong link between proper circulation of “good air” through houses, adequate space for living, and the health of the occupants [27]. In 1880, Heyman conducted research on school buildings in Stockholm; he studied CO2 concentrations, air flow rates, air temperature (indoors and outdoors), and speed and

Fig. 1.3 Bibliothèque nationale de France by Jean-Pierre Houël (Source wikimedia.org)

1.3 First and Second Industrial Revolution (1760–1914) …

9

direction of outdoor air [28], with the results indicating those schools had between 1,500 ppm to 5,000 ppm of CO2 concentration. Consequently, he concluded that not even one school room was adequately ventilated and that what people perceived to be as “dry” conditions actually was caused by pollutants [11, 29]. Pettenkofer had a profound influence on later physicians and public health practitioners, one of whom was John Shaw Billings (1838–1913), an influential scholar and practitioner across several different fields, physician, medical statistician, librarian, educator, and building designer. He is commonly known as the modernizer of the Library of the Surgeon General’s Office of the Army and as the first director of the New York Public Library. One of his lesser-known works and publications to building design, albeit a very important one, is the book he published in 1893, Ventilation and Heating by The Engineer Record [30]. In this publication, he drew on previous experiments conducted by him and other professionals in the engineering, architecture, and medical fields, providing an in-depth explanation on the appropriate level of room temperature humidity and quantity of air required. He also presented the specific formula to calculate the amount of fresh air needed and the rate of air flow [30]. He proposed and calculated 3,000 ft3 of air per hour, per person (about 50 CFM), as sufficient, which was used by English sanitarians at that time. His calculation was higher than the estimation by engineers and architects, since his main concerns as a physician were in preventing the spread of foul air and impure emissions from the human body.

1.3.3 Industrialists Meanwhile, industrialists were becoming concerned with workers’ living and working conditions. They were interested in maintaining a healthy and productive workforce; unhealthy living conditions were linked to an increase of infectious disease, harming the health of the workforce and, consequently, productivity. Industrialists started to invest in healthy housing and working conditions. The housing reform, together with zoning ordinances, began to improve conditions in most metropolitan areas in the Western world around the 1920s [25]. There were major improvements in zoning regulations that helped to advance public health: firstly, the zoning separated factories from housing areas to provide organized and clean areas; secondly, zoning specified the building heights and setbacks to control overcrowding and provide all units with daylight; and lastly, the density of the building and urban blocks were also controlled by zoning to avoid overcrowding conditions. Modern zoning and planning and building regulations had a profound influence on public health. However, zoning caused certain unintended consequences. For instance, the separation of different uses and types of buildings indirectly helped to promote the urban sprawl and other social issues, which later had a detrimental impact on human health (refer to Chap. 3, The Built Environment and Community).

10

1 A Brief History of Health and the Built Environment

1.4 Post-war Rebuilding (1930–1970): Quantitative Measurement of Healthful Homes During and after World Wars I and II, there was a growth of interest in the built environment’s impact on human health following the trend developed during the industrialization era. After the wars, the world faced the most challenging reconstruction of the built environment in human history. In the United States, the Depression of the 1930s and World War II had produced a housing shortage that Americans had never faced before. The shortage was addressed by mass new construction outside of city centers, which encouraged people to move to the suburbs to access new buildings, cleaner air, and better neighborhoods. At that time, city centers were viewed as dirty, noisy, and unhealthy places. City slums constituted grave threats to the physical and emotional health of their occupants and were viewed as a menace to the social and economic structure of American life [31]. Rebuilding American cities and providing healthy living conditions to people offered challenges and opportunities at the same time. To respond to the challenges, the American Public Health Association (APHA) formed the Hygiene and Public Health Committee (HPHC) in 1937 to create strategies, plans, and tools to address housing problems using health as a guiding principle. Among multiple documents produced by this committee, two are of particular interest to today’s built environment. The first is the report titled Basic Principles of Healthful Housing (first published in 1938) [32], and the second is the evaluation procedure An appraisal method for measuring the quality of housing (published in 1945) [33]. According to Basic Principles of Healthful Housing (BPHH), in order to provide a healthful environment, a dwelling must meet thirty essential health needs. The thirty essential needs are grouped under four categories: fundamental physiological needs, fundamental psychological needs, protection against contagions, and protection against accidents [32]. Several of the detailed quantitative requirements may have contributed to later building code requirements. For instance, in the BPHH, principle 29, protection against fall and other mechanical injuries in the home outlined specific requirements that stairways should be 178 mm to 190 mm (7 to 71/2 in) for risers and 254 mm (10 in) for tread depth. Those values are still being used as guidelines in building codes, such as the International Building Code and International Residential Code (refer to Chap. 2). In 1941, the APHA expanded its emphasis from individual buildings to a broader built environment and social and economic environment [32]. Such new development was reflected in An appraisal method for measuring the quality of housing (AMMQH). AMMQH proposed a numerical scores system to measure the quality of housing. The scores system evaluated two important components: dwelling conditions and neighborhood characteristics. It was the first time a broader built environment—in this case, a neighborhood—was recognized as an essential element for a healthy building [34]. This new method was a joint effort between the local housing authority, New Haven Health Department, and City Plan Commission and based on 1940 Housing Census data. The design of the measurement method was based on the thirty essential health needs proposed in BPHH. Author was only able to

1.4 Post-War Rebuilding (1930–1970) …

11

locate documentation of its initial testing during 1940–1950; afterwards, there is no evidence showing that this appraisal method was actually further implemented in housing or planning development in other areas.

1.5 Energy Crisis and Sick Building Syndrome (1970–1990) Unlike traditional buildings that relied on passive design strategies, most modern buildings utilized the mechanical system, which was invented in the beginning of the twentieth century (refer to Sect. 1.3) to create a comfortable indoor environment. This modern design required mechanical ventilation systems to circulate fresh air and control the temperature, humidity, and other environmental factors [35]. Its objective was comfort—not the occupants’ health or energy conservation. The results is the mechanically conditioned spaces consumed large amounts of energy. Before the first oil crisis of the 1970s, people perceived energy sources as abundant and were easily accessible through technical and economic means. However, the 1973 OAPEC oil embargo shifted people’s attention from indoor environment comfort to energy conservation. One of the perceived effective techniques to conserve energy was to reduce the ventilation rate. In the early and mid-1970s, the standard building ventilation rate was around 25 m3 per hour (m3 /h), or 15 ft3 per minute (CFM) (424 L), for each building occupant, and the ventilation moved outside fresh air into buildings, diluting and removing body odors [36]. To conserve energy following the 1973 oil embargo, the Energy Policy and Conservation Act by the United States called for a reduction in the ventilation rate, to 5 CFM (141 L) [36]. The energy conservation strategies of the 1970s had an unintended adverse impact on occupant health related to buildings and eventually triggered the sick building movement. Compounding the insufficient ventilation was a shift from the usage of natural building materials to synthetic ones. Significant off-gassing of volatile organic compounds (VOCs) was considered as a major cause that contributed to symptoms reported by building occupants: irritated eyes, runny noses, itchy skin, and headaches, among others [37]. The official term sick building syndrome (SBS) was coined by the World Health Organization (WHO) in 1983 [38]. WHO defined SBS as “a collection of nonspecific symptoms including eye, nose and throat irritation, mental fatigue, etc.” Later, in 1991, the US Environmental Protection Agency (EPA) stated that SBS “is used to describe situations in which building occupants experience acute health and comfort effects that appear to be linked to time spent in a building, but no specific illness or cause can be identified” [39]. In the United Kingdom, the Transport Salaried Staffs’ Association defined SBS as “a generic term used to describe common symptoms which, for no obvious reason, are associated with particular buildings” [40]. The common consensus was that SBS (a) had no specific symptoms, (b) was directly correlated to particular buildings, and (c) the symptoms were temporal. The first official reports of health- and comfort-related complaints from building occupants in a mechanically conditioned building were found in public health literature during the 1970s [37]. To date, the identified symptoms associated with SBS include headaches,

12

1 A Brief History of Health and the Built Environment

throat dryness, coughing, malaise, skin dryness, eye pain, a runny nose, anxiety, depression, and other general respiratory and allergic diseases. In the architecture and engineering field, poor indoor air quality was speculated as the primarily cause of SBS, which could be potentially resolved through appropriate designing and planning. The ventilation system design has been central to addressing SBS-related design issues. However, there have been no clear requirements written in building codes to prevent the causes of SBS. There are only broad guidelines or best practices, due to the unclarity of the particular causes of SBS. Since 1980s, the movement of designing healthy buildings in response to SBS has largely been used as a prevention and defense mechanism to protect building occupants by “designing out” potential health hazards, thus reducing illnesses and injuries due to a dangerous built environment.

1.6 Initiatives and Concepts for Healthy Homes (1990–2000) After the recognition of the existence of SBS, ironically, the leading US Environmental Protection Agency was sued by its own employees in the office building at 401 M Street, Washington, D.C. Employees had complained for years about the poor indoor air quality, lack of fresh air, and odors, among others, which worsened after the installation of new carpet in the EPA office building in 1985. About 65% of employees complained of respiratory and neurological problems [41], which are typical sick building symptoms. In 1995, the District of Columbia’s Superior Court overturned the original ruling by deciding that the landlord could not be held responsible for any psychogenic illnesses [42]. Despite difficulties in proving a direct relation between poor indoor environments and specific illnesses, multiple law cases, surveys, and studies generated momentum that led to the healthy homes movement. In 1999, the United States Department of Urban Development (HUD) launched its Healthy Homes Initiative (HHI) in response to a Congressional Directive over concerns about children’s environmental health. A wider range of environmental factors were addressed beyond air quality in HHI. Since then, HUD has produced studies and manuals and provided funding to address multiple childhood diseases and injuries in the home [43]. In 2009, the initiative was expanded to all occupants under the Surgeon General’s Call to Action to Promote Healthy Homes: “A healthy home is sited, designed, built, renovated, and maintained in ways that support the health of residents” [44]. This definition emphasized that to have a healthy building, the whole life cycle must be considered, from site selection all the way to the end repairs and maintenance of the building. Responding to the call of action, multiple federal agencies, together, formed the Federal Healthy Homes Work group, which consists of representatives from EPA, HUD, the Department of Agriculture, the Department of Commerce, the Department of Labor, the Department of Energy, and Centers

1.6 Initiatives and Concepts for Healthy Homes (1990–2000)

13

for Disease Control and Prevention (CDC). CDC then co-published the Healthy Housing Reference Manual with HUD in 2006 [29]. Most recently, the task force published a report, Advancing Healthy Housing- a Strategy for Action, presenting the Healthy Home Model that includes eight characteristics: dry, clean, pest free, safe, contaminate free, well ventilated, well maintained, and thermally controlled. When comparing the most recently published Advancing Healthy Housing- a Strategy for Action to the older document (BPHH) published in 1938, the latter is more comprehensive, covering not only the physical and physiological factors but also the psychological impact of the built environment. The former document is somewhat limited. Another important organization that should be mentioned is the National Center for Healthy Housing, formed in 1990 by leaders in environmental protection, affordable housing, education, children’s safety, and public health. Since then, it has been active in promoting healthy homes for all. Besides experts from the public health industry and federal agency, another important key player in healthy buildings is architects and designers. Since 2011, The American Institute of Architects (AIA) Residential Knowledge Community has initiated Healthy Homes Research and conducted multiple seminars and conferences to raise awareness of healthy home assessments and design. In 2014, AIA officially launched Design and Health Initiatives and developed six evidence-based approaches that designers can use to promote the health and well-being of occupants: environmental quality, a natural system, physical activity, safety, a sensory environment, and social connectedness [45]. AIA also outlined five principles of healthy homes: a good building enclosure, minimized indoor emissions, maintained dryness, effectively captured particles, and ventilation [46]. These principles are related but do not exactly overlap with the healthy building principle proposed by experts from the public health field.

1.7 Beyond Health (2000–Present) In the past couple decades, the focus of healthy buildings has gradually expanded from physical health to the holistic well-being of occupants. The indoor environmental quality, illumination levels, and ambient noise level all contribute to occupants’ well-being and satisfaction and workers’ performance [47, 48]. In fact, lowered productivity rates of occupants’ performance is a serious adverse effect of SBS [49]. More recently, there has been increasing interest in research regarding the association between the built environment and the psychological impact on occupants, such as stress, anxiety, and aggression [50, 51]. In 2014, Dodge Data & Analytics published a report Drive Toward Healthier Buildings SmartMarket Report, outlining the drive and demand for designing and building healthier buildings. Two years later, a second report, The Drive Toward Healthier Buildings 2016, was published, with a focus on examining how building owners and developers considered the impact of buildings on occupants’ health

14

1 A Brief History of Health and the Built Environment

and well-being in the United States. The report indicated that architects, interior designers, and contractors currently (2016) underestimate the importance of several goals that their clients have for healthier buildings, including improving employee and tenant satisfaction. Yet nearly three-quarters of US architects and more than 80% of interior designers consider the building health impact to be non-influential in their design decisions. These seemly contradictory results reveal a gap between the architects’ and engineers’ institutive understanding of both the importance of health in the design process and clients’ needs. However, clients, developers, architects, and engineers all agree on the importance of the built environment to occupants, which provides a positive foundation for moving forward. The 2016 report also revealed there is still a substantial lack of knowledge about the economic benefits of healthier buildings; more empirical evidence is still needed to prove that a healthier built environment could lead to quicker lease periods, premium rents, or higher building values [52]. This report summarizes several major healthier building features: (a) indoor lighting and daylighting, (b) enhanced thermal comfort, (c) enhanced ventilation, (d) healthy food and water, (e) spatial quality and an interior layout that enhance social interaction, (f) access to natural features, (g) site selection, and (h) healthy and transparent production information. The first three features are agreed upon by all stakeholders, whereas the remaining features remain under debate. Regardless of the large amount of interest and attention given to the health outcome of buildings and the built environment, the mechanism for understanding the built environment’s impact on people’s health and well-being requires greater development and research [53]. The science behind the impact is less defined and has not being fully explored.

1.8 The Connection Between Sustainable and Healthy Buildings: Future Trends Parallel to healthy buildings, beginning in the 1970s, the world has seen exponentially increasing interest and adoption of green and sustainable buildings. Energy efficiency and environmental impact are the two primary foci of sustainable buildings. After several decades of practice and research, the consensus is that, in order to achieve a truly sustainable building design, an integrated systematic approach is required, and the overarching goal of sustainable building design is to save energy, conserve resources, reduce the impact, and improve human life. Therefore, there should be no fundamental conflict between green building and building health. Although there is occasional disconnection between occupants’ well-being and energy consumption [54], overall, the two often merge in the same direction. As outlined in the 2013 Summit on Green Building and Human Health (US Green Building Council), health is a human right, and green building can help [55]. Furthermore, according to the US Environmental Protection Agency, “Green building is the practice of creating

1.8 The Connection Between Sustainable and Healthy Buildings: Future Trends

15

structures and using processes that are environmentally responsible and resourceefficient throughout a building’s life-cycle from siting to design, construction, operation, maintenance, renovation and deconstruction…. Green building is also known as a sustainable or high performance building” [56]. A variety of green building rating systems have incorporated healthy design features. For instance, the Building Research Establishment Environmental Assessment Method (BREEAM), created in the United Kingdom, includes health and wellbeing as one of the nine categories and has 15 credits [57]. The Leadership in Energy and Environmental Design (LEED) rating system, established in the United States, addresses occupant health and comfort by including thermal comfort, daylighting, access to outside views, and material usage in the requirements and allocates an adequate portion of credits to those considerations. The Living Building Challenge from the United States clearly defines the definition of health and well-being from a design perspective in their rating system and established two certificates particularly for health and happiness. Most recently, the WELL Building Standard focuses solely on the health of building occupants and includes both physical and psychological health. WELL was created by The International WELL Building Institute (IWBI) in 2014. It addresses eight health-related categories: air, water, nourishment, light, fitness, comfort, mind, and innovation. The business model of WELL is similar to LEED with a relatively high cost for certification, which generates certain obstacles for adoption. Similar to WELL, Fitwell also solely focuses on improving the health of occupants but is different in two aspects. Firstly, Fitwell was created by the US Center for Disease Control and Prevention (CDC) and the General Services Administration (GSA), with a focus on commercial interiors for multi- and single-tenant buildings. Secondly, Fitwell does not have a prerequisite credit requirement. Fitwell has eleven categories: location, building access, outdoor space, entrance and ground floors, stairwells, indoor environment, workspace, shared spaces, water, food, and emergency procedures.

1.9 Conclusion The connections between public health and buildings/the built environment can be traced back to thousands of years ago. Throughout history, the interest in buildings as influential factors to public health has fluctuated in response to issues related to buildings and the built environment, such as infectious disease outbreaks (e.g., the cholera epidemic in New York City in the 1830s) [23], social unrest and class conflict, industrialists’ interest in maintaining a healthier workforce, and economic downturns leading to crises in housing availability and quality [58]. Public health and building professionals continue to build on a long tradition of engagement with building and health issues. Many of the efforts that will be described in Chap. 2 have generated positive outcomes. The transformation from a sustainable building to a healthy building could be used as a transformative tool to improve public health. Despite the long traditional interest and intuitive understanding in the healthy impact

16

1 A Brief History of Health and the Built Environment

from buildings, there is still no consensus about exactly how the mechanism for the design of high-quality buildings could lead to better health outcomes, especially health related to well-being and productivity. On the contrary, a prevalent disconnection between public health practices and the built environment design still exists and requires mindset shifting. In a 2014 report published by McGraw Hill Construction, The Drive Toward Healthier Buildings: The Market Drivers and Impact of Building Design on Occupant Health, data indicated that 95% of homeowners and building users believed that hospital and school buildings affected patient and staff health and productivity. Yet only 53% of pediatricians, 32% of general physicians, and 40% of psychiatrists believed that buildings altered patient health [55, 59]. The findings also revealed that the primary sources of information for the general public about healthy buildings was through television; however, there are very few home improvement shows that currently include health considerations in their programs. A similar survey was carried out in the United Kingdom, where the findings revealed that local authorities who controlled the finances did not believe school buildings had any effect on children’s learning outcomes [60]. Until there is a full understanding of the exact mechanism of how the built environment influences physical and psychological health, the health co-benefits of sustainable building cannot be fully realized. To date, sustainable buildings have mainly focused on energy and resource conservation. In the future, enhancing public health could become the primary benefit of sustainable design. In Chap. 2, the author will take readers through an in-depth analysis of the connections and divergences between public health and the built environment.

References 1. Pappas G, Kiriaze IJ, Falagas ME (2008) Insights into infectious disease in the era of Hippocrates. IJID 12(4):347–350 2. Airs, Waters, and Places: A Climate Change Series. Harvard Public Health Magazine. https://www.hsph.harvard.edu/magazine/magazine_article/airs-waters-and-places-a-cli mate-change-series/. Accessed 10 Dec 2018 3. Lopez R (2012) The built environment and public health, vol 16. Wiley, Hoboken 4. Mead PG (1996) Architecture as environmental medicine. ACSA. https://www.acsa-arch.org/ chapter/architecture-as-environmental-medicine/. Accessed 01 August 2019 5. Pollio V (1914) Vitruvius: the ten books on architecture. Harvard University Press, Boston 6. Day C (2017) Places of the Soul: architecture and environmental design as a healing art. Routledge, London 7. Gann D, Salter A, Whyte J (2003) Design quality indicator as a tool for thinking. BRI 31(5):318– 333 8. Mak MY, Ng ST (2005) The art and science of Feng Shui—a study on architects’ perception. Build Environ 40(3):427–434 9. Chen X, Wu J (2009) Sustainable landscape architecture: implications of the Chinese philosophy of “unity of man with nature” and beyond. Landsc Ecol 24(8):1015–1026 10. Franco G (2012) Bernardino Ramazzini and women workers’ health in the second half of the XVIIth century. J Public Health 34(2):305–308

References

17

11. Sundell J (2004) On the history of indoor air quality and health. Indoor Air 14(7):51–58 12. Palladio A (1965) The four books of architecture, vol 1. Courier Corporation, Chelmsford 13. Cavallo S, Storey T (2013) Healthy living in late Renaissance Italy. Oxford University Press, Oxford 14. Kruft HW (1994) History of architectural theory. Princeton Architectural Press, New York City 15. Nova A (2006) The role of the winds in architectural theory from Vitruvius to Scamozzi. In: Kenda B (ed) Aeolian Winds and the Spirit in Renaissance Architecture: Academia Eolia Revisited. Routledge, London, pp 77–83 16. Scamozzi V (2003) Vincenzo Scamozzi, venetian architect: the idea of a Universal Architecture. ACC Publishing Group, London, Villas and Country Estates. III 17. Janssen JE (1999) The history of ventilation and temperature control. ASHRAE J. 41:48–72 18. Robert B, Thomas Tredgold and his principles of warming & ventilating. CIBSE Heritage Group. http://www.hevac-heritage.org/built_environment/pioneers_revisited/tredgold.pdf. Accessed 1 Jan 2019 19. Tredgold T (1824) Principles of Warming and Ventilating Public Buildings, Dwelling Houses, Manufactories, Hospitals, Hot-houses, Conservatories, &c.; and of Constructing Fire-places, Boilers, Steam Apparatus, Grates, and Drying Rooms. Josiah Taylor, London 20. American Society of Heating, Refrigeration, Air-condition Engineers. ANSI/ASHRAE Standard 62.1–2019. https://ashrae.iwrapper.com/ViewOnline/Standard_62.1-2019. Accessed 26 Aug 2019 21. Mokyr J (1998) The second industrial revolution, 1870–1914. Castronovo V(ed) Storia dell’economia Mondiale. Editori Laterza, Bari, pp 219–245 22. Ionescu C, Baracu T, Vlad GE, Necula H, Badea A (2015) The historical evolution of the energy efficient buildings. Renew Sustain Energy Rev 49:243–253 23. Krieger J, Higgins DL (2002) Housing and health: time again for public health action. Am J Public Health 92(5):758–768 24. McDonald L (2015) Florence Nightingale: a research-based approach to health, healthcare and hospital safety. In: Collyer F (ed) The Palgrave handbook of social theory in health, illness and medicine. Palgrave Macmillan, London, pp 59–74 25. Perdue WC, Stone LA, Gostin LO (2003) The built environment and its relationship to the public’s health: the legal framework. Am. J. Public Health 93(9):1390–1394 26. Wikipedia. List of epidemics. https://en.wikipedia.org/wiki/List_of_epidemics#16%E2%80% 9317th_centuries. Accessed 26 Aug 2019 27. Pettenkofer MV (1941) The Value of Health to a City: Two Lectures Delivered in 1873 (trans: Sigerist HE). Bull. Hist. Med 28. Heyman E (1880) Bidrag till kännedomen om luftens beskaffenhet i skolor. Nordiskt Medicinskt Arkiv 12(2):1–47 29. Boschi N (ed) (2012) Education and training in indoor air sciences, vol 60. Springer Science & Business Media, Berlin 30. Billings JS (1893) Ventilation and heating. Engineering Record, New York 31. American Public Health Association (1948) Committee on the Hygiene of Housing. Planning for the Neighborhood, vol. 1. Public Administration Service, Washington, D.C 32. Winslow C-EA (1939) Basic principles of healthful housing. American Public Health Association, Washington, D.C. 33. Winslow C-EA (1947) Health goals for housing. Am J Public Health Nations Health 37(6):653– 662 34. Winslow C-EA, Britten RH, Adams FJ, Ascher CS, Atwater HW, Chapin SF, Churchill HS et al (1943) Report of the committee on the hygiene of housing (A new method for measuring the quality of urban housing—a technic of the committee on the hygiene of housing). Am J Public Health Nations Health 33(6):729–740

18

1 A Brief History of Health and the Built Environment

35. Stolwijk JA (1991) Sick-building syndrome. Environ Health Perspect 95:99 36. Fell-Carlson D (2007) Working safely in health care: a practical guide. Cengage Learning, Boston 37. Graudenz GS (2011) GS Building Related Illnesses. In: Abdul-Wahab SA (ed) Sick Building Syndrome. Springer, Berlin, Heidelberg, pp 341–352 38. WHO (1983) Indoor air pollutants: exposure and health effects. World Health Organization, Geneva 39. Samet JM, Spengler JD (1991) Indoor air pollution: a health perspective. Johns Hopkins University Press, Baltimore 40. TSSA Building Immunity. https://www.tssa.org/en/boilers-pressure-vessels/inspections.aspx. Accessed 27 Dec 2018 41. Weisskopf M (1988) Air pollution claims victims inside headquarters of EPA. Available via 42. https://www.washingtonpost.com/archive/politics/1988/05/25/air-pollution-claims-victimsinside-headquarters-of-epa/8a2b4d03-439f-4bdc-8a01-1329a7ac9d4d/?utm_term=.d473c9 3c953b. Accessed 08 Sep 2019 43. Abdul-Wahab SA (2011) Sick building syndrome. Springer-Verlag, Berlin, Heidelberg 44. U.S Department of Housing and Urban Development. The Healthy Homes Program. https:// www.hud.gov/program_offices/healthy_homes/hhi. Accessed 02 January 2019 45. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Promote Healthy Homes. https://www.ncbi.nlm.nih.gov/books/NBK44192/pdf/Bookshelf_ NBK44192.pdf. Accessed 02 January 2019 46. The American Institute of Architects. AIA’s design and health initiative. https://www.aia.org/ pages/3461-aias-design-health-initiative. Accessed 02 January 2019 47. AIA Houston. Brown Bag Lunch & Learn: 5 Principles for a Healthy Home 48. https://aiahouston.org/v/event-detail/Brown-Bag-Lunch-Learn-5-Principles-for-a-HealthyHome/1au/ 49. Realyvásquez A, Maldonado-Macías AA, García-Alcaraz J, Cortés-Robles G, BlancoFernández J (2016) Structural model for the effects of environmental elements on the psychological characteristics and performance of the employees of manufacturing systems. Int J Environ Res Public Health 13(1):104 50. Newsham KK, Pearce DA, Bridge PD (2010) Minimal influence of water and nutrient content on the bacterial community composition of a maritime Antarctic soil. Microbiol. Res. 165(7):523– 530 51. Ghaffarianhoseini A, AlWaer H, Omrany H, Ghaffarianhoseini A, Alalouch C, ClementsCroome D, Tookey J (2018) Sick building syndrome: are we doing enough? Archit Sci Rev 61(3):99–121 52. Kamaruzzaman SN, Sabrani NA (2011) The effect of indoor air quality (IAQ) towards occupants’ psychological performance in office buildings. J Design + Built 4(1):49–61 53. Runeson-Broberg R, Norbäck D (2013) Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce. Int Arch Occup Environ Health 86(8):915–922 54. Dodge Data & Analytics. The drive toward healthier buildings 2016. https://www.worldgbc.org/ sites/default/files/Drive%20Toward%20Healthier%20Buildings%202016_ffff.pdf. Accessed 17 Dec 2018 55. Xie H, Clements-Croome D, Wang Q (2017) Move beyond green building: a focus on healthy, comfortable, sustainable and aesthetical architecture. Intell Build Int 9(2):88–96 56. Pelenur MJ, Cruickshank HJ (2013) Investigating the link between well-being and energy use; an explorative case study between passive and active domestic energy management systems. Build Environ 65:26–34 57. U.S. Green Building Council (2013) The Summit on Green Building & Human Health. https:// www.usgbc.org/sites/default/files/GBHH_Final_1.pdf. Accessed 17 Dec 2018

References

19

58. U.S. Environmental Protection Agency. Definition of Green Building. https://archive.epa.gov/ greenbuilding/web/html/about.html Accessed 17 December 2018 59. Rezaallah A, Bolognesi C, Khoraskani RA (2012) LEED and BREEAM; Comparison between policies, assessment criteria and calculation methods. In: Amoeda R, Mateus, R., Braganca,L., Pinheiro C (ed) Proceedings of the 1st International Conference on Building Sustainability Assessment (BSA 2012). Porto, Portugal, p 23–25 60. Jacobs M, Stevenson G (1981) Health and housing: a historical examination of alternative perspectives. Int J Health Serv 11(1):105–122

Chapter 2

Connections, Shifts, and Future Trends

2.1 Connections The connections between public health and the built environment are reflected on two scales: individual buildings and the larger built environment. A historical perspective is helpful to provide readers with a benchmark of change and also as a reminder of progress. Although the history of the relations between the built environment and human health is extensive, as mentioned in Chap. 1, it was the Industrial Revolution that fundamentally changed not only the built environment (living and working conditions) but also the speed and pattern of how infectious diseases spread. Prior to the Industrial Revolution, existing traditions constructed the built environment in such a way that benefitted human health (refer to Chap. 1 for the pre-industrial era). However, the notion that individuals were responsible for their own health problems was too firmly entrenched, and many people believed that physical illnesses were related to one’s morals [1, 2], with the influence of physical built environment factors treated as secondary. During the first Industrial Revolution, assumptions started to shift, and—as a growing number of built environments were constructed—people began to recognize the important role the built environment played in human health. The overcrowded, dirty city centers and horrific workers’ housing conditions, along with multiple major cholera epidemics in 1832 and 1849 [3], aroused great concern from professionals in the fields such as public health, city planning, building design, engineering, and social reform. Together, they joined efforts to reduce the harmful effects of rapid industrialization and urbanization and their related influence on particularly infectious diseases [4, 5]. Following the beliefs instilled by Vitruvius (refer to Chap. 1), they focused on the sanitary conditions of housing and working places and the layout of city streets. During this period, planning and public health research and practices were regularly influenced by the miasma (bad air) theory and contagions—the primary explanatory concept in the understanding of the diseasespreading process [6]. A variety of design solutions were provided to prevent diseases from spreading, including the control of air movement and limiting exposures to © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_2

21

22

2 Connections, Shifts, and Future Trends

sewage and trash [7]. Planners also used the power of the state to isolate populations suspected of causing diseases [5] or to separate the functions that were suspected of causing disease by creating single-use land zoning. For example, the residential areas were placed farther away from the areas where unhealthy air could be generated. One of the most influential and important public health figures was British researcher Edwin Chadwick. In 1842, Chadwick published a report, The Sanitary Condition of the Labouring Population of Great Britain, while employed by the royal commission. This report studied the built environment conditions that contributed to the population’s health [8, 9] following a serious outbreak of typhus in 1838. This report essentially led to the Britain Public Health Act of 1848 [9]. Chadwick argued that poor health conditions were caused by the physical built environments for living and working and not by vice and immorality [10]. Chadwick’s work on sanitary reform rapidly generated great interest in the United States. The promotion of modern plumbing fixtures and sewage systems represented a large part of the US sanitary reform movement since 1864 [10–12], and public health professionals, physicians, public officials, and engineers collectively joined the movement. Going beyond the sanitary system, they educated the public about hygiene and sought to eliminate overcrowding and poor ventilation, an impure water supply, and unwholesome food [12, 13]. Those efforts lead to the US first set of health and housing laws: the New York Metropolitan Health Act of 1866, the New York Tenement House law of 1867, and eventually the New York Tenement House New Law of 1901. The design solutions included requiring windows that opened to outside air in place of air shafts, separate water closets for each apartment, functional fire escapes, adequate lighting in hallways, proper sewage connections, and regular waste removal [13], of which most of those design solutions were integrated and included in modern building codes. The policy change and implementation of zoning regulations required compatible technical advancement. Along with a large interest in providing a higher-quality built environment to improve public health, industrialization brought about the heyday of technological innovation in the built environment. At the building scale, engineers and architects invented a variety of systems that could produce a consistently healthy indoor environment, so that relatively healthy living conditions—including adequate fresh air and lighting levels, clean water, and avoidance of noises—could be attained and maintained through the help of mechanical systems [14]. At the urban scale, infrastructure, such as a modern sewerage system and garbage collection, was invented to remove waste and unsanitary items off the streets [15], hence avoiding contamination and disease spreading. However, the miasma theory failed to explain other aspects of public health issues and epidemics. Certain isolated epidemics occurred only sporadically in certain urban areas, regardless of the ubiquitous filth present in most urban areas [5]. Consequently, the unexplained spread of disease activated further research on how the built environment influenced public health and furthered collaboration between the two disciplines during the 1940s and 1950s. This resulted in a comprehensive assessment of health impacts from the built environment, from individual buildings to neighborhoods and urban blocks. There were two influential documents produced during that time.

2.1 Connections

23

The first is a document titled Basic Principles of Healthy Housing (BPHH) that is mentioned in Chap. 1. BPHH included four categories. The five principles under the physiological category have become the primary performance indicators for today’s healthy buildings: (a) thermal environment, (b) indoor air environment, (c) daylight and lighting environment, (d) acoustic environment (noise), and (e) safety (psychological protection). This may have been the first time that existing house conditions could be appraised in objective terms [13]. Since its publication, BPHH became the base for later healthy house design guidelines; it was adopted by the National Center for Healthy Housing (established in 1992) to produce the National Healthy Housing Standard [16]. In the BPHH’s latest version that was published in 2018, many of the original requirements were removed, to the extent that one can no longer recognize the original comprehensive intent. The main focus in the revised version is on physical and physiological needs—such as safety and personal security, lighting, thermal comfort, ventilation, and moisture control, among others—with psychological needs completely excluded. The psychological needs originally outlined are necessary for protection and social interactions. This omission in today’s National Healthy Housing Standard may be associated with the largely ignored mental health and well-being causes in most modern building designs since the 1940s. The second influential document was Planning the Neighborhood: Standards for Healthful Housing (PNSHH) [17], which can be viewed as a companion publication to BPHH to portray a comprehensive and broad picture of a healthy built environment. It was produced by the same committee under APHA: the Committee on the Hygiene of Housing (COHH). COHH clearly stated the following: “The present report, on standards for the environment of residential areas, deals with the physical setting in which homes should be located. An attempt is made to bring into focus the basic health criteria which should guide the planning of a residential neighbourhood environment…” [3]. PNSHH was intended to be used as a guiding principle and reference by the design team to test the adequacy of design proposals based on their impact on health [17]. The essential physical characteristics of the site that should be considered to build healthful buildings were soil and subsoil conditions; ground water and drainage; and flooding, exposure to the sun, circulation, hazardous conditions, power, fire, and safety. It even provided detailed guidelines for the size of public facilities (schools, playgrounds, parks, shopping centers, and other community facilities). (Refer to Fig. 2.1 for sample tables included in PNSHH.) This publication may be the first comprehensive document to outline the requirements and recommendations for healthy buildings in a large urban context. Certain principles included need to be reinvestigated and examined, such as the preference of one- or two-story single-family houses compared to apartment buildings; however, the systematic understanding and measurement of buildings’ health quality in an urban context is still applicable. Following the initial peak interest in built environment quality from public health professionals, the interest continued for decades, although with less of a concentration. In the late 1980s, an interest in the urban environment remerged—this time, with a more defined and broader agenda. The World Health Organization (WHO) initiated the Healthy Cities and Villages movement in 1986, with the release of the report Health Cities: Promoting Health in the Urban Context [18, 19]. The Healthy

24

2 Connections, Shifts, and Future Trends

Fig. 2.1 Land area and public facility planning (Source PNSHH)

Cities and Villages movement served as a precursor to later movements, such as the smart growth and new urbanism movements. The seamless collaboration between urban planners, design professionals, and public health professionals was forged during the Industrial Revolution, triggered by a public health crisis. Following the 1950s, the different disciplines shifted their focus based on their independent underlying intellectual directions.

2.2 Shifting of the Focus (Twentieth Century to Present) The American Planning Association (APA) stated on their website: “Planning in the United States originated with a public health purpose…. The planning and public health professions were joined by a shared focus on urban reform…. Throughout the course of the 20th century and into the 21st century, however, planning diverged from its common roots with public health…” [20]. In the planning field, the land separation/zoning changed from its original health concern to uncertainty regarding efficient land use. Planners concentrated on functionality and spatial planning and a hierarchical ordering of land use following the German-inspired Haussman model [5]. This Haussman model represented the concept of dividing an entire city into residential and industrial zones [21–23]. It was invented by German social reformers in the 1870s and 1880s and was extremely well received in the United States in the early 1900s. American planners eventually emulated parts of the model, including the idea

2.2 Shifting of the Focus (Twentieth Century to Present)

25

of basing the districts on land use [23], with zoning aimed at “immunizing” urban populations by separating land use. Today, the planning systems in Germany and the United States do share some basic features; however, their differences are obvious. German planners focused on the control of noxious industry, relief from crowding, and protection of the countryside [24], whereas in the United States, in addition to the aforementioned foci, planners also made protecting housing—especially singlefamily housing—an important objective [23], which was reflected in the document: Planning the Neighborhood: Standards for Healthful Housing (PNSHH). Overall, German regulations focused on bulk and density, while US codes increasingly emphasized land use incompatibility [23]. In the United States, planning professionals turned to promoting economic development through large infrastructure and transportation projects [25], which were much needed after the two world wars. Built environment planning shifted from attempting to protect human health in densely populated urban areas to promoting suburban economic development [26]. Human health-related requirements and concerns gradually disappeared from the center stage of the planning practice. Instead, urban planning transferred its focus toward large-scale and high-level environmental health by adopting the environmental impact assessment (EIA) process [5]. Following this approach, in the discipline of built environment design and planning, the concerns for public health in the late twentieth century concentrated mainly on separation and prevention, with the minimal requirements of air quality and thermal comfort representing the highest standards to pursue. The design community’s primary concern for a sustainable and healthy community began to center around resource efficiency, energy conservation, and cost-effectiveness. At the building design level, although architects and engineers had attempted to integrate health considerations into basic building codes as a way to prevent hazardous conditions, the resulting focus was on prevention rather than promoting the health outcome. Design solutions were mainly technological and system-driven, such as air conditioning, mechanical systems, ventilation systems, and building infrastructure. Moreover, the psychological impact and social consequences of design were excluded in most building design principles and guidelines. Meanwhile, the public health field experienced fluctuations. Since the early twentieth century, interest in investigations of microbes in a laboratory setting had increased since “bad air” could not explain or answer all public health questions [5]. Accordingly, physicians, not public health practitioners and planners, emerged as the new class of public health professionals [26, 27]. The latter half of the twentieth century saw another shift in the public health field—a move toward addressing the “hosts,” or diseased individuals [5]. Consequently, research and practices were progressing farther inward, instead of studying the outside world. Social dimensions did not represent the core issue, and lifestyle, gender, and class were not taken into consideration [28]. To be more specific, the public health profession had moved from the germ theory to the biomedical model. The biomedical model is the predominant model used by physicians diagnosing diseases [29]; however, this model is based on the belief that health issues and phenomena can be reduced to their constituent parts

26

2 Connections, Shifts, and Future Trends

(organs, body, legs, etc.), measured, and then causal relationships deduced [29]. It is a linear model that tends to overlook the interaction between the built environment and human health, both physical and psychological. As the biomedical model became mainstream, researchers and practitioners started to recognize its limitations. Some countries, such as Canada and Australia, saw a public health revival in the late 1990s: a new public health practice and research approach reconciled the biomedical model and social sciences and provided a hybrid quantitative and qualitative method to not only examine the direct health causes but also those latent factors in the built environment [30]. This revival was not fully developed in the United States, partially because of the idea that diseases could be explained at the molecular level, which had been scientifically proven and promoted and was deeply rooted. Secondly, the reason could be credited to the original philosophy, where the individual was responsible for his or her own health, and individual health was largely determined by morality—not the surrounding environment [2]. In the last three decades, the revival of public health concerns has been riding on the social and economic justice movement. Researchers have found that zoning separation and preventive “design” strategies cause certain unintended consequences. In the United States, the majority of the population now lives in the built environment, which is not pedestrian-friendly and sometimes even hostile or unsafe. Figure 2.2 illustrates the evolvement of research activities in the relation between public health and the built environment in the last 30 years. The data were extracted from the published studies found on Web of Science (the largest scientific research publication database). Between 1990 and 2000, scientific research regarding the built environment’s effect on public health is sparse. However, between 2001 and 2010, there was a tremendous revival of interest, with two clusters emerging: one focused on neighborhood planning and physical activity (the green cluster) and the other concentrated on planning policy, approaches, and assessments (the red cluster). Most recently, from 2011 to 2019, the clusters intensified, with links being increasingly identified between various elements of the built environment and physical activities [31]. The elements of built environments include land use, architectural design, transportation systems, landscape design, and others [32, 33]. However, there has been limited development to connect the two clusters; more precisely, a lack in ability to translate research and studies on the built environment design related to physical activity and active living as well as policy, procedures, and assessments or measurements.

2.3 Future Trends: Reconnecting Public Health and Built Environment Planning and Design In the past several decades, the leading factors of death in the built environment, particularly in developed countries, have shifted from infectious disease to chronic conditions [18], such as diabetes, cardiovascular conditions, and cancer, among others. Therefore, the intersection between public health and the built environment

2.3 Future Trends: Reconnecting Public Health … Fig. 2.2 Research development through time (1990–2019)

27

28

2 Connections, Shifts, and Future Trends

Fig. 2.3 Connections between the built environment and public health

(buildings) in the past three decades has directed concentration to factors in the built environment affecting chronic disease, away from the previous focus of contamination and infectious disease. Figure 2.3 indicates that the research keywords were located in 3,279 publications on Web of Science between 1990 and 2019. The cluster of green words represents a focus on physical activity and related chronic conditions, diabetes, and cardiovascular diseases. The red cluster corresponds with policy and process challenges related to planning and zoning regulations. The lack of a close connection between the two clusters reflects the disconnection between research activities in the public health field and applicable research foci in the planning and design field. The smallest cluster of words, the blue cluster, demonstrates the traditional intersection between public health and the built environment, particularly the causal relation between indoor air pollution and a variety of sick building symptoms. However, this set of activities is much smaller than the other two. As the built environment becomes increasingly complex, a new set of challenges has emerged, along with different trends, calling for a new and multi-disciplinary or multi-factor approach. Besides traditional public health professionals and built environment planning and design professionals, there are several emerging fields that may contribute to the reconnection between built environment planning and design and public health. The following section outlines three future trends.

2.3.1 A New Multi-disciplinary Approach: Human Ecology, Biology, Psychology, and Neurology Buildings’ physical and physiological factors have received greater research focus, while existing attributes and factors that have a psychological and biological impact have been difficult to measure and monitor. Introducing human ecology into the equation will help to further an understanding of the lesser-known factors. Human ecology itself is a transdisciplinary field that has strong roots in biology, geography,

2.3 Future Trends: Reconnecting Public Health …

29

and sociology. It studies the interaction between humans and natural and built environments [34]. The term “human ecology” was first proposed by engineer and environmental chemist Ellen Henrietta Swallow Richard, who described it as “the study of the surroundings of human beings in the effects they produce on the lives of men” [35]. It was later adopted by sociological research [36] and interpreted as part of the works of the Chicago (ecological) School [37]. Since the 1970s, studies in human ecology have found that the levels of stimulation from the built environment are capable of moderating and optimizing human behavior and functions: a lack of stimulation can lead to boredom and sensory deprivation [38], and overstimulation can cause focus and attention deprivation [39]. Built environment stimulation includes visual, acoustic, and other sensory stimuli. The level of stimulation is influenced and sometimes determined by design features, such as the light level, the noise level, color contrast, urban density, openness of the space, and other spatial characteristics. Exposure to visual and acoustic stimulation is strongly influenced by the architectural layout [36], and the design layout includes the size, shape, volume, geometry, and orientation of the space. The second new discipline that should be integrated is microbiology, which is particularly useful to understand how architectural design could influence the diversity and structure of the built environment microbiome [40]. In recent years, the research community has intensively focused on the microbiome in buildings, with findings indicating that indoor spaces often harbor unique microbial communities [41]. Furthermore, the difference between buildings is greater than the difference between seasons [42] and locations (site and climate conditions), demonstrating the point that each individual building has a predominate effect on human health through cultivating different microbiome communities. This field represents a very interesting and promising research direction. For instance, Lax and colleagues found that, even in the same location, individual homes all have different bacterial communities [43], and the indoor microbiology environment is quite different from that of outdoors. This distinguished microbiome environment is induced by several factors. Firstly, indoor bacterial communities often originate from indoor sources [44, 45], mainly from building materials and human bodies; secondly, the physical and chemical properties of building surfaces and materials in the built environment are, for the most part, very different compared with materials and surfaces in the natural environment [46]. The uniqueness of bacterial sources and the growing environment make the microbiological environment in buildings a crucial factor to occupant health. Studies have shown that building design and operation can influence indoor microbial communities [42]: more open and connected spatial layouts or designs contained a unique collection of bacteria compared to more closed and less connected spaces [42]. The buildings’ conditions are also important, as indicated in studies of buildings with prior moisture and dampness conditions. Indoor fungal communities often differ from those in non-damp buildings, for buildings with the same function and location [40]. The observed relationship between building design and bacterial diversity suggests that architectural and engineering design could alter the indoor microbiome [41, 47]. Moreover, not all bacteria are harmful as exposure to the “right” amount

30

2 Connections, Shifts, and Future Trends

and kind of microbes may be beneficial for human health [45, 46]. In addition, architectural design has been shown to influence the types of bacteria that accumulate indoors, in part because variations in building form and interior spatial arrangement can influence the occupants’ use of space [48]. In general, this relatively new field has provided some knowledge regarding the microbiome of the built environment, and disease vulnerability has also initiated certain experimental research on how microorganisms can be transferred to occupants’ cutaneous or mucosal membranes, potentially increasing or decreasing the risk of inflammation-induced psychiatric conditions [49]. The third discipline is psychology. Environmental psychology, in particular, has a long history of studying the influence of the built environment on human behavior and, consequently, health [50, 51]. Since the early 1900s, there have been multiple theories invented to interpret the psychological impact of the built environment, such as personality and motivation theories. Personality theories advocate creating a work environment that reflects the occupant’s personality [51]. This theory created much ambiguity in understanding what the exact correlation was between the built environment, personality, and personal behavior; consequently, design challenges have been imposed that are not well-defined [51]. Motivation theories (Yerkes-Dodson Law) proposed an inverted U-shape relation between a person’s performance and their level of arousal from the built environmental stimulation [52]. In a recent German study, a correlation was found between space openness (view to outside) and occupant excitement; regarding the room proportion and occupant’s interest level, they found the optimized room ratio was actually near the golden ratio [53]. Although evidence exists in the field of environmental psychology of how visual images can induce certain emotions, there is still a lack of deep understanding of how specific visual properties (features) of the built environment contribute to this effect [54]. The fourth and most recently introduced discipline, neuroscience, could further such understanding by studying humans’ response to external stimuli [54] using advanced neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) and an electroencephalogram (EEG). With those technologies, researchers could record and study brain activity when exposed to different built environments. With a deep understanding of stimuli and their impact, the architect and designer could focus on designing an environment that can stimulate different brain responses, hence influencing activity, memory, and creativity.

2.3.2 A Multi-level Approach: Urban and Building Integration Buildings exist in relation to urban context and social infrastructure; their effects on health are not only reflected at the individual level but also extend to the urban level. In order to fully understand the health impact of buildings, the first step is to contextualize individual buildings within a community and neighborhood. Contextual urban

2.3 Future Trends: Reconnecting Public Health …

31

characteristics could help to assess the impact of buildings that are multi-dimensional, and those dimensions can be defined by density [55], land use mix [56–58], architectural and design features [59, 60], and street characteristics (connectivity and accessibility) [61, 62]. Density refers to housing, job, or population density while land use mix is often defined by the use and function of the land area or floor area. Architectural and design features include sidewalk coverage, architectural characteristics, aesthetic values, building setback or front porch coverage, and other physical variables [63, 64]. Finally, street characteristics (connectivity and accessibility) are associated with street grids, block size, and different available transportation methods. There were several efforts in the early twentieth century from the field of public health to assess the quality of healthy building within the urban context mentioned in the previous chapter, but more efforts are currently needed.

2.3.3 Multi-factor Assessment Currently, the commonly used methods to assess a building’s impact are real estate property, housing, and individual building surveys. A real estate property survey typically concerns the property value, building location, and existing conditions. Local jurisdictions and property management companies all have their own assessments, which do not typically reflect the direct health impact of a building since the real estate value is not determined by health impact. The housing assessment, such as the American Housing Survey: Housing Adequacy and Quality as Measured by the AHS (2013), was created based on the standards established by the Housing Act of 1949 [65] to determine whether a building has a suitable living environment. However, those measurements are not sufficient to quantify the quality of a healthy building since “adequacy” is a narrower concept than quality, and a building can suffer from various healthy deficiencies and still be considered as an adequate shelter [65]. Another method to assess a healthy building is an individual building inspection. Such inspections typically occur after a health complaint is filed; therefore, the assessments are often reactive rather than proactive and cause- and solution-driven rather than enhancement- and promotion-driven. The inspection results are seldom designed to be useful to others besides the inspection agency and are only related to that particular building or group of buildings. Lastly, larger urban environments, such as neighborhood environments, are usually disregarded in individual building surveys [66]. Overall, the current building impact assessment methods have been kept at a bare minimum, are solution-driven, and are based on a single factor. In order to assess impact from multiple factors, a comprehensive building and built environment quality assessment method should consider all health factors, which will be discussed in Chap. 3.

32

2 Connections, Shifts, and Future Trends

2.4 Conclusion Public health and built environment design have a long, intertwined history of promoting a healthy lifestyle and higher living quality. When built environment design and engineering and public health shared common goals, the results were not only vastly evolutional but also tremendously beneficial to the human race, in terms of reducing the spread of disease and prolonging human life. However, by the late twentieth century, the fields of urban planning, building design, and public health were largely disconnected from their initial social reform mission [5, 67]. In recent years, urban planning professionals have been focusing on planning for active living, emergency preparedness, environmental exposure, social cohesion, and mental health, which represent a higher and more strategical level of planning that could have direct and indirect health impacts. Architects and engineers are focusing on improving the localized built environment in order to improve health conditions at detailed levels. However, a gap still exists between built environment design and public health. While reconnecting the two will require an increased attention to the health effects of buildings in an urban context, it will also demand a multi-disciplinary and multi-factor approach. Design must increasingly be understood as a profession that reaches beyond the aesthetic creation of the built environment—it should create an environment and space that enhances and promotes human health.

References 1. Hamlin C, Sidley P (1998) Revolutions in public health: 1848, and 1998? BMJ 317(7158):587– 591 2. Shaw M (2004) Housing and public health. Annu Rev Public Health 25:397–418 3. Rosenberg CE (2009) The cholera years: the United States in 1832, 1849, and 1866. University of Chicago Press, Chicago 4. Healthy People (2000) Healthy People in Healthy Communities: A Systematic Approach to Health Improvement. National Center for Health Statistics. https://www.cdc.gov/nchs/data/hp2 000/hp2k01.pdf. Accessed 09 September 2019 5. Corburn J (2004) Confronting the challenges in reconnecting urban planning and public health. Am J Public Health 94(4):541–546 6. Vandenbroucke J (1988) Is ‘the causes of cancer’a miasma theory for the end of the twentieth century? Int J Epidemiol 17(4):708–709 7. Li Y, Boufford JI, Pagán JA (2017) Systems science simulation modeling to inform urban health policy and planning. Smart city networks. Springer, Berlin, pp 151–166 8. Hamlin C (1992) Edwin Chadwick and the engineers, 1842-1854: systems and antisystems in the pipe-and-brick sewers war. Technol Cult 33(4):680–709 9. Finer SE (2016) The life and times of Sir Edwin Chadwick. Routledge, London 10. Brieger GH (1966) Sanitary reform in New York City: stephen smith and the passage of the metropolitan health bill. Bull Hist Med 40(5):407–429 11. Kramer HD (1947) The beginnings of the public health movement in the United States. Bull Hist Med 21(3):352–376 12. Krueckeberg DA (2018) Introduction to planning history in the United States. Routledge, London

References

33

13. Krieger J, Higgins DL (2002) Housing and health: time again for public health action. Am J Public Health 92(5):758–768 14. Brucemann R, Prowler D (1977) 19th century mechanical system designs. JAE 30(3):11–15 15. Rosen G (2015) A history of public health. JHU Press, Baltimore 16. National Center for Healthy Housing. “National Healthy Housing Standard.” Accessed December 8,2019. https://nchh.org/tools-and-data/housing-code-tools/national-healthy-hou sing-standard/ 17. Standards for Healthful Housing: Planning for the Neighborhood (n.d.) https://babel.hathitrust. org/cgi/pt?id=mdp.39015007191813;view=1up;seq=5. Accessed 08 July 2019 18. Duhl LJ, Hancock T (1988) Promoting health in the urban context. WHO Healthy Cities Project Office, New York 19. Abrams RF, Malizia E, Wendel A, Sallis J, Millstein RA, Carlson JA, Sleet DA (2012) Making healthy places: designing and building for health, well-being, and sustainability. Island Press, Washington DC 20. Planning & Zoning for Health in the Built Environment. (n.d.). https://www.planning.org/pas/ infopackets/eip38/. Accessed 20 Sep 2019 21. Liebmann G (1996) It’s time to reconsider oppressive zoning. USA Today 125:62–64 22. Platt RH (2004) Land use and society, revised edition: Geography, law, and public policy. Island Press, Washington DC 23. Hirt S (2007) The devil is in the definitions: contrasting American and German approaches to zoning. J Am Plann Assoc 73(4):436–450 24. Lefcoe G (1979) Land development in crowded places: lessons from abroad. Conservation Foundation, Washington, D.C. 25. Fishman R (2000) The American planning tradition: culture and policy. Woodrow Wilson Center Press, Washington, D.C. 26. Porter D (2005) Health, civilization and the state: a history of public health from ancient to modern times. Routledge, London 27. Krieger N (2001) Theories for social epidemiology in the 21st century: an ecosocial perspective. Int J Epidemiol 30(4):668–677 28. Susser M, Susser E (1996) Choosing a future for epidemiology: I. Eras and paradigms. Am J Public Health 86(5):668–673 29. Baum F (1995) Researching public health: behind the qualitative-quantitative methodological debate. Soc Sci Med 40(4):459–468 30. Thomson H, Petticrew M, Morrison D (2001) Health effects of housing improvement: systematic review of intervention studies. BMJ 323(7306):187–190 31. Brownson RC, Hoehner CM, Day K, Forsyth A, Sallis JF (2009) Measuring the built environment for physical activity: state of the science. Am J Prev Med 36(4):S99–S123 32. Forsyth A, Hearst M, Oakes JM, Schmitz KH (2008) Design and destinations: factors influencing walking and total physical activity. Urban Stud 45(9):1973–1996 33. Kerr J, Rosenberg D, Sallis JF, Saelens BE, Frank LD, Conway TL (2006) Active commuting to school: associations with environment and parental concerns. Med Sci Sports Exerc 38(4):787– 793 34. Ewing R, Clemente O (2013). Measuring urban design: metrics for livable places. Island Press 35. MacNaughton P, Satish U, Laurent JGC, Flanigan S, Vallarino J, Coull B, Allen JG (2017) The impact of working in a green certified building on cognitive function and health. Build Environ 114:178–186 36. Richards EH (1910) Sanitation in daily life. Whitcomb & Barrows, Boston 37. Vaillancourt JG (1995) Sociology of the environment: from human ecology to ecosociology. Environmental sociology: theory and practice. Captus Press, Ontario, pp 3–32 38. Douglas I, James P (2014) Urban ecology: an introduction. Routledge, London 39. Evans GW, McCoy JM (1998) When buildings don’t work: the role of architecture in human health. J Environ Psychol 18(1):85–94 40. Wohlwill JF (1974) Human adaptation to levels of environmental stimulation. Hum Ecol 2(2):127–147

34

2 Connections, Shifts, and Future Trends

41. Kembel SW, Jones E, Kline J, Northcutt D, Stenson J, Womack AM, Green JL (2012) Architectural design influences the diversity and structure of the built environment microbiome. ISME J 6(8):1469 42. Stephens B (2016) What have we learned about the microbiomes of indoor environments? mSystems 1(4):e00083–16 43. Rintala H, Pitkäranta M, Toivola M, Paulin L, Nevalainen A (2008) Diversity and seasonal dynamics of bacterial community in indoor environment. BMC Microbiol 8(1):56 44. Lax S, Smith DP, Hampton-Marcell J, Owens SM, Handley KM, Scott NM, Weiss S (2014) Longitudinal analysis of microbial interaction between humans and the indoor environment. Science 345(6200):1048–1052 45. Dunn RR, Fierer N, Henley JB, Leff JW, Menninger HL (2013) Home life: factors structuring the bacterial diversity found within and between homes. PLoS ONE 8(5):e64133 46. Hospodsky D, Qian J, Nazaroff WW, Yamamoto N, Bibby K, Rismani-Yazdi H, Peccia J (2012) Human occupancy as a source of indoor airborne bacteria. PLoS ONE 7(4):e34867 47. Gilbert JA, Stephens B (2018) Microbiology of the built environment. Nat Rev Microbiol 1 48. Jeon Y-S, Chun J, Kim B-S (2013) Identification of household bacterial community and analysis of species shared with human microbiome. Curr Microbiol 67(5):557–563 49. Brown G, Kline J, Mhuireach G, Northcutt D, Stenson J (2016) Making microbiology of the built environment relevant to design. Microbiome 4(1):6 50. Hoisington AJ, Brenner LA, Kinney KA, Postolache TT, Lowry CA (2015) The microbiome of the built environment and mental health. Microbiome 3(1):60 51. Canter DV, Craik KH (1981) Environmental psychology. J Environ Psychol 1(1):1–11 52. Oseland N (2009) The impact of psychological needs on office design. J Corp Real Estate 11(4):244–254 53. Cohen RA (2011) Yerkes-dodson law. Encyclopedia of Clinical Neuropsychology. Springer, London, pp 2737–2738 54. Franz G (2006) Space, color, and perceived qualities of indoor environments. Presented at the Environment, Health and Sustainable Development Proceedings of the 19th International Association for People-Environment Studies Conference (IAPS 2006), Hogrefe & Huber, Seattle, 18 July 2006 55. Nanda U, Pati D, Ghamari H, Bajema R (2013) Lessons from neuroscience: form follows function, emotions follow form. Intell Build Int 5(sup1):61–78 56. Brownson RC, Fielding JE, Maylahn CM (2009) Evidence-based public health: a fundamental concept for public health practice. Annu Rev Publ Health 30:20–175 57. Stevenson M, Thompson J, de Sá TH, Ewing R, Mohan D, McClure R, Sun X (2016) Land use, transport, and population health: estimating the health benefits of compact cities. Lancet 388(10062):2925–2935 58. Wei Y, Xiao W, Wen M, Wei R (2016) Walkability, land use and physical activity. Sustainability 8(1):65 59. Knuiman MW, Christian HE, Divitini ML, Foster SA, Bull FC, Badland HM, Giles-Corti B (2014) A longitudinal analysis of the influence of the neighborhood built environment on walking for transportation: the RESIDE study. Am J Epidemiol 180(5):453–461 60. Larice M, Macdonald E (2013) The urban design reader. Routledge, London 61. Wolch JR, Byrne J, Newell JP (2014) Urban green space, public health, and environmental justice: The challenge of making cities ‘just green enough’. Landsc Urban Plan 125:234–244 62. Koohsari MJ, Badland H, Giles-Corti B (2013) (Re) Designing the built environment to support physical activity: bringing public health back into urban design and planning. Cities 35:294–298 63. Giles-Corti B, Bull F, Knuiman M, McCormack G, Van Niel K, Timperio A, Middleton N (2013) The influence of urban design on neighbourhood walking following residential relocation: longitudinal results from the RESIDE study. Soc Sci Med 77:20–30 64. The Drive Towards Healthier Buildings 2016. (n.d.). https://www.worldgbc.org/sites/default/ files/Drive%20Toward%20Healthier%20Buildings%202016_ffff.pdf. Accessed 20 July 2019 65. American Housing Survey: A Measure of (Poor) Housing Quality. (n.d.). https://www.census. gov/programs-surveys/ahs/research/publications/PoorHousingQuality.html. Accessed 20 July 2019

References

35

66. Nelbach P (1950) An Appraisal Method for Measuring the Quality of Housing: A Yardstick for Health Officers, Housing Officials and Planners. Part III. Appraisal of Neighborhood Environment. American Public Health Assoication, Washington D.C 67. Duhl LJ, Sanchez AK, World Health Organization (1999) Healthy cities and the city planning process: a background document on links between health and urban planning. WHO Regional Office for Europe, Copenhagen

Chapter 3

Factors That Impact Human Health in the Built Environment

Conditions related to the built environment affect human health from numerous perspectives and across multiple dimensions [1]. Based on the multi-disciplinary, multi-scale, and multi-factor framework proposed in Chap. 2, this Chapter organizes influential factors of the built environment to human health into four categories based on the leading disciplines of the built environment research where the health impact is studied. The four primary categories are physical, physiological, biological, and psychological factors.

3.1 General Overview The modern scientific and empirical study of the built environment’s impact on human health can be traced back to the 1960s. There is a total of 4,779 publications (61,404 references) in the Web of Science database, from 1960 to 2019, on the topics “healthy building” and “healthy built environment.” The publications include books, journal papers, and conference proceedings. The top five leading research countries are the United States, China, the United Kingdom, Australia, and Canada (refer to Fig. 3.1). The top five most active research disciplines (refer to Fig. 3.2) are engineering with 922 publications, public environmental occupational health with 837 publications, construction building technology with 500 publications, environmental sciences (ecology) with 415 publications, and psychology with 259 publications. The results indicate the diverse and cross-disciplinary nature of this topic. Similarly, among the top ten most influential journals publishing studies on the impact of the built environment on human health, five are in the engineering field, four are in public health, and one is in environmental science (refer to Fig. 3.3). From the 4,779 publications, four topical clusters emerged (refer to Fig. 3.4) related to the four impact factor categories to human health in the built environment. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_3

37

38

3 Factors That Impact Human Health in the Built Environment

Fig. 3.1 Publications by countries and regions (Source Web of Science)

Fig. 3.2 Publications by research disciplines (Source Web of Science)

Fig. 3.3 Publications by journals (Source Web of Science)

3.1 General Overview

39

Fig. 3.4 Co-occurrence of keywords reflecting the impact factor categories

3.1.1 Cluster One (Green)—Engineering Field: Biological, Physical, and Physiological Factors This field studies the biological, physical, and physiological factors, with a focus on the indoor environment, such as pollution or contamination and exposure and their related health outcomes at the individual building level. Since the 1970s, studies have indicated that indoor conditions have induced health symptoms. As mentioned in Chap. 1, the sick building syndrome was closely tied to the indoor built environment and heavily correlated with design and construction techniques. Since then, certain research results have been integrated to design and construction regulations and planning policies. Most of the indoor environment solutions are preventive and riskaverse, and the overall goal is to control the indoor environmental quality and reduce harm to occupants. One of the most influential and longest-standing conferences in this field is healthy buildings, organized by the International Society of Indoor Air Quality and Climate (ISIAQ) since 1988. ISIAQ members represent the fields of building engineering, architectural design, building construction, and building science as well as building owners and managers. There are also members who work in the public health and public policy realm.

3.1.2 Cluster Two (Red)—Public Health and Public Policy Field: Physiological and Psychological Factors The focus and interest in this cluster mostly reflect work in the public health field, with a high concentration on policy and socio-demographic work. The policies mainly focus on population health and community building. From 1980 to around 2010, attention was placed on physiological factors at the building scale, such as pollution

40

3 Factors That Impact Human Health in the Built Environment

exposure and bacterial transmission. However, starting in 2010, the focus has gradually moved toward chronic conditions occurring at the larger community scale, such as obesity both in adults and children. Investigations into the health impact from buildings have begun in a large urban context; for instance, one of the early studies that initiated this trend was conducted by a group of researchers from Australia, in 2010, titled Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities [2]. The research team studied 328 households and 618 children, with findings revealing that the reported childhood respiratory infections were indeed associated with poor housing conditions and infrastructures, such as a cold and damp environment. However, the association did not exist for other childhood illnesses, such as diarrhea and ear infections [2]. The findings indicated that beyond the improvement of building conditions and functions, other factors from a socio-demographic environment could have a significant impact on the health status of children. For instance, the caregiver’s (normally, the parents and relatives) psychosocial status and health-related behavior, such as maintenance of the household and personal hygiene, were associated with a reported variety of childhood illnesses [2]. Therefore, the health outcomes of children are not only impacted by the physical conditions of the housing but also determined by the overall larger social environment. The findings from this early cross-sectional, large-scale research in the public health field introduced opportunities to expand the health impacts from buildings to the larger built environment, or from the indoors to the outdoors.

3.1.3 Cluster Three (Yellow)—Public Health Field: Physical and Physiological Factors The activities in this cluster are closely related to those in cluster two, or the red cluster. Following the shift in focus around 2010, interest from the public health field has continuously remained on the built environment’s impact at community level on a large population. The relation between obesity and physical activity has become the focal point, bringing together built environment designers and engineers, public health practitioners and researchers, policy makers, and public officials. Between 2010 and 2019, more than 300 publications centered on the connection between the built environment, obesity, and physical activity in China [3], the Czech Republic [4], South Korea [5] Australia [6], Belgium [6], Hong Kong, Denmark, and Mexico [7]. Furthermore, demographics span adults [5], adolescents [8], and preschoolers [9], among others. This cluster also serves as a link connecting public health concerns with land use and transportation design and planning, which eventually form the fourth cluster, or blue cluster.

3.1 General Overview

41

3.1.4 Cluster Four (Blue)—Urban Planning/Design and Engineering Field: Physical and Physiological Factors Unlike cluster one, cluster four is situated on the opposite side of the built environment spectrum, concentrating mainly on large-scale built environment planning and design and their impact on people’s mobility and physical activities. Although activities are most frequently considered within a recreational context, physical activities can be classified according to four domains of life that describe how people spend their time, one of which is active transportation, such as walking, biking, or using public transportation [10]. Active transportation is considered a strategic and integral pathway to improving physical activity levels and thus reducing overweight and obesity levels [10]. Since travel and mobility are essential to daily living, the level of physical activity is particularly significant to human health. Physical activities have an impact on a variety of chronic diseases, such as diabetes, cardiovascular illness, colon cancer, and mental health [11], among others. Physical activities are influenced by “objective” built environment characteristics that are defined and quantified by architects and urban planners according to four categories described in Sect. 3.3.2. In recent years, a physically inactive lifestyle has been recognized as a major public health challenge [12]. The epidemiologic evidence linking physical inactivity with numerous chronicle health problems emerged in the 1980s, and, since then, it has been extensively studied in the public health field [13]. While urban planning and transportation researchers have focused on health issues in the built environment, their main concerns are traffic-related pedestrian safety and outdoor air pollutionrelated health impacts [14]. Between the 1980s and early 2000s, public health and planning and transportation researchers have used divergent approaches to understand factors that may influence physical activity and non-motorized transport [15]. In the last 15 years, there has been great interest in cross-disciplinary research to bridge the transportation, planning, and engineering fields with public health through using public transportation and physical activity as connectors. The decision to use public transportation is largely influenced by larger urban characteristics, such as connectivity, safety, and a sense of community. A sense of community—which leads residents to perceive and associate a strong identity of character with particular physical settings—is a guiding principle in designing sustainable and livable built environments [16]. Moreover, greater direct physical engagement with the community further contributes to developing a “sense of community” [10]. The four clusters reflect the most recent research activities and also represent a multi-disciplinary and multi-scale trend.

42

3 Factors That Impact Human Health in the Built Environment

3.2 Four Factors Despite the connection of public health and built environment design, as illustrated in Fig. 3.4, there is lack of sufficient connections between cluster one (green) and cluster four (blue), or the building and urban scales, which represents some disengagement between the planning and design fields and the public health community. This gap represents an opportunity where integrated smart technologies could be used to bridge the disconnection of health impacts on different scales. In order to understand how and which smart technologies could be helpful to fill the gap, the first step is to gain a deeper understanding of the four built environment factors represented by the four research topical areas: physical factors, physiological factors, biological factors and psychological factors (refer to Fig. 3.5). The following sections guide readers through the four primary built environment factors.

Fig. 3.5 Four built environment factors affecting occupant health

3.3 Physical Factors

43

3.3 Physical Factors 3.3.1 Falls and Fire Hazards (Indoors) Physical factors are directly related to design and planning. One of the most important design concerns is ensuring occupant safety by preventing injuries, especially related to the reduction of falls, both indoors and outdoors [17]. Many of the building design features and materials used influence the risk of injuries; for instance, slippery floors and insufficiently lighted stairs [18] are among the common causes of injuries. Other less-known design features that could lead to injuries include unprotected upper-story windows and low sill heights [19]. In Britain, more than a third of all adult accidents occur in the home [20], and residents who reside in highrise buildings are more prone to falls from windows and balconies [21]. Besides the dangers of falling, fire hazards are another direct physical factor to human life that can be controlled and mitigated through proper planning and housing design. Well-designed fire protection and suppression features are critical for protecting occupants from fire. For instance, residential fires most often start in the kitchen; therefore, installing a fire alarm could reduce the risk. Moreover, the basic building structure and materials need to be designed to minimize the danger of accidents due to the collapse of buildings and potential injuries—even death—especially during a fire. In general, in developing countries with less-developed building regulations and codes, the harm caused by avoidable design deficiencies is higher than in developed countries with more comprehensive regulations. According to WHO, each year, an estimated 646,000 individuals die from falls globally, of which over 80% are in lowand middle-income countries [22]. Worldwide, certain physical factors related to safety concerns have already been written into building codes and become a standard practice in planning and design. For example, all buildings should be designed adequately to ensure occupants can escape in case of fire. Egress stairways and fire protection systems are created for that purpose. To protect occupants against the danger of electrical shocks and burns, building codes also specify the procedure and standards for different types of buildings. Other mechanical injuries, such as falls, can also be prevented and avoided by following design guidelines to design stairs with certain riser and thread dimensions as well as railings and balconies with certain safety measures. The abovementioned represent only a small percentage of regulations already established in building codes to ensure the design of healthy and safe buildings. There are other physical factors related to the safety and security of occupants that occur outside of individual buildings; these need to be studied and integrated into healthy building design guidelines.

44

3 Factors That Impact Human Health in the Built Environment

3.3.2 Safety and Security (Outdoors) According to Abraham Marslow’s hierarchy of needs, safety and security are fundamental to a human’s ability to thrive, coming only after the basic needs of food and water [23]. To date, only a small percentage of these two considerations have been integrated in building codes to ensure the design of healthy buildings, which was mentioned in the previous section. In the larger built environment, the impact of inadequate safety and security regulation on people’s health is not fully understood nor addressed in design. Broken windows on a building facade, trash and litter on streets, and damaged properties are signs of insecurity. When people perceive threats or danger, it triggers the multiple episodes of the fight-or-flight biological response [24], leading to long-term stress. This chronic stress could represent the onset of post-traumatic stress disorder or other mental health disorders [13]. One of the earliest studies conducted by a multi-disciplinary team at the University of Miami focused on the Hispanic elderly population in Miami. They found certain built environment features—such as front porches providing visibility on streets— signified social support and security, while others—for instance, windows that delivered an interior view—were perceived with negative social support or as unsafe. Perceived safety, security, and social support were in turn associated with reduced psychological distress [15]. Another highly influential study in 2009, conducted by Ewing and Dumbaugh, a researcher at the University of Maryland and Texas A&M University, provided a counter theory to the accepted transportation engineering theory, which stated that creating a safe neighborhood led to an increase in driving and an inactive lifestyle [25]. Instead of building wider roads, the study found that narrow lanes, traffic-calming measures, and street trees could enhance a roadway’s safety performance, thus encouraging residents to walk outside more. The research also indicated the fundamental shortcomings of the conventional traffic safety theory in that it fails to account for the moderating role of human behavior for all types of accidents. Human decisions and behavior cannot be treated as consistent; they change and interact differently with particular built environments. Therefore, in order to meaningfully address safety and security in the built environment, planners, engineers, and architects need to develop a basic understanding of how the built environment influences accident-related injuries, crashes, violence, and even death as well as the specific behaviors that cause them, which are induced by built environment factors [26].

3.4 Physiological Factors 3.4.1 Indoor Environmental Quality Physiological factors are factors in the built environment that stimulate an occupant’s physical bodily changes, consequently affecting occupant health or comfort.

3.4 Physiological Factors

45

For example, when the room temperature is too high or low, this type of deviation from the acceptable temperature range could be associated with an increased risk of cardiovascular disease [27]. The physiological factors that are closely associated with the building design (indoors) are temperature [20], humidity [28], ventilation [29], air quality 30], illuminance level [31], and acoustic level [32], and these factors comprise the indoor environmental quality (IEQ). A 2011 study [33] of 42 office buildings showed that mechanical ventilation in buildings (sealed buildings) produced more sick building symptoms (SBS) than naturally ventilated buildings (non-sealed buildings). However, more recent research has indicated opposing results, with the prevalence of SBS in non-sealed buildings being higher than in sealed buildings. Regardless of the varied findings, the majority of research and case studies support concerns concerning the linkage between a sealed indoor environment and biological factors that contribute to SBS. Ample evidence connects a building’s indoor environmental quality and characteristics to respiratory issues and lung conditions. These diseases have been scientifically linked to cold (indoor temperature) and damp (excessive indoor humidity) environments [34]. Furthermore, dampness and mold have been found to be associated with aches and pains in the human body [35]. Exposure to toxic substances indoors released from a building’s materials or paint can result in chronic headaches, itchy eyes, asthma, and lung disease as well [26]. Additionally, a higher level of exposure to carbon monoxide results in acute intoxication [36]. Other types of exposure—such as lead [37], asbestos [38], and radon [28]—and related health impacts have been greatly studied. Well-designed lighting is another highly important design element to support an occupant’s ability to perform daily tasks and decrease the level of disability associated with these impairments [39]. Inadequate indoor lighting affects both vision and the photobiological needs of the synchronization of the circadian rhythm, which impact sleep and trigger depression [40]. Besides lighting, research results consistently reveal that acoustic quantity and quality also have physiological impacts on occupants. Indoor noise has been shown to have a strong association with hypertension and high blood pressure levels, and the noise level is influenced by the room orientation and adjacency to windows. The interference and health impact from noise have been determined from studies of schools, offices, and health care facilities located in different countries, such as Nigeria [41], South Africa [42], Hong Kong [43], and the United States [44].

3.4.2 The Outdoor Built Environment and Physical Activity Architects and urban planners use four categories to define and quantify objective outdoor built environment characteristics: (a) urban form and density: housing, workplaces, or populations [36, 45]; (b) land use mix: the use and function of an area [46–39]; (c) architecture and design features: sidewalk coverage, architectural characteristics, and aesthetic values [48–50]; and (d) street characteristics: connectivity

46

3 Factors That Impact Human Health in the Built Environment

and accessibility attributes (e.g., block size and transportation modalities) [51, 52]. Other important features include transportation modes and urban green spaces. D’Alessandro et al. [53] have indicated that accessibility, connectivity, public open spaces, and natural parks have a strong correlation to human health in general [54] and, in particular, early child development and health [53]. Ewing and Cervero’s project in 2010 have implied that walkability is strongly related to land use diversity and the number of destinations within walking distance [55]. Another neighborhood study in a large urban center lead by Kardan and his team suggested that people—across the entire socio-economic and demographic spectrums—who live in neighborhoods with a higher density of trees on their streets reported a significantly higher health perception and less cardio-metabolic conditions [56]. The majority of existing studies revealed a beneficial relationship between built environment features and physical activity, further supporting the perception of health issues stemming from an inactive lifestyle. For example, in a 2012 literature review, based on the data found in 169 articles, nearly 89.2% of participants reported beneficial relationships between the built environment, physical activities, and various health conditions [57]. De Bourdeaudhuij and his research team suggested that a compact neighborhood layout with more places to walk resulted in a lower body mass index in 12 countries [58]. However, researchers from University of Minnesota found the correlation between increased physical activity and street layout, and that urban design was non-existent [59]. These types of conflicting results may be caused by insufficient research methods since more recent studies were conducted using simple observational study methods. Additional rigorous scientific and empirical research may be useful to better understand how the built environment positively affects human health through the increase of physical activities [60].

3.5 Biological Factors Biological contributors are associated with indoor and outdoor bacteria, mold, fungi, and other insect/mite conditions that can endanger an occupant’s health and wellbeing. The growth of biological factors inside a building can be caused by the unhealthy and inappropriate use of building materials; inadequate ventilation, as indoor dampness is related to false design and construction; and inadequate repair and maintenance [61, 62]. Constant exposure to such factors can result in reoccurring health-related issues, such as respiratory diseases and allergies [63, 64]. Normally, biological factors are closely tied to the physical conditions of buildings, particularly the indoor environment. Recently, a new subfield has emerged, the “microbiology of the built environment,” which examines the communities of microorganisms found in human-constructed environments. Gilbert and Stephens indicated “the physical and chemical properties of buildings and the surface materials encountered by microorganisms in the built environment are for the most part very different compared with those in the natural environment” [65]. Different surface chemistries and physical structures promote the growth of various organisms [60]. For instance, shower

3.5 Biological Factors

47

curtains are mainly colonized by bacterial taxa associated with Sphingomonas and Methylobacterium [4]. The former can be linked to diseases such as septic arthritis and peritonitis [66], while Methylobacterium species are the cause of infections, including severe bloodstream infections, peritonitis, and pneumonia [67]. Microorganism conditions can affect patients in hospitals as well as the health of inhabitants in their homes. Children are particularly sensitive to microbiological environment changes. A research group in Finland recently published findings revealing that a farm-like, indoor microbial environment in non-farm homes can protect children from asthma development. Moreover, the protective effect is not dependent on the richness and total number of bacteria in the indoor environment; instead, it is associated with proinflammatory cytokine responses against bacterial cell wall components [68]. Farmhouses are rich in bacteria compared to non-farmhouses, but the latter have higher portions of human-associated bacteria. Even though this observational study did not reveal the causality of the protection, their findings confirmed the causal relationship between microbial exposure and certain health effects through indoor microbial exposure-modifying intervention [69]. Much more research is required to determine how the ubiquitous distribution of bacteria in the built environment influences specific health outcomes. Researchers predict that we remain many decades away from being able to apply the findings to create support for a legal case [60]. However, in the clinical research field, the dynamic interaction between the indoor physical environment and the metabolism and transmission pathways of microbial communities has reignited the conversation in refining how to better design and operate spaces in buildings to create healthful indoor microbiota and what building materials should be selected considering their potential to host certain bacteria [60]. Several possible design interventions were identified to reduce exposure to harmful microorganisms and promote exposure to beneficial ones. Those inventions typically include local control of temperature, humidity, lighting, and ventilation, the physiological factors explained in the previous section [67, 70]. For example, ventilation is a common strategic intervention to reduce an occupant’s exposure to bad microbiome. Two techniques are often applied: natural ventilation and mechanical ventilation. Natural ventilation can introduce outdoor air that either replaces the contaminated air with fresh outdoor air or dilutes the pollution indoors. However, the effectiveness of natural ventilation will depend on the filtration rate and the outdoor air condition [71]. Leakage and infiltration of the air are often associated with energy inefficiency. Therefore, in recent years, the majority of building ventilation has relied on mechanical systems, which are often composed of an airtight building envelope and mechanical ventilation. Making the building envelope tighter could help to reduce the infiltration, leading to a better controlled indoor temperature and humidity, thus lowering the likelihood of indoor moisture accumulation and reducing the entry rates of outdoor microbes [72]. However, a tighter building envelope and limited entrance of outdoor microbes might lead to an imbalanced indoor and outdoor microbe environment. The potential health outcome of this type of highly controlled biological environment has not been fully studied nor understood. This lack of understanding is

48

3 Factors That Impact Human Health in the Built Environment

partially due to the absence of a scientific research method. There are no accepted methods for defining and quantifying the “normal” level of microbiome in buildings as well as what levels are too high or low. Without a benchmark or standard, it is hard to determine whether the biological environment inside a building is healthy or harmful. Therefore, in current common practice, creating a balanced and beneficial microbial environment is not yet part of design concerns.

3.6 Psychological Factors 3.6.1 The Connection Between Psychological Impact and Physiological Impact Psychological factors go beyond basic human health, aimed at promoting or understanding an occupant’s optimal physiological, mental, and social health performance. A large number of psychological factors are intertwined with physiological factors, such as lighting and sound. Hwang and Kim studied 2,744 healthy occupants for 1.5 years to investigate the effects of indoor lighting on occupants’ visual comfort and eye health [73]. The studies had multiple findings: there was a significant correlation between the occupants’ visual comfort and the lighting conditions and luminance distribution of windows; further, daylight improved the occupants’ psychological health and productivity [69]. Öztürk and his team investigated the influence of room color in workplaces on workers’ performance, mood, and well-being and found that workplaces with colorful interiors tended to enhance performance more than those with an achromatic color scheme [74, 75]. Moreover, certain colors increased positive feelings more than others, influencing the speed of work, rate of accuracy, and absence of errors [76]. Room size is one of the primary factors that influences occupants’ affective response [77], with larger spaces perceived more positively than smaller ones [78]. Other psychological factors studied were related to overall housing and the built environment quality. Since the 1980s, lots of studies in Europe and the United States have examined the relationship between housing quality and its impact on mental health. According to Kasl, housing quality was found to have a strong link to psychological distress among adults living in lower quality neighborhoods [79]. In particular, high-rise buildings were found to be associated with poorer adult mental health, and the cause was believed to be social isolation [80, 81]. [82] indicated that the type of urban area in which people lived was more closely associated with levels of psychological impairment than the type of housing that they inhabited [83]. In more recent research, Rollings et al. [84] studied the connection between the physical quality of housing and neighborhoods and its impact on children’s mental health and motivation. They found that neither the physical quality of a neighborhood nor the interaction between housing quality and neighborhood quality was significant predicators of any health outcomes, with socio-demographic factors playing a more

3.6 Psychological Factors

49

important role [85]. Similar to the conflicting study results related to the outdoor built environment quality and physical activities previously mentioned, a lack of scientific proof and empirical data may contribute to the uncertainty surrounding the built environment and human health.

3.6.2 Defining Mental Health Impact Often, the design and quality of the built environment has a latent effect on people’s mental health and well-being, which is not easy to directly measure and requires more empirical research. Good mental health is much more than simply the absence of mental illness. To be mentally healthy means to be happy; to have peace of mind, harmony of desires and successes, and resilience to life’s tough problems [84]. WHO defined mental health as “a state of well-being in which every individual realizes his or her own potential, can cope with normal stresses of life, can work productively and fruitfully, and is also able to make a contribution to her or his community” [86]. This is a very broad interpretation, and among different disciplines, the term “well-being” has different meanings. However, it is generally agreed that well-being is different and separate from health, comfort, and happiness. In order to explain the impact of buildings on well-being, the term needs to be defined. Two key definitions of well-being that are rooted in psychology are hedonic well-being and eudemonic well-being [87]. Hedonic well-being is a general description of perceived life satisfaction and a lack of negative feelings [87]; it is also referred to as “subjective well-being.” In this book, hedonic well-being is described as the mental health of the occupants and may be induced by a variety of factors in the built environment. Eudemonic well-being is related to self-determination [88] and success [89]. In this sense, eudemonic well-being is a combination of thinking, feeling, and function, which could be defined as cognitive satisfaction (achieved through goal accomplishment) [88]. The synthesis of cognitive function and affective emotion, equating to the concept of success, is of particular interest in the context of growing demands for occupant satisfaction and productivity in buildings. Therefore, in the following sections, eudemonic well-being is discussed together with occupant productivity.

3.6.3 Mental Health and Well-Being (Hedonic Well-Being) The causes and triggers to mental health from the built environment exist on two different scales: the building scale and urban scale. At the building scale, to date, the most comprehensive and influential research on the impact of building design on health outcomes is a paper published in 2008 by Roger Ulrich and his colleagues. They examined light, noise, room types, and safety feature in buildings [83], which established a foundation for many research directions afterward. Since then, most

50

3 Factors That Impact Human Health in the Built Environment

studies have explored the direct causes between environmental factors and occupant well-being. At the urban scale, academic studies since the 1970s have provided evidence that neighborhood characteristics—such as noise level, a lack of green space, housing type [90, 91], housing quality [92], and the aesthetics of buildings and streets [93]—have an effect on residence’s mental health.

3.6.4 Cognitive Function and Productivity (Eudemonic Well-Being) Unlike hedonic well-being, cognitive functions and productivity can be measured. Since the 1990s, there has been a surge of research activities aimed at identifying the impact of building features on cognitive tasks—such as learning, thinking, and writing—with a focus on understanding the benefits of green buildings on human productivity. Similarly, researchers also found that non-green buildings with a poorer indoor environmental quality (IEQ) could impair occupants’ cognitive functions. A recent study conducted by Harvard T.H. Chan School of Public Health found that under green building conditions (with lower CO2 and VOC exposure), nine cognitive function domains,1 all performed significantly better. They concluded that the office workers had considerably improved cognitive functions scores when working in “green” environments [88]. Other researchers indicated thermal comfort as being one of the important variables that affect people’s mood, consequently influencing behavior and productivity [94]. Other than thermal comfort, noise was found to impair workers’ concentration in offices, especially telephones left ringing at vacant desks and people talking in the background [95]. Additionally, a direct view of nature from inside a building regulates stress levels and has shown certain effects on productivity as well. MacNaughton et al. [94] studied workers from ten office buildings across five US cities in a week-long session. Their empirical results indicated that workers in LEED-certified green buildings scored almost 30% higher on cognitive function tests and 6.4% higher on sleep quality and had 30% less sick building symptoms compared to those in non-LEED-certified green buildings. The current number of existing studies with a focus on psychological factors to occupants’ social performance and mental health is relatively limited [93]. However, results from the existing body of studies have suggested that two types of variables and factors from the built environment influence peoples’ mental health and well-being: the mediating factor and moderating factor [91].

1 These

cognitive function domains are basic activity level, applied activity level, focused activity level, task orientation, crisis response, information seeking, information usage, breadth of approach, and strategy.

3.6 Psychological Factors

51

3.6.5 Mediating and Moderating Factors The first type is mediating factors/variables; they are part of a causal link between the built environment and the health outcome. Noise, lighting, and indoor air quality all fall under these types of factors. Those variables are discussed earlier in this chapter and belong either to outdoor or indoor observed variables. The second type of variables is moderating factors, which are normally hard to measure, and they are associated with differences in health outcomes but not in a causal sense [96]. The proportion of space, building form, and aesthetic value are moderating factors; together, these variables can define spatial quality. Evans [91] summarized that spatial quality could directly regulate social interaction. The size, location, and permeability of interior spaces influence the degree of social interaction that occupants feel comfortable with. For instance, small intimate spaces are suitable for solitude, whereas larger and more open spaces invite public interaction opportunities [93]. Other studies found that tall and large structures, long and straight corridors, and the obstruction of views to entrances (general indications of a lack of “personal control”) are linked to fear of crime or actual crime and essentially lead to social isolation [93]. Those design features can often be found in public housing projects completed around the 1960s (refer to Fig. 3.6). Spatial quality has been used to describe and define the aggregated outcome of many latent variables. It can be used in an individual building or larger urban context. Those hidden factors were initially outlined in Basic Principles of Healthful Housing, published by the American Public Health Association in 1938 (mentioned in Chap. 1). In section B, “Fundamental Psychological Needs,” six design principles for healthy buildings were identified: need for privacy, opportunity for normal family life, opportunity for normal community life, reduction of mental fatigue, aesthetic satisfaction, and concordance with prevailing social standards [96]. However, this document did not provide a detailed explanation of how building design or urban design methods could be implemented to ensure adequate psychological outcomes. Fig. 3.6 The interior of Unités d’habitation (design by Le Corbusier; Source Wikimedia Commons)

52

3 Factors That Impact Human Health in the Built Environment

The physical health outcomes from latent variables are generally conceptually understood, but the psychological health outcomes associated with latent variables are less studied.

3.7 Conclusion Overall, the four built environment factors (physical, physiological, biological, and psychological factors) are often interrelated and difficult to be extrapolated. For instance, excessive noise levels caused by insufficient acoustic insulation in the partition wall is a physical factor, but it also leads to sleep deprivation, which essentially could cause psychological stress and activation of the hypothalamic–pituitary– adrenal axis and sympathetic nervous system, thus influencing how people think and feel [97]. Indoor pollution can cause discomfort and impact productivity through influencing cognitive functions [98]. Among the four factors, the psychological and biological factors affecting human health have been less explored, partially due to their difficulties to be quantified and measured. With the development of new methods and advancement of smart technologies, the ability to accurately measure the biological and psychological factors is practical. The first step to develop an appropriate smart technology that can help to monitor and assess those impact factors is to gain a deeper understanding of how those impact factors of the build environment could affect human health (e.g., in what mechanisms, in which ways, and to what extent). Chapter 4 will provide readers with a thorough explanation.

References 1. Li W, Keegan T, Sternfeld B, Sidney S, Quesenberry C, Kelsey J (2006) Outdoor falls among middle-aged and older adults: a neglected public health problem. Am J Public Health 96(7):1192–1200 2. Keegan T, Sternfeld B, Sidney S, Quesenberry C, Kelsey J (2006) Outdoor falls among middleaged and older adults: a neglected public health problem. Am J Public Health 96(7):1192–1200 3. Bailie R, Stevens M, McDonald E, Brewster D, Guthridge S (2010) Exploring cross-sectional associations between common childhood illness, housing and social conditions in remote Australian Aboriginal communities. BMC Public Health 10(1):147 4. Zhang T, Li H, Skitmore M (2019) Built environment and physical activity in suburban Guangzhou residences: a people–environment transaction perspective. J Urban Plan 145(4):05019013 5. Cuberek R, Pelclová J, Gába A, Pechová J, Svozilová Z, Pˇridalová J, Hron K (2019) Adiposity and changes in movement-related behaviors in older adult women in the context of the built environment: a protocol for a prospective cohort study. BMC Public Health 19(1):1–7 6. Lee EY, Lee S, Choi BY, Choi J (2019) Influence of neighborhood environment on korean adult obesity using a bayesian spatial multilevel model. Int J Environ Res Public Health 16(20):3991 7. Owen N, De Bourdeaudhuij I, Sugiyama T, Leslie E, Cerin E, Van Dyck D, Bauman A (2010) Bicycle use for transport in an Australian and a Belgian city: associations with built-environment attributes. J Urban Health 87:189–198

References

53

8. Kerr J, Emond JA, Badland H, Reis R, Sarmiento O, Carlson J, Schofield G (2015) Perceived neighborhood environmental attributes associated with walking and cycling for transport among adult residents of 17 cities in 12 countries: the IPEN study. Environ Health Perspect 124(3):290– 298 9. Nelson MC, Gordon-Larsen P, Song Y, Popkin BM (2006) Built and social environments: associations with adolescent overweight and activity. Am J Prev Med 31(2):109–117 10. Robinson JC, Temple ML, Duck A, Klamm M (2019) Feasibility and effectiveness of two built environmental interventions on physical activity among 3–5-year-old preschoolers. J Spec Pediatr Nurs 24(3):e12262 11. Roberts J, Hu M, Saksvig B, Brachman M, Durand C (2018) Examining the influence of a new light rail line on the health of a demographically diverse and understudied population within the Washington, DC metropolitan area: a protocol for a natural experiment study. Int J Environ Res Public Health 15(2):333 12. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion (1996) Physical Activity and Health: A Report of the Surgeon General. https://www.cdc.gov/nccdphp/sgr/pdf/sgrfull. pdf. Accessed 7 July abbreviated 2019 13. Jansen AS, Van Nguyen X, Karpitskiy V, Mettenleiter TC, Loewy AD (1995) Central command neurons of the sympathetic nervous system: basis of the fight-or-flight response. Science 270(5236):644–646 14. Sallis JF, Frank LD, Saelens BE, Kraft MK (2004) Active transportation and physical activity: opportunities for collaboration on transportation and public health research. Transp Res A Pol Pract 38(4):249–268 15. Schneiderman N, Ironson G, Siegel SD (2005) Stress and health: psychological, behavioral, and biological determinants. Annu Rev Clin Psychol 1:607–628 16. Litman T (2002) If health matters: Integrating public health objectives in transportation planning. Virtoria Transport Policy Institute, Victoria, BC 17. Puddifoot JE (1995) Dimensions of community identity. J Community Appl Soc Psychol 5:357–370 18. Oakley A, Dawson MF, Holland J, Arnold S, Cryer C, Doyle Y, Sheldon T (1996) Preventing falls and subsequent injury in older people. Qual Health Care 5(4):243 19. American Academy of Pediatrics (2001) Falls from heights: windows, roofs, and balconies. Pediatrics 107(5):1188–1191 20. Burge S, Hedge A, Wilson S, Bass JH, Robertson A (1987) Sick building syndrome: a study of 4373 office workers. Ann Occup Hyg 31(4A):493–504 21. World Health Organization (2018) Falls (nd) https://www.who.int/news-room/fact-sheets/det ail/falls. Accessed 20 July 2019 22. Shaw M (2004) Housing and public health. Annu Rev Public Health 25:397–418 23. Stollard P (2003) Crime prevention through housing design. Taylor & Francis, London 24. Maslow AH (1943) A theory of human motivation. Psychol Rev 50(4):370 25. Brown SC, Mason CA, Lombard JL, Martinez F, Plater-Zyberk E, Spokane AR, Szapocznik J (2009) The relationship of built environment to perceived social support and psychological distress in Hispanic elders: the role of “eyes on the street”. J Gerontol Series B 64(2):234–246 26. Benveniste G (1989) Mastering the politics of planning: crafting credible plans and policies that make a difference. Jossey-Bass Inc Pub, San Francisco 27. Ewing R, Dumbaugh E (2009) The built environment and traffic safety: a review of empirical evidence. J Plan Lit 23(4):347–367 28. Krieger N (1999) Questioning epidemiology: objectivity, advocacy, and socially responsible science. Am J Public Health 89(8):1151–1153 29. Holmes SH, Phillips T, Wilson A (2016) Overheating and passive habitability: indoor health and heat indices. BRI 44(1):1–19 30. Persily A (2015) Challenges in developing ventilation and indoor air quality standards: the story of ASHRAE Standard 62. Build Environ 91:61–69

54

3 Factors That Impact Human Health in the Built Environment

31. Pitarma R, Marques G, Ferreira BR (2017) Monitoring indoor air quality for enhanced occupational health. J Med Syst 41(2):23 32. Figueiro MG, Steverson B, Heerwagen JH, Rea MS (2015) Daylight in office buildings: Impact of building design on personal light exposures, sleep and mood. Proceedings of the 28th Session of the CIE. https://www.semanticscholar.org/paper/DAYLIGHT-IN-OFFICEBUILDINGS%3A-IMPACT-OF-BUILDING-ON-Figueiro-Steverson/ac5a0ccc0bd5aded02 4769b77573e9f365bc93b2. Accessed 20 July 2019 33. Freihoefer K, Guerin D, Martin C, Kim HY, Brigham JK (2015) Occupants’ satisfaction with, and physical readings of, thermal, acoustic, and lighting conditions of sustainable office workspaces. Indoor Built Environ 24(4):457–472 34. Boechat J, Rios J, Ramos M, Luiz R, Neto FA, e Silva JL (2011) Sick Building Syndrome (SBS) Among Office Workers and Exposure to Indoor Fungal Allergens in Rio de Janeiro, Brazil. J Allergy Clin Immun 127(2):AB178 35. Bambra C (2016) Health divides: where you live can kill you. Policy Press, Bristol 36. Johansson P, Svensson T, Ekstrand-Tobin A (2013) Validation of critical moisture conditions for mould growth on building materials. Build Environ 62:201–209 37. Jargowsky PA (1997) Poverty and place: Ghettos, barrios, and the American city. Russell Sage Foundation, New York 38. Tesh SN (2018) Uncertain hazards: Environmental activists and scientific proof. Cornell University Press, Ithaca 39. Wei YD, Xiao W, Wen M, Wei R (2016) Walkability, land use and physical activity. Sustainability 8(1):65 40. Brawley EC (2009) Enriching lighting design. Neuro. Rehabilitation 25(3):189–199 41. Foraster M, Künzli N, Aguilera I, Rivera M, Agis D, Vila J, Ramos R (2014) High blood pressure and long-term exposure to indoor noise and air pollution from road traffic. Environ Health Perspect 122(11):1193–1200 42. Seabi J (2013) An epidemiological prospective study of children’s health and annoyance reactions to aircraft noise exposure in South Africa. Int J Environ Res Public Health 10(7):2760–2777 43. Gou Z, Lau SS-Y, Shen J (2012) Indoor environmental satisfaction in two LEED offices and its implications in green interior design. Indoor Built Environ 21(4):503–514 44. Lee YS, Kim S-K (2008) Indoor environmental quality in LEED-certified buildings in the US. J Asian Archit Build 7(2):293–300 45. Brownson RC, Baker EA, Deshpande AD, Gillespie KN (2017) Evidence-based public health. Oxford University Press, London 46. Frumkin H (2002) Urban sprawl and public health. Public Health Rep. 17:201–217 47. Stevenson M, Thompson J, de Sá TH, Ewing R, Mohan D, McClure R,nWallace M (2016) Land use, transport, and population health: estimating the health benefits of compact cities. Lancet 388(10062):2925–2935 48. Knuiman MW, Christian HE, Divitini ML, Foster SA, Bull FC, Badland HM, Giles-Corti B (2014) A longitudinal analysis of the influence of the neighborhood built environment on walking for transportation: the RESIDE study. Am J Epidemiol 180(5):453–461 49. Jackson RJ, Dannenberg AL, Frumkin H (2013) Health and the built environment: 10 years after. Am. J. Public Health 103(9):1542–1544 50. Larice M, Macdonald E (eds) (2013) The urban design reader. Routledge, London 51. Wolch JR, Byrne J, Newell JP (2014) Urban green space, public health, and environmental justice: The challenge of making cities ‘just green enough’. Landsc Urban Plan 125:234–244 52. Koohsari MJ, Badland H, Giles-Corti B (2013) (Re)Designing the built environment to support physical activity: bringing public health back into urban design and planning. Cities 35:294–298 53. D’Alessandro D, Buffoli M, Capasso L, Fara GM, Rebecchi A, Capolongo S (2015) Green areas and public health: improving wellbeing and physical activity in the urban context. Epidemiol Prev 39(4):8–13 54. Koohsari MJ, Mavoa S, Villanueva K, Sugiyama T, Badland H, Kaczynski AT, Giles-Corti B (2015) Public open space, physical activity, urban design and public health: Concepts, methods and research agenda. Health Place 33:75–82

References

55

55. Christian H, Zubrick SR, Foster S, Giles-Corti B, Bull F, Wood L, Boruff B (2015) The influence of the neighborhood physical environment on early child health and development: A review and call for research. Health Place 33:25–33 56. Ewing R, Cervero R (2010) Travel and the built environment: a meta-analysis. JAPA 76(3):265– 294 57. Kardan O, Gozdyra P, Misic B, Moola F, Palmer LJ, Paus T, Berman MG (2015) Neighborhood greenspace and health in a large urban center. Sci 5:11610 58. Ferdinand AO, Sen B, Rahurkar S, Engler S, Menachemi N (2012) The relationship between built environments and physical activity: a systematic review. Am J Public Health 102(10):e7– e13 59. De Bourdeaudhuij I, Van Dyck D, Salvo D, Davey R, Reis RS, Schofield G, Sugiyama T (2015) International study of perceived neighbourhood environmental attributes and Body Mass Index: IPEN Adult study in 12 countries. Int J Behav Nutr Phys Act 12(1):62 60. Gilbert JA, Stephens B (2018) Microbiology of the built environment. Nat Rev Microbiol 16(11):661–670 61. Oakes JM, Forsyth A, Schmitz KH (2007) The effects of neighborhood density and street connectivity on walking behavior: the Twin Cities walking study. Epidemiol Perspect Innov 4(1):16 62. Pietrzyk K (2015) A systemic approach to moisture problems in buildings for mould safety modelling. Build Environ 86:50–60 63. Norbäck D, Zock J, Plana E, Heinrich J, Tischer C, Jacobsen Bertelsen R, Olivieri M (2017) Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II. Indoor Air 27(5):921–932 64. Kielb C, Lin S, Muscatiello N, Hord W, Rogers-Harrington J, Healy J (2015) Building-related health symptoms and classroom indoor air quality: a survey of school teachers in New York State. Indoor Air 25(4):371–380 65. Hwang T, Kim JT (2011) Effects of indoor lighting on occupants’ visual comfort and eye health in a green building. Indoor Built Environ 20(1):75–90 66. Tuson HH, Weibel DB (2013) Bacteria–surface interactions. Soft Matter 9(17):4368–4380 67. Göker T, A¸sık RZ, Yılmaz MB, Çelik ˙I, Tekiner A (2017) Sphingomonas paucimobilis: a rare infectious agent found in cerebrospinal fluid. J Korean Neurosurg Soc 60(4):481 68. Kovaleva J, Degener JE, van der Mei HC (2014) Methylobacterium and its role in health care-associated infection. J Clin Microbiol 52(5):1317–1321 69. Kirjavainen PV, Karvonen AM, Adams RI, Täubel M, Roponen M, Tuoresmäki P,… Renz H (2019) Farm-like indoor microbiota in non-farm homes protects children from asthma development. Nat Med 1:81 70. Stephens B (2016) What have we learned about the microbiomes of indoor environments? M Systems 1(4):e00083–16 71. Adams RI, Bhangar S, Dannemiller KC, Eisen JA, Fierer N, Gilbert JA, Stephens B (2016) Ten questions concerning the microbiomes of buildings. Build Environ 109:224–234 72. Schulze T, Eicker U (2013) Controlled natural ventilation for energy efficient buildings. Energy Build 56:221–232 73. National Academies of Sciences, Engineering, and Medicine (2017) Microbiomes of the Built Environment: A Research Agenda for Indoor Microbiology, Human Health, and Buildings. National Academies Press, Washington DC 74. Ghaffarianhoseini A, AlWaer H, Omrany H, Alalouch C, Clements-Croome D, Tookey J (2018) Sick building syndrome: are we doing enough? Archit Sci Rev 61(3):99–121 75. Öztürk E, Yılmazer S, Ural SE (2012) The effects of achromatic and chromatic color schemes on participants’ task performance in and appraisals of an office environment. Color Res Appl 37(5):359–366 76. Manav B (2017) Color-emotion associations, designing color schemes for urban environmentarchitectural settings. Color Res Appl 42(5):631–640

56

3 Factors That Impact Human Health in the Built Environment

77. Lebedkov SM, Panteleeva NS, Stepanova IV (2012) Influence on visual working capacity of colour decoration of the workplace for work with a computer. Light Eng 20(3):20–25 78. Stamps AE III (2011) Effects of area, height, elongation, and color on perceived spaciousness. Environ Behav 43(2):252–273 79. Franz G (2006) Space, color, and perceived qualities of indoor environments. In: Environment, health and sustainable development Proceedings of the 19th International Association for People-Environment Studies Conference. Hogrefe & Huber, Seattle 80. Kasl SV, Will J, White M, Marcuse P (1982) Quality of the residential environment and mental health. In: Baum A, Singer JE (eds) Advances in environmental psychology. Erlbaum, Hillsdale, pp 1–30 81. Chatterjee M (2018) A study on loneliness and social interaction pattern among the high rise dwellers of Kolkata city. Res J Soc Sci 9(4) 82. MaCarthy, J. B., Basara, M. L., Palm, S. L., Sas, D. F., & Furcht, L. T. (1985) The role of cell adhesion protein-laminin and fibronectin-in the movement of malignant and metastatic cell. Cancer Metastasis Rev, 4:125–152 83. Deci EL, Ryan RM (2008) Hedonia, eudaimonia, and well-being: an introduction. J Happiness Stud 9(1):1–11 84. Rollings KA, Wells NM, Evans GW, Bednarz A, Yang Y (2017) Housing and neighborhood physical quality: children’s mental health and motivation. J Environ Psychol 50:17–23 85. McCarthy P, Byrne D, Harrison S, Keithley J (1985) Housing type, housing location and mental health. Soc Psych 20(3):125–130 86. Duval AM (1960) Building a mentally healthy community. Psychiat Serv 11(8):7–11 87. World Health Organization. Mental health: a state of well-being. https://www.who.int/features/ factfiles/mental_health/en/. Accessed 21 March 2019 88. Suglia SF, Duarte CS, Sandel MT (2011) Housing quality, housing instability, and maternal mental health. J Urban Health 88(6):1105–1116 89. Ryan RM, Deci EL (2001) On happiness and human potentials: A review of research on hedonic and eudaimonic well-being. Annu Rev Psychol 52(1):141–166 90. Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, Joseph A (2008) A review of the research literature on evidence-based healthcare design. HERD 1(3):61–125 91. Evans GW, Wells NM, Moch A (2003) Housing and mental health: a review of the evidence and a methodological and conceptual critique. J Soc Issues 59(3):475–500 92. Gifford R (2002) Satisfaction, health, security and social relations in high rise buildings. In: Social effects of the building environment. E & FN Spon, London 93. Banbury SP, Berry DC (2005) Office noise and employee concentration: Identifying causes of disruption and potential improvements. Ergonomics 48(1):25–37 94. Allen JG, MacNaughton P, Satish U, Santanam S, Vallarino J, Spengler JD (2015) Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: a controlled exposure study of green and conventional office environments. Environ Health Perspect 124(6):805–812 95. Geng Y, Ji W, Lin B, Zhu Y (2017) The impact of thermal environment on occupant IEQ perception and productivity. Build Environ 121:158–167 96. Dunn JR, Hayes MV (2000) Social inequality, population health, and housing: a study of two Vancouver neighborhoods. Soc Sci Med 51(4):563–587 97. Winslow CEA (1939) Basic principles of healthful housing. American Public Health Association, Washington DC 98. Richards EH (1910) Sanitation in daily life. Whitcomb & Barrows, Boston

Chapter 4

Indoor Environmental Impact on Human Health

Following the discussion in Chap. 3, This Chapter focuses on the indoor built environment to provide a deeper understanding of how the built environment may have a causal relation to certain health outcomes. Five indoor variables are identified and their health impacts explained to build a foundation for comprehending the need for smart technologies, which will be introduced in Chap. 5. Finally, the conversation shifts from existing built environmental quality deficiencies to potential opportunities for smart technology applications with the aim to create a healthy built environment, setting the tone for Chap. 5.

4.1 Indoor Observed Variables In both developed and developing countries, majority of people spend more than 90% of their time indoors, either in buildings or cars [1]. Since the early 1970s, there have been numerous guidelines and policies regulating indoor environmental quality. Under the 1970 Clean Air Act (revised in 1990), the U.S. Environmental Protection Agency (EPA) was authorized to establish National Air Quality Standards (NAQS), which regulate both outdoor and indoor air quality. Other indoor environmental quality factors are identified in NAQS as well, such as mold and lead paint [2]. Another agency in the United States, the National Institute for Occupational Safety and Health (NIOSH), identifies multiple variables that affect indoor environmental quality: building ventilation and HVAC systems, dampness and mold, chemicals and odors, and temperature and humidity, among others; NIOSH also provides related control strategies [3]. Besides the policies, standards, and regulations from governmental agencies, professional and industry organizations also have standards and building codes to ensure the minimal indoor environmental quality can be met. In the United States, one of the leading professional organizations, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), has © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_4

57

58

4 Indoor Environmental Impact on Human Health

traditionally addressed indoor environmental quality through minimum ventilation and thermal comfort requirements in building codes. These requirements have been based on industry consensus standards, such as ANSI/ASHRAE Standard 62.1/62.2 for ventilation and indoor air quality and ANSI/ASHRAE Standard 55 for thermal environmental condition for human occupancy [4]. In other countries, different organizations have also established minimal standards for indoor air quality and thermal comfort [5]. The effects of indoor environmental quality (IEQ) on occupants are often highly complex and can be both short term and long term [6]. The potential health issues induced by IEQ include respiratory, pulmonary, and cardiovascular diseases and visual impairment, among others. Based on research findings, these diseases can be associated with certain building components and systems. Excessive moisture in building assemblies, particularly in the building envelope (façade and roof), leads to dampness and mold conditions indoors, which has been associated with respiratory diseases [4]. Evidence indicates indoor air pollution is linked to pulmonary and cardiovascular diseases [7] that are potentially caused by the combination of an insufficient ventilation rate and moisture and dirt in mechanical systems. Other indoor building quality-related health issues, such as sick building syndrome, are difficult to pinpoint to particular building features, elements, or design solutions; therefore, it is challenging to determine direct and effective mitigation strategies. Besides physical health, IEQ variables also influence occupants’ mental health, well-being, and productivity [8, 9] through design-related indoor spatial quality, visual quality, and social environment [10], which will be addressed in the last section of this chapter. Overall, the consensus among researchers indicates that the primary variables of IEA and related measurements are indoor air quality (IAQ), indoor thermal comfort (ITC), indoor lighting quality (ILQ), indoor view quality (IVQ), indoor sound quality (ISQ), and indoor spatial quality (ISPQ). The understanding and measurements of the aforementioned six variables draw research findings from building physics, human ecology, and environmental psychology (refer to Fig. 4.1). In the following sections, detailed explanations are provided for each of the variables.

Fig. 4.1 Variables of indoor environmental quality

4.2 Indoor Air Quality (IAQ)

59

4.2 Indoor Air Quality (IAQ) Indoor air quality (IAQ) is a simplified term that is used to describe the complex topic of how indoor air may affect human health, comfort, and productivity. Since the 1970s, findings from scientific research about IAQ have grown. Recently, researchers in Harvard T.H. Chan School of Public Health summarized IAQ as being influenced by three primary factors: pollutants generated indoors from building materials and products, pollutants generated outdoors that infiltrate indoors, and building systems that mitigate or exacerbate those exposures [11]. One of the most common pollutant sources is off-gas formaldehyde from a range of building materials and products, such as engineered wood products, paper products, and adhesives, among others. The short-term health impacts from formaldehyde include a burning sensation in the eyes, nose, or throat; coughing; nausea; and other types of irritation [12]. Potential long-term health effects could lead to leukemia, particularly myeloid leukemia, based on studies by the National Cancer Institute [13]. Another common pollutant source is volatile organic compounds (VOCs). VOCs are emitted as gases and include a variety of chemicals that have short-term, as well as long-term, health effects [14], such as eye, nose, and throat irritation and headaches. VOCs can be found in a variety of building materials and furnishings, paint, carpet, vinyl flooring, caulks, adhesive, and some composite wood products [15]. Pollutant sources from outside include radon and diesel exhaustion from car traffic and other activities. In the public health field, it was initially quite clear that indoor air quality played an important role in occupancy health. This is reflected in a report published in 2000 by WHO declaring the human right to healthy indoor air: “Indoor air quality is an important determinant of health and wellbeing…. The control of indoor air quality is often inadequate in spite of its significant role in determining health” [16, 17]. In the building and construction industry, acceptance of the relation between building systems, indoor air quality, and health outcomes has not been easily accepted, regardless of the fact that IAQ is directly linked to building ventilation systems through the regulation of the indoor and outdoor air exchange rate. Ventilation systems are designed to bring fresh outside air indoors and dilute occupantgenerated pollutants, such as odors, CO2 , and other pollutants from building materials and products. When the outdoor air is heavily polluted, the ventilation system will filter out those pollutants before allowing the outdoor air to circulate into indoor spaces. In the building design field in the United States, the primary design code is ASHRAE standard 62.1/62.2, Ventilation for Acceptable Indoor Air Quality, as mentioned previously. Standard 62.1 serves for commercial, institutional, and highrise residential buildings, and standard 62.2 serves for low-rise residential buildings [18]. These prominent ventilation standards were originally published in 1973 [19]. They provided a large number of space types and ventilation rates for each space type; however, such justification for individual values was not documented [17], which led to a long-term debate among ASHRAE members. In this first version, ASHRAE 62 recommended the ventilation rate be 7.5–12.5 L/s per person for a typical office space, and it is stated that the goals of the standard included preserving occupants’

60

4 Indoor Environmental Impact on Human Health

health, safety, and well-being. Since its publication, certain ASHRAE members felt that, as an engineering society, it was not appropriate to include health concerns in a design standard. The debate and concern led to a membership petition in 1999 that called to restrict all ASHRAE IAQ and ventilation standards from making claims regarding “health, comfort or occupant acceptability” [17, 20]. Nine years later, in 2008, the ASHRAE Board of Directors issued several additional questions to the members to help clarify the intent in approving the petition. Eventually, the board approved a ruling stating that IAQ standards “shall not make claims or guarantees that compliance will provide health, comfort or occupant acceptability, but shall strive for those objectives…” [17, 21]. This statement helped to reinstate the health impact consideration in the building system design while restricting the ability for engineers to pursue higher standards for occupant health and well-being. It is understandable, as a design standard produced by an engineering society, that health regulation does not fall within professional liability or expertise. Conversely, without a holistic understanding of the health implications of the building system design, it is very likely that design solutions proposed by engineers may be ignorant of human health conditions. One example is the ventilation rate, which has experienced multiple changes since the 1970s and was settled recently, in 2016. In the 1970s, the first oil crisis ignited the need for energy conservation. One effective energy-saving approach was to decrease the ventilation rate in order to minimize the outdoor and indoor air exchange. This illconceived approach, meant to increase energy efficiency, degraded indoor air quality [17], leading to the onset of the sick building syndrome. Later, the ventilation rate was increased back to its normal level after the oil crisis had passed. Many iterations and changes occurred between ASHRAE’s original 1973 requirement and the most recent 2016 requirement. In the current version, the minimal ventilation requirement is 8.5 L/s per person (17 ft3 per minute per person, cfm) for office spaces and 4.3 L/s per person (8 cfm) for lecture halls with fixed seats (ASHRAE 2016). However, these standards merely provide the minimal acceptable IAQ despite decades of research indicating the benefits of higher ventilation rates. Studies have acknowledged that the correlation between building ventilation, indoor air quality, and occupants’ health outcome is apparent across all age groups, climate conditions, regions, building types, and cultural contexts. Bentayeb et al. [22] studied 600 elderly people from 50 nursing homes in seven European countries, with results revealing that, even at low levels, indoor air quality affected the respiratory health of elderly people living in nursing homes, and the magnitude of the effects was modulated by the ventilation rate [22]. For schoolchildren, another vulnerable population, an insufficient ventilation rate and poor indoor air quality have proven to be related to student health risks and low performance scores in the United States [23], France [24], Finland [25], the United Kingdom [26], India [27], and other countries. In certain unexpected building types, such as a subway station, a research team from Massachusetts Institute of Technology demonstrated that improving ventilation strategies could improve the platform PM10 levels, leading to a reduction in health risks [28]. Besides having a health impact, IAQ also affects workers’ productivity and performance. Evidences indicated that doubling the ventilation rate from the ASHRAE 2013 standard improved the performance of workers

4.2 Indoor Air Quality (IAQ)

61

by 8%, equivalent to a USD 6,500 increase in employee productivity each year [29]. Based on a computer-based cognitive assessment, a Harvard T.H. Chan School of Public Health study demonstrated that people’s cognitive function was significantly higher in green buildings (with potential higher IAQ) than in the conventional buildings [30]. Another study used a cognitive drug research computerized assessment to measure schoolchildren’s cognitive function. The results indicated that students were likely to be less attentive and have lower levels of concentration with increased levels of CO2 (from 690 to 2909 ppm); this decrease in focus and concentration could potentially have a detrimental effect on learning and education attainment [31]. Overall, research has been established in the last several decades to connect indoor air quality to occupants’ health outcomes and other performance indicators. As today’s sustainable building focus is shifting toward net zero energy building, requiring high energy efficiency, engineers and architects must be cautious to not repeat the mistakes of the past nor create new problems.

4.3 Indoor Thermal Quality (ITQ) ANSI/ASHRAE standard 55 defines thermal comfort as “the condition of mind that expresses satisfaction with the thermal environment and is assessed by subjective evaluation” [32]. Thermal comfort is another factor that has been extensively studied by researchers, building practitioners, and medical doctors for a long time. It took 100 years to develop an understanding of what constitutes human comfort, what the measured variables are, and which latent variables cannot be measured but will influence humans’ perception of thermal comfort. Comfort is the result of the interaction of physical, physiological, psychological, social, and cultural attributes [33]. Accordingly, thermal comfort is influenced by three factors: spatial physical characters, personal physiological characters, and personal psychological characters (refer to Fig. 4.2). Spatial physical characters are indoor temperature, humidity, and air movement, whereas personal physiological characters include clothing, activity, gender, and age, among others. Lastly, personal psychological characters are mainly derived from social-economic and cultural backgrounds. For instance, Aljawabra et al. [34] found those who had a higher level of education and better occupation and financial circumstances were more sensitive to environmental conditions [34]. The scientific and systematic study of thermal comfort, like many other factors, originated from concerns of human health. People exposed to extreme thermal discomfort undergo thermal stress that affects their health, comfort, productivity, and performance. Modern knowledge about thermal comfort in buildings was developed by multiple disciplines: engineers, architects, and physiologists. The earliest known experiment on humans’ thermal comfort level was a series of experiments conducted by British physician and scientist Sir Charles Blagden in 1774 and 1775. He put himself and his companion dog in a super-heated room, up to 260 °F (127 °C), to observe how the human body and animal body responded to extreme heat [35]. The

62

4 Indoor Environmental Impact on Human Health

Fig. 4.2 Attributes contributing to thermal comfort

records indicate that the dog endured a temperature of 236 °F (113 °C) for a full hour, with seemingly little distress [36]. In order to provide a chronological overview of the development of our understanding of thermal comfort and its impact on humans, in the following section, two tracks of research will be followed: one is referred to as the “American School,” associated and derived from a physical and psychological approach [36] and heavily influenced by the ASHARE standard development; the other is called the “European School” [36], leaning toward a psychological understanding of comfort. This may appear to be an oversimplified categorization, since there were many development trends around thermal comfort in the United States and Europe from the onset of the twentieth century to present day. However, the purpose of this generalization is to help readers understand the parallel development of the two different approaches. In the “American School,” one of the pioneer researchers in thermal comfort, Adolf Pharo Gagge was a renowned biophysicist and professor emeritus of epidemiology at the Yale School of Medicine. He was one of the earliest investigators of interaction of varied environments with human body temperature [37]. In 1936, during his tenure at JB Pierce Laboratory, he and his colleagues wrote the article “The linearity criterion as applied to partitional calorimetry” using experimental data to explore the relationship between the human body and environment. Gagge proposed the first principle of thermodynamics of the human body by a two-node model [33, 38, 39]. Interestingly, the lead author (Gagge’s research collaborator) of the aforementioned article was one of the most influential figures in public health, Carles-Edward Amory

4.3 Indoor Thermal Quality (ITQ)

63

Winslow (CEA Winslow), the founder of the Yale School of Public Health. Since its founding in 1933, the JB Pierce Laboratory has maintained ties with Yale University. It is supported by the John B. Pierce Foundation, named after the founder of the American Radiator Company, with the mission to connect scientific research and technical knowledge in the building industry (particularly, building heating and the ventilating system) to occupants’ health and thermal comfort [33]. Like other industrialists in the early twentieth century, Pierce realized a link existed between the building system and health outcome of a large population. Since then, the lab has produced many important research works that defined the physical and physiological principles to understand how thermal comfort affects the human body and how the human body exchanges heat with the environment [33]. After Gagge retired from the military, he resumed his career as an academia and researcher at Yale University. Later, Gagge published a paper predicting thermal comfort based on a thermal equilibrium approach for ASHRAE in 1969 [36]. Two years later, he introduced an important thermal comfort index, effective temperature scale (ETS), in the paper An effective temperature scale based on a simple model of human physiological regulatory response [37]. Different from most previous thermal comfort indices, ETS takes into account the clothing, activity, and radiation exchange expressed through a series of nomograms [33]. In parallel to the American School approach mentioned above, Danish scientist Povl Ole Fanger (1934–2006) began a series of experiments to understand the relationship between the physiological parameters of thermal comfort and psychological parameters of people and, most importantly, the perception of well-being expressed by themselves. The primary contribution of Fanger’s work was his introduction of two important comfort indices based on people’s perceived comfort level: predicted mean vote (PMV) and predicated percentage of dissatisfied (PPD). PMV allows occupants to give a score of thermal comfort based on the measurement of the physical factors of an environment, such as air speed, radiant temperature, and air humidity, with their individual conditions, different metabolic rates, and clothing. PPD represents the percentage of people who express dissatisfaction. These indices are not only closer to reality, but they also create an area of “feel-good” bounded by the values of measurable parameters of the built environment, which provide an in-depth understanding of the relation between people’s perception and physical condition. PMV/PPD remains as the most popular comfort index and standard used to predicate the comfortability and acceptability of an indoor environment. Further, ISO 7730 adopted PMV and PPD to determine and interpret thermal comfort. Based on the understanding of thermal comfort from both schools of thought, the thermal comfort impact on humans could be categorized as physical and psychological. The physical effect is abundantly studied under heat and cold stress. In the physical impact category, severe thermal conditions lead to illness and, to the extreme, death. Some recorded early incidents date back to the 1960s. Leithead and Lind described a death of an electrician as being directly relate to indoor heat stress; the person died only one hour after entering the space for repair work [40]. Since then, other studies have also found death to be associated with extreme high indoor temperatures [41]. Other unfavorable thermal characters, such as humidity and air

64

4 Indoor Environmental Impact on Human Health

velocity, have been reported as being associated with certain common sick building symptoms, such as respiratory irritation, negative mood, and fatigue [42, 43]. Low humidity and low temperature change the transmission of infectious disease particles [11], and warmth and excessive humidity induce the growth of mold and fungi, which cause sinus problems, coughing, shortness of breath, and other symptoms [3]. Other human physical functions could also be affected by thermal conditions since the human body regulates heat stress through sweating, and large amounts of sweating affects activities requiring grip, hence influencing performance on some tasks [41]. Psychological impacts are reflected in workers’ productivity and occupants’ mental health. From the early twentieth century, researchers from the fields of medicine, public health, human ecology, urban planning, and urban design have produced substantial evidence about the negative impacts from extreme or poor thermal conditions. Among all the factors influencing thermal comfort, temperature has been the most studied. In general, working in the heat or hot conditions could cause lassitude, distraction, irritability, and fatigue, which impacts performance and learning. Research also found that cognitive performance decreased in schoolchildren, college students, and office employees exposed to high temperatures [44–46]. In 1945, Weiner and Hutchinson conducted an experiment on six human subjects by exposing them to “effective” temperatures above 32.3 °C. The results indicated that motor coordination1 was impaired in a hot, humid environment [47]. Later, in 1955, Mayo studied 404 men in air-conditioned and non-air-conditioned spaces in a U.S. Navy training center and found people’s learning ability was impaired under higher temperatures [48]. There is also evidence at a global level. The Australian National Center for Epidemiology and Population Health studied health and productivity in workplaces under heat stress for low- and middle-income countries, and a trend was identified: productivity (work capacity measured by effective working hours) rapidly reduced as the wet bulb globe temperature exceed 26–30 °C [49]. The wet bulb globe temperature is defined by the combination of dry temperature and humidity. Moreover, there are additional studies supporting the relation between thermal comfort and occupant performance; the most recent development in indoor thermal comfort in the past decades is adaptive thermal comfort. This approach takes into account the dynamic variation of internal and external environmental conditions and the individual [33].

4.4 Indoor Lighting Quality (ILQ) Indoor lighting quality and quantity have physical and psychological effects (visual and non-visual effects) on humans as well. The physical impacts include visual strain, blurred vision, and irritated eyes induced by insufficient light levels (illuminance), glare, and the level of contrast between the inside and outside [11]. There are also 1 Motor

coordination is the combination of body movements created with kinematic and kinetic parameters that result in intended actions [Wikipedia].

4.4 Indoor Lighting Quality (ILQ)

65

studies related to the quality of lighting fixtures; for instance, the flickering of lights has been associated with visual discomfort and a decreased reading accuracy [50, 51] in a healthy population. For children with autism, the flickering lights or low-quality lights that emit a sound are recommended to be completely avoided [52]. The psychological effects consist of short-term and long-term effects. The shortterm effects involve the occupants’ mood, and the primary characters of lighting influencing psychological mood are light levels, light color, spectral distribution, and temporal patterns [53–55]. The discovery of long-term psychological and physiological effects from non-visual aspects of light emerged from circadian rhythm research [56]. The circadian rhythms synchronize the physiological and behavioral processes with the cyclic nature of environmental stimuli [8] and can be found in virtually all plants and animals. Circadian rhythms control our natural physical routine, such as falling asleep and waking up. Its operation requires external stimuli, with the light– dark cycle being one of the most potent stimuli [56]. Daylight and artificial lighting systems have a significant impact on an occupant’s circadian system in a building, and, consequently, such impact carries the effects far beyond those normally associated with poor light quality because of two reasons. First, the circadian system is the DNA of human physiology, which creates many ripple effects. Second, in present day, people spend the majority of time indoors; therefore, there is a large chance that the natural circadian system will be affected by the indoor lighting condition. Studies have suggested that some residential lightings are insufficient to meet the required light level in order to regulate the appropriate circadian clock. Under such conditions, the inhabitants reside in poorly lit residences and could be living in constant biological darkness [56]. Fatigue and excessive sleepiness can be linked to insufficient lighting levels, and insomnia and other sleep disorders may be treated by exposure to light at the right time to reset the circadian rhythm [57, 58]. The lighting design could also be linked to other known health conditions through the operation of the circadian system, such as seasonal affective disorder [53, 59] and Alzheimer’s disease [60, 61]. Researchers have connected breast cancer and other hormone-related cancers to circadian disruption from electric lighting [62–64] as well. Conversely, the lighting has been found effective in reducing winter depressive symptoms related to seasonal affective disorder [65] or breast cancer [66]. Other than physical health, lighting quality and quantity also play a role in people’s cognitive function. In the last decade, there has been a large body of research published due to the interest in lighting and people’s well-being and productivity. The general consensus is that ambient light and its physical characteristics are major modulators of brain function and cognition [55].

4.5 Indoor View Quality (IVQ) Besides lighting, a building’s view also plays a role in human health. According to the attention restoration theory proposed by pioneer environmental psychologists Rachel and Stephen Kaplan [67] in the 1989, the natural environment and elements

66

4 Indoor Environmental Impact on Human Health

have the ability to restore people’s attention and release stress [68]. Their work had a significant influence on architecture, landscape, and urban design and has been cited broadly. Based on the theory, researchers suggested the elements representing or mimicking natural environments could have certain restorative functions, and the views to those elements are critical to occupant health. Views from the indoor environment can be divided into three types. The first type is the direct visual connection to the outdoor natural environment [69]. Early well-known research conducted by Roger Ulrich at Pennsylvania hospitals between 1972 and 1981 revealed that surgical patients assigned to rooms with windows viewing a natural scene had shorter postoperative hospital stays [70]. The same restorative effects of views of nature have also appeared in other healthy population settings, such as homes [67], schools [71], and offices [72]. The second type is the visual connection to indoor natural elements, such as green walls and water features, among others. In 2016, a research team in Netherland studied classrooms in two elementary schools for four months. The results demonstrated that children scored better on a test for selective attention in the classrooms with green walls; however, there was no difference in the children’s self-report on well-being [73]. The use of those types of natural representing elements could be summarized as a biophilia design. The term “biophilia” was initially coined by Edward O. Wilson in 1984 to refer to the basic human need to affiliate with life and lifelike processes [74]. People tend to prefer natural environments more than built environments and built environments with water, trees, or other vegetation more than built environments without such features [75]. Therefore, a view of nature and nature inside buildings are the preferable options linked to potential health outcomes. The “lifelike processes,” however, are not well defined, measured, or understood yet. The third type of view falls into such category (refer to Fig. 4.3). The third type is the visual connections between occupants and other living forms or “lifelike processes.” The living form could be other humans or animals. Moreover, the lifelike process represents the natural pattern, form, or interactions. For instance, Fig. 4.3 Lobby of American Society of Interior Designers’ headquarters (the zigzag lobby corridor represents the nature form)

4.5 Indoor View Quality (IVQ)

67

a corridor with a connection to multiple spaces, public or private, imitates the environment in nature, thus allowing occupants to feel safer and more connected and, consequently, less isolated and more content. The simulated nature or technological nature has not been found to be reliable to produce such restorative functions to occupants, with many studies providing mixed results. Freier and Kahn [76] hypothesized that simulated nature could provide similar restorative benefits as exposure to a real natural environment would. They used an HDTV displaying an outdoor scene to simulate a real window view in their study. The test spanned a 17-week period with two test subjects; their findings indicated that both participants demonstrated certain positive psychological improvements [76]. However, a later study by Kahn et al. [77] indicated different results. The research team exposed a simulated nature setting through an HDTV plasma display “window” to 90 participants in an office, and the results revealed no difference between the plasma window and blank wall [77]. Accordingly, more research and studies are needed to determine the effectiveness of the type of indoor views and related health outcomes.

4.6 Indoor Sound Quality (ISQ) Sound has a strong correlation with cardiovascular disease; for instance, based on studies published between 2007 and 2018 on the relation between noise and the risk of cardiovascular disease, Hahad et al. [78] concluded a 10 decibel (dB) sound increase starting from 50 dB could result in a 8% elevated incidence of coronary heart disease [78]. The effect of noise has a direct societal implication since there are 145.5 million people in the United States alone, in urban areas, who may be exposed to higher levels of sound, above 55 dB [79]. The effect of noise on vulnerable populations, such as schoolchildren, is more severe. There has been much research since the 1970s indicating that students’ performance is directly related to the level of noise they have been exposed to in all performance categories tested: mathematics and reading [80]. For adults, noise has been found to significantly impair the detection of grammatical errors [81], speed of text typing, and comprehension of dialogue [82]. Besides noise originating from indoors, sounds from outside could also be hazardous to health. For buildings located in dense urban areas, outdoor sound infiltrating windows and doors is a significant source of noise. Design communities established design guidelines and techniques to control these sounds and noises. For instance, ANSI/ASA S12.60, Acoustical Performance Criteria, Design Requirements for Schools, is the design standard implemented by industry. Federal agencies have also issued a variety of standards for acoustic design, such as the UFC2 3-450-01 Noise and Vibration Control [83], UFGS3 09 51 00 Acoustical Ceiling [84], and UFGS 09 83 13 Acoustical Wall Treatment. Many design guidelines focus on the building’s interior design 2 UFC

stands for Noise and Vibration Control, issued by the Department of Defense. stands for Unified Facilities Guide Specifications, issued by the Department of Defense.

3 UFGC

68

4 Indoor Environmental Impact on Human Health

since controlling sound-reflecting surfaces in buildings is as equally important as controlling the sound source. Sound-reflecting surfaces are building interior partitions, floors, and ceilings. The materials that designers choose will have an effect on both sound volume and sound quality, and a variety of insulation materials will be effective in controlling traveling sounds and noise leakage. To prevent outdoor noise from leaking into a building, a well-insulated building envelope is necessary; useful techniques that can be applied include adding sound insulation to the wall and sealing the windows and doors more tightly. Insulation layers can also be applied to the interior walls and floors to reduce the sound transmission. However, over-control or over-damping the sound could generate a negative impact as well. The study found that a sound-absorbent office caused a larger decrease in occupants’ acceptability of noise than a real open-plan office [82].

4.7 Indoor Spatial Quality (ISPQ) The study of the impact of indoor spatial quality (ISPQ) on productivity and cognitive function primarily belongs to the field of environmental psychology. There are much fewer studies in this area since many spatial characters are difficult to measure, and the characters are less defined. Several studies with varying results examined the potential impact of the interior layout (floor plan layout). Brennan et al. [10] conducted a longitudinal field study to exam workers’ satisfaction and productivity before and after being relocated from traditional (enclosed) offices to open offices. They found the workers were less satisfied following the move, and such dissatisfaction endured after an adjustment period [10]. Their findings are aligned with certain early studies by Hedge in 1982 [85] and Sundstrom et al. in 1980 [86]. The research contributed to the perception of dissatisfaction with increased spatial openness, with the increased accessibility related to amplified disturbances and decreased privacy [10]. A U.S. national survey study in 2003 proved that the environment of an attractive (good architectural design) physical school (middle and high schools) is associated with less problematic and risky student behavior, whereas a less attractive physical environment is not [87]. However, this study only differentiated between attractiveness and cleanness but did not define attractiveness. The suggested reason for this is that a school’s spatial quality (physical environment design) has multiple dimensions, each imbued with different meanings and messages for students. Overall, an attractive, clean, and orderly space composes a high spatial quality and conveys to students a place where learning and growth are both valued and supported [84]. On a larger scale—the neighborhood scale—a Dutch study indicated that neighborhood attractiveness positively added to residents’ life satisfaction and well-being, while traffic safety did not show a significant positive effect [88]. This research suggested a suitable appearance and the attractiveness of a neighborhood may be associated with social status, which could contribute to social safety—a benefit for well-being [89]. On the contrary, the attractiveness of a neighborhood, traffic convenience, and accessibility to facilities did not appear to significantly affect life satisfaction [85]. These

4.7 Indoor Spatial Quality (ISPQ)

69

findings call for further research and a deeper understanding of the relation between spatial quality and occupant cognitive function, performance, and productivity; the term “spatial quality” also requires more definition.

4.8 Conclusion The built environment influences human health via many mechanisms, from pollutants in the air to the noise inside of buildings; meanwhile, there are many challenges in providing not only energy-efficient but also healthy buildings. There is an opportunity to expand current sustainable building practices to include healthpromoting indoor environmental factors as basic design principles and requirements for constructing new buildings and renovating old buildings. In order to create clear and effective guidelines for the construction of healthy buildings, the first step is to better understand the variables and factors of the built environment that promote or undermine human health. This chapter introduces six indoor built environment variables that contribute to health outcomes (refer to Fig. 4.4). In addition to the indoor variables, outdoor factors that influence human health include outdoor environmental safety and security, urban and housing density, land use, architectural design features, and street characteristics. Together, the indoor and outdoor environments help to shape people’s perceptions of a place [90], hence impacting their psychological health, well-being, and productivity.

Fig. 4.4 Influential variables of the built environment affecting human health

70

4 Indoor Environmental Impact on Human Health

In the last couple of decades, studies have been conducted about the above six indoor variables; however, due to capacity limitations to gather and process large amounts of data, research results have occasionally produced conflicting findings, leading the public to have limited trust in those claims. The current issue remains the lack of progress in gaining knowledge and understanding the precise mechanism of how those variables affect occupants’ physical and mental health, well-being, and cognitive functions. Most existing studies are based on self-report and perception studies, with very few studies connecting variables to physiobiological symptoms using empirical data. With the advancement of technology, especially smart digital technologies, large amounts of data can now be collected that may provide the gateway to assess those questions. In Chap. 5, the author begins to examine certain new and advanced technologies and the concept of smart buildings, which were initially created to improve the built environment quality and, in turn, human health outcomes.

References 1. Klepeis NE, Nelson WC, Ott WR, Robinson JP, Tsang AM, Switzer P, Engelmann WH (2001) The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Sci Environ Epidemiol 11(3):231 2. U.S. Environmental Protection Agency. Regulatory information by topic: air. https://www.epa. gov/regulatory-information-topic/regulatory-information-topic-air. Accessed 20 March 2019 3. Centers for Disease Control and Prevention, the National Institute for Occupational Safety and Health (NIOSH). Indoor Environmental Quality. https://www.cdc.gov/niosh/topics/indoorenv/ default.html. Accessed 20 March 2019 4. Persily A, Hewett M (2010) Using ASHRAE’s new IAQ guide. ASHRAE J 52(5):75–80 5. Abdul-Wahab SA, En SCF, Elkamel A, Ahmadi L, Yetilmezsoy K (2015) A review of standards and guidelines set by international bodies for the parameters of indoor air quality. Atmos Pollut Res 6(5):751–767 6. Mohammed A, Katafygiotou M, Mazroei A, Kaushik A, Elsarrag E (2016) Impact of indoor environmental quality on occupant well-being and comfort: a review of the literature. Int J Sustain 1:1–11 7. Uzoigwe JC, Prum T, Bresnahan E, Garelnabi M (2013) The emerging role of outdoor and indoor air pollution in cardiovascular disease. N Am J Med Sci 5(8):445 8. MacNaughton P, Satish U, Cedeño-Laurent JG, Flanigan S, Vallarino J, Coull B, Spengler JD, Allen JG (2017) The impact of working in a green certified building on cognitive function and health. Build Environ 114:178–186 9. Banbury SP, Berry DC (2006) Office noise and employee concentration: Identifying causes of disruption and potential improvements. Ergonomics 48(1):25–37 10. Brennan A, Chugh JS, Kline T (2002) Traditional versus open office design: a longitudinal field study. Environ Behav 34(3):279–299 11. Cedeño-Laurent JG, Williams A, MacNaughton P, Cao X, Eitland E, Spengler Allen JG (2018) Building evidence for health: green buildings, current science, and future challenges. Annu Rev Publ Health 39:291–308 12. American Cancer Society. What is formaldehyde? https://www.cancer.org/cancer/cancer-cau ses/formaldehyde.html. Accessed 21 October 2019 13. National Cancer Institute. Formaldehyde and Cancer Risk. https://www.cancer.gov/aboutcancer/causes-prevention/risk/substances/formaldehyde/formaldehyde-fact-sheet. Accessed 8 Feb 2019

References

71

14. United States Environmental Protection Agency. Volatile Organic Compounds’ Impact on Indoor Air Quality. https://www.epa.gov/indoor-air-quality-iaq/volatile-organic-compoundsimpact-indoor-air-quality. Accessed 8 Feb 2019 15. Minnesota Department of Health. Volatile Organic Compounds in your home. http://www.hea lth.state.mn.us/divs/eh/indoorair/voc/. Accessed 8 Feb 2019 16. Mølhave L, Krzyzanowski M (2003) The right to healthy indoor air: status by 2002. Indoor Air 13:50–53 17. Persily A (2015) Challenges in developing ventilation and indoor air quality standards: the story of ASHRAE Standard 62. Build Environ 91:61–69 18. American Society of Heating (2016) Standard 62–73: standards for natural and mechanical ventilation. Refrigerating and Air-conditioning Engineers, New York 19. ASHRAE (1973) Standard 62–73: Standards for Natural and Mechanical Ventilation. American Society of Heating, Refrigerating and Air-conditioning Engineers, New York 20. Truth Tobacco Industry Documents, University of California, San Francisco (1999) Chronology of Activities Relating to the Revision of ASHRAE Standard 62–1989. http://legacy.library.ucsf. edu/tid/hbq86a00. Accessed 8 Feb 2019 21. ASHRAE (2014) Rules of the Board. American Society of Heating, Refrigerating and AirConditioning Engineers. https://www.ashrae.org/society-groups/rules-of-the-board. Accessed 10 August 2019 22. Bentayeb M, Norback D, Bednarek M, Bernard A, Cai GH, Cerrai S, Eleftheriou KK (2015) Indoor air quality, ventilation and respiratory health in elderly residents living in nursing homes in Europe. Eur Respir J 45(5):1228–1238 23. Haverinen-Shaughnessy U, Shaughnessy R, Cole E, Toyinbo O, Moschandreas D (2015) An assessment of indoor environmental quality in schools and its association with health and performance. Build Environ 93:35–40 24. Annesi-Maesano I, Hulin M, Lavaud F, Raherison C, Kopferschmitt C, Blay F, Charpin DA, Denis C (2012) Poor air quality in classrooms related to asthma and rhinitis in primary schoolchildren of the French 6 Cities Study. Thorax 67(8):682–688 25. Turunen M, Toyinbo O, Putus T, Nevalainen A, Shaughnessy R, Haverinen-Shaughnessy U (2014) Indoor environmental quality in school buildings, and the health and wellbeing of students. Int J Hyg Environ Health 217:733–739 26. Bakó-Biró Z, Clements-Croome DJ, Kochhar N, Awbi H, Williams M (2012) Ventilation rates in schools and pupils’ performance. Build Environ 48:215–223 27. Chithra VS, Shiva Nagendra SM (2012) Indoor air quality investigations in a naturally ventilated school building located close to an urban roadway in Chennai, India. Build Environ 54:159–167 28. MinJeong K, Braatz RD, Kim JT, Yoo CK (2015) Indoor air quality control for improving passenger health in subway platforms using an outdoor air quality dependent ventilation system. Build Environ 92:407–417 29. MacNaughton P, Pegues J, Satish U, Santanam S, Spengler J, Allen JG (2015) Economic, environmental and health implications of enhanced ventilation in office buildings. Int J Environ Res Public Health 11:14709–14722 30. Allen JG, MacNaughton P, Satish U, Santanam S, Vallarino J, Spengler JD (2015) Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: a controlled exposure study of green and conventional office environments. Environ Health Perspect 124:805–812 31. Coley DA, Greeves R, Saxby BK (2007) The effect of low ventilation rates on the cognitive function of a primary school class. Int J Vent 6:107–112 32. ASHRAE (2015) Standard 55- Thermal environmental conditions for human occupancy. https://www.ashrae.org/technical-resources/bookstore/standard-55-thermal-environme ntal-conditions-for-human-occupancy. Accessed 13 February 2019 33. Fabbri K (2015) Indoor thermal comfort perception. A Questionnaire Approach Focusing on Children, Springer, Berlin 34. Aljawabra F, Nikolopoulou M (2010) Influence of hot arid climate on the use of outdoor urban spaces and thermal comfort: Do cultural and social backgrounds matter? Intell Build Int 2:198–217

72

4 Indoor Environmental Impact on Human Health

35. Blagden C (1775) XII. Experiments and observations in an heated room. Philos Trans 65:111– 123 36. Alfano FRDA, Olesen BW, Palella BI (2017) Povl Ole Fanger’s impact ten years later. Energy Build 152:243–249 37. National Academy of Engineering (1994) A. Pharo Gagge 1908–1993. https://www.nae.edu/ 188533.aspx. Accessed 20 September 2019 38. Taleghani M, Tenpierik M, Kurvers S, Van Den Dobbelsteen A (2013) A review into thermal comfort in buildings. Renew Sust Energ Rev 26:201–215 39. Winslow CE, Herrington LP, Gagge AP (1936) A new method of partitional calorimetry. AJP-Legacy 116(3):641–655 40. Leithead CS, Lind AR (1964) Heat stress and heat disorders. Cassell & Co ltd, London 41. Parsons K (2014) Human thermal environments: the effects of hot, moderate, and cold environments on human health, comfort, and performance. CRC Press, Boca Raton 42. Lan L, Wargocki P, Wyon DP, Lian Z (2011) Effects of thermal discomfort in an office on perceived air quality, SBS symptoms, physiological responses, and human performance. Indoor Air 21(5):376–390 43. Bluyssen PM, Roda C, Mandin C, Fossati S, Carrer P, de Kluizenaar Y, Bartzis J (2016) Self-reported health and comfort in ‘modern’ office buildings: first results from the European OFFICAIR study. Indoor Air 26(2):298–317 44. Loftness V, Hakkinen B, Adan O, Nevalainen A (2007) Elements that contribute to healthy building design. Environ Health Perspect 115(6):965–970 45. Haverinen-Shaughnessy U, Moschandreas DJ, Shaughnessy RJ (2011) Association between substandard classroom ventilation rates and students’ academic achievement. Indoor Air 21(2):121–131 46. Lan L, Wargocki P, Lian Z (2011) Quantitative measurement of productivity loss due to thermal discomfort. Energy Build 43(5):1057–1062 47. Weiner JS, Hutchinson JCD (1945) Hot humid environment: Its effect on the performance of a motor co-ordination test. Br J Ind Med 2(3):154 48. Mayo GD (1955) Effect of temperature upon technical training. Am J Appl Psychol 39(4):244– 246 49. Kjellstrom T, Holmer I, Lemke B (2009) Workplace heat stress, health and productivity—an increasing challenge for low and middle-income countries during climate change. Glob Health Action 2(1):2047 50. Singh J (1996) Impact of indoor air pollution on health, comfort and productivity of the occupants. Aerobiologia 12(1):121–127 51. Ticleanu C, Littlefair P (2015) A summary of LED lighting impacts on health. Int J Sustain Light 17:5–11 52. Nagib W, Williams A (2017) Toward an autism-friendly home environment. Hous Stud 32(2):140–167 53. Figueiro MG, Rea MS (2016) Office lighting and personal light exposures in two seasons: Impact on sleep and mood. Light Res Technol 48(3):35–364 54. Daurat A, Aguirre A, Foret J, Gonnet P, Keromes A, Benoit O (1993) Bright light affects alertness and performance rhythms during a 24-h constant routine. Physiol Behav 53(5):929– 936 55. Vandewalle G, Maquet P, Dijk DJ (2009) Light as a modulator of cognitive brain function. Trends Cogn Sci 13(10):429–438 56. Boyce PR (2010) The impact of light in buildings on human health. Indoor Built Environ 19(1):8–20 57. Czeisler CA, Waterhouse JM (1995) The effect of light on the human circadian pacemaker. In: Czeisler C (ed) Circadian clocks and their adjustment. Wiley Online, Hoboken, pp 254–290 58. Shochat T, Martin J, Marler M, Ancoli-Israel S (2000) Illumination levels in nursing home patients: effects on sleep and activity rhythms. J. Sleep Res. 9(4):373–379 59. Profita HP, Roseway A, Czerwinski M (2016) Personal and social considerations of wearable light therapy for seasonal affective disorder. In: Proceedings of the 10th EAI International Conference on Pervasive Computing Technologies for Healthcare. ACM, Cancun, pp 194–201

References

73

60. Musiek ES, Bhimasani M, Zangrilli MA, Morris JC, Holtzman DM, Ju YES (2018) Circadian rest-activity pattern changes in aging and preclinical Alzheimer disease. JAMA Neurol 75(5):582–590 61. Musiek ES, Xiong DD, Holtzman DM (2015) Sleep, circadian rhythms, and the pathogenesis of Alzheimer disease. Exp Mol Med 47(3):e148 62. Stevens RG, Brainard GC, Blask DE, Lockley SW, Motta ME (2014) Breast cancer and circadian disruption from electric lighting in the modern world. CA Cancer J Clin 64(3):207–218 63. Hansen J (2001) Light at night, shiftwork, and breast cancer risk. J. Natl Cancer Inst. 93(20):1513–1515 64. He C, Anand ST, Ebell MH, Vena JE, Robb SW (2015) Circadian disrupting exposures and breast cancer risk: a meta-analysis. Int Arch Occup Environ Health 88(5):533–547 65. Terman M, Terman JS, Quitkin FM, McGrath PJ, Stewart JW, Rafferty B (1989) Light therapy for seasonal affective disorder. Neuropsychopharmacol 2(1):1–22 66. Desautels C, Savard J, Ivers H, Savard MH, Caplette-Gingras A (2018) Treatment of depressive symptoms in patients with breast cancer: A randomized controlled trial comparing cognitive therapy and bright light therapy. Health Psychol 37(1):1 67. Kaplan S (1995) The restorative benefits of nature: Toward an integrative framework. J Environ Psychol 15(3):169–182 68. Ulrich RS, Simons RF, Losito BD, Fiorito E, Miles MA, Zelson M (1991) Stress recovery during exposure to natural and urban environments. J Environ Psychol 11(3):201–230 69. Kaplan R (2001) The nature of the view from home: Psychological benefits. Environ Behav 33(4):507–542 70. Ulrich RS (1984) View through a window may influence recovery from surgery. Sci 224(4647):420–421 71. Li D, Sullivan WC (2016) Impact of views to school landscapes on recovery from stress and mental fatigue. Landsc Urban Plan 148:149–158 72. Grinde B, Patil G (2009) Biophilia: does visual contact with nature impact on health and well-being? Int J Environ Res Public Health 6(9):2332–2343 73. Van den Berg AE, Wesselius JE, Maas J, Tanja-Dijkstra K (2017) Green walls for a restorative classroom environment: a controlled evaluation study. Environ Behav 49(7):791–813 74. Wilson EO (2003) Biophilia. Harvard University Press, Boston 75. Kaplan R, Kaplan S (1989) The experience of nature: A psychological perspective. Cambridge University Press, Cambridge 76. Friedman B, Freier NG, JrPH K (2004) Office window of the future?: two case studies of an augmented window. Proceeding of CHI’04 Extended Abstracts on Human Factors in Computing Systems. ACM, Honolulu, p 1559 77. Kahn PH Jr, Friedman B, Gill B, Hagman J, Severson RL, Freier NG, Stolyar A (2008) A plasma display window?—The shifting baseline problem in a technologically mediated natural world. J Environ Psychol 28(2):192–199 78. Hahad O, Kröller-Schön S, Daiber A, Münzel T (2019) The cardiovascular effects of noise. Dtsch Ärztebl Int 116(14):245 79. Hammer MS, Swinburn TK, Neitzel RL (2013) Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122(2):115–119 80. Shield BM, Dockrell JE (2003) The effects of noise on children at school: a review. Build Acoust 10(2):97–116 81. Weinstein ND (1977) Noise and intellectual performance: A confirmation and extension. J Appl Psychol 62(1):104 82. Balazova I, Clausen G, Rindel JH, Poulsen T, Wyon DP (2008) Open-plan office environments: a laboratory experiment to examine the effect of office noise and temperature on human perception, comfort and office work performance. In: Strøm-Tejsen P, Olesen BW, Wargocki P, Zukowska D, Toftum J (eds) Proceeding of 11th International conference on indoor air quality and climate. ACM, Copenhagen

74

4 Indoor Environmental Impact on Human Health

83. Department of Defense. Unified Facilities Criteria (UFC). https://www.wbdg.org/ffc/dod/uni fied-facilities-criteria-ufc/ufc-3-450-01. Accessed 9 October 2019 84. Department of Defense. Unified Facilities Guide Specifications (UFGS). https://www.wbdg. org/ffc/dod/unified-facilities-guide-specifications-ufgs/ufgs-09-51-00. Accessed 9 October 2019 85. Hedge A (1982) The open-plan office: a systematic investigation of employee reactions to their work environment. Environ Behav 14(5):519–542 86. Sundstrom E, Town JP, Brown DW, Forman A, Mcgee C (1982) Physical enclosure, type of job, and privacy in the office. Environ Behav 14(5):543–559 87. Kumar R, O’Malley PM, Johnston LD (2008) Association between physical environment of secondary schools and student problem behavior: a national study, 2000-2003. Environ Behav 40(4):455–486 88. Ettema D, Schekkerman M (2016) How do spatial characteristics influence well-being and mental health? Comparing the effect of objective and subjective characteristics at different spatial scales. Travel Behaviour and Society 5:56–67 89. Deci EL, Ryan RM (2000) The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychol Inq 11(4):227–268 90. Hu M, Chen R (2018) A framework for understanding sense of place in an urban design context. Urban Sci 2(2):34

Chapter 5

Smart Building and Current Technologies

This chapter serves as an initial connector for the smart technologies and primary causes of health issues in the built environment that were introduced in previous chapters. In this book, “smart buildings” and “intelligent buildings” are used interchangeably. This Chapter first introduces different definitions of smart buildings, followed by a brief history of smart building development. Through a comparison of the constituents of different definitions, this chapter extracts three sets of key smart technologies developed or being developed with relations to health impacts from the built environment.

5.1 History of Smart Building In the past few decades, the concept of smart buildings (SBs), or intelligent buildings (IBs), has become increasingly attractive due to their potential for deploying design techniques and emerging smart technologies that attempt to maximize occupants’ health and well-being. According to Google Trends, whereas searches for “green buildings” have decreased since around 2008, web search popularity for “smart homes” has risen since 2004, surpassing global interest in green buildings around 2013–2014 (refer to Fig. 5.1). The development of smart building has undergone three phases: automated buildings, smart buildings, and cognitive buildings (refer to Fig. 5.2).

5.1.1 Automated Buildings (1980s–2000) The concept of smart and intelligent buildings was born in the United States around the 1980s. One of the pioneers, Michael Mozer, a computer scientist who created a © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_5

75

76

5 Smart Building and Current Technologies

Fig. 5.1 Google Trends data on sustainable building, smart building, smart home, and green building

Fig. 5.2 Timeline of smart building development (Source Christopher Pearce)

5.1 History of Smart Building

77

neural network house, defined a smart home as a place where the appliances, entertainment centers, utilities, thermostats, and lights are connected with microprocessors that allow the devices to communicate with each other and thereby behave intelligently [1]. The Intelligent Building Institute of the United States in 1989 defined an intelligent building as “one which has an information communication network through which two or more of its services systems are automatically controlled, guided by predictions based on upon a knowledge of the building and usage, maintained in an integrated data base” [2]. The purpose to maintain such an integrated database is to effectively manage resources in a coordinated mode to maximize efficiency and technical performance. An intelligent building optimizes building through its four basic elements: (a) structures, (b) systems, (c) services and management, and (d) the interrelationships between them [3, 4]. During this period, the leading force of this development was industry. Their focus of intelligence or smartness was mainly the equivalence of the automation of the building system, and the primary goal was saving energy and optimizing building performance. One of the industry leaders, the United Technology Building Systems Corporation (UTBS) in the United States, first used the term “intelligent building” in 1981. Their initial attempt to implement smart technologies in buildings was reflected in the City Place Building in Hartford, Connecticut. It was called “the world’s first intelligent building” [5]. The intelligence of this building was reflected in a centralized computer system linked by a fiber-optic network (data highway) to control the building’s service systems, such as heating, cooling, transportation, security, fire protection, and telecommunication.

5.1.2 Smart Buildings (2000–2015) Since 2000, major technological, economic, and environmental changes have generated interest and demand in smart cities. Major events, such as climate change and economic restructuring, are disruptive and promote society to search for smart and sustainable solutions. The smart cities movement partially answers that demand. The fast development of smart cities induced a surge of interest in smart buildings and smart technologies used in buildings. According to Connected Cities USA, “Data collected and insights generated by smart building technologies can lead to changes in facilities management that reduce energy consumption for climate and sustainability goals and help improve public health and safety” [6]. The main difference between an automated building and smart building is the whole-system connectivity. Smart buildings are digitally connected systems or structures that combine an automated independent building system with smart data management to enhance the building occupants’ experience. The data management system is normally integrated with a conventional building management system and can process contextual data, such as climate or weather data, and localized data, such as an individual office’s demand and schedule. Automation is typically based on a preset schedule or algorithm, while a smart system has the following abilities: first, integrate a large real-time dataset; second, provide a platform to link building equipment and appliances; and

78

5 Smart Building and Current Technologies

lastly, adjust building operations based on connected and synchronized real-time data from all equipment and systems. More concisely, smart buildings enable real-time operation management, whereas automated buildings depend on a predetermined control system. Sinopoli, in his book Smart buildings systems for architects, owners and builders [7], describes the following: “A smart building involves the installation and use of advanced and integrated building technology systems.” In an automated building system, critical technological components—such as the HVAC system, lighting system, and power management—may work on the same database; however, they are essentially standalone systems that share data but function independently of each other. In contrast, a smart building has an integrated building system, and such integration takes place at multiple levels: physical resources, network, and application [7]. The physical resources are cabling, space, power, and environment controls and other infrastructure supports. The functional integration refers to the interoperation capability, meaning integrated systems provide functionality that cannot be provided by any single systems, and the whole system is greater than the sum of the parts [7]. For example, one can imagine a room temperature sensor that detects a higher indoor temperature than the optimal range and an occupant who feels discomfort. In an automated building, the cooling system will turn on immediately, while in an intelligent building, the ventilation system will synchronize the ventilation rate with outdoor air movement and quality data to decide whether to switch to the natural ventilation mode. Instead of lowering the temperature, the ventilation can bring air movement; hence brings comfort to occupants while conserving energy by not activating the cooling system. In this scenario, all building systems communicate with each other and work as a synchronized system.

5.1.3 Cognitive Buildings (2015–Future) The term “cognitive building” was adopted by IBM to describe buildings that can “flexibly adapt to changing occupant needs while saving energy and cost” [8]. The concept of cognitive buildings is derived from cognitive architecture. Coined by one of the research pioneers in the field of artificial intelligence in 1960 [9], cognitive architecture is a theory about the structure of the human mind that is used to create artificial intelligence to simulate the process of how the human mind processes information and makes decisions. The major difference between smart buildings and cognitive buildings is the control algorithm. Smart buildings with a large dataset have an adjustable algorithm. However, these algorithms are not intelligent like those in the cognitive buildings, which can learn from live data from occupants and predict, adapt, and change operations accordingly. One can imagine the following situations: an individual’s home presets their preferable sleeping temperature a couple of hours before their sleeping time. Their office reserves a parking space and workstation prior to the person’s typical arrival time and, and even more, their office sets the lighting level, temperature, sound, and other conditions based on their preference and

5.1 History of Smart Building

79

schedule. These examples actually reflect current technologies and a trend gaining momentum. Cognitive building is human-centered and responsive to human needs, which is one step further than smart buildings. Not only does it enable analysis and an understanding of occupants based on existing and available data, it can also predict requirements of the indoor environment, understand energy flow and building occupants’ behavior, and make corresponding decisions. In the future, cognitive buildings will have dual characteristics: one defined by physical assets and the other defined by digital assets. With the introduction of Internet of Things (IoT) to the building management system, the smartness of the building will become heavily intertwined with the digital infrastructure of the building. The digital infrastructure will become the “brain” of buildings. From this perspective, the “smart building framework consists of the physical assets within the building…, the digital assets that create a fabric throughout the connected space, and finally the use cases…that are enabled by the marriage of physical assets and digital assets” [12].

5.2 Defining “Smartness” The smart building definition was initially derived from building performance and operational cost perspectives with a focus on comfort, adaptability, a reduction in life cycle cost, and enhanced control over available resources [2]. It is typically composed of three components: smart mechanics (automated building system), a large dataset, and a control algorithm (building information communication infrastructure). The smart mechanics include sensors, lighting systems, HVAC systems, window and shading systems, and a personal control system with real-time monitoring and controls using advanced technologies [10, 11]. The large dataset refers to any data collected about building operation, performance, and occupants’ feedback. As for the control algorithm, a number of key control algorithms have created the foundation for smart buildings, including cloud infrastructure, data analytics, machine learning, and artificial intelligence [12]. This will be further detailed in chapter six. Smart building is an interdisciplinary field that draws knowledge from building engineering, architectural design, computer science, and materials science (refer to Fig. 5.3). The understanding of smart buildings and smart technologies in buildings also varies across a variety of disciplinary perspectives. In order to gain a holistic view of smart buildings and technologies, it is useful to examine the different definitions of smart buildings. In the following sections, the author provides a general overview of interpretations of smart buildings per discipline and region.

80

5 Smart Building and Current Technologies

Fig. 5.3 Smart building definitions per discipline (Source Christopher Pearce)

5.2.1 Smart Building Definitions Per Discipline Computer and information scientists define smart buildings as buildings using information and communication technologies (ICT) in building control, ranging from controlling appliances to the automation of building features such as smart lighting [13]. The key element of the smartness is the utilization of intelligent power scheduling algorithms which automate the building system and appliances’ operation with the main goal to save energy. The focus is on the human technology interaction. Material scientists believe the key to advancing smart buildings relies on the development of smart materials [14], which may not only save energy but also enhance building performance through responsiveness and self-adjustment. Examples include smart glazing and windows [15] and self-repair and self-cleaning materials that are available to reduce the repair demand [16, 17]. Other types of smart materials include shape memory alloys that have the ability to reform and define the shape or size when subjected to external stimuli such as temperature changes [18]. Engineers (mechanical engineers, structural engineers, civil engineers) view smart building as a connected building system that has the ability to monitor, detect, adjust, optimize, and correct its operation. Certain researchers examined modular prefabricated buildings with steel structural systems and integrated building envelopes using computational simulations [19]. Others focused on applying computational

5.2 Defining “Smartness”

81

intelligence (CI) techniques for the prediction, optimization, control, and diagnosis of HVAC systems or all district energy systems and to make them smart [20, 21]. Overall, from the engineers’ perspective, the intelligence can only root from the integration and interoperability of a variety of building systems, thus the smart focus centers on building systems. Architects, building owners, and developers take a user-centered approach, as buildings are becoming micro-energy hubs. The global building and construction sector accounted for nearly 40% of energy- and process-related emissions in 2018 [22], making it the largest emitter of greenhouse gases on the planet. Building performance is significantly affected by occupants’ behaviors. In order to influence behavioral change, a mindset shift is equally as important as the advancement of building technologies. One effective strategy to shift mindsets and behavior is to provide an interactive database and a personalized and responsive built environment. Therefore, architects and building owners are perceptive to the user-responsiveness and userfriendliness of smart technologies. Different types of wearable sensors have become the key players for smart integrated building systems. A sensor-based activity recognition system can recognize housekeeping tasks and classify the activity level [23]. Consequently, this can be implemented in developing a smart built environment for assisted-living systems for elderly care [24], as well as service to other populations. In other applications, such as design and construction, smart shoes were proposed for building a 3D map as a tool for floor plan surveying, construction process monitoring, renovation planning, and other building maintenance-related uses [25].

5.2.2 Smart Building Development Per Region The definition of smart buildings varies per region as well. Figure 5.4 illustrates the different interpretations and focuses of smart buildings in leading countries. Certain countries have more long-term plans for SB development while others concentrate on short-term benefits; select countries are more technology-driven than user-focused and vice versa. In this section, the author will focus on several leading countries and regions. The London-based European Intelligent Building Group (EIBG), a subgroup under the Chartered Institute of Building Service Engineers (CIBSE), defines a smart or intelligent building as a building that creates an environment that maximizes the effectiveness of its occupants while, at the same time, enabling the efficient management of resources with minimum life-time costs of hardware and facilities [4]. In the rest of Europe, Buildings Performance Institute Europe (BPIE) created a vision for smart buildings in Europe and ten interrelated principles and smartness indicators. It defined smart building as a building that is “highly energy efficient and covers its very low energy demand to a large extent by on-site or district-systemdriven renewable energy sources.” A smart building can stabilize and drive faster

82

5 Smart Building and Current Technologies

Fig. 5.4 Smart definition per region (credit: Christopher Pearce)

decarbonization, empower users with control over energy flow, and recognize occupants’ needs for comfort, health, and well-being [23]. By 2017, BPIE determined that no countries in the European Union were ready for smart buildings according to its ten principles. To date, Denmark, Finland, Switzerland, and the Netherlands are leading the way [26, 27]. There are two commonalities among definitions of smart buildings in Europe and North America. First, both regions consider the building service systems as an essential piece of the smart system, with those service systems being HVAC, safety, fire, and telecommunication systems. Due to the complexity of building service systems, the smart building approach has heavily focused on system integration. The second commonality is that both regions are coupling smart buildings with advanced information technology (IT), and smart buildings are becoming increasingly tied to IoT. The difference between the two definitions is the European definition is more focused on users’ requirements, while the US definition is more concentrated on technologies and building system integration [28]. This is similar to the divergences between the American School and European School mentioned in chapter four, regarding the understanding of thermal comfort and its impact on humans. Some areas in Asia, such as Hong Kong and Japan, use the term of intellegient buildings. Hong Kong-based Asian Institute of Intelligent Buildings (AIIB) defines smart buildings as relating to buildings that contain high-speed local area networks, protocols, fiber optics, multimedia environments, and even satellite conferencing [29]. Their understanding of smartness is mainly tied to advanced information processing technologies, similar to the US definition, but different in their focus

5.2 Defining “Smartness”

83

on communication technologies. This could differentiate these regions from the development of smart technologies and buildings in other regions such as mainland China. In China, the development of smart buildings first began in the 1990s, initiated by government and professional organizations that represent the government. With financial and legislative support from local and central governments, several largescale projects have been completed that are considered intelligent buildings. These include Shanghai Jinmao Tower (completed in 1999) and Nanjing Deying International Plaza using the Honeywell BMS system. Furthermore, in 2017, Honeywell (a US company that provides traditional automation for building systems) announced a collaboration with Huawei (a Chinese ICT company) to develop a smart building in China. Unlike in North America and Europe, the emphasis of smartness in the Chinese building industry is focused on traditional building systems—such as HVAC, transportation, and telecommunication—and the most important goal is to improve the energy efficiency of buildings.

5.3 Current Smart Technologies for Healthy Buildings In general, smart technologies are first correlated to healthy building variables; second, they depend on users’ needs; and lastly, they respond to users’ lifestyle. For specific user groups—such as the elderly, children, or people with disabilities— smart technologies can provide health care, monitoring, and assistance. For example, a system called Walabot Home continuously scans the premises of a senior’s home and detects falls. If the system senses the senior has fallen, it calls the emergency contact’s phone, which enables the senior to talk to their caregiver through Walabot Home’s speakerphone and get immediate assistance. The technology behind the system is 3D imaging based on radio waves, and it is able to differentiate between falling and kneeling down. Another example is E-vone, a French shoe company, which launched smart shoes that are able to detect fallen elderly people and workers and send an alert to the caregiver or emergency contact. For people who need longterm care, traditional hospitals and other health care facilities will not be efficient; instead, those users require safety, security, and immediate health support in case of an emergency happening at home [30]. Smart homes can provide such care by integrating and combining multiple smart technologies to help seniors who desire to live alone. For example, the commercial system TruSense integrates multiple affordable and simple sensors with a user-friendly dashboard to provide a complete monitoring of health and safety for the entire household, especially for seniors. The TruSense starter kit includes motion sensor tracking activities and detects falls. The contact sensor allows the system to determine if a door has been left open too long, and the customizable online dashboard permits a caregiver or relatives to monitor live conditions. Additional technologies can also be added to monitor activities outside of the home, such as a GPS tracker that tracks driving and walking [31]. Overall, such smart technologies provide seniors and people with disabilities with extended

84

5 Smart Building and Current Technologies

capabilities and the freedom to live more independently. If these technologies were applied to the rest of the population, they could enhance people’s living quality by tracking, monitoring, and responding to variables and factors in the built environment that affect people’s health.

5.3.1 Summary of Smart Technologies As discussed in chapters two and three, the causes of building-related health issues are physical, physiological, biological, and psychological. To avoid those causes, three sets of technologies can be enabled, with some of the technologies overlapping (relate to Sects. 5.3.2 to 5.3.4). The three sets of technologies are identified in this book based on their current adoption and application rates; however, readers should be aware that there will be continuous growth in technologies in the future that will impact human health. Therefore, this book only provides a current-day overview. Table 5.1 lists those smart technologies and their related health causes. They are composed of three components mentioned in Sect. 5.2.

5.3.2 Physical Causes: Sensors, Devices, and Equipment The first set of smart technologies is mechanisms that collect data to assess the built environment (indoors and outdoors) and the status of users against the physical causes of health. The sensors and monitoring systems can be classified into two categories: sensors and multimedia devices [30]. Sensors, normally wireless, can detect the ambient environment conditions, such as temperature, humidity, light level, sound, and airflow. In general, the use of sensors has become very common due to the ease of installation and simplicity. For example, pressure or force sensors can detect users’ behavior, such as falls and positions [32, 33]. A smart floor system using pressure sensors was designed and built in the Gator Tech Smart House; it was installed underneath a conventional residential-grade raised platform. Unlike other tracking methods, this smart floor with force sensors does not require attention from the residents, and there are no cameras that invade the residents’ privacy [34]. Power sensors are used to identify whether the equipment of system is currently active [35]. Another example is smart smoke alarms, which can remotely alert homeowners about urgent situations at home, giving users a chance to remotely control the home emergency service to ensure minimal damage. Multimedia devices capture audio and visual signs and activities. This data can either be used for analyzing users’ behavior or providing some interaction between the system and users, such as encouraging users to be more active or drink more water. Cameras and microphones are common data acquisition tools; most smart speakers are built based on voice data collection. Other multimedia devices—such as plasma displays, headsets, and LCDs—can also create a platform for information exchange

5.3 Current Smart Technologies for Healthy Buildings

85

Table 5.1 Smart technologies and related health variables Healthy building/built environment variables

Smart technologies

Physical causes

Safety and security Falls and injuries

3D camera, motion Real-time data Control algorithm sensors, pressure sensors

Physiological causes

Indoor air quality

Wireless VOC/CO2 /NO2 sensors

Weather data/real-time data

Thermal comfort

Wireless temperature and humidity sensors

Weather data/real-time data

Lighting comfort

Wireless light/occupancy sensors

Weather data

Acoustic quality

Wireless sound sensors

Real-time data

Safety and security

3D camera, motion Real-time data sensors, pressure sensors

Indoor mold, fungi

Wireless sensors

Real-time data

Pollution

Wireless sensors

Real-time data –

Well-being and mental health

–

–

–

Cognitive function and productivity

–

–

–

Social interaction

–

–

–

Biological

Psychological health

Cloud computing/central control unit/smart device control (iPhone, iPad)

[42]. Most recently, certain devices combine facial recognition (with a camera) with voice recognition to identify and track users. The commercial system Lighthouse is able to identify pattern changes. Lighthouse has a custom optical module featuring a 3D time-of-flight sensor on a home awareness device. This sensor measures the time it takes for emitted light to return to the lighthouse camera after bouncing off objects in the environment, producing a continuously updated 3D model of the scene to accurately identify real-time in-house conditions. Furthermore, the system uses a deep learning algorithm to distinguish between adults, children, and pets, and it also quickly learns the difference between known and unknown faces and other activity patterns. Based on this knowledge, if the system recognizes unusual patterns, it will send an alert to relatives or caregivers. An example message could be: “Ping me if you don’t see anyone at the kitchen camera by 8am every day” [36]. However,

86

5 Smart Building and Current Technologies

the development of multimedia devices is still in its early stage and faces a few technological challenges and concerns about privacy.

5.3.3 Physiological Causes: Sensors and Devices The second set of smart technologies is physiological sensors and devices. Temperature and humidity sensors normally work together with smart thermostats to adjust the indoor temperature automatically, ensuring the temperature and humidity are within a comfortable zone. Motion sensors and light sensors can be used together with a smart plug; when sunlight is not sufficient, electrical lightings can be activated based on the predetermined light level. Motion sensors can also detect the users’ presence and turn lights on and off accordingly. A San Francisco-based startup company, Awair, built a smart home device tracking indoor air quality to monitor temperature, humidity, chemicals, dust, VOCs, TVOCs, and carbon dioxide and provide an air quality score. The device, Awair, is the first to combine all five sensors into one. It can also be connected to a smart thermostat to make adjustments that improve indoor air quality [37] (Fig. 5.5). Physiological devices monitor the health conditions and vital signs of users [32]. The most common devices monitor users’ heart rate, weight, skin temperature, and pulse, utilizing smart houses as a piece of a large monitor to track users’ health. Many popular wearable devices, such as iWatch or Fitbit, can track heart rates. Most recently, certain smart watches can measure blood pressure and are as affordable as less than USD 60. A New York-based company, Eight Sleep, invented a sleep pod/mattress with embedded sensors that not only track physiological signals but also analyze sleep patterns [38]. Moreover, in 2018, Google obtained a patent for an invention that turns smart homes into remote patient tracking devices. The invention, an optical sensor, can be embedded in something like a bathroom mirror and works to track blood flow dynamics in the body [39]. Fig. 5.5 Sensors to track invisible fine dust and chemicals in buildings (Source Awair)

5.3 Current Smart Technologies for Healthy Buildings

87

5.3.4 Psychological Causes The third and last set of smart technologies is related to the psychological causes of occupant health, such as emotional stress and cognitive function degradation. Most psychological benefits from smart technologies are indirect. Evidence from neuroscience research suggests that smart home technologies may aid in the feeling of safety and control over one’s daily life, which contributes to social and emotional well-being as well as the capacity to continue participating in outside interests and activities [40]. Anxiety and stress are two of the most common forms of mental illness, where anxiety can be viewed as a reaction to stress. Both can affect people’s health [41] and also occupants’ overall well-being. Stress is caused by a range of reasons and typically can be mitigated and minimized. For environment-induced stress, smart technologies that provide the occupant with full and instantaneous control are beneficial to reduce stress levels. For example, smart doorbells with a camera and smart lock secure the safety of homes, and smart and remote control systems enable users to have better control of their living conditions, even when away from home. Both feeling in control and having actual control can ease stress and anxiety. These smart devices also allow people with certain disabilities or health issues to control appliances when they are out of reach so they can live an independent and comfortable life, which boosts their sense of security and connectedness to the outside world. Certain interactive smart technologies can improve socialization and even help occupants to overcome feelings of isolation that may lead to depression [42]. Examples include voice-activated devices, such as smart speakers (Siri, Alexa), which can provide certain comforts and interactions.

5.4 Smart Building Components The future global economy will be shaped by decarbonization and a focus on human health. Other drivers could also play important roles such as resource conservation. The conventional view of treating buildings as standalone objects that are only responsive to their surrounding environment causes many opportunities to be overlooked. Out of the ten principles for smart buildings proposed by BPIE (mentioned in Sect. 5.2.2), the majority of the principles are about energy saving and largescale infrastructure building, with an aim to make effective building function as micro-energy hubs. To build upon BPIE’s smart building principles, smart building principles can be expanded beyond energy conservation and operation optimization with the addition of two more aspects: system intelligence and occupants’ health and well-being. Based on the scientific literature and BPIE’s version for smart building in Europe, this book proposes five components of a smart building. They are illustrated in Fig. 5.6: (a) high energy efficiency and an exceptional indoor environment, (b) a dynamic interaction between the building system and its occupants, (c) real-time

88

5 Smart Building and Current Technologies

Fig. 5.6 Smart building principles (credit Christopher Pearce)

data collection and adjustments to the building operation using a self-learning algorithm, (d) facilitation of occupants’ control over their immediate environment, and (e) promotion of occupants’ health and well-being.

5.5 Conclusion Smart buildings have multifaceted goals: to promote smart growth, enhance sustainable development, and create a healthy environment. There is significant progress being made in developing smart technologies that can be applied to smart buildings; however, the challenges are also apparent. A major argument raised by a variety of researchers has been that most studies only demonstrate the feasibility of technological solutions in a laboratory setting without scaled-up evidence [43]. Significant gaps still exist to bridge laboratory scale research and ordinary people’s daily applications. Another challenge of smart buildings is the heterogeneity in technology. In order to create a smart building and environment, a collection of smart sensors, devices, and systems are typically installed. Each of these adheres to different protocols and standards, which easily leads to confusion and conflict. Consequently, the selection of a specific set of devices consumes a large portion of the development

5.5 Conclusion

89

time and budget [36], creating a mental block for adoption of such technologies. Additionally, the effectiveness of smart technologies to support diverse groups of people in their homes and working places is still not well understood or documented. More translational research is necessary. Despite the challenges, the level of intelligence of buildings could be greatly enhanced by existing and future personal smart technologies. These technologies or devices will gradually impact mainstream consumers’ daily life. In chapter six, the author guides readers through several promising and upcoming smart technologies that could shift the smart building landscapes.

References 1. Mozer MC (1998) The neural network house: an environment that adapts to its inhabitants. In: Proceedings of AAAI Spring Symposium, vol. 58. Association for the advancement of artificial intelligence, Palo Alto 2. Ghaffarianhoseini A, Berardi U, AlWaer H, Chang S, Halawa E, Clements-Croome D (2016) What is an intelligent building? Analysis of recent interpretations from an international perspective. Archit Sci Rev 59(5):338–357 3. Omar O (2018) Intelligent building, definitions, factors and evaluation criteria of selection. Alex Eng J 57(4):2903–2910 4. Wigginton M, Harris J (2013) Intelligent skins. Routledge, London 5. Marcus SJ (1983) The ‘Intelligent’ Buildings. New York Times. https://www.nytimes.com/ 1983/12/01/business/the-intelligent-buildings.html. Accessed 22 Jan 2019 6. Forbes. Smart buildings: forming the foundation of smart cities. https://www.forbes.com/sites/ insights-inteliot/2018/10/24/smart-buildings-forming-the-foundation-of-smart-cities/#22f129 c5585e. Accessed 25 Feb 2019 7. Sinopoli JM (2009) Smart buildings systems for architects, owners and builders. ButterworthHeinemann, Oxford 8. IBM. Improve energy use and facilities management. https://www.ibm.com/ibm/green/sma rter_buildings.html. Accessed 10 Nov 2019 9. Kieras DE, Meyer DE (1997) An overview of the EPIC architecture for cognition and performance with application to human-computer interaction. Hum-Comput Interac 12(4):391–438 10. Fan C, Xiao F (2017) Assessment of building operational performance using data mining techniques: a case study. Energy Procedia 111:1070–1078 11. Aste N, Manfren M, Marenzi G (2017) Building Automation and Control Systems and performance optimization: a framework for analysis. Renew Sust Energ Rev 75:313–330 12. Deloitte Insights. Smart buildings: four considerations for creating people-centre smart, digital workplaces. https://www2.deloitte.com/content/dam/insights/us/articles/4748_Smartbuildings/DI_Smart-buildings.pdf. Accessed 25 Feb 2019 13. Stojkoska BLR, Trivodaliev KV (2017) A review of internet of things for smart home: challenges and solutions. J. Clean. Prod. 140:1454–1464 14. Casini M (2016) Smart buildings: advanced materials and nanotechnology to improve energyefficiency and environmental performance. Woodhead Publishing, Cambridge 15. Cannavale A, Martellotta F (2019) Smart perovskite-based technologies for building integration: a cross-disciplinary approach. In: Pacheco-Torgal F, Diamanti MV, Nazari A, GoranGranqvist C, Pruna A, Amirkhanian S (eds) Nanotechnology in Eco-efficient construction. Woodhead Publishing, Cambridge, pp 441–466 16. Wegst UG, Bai H, Saiz E, Tomsia AP, Ritchie RO (2015) Bioinspired structural materials. Nat. Mater. 14(1):23

90

5 Smart Building and Current Technologies

17. Dry CM (1992) Smart building materials which prevent damage or repair themselves. MRS Online Proceedings Library Archive, 276 18. Song G, Ma N, Li HN (2006) Applications of shape memory alloys in civil structures. Eng. Struct. 28(9):1266–1274 19. Li J, Duan Q, Zhang E, Wang J (2018) Applications of Shape Memory Polymers in Kinetic Buildings. https://pdfs.semanticscholar.org/8beb/624eb1a2e6efd2f5208ca38441a8d341c468. pdf. Accessed 13 Dec 2019 20. Ahmad MW, Mourshed M, Yuce B, Rezgui Y (2016) Computational intelligence techniques for HVAC systems: a review. Build Simul 9(4):359–398 21. Yuce B, Mourshed M, Rezgui Y (2017) A smart forecasting approach to district energy management. Energies 10(8):1073 22. World Green Building Council. 2019 Global status report for buildings and construction. https://www.worldgbc.org/news-media/2019-global-status-report-buildings-and-constr uction. Accessed 13 Dec 2019 23. Liu KC, Yen CY, Chang LH, Hsieh CY, Chan CT (2017) Wearable sensor-based activity recognition for housekeeping task. In: Leonhardt S, Yang, G-Z., Habetha J (eds) Proceedings of 2017 IEEE 14th international conference on wearable and implantable body sensor networks (BSN). IEEE, Eindhoven, pp 67–70 24. Zhu C, Sheng W, Liu M (2015) Wearable sensor-based behavioral anomaly detection in smart assisted living systems. IEEE T Autom Sci Eng 12(4):1225–1234 25. Nguyen LV, La HM, Sanchez J, Vu T (2016) A smart shoe for building a real-time 3D map. Automat Constr 71:2–12 26. Building Performance Institute (2019) A vision for smart buildings in Europe. http://bpie.eu/ wp-content/uploads/2017/04/smart-building-ws-April-2017_BPIE.pdf. Accessed 25 Feb 2019 27. Building Performance Institute (2019) Is Europe ready for the smart buildings revolution? http://bpie.eu/publication/is-europe-ready-for-the-smart-buildings-revolution/. Accessed 25 Feb 2019 28. Wong JKW, Li H, Wang SW (2005) Intelligent building research: a review. Automat Constr 14(1):143–159 29. Asian Institute of Intelligent Buildings. IB technical: What are IBS. http://www.aiib.net/index_ topic.php?did=248228&didpath=/248063/248228. Accessed 22 Jan 2019 30. Alam MR, Reaz MBI, Ali MAM (2012) A review of smart homes—Past, present, and future. IEEE Trans Syst 42(6):1190–1203 31. Trusennse. How it works. https://mytrusense.com/independent-living-2/how-it-works/. Accessed 20 Jan 2019 32. Noury N, Hervé T, Rialle V, Virone G, Mercier E, Morey G, Porcheron T (2000) Monitoring behavior in home using a smart fall sensor and position sensors. In: Proceedings of 1st Annual International IEEE-EMBS Special Topic Conference on Microtechnology in Medicine and Biology (Cat. No. 00EX451). IEEE, Lyon, p 607–610 33. Suryadevara NK, Mukhopadhyay SC, Wang R, Rayudu RK (2013) Forecasting the behaviour of an elderly using wireless sensors data in a smart home. Eng Appl Artif Intel 26(10):2641–2652 34. Helal S, Chen C (2009) The Gator Tech Smart House: enabling technologies and lessons learned. In: Proceedings of the 3rd International Convention on Rehabilitation Engineering & Assistive Technology. ACM, Singapore, p 13 35. Li M, Lin HJ (2015) Design and implementation of smart home control systems based on wireless sensor networks and power line communications. IEEE Trans Ind Electron 62(7):4430–4442 36. Aging In Place Technology Watch. Lighthouse helps elderly parents age in place in their home longer and more safely. https://www.ageinplacetech.com/pressrelease/lighthouse-helpselderly-parents-age-place-their-home-longer-and-more-safely. Accessed 5 July 2019 37. Awair. See the invisible. https://getawair.com/pages/awair-glow. Accessed 11 Nov 2019 38. Eight Sleep. Smart Bed. https://eightsleep.com/product/smart-bed/. Accessed 6 March 2019 39. United States Patent and Trademark Office. Assessing cardiovascular function using an optical sensor. http://pdfaiw.uspto.gov/.aiw?PageNum=0&docid=20180000355&IDKey=

References

40. 41. 42. 43.

91

1D7F3A694412&HomeUrl=http%3A%2F%2Fappft.uspto.gov%2Fnetacgi%2Fnph-Parser% 3FSect1%3DPTO1%2526Sect2%3DHITOFF%2526d%3DPG01%2526p%3D1%2526u% 3D%2Fnetahtml%2FPTO%2Fsrchnum.html%2526r%3D1%2526f%3DG%2. Accessed 6 March 2019 Morris ME, Adair B, Miller K, Ozanne E, Hansen R, Pearce AJ, Said CM (2013) Smart-home technologies to assist older people to live well at home. J Aging Sc 1(1):1–9 Anxiety and Depression Association of America. Facts & Statistics. https://adaa.org/aboutadaa/press-room/facts-statistics. Accessed 1 April 2019 Marikyan D, Papagiannidis S, Alamanos E (2019) A systematic review of the smart home literature: a user perspective. Technol Forecast Soc Change 138:139–154 Ding D, Cooper RA, Pasquina PF, Fici-Pasquina L (2011) Sensor technology for smart homes. Maturitas 69(2):131–136

Chapter 6

Future Smart Technologies for Human Health

This Chapter first focuses on the smart priority shift and related technological impact. Then, the chapter describes five unique smart capabilities that future smart buildings will possess. “Capability” relates to technological advancements and health benefits, and the potential populations who could be served are described as well. The five smart capabilities and components introduced in this chapter will be used to describe three case studies in Chap. 7.

6.1 Smart Priority Shift The focus on smart buildings and technologies has changed over time. Initially, in the 1980s, smartness focused on improving building performance and reducing the operational cost. Starting in the late 1990s, the focus on smart buildings shifted from system automation to user experience. The interaction between people and the built environment, with the aim to improve the quality of life, has become the focal interest across disciplines [1, 2]. Between 1990 and 2000, smartness was defined as responsiveness, rather than automation, and the design no longer centered on just the building; the users and the environment were given equal amount of attention [2]. Beginning in the early 2010s, traditionally ignored social and economic factors were recognized and added to the more recent definitions of smart buildings [3, 4]. Using advanced technologies to enhance, promote, or encourage social interaction and engagement became a dominant research and development trend. Following this trend, information and communication technology (ICT) in the building industry started to create the digital “brain” of smart buildings. If individual buildings are treated as their own ecosystems, the physical system and components have distinguishing functions. The plumbing system circulates water, the electric wires supply power, and the structural beams and columns support the whole building. Until

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_6

93

94

6 Future Smart Technologies for Human Health

Fig. 6.1 Five trends in the smart priority shift

recently, the physical built environment has lacked the most critical part: an intelligent brain. Without this, the users (building occupants) have to manage the plumbing, electric, and structural systems manually or semi-manually. Powerful new cognitive abilities of buildings constructed using ICT are the results of utilizing the massive data flow within the physical structures [5]. Through the collection analyses of this massive data, smart buildings not only respond to occupants’ demands and requests but also learn, adapt, think, and react. In the following section, five primary priority shifts (refer to Fig. 6.1) establish the foundation for future smart technologies development.

6.1.1 Shift One: Smart Versus Sustainable As mentioned in Chap. 5, the main purpose of smart buildings in the 1980s was to improve building facility management and allow building owners to have better control of the buildings, with one of the goals being to minimize costs through energy

6.1 Smart Priority Shift

95

Fig. 6.2 Search trends on Google (Source Google Trends)

savings. Overall, the development and advancement of the smart building movement has been highly linked to sustainability principles for two reasons [6]. Firstly, the primary concern in the past few decades has been energy and resources conservation in developing and developed countries. Secondly, fast-growing environmental degradation and climate change have posed a global threat to humans. However, this focus is changing. According to search interest on Google from January 2004 to July 2019 (refer to Fig. 6.2), trends clearly indicate a decline in search interest for “sustainable building” and an increase in interest for “smart building.” In line with this increase in interest for smart buildings, searches for “healthy building” or “well building” are growing steadily. Globally, interest in sustainable buildings was superseded by interest in smart and healthy buildings around the beginning of 2017, and based on the current trajectory, the focus on smart building will experience an uptick in the near future. Development among major developed countries who have been leading the efforts in sustainable building and smart building (refer to Fig. 6.3) reflects different focus areas across countries. Regarding smart building topics, Germany and Japan are several steps ahead of the United States and the United Kingdom, where smart buildings have already became the leading topic, surpassing sustainable buildings. Meanwhile, in the United Kingdom, overall, sustainable buildings still control the primary market interest, even though the margin is small.

6.1.2 Shift Two: Black Box Versus Digital Identity Built upon shift one, sustainability (energy conservation and environmental protection) is not the only focus of smart buildings. A building’s intelligence is also vital: building occupants want to decrease costs, improve the indoor environment, and occupy a building or built environment that understands their needs. Before, a

96

6 Future Smart Technologies for Human Health

Fig. 6.3 Search trends comparison among the United States, the United Kingdom, Japan, and Germany (Source Google Trends)

building’s system operation was essentially a black box: only the building engineers understood the building’s operations, and data was only available and examined when a problem occurred. In 1999, Ken Sinclair, a building automation expert, mentioned the concept of a building functioning as an internet service provider and correctly predicted that the internet server would be part of all buildings’ future [7]. The concept of a large building with its own internet identity is now the latest development in smart building history. Emerging 5G technology and Citizens Broadband Radio Service (CBRS), together with real-time operational data, are used to create a dynamic and virtual model of the physical structure, which is called the “digital twin” of the physical built environment (refer to Fig. 6.4) [5]. The concept of a digital twin was first coined by Dr. Michael Grieves in a presentation given to industry in 2002 for the formation of the Product Lifecycle Management center at the University of Michigan [8]. The internet of things (IoT) technology made digital twin affordable and accessible to many people [9]. IoT-enabled sensors track a building’s “pulse” and feed data back into a control algorithm. Building managers are able to reconstruct every relevant metric from a physical structure in a digital environment. All assets, equipment, and devices can be monitored, analyzed, and shared. The following are examples: How much power did the third floor use during the winter months? When was the dishwasher typically turned on in one-bedroom units? Does the temperature and air quality in the waiting room of this hospital meet the requirements? The intelligent digital twin of a physical world will be able to operate buildings in a more effective and efficient way that makes every building sustainable. Instead of being a stand-alone commodity, sustainability will become an integral part of smart buildings. The transparency

6.1 Smart Priority Shift

97

Fig. 6.4 Digital twin of the physical built environment (credit: Christopher Pearce)

of available real-time data helps deliver a prioritized overview of potential improvements in building performance, energy use, and indoor air quality. Transparency helps potential building owners and users to understand the added value of smart buildings. This added value manifests itself in lower operating costs through quick responses and greater efficiencies, adaptability, comfortability, and flexibility.

6.1.3 Shift Three: Product-Centered Versus Individual User-Centered Since the 1990s, technologies centered on smart houses have been product- and system-centered, and have focused on technology advancement instead of the users’ viewpoint [10]. The majority of research and experiments discuss potential benefits that smart technologies would provide; however, there is very little empirical evidence regarding the users’ experience and feedback [9]. In the past several years, smart technologies, such as smart phones and the smart watches have reached the mainstream. Additionally, smart homes have been rapidly advancing and attracting much attention from academia and industries other than the building automation field. The priority of technological development has shifted from product-centered to user-centered. Personal care, especially home-based care for the elderly and other vulnerable populations, has become an important issue: Can smart homes help seniors to live a more independent life? Can smart technologies safeguard children’s safety?

98

6 Future Smart Technologies for Human Health

Can smart buildings improve and enhance users’ health and well-being? Smart technologies can also improve the lives of those not included in vulnerable populations. According to a study by the Center for Disease Control (CDC), American employers lost $225.8 billion each year ($1,685 per employee) due to worker illnesses and injuries [11]. Globally, the economic burden of work-related injuries is equal to 4% of the world’s gross domestic product [11]. Besides physical illnesses, mental health and psychological conditions also affect employees’ productivity. Stress, depression, fatigue, and other emotional issues could cost the US economy roughly $16 trillion over the next 20 years—more than the cost of any other non-communicable disease [12, 13]. Therefore, employers have a business incentive to protect their employees’ health through providing a safe, healthy, and comfortable working environment. Smart technology has focused on personal health since early 2010. The invention and popularity of smart wearable devices, such as the Apple Watch and Fitbit, help to monitor people’s activities and physiological data for long periods of time and then extract information and provide recommendations based on personal data. A growing number of tech companies and designers have started to examine the methods to integrate such smart technologies and data monitoring or collecting mechanisms in buildings, which is described as a biometric data integrated system. The focus of smart buildings on equipment and as being system-centered has begun to shift toward individual user-centered technologies. In Chap. 7, several smart houses equipped with intelligent systems will be used as case studies to demonstrate the functions, advantages, and future applications of those smart technologies as well as the weaknesses and disadvantages.

6.1.4 Shift Four: Failure Prevention Versus Responsive Building Since the onset of smart technologies application in the building control system, the central focus has been ensuring energy efficiency, which also reduces costs while keeping system failures and downtime to a minimum. Furthermore, smartness is reflected in quick responsiveness. Increasingly, as knowledge and technologies advance, preventing building systems from failing is no longer the largest challenge; instead, providing comfort to all building occupants has been a significant concern since people have different biological and psychological needs. Riding on the shift from being product-centered to user-centered, a personalized local environment has become one of the reachable goals of smart buildings. Providing personalized comfort contributes to users’ productivity and well-being. Wearables have the potential to help smart buildings provide a personalized environment suited to the individual users within one smart space (refer to the case studies in Chap. 7). If a wearer’s personal preferences are known, then the local environment can be adjusted to the optimal temperature and humidity, among others. By tracking the wearer’s movements, wearables help to ensure that heating and cooling is directed to where

6.1 Smart Priority Shift

99

it is needed; they also take into account variable factors like body heat, which varies among users of a building [14]. As with other areas of data and analytics, the information collected from wearables will be of limited value unless the building control system, especially the HVAC system and communication system, can respond in a smarter way. For example, if the HVAC system can only modify conditions across a wider area, such as by floor, then the wealth of collected personal data will not be useful, and personalized comfort will not be achieved. Personal preferences require a locally modifiable environment, and existing building systems likely do not meet those requirements sufficiently. A real breakthrough for smart wearable technologies requires an evolution of conventional building systems. In Sect. 6.2, several future and potential solutions will be explained in detail.

6.1.5 Shift Five: Smart Built Environment Versus the Individual Building Most recently, the interest in smart and intelligent buildings has been fostered by attention to the concept of smart cities and carbon-neutral cities. A true smart building does not exist without a smart infrastructure and smart built environment, and smart cities require information and resources to be shared effectively and intelligently among the inhabitants. It is impossible for cities to become smart if buildings are not integrated with other aspects of the city, such as the energy grid, transportation system, and other supply chains. Moving forward, the development of smart buildings will depend on the integration between individual buildings and larger built environment. Smart built environments have been developed or renovated with a smart and different mindset. The activities within a smart built environment are more important than the raw infrastructure or the individual building. The occupants of the building become customers instead of tenants: instead of tenants paying rent for a shelter, they are now customers paying for the services provided in smart buildings [15]. More connected buildings allow for an increase in the quality and quantity of services the building can provide for customers.

6.2 Future Smart Building Technology: What Makes a Building Smart? As the concept of a digital twin of a physical built environment (mentioned in Section 6.1) becomes more accepted, one can imagine a dynamic and virtual model of the physical built environment powered by the significant amount of data collected from a variety of smart devices, such as smart thermal stats, smart lighting sensors, and smart watches. The digital twin of a smart building could function as a living

100

6 Future Smart Technologies for Human Health

Fig. 6.5 Five abilities that make a building smart

organism or even think or behave like a human. We can think of artificial intelligence as the brain, IoT as the body, and the control algorithm as the nervous system connecting them. In this book, the author organizes smart technologies into five primary components or abilities of smart buildings, and the future intelligence of smart buildings is the combination of those five abilities to adapt to human needs. The five abilities are: (a) the collection of raw data through IoT, (b) learning of past experiences through an intelligent control algorithm, (c) the artificial intelligence function as a brain, (d) a customized environment through biometric integration, and (e) adaptation to the ever-changing environment through context awareness (understanding of surroundings). In the following section, the author takes a deep dive into those five abilities (Fig. 6.5).

6.2.1 Collection of Raw Data Through IoT The term IoT was first proposed in 1999 by Ashton [16], a British technology pioneer. It was also known as pervasive computing, ubicomp, and ambient intelligence. The internet of things is a network of connected sensors, devices, equipment, appliances, and meters that are capable of sending or receiving and sharing data [17]. It allows data to be stored in the cloud. In the context of the built environment, while the term is new, its operation is not. The building industry served as one of the first industries to realize and embrace the foundation concepts of IoT in the form of building automation. For example, direct digital control (DDC) is commonly used in complex HVAC systems. DDC allows for a system controller to compute the sequences of operations based on the digital input from systems’ sensors [18]. The development of DDC allows building systems to receive real-time digital input data, which provides machines and people with the ability to evaluate and manipulate the physical world; this is referred to as IoT [19]. IoT is normally composed of wireless sensor networks (WSNs) and radiofrequency identification (RFID) devices. A WSN consists of smart sensing devices that can communicate through direct radio communication [20]. In buildings, the smart sensing devices could be daylight, occupancy, movement, temperature, and

6.2 Future Smart Building Technology: What Makes a Building Smart?

101

sound detectors. They are used to measure key performance indicators: indoor air quality, lighting level, sound level, and others. These sensors are connected and communicate with each other through radio communication. RFID devices consist of two components: an integrated circuit with some computational capabilities and an antenna for communication [20]; normally, in a building, such devices are physical devices. The wireless sensors could also be embedded in home appliances or office equipment. Lastly, in order to be called IoT devices, they need to be connected to a cloud-based service and other IoT devices. Devices with built-in wireless connectivity that do not connect to a data cloud or share information with other devices are not IoT devices. For example, a smart light bulb that is controlled by a remote control or device without sharing information with other devices is not considered IoT. The cloud provides a massive data storage and processing infrastructure, which is the central part of the smart system (refer to Fig. 6.6). Currently, sensors, WSNs, and RFID devices are all available on the market and can be adapted to existing buildings. IoT could potentially transfer building stocks into an energy-aware, climate-sensitive, and user-responsive environment [20]. Unlike the integration of IoT within a large energy infrastructure grid, most technical challenges—such as electromagnetic interference [21], network latency and available bandwidth, and unviability of a universal language [22]—are not present in a smart building or smart home environment. For example, strong electromagnetic fields related to a large grid are not associated with a home grid infrastructure [20]; furthermore, the network latency is less obvious in a smart building or smart home environment. Therefore, there are fewer technical difficulties and barriers to creating a smart building environment with IoT.

Fig. 6.6 IoT ecosystem of smart buildings or smart houses (Source Christopher Pearce)

102

6 Future Smart Technologies for Human Health

The most famous smart building or smart home technologies based on IoT are Google Home and Amazon Alexa, both available in the United States, which connect a variety of smart appliances and devices at home to a cloud database. The Amazon Echo smart speaker (Alexa) is one of the most affordable ways to connect and control multiple smart devices and appliances. Google acquired a smart home thermostat company called Nest in 2014, which is best known for creating the Nest Learning Thermostat, which learns the temperature preference of its users [23]. The deployment of IoT in smart buildings can ensure indoor environment comfortability, high functionality, and energy efficiency of buildings by connecting devices, appliances, and building systems together. However, IoT integration in smart buildings does have challenges, such as security [24], privacy [25], and reliability. Despite the vast opportunities and merits of IoT integration in a smart built environment, only small amounts of data can be stored within a device because of the limited storage capacity of memory cards. Moreover, storing data on other sites demands high security and privacy. It is expected that smart objects will dominate the market in the next few years and will become omnipresent in smart buildings and smart homes [20]. The success of smart technologies in buildings will depend on whether solutions can be found to overcome security and privacy concerns.

6.2.2 Learning from Past Experiences Through an Intelligent Control Algorithm While buildings that use IoT do increase energy efficiency and cost effectiveness, the priority of IoT is to intelligently address the needs of buildings’ occupants, which include physical, physiological, and psychological needs. As mentioned in Chap. 2, indoor environmental quality plays a critical role in occupant’s health. The connected air quality sensors will detect any issues related to the air quality and CO2 levels and then send a signal to the building management system. As a result, the building system can identify problematic areas before the occupants sense the discomfort and proactively address air quality-related issues through adjusting the ventilation system or other methods. Furthermore, the connected daylight and occupancy sensors detect the occupant’s movement or body heat, so lighting fixtures or fans can be turned on or off based on the needs. The lighting control system is also often integrated with a shading device, so it can control the lighting level. It can also adjust the shade position based on personal preference and working schedule, in order to minimize glare and increase the occupant’s physiological and psychological comfort. Such intelligent utilization and application of data are enabled through a control algorithm that can learn from past experiences and real-time data and then predict future problems.

6.2 Future Smart Building Technology: What Makes a Building Smart?

103

The purpose of a control algorithm is to provide intelligence to the built environment and establish the interaction between users and systems. Most smart mechanisms are connected to each other, the users, and the central unit through a communication network, and information can be shared back and forth. Majority of early control algorithms in smart buildings were reactive and focused on energy conservation, such as the automated system and smart appliances. For example, the HVAC systems were connected to the automation system based on local weather data and real-time indoor ambient environmental data collected through the smart sensors mentioned above [26, 27]. This type of control algorithm has been in development since the early 1990s and has already reached its mature stage to date. There are many affordable products available to users. For example, one of the industry leaders in building automation, Honeywell, created a smart home system to reduce energy consumption and related carbon emissions by adopting the “start-stop” automatic system used in the car industry [28]. When no heat is required from the individual room control, its heat generation will be automatically switched off; the same applies to cooling as well. The next level of algorithm is proactive, which can add additional functionalities of users’ behavior tracking and activity recognition, therefore predicting the users’ potential needs. Popular proactive control algorithms include the artificial neural network (ANN) [29, 30], distributed intelligent multi-agent system [31, 32], Bayesian method [33, 34], and summarization algorithm [35]. ANNs are used in home energy control systems to conserve energy by detecting the usage patterns of home appliances [35]. Even though the ANN system requires much time to obtain reasonable efficiency, it does not require any previous knowledge about the users or built environment; its ease of installation has made it quite popular for users [35]. Multi-agent algorithms are highly adaptable to various applications, such as thermal comfort control [36] and energy conservation [37]. Bayesian methods are used to detect and predict the activities and locations of users or to understand the temperature preference of different users, with a success rate of 82% [33, 34]. Currently, proactive algorithms are the most challenging part of smart systems or platforms for the built environment, and there are several major barriers. Firstly, regarding multiple users simultaneously inhabited in the same space, it is still difficult to track them with enough independent algorithms. Secondly, the accuracy of the algorithms is not completely verified yet [36]. Without sufficient tracking and high-level accuracy, current smart buildings still depend on users to make the most important decisions; therefore, the intelligence of buildings remains incomplete. In the future, a proactive control algorithm could have more intelligence by integrating a machine learning capability, so that the control system not only responds to the immediate users’ requests but also predicts users’ demands based on observed behavior patterns. Central to the realization of such a proactive control algorithm is artificial intelligence (AI). As mentioned before, AI acts as the brain of the smart building while the control algorithm functions as the nervous system, delivering instructions to smart organs (e.g., appliances, equipment, devices).

104

6 Future Smart Technologies for Human Health

6.2.3 Artificial Intelligence: The Brain To understand artificial intelligence, human intelligence must first be examined. As individuals, humans can cope with a vast range of challenging situations, including those for which they have no prior experience. Success and capability stems from humans’ innate ability to integrate how they perceive the environment, process memories, respond to stimuli, comprehend the information, and communicate with others [38]. Nils J. Nilsson, one of the founding researchers of computer science from Sandford University, defined AI as follows: “…the activity devoted to making machines intelligent, and intelligence is that quality that enables an entity to function appropriately and with foresight in its environment” [39]. Machine intelligence is used to define artificial intelligence in contrast to human intelligence yet mimic the “cognitive” functions that humans associate with the human mind, such as information processing, problem-solving, and contextual understanding. The adoption of AI technologies in the building and construction sector is still relatively nascent. Overall, the adoption of AI is low in the building industry, especially compared with other industries (refer to Fig. 6.7). McKinsey research compared building construction to

Fig. 6.7 Adoption of AI in different sectors and industries (Source McKinsey & Company) [42]

6.2 Future Smart Building Technology: What Makes a Building Smart?

105

12 other industries. Ten of those industries are further along in current AI adoption, such as financial services, high tech and communication and transportation; construction and education are two sectors falling behind [40]. Those sectors who are leading in the adoption of AI also intend to grow their future investments the most [42]. Even with the slow adoption of AI in the building industry, there are many potential applications of AI that can be explored, such as computer vision, advanced robots, and management optimization. The initial application of AI in the building industry was in risk management for construction sites. Computer vision seeks to automate tasks that the human visual system cannot perform from an engineering perspective. For instance, a computer vision program monitors the safety conditions of a job site, and it can automatically notify the site security officer if a safety compliance breach is detected. Video images can also be used for incident analysis. A combination of computer vision and advanced robots is emerging in the construction sector. Advanced robots capture 3D scans of construction sites and analyze the site conditions using computer vision. Then, 3D scans, combined with a safety and risk database, can be used to evaluate the safety conditions of the site using a deep neural network. Lastly, the data and evaluation are able to predict the risks. Afterwards, the design and construction team can communicate these risks to the project manager. From this perspective, the purpose of AI is to enhance and improve efficiency, not to replace human intelligence. Besides risk management, advanced robots can also be employed to increase productivity by reducing the construction time. The first wave of construction robots was in the 1980s and was based largely on bolt-on enhancements, laser guidance, and an ultrasound that were built into the product equipment to improve work efficiency [33], decrease construction time, and improve precision. The second wave of robotic application occurred in the 2000s by architects: small-scale 3D printers were used to quickly print 3D models for studies or presentations. The third wave, which emerged around the beginning of the 2010s, scaled up the 3D printer and combined it with building information modeling (BIM) to produce real-scale buildings. ICON, an Austin-based construction technologies company, produced the first 3D-printed home in the United States in a few weeks using robotics (see Figs. 6.8 and 6.9). AI in management optimization often can be found in smart building management that has the ability to predict human behavior from a collection of raw data, and the management of information. IT corporations IBM and Microsoft have released their versions of AI application aimed at augmenting management decision-making capabilities while increasing interoperability. Watson IoT is a cloud-based AI platform developed by IBM [41] that connects legacy building systems (e.g., mechanical system, lighting system), modern sensors, and external products with a responsive web application. Firstly, an AI model creates a knowledge graph of each building, which understands large datasets of concepts and objects in a building and how they are related. Then, the AI model uses the knowledge graph, as well as data received from IoT sensors and building systems, to detect and predict future behavior. The IBM Watson IoT headquarters, located in Munich, Germany, was called the smartest

106

6 Future Smart Technologies for Human Health

Fig. 6.8 Chicon House 3D printed by robots (Source ICON)

Fig. 6.9 Vulcan II printers that were used to print the Chicon House (Source ICON)

building in the world (Fig. 6.10). The building covers more than 2,400 m2 , with over 1,000 employees and clients using the space. The Watson IoT system created the digital twin of the building and also gave each person a unique digital identity. The system can detect a specific person sitting down and set the heating, lighting, and cooling conditions to this person’s preference [42].

6.2 Future Smart Building Technology: What Makes a Building Smart?

107

Fig. 6.10 IBM Watson IoT HQ, Munich (Source IBM)

6.2.4 Customized Environment Through Biometric Integration Biometric recognition refers to the automatic recognition of individuals based on their physiological and behavioral characteristics, such as facial recognition, fingerprint recognition, color and size of the iris or retina, shape of the hand, shape of the ear, voice recognition, movement of body, and typing style, among others [43]. With the integration of biometric sensors for lighting, heating, and cooling in a building’s control system, the building can create a localized ambient environment tailored to the user’s personal preferences. There are many advantages associated with providing a customized indoor environment for an individual, with one being the promotion of the health and well-being of occupants. Through biometric sensors identifying users, the room temperature and lighting of a smart home will be adjusted based on the user’s preference registered in the system. Even the height of a chair, preferred music, and preferred height of shades can be automatically altered to a user’s preference. This may seem to be a distant reality; however, a house or a building that can anticipate its user’s needs and wants is not a recent idea. One pioneer is Bill Gates, who advocated the intelligence of a house through its ability to recognize the user and adjust the ambient environment accordingly. In his 1995 book The Road Ahead, he described his current house: My house is made of wood, glass and stone. It is also made out of software. If you come to visit, you will probably be surprised when you come in someone will give you an electronic pin to wear. The pin tells the house who and where you are. The house uses this information to give you what you need. When it’s dark outside, the pin turns on the lights nearest you, and then turns them off as you walk away. Music moves with you too…. Of course, you are also able to tell the house if you want something….

This may not be the first description of a smart house, but it could be one of the most detailed descriptions close to the present direction of where the smart house is headed. Gates also predicted in his book: “I believe that ten years from

108

6 Future Smart Technologies for Human Health

now, most new homes will have the system that I’ve put in my house.” More than twenty years later, in 2020, there are several smart home control systems, mostly using voice control, motion sensors, and smart phone applications, among others. Today, users can remotely control heating, lighting, and cooling from their cell phone applications, such as Google Home, Amazon Alexa, or Samsung Bixby. The core of such automation is based on biometric data. There are some biometric sensors, such as facial recognition systems and fingerprint scanners, which have been implemented in security systems in smart homes since 2015. For example, the Next Hello, a video doorbell, will alert owners when someone is at their door as well as the identity of the person, and Nest Hub Max (a touchscreen smart speaker) can locate a person’s face across a room and then display information specific to that person without speaking. Besides being integrated in the security system, biometric data integration can help vulnerable populations to dramatically improve their life quality and help people with special needs to become more independent. For instance, for healthy elderly people who prefer to live in their own house, a combined home control and security system could help them maintain their autonomy in their daily activities. Certain wireless biometric smart home systems cost as low as $6,000 [44]. This type of biometric system includes vein recognition and fingerprint recognition sensors. A building’s systems or components that can be paired with the biometric system are a burglar deception system, lighting control system, window control system, gas leakage detection system, and structural soundness monitoring system. Overall, biometric systems focus on security and daily building operations. Other smart home systems focus more on elderly people’s well-being. Wireless sensors that track the heart rate, pulse rate, respiration rate, body temperature, and blood pressure can be installed in a smart home, and real-time monitoring data helps elderly users check their health status on their own or report to their caregivers. These types of biometric data, which are highly correlated with health, can be collected and then correlated with the environmental situation to diagnose and predict an elderly person’s health condition. In Chap. 7, an experimental house for an elderly inhabitant details the smart technologies used and related functions. One of the disadvantages of conventional sensors (even the most recent wearable sensors) is their intrusiveness; the users must carry them around in order for data to be collected. Recently, researchers have been working on biometric sensing technology that is not intrusive and easy to be implemented. A team of researchers at MIT’s media lab introduced a wireless sensing technology that can remotely monitor the heart rate and breath by detecting chest movements and skin vibrations due to heartbeats. This sensing technology is not only non-intrusive but also enables a smart building to monitor multiple people simultaneously [44]. Further developments of such nonintrusive sensing technology that integrates biometric data could lead to intelligent buildings that can monitor people’s vital signs remotely and actively contribute to people’s health and well-being [44]. Furthermore, such biometric sensor integration is not only beneficial to the elderly and other vulnerable populations—it can also be useful to the general population. One of the pioneer examples is the Darwin system developed by Delos. The Darwin

6.2 Future Smart Building Technology: What Makes a Building Smart?

109

system is a data-synthesizing technology that is part of a project led by the largest homebuilder in the United States: KB Home. In 2019, KB Home launched ProjeKt, which responds to the future needs by integrating smart and sustainable technologies in regular households [45]. Delos is a wellness real estate and technology company that is shifting conventional real estate to a new focus: the improvement of occupants’ health, well-being, and performance [46]. It is the founder of the WELL Building Standard: the first building design standard to focus on the indoor environmental impact on people’s health and well-being. The WELL Building Standard includes seven categories: air, water, nourishment, light, fitness, comfort, and mind. The Darwin system was launched in September 2018 and was the world’s first residential wellness technology platform to monitor, calibrate, and activate indoor environments and respond to changing conditions [47]. This platform consists of four components: air quality, indoor comfortability, circadian lighting quality, and water purification. Air quality sensors are installed and connected to the platform, and air quality data are analyzed through an algorithm developed by Delos to alert occupants when the air quality drops while automatically starting the air purification system to remediate poor air quality. Indoor comfort mainly centers on temperature control and automation of the shades, together with circadian (dimmable) lighting, to mimic natural lighting and thermal conditions in order to improve comfort and enhance sleep quality. Despite the large number of smart technologies created in the past ten years that enable biometric integration in building control systems, the level of intelligence of such biometric integration has not reached the same level of Gates’s prediction in 1995. Much of the integration of biometric sensors in smart buildings has been hindered largely due to the concern for security and privacy. Most biometric information is not resettable; once stored, it can be misused if no security protocol is put in place. Consequently, users and regulators are greatly concerned about the impact of potential misuse. Due to such concerns, most existing biometric integration in smart buildings still relies on explicit selected input from the user, allowing users to choose what to share. The consequence is that the building itself still cannot track its occupants’ physiological conditions, monitor their behavior, and adapt to their needs. Besides the control algorithm that could integrate biometric information, in order for a building to perform at the level that Gates described, it would also need the ability to be aware of its surroundings, both inside and outside. However, this would generate even higher privacy and security concerns. In order to further develop a smart built environment with biometric integration, the first step is to create a data collection, process, and sharing protocol across all stakeholders in the global building and construction industry that addresses the privacy and security concerns.

6.2.5 Context Awareness: Consciousness Context awareness concerns the capability to detect and react when an object is changed or the surrounding environment is changed [47]. Context awareness in smart

110

6 Future Smart Technologies for Human Health

buildings has two layers. First, the house needs to sense and track occupants. Knowledge of a user’s location enables an effective information transfer to the user’s mobile devices, such as the local time, weather, or directions to the nearest coffee shop or hospital [48]. Most researchers envision this type of awareness technology being integrated into a smart building to make the building actively respond to the user’s potential demands instead of reacting passively. For instance, based on weather data and predicted snowstorm conditions, together with the health condition of elders and children in a family, a smart house could automatically raise the set temperature in the rooms and turn on the snow melting system on the patio at a certain time. Moreover, a smart office building can automatically set the lighting levels based on multiple employees’ working schedules and preferences. Wherever the occupants choose to sit and work, the desk lighting conditions can be automatically tuned to the optimal setting for that particular user, while the overall lighting level on the entire floor is adjusted to the outside ambient conditions. The second layer of context awareness is where a house is aware of its own existence and conditions, allowing it to make decisions, such as whether to order a predictive checkup or maintenance of a piece of equipment before it breaks down [48]. Predictive maintenance is different from preventative maintenance; the latter relies on assumptions while predictive maintenance is based on the real and current building conditions. The manufacturer warranty and the life span of a building component or piece of equipment are typically used to create a preventative maintenance schedule, but it is difficult to account for variations during the actual building operations. Some components might wear out sooner than expected while others last longer. For example, a harsh outdoor environment (e.g., high temperatures, flooding) could accelerate the wear and tear of rooftop mechanical units and the exterior brick mortar. Predictive maintenance uses real data collected from a variety of IoT sensors and synchronizes the information in the cloud to get a realistic assessment and produce a data-driven report on the state of the building. Maintenance is then performed when it is truly required. In this sense, the building itself could be aware of its own conditions and make predictions about when and where attention is needed.

6.3 Further Benefits of Smart Buildings: Health and Well-Being Traditionally, smart technologies, such as smart controls and sensors, have been employed to improve buildings’ operational efficiency. For example, daylight sensors, occupancy sensors, and the building automation system, together, have reduced the energy consumed from lighting in both commercial and residential building sectors. Smart appliances and demand-response programs have helped to improve the efficiency of heating and cooling systems. Smart technologies have become highly attractive to the commercial market, particularly for large energy consumers, such as business parks, manufacturers, and institutional campuses. There

6.3 Further Benefits of Smart Buildings: Health and Well-Being

111

has been limited interest or movement in the residential market; one of the major barriers is the percentage of energy consumption in overall household expenses. Energy costs typically represent a small percentage, with the average being 1.5% for non-low-income families in the United States [49]. The small benefit of energy savings will not be enough to incentivize residents to invest in smart technologies with a higher upfront cost. Different benefits and incentives are needed for promoting the adoption of smart technologies, and one of the strongest candidates is health benefits. Until very recently, health has not been an integral part of home buyers’ concerns or builders’ construction criteria, although the majority of Americans spend more than 80% of their time indoors [50] and despite evidence proving the relation between energy poverty, energy inefficiency, and human health. Thermal discomfort can exacerbate existing health conditions, such as arthritis and rheumatism [51]; children are also at a higher risk than the general population [52]. In the wintertime, an energyinefficient house can aggravate respiratory disease among older populations [53]. Hamilton et al. [55] used the 2010 English Housing Survey to assess the potential public health impacts of indoor quality and temperature changes of 896 prototype dwellings in England that had received an energy efficiency retrofit. The results indicated that a building envelope retrofit can improve health and reduce mortality and morbidity over 50 years if appropriately implemented alongside sufficient ventilation [54]. Colton and team members from the Harvard T. H. Chan School of Public Health focused on sustainable public housing and found that green construction or renovation could simultaneously reduce harmful indoor exposures, promote resident health, and reduce operational costs [55]. Thomson et al. [57] conducted an analysis across 32 European countries and discovered that people’s well-being was lower for individuals living in energy poverty. Well-being was measured using the World Health Organization’s Well-being Index (WHO-5) to measure the subjective emotional well-being [56]. In order to further understand the link between energy efficiency or poverty and objective human health, more empirical measurements of occupants’ physiological conditions that represent well-being are needed rather than self-reports. In addition to the objective measurements, large real-time datasets are required as well. Smart technologies have only recently made real-time continuous measurements feasible. As consumers, home buyers and renters have realized that smart technologies and sensors collect large amounts of data on house operations as well as on one’s health condition, and those data and technologies could provide people with more control over their personal health than ever before. The collected data allows individuals to understand the nuances of their health, and smart control systems are able to adjust to the built environment (living condition) to have a positive impact on the inhabitants’ health. The WELL Living Lab, a joint effort between Delos and Mayo Clinic, utilized close to 1,000 smart devices (e.g., sensors, actuators, hardware) to collect and analyze thousands of data points in their 550-m2 laboratory, which functions as an adjustable open office [57]. The researchers set up six different environmental “scenes”—combinations of acoustic, lighting, and thermal conditions—over 18 weeks. They found that the environmental conditions affected health conditions, such as sleep problems and people’s feelings (e.g., happiness) [58]. Moreover, the changes

112

6 Future Smart Technologies for Human Health

in office environmental conditions affected occupants’ environmental satisfaction and their workday experiences as well.

6.4 Conclusion As predicated by Gartner, Inc., a global research and advisory firm, a typical family home in a mature affluent market could contain several hundred smart objects by 2022 [59]. Such smart technologies and smart homes could help people, especially vulnerable populations like the elderly and people with disabilities who are more likely to be exposed to daily life problems [60]. For instance, elderly people with Alzheimer’s who suffer from memory loss often forget to turn off the kitchen gas stove or other devices, posing a danger. However, with a smart home control system, those devices could be turned off after a certain inactive time period, thus reducing hazards and danger [61]. Other smart home technologies applicable to the elderly and disabled populations are fall detection [61] and sound or light detectors/actuators for deaf people [62]. There are immense opportunities for those who understand the changes that smart technologies can bring to improve human health in a built environment and who are then willing and able to exploit them. In contrast, as more advanced smart technologies mature and become integrated in peoples’ daily lives, there is the fear that those smart technologies, especially AI, may increasingly outperform the physical and cognitive skills of humans at all levels [38]. Understanding which smart technology is appropriate for each application is essential for the adoption and development of smart technologies. In the next chapter, three case studies will provide readers with a closer look at those smart technologies.

References 1. Preiser WF, Schramm U (2002) Intelligent office building performance evaluation. Facilities 20(7/8):279–287 2. Wigginton M, Harris J (2013) Intelligent skins. Routledge, London 3. Jamaludin O (2011) Perceptions of intelligent building in Malaysia: case study of Kuala Lumpur. Doctoral dissertation, Universiti Teknologi MARA. http://ir.uitm.edu.my/id/eprint/ 5471/. Accessed 10 Oct 2019 4. GhaffarianHoseini A (2012) Ecologically sustainable design (ESD): theories, implementations and challenges towards intelligent building design development. Intell Build Int 4(1):34–48 5. IBM. Creating a biding’s digital twin. https://www.ibm.com/blogs/internet-of-things/creatingbuildings-digital-twin/. Accessed 10 July 2019 6. GhaffarianHoseini A, Dahlan ND, Berardi U, GhaffarianHoseini A, Makaremi N, GhaffarianHoseini M (2013) Sustainable energy performances of green buildings: a review of current theories, implementations and challenges. Renew Sust Energ Rev 25:1–17 7. AutomatedBuildings.com. Your building address as a.com? http://www.automatedbuildings. com/news/may99/articles/addresses/addresses.htm. Accessed 10 July 2019

References

113

8. Grieves M (2015) Digital Twin: Manufacturing Excellence Through Virtual Factory Replication. https://www.researchgate.net/publication/329311603_DIGITAL_TWIN_MAN UFACTURING_EXCELLENCE_THROUGH_VIRTUAL_FACTORY_REPLICATION. Accessed 10 July 2019 9. Forbes. 7 Amazing examples of digital twin technology in practice. https://www.forbes.com/ sites/bernardmarr/2019/04/23/7-amazing-examples-of-digital-twin-technology-in-practice/# 7002850e6443. Accessed 27 Oct 2019 10. Chan M, Campo E, Estève D, Fourniols JY (2009) Smart homes—current features and future perspectives. Maturitas 64(2):90–97 11. CDC Foundation. Healthy workforce. https://www.cdcfoundation.org/businesspulse/healthyworkforce-infographic. Accessed 25 Feb 25 2019 12. Kalia M (2002) Assessing the economic impact of stress—The modern day hidden epidemic. Metab., Clin. Exp. 51(6):49–53 13. Levy Nir. Smart tech can help companies keep their employees healthier: Here’s how. https:// www.itproportal.com/features/smart-tech-can-help-companies-keep-their-employees-health ier-heres-how/. Accessed 25 Feb 2019 14. AutomatedBuildings.com. Trends towards wearables and wellbeing. http://automatedbuildi ngs.com/news/oct17/reviews/170926014600wearables.html. Accessed 12 July 2019 15. Clarke O. Smart cities in Europe: The future of the built environment. https://www.osbornecl arke.com/media/filer_public/5e/5e/5e5e086a-49ae-4b2a-a89a-b27b6dc720ed/oc_future_of_ built_environment.pdf. Accessed 07 Jan 2020 16. Ashton K (2009) That ‘Internet of Things’ Thing. RFID. 22(7):97–114 17. Gubbi J, Buyya R, Marusic S, Palaniswami M (2013) Internet of Things (IoT): a vision, architectural elements, and future directions. Future Gener Comp Sy 29(7):1645–1660 18. Sinopoli JM (2009) Smart buildings systems for architects, owners and builders. ButterworthHeinemann, Oxford 19. Facilitiesestesnet. Convergence of direct digital controls and internet of things brings highperformance HVAC. https://www.facilitiesnet.com/hvac/article/Convergence-of-Direct-Dig ital-Controls-And-aInternet-of-Things-Brings-High-Performance-HVAC–17102. Accessed 08 Feb 2019 20. Stojkoska BLR, Trivodaliev KV (2017) A review of Internet of things for smart home: challenges and solutions. J Clean Prod 140:1454–1464 21. Gungor VC, Sahin D, Kocak T, Ergut S, Buccella C, Cecati C, Hancke GP (2012) A survey on smart grid potential applications and communication requirements. IEEE T Ind Inform 9(1):28–42 22. Ahmed E, Yaqoob I, Gani A, Imran M, Guizani M (2016) Internet-of-things-based smart environments: state of the art, taxonomy, and open research challenges. IEEE Wirel Commun 23(5):10–16 23. Forbes. Google acquires smart thermostat maker next for $3.2 billion. https://www.forbes.com/ sites/aarontilley/2014/01/13/google-acquires-nest-for-3-2-billion/#54a60ac56ee2. Accessed 17 July 2019 24. Zhang N, Mi X, Feng X, Wang X, Tian Y, Qian F (2018) Understanding and mitigating the security risks of voice-controlled third-party skills on Amazon Alexa and Google Home. https:// arxiv.org/abs/1805.01525. Accessed 17 July 2019 25. Chung H, Iorga M, Voas J, Lee S (2017) Alexa, can I trust you? Computer 50(9):100–104 26. Pipattanasomporn M, Kuzlu M, Rahman S (2012) An algorithm for intelligent home energy management and demand response analysis. IEEE T Smart Grid 3(4):2166–2173 27. Zhou B, Li W, Chan KW, Cao Y, Kuang Y, Liu X, Wang X (2016) Smart home energy management systems: Concept, configurations, and scheduling strategies. Renew Sust Energ Rev 61:30–40 28. Honeywell Home. Smart Home System. https://homecomfort.resideo.com/sites/Europe/engb/Solutions/Smart_Home_System/Pages/Smart_Home_System.aspx?Solution=Smart%20H ome%20System. Accessed 10 June 2019

114

6 Future Smart Technologies for Human Health

29. Mozer MC (1998) The neural network house: An environment that’s adapts to its inhabitants. In: Proceedings AAAI Spring Symposium, vol 58, Palo Alto 30. Zheng H, Wang H, Black N (2008) Human activity detection in smart home environment with self-adaptive neural networks. In: Proceedings of 2008 IEEE International Conference on Networking, Sensing and Control, Hainan, pp 1505–1510 31. Asare-Bediako B, Kling WL, Ribeiro PF (2013) Multi-agent system architecture for smart home energy management and optimization. In: Proceedings of 2013 IEEE PES Innovative Smart Grid Technologies Europe (ISGT Europe 2013), Copenhagen, p 1–5 32. Li W, Logenthiran T, Woo WL (2015) Intelligent multi-agent system for smart home energy management. In: Proceedings of 2015 IEEE innovative smart grid technologies-Asia (ISGT ASIA), Bangkok, pp 1–6 33. Kim Y, An J, Lee M, Lee Y (2017) An activity-embedding approach for next-activity prediction in a multi-user smart space. In: Proceedings of 2017 IEEE international conference on smart computing (SMARTCOMP), Hong Kong, pp 1–6 34. Chen X, Li X (2016) Virtual temperature measurement for smart buildings via Bayesian model fusion. In: Proceedings of 2016 IEEE international symposium on circuits and systems (ISCAS), Montreal, pp 950–953 35. Noguchi H, Mori T, Sato T (2002) Construction of network system and the first step of summarization for human daily action data in the sensing room. In: Proceedings of IEEE workshop on knowledge media networking, Gaithersburg, p 17–22 36. Wang Z, Yang R, Wang L (2010) Multi-agent control system with intelligent optimization for smart and energy-efficient buildings. In: Proceedings of 36th annual conference on IEEE industrial electronics society, Glendale, p 1144–1149 37. Shaikh PH, Nor NBM, Nallagownden P, Elamvazuthi I, Ibrahim T (2014) A review on optimized control systems for building energy and comfort management of smart sustainable buildings. Renew Sust Energ Rev 34:409–429 38. Hoar C, Atkin B, King K (2017) Artificial intelligence: What it means for the built environment. https://www.rics.org/north-america/news-insight/research/insights/artificial-int elligence-what-it-means-for-the-built-environment/. Accessed 20 Oct 2019 39. Nilsson NJ (2009) The quest for artificial intelligence. Cambridge University Press, Cambridge 40. McKinsey Global Institute. Artificial Intelligence: the next digital frontier? https://www.mck insey.com/~/media/McKinsey/Industries/Advanced%20Electronics/Our%20Insights/How% 20artificial%20intelligence%20can%20deliver%20real%20value%20to%20companies/MGIArtificial-Intelligence-Discussion-paper.ashx. Accessed 30 Oct 2019 41. IBM. Watson Internet of Things. https://www.ibm.com/internet-of-things/explore-iot/bui ldings. Accessed 30 Oct 2019 42. PlaceTech. World’s Smartest Buildings: Watcon IoT HQ, Munich. https://placetech.net/ana lysis/worlds-smartest-buildings-watson-iot-hq-munich/ Accessed 30 Oct 2019 43. El-Basioni BMM, El-Kader SMA, Abdelmonim M (2013) Smart home design using wireless sensor network and biometric technologies. Inf Techno 1:2–6 44. Adib F, Mao H, Kabelac Z, Katabi D, Miller RC (2015) Smart homes that monitor breathing and heart rate. In: Proceedings of the 33rd annual ACM conference on human factors in computing systems, Honolulu, p 837–846 45. Builder. Health and Well-being at home today—and in 2040. https://www.builderonline.com/ design/projects/health-and-well-being-at-home-today-and-in-2040_o. Accessed 15 August 2019 46. Delos. Welcome home to wellness. Delos launches world first residential wellness technology platform. https://delos.com/press-releases/welcome-home-wellness-delos-launchesworlds-first-residential-wellness-technology-platform. Accessed 21 Jan 2019 47. Hui TK, Sherratt RS, Sánchez DD (2017) Major requirements for building Smart Homes in Smart Cities based on Internet of Things technologies. Future Gener Comp Sy 76:358–369 48. European Research Media Center. Smart buildings: predictive maintenance is crucial. http:// www.youris.com/energy/ecobuildings/smart-buildings-predictive-maintenance-is-crucial.kl. Accessed 31 July 2019

References

115

49. Drehobl A, Ross L (2016) Lifting the high energy burden in America’s largest cities: How energy efficiency can improve low income and underserved communities. https://www.energyefficiencyforall.org/resources/lifting-the-high-energy-burden-in-ame ricas-largest-cities-how-energy/. Accessed 31 July 2019 50. Environmental Protection Agency. Healthy Buildings, Healthy People. https://www.epa.gov/ sites/production/files/2014-08/documents/hbhp_report.pdf. Accessed 20 July 2019 51. Liddell C, Morris C (2010) Fuel poverty and human health: A review of recent evidence. Energ Policy 38(6):2987–2997 52. Karimu A, Asiedu E, Abor J (2018) Energy Poverty and Classes Missed by a Child. Evidence from a Developing Country. https://www.researchgate.net/publication/325576977_ Energy_Poverty_and_Classes_Missed_by_a_Child_Evidence_from_a_Developing_Country Accessed 08 June 2019 53. Rudge J, Gilchrist R (2005) Excess winter morbidity among older people at risk of cold homes: a population-based study in a London borough. J Public Health 27(4):335–353 54. Hamilton I, Milner J, Chalabi Z, Das P, Jones B, Shrubsole C, Wilkinson P (2015) Health effects of home energy efficiency interventions in England: a modelling study. BMJ Open 5(4):e007298 55. Colton MD, Laurent JGC, MacNaughton P, Kane J, Bennett-Fripp M, Spengler J, Adamkiewicz G (2015) Health benefits of green public housing: associations with asthma morbidity and building-related symptoms. Am J Public Health 105(12):2482–2489 56. Thomson H, Snell C, Bouzarovski S (2017) Health, well-being and energy poverty in Europe: a comparative study of 32 European countries. Int J Environ Res Public Health 14(6):584 57. Delos. WELL Living Lab. http://welllivinglab.com/technology/. Accessed 22 July 2019 58. Jamrozik A, Ramos C, Zhao J, Bernau J, Clements N, Wolf TV, Bauer B (2018) A novel methodology to realistically monitor office occupant reactions and environmental conditions using a living lab. Build Environ 130:190–199 59. Gartner, Inc. “Gartner says a typical family home could contain more than 500 smart devices by 2022. https://www.gartner.com/en/newsroom/press-releases/2014-09-08-gartnersays-a-typical-family-home-could-contain-more-than-500-smart-devices-by-2022. Accessed 12 July 2019 60. El-Basioni BMM, El-Kader SMA, Eissa HS (2014) Independent living for persons with disabilities and elderly people using smart home technology. Int J Innov Res Sci Eng Technol 3(4):11–28 61. Wang J, Zhang Z, Li B, Lee S, Sherratt RS (2014) An enhanced fall detection system for elderly person monitoring using consumer home networks. IEEE T Consum Electr 60(1):23–29 62. Mielke M, Brück R (2015) A pilot study about the smartwatch as assistive device for deaf people. In Proceedings of the 17th International ACM SIGACCESS Conference on Computers & Accessibility. Lisbon, p 301–302

Chapter 7

The Nexus Between Smart, Sustainable, and Healthy Buildings: Three Case Studies

In recognition that a real project is essential to understand the connection between smart and healthy buildings, this chapter further pursues the discussion of how smart technologies can create sustainable and healthy buildings. Three case studies of built projects are presented that illustrate the nexus between smart, sustainable, and healthy buildings.

7.1 Overview A variety of published scientific evidence, to date, indicates a correlation between measured and perceived built environmental quality and human health in buildings [1]. Additionally, studies suggest that a relationship exists between energy efficiency, human health, and well-being [2]. Thomson and Bouzarovski [2] analyzed 32 countries in Europe and found that populations suffering from energy poverty were statistically more likely to report a decline in health, emotional well-being, and job satisfaction compared to unaffected populations [2]. Other studies conducted among European countries demonstrated similar results. For example, in the United Kingdom’s fuel poverty strategy report (6th annual progress report), experts stated “the likelihood of ill health is increased by cold homes, with illness such as influenza, heart disease and strokes…. Cold homes can also promote the growth of fungi and dust mites…” [3]. Besides the impact of buildings on physical health, exposure to energy poverty has also been associated with stress, anxiety, and depression [4, 5]. Churchill et al. 6 surveyed 7,682 households and 19,914 individuals in Australia, with results revealing that an increase in energy poverty is associated with a decline in subjective well-being. Subjective well-being is the measure of peoples’ life satisfaction and mood. Energy poverty is commonly determined based on the proportion of income that households spend on fuel or energy [6].

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_7

117

118

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

As mentioned in Chap. 2, the relationship between built environmental design practices and public health practices shifted direction around the middle of the twentieth century. Current practices for building and built environmental design disregard protecting occupants’ health and instead focus primarily on enhancing or promoting well-being. For example, the US General Services Administration (GSA) published one of the most comprehensive health and wellness design guidelines: the Sustainable Facilities Tool, which compiled requirements from ASHRAE 189.1-2017, DoD1 UFC 1-200-02 (2016),2 Fitwel V1,3 Green Globes,4 GSA PBS-P100 (2018), LEED v4.1, and WELL v2. Among those requirements, ASHRAE and GSA PBS-P100 have a code-binding effect, whereas the rest are volunteer rating systems. While there are emerging requests from the public demanding that these provisions be included in building codes, current design codes and regulations have largely ignored the impact of buildings on physical and emotional health. Other design guidelines (neither codes nor regulations) attempt to address this human health issue with considerable and notable requirements related to the effect of buildings on human health. However, many of these requirements simply address the baseline building performance instead of higher-level performance. One such guideline is the Sustainable Facilities Tool provided by GSA. Intended to address indoor air quality, this tool only meets the minimal requirements, which are too lenient to promote or enhance occupants’ health or well-being. Strengthening the code requirements and increasing more specific health-related standards would make it possible to design and construct buildings that are environmentally friendly, smart, and healthy. In this chapter, the three chosen case studies represent two different building types: commercial and residential. The first case, The Edge, is a large-scale, privately owned commercial office building designed and built with a smart technology platform that was conceived and developed by, EDGE Technologies. EDGE is the building owners and operators. The second case is Gator House: a small-scale residential home at the University of Florida. Researchers used the Gator House as a laboratory to explore general residential smart technologies as well as methods to improve the quality of life for the elderly or people with disabilities. The last case is the CASAS Smart Home project, which is a longitudinal, large-scale research project at Washington State University. The project focused on the creation of an intelligent home environment, where smart homes were treated as intelligent agents that perceived and acted upon their environment. In Chap. 6, the author discussed the five components or abilities a building needs to become smart: (a) the ability to collect data through IoT, (b) the ability to learn from current and past experiences through algorithms, (c) the ability to use artificial intelligence as a brain, (d) the ability of context awareness, 1 ASHRAE

189.1-2017: Standard for the Design of High-Performance Green Buildings Except Low-Rise Residential Buildings. 2 DoD UFC 1-200-02: Department of Defense Unified Facilities Criteria for High Performance and Sustainable Building Requirements. 3 Fitwel is a building rating system for commercial interiors and both multi-tenant and single-tenant existing buildings. 4 Green Globes is a green building assessment and certification in the United States and Canada.

7.1 Overview

119

and (e) adaptation to the ever-changing environment. All three buildings have these components in different formats. In this chapter, the three cases studies will be examined in terms of these five different components.

7.2 The Edge The Edge is a futuristic office building located in Amsterdam, the Netherlands, completed in 2015. Currently, the building serves as Deloitte’s Amsterdam headquarters. The building was developed with the aim to precede the next generation of building systems. It was developed and is owned by EDGE Technologies, which is a real estate developer focused on reinventing the modern workplace as a driver for health, sustainability, and innovation. The Edge is a 40,000 m2 multi-tenant office building in the Zuidas business district in Amsterdam [7] (refer to Fig. 7.1). This building was designed to reduce energy costs, thus minimizing its environmental impact. The designers also strived to create a comfortable and productive environment for employees. According to the British green building rating system, BREEAM, The Edge received the highest sustainability score ever awarded in 2015, and it uses 70% less electricity than comparable office buildings [8]. The building is equipped with 6,000 low-energy LED lights, with the resulting energy use intensity from lighting being only 3.9 W/m2 , compared to the Netherlands’ national average of 8 W/m2 [9]. Designers of The Edge implemented a variety of smart technologies in order to make the building intelligent. Table 7.1 summarizes the use of smart technologies and components in The Edge and their related health benefits.

Fig. 7.1 The Edge (Source Mapiq)

120

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

Table 7.1 Smart technologies and health benefits The Edge, Amsterdam, Netherlands, 2016 Smart technology

Description

Health benefits

Target population

Customized system

Smart lighting

The building’s Ethernet-powered LED lighting system is integrated with 30,000 sensors to continuously measure occupancy, movement, lighting levels, humidity, and temperature, allowing it to automatically adjust energy use

Track, monitor, and control local indoor lighting environment

Office workers

No

Smart lighting

The light system is powered by Ethernet and 100% IP based. This makes the system (i.e., each individual luminaire) computer controllable so that changes can be implemented quickly and locally

Track, monitor, and control local indoor lighting environment

Office workers

Yes

Building management system (BMS)

The data collected through the lighting system is fed to facility managers via the BMS Custom lighting, HVAC, and real-time alerts about scheduling and traffic within the building; all connected to an application (Mapiq) that occupants are required to use

Create customized Office indoor workers environment based on personal preferences

Maybe*

(continued)

7.2 The Edge

121

Table 7.1 (continued) The Edge, Amsterdam, Netherlands, 2016 Smart technology

Description

Health benefits

Target population

Customized system

Artificial intelligence/Building management system (BMS)

Mapiq is an application developed by Deloitte Netherlands, who is the primary tenant of The Edge. It syncs occupants’ profiles with the building’s camera system, which allows the BMS to keep track of who is in the building and where they are

Allows the building to act as an entity that decides how to best use itself. Streamlines the experience for occupants

Office workers

Yes

7.2.1 Collection of Data (IoT) The Edge is equipped with thousands of smart devices and sensors. One innovative smart technology is power over Ethernet (PoE) lighting. As the name suggests, PoE lighting fixtures are powered through Ethernet cables. The system uses nearly 6,500 connected LED luminaries to create a “digital ceiling” in the building. With integrated IoT sensors in 3,000 of these luminaries, which all connect to Mapiq (an application for building system management), the “digital ceiling” system not only provides lightings but also captures, stores, and transmits data and information throughout the illuminated spaces. Building managers can use the Mapiq interface to visualize lighting usage, analyze data, track energy consumption, and streamline maintenance operations [10]. The PoE system implemented in The Edge was developed by Philips and is called InterAct Office. As Philips stated “The digital nature of LED technology brings illumination and IT together, allowing lighting systems to participate in the Internet of Things” [7, 10] (Fig. 7.2).

7.2.2 Artificial Intelligence and Control Algorithm (Learning from the Past and Management of Information) Mapiq is a customized, cloud-based management platform that occupants are required to use in The Edge. Mapiq’s office analytics provide real-time building data and personal data. The application can track data at many different scales, including room occupancy, building temperature, and availability of smart lockers.

122

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

Fig. 7.2 The Edge’s digital ceiling uses PoE lights (Source Raimond Wouda)

The application uses facial recognition technology to connect the occupants’ faces to their profile on Mapiq. When they enter the building, the application directs them to their workspace for the day. Before their arrival, occupants’ workspaces are set to the preferred temperature and lighting based on previous inputs and settings. Alternatively, the occupants can customize their lighting and temperature settings manually while also viewing how energy efficient their preferences are. This rich data and intelligent control system aims to increase the utilization of space to create customized environments for specific users [11]. All data recorded in the cloud-based Mapiq platform is anonymized, so individual employees cannot be tracked with Mapiq Analytics; only their preferred space and spatial environment settings are registered. The Mapiq dashboard can also display real-time data. Mapiq leverages Microsoft’s Power BI platform, which is a strong data visualization tool. Figure 7.3 illustrates how the real-time building usage data is displayed on Mapiq. The presence of artificial intelligence in the application makes the building use far easier, as Mapiq and sensors work together to anticipate users’ needs. Day-to-day redundancies—such as where to work and meet, where to find parking spots, and even what kind of coffee the users prefer—are managed to streamline occupant use.

7.2 The Edge

123

Fig. 7.3 Mapiq app interface (Source Mapiq)

7.2.3 Context Awareness Using the PoE system, Mapiq can integrate corporate calendars to reserve spaces or automatically cancel meeting reservations based on real-time occupancy analytics. Comparatively, 20% of reserved meetings rooms remain unused in conventional office buildings. When a meeting is scheduled minutes before it takes place, the Mapiq application helps occupants locate and quickly navigate to their desired space via Philips indoor positioning smart algorithms [12]. The indoor positioning system works with LED lights that are embedded with visible light communication (VLC) technology. Using the light from the lighting fixtures, the system sends a unique code to a mobile device, pinpointing the user’s location on a map of the building. The occupant’s smart device then becomes location-aware, and the application can deliver information about location-based services in the building, such as lighting levels, window operations, and coffee machines [13]. Figure 7.4 illustrates the smart algorithm for indoor positioning. By sharing this type of information, the building becomes aware of the building users’ presence and preferences. It can also detect real-time conditions within the building; for example, there are too many rooms on the fourth floor not in use, the printer on the second floor needs a new cartridge, or the building has uneven temperature distribution between the east and west sides.

124

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

Fig. 7.4 Indoor positioning smart algorithm that works with LED lights (Source Philips)

7.2.4 Adaptation to the Environment All of The Edge’s systems are monitored and tracked through Ethernet bridges. A customized Ethernet bridge system was developed specifically for The Edge, which allows for information to flow between systems expeditiously. Information concerning solar harvesting, light use, HVAC use, or building occupancy is recorded and then sent to the building management system (BMS). The BMS can adjust certain variables, such as temperature settings in rooms not being used or electric light intensity in the atrium. This system is designed to optimize the building’s performance in real time. The occupants can also personally control the lighting above their desk—even in the open office or via smart phones—so that they always have the desired light level to support their personal comfort and productivity. In this way, the building can adapt to a variety of occupants’ needs, while individuals may still adjust their local environment to adapt to different work functions.

7.3 The Gator Tech Smart House (GTSH)

125

7.3 The Gator Tech Smart House (GTSH) The Gator Tech Smart House is a research-based smart home project in Gainesville, Florida (built in 2005). The primary research focus is to develop hardware or software systems and devices to support elderly populations and people with disabilities. Figures 7.5 and 7.6 and Table 7.2 illustrate the smart technologies explored in the GTSH.

7.3.1 Collection of Data (IoT) Researchers installed many smart sensors to attempt to collect data without intruding on the user’s privacy. Figure 7.7 shows the Atlas sensor platform which was developed as a universal adaptor that transforms any sensor or actuator attached to it into a software service running on an edge or a cloud computer. The house has a smart floor system, which provides locational tracking and activity monitoring functions. The raised floor system is composed of a 2 × 2-inch grid, with a force sensor underneath each tile that can detect pressure changes from the footsteps above (refer to Fig. 7.8).

Fig. 7.5 The GTSH project features numerous existing (E), ongoing (O), or future (F) hot spots located throughout the premises (Source Prof. Sumi Helal, Director of the GTSH)

126

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

Fig. 7.6 Gator Tech Smart House and team (Source Prof. Sumi Helal, Director of the GTSH)

If the smart floor step counts deviate from the normal patterns, then the system sends a signal to the caregiver, or family member. Besides detecting sudden changes and emergencies, this type of nonintrusive activity monitor can also record elderly residents’ typical amounts of movement in a day. Moreover, the system can be used to track significant decreases in activity and changes in overall patterns. If the system notices activity anomalies, it will automatically notify the caregiver [14]. The notable advantage of such smart systems is that, unlike other tracking methods, the smart floor requires no attention from the resident, and there are no cameras that invade their privacy [14]. In addition to the smart floor system, GTSH researchers employed a smart front door system that allows for keyless entry. The entryway is combined with a smart camera, a text LCD, an automatic door opener, an electric latch, and a speaker. All of these measures provide more information about who is trying to enter their home, so that homeowners can better control access to their house. This could greatly enhance the safety of elderly people who live alone. In a situation where a resident forgets their keys, the smart door system will allow the owner to enter their home after identity verification. Other sensors installed in the GTSH include those in the smart bed, which are used to monitor sleepless nights and sleep patterns, and those in the smart toilet that monitor the occupant’s biometrics (e.g., body weight, temperature). For a complete list of smart systems installed in the house, refer to Table 7.2.

Identifies and tracks locations of all house Knows where residents are within the occupants. Detects falls and reports to building; notifies authorities of any emergency services. Pressure sensors are strange or noteworthy behavior embedded into each tile of the raised floor used in the house

Senses mail arrival and notifies the resident

Smart floor

Smart mailbox

Reminds residents to pick up mail

Anyone; elderly persons who are forgetful

Elderly persons; people with physical or mental disabilities

Anyone

Automatic control of ambient light and privacy through remote and motorized blinds

Smart blinds

Conserves energy by blocking solar heat gain when AC is on

Smart cameras help provide a safe Identifies who is entering and exiting Anyone environment by supplying complete video the house; protects and tracks the entry surveillance of the space around the smart and exit of the residents house. Software management of the cameras allows for features such as motion detection, image processing, and control of other smart house devices based on image analysis

Target population

Smart cameras

Health benefits

Description

Smart Technology

Gator Tech Smart House, Gainesville, Florida, 2005

Table 7.2 Smart technologies used in the GTSH

(continued)

Yes

Yes

Yes

Yes

Custom

7.3 The Gator Tech Smart House (GTSH) 127

Clothing suggestions based on outdoor Ensures that residents are equipped to weather. RFID readers are installed into deal with the weather on a daily basis the closet to read tags embedded in the clothes. Residents are notified if they wear clothes unsuitable for the current weather

Monitors sleepless nights and sleep Allows caregivers and other third patterns. Caregivers can learn from the parties to ensure residents are getting data saved by the bed if there is the good quality sleep resident is possibly experiencing insomnia. This is done by using embedded pressure sensors

A display device only visible when needed. Used for displaying important messages or reminders.

Smart closet

Smart bed

Smart mirror

Gives residents reminders when using the bathroom and other daily tasks

RFID tag for keyless entry by Allows for keyless entry; records who homeowners and authorized personnel. is entering and exiting Microphone, camera, text LCD, automatic door opener, electric latch, and speakers for homeowner communication and control of home entry to visitors

Smart front door

Health benefits

Description

Smart Technology

Gator Tech Smart House, Gainesville, Florida, 2005

Table 7.2 (continued)

Yes

Custom

Elderly persons who are forgetful

Elderly persons; disabled persons

(continued)

Yes

Yes

Elderly persons who are forgetful; people Yes with disabilities

Anyone; elderly persons who are forgetful

Target population

128 7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

The smart bathtub and shower regulate the Ensures residents don’t scald water temperature and prevent scalding. It themselves; tracks who is using the can even identify the person in the bathtub shower and adapts to their preferences and regulate the temperature based on the person’s preference (part of the smart bathroom)

In combination with the smart closet, Reminds residents to do laundry; notifies the homeowner when laundry tracks what is being laundered so should be done and helps sort the laundry. clothes don’t get ruined Might give warnings if white and colored clothes are mixed

Monitors food availability and consumption, detects expired food items, and creates shopping lists automatically with an integrated meal preparation advisor based on items in the refrigerator and pantry

Smart bathtub/shower

Smart laundry

Smart refrigerator/pantry

Tracks what food is in the kitchen and when the food expires; ensures residents are eating fresh food

Passive way of tracking residents’ biometrics

Monitors the occupant’s biometrics (body weight, temperature, etc.), toilet paper sensor, and flush detector in conjunction with a smart soap dispenser (monitors cleanliness of occupants and reports to service center when refills are required). Part of the smart bathroom

Smart toilet

Health benefits

Description

Smart Technology

Gator Tech Smart House, Gainesville, Florida, 2005

Table 7.2 (continued)

Anyone; elderly persons; disabled persons

Anyone; elderly persons; disabled persons

Elderly persons; disabled persons

Elderly persons; disabled persons

Target population

Yes

Yes

Yes

Yes

Custom

7.3 The Gator Tech Smart House (GTSH) 129

130

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

Fig. 7.7 Customized sensor platform (Source Prof. Sumi Helal, Director of the GTSH)

Fig. 7.8 Smart floor sensor (Source Prof. Sumi Helal, Director of the GTSH)

7.3 The Gator Tech Smart House (GTSH)

131

7.3.2 Artificial Intelligence and Control Algorithm The Gator Tech Smart House was developed using pervasive computing, which is also known as ubiquitous computing. As opposed to desktop computing, ubiquitous computing can use any smart device (IoT) in any location and in many different formats. Pervasive computing provided the opportunity for the GTSH to build a self-integration framework called Atlas. Atlas is a combination of hardware and software architecture that allows plug-and-play integration. It is composed of three parts: hardware nodes for physically connecting the smart devices, a mechanism for translating those devices into software services using unique identity, and the server software that is capable of understanding the raw data provided by the node associated with a unique ID [15]. Atlas can automatically detect the device’s existence on the network and can facilitate easy data sharing among different applications [15]. When a person enters the space with any device, the system identifies and integrates it with an associate service (if the device is powered on). The smart home programmer then creates adapted applications and services, such as temperature controls, security controls, social interaction controls, or calendar reminders. The programmers with access to these controls could be building users, health caregivers, or technicians. This framework and system are different from the control algorithm used in The Edge. The users in The Edge could manipulate their local conditions, but in the GTSH, the building users are able to program the entire space.

7.3.3 Context Awareness: Understanding of Surroundings In order to make the GTSH smart and aware of its context, three components were included. The first is the context engineer (a computer algorithm), which interprets sensory data and identifies high-level states of interest, such as “hot” and “cold.” The second is the software engineer, which describes the various software commands; for example, turning the lights on or off. The third component is the building’s ability to associate commands with context. For instance, defining which pieces of software should execute in a particular context, and which pieces of the built system should react upon changes in the environment [16]. In one scenario, after the context engineer processes the sensory data collected from the smart refrigerator, the system engineer can determine that there is no food left in the refrigerator. The software engineer can then send out a purchase order through the central computer to a grocery store, based on a preset grocery delivery service. If there is no grocery delivery service available in that area, the system can inform the caregiver that it is time to restock [16]. In this regard, the GTSH is not only aware of its own existence, but it can also form an action based on a detected or perceived condition.

132

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

7.3.4 Adaptation to the Environment Prior to the GTSH, the research team led by Dr. Sumi Helal created the Matilda Smart House as a laboratory prototype, designed to prove the feasibility and usefulness of assistive environments [16]. Through the prototype, the research team learned that altering existing (market available) hardware and software could create an effective solution. However, the Matilda Smart House was not a smart environment that people could inhabit, and it could not adapt to real people’s needs and lifestyles. In order to create a smart environment that could adapt to changing contexts and occupants’ demands, the research team created a pervasive computing system with the ability to evolve as new technologies emerge or as application domains mature [16]. Such a system is called a programmable pervasive space. The same system is employed in the GTSH. GTSH was designed in such a way that the house can sense itself and its residents and then react, respond, and adapt to residents after learning their lifestyle and daily patterns, among others. For instance, the smart microwave, SmartWave (refer to Fig. 7.9), can read the labels on frozen food packages, automatically adjust the microwave time and power settings, and provide instructions to users based on how to correctly prepare the food for cooking [16]. After the completion of the GTSH, the research team conducted a pilot live-in trial: a 78-year-old elderly woman with no significant impairments stayed a full day and night in GTSH. The smart microware was one of her favorite smart technologies and applications. The elderly participant stated: “I absolutely loved having the microwave greet me. Telling me what I am having which is sometimes reassuring because you can go to the freezer and take out the wrong thing…. I liked being reminded what I have put in the microwave and then told it is ready” [17]. There are many other smart technologies that were tested in the GTSH in 2005 that have since become market mature and available to date, such as voice control systems that connect to lighting, blinds, and door openings. Currently, there are many voice activation systems. For example, the Philips Hue smart bulb can be identified and controlled by Amazon Alexa (cloud-based voice service). Alexa Fig. 7.9 SmartWave (Source Prof. Sumi Helal, Director of the GTSH)

7.3 The Gator Tech Smart House (GTSH)

133

is also able to recognize multiple users’ voices and accents. The ultimate goal the research team described in 2005 was to create a “smart house in a box”: off-the-shelf assistive technology for the home that the average user can buy, install, and monitor without the aid of engineers. Fifteen years have passed, and a large portion of their goal is on track to be realized.

7.4 Smart Home in a Box (SHiB) by CASAS The third smart building project discussed in this chapter is a large-scale, longitudinal research project, Smart Home in a Box (SHiB), led by the Center for Advanced Studies in Adaptive Systems (CASAS) at Washington State University. Since 2008, CASAS has conducted multiple small- and large-scale smart environmental research projects. The smart underlying mechanisms explored in CASAS are similar to those tested in the GTSH: ubiquitous computing, which was proposed in the early 1990s [1]. The promise of these types of ambient, smart, or calm technologies has driven work in many disciplinary areas of engineering, computer science, health care, architecture, and information management [23]. Prior to SHiB, CASAS projects studied other small-scale smart home projects in the research areas of early-stage dementia detection, activity detection, energy tracking, assisted living conditions, and identification of individuals, among others. CASAS’s primary research focus has been to identify individuals through using behavioral analysis and activity monitoring of daily living [18]. The CASAS research group has also developed several important technical components which made SHiB possible. The first is the Clinical Assessment using Activity Behavior (CAAB) approach to predict the cognitive and mobility scores of smart home residents. This is done by monitoring a set of basic activities within daily living, which are collected through sensors [19]. To recognize the activities and predict future events, CAAB relies on an activity recognition (AR) algorithm and a machine learning algorithm [19], which are also developed by the CASAS team. Altogether, the sensors, CAAB, and AR comprise a smart infrastructure that can identify repeatable behavior, predict residents’ activity, and improve operating efficiency, ensuring residents’ health and safety. One of the large-scale projects that CASAS conducted was Horizon House, built in 2012. It was installed at Seattle’s Continuing Care Retirement Center (CCRC), where elderly adults voluntarily had the CASAS sensor technology installed in their apartments. Altogether, it had 16 running apartments with each having multiple years’ worth of data [23]. After a successful pilot test, the research team assembled the SHiB tool kit. The team planned to deploy SHiB in 120 spaces (include homes, offices, and apartments), and they utilized a smart environment (smart building) as a method to study a range of research topics. The research topics included health-related behavioral changes [20], potential smart home behavior data to detect diseases [21], human perception to smart technology, and ease of the smart home system installation by elderly populations [22]. As opposed to other smart building and smart environment projects that focus on the development and testing of smart devices and systems,

134

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

SHiB’s primary goal is to provide smart environmental data and a tool infrastructure on a large scale [23]. The secondary goal of SHiB is to monitor behavioral patterns over months or years and allow researchers to examine behavioral cycles and trends [24]. Their primary test subjects are elderly populations with cognitive decline; consequently, these testing spaces are in private homes and elderly care facilities.

7.4.1 Collection of Data (IoT) There are three different types of sensors employed in the original SHiB: infrared motion or light sensors (24 per house), door sensors (1 per house), and temperature sensors (2 per house). Additionally, one computer server and two relays are also included in the SHiB toolkit. The entire SHiB package costs about $2,765 per house [24] (refer to Fig. 7.10). These sensors generate data related to the activities and consist of a date, time, sensor identifier, and sensor message. The sensors can detect whether activities are related to hygiene, sleep, relaxation, or work. Refer to Fig. 7.11 for the SHiB sensor components. After the data is collected, they are annotated in order to understand their relationship to human activities. Based on CASAS’s previous experience, the value of smart home data increases dramatically if it is annotated. These annotations have been historically performed by humans, but experience indicates that it takes roughly 1.5 h of labor to annotate one 24 h period of data in a home [24]. Consequently, SHiB developed a customized activity recognition (AR) algorithm to map a sequence of sensor data to a corresponding activities label. The AR is explained below as the AI component of SHiB.

Fig. 7.10 SHiB cost (Source Dr. Diane Joyce Cook and Dr. Aaron Spence Crandall)

7.4 Smart Home in a Box (SHiB) by CASAS

135

Fig. 7.11 CASAS’s SHiB sensor, including motion and light sensors attached to the ceiling (upper left), door or temperature sensors (upper right), object shake sensors (lower left), a smart phone (lower middle), and a TED power meter (lower right) components (Source Dr. Diane Joyce Cook and Dr. Aaron Spence Crandall)

7.4.2 Artificial Intelligence and Control Algorithm The CASAS activity recognition software, called AR, provides real-time activity labeling. Such labeling allows for the sensor data to be translated into meaningful and specific activities [24]. For instance, the motion sensor installed in the bed can be programmed to label “off” as “sleep” and “on” as “awake” activities. Normally, such data is manually labeled, but for SHiB, the research team designed a support vector machine (SVM) method. This model of machine learning digitally labels the large data set collected from multiple smart houses per day. Based on the collected data, the SHiB team also developed an activity discovery algorithm (AD). AD searches through the unlabeled data and then extends the discovered patterns into the previous iteration by considering the activities occurring both before and after labeled events. Through this search and labeling, AD is able to demonstrate a sequential pattern of behavior. For instance, a sequence consisting of motion in the bedroom, followed by a motion in the living room and then more motion in the bedroom around 10:20 pm might indicate events that occur prior to sleeping and can therefore represent a person getting ready for bed [24].

136

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

7.4.3 Context Awareness: Understanding the Building Occupants A truly intelligent environment not only collects data but also distributes commands through recognition of different contexts within the space. The analysis of data from environmental sensors provides an awareness of physical context (temperature, lighting, house layout), temporal context (year, month, day of week, hour of day), and human context (location, activities, preference). When different layers of data are overlaid and examined together, the smart environment functions as a smart agent that can recognize users’ behavioral patterns. Patterns of discovery methods, combined with the activity recognition algorithm, can identify activities or patterns of interest that later can be tracked. Tracking certain activity patterns helps to monitor a smart home resident’s daily routine and determine trends or abrupt changes [25]. Abnormal activities or patterns may indicate a crisis or an abrupt change associated with health or safety issues [26]. In this case, the smart home or space can assess users’ health or safety conditions. For example, an elderly smart home resident habitually leaves their home in the morning at approximately 7 am to take a walk and then returns home at 8 am to have breakfast. This resident’s daily routine—including activities in the living room, bedroom, and kitchen—will be monitored and registered using the data collected from a variety of sensors. If the resident chooses to diverge from their everyday morning walk at 7 am, the algorithm will detect this abnormal pattern. It can then send a message requesting that the resident or caregivers (relatives) to check in. Such nonintrusive monitoring does not require residents to constantly log in and self-assess or report, but it could be improved to be more precise and sensitive to behavior changes. The CAAB approach, mentioned at the beginning of 7.4, first observes a set of basic and instrumental daily living activities. It then extracts activity features from the activity performance that train machine learning algorithms to predict the cognitive and mobility scores of the residents. To date, the CASAS team has verified the robustness of such algorithms in 18 real-world smart homes with elderly residents [19]. To study health-related behavioral changes, the research team installed the SHiB toolbox in two homes (both were single-resident apartments) to collect data. The two apartments were equipped with motion and light sensors on the ceilings and doors. The team also installed temperature sensors on cabinets and doors [20]. Once the sensor data was collected, each event (such as the door opening and closing) was labeled with the CASAS-AR activity recognition algorithm (mentioned above) and then used to study the occupants’ activities and behavioral changes. These behavioral changes were presumably related to health events. The research team focused on determining whether a significant change in behavior occurred at the time of the health event and the nature of the behavioral change. Two elderly residents, aged 86 and 91 years old, that were monitored experienced health events of lung cancer and insomnia, respectively. The research team found clear correlations between the quantifiable behavioral changes and health events. The implications of such developments are that if smart homes can recognize health-related events by identifying

7.4 Smart Home in a Box (SHiB) by CASAS

137

the residents’ behavioral changes, they could potentially make corresponding adjustments and changes in order to help residents seek help. The homes could also alter the environment to provide more comfort to residents while allowing them to maintain their independence—an issue that is particularly difficult for elderly populations with health issues. The next section examines how SHiB helps residents adapt to their environment or their changed health conditions.

7.4.4 Adaptation to the Environment SHiB can provide residents with activity-aware health assistance in the form of a prompt to initiate daily activities, such as taking medicine, exercising, or talking to their children [27]. Many preset reminder systems function this way but lack the intelligence and capability to provide context-aware prompts, which are only available through recognition of the behaviors and patterns of residents. Additional applications for SHiB include the ability to adapt to changing external climatic conditions and internal behavior. By identifying activities concurrently occurring inside and outside the home, the control algorithm can predict activities and climate-related energy consumption. Then, the smart home system can prompt a message to either remind the residents to put on more layers when going out, automatically increase the internal temperature once the weather changes, or automatically turn on the icemelting function on the front patio. Currently, several smart home systems allow residents to remotely control their smart lights, smart thermostats, and smart appliances. Such smart environments can adapt to residents’ needs, external climate conditions, and energy consumption measures. The smart home can automatically turn off the heating if it detects no one in the home for more than 30 min and turn the heat back on prior to residents returning home after their weekly doctor’s visit. Consequently, the house will be warm enough upon their return while still conserving energy.

7.5 Conclusion The three case projects demonstrate how smart buildings can appear in different forms, employ varying technologies, and serve diverse populations. However, they all share the same five smart abilities, which consist of several important components. For many decades, the primary focus of building intelligence has centered on delivering a functional, sustainable, and comfortable space to building users, which focused on energy efficiency and operational cost reduction. If the period between the 1990s and present day is recognized as the era of sustainable building, then future decades may represent the era of healthy and smart buildings. A true sustainable building contributes to the overall environmental sustainability but must also sustain human health. A smart building is an ideal environment for performing automated health monitoring and assessments [28]. With technological advancements in recent

138

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

years, smart building- and smart home-based systems can be used without requiring major changes to a building occupant’s routine activities and with minimal intrusion. Smart home assistive technologies, such as Amazon Alexa, have become widely accepted and have been integrated in many households. Current smart building technologies are still based on explicit inputs from smart phone applications or voice control systems, such as Alexa or Google Home, to perform particular tasks. In the future, smart buildings could act as an intelligent agent, using sensors to perceive the state of the physical environment and its residents’ activities. The building would then analyze and interpret the conditions using artificial intelligence. Afterwards, the smart building would take actions to achieve its specified goals [24]: either to adapt to residents’ needs or to help residents adapt to their changed environment. According to Dr. Sumi Hela, “One huge lessons we learned though from the GTSH, and which I wish the architecture community keep in mind, is that it is better to architect “smart-ready” spaces, rather than smart spaces. In other words, we learned that the variables and specifics of a given mission changes over time and we should be ready to re-program the smart house over and over as the resident’s needs change. And from a commercial point of view, not knowing who the buyers are, makes “smart-ready” much more preferred than any smart home with a fixed smartness. Together, technologists and architects can work on the specification of such smart-ready spaces of the future.” (quote from Dr. Hela). Going forward, smart buildings can only exist in a smart built environment. The built environment is more than a collection of buildings; it encompasses the complex relationship between buildings, infrastructures, and landscapes at a systematic level. Buildings exist in relationship to their urban and community context; hence, their impact on human health extends to larger urban and community levels as well. In the near future, the “smartness” of buildings will include buildings that are able to communicate with and respond to one another within the wider urban context [28]. The intelligence of smart buildings includes physical features, such as sensors and responsive components, as well as urban informatic infrastructures and interconnected databases. Together, these intelligent components and systems could serve to improve the built environment and reduce adverse health-related impacts, thus making buildings a truly healthy environment for occupants and communities.

References 1. Allen JG, MacNaughton P, Laurent JGC, Flanigan SS, Eitland ES, Spengler JD (2015) Green buildings and health. Curr Environ Health Rep 2(3):250–258 2. Thomson H, Snell C, Bouzarovski S (2017) Health, well-being and energy poverty in Europe: a comparative study of 32 European countries. Int J Environ Res Public Health 14(6):584 3. Department of Trade and Industry. UK fuel poverty strategy. https://www.bristol.ac.uk/poverty/ downloads/keyofficialdocuments/Fuel%20poverty%20strategy%202008.pdf. Accessed 13 Aug 2019 4. Hernández D, Phillips D, Siegel E (2016) Exploring the housing and household energy pathways to stress: a mixed methods study. Int J Environ Res Public Health 13(9):916

References

139

5. Harrington BE, Heyman B, Merleau-Ponty N, Stockton H, Ritchie N, Heyman A (2005) Keeping warm and staying well: findings from the qualitative arm of the Warm Homes Project. Health Soc Commun 13(3):259–267 6. Churchill SA, Smyth R, Farrell L (2020) Fuel Poverty and Subjective Wellbeing. https:// www.researchgate.net/profile/Sefa_Awaworyi_Churchill/publication/337902999_Fuel_Pove rty_and_Subjective_Wellbeing/links/5df18d8c299bf10bc35457bb/Fuel-Poverty-and-Subjec tive-Wellbeing.pdf. Accessed 01 Jan 2020 7. Interact Office. A smarter office with interact office software. https://www.interact-lighting. com/b-dam/b2b-li/en_AA/interact/case-study/the-edge/case-study-the-edge.pdf. Accessed 10 Aug 2019 8. BREEAM. The Edge, Amsterdam. https://www.breeam.com/case-studies/offices/the-edgeamsterdam/https://www.breeam.com/case-studies/offices/the-edge-amsterdam/. Accessed 25 Nov 2019 9. The Edge. https://edge.tech/portfolio/the-edge. Accessed 13 Aug 2019 10. Philips. PoE Lighting for Offices. https://www.usa.lighting.philips.com/systems/connected-lig hting-for-offices. Accessed 19 Aug 2019 11. Mapiq. Optimise your office with dat-driven decisions. https://www.mapiq.com/. Accessed 4 Nov 2019 12. Philips. InterAct Office: building intelligence with light. https://www.lighting.philips.com/ main/systems/lighting-systems/connected-lighting-interact-office. Accessed 19 Aug 2019 13. Philips. Indoor positioning. https://www.lighting.philips.com/main/systems/lighting-systems/ indoor-positioning. Accessed 4 Nov 2019 14. Helal S, Chen C (2009) The Gator Tech Smart House: enabling technologies and lessons learned. In: Wei tech Ang; Thantachat, W (eds) Proceedings of the 3rd International Convention on Rehabilitation Engineering & Assistive Technology, Association for Computing Machinery, New York, United States, p 13 15. Abdulrazak B, Helal A (2006) Enabling a Plug-and-play integration of smart environments. In: Proceedings of 2nd International Conference on Information & Communication Technologies, Damascus. Association for Computing Machinery, New York, United States. (1):820–825 16. Helal S, Mann W, El-Zabadani H, King J, Kaddoura Y, Jansen E (2005) The gator tech smart house: a programmable pervasive space. Comput 3:50–60 17. Davenport RD, Elzabadani H, Johnson JL, Helal AS, Mann WC (2007) Pilot live-in trial at the GatorTech smarthouse. Top Geriatr Rehabil 23(1):73–84 18. Crandall AS, Cook DJ, Kusznir J, Thomas B (2008) CASA project: a comprehensive smart home research testbed. https://research.wsulibs.wsu.edu:8443/xmlui/bitstream/handle/2376/ 1350/Crandall%20summary.pdf?sequence=1. Accessed 20 Nov 2019 19. Dawadi PN, Cook DJ, Schmitter-Edgecombe M (2015) Automated cognitive health assessment from smart home-based behavior data. IEEE J Biomed Health Inform 20(4):1188–1194 20. Sprint G, Cook D, Fritz R, Schmitter-Edgecombe M (2016) Detecting health and behavior change by analyzing smart home sensor data. In: Proceedings of 2016 IEEE International Conference on Smart Computing (SMARTCOMP), St. Louis, pp 1–3 21. Alberdi A, Weakley A, Schmitter-Edgecombe M, Cook DJ, Aztiria A, Basarab A, Barrenechea M (2018) Smart home-based prediction of multidomain symptoms related to Alzheimer’s disease. IEEE J Biomed Health Inform 22(6):1720–1731 22. Hu Y, Tilke D, Adams T, Crandall AS, Cook DJ, Schmitter-Edgecombe M (2016) Smart home in a box: usability study for a large scale self-installation of smart home technologies. J Reliab Intell Environ 2(2):93–106 23. Crandall AS, Cook DJ (2012) Smart home in a box: a large scale smart home deployment. In: Proceedings of intelligent environments workshops, Guanajuato, p 169–178 24. Cook DJ, Crandall AS, Thomas BL, Krishnan NC (2012) CASAS: a smart home in a box. Comput 46(7):62–69 25. Rashidi P, Cook DJ, Holder LB, Schmitter-Edgecombe M (2010) Discovering activities to recognize and track in a smart environment. IEEE T Knowl Data En 23(4):527–539 26. Cook DJ, Krishnan N (2014) Mining the home environment. J Intell Inf Syst 43(3):503–519

140

7 The Nexus Between Smart, Sustainable, and Healthy Buildings …

27. Krishnan NC, Cook DJ (2014) Activity recognition on streaming sensor data. Pervasive Mob Comput 10:138–154 28. Pedersen Zari M (2015) Ecosystem processes for biomimetic architectural and urban design. Archit Sci Rev 58(2):106–119

Chapter 8

Look Ahead

This chapter synthesizes the preceding chapters to derive a final framework that integrates the healthy and smart building practices. The benefits and future potential of this integrated approach are outlined and emphasized.

8.1 Overview The United Nations estimates that 2007 was the year that, for the first time in human history, more people lived in urban rather than rural areas [1]. In 2018, more than four billion people lived in urban areas globally, and it is projected that by 2050, 68% of the world’s population will live in densely populated built environments, that is, cities [1]. The built environment plays an important role in public health through disease and contamination prevention of chronic and infectious disease. The urbanization trend and worldwide travel have increased the risk of epidemic outbreaks. This book was written as the COVID-19 virus posed a major threat to humanity and while the world was still searching for cures. The high population densities, low herd immunities, and increased mobility of people lead to broader spread of diseases such as COVID-19 within built environments [2]. As explained in previous chapters, the impact of built environments on public health can be direct— for example, changing the indoor environmental quality can induce a variety of “sick building” syndromes. The impact can be indirect as well through influencing behaviors associated with health conditions. When looking into the future for ways in which built environments can help improve public health, three characteristics stand out regarding the development of smart technology: small size, adaptability, and affordability.

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2021 M. Hu, Smart Technologies and Design For Healthy Built Environments, https://doi.org/10.1007/978-3-030-51292-7_8

141

142

8 Look Ahead

8.2 Smart Physical Technologies: Small and Adaptable As outlined in Chap. 2, the threat of infectious diseases has directly spurred changes in urban planning and architectural design since the mid-nineteenth century, especially those stemming from efforts to provide healthy living and working conditions that could help prevent the outbreak and spread of epidemics. In these efforts to prevent infectious disease transmission, especially through reducing the spread of airborne viruses, modern building standards have identified a variety of disease transmission modes and developed control mechanisms. For example, healthcare design standards require 100% fresh air ventilation in buildings to reduce the dissemination of airborne viruses such as influenza. The role of building in preventing disease spread [way in which a building can spread disease was highlighted in the 2003 SARS outbreak in a private residential apartment complex in Hong Kong, where the ventilation system and sanitary plumbing expedited the spread of the virus [3, 4]. Today, a new generation of biosensors can be integrated in smart building control systems to detect viruses, send warning messages to building control systems, and automatically shut down the central mechanical air circulation system to prevent further virus transmission. Some promising smart sensors include electrochemical, piezoelectric, and optical biosensors [5]. These sensors are small and adaptable and have become more affordable in recent years. In addition to smart sensors, smart materials can play important roles in making buildings healthy. Besides viruses, toxic pollutants generated from building materials can cause various neurological, cognitive, and behavior problems [6]. More stringent building material requirements can prevent such pollution. Furthermore, incorporating smart building material designs at the nanoscale can turn buildings into pollutant cleaners instead of generators. For example, the Palazzo Italia at Expo 2015 in Milan and the Hospital General Doctor Manuel Gea Gonzalez in Mexico City used bio-dynamic concrete [7] to develop a “living façade” system that breaks down pollutants such as sulfur oxides, soot particles, and nitrogen oxides. The latter are a major component of smog. The bio-dynamic concrete comprises conventional cement mixed with titanium dioxide. The titanium dioxide functions as a catalyst to generate a catalytic chemical reaction when exposed to sunlight. The porous concrete façade allows air to pass through while simultaneously capturing nitrogen particles. The collected nitrogen particles are then washed off by rain. According to the biodynamic concrete designers, the nitrogen particles captured by one of the building façade in Mexico City can offset the effects of air pollution from one thousand cars [7]. Concrete is a very versatile yet fundamental building material. The future application of such technology could be widespread. Besides improving conventional concrete at the molecular scale as with bio-dynamic concrete, other smart building materials and systems are under development. The data collected from their pilot projects will shape the way in which smart technologies can change our approach to pollution mitigation.

8.3 Smart Design Technologies: Affordable

143

8.3 Smart Design Technologies: Affordable Fortunately, not all smart technologies are costly. Many sustainable design technologies create no additional costs as they provide health benefits to people. For example, windows that open are essential for natural ventilation. Using natural ventilation can decrease the need for cooling in the summer and increase air circulation to prevent air stagnation, which is a crucial defense against airborne viruses. Research has shown that, while viral particles are too small to be blocked by air filters in mechanical systems, natural ventilation strategies can dilute the concentration of virus particles indoors by bringing in fresh air [8]. Also, in high humidity environments, virusbearing water droplets get bigger, settle out of the air more quickly, and thus don’t travel as far [8]. This characteristic may be why the flu season often coincides with winter, which is a low-humidity season [9, 10]. Therefore, sustainable design strategies that provide comfortable indoor environments with appropriate humidity ranges will help fight virus transmission. Such smart design strategies normally do not involve additional costs. They only need to be integrated in projects right from the start. In the previous chapters, we explained built environment design strategies—for instance, a well-designed and maintained street segment—correlate with building residents being more active physically and experiencing lower mental stress. In contrast, large streetscapes with low detailing and complex building facades are more likely to be perceived as stressful [11]. Again, changing design strategies to avoid this stress-inducing effect has no associated cost and therefore is affordable for everyone. However, achieving such change requires an integrated approach from urban planners, transportation engineers, policymakers, and architecture designers, along with an in-depth understanding of how built environments can impact public health.

8.4 Emerging Issues: Epidemic and Aging Currently, two major public health threats exist that can be substantially influenced by built environments: epidemics and aging. Built environments have significant impacts on disease transmission and on human behavior related to disease spread. The spread of a virus can be directly influenced by built environment properties such as spatial configurations within buildings and how people’s mobility is affected by the city’s spatial configuration [11]. People’s daily movement patterns in densely populated urban areas are highly predictable [11], and current city-level epidemiological models can integrate commuting information, geospatial data, and infection dynamics and spreading characteristics to help cities develop preventive strategies [12–14]. That said, the spatial configuration of physical built environments is not being taken into consideration in developing such strategies [11]. Bridging the gap between urban planning and public health prevention planning can lead to different

144

8 Look Ahead

types of urban spatial planning. Perhaps school buildings should be located adjacent to public transportation hubs. Perhaps people should work in places close to home to reduce their “mobility” and hence reduce the opportunity for virus transmission. And perhaps large suburban shopping malls are an “unhealthy” building type that facilitates cross-contamination. These are questions planners, urban designers, and public health researchers should collectively investigate and answer. Aging is another growing public health concern. Chronic disease affects the older population disproportionally. In the United States, the proportion of the population aged ≥65 years, which was 12.4% in 2000, is projected to increase to 19.6% in 2030. Persons aged ≥80 years, who numbered 9.3 million in 2000, are expected to increase to 19.5 million in 2030 [15]. In response, over the past decade, a variety of age and disability friendly smart building systems have been developed. The three case projects introduced in Chap. 7 demonstrate a wide range of available smart systems and technologies. The common theme of those technologies is to make “aging in place” and “living independently” possible and affordable. The guiding principle of smart design is to make built environments and architectural spaces “smart ready” so they can accommodate ongoing technological advancement. In other words, smart buildings and smart built environments should not be fixed sets of equipment, devices, and spaces. Instead, they should be flexible and adaptable to future changes.

8.5 Looking Ahead: Ways the Built Environment Will Change Post-pandemic Technology alone will not make a healthy built environment. If other core elements of built environments, such as public health and public service, are not integrated in design and planning, the efforts to construct technologically advanced smart buildings and cities that promote and preserve health will fail. The built environment must change profoundly, especially after pandemics like COVID-19. Public health concerns demand built environments with smart infrastructures and smart buildings that work together to set up a holistic and integrated approach. At the urban scale, the public transit pattern in particular will need to change. Crowded public transit hubs clearly pose risks for rapid virus transmission. According to Milan’s mayor, Beppe Sala, the city plans to reduce its metro system’s capacity by up to 30% of its pre-pandemic activities [16]. In The Netherlands, longer, more spacious trains will be put in use to give passengers more room to spread out. Berlin is opening up more lanes for cyclists. In Britain, bus passengers are entering through the middle or rear doors to reduce the virus risks for drivers [17]. Along with this kind of smart planning, smart technologies are being used for contact tracing, especially in the Asian countries hit earliest by the novel coronavirus and with the highest population densities. Tech companies such as Apple and Google have announced plans to turn phones into opt-in COVID-19 tracking machines, which will make it easier for

8.5 Looking Ahead: Ways the Built Environment Will Change Post-pandemic

145

health officials to identify and alert people if they have been exposed to the virus while preserving their privacy [18]. At the building scale, touchless smart sensor technologies could become dominant post-pandemic. We already have touchless faucets, automatic doors, and smart thermostats, among other innovations. Smart sensors will be added in densely populated building types such as apartments and schools to monitor the environment and reduce unnecessary contact. Also, during the current lockdown, the empty commercial buildings worldwide have wasted energy on unnecessary ventilation and heating. Many empty buildings continue to run central plant equipment and have not adjusted their operating time schedules in many cases due to the inflexibility of the building management systems. Smart building technologies can dramatically curb energy waste by monitoring and managing building operations remotely [19]. Eventually, the world will go back to more in-person contact. Workers need to interact with colleagues to spark ideas. School children need to interact with teachers and other students to develop social skills. For people to feel confident that we can safely go back to normal life, we need to provide clean office environments and public spaces. More importantly, we need to collectively make smart, healthy buildings, and built environments the norm. In the past few decades, the focus of built environment design and construction has been on energy and resource conservation, and smart technologies have been developed to meet those goals. This focus is understandable in the context of the sustainability movement. But buildings are not only machines for living. They are also shelters to escape to, places to recover. In that sense, they should be environments that can protect and improve people’s physical and mental health. Built environments affect human health at multiple scales, including the urban and building scales. At the urban scale, urban planning and design can impact population-level processes by shifting how close individuals must be to one another and their mobility patterns. At the building scale, the interior layout and spatial structure can affect people’s physical and psychological wellbeing. Tomorrow’s challenge lies in creating healthy, sustainable, smart built environments with low energy use. Sustainable building should also be healthy building in terms of its responsiveness to occupants’ wellbeing and health [20]. Smart technologies can help achieve such goals. The first step toward a comprehensive guideline for smart, healthy, sustainable building is to gather more empirical data so that the mechanisms of how built environments influence human health can be better understood. There is also an urgent need to create greater public awareness of the health impact of built environments, as well as the availability of smart technologies that can mitigate negative impacts. Overall, the built environment design and construction industry needs to focus primarily on making built environments healthy for living and working. For this to succeed, new players need to be involved, players such as computer science, information, and communication technology (ICT) professionals, to develop and implement smart technologies and solutions. The collaboration of all stakeholders will likely be the key to our succeeding in building healthy, smart built environment over next decade or two.

146

8 Look Ahead

References 1. Ritchie H, Roser M (2018) Urbanization in Our World in Data. https://ourworldindata.org/urb anization. Accessed 03 May 2020 2. Vazquez-Prokopec GM, Kitron U, Montgomery B, Horne P, Ritchie SA (2010) Quantifying the spatial dimension of dengue virus epidemic spread within a tropical urban environment. PLoS Neglect Trop Dis 4:e920 3. McKinney KR, Gong YY, Lewis TG (2006) Environmental transmission of SARS at amoy gardens. J Environ Health Denver 68:2 4. Sample H (2012) Emergency urbanism and preventive architecture. In: Borasi G, Zardini M (eds) Imperfect health: the medicalization of architecture. Canadian Centre for Architecture, Montreal, Canada, pp 231–250 5. Saylan Y, Erdem Ö, Ünal S, Denizli A (2019) An alternative medical diagnosis method: biosensors for virus detection. Biosensors 9(2):65 6. Evans GW (2003) The built environment and mental health. J Urban Health Bull NY Acad Med 80:536–555 7. The Green Dandelion. Mexico’s smog eating building. https://blogs.rochester.edu/thegreend andelion/2013/11/mexicos-smog-eating-building/ Accessed 03 May 2020 8. ScienceDaily. COVID-19 and the built environment: Examining how building design can influence disease transmission. www.sciencedaily.com/releases/2020/04/200410162450.htm. Accessed 03 May 2020 9. Shoji M, Katayama K, Sano K (2011) Absolute humidity as a deterministic factor affecting seasonal influenza epidemics in Japan. Tohoku J Exp Med 224(4):251–256 10. Lowen AC, Mubareka S, Steel J, Palese P (2007) Influenza virus transmission is dependent on relative humidity and temperature. PLoS Pathog 3(10):e151 11. Pinter-Wollman N, Jeli´c A, Wells NM (2018) The impact of the built environment on health behaviours and disease transmission in social systems. Philos Trans Royal Soc B: Biol Sci 373(1753):20170245 12. Mei S, Chen B, Zhu Y, Lees MH, Boukhanovsky AV, Sloot PMA (2015) Simulating city-level airborne infectious diseases. Comp Environ Urban Syst 51:97–105 13. Bian L (2013) Spatial approaches to modeling dispersion of communicable diseases—a review. Trans. GIS 17:1–17 14. Qi F, Du F (2013) Tracking and visualization of space–time activities for a micro-scale flu transmission study. Int J Health Geogr 12:6 15. U.S. Census Bureau. International database. Table 094. Midyear population, by age and sex. http://www.census.gov/population/www/projections/natdet-D1A.html. Accessed 03 May 2020 16. Worldcrunch. The world’s cities get ready to take public transport again. https://worldcrunch. com/coronavirus/the-world39s-cities-get-ready-to-take-public-transport-again. Accessed 03 May 2020 17. StarTribute. Making public transit safe a next hurdle in easing lockdowns. https://www. startribune.com/making-public-transit-safe-a-next-hurdle-in-easing-lockdowns/570045442/ Accessed 03 May 2020 18. Apple. Privacy-preserving contact tracing. https://www.apple.com/covid19/contacttracing. Accessed 03 May 2020 19. BusinessGreen. Empty commercial buildings wasting energy and money during Covid19 lockdown. https://www.businessgreen.com/news/4014476/study-commercial-buildingswasting-energy-money-covid-19-lockdown. Accessed 03 May 2020 20. Xie H, Clements-Croome D, Wang Q (2017) Move beyond green building: a focus on healthy, comfortable, sustainable and aesthetical architecture. Intell Build Int 9(2):88–96