When hospital buildings are not healthy

[edit] Introduction

Air conditioning is becoming required more and more to manage the temperature in buildings. We all know that we are spending increasing amounts of time indoors, avoiding the elements, and whilst we do, the fact is, we are damaging those elements.

[edit] Building to accommodate the elements

One question that I have asked myself and peers many a time, is why are we not building better to accommodate the effects of the elements? The answer is a wide range of justifications to the fact that we are.

My argument in response is that in a lot of cases, we are avoiding the obvious. To build with the effect of the elements in mind, we are utilising technology in cooling that does quite the opposite.

[edit] The shortcomings of healthcare environments

Hospitals and hospices are the biggest contradiction. In a healthcare environment the occupants need daylight more than ever. I do not need to harp on about the benefits. A connection to the outdoors and having access to natural light helps patients heal faster, making for a shorter hospital stay, and in general, the therapeutic environment that is strived for.

Whilst one would assume methodology for optimising daylight was applied in the initial phases of the building design, what were the designer’s/client’s overriding decision factors for the final design?

There is always a compromise. Was it high levels of daylight alone? Energy efficiency? A combination of both? What about managing the heat that the daylight also provides? Mitigating glare?

These factors are all too often disregarded, or deprioritised, and found to be a problem after the building is occupied. The facilities manager then takes on the burden.

[edit] The role of air conditioning

In 2018, a UK heatwave saw NHS trusts bulk buying mobile air-conditioning units, fans and bottled water to help beat the negative effect of temperatures. This widespread problem is only expected to get worse. Predictions indicate the year 2020 is the warmest year in UK history, plus, there are the complications associated with dealing with the global COVID-19 pandemic.

Hospitals are complex builds to deliver; no one would deny that. Installation of air conditioning uses large amounts of energy and contributes to climate change. Ventilation is needed, especially whilst dealing with the pandemic, but so are heat and light control.

Worse still, healthcare trusts that do not have imminent budgets for new buildings are seeing their running costs rise year after year. This is necessary in order to manage temperatures in buildings built when these levels of temperatures were not even a consideration.

The Committee on Climate Change (the Government’s official climate change advisors) stated in a report that the types of hospital wards that are vulnerable to overheating currently make up 90% of the total stock (by floorspace). A Cambridge University report found that some £17.5bn of upgrades could be needed to make UK hospitals resilient to the heat through new shading measures and improved ventilation. Overheating in hospitals is a serious issue.

[edit] Reducing overheating while providing access to natural light

The general design guidance for healthcare premises as defined by the Department of Health isn’t prescriptive when it comes to solar gain and glare. The management of heat and glare is left to shading solutions that, at best, remove only some of the problems, or at worst, also remove the benefits of the glazing and/or the daylight.

Internal blind systems remove visibility and a connection with the outside world and only protect the room from a minimal amount of heat gain. External shading systems do work but are expensive to install and maintain as well as reducing the quality of daylight. Even the most recent advances in glazing technology reduce the view out.

What is the answer? How do you get optimum daylight distribution, visibility to the outside world, protection from glare and the opportunity for ventilation? You stop the heat and light before it hits the glass, with a metal fabric that has micro fine louvres woven in to dissipate the sun’s heat and energy but not block natural daylight, natural ventilation or vision out.

This solution works totally differently from traditional external and internal blinds, which reflect, distort and restrict vision and light. This type of fabric (such as the product known as MicroLouvre) simply and invisibly neutralises solar heat gain and glare before these factors even reach the window, working non-stop like a heat exchanger dissipating the sun’s heat and energy into the atmosphere.

It does not diffuse daylight. Instead, it provides all the benefits but not the negative impact of excessive heat gain and glare. The fine louvres are angled at a level to ensure optimum light in and visibility out, whilst protecting the building occupants from the heat, glare and even external viewing in. This strategy is referred to as angular selective technology.

The performance of this fabric has been tested time and time again by standards agencies, scientists and researchers, including BRE. It has been around since the 1940s, but in recent years, it has been honed, and the production process improved, so that it remains the best solution for solar shading.

This article originally appeared in the Architectural Technology Journal (at) issue 134 published by CIAT in Summer 2020. It was written by Andrew Cooper, Managing Director of Smartlouvre Technology Limited.

--CIAT

[edit] Related articles on Designing Buildings Wiki

• Air conditioning.
• Angular selective shading systems.
• Blinds.
• BREEAM Visual comfort Glare control.
• CIAT articles.
• Control of solar shading IP 4 17.
• Daylight lighting systems.
• Design of isolation rooms for infection control.
• Emergency healthcare architecture in Brazil.
• Glare.
• Hospital.
• IAQ developments accelerated by COVID-19 pandemic.
• Overheating.
• Sick building syndrome.
• Solar shading.
• Thermal comfort.