HEALTHCARE VENTILATION
Better indoor air quality in health buildings
Dr. Iyad Al-Attar, a mechanical engineer and independent air filtration consultant, and a Visiting Academic Fellow at the School of Aerospace, Transport, and Manufacturing at Cranfield University, explores the evolution of indoor air quality (IAQ) governance, tracing advancements in building technology – ‘from basic mechanical systems to sophisticated smart building technologies’. Highlighting ‘the historical neglect of IAQ as a public health concern’, he contrasts it with the increased focus spurred by recent pandemics, and explains how air quality governance ‘leads the way to the promise of better IAQ – from theory into practice’.
Historically, cities have been viewed as unnatural environments for humanity, representing a departure from rural life, where clean air and abundant resources are prevalent. Jean-Jacques Rousseau described the isolation experienced in urban settings by characterising towns as ‘the abyss of the human species’. He dismissed cities as ‘pestilential to man’s morals, health, and liberties’. As nations work to move from poverty to prosperity through urban development, the unprecedented scale, speed, and scope of current urbanisation raise concerns about its sustainable trajectory and the potential for cities filled with disease and danger. Buildings have evolved alongside technological advancements throughout history. Each era has witnessed significant leaps in building technology, shaped by societal expectations and technological possibilities. This evolution demonstrates an increasing reliance on integrated and adaptive systems as crucial elements in building design and operation. From basic mechanical systems to digital and sustainable solutions, technology has become more complex, interconnected, and responsive to human needs. This shift from passive solutions to proactive, intelligent systems aims to create healthier, more comfortable, and sustainable buildings. Disruptive technological advancements change how occupants gauge and perceive their expectations, and influence their interactions with their buildings, fulfilling current technologies’ social promise.
Industrial era’s key advances The industrial era introduced machinery such as steam engines and early HVAC systems to buildings. Advances in plumbing technology made sanitation systems and indoor toilets possible, dramatically improving public health. Gas lighting initially transformed how spaces were lit, followed by electric lighting in the late 19th century, bringing a more stable and safer lighting source. These developments were not just about functionality, but also about ascending the heights of public health and wellbeing. Mechanisation also extended to elevators in the late 19th century, which enabled high-rise construction. By the 1920s and 1930s, boilers and early air-conditioning systems were incorporated into buildings, especially in urban areas. The increased availability of electricity enabled the
installation of more complex electrical wiring. Hence, more HVAC systems facilitated the desired thermal comfort to inhabit buildings and prosper amid humanity’s massive urbanisation. Singapore’s founding leader, Lee Kuan Yew, was convinced that air-conditioning was key to his nation’s achievements, and was the greatest innovation of the 20th century.1
The ‘neglect’ of IAQ Although the premise of all these technologies was to improve the functionality of a building, public health and wellbeing through the lens of air quality received less attention and emphasis. When building automation systems emerged through digital controls for HVAC, lighting, and security – allowing remote control and more efficient energy management, air quality was not one of the driving forces of smart building technologies. Today, the availability of air quality sensors, IoT devices, and computer-based systems, has enabled ‘smart’ buildings to exist. Additionally, these various system have facilitated monitoring of environmental changes and occupancy pattern variations to allow for responses to any deterioration in indoor air quality. The narrative of better IAQ in the building still needs to catch up as a priority. To date it has tended only to gain spot momentum during pandemics, wildfires, and volcanic eruptions. Modern buildings are far better positioned to embrace air quality monitoring systems, and act upon their data through their enhanced connectivity than ever before. IAQ data can be capitalised on by integrating
Figure 1: The aesthetic of interior design can overshadow the IAQ importance.
February 2025 Health Estate Journal 71
All images used courtesy of Dr Iyad Al-Attar
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