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BUILDING DESIGN


The circadian cycle is the natural biological regulation between day and night made by the human body through the production of hormones cortisol and melatonin


The Brazilian Health Ministry does not


control water and energy hospitals consumptions and, while Brazilian Health Surveillance requires a maintenance and control operation plan, it does not yet include measures for VOC, particulates, ozone, carbon monoxide, formaldehyde or ‘target’ chemicals. However, the Brazilian Hospital Services Company (EBSERH),19


related


to the Education Ministry, is a national company responsible for managing 40 teaching hospitals all over the country. EBSERH is aware of sustainability importance and strives for quality through the management of hospital facilities. There are EBSERH manuals and standards concerning sustainable resources and materials, other subjects like maintenance and best practices in healthcare design are under development. Figure 3 shows the locations - marked


in light green – of 40 EBSERH teaching hospitals (HUFs). It can be observed that the North region of Brazil has less hospital facilities.


Conclusion Hospitals need to be efficient, safe and comfortable to attract and enhance people´s health and wellbeing. Hospitals need to focus on people to be turned into a genuinely healthy building. To obtain excellence in healthcare,


merely following built environments standards are not sufficient. Hospitals and all healthcare buildings need a multidisciplinary team with architects, engineers, public health specialists, health scientists, chemicals, business planners. All health professionals are needed in an integrated and collaborative approach.


Indoor air quality aspects can be decision-making indicators about possible interventions in the built environment. It is important to prioritise indoor environmental aspects that are conducive to human health. People now have the opportunity to change, redesign, rebuild, retrofit, re-evaluate and really create a ‘new normal’ with updated hospitals.


References 1 Kepleis NE, Nelson WC, Ott WR et al. The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants. J Expo Anal Environ Epidemiol 2001; 11: 231-52.


IFHE DIGEST 2021


2 Zioni EC. Planejamento físico-funcional e hotelaria em saúde. São Paulo: Editora Senac, 2018.


3 Brazilian Health Ministry, https://localizasus.saude.gov.br.


4 World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations: scientific, 2020. https://apps.who.int/iris/handle/10665/ 331601.


5 Morawaska L, Milton DK. It is Time to Address Airborne Transmission of COVID-19? Clinical Infectious Diseases, 2020. https://doi.org/10.1093/cid/ciaa939.


6 Associação Brasileira de Normas Técnicas. NBR 7256: Tratamento de ar em estabelecimentos assistenciais de saúde (EAS) – Requisitos para projetos e execução das instalações. ABNT Rio de Janeiro, 2005.


7 LEED – Leadership in Energy and Environmental Design, 2020. https://usgbc.org.


8 BREEAM, BREEAM Certification 2020. https://www.breeam.com/worldwide.


9 EDGE Buildings. Excellence in Design for Greater Efficiencies. Version 2.1.5, Hospitals.


EDGE 2020. https://app.edgebuildings.com/ project/hospitals.


10 International Well Building Institute, WELL Building Standard v.2, 2020. http://www.wellcertified.com.


11 Sanchez-Cano A, Pérez OL, Aporta J. Proposal to calculate the circadian component in lighting projects. Optica Pura y Aplicada, 2019.


12 Alzubaidi S, Roaf S, Banfill PFG, Talib RA, Al-Ansari A. Survey of Hospitals Lighting: Daylight and Staff Preferences. International Journal of Energy Engineering 2013; 3 (6): 287-93.


13 Shepley M, Gerbi R, Watson A, Imgrund S, Sagha-Zahed R. The impact of daylight and windows on ICU patients and staff. Health Environments Research and Design Journal, 2012.


14 Healthy Buildings Certificate. Building Evidence: The 9 Foundations of a Healthy Building, 2019, https://9foundations.forhealth.org/.


15 Allen JG, Macomber JD. Healthy Buildings: how indoor spaces drive performance and productivity, Harvard University Press, 2020.


16 Bitencourt F. Conforto Ambiental em Estabelecimentos Assistenciais de Saúde, Brasília: Agência Nacional de Vigilância Sanitária. p. 165, 2014.


17 Bitencourt F. Impact of sustainability on design and build. International Federation of Hospital Engineering Digest 2019; p73-4.


18 Associação Nacional dos Hospitais Privados (ANAHP). National Association of Private Hospitals. www.anahp.com.br/produtos.


19 Empresa Brasileira de Serviços Hospitalares (EBSERH). https://www.gov.br/ebserh/pt-br.


Phases IFHE


With contract Without contract Public company


Figure 3. Location of 40 EBSERH teaching hospitals. 59


Source: EBSERH Empresa Brasileira de Serviços Hospitalares. Brazilian Hospital Services Company.


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