September 5, 2007JEMH van Bronswijk 1 Preventing disease (7y900) (incidence, prevalence, building determinants, DALY)

September 5, 2007JEMH van Bronswijk 2 Indicators for Public Health 1. Incidence of disease or infliction = number of cases diagnosed in a certain year 2. Prevalence of disease or infliction = number of cases known to be present in a certain year 3. Prevalence of increased risk = number of persons with increased risk in a certain year 4. Lost Years of Life = extra years of life that could have been expected, had the deadly condition not occurred 5. Disability Adjusted Life Years (DALY’s) = healthy years in a life span

September 5, 2007JEMH van Bronswijk 3 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

September 5, 2007JEMH van Bronswijk 4 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

September 5, 2007JEMH van Bronswijk 5 Indoor Air Suitability (NL) After MCL Snijders. PhD Thesis, TU/e, September 5, 2001 User Group With Chronic Lung Disease Children, Elderly, Non- sensitized Atopics Healthy, non-atopic Adults None CO 2 in ppm <= < CO 2 =< < CO 2 =< 1085> 1085 Moisture: % of time in Humidity Class I or II 95 < 95 Room Ventilation Rate (RVR) in l s -1 m - 2 >= > RVR >= > RVR >= 1.05< 1.05 Suitable Living Rooms in Heating Season 00432

September 5, 2007JEMH van Bronswijk 6 Atopy Inherited constitution ( 40% of the population )Inherited constitution ( 40% of the population ) Disease process is IgE mediatedDisease process is IgE mediated 1 st phase: Sensitization ( skin- and laboratory tests )1 st phase: Sensitization ( skin- and laboratory tests ) 2 nd phase: Disease symptoms2 nd phase: Disease symptoms 85% of symptoms building related85% of symptoms building related Affected organs: eyes, nose, lungs, skin, alimentary canalAffected organs: eyes, nose, lungs, skin, alimentary canal

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September 5, 2007JEMH van Bronswijk 9 House Dust Mites

September 5, 2007JEMH van Bronswijk 10 The 6 Global Risk Areas for mite growth and survival in carpeting of well ventilated and heated rooms 1. No survival 2. Survival on poorly insulated ground floors 3. Survival on all floors 4. Growth on poorly insulated ground floors 5. Growth on most floors 6. Growth on all floors

September 5, 2007JEMH van Bronswijk 11 Temperature and House Dust Mites in Carpeting Source: JEMH van Bronswijk, G Pauli (eds) An update on long-lasting mite avoidance. GuT, Aachen. ISBN

September 5, 2007JEMH van Bronswijk 12 The 6 Global Risk Areas for mite growth and survival in carpeting of well ventilated and heated rooms 1. No survival 2. Survival on poorly insulated ground floors 3. Survival on all floors 4. Growth on poorly insulated ground floors 5. Growth on most floors 6. Growth on all floors

September 5, 2007JEMH van Bronswijk 13 Prevalence of Sensitisation to mite allergen in atopic patients Source: JEMH van Bronswijk, G Pauli (eds) An update on long-lasting mite avoidance. GuT, Aachen. ISBN

September 5, 2007JEMH van Bronswijk 14 Top-10 Diseases The Netherlands 1994 Cause(s) in built environment characteristics Built environment may compensate / support

September 5, 2007JEMH van Bronswijk 15 Important Infections in Architecture, Building & Planning Infection Transmitted through AirWaterSurfacesOutdoor Influenza A xxx(x) Lyme disease ---x SARSxxx(x) Tuberculosisx--- Veteran’s disease -x-- Weil’s disease ---x In green: diseases associated with pneumonia In red: zoonoses

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September 5, 2007JEMH van Bronswijk 17 Pneumonia: Influenza A: bird flu Virus particles are spherical (diameter of nm) or filamentous (length 1 mu m) Source:

September 5, 2007JEMH van Bronswijk 18 Pneumonia: SARS

September 5, 2007JEMH van Bronswijk 19 SARS - Severe Acute Respiratory Syndrome - Coronavirus, person to person transmission : 908 dead among patients - Survivors: medication caused osteoporosis - Damage to the economy Influenza A -Orthomyxovirus, person to person transmission ? -Some death did occur -Pandemic: after person to person transmission

September 5, 2007JEMH van Bronswijk 20 Zoonosis Definition: Disease of animals that may be transmitted to humansDefinition: Disease of animals that may be transmitted to humans Severity: Expect severe diseaseSeverity: Expect severe disease Use: Some zoonoses are used in biowarUse: Some zoonoses are used in biowar Currently abundant in NL: Diseases of Lyme and WeilCurrently abundant in NL: Diseases of Lyme and Weil

September 5, 2007JEMH van Bronswijk 21 Technology to enlarge vitality? 93% of NL-elderly (2.2 mil of 65+) live independently 33% of the elderly with a severe physical disorder live in an unsuitable dwelling (not fully accessible, limited support) Source: Lectoraat Vraaggestuurde Zorg (dr. H.S.M. Kort), Utrecht 2005

September 5, 2007JEMH van Bronswijk 22 A Smart Home Environment (2 nd semester 7y910) is a home environment that adapts itself to the dweller. A SHE forms an invisible, intelligent, self-learning part of our daily life, combining functions pertaining to demand-driven comfort, domestic tasks, personal care, quality of life, and professional care Source: Bronswijk et al. 2005: De Intelligente Thuisomgeving. In: Handboek Zorg Thuis. Amsterdam: Elsevier

September 5, 2007JEMH van Bronswijk 23 Next class September 12: No class, consultation on request September 19: The DALY construct (Disability Adjusted Life Years) to evaluate building services