s640-5PubEng: J.E.M.H. van Bronswijk 1 Facility Manager and Health Complaints Costs and Quality

s640-5PubEng: J.E.M.H. van Bronswijk 2 Complaint = Quality Tool - Not an easy tool - Basic complaints are hidden - No direct relationship between complaint and cause - Adding Work, Home, School, Recreational Exposures - Incubation time of discomfort, stress and disease - Multidisciplinary problem is the rule - Awkward cooperation among disciplines

s640-5PubEng: J.E.M.H. van Bronswijk 3 The Phobia The Phobia (up to 12% of population) Source: Cambridge International Dictionary of English: Extreme fear of a particular thing or situation, especially one that cannot be reasonably explained Dictionary.com: A persistent, abnormal, or irrational fear of a specific thing or situation that compels one to avoid the feared stimulus Mental health professionals: A fear that interferes in a person's life. Symptoms: shortness of breath, redness in the face, heart palpitations, excessive sweating, dizziness, nausea and an inability to speak or think clearly

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s640-5PubEng: J.E.M.H. van Bronswijk 5 Drawn after: D Ruwaard & PGN Kramers eds Volksgezondheid Toekomst Verkenning. De JEMH van Bronswijk - April 9, 1996 gezondheidstoestand van de Nederlandse bevolking in de periode SDU, Den Haag d e t e r m i n a n t s : i n d i c a t o r s : - experienced functioning: diagnosed (un)healthiness - sick leave - loss of working capacity mortality(un)healthy life expectancy hereditary trait living habit social environment occupational environment consumption - medicament domestic environment disease (morbidity) From Determinants to Indicators

s640-5PubEng: J.E.M.H. van Bronswijk 6 Ventilation & Loss of Health Source: LGH Koren, CEE Pernot, JEMH van Bronswijk. Gezondheidsrisico’s van ventilatiesystemen in woningen. TU/e, NOVEM, July 30, 2001 Loss of Healthy Years in the Netherlands / Million Inhabitants in 1994 Total Attributable to Indoor Air Quality n% Atopic Diseases1,9811,58580 Chronic bronchitis & Lung Emphysema9,2042,76130 Lung Cancer8,

s640-5PubEng: J.E.M.H. van Bronswijk 7 Children at School The Allergy Example Outdoor Environment Outdoor Environment Pollen, Spores, (Diesel)exhaust Indoor Environments Indoor Environments + At School At School % of schools with excess of: Mites: 50% Mites: 50% Fungi: 20% Fungi: 20% Irritants: 100% Irritants: 100% At Home At Home % of dwellings with excess of: Mites: 70-95% Mites: 70-95% Fungi: 20% Fungi: 20% Irritants: 70-95% Irritants: 70-95%

s640-5PubEng: J.E.M.H. van Bronswijk 8 (Office) Building-in-Use Health Questionnaire - Person Identification - Workplace Location in Building - Local Indoor Climatization - View while Working - Thermal Comfort - Perceived Indoor Air Quality & General Hygiene - Noise Hindrance / Light & Lighting / Visual Comfort - Social & Emotional Comfort - Ergonomic quality of Office Furniture - PC / Laptop use at Work & at Home - Domestic & Leisure Environments - Bodily Complaints

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s640-5PubEng: J.E.M.H. van Bronswijk 16 Effective Allergy Management Step 1: (Possible) Sensitizations Prevention of sensitization? Prevention of symptoms ? Step 2: Assessment of Actual Exposure Inspection round (all allergens and irritants) House-dust sampling and analysis Wall sampling and analysis Step 3: Management Plan Optimizing ventilation and heating Terminate indoor smoking, remove pets from indoors Care of floor coverings, furniture and remaining furnishings Care for walls and ceilings ‘Allergen-proof’ (re)furnishing Suitable Building (services) engineering Step 4: Evaluation; back to Step 1? Sensitization / symptoms prevented? Exposure diminished ?

s640-5PubEng: J.E.M.H. van Bronswijk 17 Human Capital needs Healthy Air to be productive (i)Activities (ii)Ventilation & Heating (iii)Interior Decoration (iv)Cleaning (v)Organisation (vi)The Architect Indoor Air Quality is influenced by: The Facility Manager integrates these aspects

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s640-5PubEng: J.E.M.H. van Bronswijk 20 CO 2 as a pollution marker Pollutants in the Indoor Air Pollutants in the Indoor Air 340 ppm Outdoor value 340 ppm Outdoor value 700 ppm Airway irritation in Chronic Lung Patients 700 ppm Airway irritation in Chronic Lung Patients 1000 ppm Airway irritation in most persons 1200 ppm Hygienic limit in Netherlands Schools

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s640-5PubEng: J.E.M.H. van Bronswijk 22Activity Vapour in g 1 Hour Laying down40 1 Hour Sitting45 1 Hour light office work45 1 Hour medium-load physical work or exercise100 1 Hour of dancing or playing tennis500 Preparing 1 l tea on natural gas3 Water Vapour Production Source: ER Schramek (ed) Taschenbuch für Heizung und Klimatechnik Einschliesslich Warmwasser und Kältetechnik. 67. Auflage. Wien: Oldenburg

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s640-5PubEng: J.E.M.H. van Bronswijk 24 Ongewervelden-Hygrometer

s640-5PubEng: J.E.M.H. van Bronswijk 25 Indoor Air Suitability 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

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s640-5PubEng: J.E.M.H. van Bronswijk 33 Legionella extermination * Use a thermostatic mixing tap with automatic emptying, to prevent both burns and a Legionella infection! Source: Report Gezondheidsraad 1986; Pubmed At temperatures >64°C no breathing of Legionella occurs*At temperatures >64°C no breathing of Legionella occurs* No growth <18°C; Legionella remains vitalNo growth <18°C; Legionella remains vital 0.5 mg free chlorine / l water kills bacteria0.5 mg free chlorine / l water kills bacteria Copper or silver-ions in the water decrease growthCopper or silver-ions in the water decrease growth