Florence Nightingale was right: Fresh air = healthy buildings

IMAGE: Joseph Allen is an associate professor at Harvard’s T.H. Chan School of Public Health and co-author of Healthy Buildings – How Indoor Spaces Drive Performance and Productivity. (Courtesy Harvard)

Joseph Allen is an associate professor at Harvard’s T.H. Chan School of Public Health and co-author of Healthy Buildings – How Indoor Spaces Drive Performance and Productivity. (Courtesy Harvard)

Building owners should take advice from Florence Nightingale in their efforts to make their indoor spaces safe from COVID-19, says an international expert on fixing sick buildings.

Nightingale advocated fresh air from open windows for her patients, Joseph Allen, keynote speaker at BOMEX 2020, said Wednesday. Better ventilation, air filtration and portable HEPA air filters can mitigate the risk of COVID-19 in indoor spaces, Allen told BOMA Canadas virtual convention.

“Where we’ve had failures – whether it’s a spin class or a choir practice, office building or school – it’s time spent indoors, no mask, low to no ventilation,” said Allen. “If you layer enough defences on top of each other, you can lower those risks.”

Allen told his online audience of building owners and managers ventilation standards have declined since Nightingale issued her prescription 160 years ago.

Why some buildings aren’t healthy

“We used to set ventilation rates in buildings for infectious disease and health. In the 1970s, in response to the energy crisis, we started tightening up our building envelopes; we started choking off the air supply and this ushered in the era of sick buildings.

“And, in fact, buildings right now often are not flexible enough to increase the outdoor air delivery rate, or to put in better filters in response to this crisis.”

Allen is an associate professor at Harvard’s T.H. Chan School of Public Health and co-author of Healthy Buildings – How Indoor Spaces Drive Performance and Productivity. Since January, he has written 21 opinion pieces for various publications on science-based tips for COVID-19 control.

He said evidence shows the COVID-19 virus reaches areas of buildings, such as ductwork, that can only be reached through the air. The fundamental ways to battle airborne transmission of the virus are dilution through good ventilation, and cleaning via filtration.

He also advocates worker health and safety hierarchies to tackle risk reduction.

These include determining the core people who must be physically present to run a building, engineering controls such as ventilation, administration controls such as managing elevator and washroom use, and universal masking.

“Can we keep people safe in buildings outside of our homes? Yes, if you put in those strict risk-reduction measures, really a layered defence approach.”

Healthy buildings matter to your health

Allen also spoke more generally about how buildings can affect the health, performance and productivity of employees.

Humans spend 90 per cent of their time indoors, he said: “The person who manages your building has a greater impact on your health than your doctor.”

Allen said he and his colleagues think health performance indicators are needed for buildings, addressing issues such as how building owners audit indoor air quality, design, operate and maintain buildings and do real-time measurements on the environment of indoor spaces.

He outlined a study done on 24 knowledge workers in an office environment who were administered cognitive function tests over 90 minutes.

During that period the air in their work space was improved, with more outdoor air coming in in addition to lower carbon dioxide levels and lower concentration of common chemical compounds.

Participants with an optimized environment performed significantly better on tasks including strategic decision-making and crisis management, he said.

BOMA Best Clean Buildings

With the pandemic has come increased scrutiny of the health and environmental aspects of buildings, Allen advised. And if something is awry, it finds its way on to workplace information-sharing websites like Glass Door.

“Everyone’s paying attention. Everyone’s interviewing your building and this information is now being shared for others to look at and evaluate.”

BOMA Canada CEO and president Benjamin Shinewald announced a new health-related initiative for the association at the outset of this year’s convention.

BOMA Best Clean Buildings will be a new certification for cleaning companies and for commercial real estate buildings that will set the standards for the industry while also reassuring tenants at “this difficult time,” Shinewald said.



Kathy Kerr is an Alberta journalist with four decades of experience as a writer and editor. She covered general news and provincial politics as a reporter for the Calgary Herald…

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Kathy Kerr is an Alberta journalist with four decades of experience as a writer and editor. She covered general news and provincial politics as a reporter for the Calgary Herald…

Read more




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