**5. Case study**

106 Health Management – Different Approaches and Solutions

8. Content of CO, CO2, TVOCs, HCHO, O2, O3 in the air: CO content is measured by CO Meter (Model: GCO-2008). See left picture of Fig. 10. The measurement range is 0~1,000 ppm and the resolution is 1ppm. The meter can be used with software. The measurement range of CO2 Meter (Model: GCH-2018) is 0~4,000 ppm and the resolution is 1 ppm, and the meter can be used with software. See the right picture of Fig. 10.

TVOCs content is measured by TVOCs Monitor (Model: Series 500). See the left picture of Fig. 11. The measurement range is 0~500 ppm, and the resolution is 1 ppm. The unit of concentration can be ppm or mg/m3. The meter can be used with software. HCHO content is detected by HCHO Detector (Model: FP-30). See the right picture of Fig. 11.

Oxygen content is measured by GMI-Portable Gas Detector, whose measurement range is 0%~25% Vol. See the left picture of Fig. 12. Ozone content is measured by O3 Monitor

The measurement range is 0~0.4 ppm, and the meter can be used with software.

Fig. 9. PH Meter (left)/ Turbid meter (middle)/ Portable Colorimeter (right)

Fig. 10. CO Meter (left)/CO2 Meter (right)

Fig. 11. TVOC Monitor (left)/HCHO Detector (right)

The cases presented here is the combined result of the service learning course, Building Diagnosis Technology (BDT), and Building Medicine. The teaching goal of BDT is to train students to be able to use technological meters to diagnose the health and safety hazardous factors hidden in the community environment, and are also able to describe the sources of the problems. Finally, they work in teams and perform health diagnosis service in the public environments of communities. Through this course, they can understand and experience the training and practice of building doctors, and they can also make presentation to residents to explain the hazardous factors which may be hidden in their environments. The tested items are the 17 items listed in Table 1.

From 2009 to 2010, the total number of students who took these two classes is 154, and the service was performed in 3 communities (public space) and 1 elderly day care center (indoor environment). The total number of the serviced buildings is 30, which are of RC structures. The total testing service time in each community is 12 hours. There are 3 buildings in Case 1

Making a Healthy Living Space Through the Concept of Healthy Building of Building Medicine 109

customizing the number of health check items based on the conditions of each building, all the items are performed. Students are also taught that some of the problems are less likely to happen in certain conditions. For example, the interior fitting and decoration of the Case 1 buildings have been installed for more than 10 years, which makes the problem of high formaldehyde level unlikely to happen. Nevertheless, the author still wanted students to do all the tests to verify this hypothesis, and the result can also be compared to the

Fig. 17. The author led students to perform particle test in the rest area of elderly residents

As it is discussed above, each building's conditions vary just like every human patient's health is affected by various conditions. As a result, when making a health check plan for buildings, building doctors should consider each diagnosed subject's condition. For example, the building age of Case 1 is higher, as a result; the tests on public area should focus on water quality (the pH level), basement ventilation (CO and O2 level), and whether indoor lighting is insufficient because of lack of maintenance. Case 2 building is younger, and it is a luxury housing project with a lot of interior decoration works. Therefore, Indoor Air Quality (IAQ) should be the focus of building health checks, such as the tests of formaldehyde and TVOCs. Case 3 buildings are located next to a night-market. The noise during the nights is louder, so the night noise test is important. As to the elderly day care center of Case 4, since the occupants are the elderly, particles which may trigger allergies or lung diseases are the focus of the test. Furthermore, the water quality test on drinking water

The tests performed in these four cases have produced many valuable experience and information. However, this study follows the non-disclosure policy of medical records, and do not disclose and discuss the test result of each case (the results of most items are in the safe range). Therefore, in the following discussion, the author shares common problems and

1. Noise: The common causes of the noise level which exceeds the standard are ambulance siren, engine sounds of motorcycles, construction works, religious events held by temples, and engine sounds of ventilation fans in basements. Ambulance sirens and engine sounds of motorcycles are transient noises. Because they only last for a very short time, they wouldn't affect hearing. To lower down the noise of construction works and religious events, the occupants may report to local environmental protection bureaus and have the noise sources keep their noise down to the legal standard. If the recurring noises have constituted a psychological anxiety to occupants, it is suggested that occupants should install acoustic windows, which usually can reduce noise level up to 30 dB (A). Furthermore, the noise of the ventilation fans in basements can be reduced by installing vibration reduction devices or improving the motor's

formaldehyde levels of new buildings' interior fitting.

and water quality tests on drinking fountains

and TVOCs test on bathroom detergents are also important.

their solutions based on his 'clinical experience.'

community. It is a condominium, and its buildings are 17-years-old with 13 floors above ground and 3 floors underground. See Fig. 14.

Fig. 14. The author led students to perform radiation tests on steel bars, electromagnetic waves tests in courtyards, and formaldehyde tests in the library room

Case 2 community only has one building. The building is a 2-years-old condominium with 26 floors above ground and 4 floors underground. See Fig. 15.

Fig. 15. The author led students to perform formaldehyde tests in the rest area of SPA center, and oxygen, temperature, and humidity test in the lobby

Case 3 community is a mega-size condominium. There are 25 buildings and the number of households is more than 1,200. The number of floors above ground is from 8 to 12, and the number of floors underground is 2. See Fig. 16.

Fig. 16. The author led students to perform noise tests on sound-proof walls, illumination tests in stairways, and turbidity test on public use water

Case 4 is a case of diagnosis service performed on an elderly day care center. The center is located on the ground floor of one building. The space is divided into a rest area, a dining area, an activity area, and two bathrooms. See Fig. 17.

In the field of medical health, not all the items are tested in a health check. Health check items for each patient are recommended based on the patient's sex, age, symptoms, or living condition. Building health checks should be done this way. However, the health check cases discussed in this study are community services performed by students. Therefore, instead of

community. It is a condominium, and its buildings are 17-years-old with 13 floors above

Fig. 14. The author led students to perform radiation tests on steel bars, electromagnetic

Case 2 community only has one building. The building is a 2-years-old condominium with

Fig. 15. The author led students to perform formaldehyde tests in the rest area of SPA center,

Case 3 community is a mega-size condominium. There are 25 buildings and the number of households is more than 1,200. The number of floors above ground is from 8 to 12, and the

Fig. 16. The author led students to perform noise tests on sound-proof walls, illumination

Case 4 is a case of diagnosis service performed on an elderly day care center. The center is located on the ground floor of one building. The space is divided into a rest area, a dining

In the field of medical health, not all the items are tested in a health check. Health check items for each patient are recommended based on the patient's sex, age, symptoms, or living condition. Building health checks should be done this way. However, the health check cases discussed in this study are community services performed by students. Therefore, instead of

waves tests in courtyards, and formaldehyde tests in the library room

26 floors above ground and 4 floors underground. See Fig. 15.

and oxygen, temperature, and humidity test in the lobby

tests in stairways, and turbidity test on public use water

area, an activity area, and two bathrooms. See Fig. 17.

number of floors underground is 2. See Fig. 16.

ground and 3 floors underground. See Fig. 14.

customizing the number of health check items based on the conditions of each building, all the items are performed. Students are also taught that some of the problems are less likely to happen in certain conditions. For example, the interior fitting and decoration of the Case 1 buildings have been installed for more than 10 years, which makes the problem of high formaldehyde level unlikely to happen. Nevertheless, the author still wanted students to do all the tests to verify this hypothesis, and the result can also be compared to the formaldehyde levels of new buildings' interior fitting.

Fig. 17. The author led students to perform particle test in the rest area of elderly residents and water quality tests on drinking fountains

As it is discussed above, each building's conditions vary just like every human patient's health is affected by various conditions. As a result, when making a health check plan for buildings, building doctors should consider each diagnosed subject's condition. For example, the building age of Case 1 is higher, as a result; the tests on public area should focus on water quality (the pH level), basement ventilation (CO and O2 level), and whether indoor lighting is insufficient because of lack of maintenance. Case 2 building is younger, and it is a luxury housing project with a lot of interior decoration works. Therefore, Indoor Air Quality (IAQ) should be the focus of building health checks, such as the tests of formaldehyde and TVOCs. Case 3 buildings are located next to a night-market. The noise during the nights is louder, so the night noise test is important. As to the elderly day care center of Case 4, since the occupants are the elderly, particles which may trigger allergies or lung diseases are the focus of the test. Furthermore, the water quality test on drinking water and TVOCs test on bathroom detergents are also important.

The tests performed in these four cases have produced many valuable experience and information. However, this study follows the non-disclosure policy of medical records, and do not disclose and discuss the test result of each case (the results of most items are in the safe range). Therefore, in the following discussion, the author shares common problems and their solutions based on his 'clinical experience.'

1. Noise: The common causes of the noise level which exceeds the standard are ambulance siren, engine sounds of motorcycles, construction works, religious events held by temples, and engine sounds of ventilation fans in basements. Ambulance sirens and engine sounds of motorcycles are transient noises. Because they only last for a very short time, they wouldn't affect hearing. To lower down the noise of construction works and religious events, the occupants may report to local environmental protection bureaus and have the noise sources keep their noise down to the legal standard. If the recurring noises have constituted a psychological anxiety to occupants, it is suggested that occupants should install acoustic windows, which usually can reduce noise level up to 30 dB (A). Furthermore, the noise of the ventilation fans in basements can be reduced by installing vibration reduction devices or improving the motor's

Making a Healthy Living Space Through the Concept of Healthy Building of Building Medicine 111

7. Problems of chloride residues in the water: Some of the drinking water was detected insufficient chloride residues (lower than 0.2 mg/L), which can result in improper disinfection, higher bacteria, and possible contraction of typhoid, dysentery, and cholera. Excess chloride residues in the swimming pool were also detected in some cases. Building managers should review the chloride adding process and amount, and

8. Problem of electro-magnetic field: Some of the indoor entertainment and exercise equipments have bigger motors. When people use these equipments, the EMF figures measured near the motors would be higher (180mG, for example). The measured figures are still lower than Taiwan government's legal standards (833mG), but the legal standard is transient exposure value, so it is not suitable to be used as a long-term safety standard. As a result, it is recommended the users should avoid using the

As the influence of indoor air quality and indoor environment quality are so significant to human health, the knowledge of BHD is also crucial to architects and civil engineers. In 2010, an incident of carbon monoxide killed several people in an apartment building. Architects and civil engineers who had built the building faced criminal charge and were sentenced jail time because the improper design and construction of the building caused carbon monoxide flowed to different floor levels. Although the higher court is still deliberating on the appeal, it also showed the training and education of healthy environment planning, construction, and inspection are still insufficient or have been long ignored in the traditional architecture and civil engineering fields. Thus, in the future, cross-disciplinary knowledge, such as medicine, public health, and environmental protection, should be integrated to form a discipline of healthy environment planning and management which would be taught, studied and applied to the field practices of architecture and construction. In this way, architects and civil engineers are able to make sure future building users are protected from any health hazards. Furthermore, at the later stage of building lifecycle, property managers must be able to apply their management and maintenance expertise to eliminating any health hazard problems hidden in the environment or hardware of the buildings for 50 or more years of building

There are many potential health hazard factors existing in household environments, including: hazardous gas, poor air quality, bad water quality, EMF, radiation, over-bright or insufficient lighting, noise, temperature, and humidity. Particular space, building materials, facilities, or inappropriate use habits can become the direct or indirect source of pollution. For example, bad ventilation plan (especially close or underground space), hazardous building materials (such as vaporized formaldehyde or high concentration of TVOCs), unsatisfying building material performance (such as bad sound proof performance of windows or doors), using electrical appliances for a long time and in close

aglaonema, pleomele, dracaena, chrysanthemum, peace lily.

equipments too long or keep their heads away from the motors.

hire professionals to test water quality regularly.

**6. Discussion and suggestion** 

use and management period.

found in stairways, elevators, and underground parking lots, which may be caused by fresh paints or new interior fitting and decoration. Building managers should consider choosing green building materials for future renovation. If the circumstance allows, building mangers may consider growing some plants which can absorb TVOCs, such as

performance. However, if occupants would not listen to the noise for a long time, they do not need to worry about the problem.


found in stairways, elevators, and underground parking lots, which may be caused by fresh paints or new interior fitting and decoration. Building managers should consider choosing green building materials for future renovation. If the circumstance allows, building mangers may consider growing some plants which can absorb TVOCs, such as aglaonema, pleomele, dracaena, chrysanthemum, peace lily.

