**3. Interrelationship between living space and health problems**

Environmental impacts to human health have long been confirmed by the medical field. An epidemiological model that supports health policy analysis and decisiveness must be broad, comprehensive, and must include all matters affecting health. Consequently, four primary factors have been identified: (1) System of Health Care Organization; (2) Life Style (selfcreated risks); (3) Environment; and (4) Human Biology. Taking the analysis of cancer causes as an example, the impact degrees of the four factors are 10%, 37%, 24% and 29% (Dever, 1976). The impact degree of environment factor in cancers is 24%. People are highly concerned about cancer prevention when it comes to their health management. Many cancer insurance policies are on offer in the market. However, the possible health hazards caused by the environment factor have been often overlooked in the education and training of architects and civil engineers who design and construct physical structures and interior environments. Not only recently do the issues of green buildings and non-toxic building materials gradually become more and more important in the fields of civil engineering and architecture, and these fields start to take steps to build healthy environments for the general public.

Living space is closely related with human health problems. From the viewpoint of civil engineering field, the issue can be explored initially by looking into building materials, building physics, and building management and maintenance and searching which factor

Making a Healthy Living Space Through the Concept of Healthy Building of Building Medicine 101

7. Water turbidity: Turbidity exceeding a certain level may result in gastroenterology diseases (Mann et al., 2007). Turbidity is one of the key indicators of drinking water quality. High turbidity means there might be micro-organisms in water particles and it would be harmful to human health. If turbidity is visible to naked eyes, the level of

8. Chloride residues in water: Consumption of drinking water with high trihalomethane content may increase the risk of melanoma and possibly of hormone-dependent cancers such as neoplasm of the prostate, the breast, and the ovary. (Marco et al., 2004) Free chloride is added in water as a disinfectant. It may cause unpleasant smell, and it may be interacted with organic matters and form a hazardous by-product. Chloride residues remaining in water pipelines are not powerful enough to sterilize and may be harmful to human bodies. Chloride residues in tap water would damage hair and skin. After chloride is being absorbed by human bodies, it enters directly into blood, and is metabolized by the kidneys. However, if people absorb an amount too large or their

kidney functions are low, they would show symptoms of chloride poisoning. 9. Temperature: High temperature may cause heatstroke, heat exhaustion, and heat cramps. Heat exhaustion means human body temperature exceeds 38.0℃. Its symptoms include profuse sweating, malaise, headache, dizziness, anorexia, nausea, vomiting, vertigo, chills, muscle or general weakness, tachycardia and hypotension, visual disturbances and cutaneous flushing. Heat stroke happens when body temperature reaches 40.5℃ or higher, and its symptom is neurologic impairment. Heat stroke is a medical emergency. Patients must be given cooling treatment and their temperature

10. Humidity: Highly humid environment induce the growth of fungus, which would trigger respiratory tract irritation, allergies (Bornehag et al., 2004), rheumatism, athlete's

11. CO: Minor carbon monoxide poisoning results in higher blood pressure, rising heart rate, higher breathing frequency, rapid and shallow breathing, chest pain, dizziness, anxiety, nausea, and headaches. Severe carbon monoxide poisoning makes people slip

12. CO2: When the density of carbon dioxide reaches 15,000 ppm or more, it would affect breathing function. When it exceeds 30,000 ppm, it would stimulate respiratory center and causes breathing difficulties (Jones, 1999), headaches, drowsiness, hyporeflexia,

13. O3: Absorption of O3 of high density would reduce lung function, increase bronchial contraction, and raise the risk of asthma attack (D'Amato et al., 2005). When O3 level exceeds the permissible exposure limit, it would causes coughing, short of breath, headache, decreasing lung function, respiratory inflammation, decrease the resistance of lungs against contagion and toxins. In the severe condition, it may result in

14. TVOCs: Among indoor air pollutants, total volatile organic compounds (TVOCs) are one type of common and hazardous pollutants. Many kinds of volatile organic gas are strong poison, which would suppress the central nervous system, irritate eyes and respiratory tracts, and trigger allergies in eyes, skin, and lungs (Jones, 1999). TVOCs

exceeding 8.5 may cause bitter taste and produce pipe scale.

turbidity is usually over 5 NTU.

must be lowered to at least 38.8℃.

into coma, twitching, cardiac arrest (Goldstein, 2008).

foot, and mosquito infestation.

lethargy.

pulmonary edema.

gastroenterology diseases (Eife et al., 1999). When pH level is over 8.0, water would be less disinfected, which would cause potential health threats. PH level of water

would result in users' health problems. By doing so, it can make architects and civil engineers aware the importance of building a healthy environment at the stage of design and construction. This concept can be seen as building eugenics promoted by Building Medicine. Since there are many factors which affect health, this study cannot cover all the health hazardous factors. Therefore, this study discusses hazardous factors which are covered by current teaching and research plans of non-destructive tests on buildings.

Common hazardous factors in the living space include:


would result in users' health problems. By doing so, it can make architects and civil engineers aware the importance of building a healthy environment at the stage of design and construction. This concept can be seen as building eugenics promoted by Building Medicine. Since there are many factors which affect health, this study cannot cover all the health hazardous factors. Therefore, this study discusses hazardous factors which are

1. Noise: Increased risk for long-lasting syndromal anxiety states (Generalized Anxiety Disorder and Anxiety Disorder NOS), thus supporting the hypothesis of a sustained central autonomic arousal due to chronic exposure to noise (Hardoy et al., 2005). Sound louder than 70 decibel (dB (A)) makes people uncomfortable. Their blood vessels would start to contract, and their blood pressure would rise. And their concentration would waver, become more nervous, and affect their learning performance. Spending a long time in an environment of 85 dB (A) cause hearing impairment, sometimes even severe hearing loss. Sound louder than 90 dB (A) may affect endocrine system, trigger mood swings, anxiety and headache, and cause people more prone to make mistakes. Sound louder than 130 dB (A) results in ear pain. Sound which register 140 dB (A) or more

2. Illumination: Light suppresses melatonin (Boyce et al., 1987) and may cause serious sleeping problems. Either excessive or poor lighting would affect human bodies. Poor outdoor lighting may cause injuries or even death because people are easier to trip and fall. Excess indoor lighting may be harmful to vision. Therefore, both indoor and

3. ELF-EMF: International Agency for Research on Cancer (IARC) classifies extremely low frequency (ELF) as a possible carcinogen (Kheifets et al., 2005). Allergic reaction may be shown in a small number of people when they are exposed to ELF. The symptoms include skin rash, itchy skin, skin burning sensation, nervous exhaustion and other unspecific symptoms, such as fatigue, vertigo, nausea, palpitation, and gastric disorder. 4. HF-EMF: Research shows high-frequency electromagnetic fields (HF-EMF) with a carrier frequency and modulation scheme typical of the GSM signal may affect the integrity of DNA (Franzellitti et al., 2010). Living in an environment of HF-EMF for a long time may cause eye diseases, lower resistance against disease, higher chance of cancer occurrence, affecting reproductive systems of both sexes with possible consequence of infertility, headaches, dizziness, nausea, loss of memory, sleeping difficulties, and hair loss. Long-term influences include higher chance of Alzheimer occurrence, tinnitus, loss of balance, skin diseases, irregular pulse, arrhythmia, labored

5. Radiation: If being exposed to high levels of ionizing radiation, infants and pregnant women have a higher chance of leukaemia and solid cancer (Lane et al., 2010). It may trigger gene mutation, infertility, cataract, nausea, blood cell deformation. If pregnant women are exposed to radiation, the babies they carry are prone to mental retardation,

6. PH level of water: The impact of pH level to human health is indirect. Only extreme pH level is harmful to human bodies. When pH level of water is too low, metal water pipes will be eroded, which will cause high level of lead, copper, and zinc in water. Related studies show copper would cause acute and chronic poisoning. In Germany, copper in tap water caused a series of severe disease (such as liver cirrhosis), and other

covered by current teaching and research plans of non-destructive tests on buildings.

Common hazardous factors in the living space include:

outdoor lighting should be at a proper level.

breathing, joint pain, and sore muscle.

miscarriage, polydactyl, and Down syndrome.

would make eardrum burst.

gastroenterology diseases (Eife et al., 1999). When pH level is over 8.0, water would be less disinfected, which would cause potential health threats. PH level of water exceeding 8.5 may cause bitter taste and produce pipe scale.


Making a Healthy Living Space Through the Concept of Healthy Building of Building Medicine 103

02 Illumination LED advertisement board(too bright), insufficient natural light, poor lighting, no lighting equipment installed

05 Radiation Building materials polluted by radiation, laboratories, areas adjacent

water Water supply piping, improper processing of raw water 07 Water turbidity Pollution of water supply piping, improper processing of raw water

09 Temperature Geography and climate, bad ventilation of the environments, improper design of air-conditioning 10 Humidity Geography and climate, bad ventilation of the environments, improper design of air-conditioning

14 TVOCs Solvent-based coating, adhesives for bonding plates and panels

16 O2 Basements, storage rooms, or closed and unventilated space

15 Formaldyhyde New interior building materials or furniture, such as carpets, PVC

17 Particles Damp walls and ceilings, synthetic fiber, asbestos, carpets, furniture,

In order to promote BHD, the author has started to offer a class called Building Diagnosis Technology (BDT) in Feng Chia University. As the University was promoting the attitude of 'learning through community service', this class was designed as a long-term learning program of community service. The University agreed to allocate funds for purchasing building and environment test devices, so students not only fulfil their community service responsibility, they also can apply the knowledge of civil engineering they learned in class to health diagnosis cases in communities. The author taught students how to make use of the management concepts of Building Medicine and the diagnosing and management knowledge they had learned in the preparatory class (BHD). Then he taught them how to use test devices. Finally, students were sent to communities arranged by this community service program to

Public facilities (such as motors or transformer boxes), modes of transport, events or activities, public address systems, construction

Indoor air-conditioning, computers, speakers, television sets, refrigerators, electric water boilers, and other electrical appliances Outdoor electric boxes, machinery rooms, utility poles, cables

Radio, mobile phone base stations, wireless handsets, wireless local area network (WLAN), blue tooth, radar, radio stations, and wireless

Water supply piping is too long, improper processing of raw water

Incomplete combustion of household heating system, incomplete combustion of vehicles or electricity generators in undergroud

tiles, plywood, new sofas, chairs, wardrobes, or system furniture

ill-maintained dehumidifiers, air-conditioning, bedding, pets

Diagnosis Items Sources of Problems

to hospital radiology rooms

12 CO2 High occupant density, bad air exchange efficiency 13 O3 Photocopiers, all-in-one printers, air cleaners

together in renovation

TV signals

parking lots

Table 1. Diagnosis items of BHD and source of problems

works, airports, factories, railways

01 Noise

03 ELF-EMF

04 HF-EMF

<sup>06</sup>PH level of

11 CO

Chloride residues in water

08

existing in the environment include formaldehyde, toluene, xylene, styrene, etc. Being exposed to high level of volatile organic compounds for a long time would inflict damages to the nervous system, liver, and kidneys.


The indoor air quality test taken by this study included all the general items except for bacteria and fungus because testing equipments are not yet acquired. For physical environment of the buildings, the levels of noise, illumination, humidity, and oxygen are tested, and the other tested items include radiation, ELF-EMF, HF-EMF, pH level of water, turbidity, and chloride residues. In total, 17 items are tested. Of course, environmental factors which affect health are more than 17 items. However, due to the restraints of time and budget, this study only discusses items which are covered by current teaching and testing practices.
