Healthy buildings, productive people!

Can indoor building features such as ventilation, pollutants and lighting influence our thinking, behavior and health? New research suggests a big "yes."

Have you felt tired at your desk lately? Culprits larger than a lack of coffee or a poor night's sleep may be to blame. According to new research, environmental factors within your building—the degree or type of ventilation, airborne contaminants, lighting and noise levels, for example—can play a surprisingly large role in how good or bad you feel, and even how well you think

This investigation is part of a budding multidisciplinary field of "healthy building" research that is addressing a widespread phenomenon: While the Environmental Protection Agency estimates we spend more than 90 percent of our time inside, builders in general have paid scant attention to the health aspects of indoor spaces, instead focusing on design features and on meeting minimum environmental standards to keep costs down.

Researchers interested in environmental health issues are taking a hard look at this gap, examining whether changes in indoor variables—carbon dioxide levels or the color or amount of lighting, for example—might influence our performance, behavior and health. Among the investigators are psychologists, who are making new inroads into their long-term study of the office environment by collaborating with health-care practitioners, engineers, human factors specialists and public health researchers to see how the indoor environment may impact such psychological variables as cognition and behavior.

"There is a growing recognition that not only does the kind of work that we do matter to our health and productivity, but that the physical environment affects those outcomes as well," says environmental researcher Ann Sloan Devlin, PhD, a Connecticut College professor of psychology and editor-in-chief of the journal Environment and Behavior.

That's potentially good news: Such findings may give us the ability to adjust our surroundings in ways that could make a significant difference in our well-being and productivity—not just in the office, but at home and elsewhere, too.

Cognitive performance

In one line of work, researchers at Harvard University's T.H. Chan School of Public Health and research collaborators Suresh Santanam, ScD, associate professor of engineering at Syracuse University, and Usha Satish, PhD, a cognitive psychologist at SUNY Upstate Medical Center, assessed the effects of indoor air quality on workers' cognitive performance—important both for health and for companies' bottom lines, says Joseph Allen, PhD, assistant professor of environmental health at Harvard and principal investigator of the studies.

"The true cost of running our buildings should take into account the health and productivity of people in those buildings," Allen says. In fact, an analysis by the team reported in the International Journal of Environmental Research and Public Health showed that the cost of making changes that could vastly improve cognitive performance was minuscule compared with the related increase in productivity—about $40 per person, per year, compared with a $6,500 increase in employee productivity.

The team's first study, published in Environmental Health Perspectives in 2015, was conducted at the Syracuse Center of Excellence, a research organization devoted to studying and developing green technologies. The center houses a lab that allows researchers to test a wide range of indoor air quality factors using sophisticated ventilation systems.

For six days over two weeks, 24 office workers with administrative, technical, professional or managerial jobs came to the lab and performed their regular job duties, as well as participated in an hour and a half of cognitive testing at the end of the day. Each day, the indoor environment was controlled with different amounts of ventilation, carbon dioxide and volatile organic compounds, or VOCs—the toxic byproducts of common office products. The office workers were blinded to the conditions.

The cognitive tasks used in the study came from a validated measure that has participants respond to online scenarios that mimic real-life situations, such as managing a city as a mayor, for instance.

Researchers then compared workers' performances under the various conditions. They found that workers scored 61 percent higher on the cognitive tasks on "green condition" days than on days reflecting typical office building conditions. In addition, they scored more than 100 percent better in an "enhanced green condition," where the room received twice the ventilation of a typical office building and had the lowest level of VOCs.

The findings are remarkable for showing, in a well-controlled study, that indoor air quality factors can significantly degrade cognitive performance in buildings that would otherwise meet current building standards, notes environmental psychologist Craig Zimring, PhD, director of Georgia Tech University's SimTigrate Design Lab.

"If these findings are replicated in other labs and in real-world work environments," he says, "they could lead to designs that provide much more outside air through mechanical ventilation or operable windows, for example"—in turn, promoting better health and performance.

In a second study reported in the March issue of Building and Environment, the Harvard-Syracuse team moved from the lab to the real world. Using the same methodology, they compared test scores of 109 people working in 10 buildings—about 12 people per site—in two buildings in each of five cities. All of the buildings shared good ventilation rates and low levels of VOCs and carbon dioxide, but only one in each pair had been certified by a green-building certification organization. The building pairs were assessed concurrently and also shared the same company tenant, which ensured a similar workforce in both types of buildings.

Workers in green-certified buildings scored 26.4 percent higher on the cognitive tasks than those in noncertified buildings. They also had 30 percent fewer "sick building" symptoms than those in noncertified buildings: fewer headaches and respiratory complaints, for example. They slept better on returning home at night, too, as measured by a wristwatch that tracks sleep quality.

When the team examined the buildings for differences, they found that certified buildings had lower humidity levels and brighter light than the non-certified buildings. That said, the differences in humidity and lighting didn't entirely explain the differing cognitive function scores, leading the researchers to believe environmental perceptions or other factors may also play a part, notes Harvard research fellow Piers MacNaughton, ScD, who led the study.

The team plans to continue the research using an even broader lens, Allen adds. Under their umbrella term "buildingomics," the researchers propose assessing the totality of factors that influence health and productivity in the built environment—a framework that encourages interdisciplinary teams to examine the effects not just of air quality, but also lighting and views, water quality, noise, safety and security, and other factors (for more, see "Nine Foundations of Healthy Buildings" under "Resources").

The well living lab

Researchers at the new Well Living Lab in Rochester, Minnesota, are embarking on similar studies in another state-of-the-art testing facility. The 5,500-square-foot laboratory is a collaboration between the Mayo Clinic and Delos, a green real-estate company and consulting firm. The lab offers six large research modules that can be configured as office, home, hotel and other spaces, as well as a system of sensors that can test a wide range of environmental factors. In addition, the facility has reconfigurable ceilings, floors, windows and other room elements that allow researchers to vary aspects of lighting, temperature, humidity, sound and air quality.

Cognitive psychologist Anja Jamrozik, PhD, helped to test the lab's capabilities in a "proof of concept" study last summer. Her team organized three of the six modules into an open office space, then invited Mayo Clinic medical records workers to perform their regular duties there for 18 weeks. Each week, the workers received a different combination of thermal conditions, noise and lighting, all shown to have significant effects on people's comfort, performance and productivity. (They worked in each scenario at least twice over the course of the study.) At the end of each day, participants completed surveys related to their ability to work well and comfortably, and took part in qualitative interviews.

The study showed that changing the lab conditions had measurable effects on lab occupants, with some particular themes emerging. Overall, the workers said they disliked conditions with no natural light, as well as temperatures below 71 degrees and higher noise volumes. They felt confined in rooms with closed shades, and happier when windows let in daylight. When the temperature was below 71, they made efforts to get more comfortable, for example by donning extra clothes or bringing in images of fireplaces to put on available TV monitors. When the workers heard noises that simulated speaking, they reported feeling distracted and having trouble concentrating on the task at hand.

On a positive note, workers exposed to blue-enhanced lighting—that is, lighting in the blue part of the light spectrum—said they slept better that week than those in other conditions, a finding that echoes other research which finds that blue-range lighting affects the production of melatonin, a sleep-promoting hormone.

Next, the researchers will probe more deeply into the effects of light, examining how various lighting conditions affect cognition, productivity and life outside the lab, including sleep, Jamrozik says. Over time, they also want to take the lab's technology to other buildings and see if they can translate lab-based successes to the real world.

"Our hope is to eventually provide recommendations to designers, architects and builders about how to structure spaces to support the people who are living and working in them," she says.

Spontaneous collaborations

A new building on the Washington University campus in St. Louis, Missouri, is providing another opportunity to examine how green building design can affect health and behavior. Called Hillman Hall, the 20,000-square-foot space houses a new school of public health as well as overflow faculty and students from the university's Brown School of Social Work, located in two separate buildings.

The new building was designed with the highest LEED (Leadership in Energy & Environmental Design) standards available, as well as design elements intended to foster more collaboration, physical activity and sustainable energy practices, says Amy Eyler, PhD, associate professor and assistant dean for public health at the Brown School. The design includes easy access to stairways, plenty of natural light, generous spaces for collaboration, desks that allow people to sit or stand up, and inviting places to walk. Unlike traditional hallways designed as long corridors with private offices to either side, for example, "these hallways include classrooms, offices and spaces to sit, so they are multi-use—you have many reasons to walk them," says Eyler.

To test how the building might affect people's behavior, Eyler conducted a pre-test in March, 2015, before people moved in, and a post-test one year later. Her team collected data on the three main features the designers were attempting to foster—physical activity, collaboration and sustainable practices. They then compared workers in the new building to colleagues in the other three buildings. They monitored study participants using surveys, accelerometers that measure physical activity, focus groups and text-message data collection, among other tools.

People were more likely to take part in spontaneous collaborations in the new space than in the older ones, and to be physically active within the new space, the team found. In some cases, increased activity was linked specifically to design features: People said they liked having to walk to a centralized printer area to retrieve copies—exactly what the designers had hoped for. In addition, employees in the new space used office lights about half as often as colleagues in the other buildings, thanks to the abundance of natural light.

Like other researchers in this growing field, Eyler sees multidisciplinary collaboration as the key to success. Administrators, public health faculty and architects worked together to create a building that captured the university's vision for a space that fosters collegial work and health for faculty, staff and students—a shared goal evidenced by the fact that the architecture firm that designed the building also funded part of the research.

"Complex projects like this one need teams of people with varied backgrounds and expertise in order to solve them," Eyler says.


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