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Sick buildings, sick kids: facilities construction and management take on illness prevention
University Business, July, 2005 by Rebecca Sausner
An outbreak of norovirus resulted in some 60 vomiting students at Worcester Polytechnic Institute (Mass.) who were taken to the hospital in April. At the University of North Carolina, there were three confirmed and one suspected case of bacteria[ meningitis this year. Last fall, Franklin & Marshal[ College (Pa.) had to move 50 students out of a residence hall while facilities crews cleaned up a mold infestation.
A LexisNexis search of the words "college" and "outbreak" returns hundreds of similar stories, all with two themes: students are sick, and facilities management is critical to the process of ensuring clean air and dean surfaces inside campus buildings.
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"The facilities group is very sensitive to these kinds of issues," says Christopher Ahoy, associate vice president for Facilities at Iowa State and president-elect of APPA: The Association of Higher Education Facilities Officers (www.appa.org). "The question is how do you solve these problems and what resources are there to address them?"
INDOOR GERM WARFARE
When it comes to infectious diseases like influenza, meningitis, and gastrointestinal viruses like norovirus, building designers are increasingly asked to take health issues into account. At most colleges and universities this means bringing in more fresh but preconditioned air from outside, rather than constantly re-circulating inside air.
"One reason flu epidemics come through schools in the winter is that they're re-circulating all this air," says David Kromm, president of Kromm, Rikimaru & Johansen, a St. Louis-based architectural firm. "Having more fresh air allows you to get rid of some of the polluted air so you don't have a building full of germ-laden air."
And while the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) standards were updated about five years ago to increase the amount of fresh air that new buildings must provide, older buildings are exempt from this standard. "Many of the older buildings on campuses don't even have a provision for ventilation of air," says Alex Wing, senior associate in the higher education group at Pittsburgh-based architectural firm Burr Hill Kosar Rittelmann Associates. "In buildings that are 100 years old, they just open the windows. We're finding that we have to retrofit those buildings with good AC units that provide a higher [eve[ of fresh air."
HOSPITAL STANDARDS
IHEs that are serious about controlling communicable illnesses might do well to adopt some design and maintenance practices regularly implemented in health care facilities, architects say.
"I believe the best way to address this problem is to model higher ed solutions after health care, where infection control is central to all facility design," says Wing.
Many new hospitals are installing HVAC systems that call for 100 percent air replacement, a standard far above the current norm of 20 percent per hour. While this extreme [eve[ would be prohibitively expensive in many higher ed settings, it gives rise to the question of how much fresh air is enough to have an illness prevention effect.
"Keep in mind that building codes, as a rule, provide the minimum standard, not the optimum or best practice," says Bruce Knepper, a principal in the health care group at Burt Hill.
Perhaps even more important than air, though, is preventing the spread of germs from human contact. In other words, follow your mother's orders and "Wash your hands!" In health care, it was education about the importance of hand washing that lead to dramatic reductions in the spread of disease. Wing suggests that IHEs worried about illness on campus undertake the same educational mission, and perhaps even go as far as to install waterless hand washing stations in strategic areas. Waterless systems typically use alcohol-based hand cleansers that reduce the amount of germs on hands without the need for a sink, soap, or towels.
SURFACE PATROL
After air quality and clean hands, indoor surfaces become the next major concern for facilities managers and custodial services on campus.
At the University of LaVerne (Calif.), the astute response of a custodian who noticed blood in vomit found in a bathroom helped ease campus concerns after a student was diagnosed with bacterial meningitis there in April. (Meningitis can't live outside the body for very long, and is primarily passed along through close contact with someone who is affected.)
"The custodian recognized the blood and went through the requirements of cleaning up for a possible blood-born pathogen," says Charles Bentley, director of public relations at the university.
At Worcester Polytechnic Institute (Mass.), when it became dear that dozens of students were falling ill at the same time, the school's food service vendor immediately implemented an emergency protocol, as though the outbreak were caused by food poisoning. (Noroviruses are typically transmitted through oral-fecal contamination and are highly contagious.)
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