Healthy Building Network and Perkins+Will; March 2017
The authors explore the increasingly prevalent incorporation of antimicrobial additives in buildings and interiors. No evidence yet exists to demonstrate that products intended for use in interior spaces that incorporate antimicrobial additives actually result in healthier populations. Further, antimicrobials may have negative impacts on both people and the environment. They also acknowledge the hurdle that the lack of transparency surrounding antimicrobial agents creates for the average consumer in making informed selections of products with reduced negative impacts. This paper serves to provide information to the industry, and the authors conclude that antimicrobial additives should be approached with skepticism and caution.https://perkinswill.com/sites/default/files/Antimicrobial_WhitePaper_PerkinsWill...
Ted Schettler MD, MPH; March 2016
The results of this study prompted Health Care Without Harm to urge health care systems and organizations to seek more evidence on the safety and efficacy of furnishings containing antimicrobials before purchasing. In the study, the author notes that there is a dearth of evidence to support the use of antimicrobials included in a growing number of furnishing products. And, he notes, although some antimicrobials reduce the microbial load on textiles and other environmental surfaces in laboratory settings, they have rarely been evaluated in well-designed clinical studies for their effectiveness in contributing to HAI reduction. Additionally, beyond their potential impact on HAIs, life-cycle safety concerns associated with the manufacture, use and disposal of antimicrobials also need careful research, the report says.
Bill Walsh; October 2014
The author, noting that the “green building movement” is putting new emphasis on improving human health, argues that an unintended consequence of this awareness is the overuse of antimicrobials. Citing the increasingly common practice of adding antimicrobials to a wide variety of products, he says that, as with the overuse of antibiotics, the practice “may contribute to the evolution of microbes that are more resistant to our known antimicrobial defenses.” The judicious use of antimicrobials is even more critical, he argues, given assessments like those from the CDC and Kaiser Permanente that antimicrobials do not significantly advance infection control.
Business and Institutional Furniture Manufacturers (BIFMA); October 2014
The object of these guidelines is to offer “standard test methodologies and specific performance recommendations to which manufacturers can test.” The guidelines also provide criteria that the users of these furnishings can use to evaluate relative product performance. After providing definitions of terms and descriptions of typical cleaning agents and disinfectants, the balance of the content describes various tests and their purpose, and accepted procedures for conducting them. The guidelines apply to seating, tables, carts, storage, and other furniture used in healthcare environments.
Eileen B. Malone and Barbara A. Dellinger; May 2011
This paper describes the creation of an Evidence-Based Design (EBD) Furniture Checklist based on current research findings and industry standards. The one-page checklist includes eight goals. Three focus on key patient safety concerns that result in significant patient morbidity, mortality, and healthcare costs, and three on the use of furniture to improve psycho-social and work-associated outcomes. The remaining two goals deal with environmental safety and practical considerations for making the best furniture investment, respectively. The checklist is designed to help make purchase decisions that “improve healthcare outcomes across the furniture life cycle.”
Dayle Laing and Walter F. Kean; Fall 2011
The authors of this article published in 2011 discuss the “greening of healthcare textiles” as part of overall efforts to make healthcare facilities healthier for the people who provide care and those who receive it. The authors’ contribution to this effort takes the form of a resource that lists chemicals of concern (though new chemicals of concern are identified constantly), identifies third-party certifications for textiles, suggests five selection criteria, and reviews surface finishes and their cleanability. (Payment required to view full content.)
This series of articles was published in a special issue of the Healthcare Environments Research & Design (HERD) Journal. They are the result of a project sponsored by the Agency for Healthcare Research and Quality (AHRQ) to determine the validity of claims that design interventions can decrease infection risk. As Carolyn Clancy, MD, wrote in the guest editorial, “we can conclude that it takes two kinds of science to fight HAIs. The first is traditional infection control science…. The second kind of science…is no less important—behavioral and human factors science, including how design can affect our work.”
N. Gokarneshan, P. P. Gopalakrishnan, and B. Jeyanthi; November 2012
This paper reviews and compares the merits of nanomaterial finishes. It considers two main categories: a) finishes applied on natural fibers and blends and b) those applied to synthetic fibers. The research the authors share indicates promise for wider application of nanofinishes in medical textiles, but they caution that the impact of the different nanomaterials on human health and the environment needs to be well researched and established before gaining commercial acceptance.
Sheila Shahidi and Jakub Wiener; September 2012
This article discusses the various antimicrobial treatments of textiles, including the use of biocides, chemical substances and microorganisms that have been known to deter, render harmless, or exert a controlling effect on harmful organisms by chemical or biological means. Particular emphasis is put on finishing agents and each is analyzed in terms of scientific efficacy. The article culminates with a discussion of the mechanisms of antimicrobial finishes and the test methods used for evaluating them.
Seshadri Ramkumar; January 2012
This article discusses the continued growth within the technical textile industry, particularly those textiles intended for medical and hygiene use. The author discusses recent advances that have increased the efficacy of nonwovens and notes the work being done to develop barrier fabrics that are effective against drug-resistant bacteria and viruses, as well as specialty fabrics that can clean toxic chemicals from human skin. The article closes with a brief discussion of nanoscience and notes investigations into the use of submicron-sized nanofibers for highly efficient barrier masks.
Heidi Hubbard, Dustin Poppendieck and Richard L. Corsi; January 2009
This paper reports the results of experiments involving the removal of chlorine dioxide, increasingly used for the disinfection, from 24 different indoor materials. For most materials, deposition velocity (the rate at which aerosol particles collect or deposit themselves on solid surfaces) decreased significantly over a 16-hour disinfection period. That is, materials became smaller sinks for chlorine dioxide with the passage of time. Four materials (office partition, ceiling tile, medium density fiberboard, and gypsum wallboard) accounted for the most short- and long-term consumption of chlorine dioxide. (Payment required to view full content.)
Julie Silas, Jean Hansen, and Tom Lent; October 2007
This paper examines specific health concerns associated with chemicals used in fabric manufacturing and finishing. It considers approaches to reducing or eliminating the hazards of these chemicals and reviews the nonprofit and standards setting organizations that have initiated efforts to help guide the industry toward a healthier, more sustainable future. Finally, the authors envision a future in which end users and designers can “make more informed decisions and collectively help move the market by their specifications and purchasing power.”
Mary G. Lankford, Susan Collins, Larry Youngberg, Denise M. Rooney, John R. Warren, and Gary A. Noskin; 2007
This study investigated the ability of various surfaces to harbor bacteria, determined recovery of organisms on environmental surfaces after cleaning, and evaluated the potential for healthcare worker transmission. Researchers studied 14 environmental surfaces used for upholstery, flooring, and wallcovering. They inoculated all surfaces with vancomycin-resistant enterococci (VRE) and Pseudomonas aeruginosa (PSAE), then cleaned them according to manufacturers’ recommendations and simulated transmission through human touch. The researchers conclude that, “Many bacteria commonly encountered in hospitals are capable of prolonged survival on environmental surfaces and may promote cross-transmission.”
Mark Rossi and Tom Lent; September 2006
This paper begins with case studies that highlight two healthcare organizations and their efforts to make their environments more “green.” Building on these case studies, the authors provide practical suggestions for setting goals, defining the criteria for green materials, and putting the criteria into practice. The paper concludes with recommendations for addressing the daunting task of shifting to healthier, greener materials across a healthcare system.
Ruth Brent Tofle, Benyamin Schwarz, So-Yeon Yoon, and Andrea Max-Royale; July 2004
This research report reviews the myths and realities of the effect of color in healthcare environments. The authors reviewed more than 3,000 citations to identify theories that could have had supportable design implications for the use of color in healthcare design. They concluded that “the use of color in healthcare settings is not based on a significant evidence-based body of knowledge” and suggest that “the application of research findings in healthcare settings requires caution.”
The contents of the whitepapers included here represent the work and thoughts of the authors only. Facilitating access to them does not imply endorsement.