The United Nation’s Sustainable Development Goals (SDGs) 7 (Affordable and Clean Energy), 9 (Industry, Innovation and Infrastructure), and 11 (Sustainable Cities and Communities) focus on the responsible use of energy across all industries in order to fight climate change and associated health consequences, with construction at the forefront. Throughout their life cycle, buildings emit significant amounts of carbon dioxide into the atmosphere, aggravating the greenhouse effect 1; healthcare buildings have a particularly large impact on the environment given their 24/7 utilization. In addition to adapting their structure and infrastructure to climate change-related phenomena, the carbon footprint of healthcare can be mitigated through green hospital design and construction practices rooted in creative, innovative solutions 2.
First, hospitals should ideally be built using environmentally sustainable materials acquired in energy-efficient manners. Cement has been used for most buildings since the 1940’s due to its convenience and relatively low cost: However, it requires substantial energy to prepare, releasing significant amounts of carbon dioxide into the atmosphere during the fuel-intensive kiln heating process required to make it – cement production alone accounted for 7% of total carbon dioxide emissions in 2019 3. Carbon dioxide release from cement use can be curbed by using more efficient kilns, a lower clinker-to-cement ratio, or lower-carbon fuels. To this end, Germany’s HeidelbergCement aims to establish the world’s first carbon neutral cement plant by 2030 by both increasing the proportion of biomass fuel used to run the plant, all the while using carbon capture technologies to reduce its net carbon emissions4 – such efforts play a significant part in green hospital construction. In parallel, painting materials containing lead or cadmium should be avoided, as should any materials harboring persistent bio-accumulative toxic chemicals, including various types of plastics and flame retardants. Finally, construction materials should be acquired in an environmentally friendly way, such as by using local materials or renewable energy-fueled modes of transport 5.
Second, hospital design must be as energy efficient as possible. To this end, buildings should be engineered such as to maximize the use of daylight (for example, with many windows and South-facing if in the Northern hemisphere), while certain species of plants can be used to absorb pollution in a natural manner. Energy management systems should be established that leverage onsite renewable energy sources.
Finally, hospitals can be designed such as to respect and improve the local ecosystem: high reflectance roofing or “green roof” systems can be used in order to increase the albedo effect, reduce urban heat, and manage stormwater while promoting local ecosystems. In addition, local biodiversity in the form of floral and faunal life should be assessed and protected in the construction of healthcare facilities: These should be deliberately designed such as to respect and be best integrated into their local natural contexts.
Buoying such efforts, a number of countries to date have developed healthcare building-specific rating systems providing an effective framework to probe building environmental performance and integrate sustainable development into their construction. These systems, such as the United Kingdom’s BREEAM (Building Research Establishment’s Environmental Assessment Method), the United States’ LEED (Leadership in Energy and Environmental Design), and Australia’s GREEN STAR rating system, address all aspects of building construction, including but not limited to management, health and wellbeing, pollution, and land use and ecology 6.
Both within the United States and globally, a shift in standards will be required to ensure green hospital construction and a lower carbon footprint. New structural codes should be designed and adopted to promote decarbonized construction processes and energy-efficient buildings, potentially supported by government-regulated mandatory smart-building certifications or financial incentives to individuals and organizations.
- Lu, K. & Wang, H. Estimation of Building’s Life Cycle Carbon Emissions Based on Life Cycle Assessment and Building Information Modeling: A Case Study of a Hospital Building in China. J. Geosci. Environ. Prot. (2019). doi:10.4236/gep.2019.76013
- Khahro, S. H. et al. Optimizing energy use, cost and carbon emission through building information modelling and a sustainability approach: A case-study of a hospital building. Sustain. (2021). doi:10.3390/su13073675
- Factbox-Cement: the carbon cost of construction | Reuters. Available at: https://www.reuters.com/article/climate-cement-factbox/factbox-cement-the-carbon-cost-of-construction-idUSKBN2H80D2.
- HeidelbergCement to build the world’s first carbon-neutral cement plant. Available at: https://www.heidelbergcement.com/en/pr-02-06-2021.
- Danilov, A., Benuzh, A., Yeye, O., Compaore, S. & Rud, N. Design of healthcare structures by green standards. doi:10.1051/e3sconf/202016405002
- Green Assessment Criteria for Public Hospital Building Development in Malaysia | Elsevier Enhanced Reader.