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Sustainability in healthcare – A step towards green revolution by Dr Prem

With the global population increasing at an unbelievable pace, energy consumption is projected to go up by 200 per cent. If the projections for the sustainability trends are anything to go by and with rampant environmental degradation along with depleted energy & natural resources, the world would need another planet to sustain life on earth by 2050. If appropriate measures are not taken today, sustainability will remain a distant dream. With various industry sectors across the globe taking notable efforts towards achieving green revolution, this article analyses the sustainability trends and issues in the healthcare industry with focus on sustainable architecture.   

Sustainability is a robust concept that has proven its worth across a range of different industries including energy, agriculture, forestry, chemicals, construction and many others. Talking about the healthcare industry, there are evidences that the current health systems of nations around the world will be unsustainable if revolution does not take place in next 15 years. There is ample scope of conserving energy in the healthcare sector. However, a number of energy conservation opportunities have remained untapped due to various reasons. The key barrier has been low awareness among the healthcare professionals and limited availability of in-house expertise to implement energy saving plans. Good energy management structure can bring in not only an energy efficient culture within the hospital but also provide substantial reduction in expenses without compromising on the quality of healthcare delivery.

Benefits of Sustainable Healthcare

The construction of conventional buildings consumes billions of tons of raw materials and a tremendous amount of energy, generates significant waste, as well as contributes toxic emissions to the air. Considering the impact this has on the environment and thereby on the human health, there are significant opportunities to improve environmental quality and human health through encouraging the concept of green buildings. Green buildings conserve natural resources, generate less waste, use less toxic chemicals and provide healthier space for occupants.

Apart from the environmental benefits, there are many financial benefits of incorporating sustainable designs. One area of financial savings obviously relates to decreased demands for energy and water.

Further, materials used for sustainable or green buildings might be a little costly than those used for the conventional buildings (due to their recent introduction and relatively limited initial market), but these materials have benefits above and beyond their sustainable features in terms of maintenance, life span etc. It is learnt that standard particle board millwork, doors, fiberglass insulation, paints, adhesives & sealants are all commonly made with urea formaldehyde and other volatile organic compounds (VOCs) that are known or suspected carcinogens or asthma triggers. Hence, agricultural board cabinets (wheat board & strawboard) and recycled denim for insulation, along with low-VOC paints and adhesives are materials to be opted for. Building materials that contain recycled items and that are themselves recyclable are becoming more readily available.

In past, there have been cases where many sustainable building strategies have yield worthwhile social and professional benefits. For example, some reports suggest health features of green buildings like improved access to daylight. The reports further say that access to daylight improves worker productivity. Studies also indicate that daylight may decrease medical error rates, a reduction which can save lives and also the costs associated with medical errors.

Designing & Building Green Architecture

Buildings are classified as certified, silver, gold, or platinum depending upon the number of points they acquire within six building components which include:

1. Sustainable Sites

2. Water Efficiency

3. Energy & Atmosphere

4. Materials & Resources

5. Indoor Environmental Quality

6. Innovation & Design Process

Within each of these categories, there are a specific number of credits available via many subcategories, which are important parameters for a building to get a green certification.

Green Building May


  • Use building materials and products that contain post-consumer recycled content.
  • Utilize rapidly renewable materials such as bamboo flooring or genuine linoleum flooring.
  • Have a STP (sewage water treatment plant) and rain water harvesting treated & reused for either gardening or cooling towers of air-conditioning.


According to Pricewaterhouse Cooper (PwC) study report, focus on design should be a priority while building a hospital. When the design is developed to ensure that it can be promoted as an environmental friendly, nurses and other personnel will be more motivated to be a part of it. Also, it has valuable impact on the minds of the patients.

Employing environmentally sensitive designs can lead to savings of the order of 20-50 per cent. Initial investment cost may increase by 10-15 per cent. However, it is important to look at this incremental cost in relation to the full life cycle cost. Typically, over its life cycle, the operating cost may work out to 80-85 per cent of the capital cost while the incremental cost is a one-time cost. Due to substantial reductions in operational cost, the total cost of ownership of green buildings is usually lesser than conventional buildings.

On regulatory front, the US Green Building Council (USGBC) has introduced its latest green building rating system- Leadership in Energy and Environmental Design (LEED) for healthcare. The rating system guides the design as well as construction of both new building and major renovations of existing buildings, and can be applied to inpatient & licensed long-term care facilities, medical offices assisted living facilities and medical education & research centers. The LEED green building rating system encourages sustainable green building and development practices through an internationally acceptable set of criteria.

Other nations have their own rating and certifications systems as well. For example, in India it is Energy Conservation Building Code (ECBC). Also, with the introduction of the Energy Conservation (EC) Act 2001, the Government of India in recent years has been promoting energy efficiency in different industrial and commercial sectors.

A Case Study

Manhattan’s Bank of America Tower at One Bryant Park is one of America’s pioneering Platinum LEED towers. The tower not only uses significantly less energy and water than a conventional high-rise, but there are some features that specifically promote health as well.

The design of the building makes it environment friendly, using technologies such as floor-to-ceiling insulating glass to contain heat and maximize natural light, and an automatic daylight dimming system. The tower also features a grey water system, which captures rainwater for reuse. Bank of America states that the building is made largely of recycled and recyclable materials. Air entering the building is filtered, and the air exhausted is cleaned as well. Bank of America Tower is the first skyscraper designed to attain a Platinum LEED Certification.

The tower is constructed using a concrete manufactured with slag, a byproduct of blast furnaces. The mixture used in the tower concrete is 55% cement and 45% slag. The use of slag cement reduces damage to the environment by decreasing the amount of cement needed for the building, which in turn lowers the amount of carbon dioxide produced through the normal cement manufacturing process.

Temperature control and the production of some of its energy are accomplished in an environmentally friendly manner for the tower. Insulating glass reduces thermal loss, lowering energy consumption and increasing transparency. Carbon dioxide sensors signal increased fresh air ventilation when elevated levels of carbon dioxide are detected in the building.

Conditioned air for the occupants is provided by multiple air column units located in the tenant space that deliver 62 degree air into a raised access floor plenum. This under floor air system provides users with the ability to control their own space temperature as well as improving the ventilation effectiveness. When building churn occurs, workstation moves can be performed easier with lower cost and less product waste.

The cooling system produces and stores ice during off-peak hours, and allows the ice to melt to help cool the building during peak load, similar to the ice batteries in Hotel New Otani in Tokyo, Japan. Ice batteries have been used since absorption chillers first made ice commercially available 150 years ago, before the invention of the electric light bulb.

The tower has a 4.6-megawatt cogeneration plant, which provides part of the base-load energy requirements. Onsite power generation reduces the significant electrical transmission losses that are typical of central power production plants.

Overcoming challenges through sustainability

Cost of resources that the healthcare industry uses is rising. Fuel & coal prices have witnessed a rising trend. Water scarcity is a reality in many locations. Increasing awareness and rising stakeholder expectations on clean and healthy environment requires phasing out of toxic chemicals as well as the use of more benign alternatives in construction. With relaxation of duties in the finance budget on LED, solar and wind components, energy efficiency and use of renewable energy are likely to take off at a much faster rate.

No country has got all the healthcare answers. Whilst different health systems inevitably reflect local and political realities, there are valuable lessons to be learned from observing how other health economies make things happen and learn from it. Government should encourage Green buildings and all the hospitals & healthcare corporates should have in-house experts helping them to implement realistic sustainability plans.

On the concluding note

On the concluding note one can say, investing in green buildings in the healthcare would make sure that fulfilling the healthcare needs of our citizens would not impose additional burden on nature and would clearly be a win-win proposition for present and future generations. The industry needs to collaborate worldwide and all the nations need to share their best practices and plans, which would make a difference. There is no reason why individual countries and hospitals need to go through the same hurdles, make the same mistakes or learn the wrong way. The green revolution is possible with the world coming together to save our beloved planet Earth and the life of future generations as well.


Dr Prem Jagyasi and Team

Dr Prem is an award winning strategic leader, renowned author, publisher and highly acclaimed global speaker. Aside from publishing a bevy of life improvement guides, Dr Prem runs a network of 50 niche websites that attracts millions of readers across the globe. Thus far, Dr Prem has traveled to more than 40 countries, addressed numerous international conferences and offered his expert training and consultancy services to more than 150 international organizations. He also owns and leads a web services and technology business, supervised and managed by his eminent team. Dr Prem further takes great delight in travel photography.

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