Design approaches towards energy efficient hospitals often result in a deteriorated indoor environmental quality, adverse health and comfort outcomes, and is a public health concern. This research presents an advanced approach to the design of a hospital environment based on a stimulative paradigm of healing to achieve not only healthy but also comforting conditions. A hospital room for severely burn patient was considered as one of the most demanding spaces. The healing environment was designed as a multi-levelled, dynamic process including the characteristics of users, building and systems. The developed integral user-centred cyber-physical system (UCCPS) was tested in a test room and compared to the conventional system. The thermodynamic responses of burn patients, health care worker and visitor were simulated by using modified human body exergy models. In a healing environment, UCCPS enables optimal thermal balance, individually regulated according to the user specifics. For burn patient it creates optimal healing-oriented conditions with the lowest possible human body exergy consumption (hbExC), lower metabolic thermal exergy, lower sweat exhalation, evaporation, lower radiation and convection. For healthcare workers and visitors, thermally comfortable conditions are attained with minimal hbExC and neutral thermal load on their bodies. The information on this is an aid in integral hospital design, especially for future extensive renovations and environmental health actions.

Upgrades in building energy efficiency codes led to differences between buildings designed according to outdated codes and those with most recent requirements. In this context, our study investigates the influence of external wall thermal transmittance, thermal inertia, and orientation on energy demand (heating, cooling) and occupant thermal comfort. Simulation models of an office building were designed, varying (i) the thermal transmittance values (0.20 and 0.60 W/(m²K)), (ii) the room orientation (four cardinal directions), and (iii) the wall thermal inertia (approximately 60 kJ/(m²K) for low and 340 kJ/(m²K) for high thermal inertia. The energy demand for heating and cooling seasons was calculated for Ljubljana using EnergyPlus 9.0.0 software. The reduction of the external wall thermal transmittance value from 0.6 W/(m²K) to 0.2 W/(m²K) contributes to significant energy savings (63% for heating and 37% for cooling). Thermal inertia showed considerable potential for energy savings, especially in the cooling season (20% and 13%, depending on the external wall insulation level). In addition, the orientation proved to have a notable impact on heating and cooling demand, however not as pronounced as thermal inertia (up to 7% total energy demand). Comparison of the thermal comfort results showed that when internal air temperatures are identically controlled in all the rooms (i.e., internal air temperature is not an influencing factor), the external wall thermal transmittance, thermal inertia, and room orientation show negligible influence on the average occupant thermal comfort. The simultaneous achievement of thermally comfortable conditions in the working environment and low energy use can only be achieved by simultaneously considering the U-value and thermal inertia.

Izvleček Izhodišča: Bolnišnice predstavljajo kompleksno notranje okolje, v katerem so bolniki, zaposleni in obiskovalci izpostavljeni številnim dejavnikom tveganja za zdravje. Raziskav, ki bi obravnavale več dejavnikov tveganja hkrati, je danes malo. Ne izhajajo iz povezave med uporabniki, stavbo in sistemi. Namen metaanalize je prepoznati fizikalne, biološke in kemične dejavnike tveganja za zdravje v bolnišničnem okolju ter izdelati izhodišča za pripravo priporočil za njihovo preprečevanje in obvladovanje. Pri tem bomo upoštevali uporabnike ter življenjski cikel stavbe in sistemov. Metode: Opravili smo metaanalizo raziskav na področju fizikalnih, bioloških in kemičnih dejavnikov tveganj za zdravje v bolnišničnem okolju. Zajeli smo dve bibliografski bazi (Pub Med in Science Direct). V analizo je bilo vključenih 634 virov literature, ki so bili objavljeni med letoma 1934 in 2012. Izhodišča za pripravo priporočil smo izdelali po nadgrajeni metodi inženirskega načrtovanja. Rezultati: Na podlagi izsledkov metaanalize smo pripravili izhodišča za pripravo priporočil, ki vključujejo sistematične ukrepe, specifične za bolnišnično okolje. Preprečevanje fizikalnih dejavnikov tveganja za zdravje vključuje ukrepe s področja zakonodaje, načrtovanja stavbe in sistemov ter usposabljanja zaposlenih. Najpomembnejši ukrepi s področja bioloških in kemičnih dejavnikov tveganja za zdravje so: preprečevanje in obvladovanje poti prenosa povzročiteljev bolezni ter nadzor kemičnih onesnaževal v notranjem in zunanjem zraku. Zaključki: Metaanaliza predstavlja nov pristop k preprečevanju in obvladovanju fizikalnih, bioloških in kemičnih dejavnikov tveganja za zdravje v kompleksnem bolnišničnem okolju - od načrtovanja stavbe do njene uporabe in vzdrževanja. Učinkovitost stavbe in sistemov se doseže s celostnim upoštevanjem značilnosti uporabnikov, bolnišničnega okolja in rabe energije. Uporabljen pristop je tudi pogoj za načrtovanje stavb in sistemov; je temelj uspešnih prenov.