Starting from a previous experience carried out by the working group “Building and Environmental Hygiene” of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a “Healthy and Salutogenic City”, which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

Cities are experiencing an increased rate of climate-related extreme events threats derived from climate change. Floods are one of the most challenging issues to address to reduce damages and losses in urban areas. Building resilience through adaptation to these changing conditions has become a common goal for different disciplines involving planning for the future. Adaptation planning is widely recognized as generally applicable to any field. However, there are current limitations to overcome for architectural and urban planning to switch from theory to practice. This paper proposes a critical overview of literature works on flood mitigative strategies and adaptive approaches considering uncertainties, linking strategies for the Built Environment (BE) to mitigate the effects of floods, and operative frameworks to pursue adaptation under changing environmental conditions. The literature selection accounts for the pivotal components of the BE: open spaces (OSs), buildings, and users. Next, we provide an overview of the most relevant adaptive methodologies that have emerged in literature, and, lastly, the planning strategies are discussed, considering the climate-related uncertainties that might undermine the effectiveness of the designed action. The present paper aimed to provide a contribution to the discussion regarding the necessity of making architectural and urban planning adaptive, providing a base for future studies for operative adaptation.

The profound qualitative changes of indoor air and the progressive increase in the absolute number of pollutants, combined with the scientific awareness of the health impacts deriving from spending more than 90% of one’s time inside confined spaces, have increased the attention onto the needs of well-being, hygiene, and the health of users. This scientific attention has produced studies and analyses useful for evidence-based insights into building performance. Among the main pollutants in the indoor environment, Volatile Organic Compounds (VOCs) play a central role, and the use of box-models using the mass balance approach and Computational Fluid Dynamics (CFD) models are now consolidated to study their concentrations in an indoor environment. This paper presents the use of both types of modelling for the prediction of the VOC concentration in the indoor environment and the proposal of a guide value for the Indoor Air Quality (IAQ)-oriented building design, specifically related to the indoor VOC concentration due to building materials. Methodologically, the topic is addressed through environmental sampling, the definition of the parameters necessary for the numerical models, the simulations with the box-model and the CFD, and the comparison between the results. They show a good correspondence between the modelling tools used, highlighting the central role of ventilation and allowing a discussion of the relationship between regulatory limits of emissivity of materials and Indoor Air Guide Values for the concentration of pollutants.

Postoperative infections are a concern, especially in total knee and total hip arthroplasty. We evaluated the air quality in orthopaedic operating theatres in southeastern Italy to determine the level of bacterial contamination as a risk factor for postoperative infection. Thirty-five hospitals with operating theatres focused on total knee and total hip arthroplasty participated. We sampled the air passively and actively before surgeries began for the day (at rest) and 15 min after the surgical incision (in operation). We evaluated bacterial counts, particle size, mixed vs turbulent airflow systems, the number of doors, number of door openings during procedures and number of people in the operating theatre. We found no bacterial contamination at rest for all sampling methods, and significantly different contamination levels at rest vs in operation. We found no association between the number of people in the surgical team and bacteria counts for both mixed and turbulent airflow systems, and low bacterial loads, even when doors were always open. Overall, the air quality sampling method and type of ventilation system did not affect air quality.

The relationship between users and the built environment represents a fundamental aspect of health. The factors that define the properties linked to health and well-being are increasingly becoming part of building design. In these terms, building information modelling (BIM) and BIM-based performance simulation take on a priority role. Among the key features for the design of Healthy Buildings, indoor air quality (IAQ) plays a central role. There are numerous indoor pollutants with significant health effects; volatile organic compounds (VOCs) are to be mentioned among these. The paper presents the proposal of an integrated workflow in the BIM process for the check and control of VOC emissions from building materials and their concentration in confined environments. The workflow is developed through the systematisation of IAQ parameters for the open BIM standard, the integration in the BIM process of a numerical model for the prediction of the VOCs concentration in the indoor environment, and the development of model checkers for performance verification. The results show a good adhesion between the numerical model and the implementation in BIM, providing the designer with a rapid control instrument of IAQ in the various phases of the building design. The present study is the first development focused on TVOC, but implementable concerning other aspects of IAQ, as needed for the effectiveness of performance building-based design for health and wellness issues.