Infection Control or Greenwashing? Unintended Consequences of Overdesign (Part II)

Infection Control or Greenwashing? Unintended Consequences of Overdesign (Part II)

LEED-certified design consultant Bruce Maine follows up his assessment of gypsum wallboard, ceiling tile, and paints with some tough questions about the health benefits and risks presented by antimicrobial cleaning agents.

We recognize that germs are real and constitute a serious threat -- especially in environments where infection control isn't just a casual incentive but absolutely necessary. The architectural community has responded to infection control in a variety of ways. The industry has adapted strategies from sophisticated technical enhancements, such as UV lights in supply air ducts, to more tested and fundamental hygienic imperatives like providing hand washing sinks in patient rooms. The building products industry has also responded to the challenges of infection control, but in a much different manner. As concern for the efficacy of the interior environment continues to grow, so does the pallet of products that are intended to combat mold, mildew, and biological contaminants. The question that should be asked, however, is to what extent these product enhancements are truly beneficial, or if appropriate design is the better strategy to eliminate unwanted and dangerous contaminants in the interior environment.

Sanitizers, Biocides, and Antimicrobials

Regardless of what manufacturer's claim, sanitizers, biocides, and antimicrobials are essentially pesticides. The EPA controls these under the Federal Insecticide, Fungicide, and Rodenticide Act. Substances are registered either as Public Health or Non-Public Health antimicrobial agents. Public health agents are intended to control infectious microorganisms that may be a hazard to human health. To obtain the designation of "public health" antimicrobial for an agent, a manufacturer must present data to the EPA demonstrating that the agent is effective against specific infectious microorganisms and meets standards of safety and toxicity. An agent is considered effective if it controls the specified microorganisms, not necessarily the diseases caused by the microorganisms. The manufacturer cannot claim that the agent prevents diseases.

Although antibacterials may definitely be effective in killing bacteria, there is considerable controversy surrounding their health benefits. Some scientists believe this is a potential danger because laboratory conditions used in the research studies do not represent the "real world." Others believe the use of these agents create a false sense of security that may cause architects and engineers to become lax in designing an appropriate building envelope or mechanical systems or facilities managers to become indifferent to fundamental maintenance. It should also be remembered that most bacteria are harmless and in many cases, even beneficial. Very few bacteria actually cause disease and constant use of disinfecting agents tends to disrupt the normal bacteria that act as barriers against invading pathogens.

Does the continued use of antimicrobials portend the same kinds of health issues we now face with antibacterial agents? In the American Academy of Microbiology's Antimicrobial Resistance, an Ecological Perspective, it was noted that "increasing use of disinfectants, in everything from soap to gym clothes to baby toys and toothpaste, sends the message that every attempt should be made to eliminate as many bacteria in our personal environment as possible. The result is that everyday household products put increasingly selective pressure on the bacterial population to become more resistant in the homes that use these products. This change in the normal flora can have adverse consequences if and when the members of the household become ill with an infectious disease. The use of these products may reduce the number of harmless bacteria and increase the selection for antimicrobial-resistant organisms."

Cautions

The Centers for Disease Control (CDC), June 2000 draft of Public Health Action Plan to Combat Antimicrobial Resistance PDF) called for an evaluation of "the benefits and risks of incorporating antimicrobial disinfectants or antiseptic chemicals into consumer products (e.g., soap, toys, kitchen utensils, clothes, paints, plastics and film preservatives)." The NIOSH/EPA document, Building Air Quality: A Guide for Building Owners and Facility Managers, recommended that biocides, disinfectants, and sanitizers "be used with caution to ensure that occupant exposure is minimized." In the CDC's 2003 Guidelines for Environmental Infection Control in Health Care Facilities, the Construction Design and Function Considerations for Environmental Infection Control stress proactive design measures to achieve infection control attributes in building products in lieu of recommending products with pesticides to achieve those same results.

Sustainable design requires us to view our profession with a different perspective. It is no longer possible to walk away from a project without understanding the consequences or ramifications of our labor. Appreciating how products are manufactured, marketed, specified, and used is a critical component of our new obligation to address environmental issues in the pursuit of our professional responsibilities. The first rule should be that "every new thing is not necessarily a good thing" and what purports to protect your clients may, in fact, not be in their best interests or the best interests of the community. There is adequate evidence that we can design buildings that resist the growth of mold and similar unwanted biological insurgents without having to resort to specifying products that may look good in the short run but carry significant health and environmental liabilities when viewed in the light of sustainability.

Today the disinfectant and antimicrobial industry represents a $2 billion market that is expected to grow at 5 percent annually through 2009 based on public concerns about bacterial and pathogenic threats. Of concern to architects, facility managers, and infection control professionals is how much of that is used as unnecessary additives in building products that may have unsustainable ramifications beyond the relatively short life of a commodity. Consider the environmental burden of antimicrobials in any building material. Is there a risk beyond any benefit that may be intimated? What are the environmental consequences beyond a perceived short-term advantage? We must be prepared to ask such questions if sustainability is to be a serious dynamic in the design, construction, and maintenance process.

Making Intelligent Choices

Many building products, despite our best intentions, are still destined to landfills and those likely candidates, such as gypsum board, ceiling tile, and carpet, may be laced with pesticides to fulfill some short-term exaggerated benefit while ignoring long-term consequences.

Experience reminds us there is no magic bullet -- no panacea that delivers good results from poor design and product selection decisions. Defeatism is defined as “acceptance or expectation of or resignation to defeat.” That is too often how we select products -- anticipating some failure that makes specific enhancements necessary. No doubt many building product manufacturers have reveled in profits from products invented to compensate for failed design. By applying the principles of proper envelope design, construction accountability, and systems effectiveness, we can minimize risks from mold and associated contaminants, as well as unintended risks from cures that may be worse than the disease.

--------
Bruce Maine LEED AP, is a sustainable design consultant with HDR Architecture, a firm based in Omaha, Neb.