Get Sust! Issue 44

Fresh air and sunshine combat flu

Modern hospitals might not be the best place for Swine Flu patients, and alternative measures should be considered, say UK-based researchers.

Richard Hobday of the School of the Built and Natural Environment at the University of the West of England, and John W Cason of Kings College London, have jointly published a survey of successful strategies for dealing with flu patients during the major epidemics of the 20th century. Their conclusions are published in a recent issue of the American Journal of Public Health, and make interesting reading for architects and building services engineers who are involved in designing daylighting and ventilation for hospitals.

Much of the article focuses on the use of field hospitals during the 1918–1919 outbreak of H1N1 “Spanish flu”, which killed between 50 million and 100 million people. Historical records from an “open-air” hospital in Boston, Massachusetts, suggest that some patients and staff were spared the worst of the outbreak via a combination of fresh air, sunlight, scrupulous standards of hygiene, and reusable face masks.

The authors suggest that the health of the staff and patients may have benefited from levels of natural ventilation that were far higher than in a conventional hospital ward. They point out that the minimum amount of ventilation needed to prevent the spread of infectious diseases such as severe acute respiratory syndrome (SARS) and tuberculosis is unknown. Much more fresh air may be needed than is currently specified for hospitals, schools, offices, homes, and isolation rooms.

They also suggest that further research is required to fully understand the role that solar radiation can plan in killing bacteria and viruses. Furthermore, it is not yet know what proportion of influenza infections occur by the airborne route.

“Improvements in air-handling equipment, portable filtration units, and the introduction of physical barriers in the form of partitions or doors may offer some protection,” they write. “However, more might be gained by introducing high levels of natural ventilation or, indeed, by encouraging the public to spend as much time outdoors as possible.” They also suggest that the UK and US might benefit from preparing field hospitals to accommodate patients outside if the pandemic becomes serious.

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The Open-Air Treatment of Pandemic Influenza by Richard A. Hobday, and John W. Cason, Am J Public Health is free to download from www.ajph.org