Building and building services for compressing morbidity

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Building and building services for compressing
morbidity

• 2007 International Master Class on Gerontology
  and Gerontechnology
• Nan Kai Institute of Technology, Taiwan
• Session NL-2
• March 29, 2007 13.20-14.50 H

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Introducing the speaker

• Chair holder Public Health Engineering for Built
  Environments, Department of Architecture,
  Building Planning, Technische Universiteit
  Eindhoven, the Netherlands (www.phe.bwk.tue.nl)
• Editor-in-Chief of ISGs Gerontechnology
  Quarterly Journal (www.gerontechjournal.net)
• Nankai Institute of Technology and the chair
  signed a Memorandum of Understanding for
  collaboration, student and staff exchange

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To the students .

• Please pose your questions during my talk do not
  wait until the end
• I will also ask YOU about the situation in Taiwan
  as to health, DALYs and HACCP methodology
• Together we can make new knowledge for the Taiwan
  environment

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Definition by the World Health Organization since
1946
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Aging in the World
Source http//esa.un.org/unpp
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(Geron)technology, for whom?
Source http//esa.un.org/unpp
http//eng.stat.gov.tw/
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A functional Gerontechnology Framework

• Domain of human activity
• Health self-esteem / Housing daily activities
• Communication governance / Mobility transport
• Work leisure
• Technology intervention / Impact level
• Enhancement satisfaction / Prevention
  engagement
• Compensation assistance / Care and care
  organisation

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Building for housing daily activities

• Choice of location
• Neighbourhood
• Architecture
• Construction
• Maintenance operation
• Ventilation, cooling, heating
• Other building services

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The Dutch Situation
How about Taiwan?
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Delaying chronic disease
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Building services to fight disease

• Ventilation
• Provision of potable water (also for bathing)
• Liquid and solid waste removal
• Noise and lighting levels (day and night)
• Communication for leisure, social interaction,
  guidance, care

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Inhaled air as an example

• Asthma
• NL 80 building related mites, fungi, other
  pollutants
• COPD (chronic bronchitis, lung emphysema)
• NL 40 building related tobacco smoke, other
  pollutants)
• Lung cancer
• NL 25 building related tobacco smoke, other
  pollutants

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Disability Adjusted Life Yearsall calculations
concern one calendar year

• DALYs of a disease in a population
• Years lost due to premature death
• Years in disability x Disability weight

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DALYs calculation results
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Gains and costsasthma, COPD, lung cancer

• The Netherlands
• Healthy years lost/Yr (DALYs) 313x103
• Smart ventilation systems cost / Yr
• NT 101x109 ( 2.3x109)
• Possible gains in healthy years / Yr 89x103
• Reduction in healthcare costs / Yr
• NT 17.3x109 ( 394x106)
• Cost of 1 extra healthy year NT 1,1x106 (
  26x103)
• Taiwan
• Healthy years lost / Yr (from previous slide)

Depreciation of investment (15 Yrs), interest,
maintenance, and energy
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HACCP for control

• Hazard Analysis by Critical Control Point
• From the food industry
• Applied to building services
• Total Quality Management (TQM)

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Examples of end-products

• HVAC good quality inhales air
• Sewer system infection-low residential area
• Water works water safe for consumption bathing
• ICT-infrastructures applications
• media good quality leisure, guidance
• alarms safety security
• care good quality treatment, diagnosis, guidance

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HACCP steps for control

• Base Process description, end-product defined
• 1 Process analysis
• 2 Critical Control Points (CCPs)
• 3 Critical limit / CCP
• 4 Monitoring procedure / CCP
• 5 Intervention at exceeded critical limit / CCP
• 6 Verification procedure / CCP
• 7 Registration documentation procedures
• (for in-company and out-company certification)

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Compressing morbidity

• List chronic conditions concerned
• Calculate their DALYs
• Upgrade relevant engineering
• Control with HACCP
• Measure / calculate health years earned

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Morbidity and Mortality

• 21st Century gerontechnoloy engineer
• A major morbidity fighter
• Gains for the older part of the population
• 20th Century sanitary engineer
• A major mortality fighter
• Gains for infants and children
• Combine mortality and morbidity fight

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Thank you for your attention