September 23, 2003 JEMH van Bronswijk TU/e 1

Differential Diagnosis of Differential Diagnosis of RisksRisks

With focus on methodologyWith focus on methodology

September 23, 2003 JEMH van Bronswijk TU/e 2

Source: http://www.who.org/aboutwho/en/definition.html

September 23, 2003 JEMH van Bronswijk TU/e 3

A Differential Diagnosis of A Differential Diagnosis of Risks of built environments Risks of built environments

includes:includes:

- Well beingWell being- HealthHealth- SafetySafety- SecuritySecurity- IndependenceIndependence- Success and GrowthSuccess and Growth- Other AspirationsOther Aspirations

September 23, 2003 JEMH van Bronswijk TU/e 4

Technology Impact on HealthTechnology Impact on Health

• Enhancement & Satisfaction• Prevention & Engagement• Compensation & Assistance• Care Support & Organisation

Source: JEMH van Bronswijk, H Bouma, JL Fozard 2002. Technology and Quality of Life: an enriched texonomy. Gerontechnology 2(2):169-172

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Technology Application DomainsTechnology Application Domains

• ‘Medical’ Health & Self-Esteem• Housing & Daily Living• Mobility & Transport• Communication & Governance• Work & Leisure

Source: JEMH van Bronswijk, H Bouma, JL Fozard 2002. Technology and Quality of Life: an enriched texonomy. Gerontechnology 2(2):169-172

September 23, 2003 JEMH van Bronswijk TU/e 6

1.1. Legislature, guidelines, patents (Legislature, guidelines, patents (in reportin report))2.2. Textbooks (Library! Textbooks (Library! in reportin report))3.3. Scientific journals & conferences (see virtual Scientific journals & conferences (see virtual

libraries and visit the actual library libraries and visit the actual library in reportin report ) )4.4. Questionnaires & interviews (Questionnaires & interviews (in reportin report))5.5. Physical measurements (building physics / Physical measurements (building physics /

medical assessment, medical assessment, in report accept for in report accept for actual building physics measurementsactual building physics measurements))

Risk assessment Risk assessment methodologiesmethodologies

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Legislature, guidelines, Legislature, guidelines, patentspatents

• Building CodeBuilding Code• OSH (Occupational Safety & Health) OSH (Occupational Safety & Health)

LegislatureLegislature• Copyright, Intellectual Property Copyright, Intellectual Property

RightsRights

What to do when legal issues on Health & Comfort seem to clash?

September 23, 2003 JEMH van Bronswijk TU/e 8

Comparing Relevant LegislationsComparing Relevant Legislations

Theme Building Code OSH Legislation Intellectual Property

Object New and existing buildings

New and existing working environments

Works of Art & Ingenuity

Aim Implementing minimal safety, health & usefulness

Guarantee optimal OSH conditions

Protecting Individual Rights

Types of Standards

Performance requirements

OSH Conditions Optimization

Principle of Uniqueness

Compliance Responsibility

Commissioner, Owner Employer Each individual

National Responsibility

Department of Housing Department of Health Civil Jurisdiction

Inspectorate Local: Fire Department, Building Inspectorate before building

National: OSH Inspectorate after building is completed

Individual: Owner of Intellectual Property Right after breach of rights

September 23, 2003 JEMH van Bronswijk TU/e 9

1.1. Building, Building Services, Urban PlanningBuilding, Building Services, Urban Planning2.2. Furnishing and Furnishing and MaintenanceMaintenance3.3. Hereditary Factors, Physical and Mental Hereditary Factors, Physical and Mental

Fitness, Vaccinations, Healthy NutritionFitness, Vaccinations, Healthy Nutrition

3 Barriers against Disease3 Barriers against Disease

September 23, 2003 JEMH van Bronswijk TU/e 10

Disease risk domains of Disease risk domains of built environmentsbuilt environments

Indoor airIndoor air

Water supplyWater supply

Finishing & furnishing materialsFinishing & furnishing materials

Indoor & outdoor spacesIndoor & outdoor spaces

CommunicationCommunication

(Lack of) physical activity(Lack of) physical activity

September 23, 2003 JEMH van Bronswijk TU/e 11

PreventionPrevention & & AssistanceAssistance INDOOR AIRINDOOR AIR

Atopic DermatitisAtopic Dermatitis; ; Asthma & COPDAsthma & COPD; ; Lung CancerLung Cancer

WATER SUPPLYWATER SUPPLY

Gastro-intestinal Tract InfectionGastro-intestinal Tract Infection; ; PneumoniaPneumonia

FINISHING & FURNISHING MATERIALSFINISHING & FURNISHING MATERIALS

Contact DermatitisContact Dermatitis

INDOOR & OUTDOOR SPACESINDOOR & OUTDOOR SPACES

AccidentsAccidents; ; Anxiety DisorderAnxiety Disorder; ; OsteoporosisOsteoporosis;;

Upper-airway Infections / InfluenzaUpper-airway Infections / Influenza

COMMUNICATIONCOMMUNICATION

Hearing DisorderHearing Disorder; ; Anxiety DisorderAnxiety Disorder

STIMULATING FITTING PHYSICAL ACTIVITY STIMULATING FITTING PHYSICAL ACTIVITY

Arthrosis of LimbsArthrosis of Limbs; ; Back problemsBack problems; ; DepressionDepression

September 23, 2003 JEMH van Bronswijk TU/e 12

Incidence Prevalence Lost Years Upper Airways Infection Back Problems Coronary Heart Disease Accident in Private Domain Hearing Disorder Lung Cancer Back Problems Anxiety Disorder Stroke Sport Accident Arthrosis of Limbs Breast Cancer Pneumonia / acute bronchi(oli)tis Asthma & COPD Heart Failure Acute Urinary Tract Infection Contact Dermatitis Suicide Contact Dermatitis Diabetes Asthma & COPD Gastro-Intestinal Tract Infection Depression Intestinal Cancer Influenza Atopic Dermatitis Traffic Accident Accident at Work Osteoporosis Diabetes

Top-10 DiseasesTop-10 DiseasesThe Netherlands 1994The Netherlands 1994

Partly caused by built environment Assistance by built environment

September 23, 2003 JEMH van Bronswijk TU/e 13

September 23, 2003 JEMH van Bronswijk TU/e 14

Major Improvements in Public Health 1890-1990

1. Interruption of human-to-human infection-cycles

2. Reducing zoonoses

4. Improvement of Work

Complete seperation of water-to-be-used, and waste water or rain water Prohibiting open sewers = ‘open’ discharge of waste water or rain water Prohibiting fertilization with human urine or stool Enlarging floor surface / occupant in dwellings

Separation of stable and dwelling spaces

Prohibiting basement dwellings, cave dwellings, or other subsurface dwellings Governmental Meat Inspection

Decrease of Accident Risk and Severity Decrease in Exposure to Poisonous and Carcinogenic Substances Less Physical Exhaustion and Wear

Extermination of small mammals, birds, insect and mites on and near buildings Prohibiting open sewers = ‘open’ discharge of waste water or rain water

Prescribing ventilation with fresh outdoor air

Filling up of shallow water and swamps in the living environment

JEMH van Bronswijk, 14 maart 1997

Housing Societies & National Public Health Inspection (Legislature to Parliament in 1899)

3. Improved Nutrition Farming, Storage and Transport Technology

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1.1. Use Reference Manager (Use Reference Manager (RefmanRefman))a.a. Download from TU/e library, orDownload from TU/e library, or

b.b. Buy stand alone:Buy stand alone: http://www.researchsoftware.nl/

2.2. Search at least Google Scholar, Web-of-Science, Search at least Google Scholar, Web-of-Science, Webspirs & Science Direct, and import relevant Webspirs & Science Direct, and import relevant references in your references in your RefmanRefman database database

3.3. Include in your Include in your RefmanRefman database also textbooks, database also textbooks, patents, standards, guidelines, reports and other patents, standards, guidelines, reports and other published information sourcespublished information sources

4.4. For export in your report, use the reference layout of For export in your report, use the reference layout of NatureNature

Risk assessment Risk assessment Information managementInformation management