What Buildings Cost 1/3: What Does It Cost?

In 2012 a research team from the Bavarian Health and Food Safety Authority ran an experiment in six German schools (Twardella et al., 2012, Indoor Air). In 20 classrooms they altered the air quality, once good at 1,045 ppm CO2, once poor at 2,115 ppm. Then they tested the children with a standardized concentration test.

The children with poor air were not more tired and not slower. But they made more mistakes. The error rate increased significantly. Neither the children nor their teachers noticed.

2,115 ppm CO2 is not an extreme value. In many German classrooms without mechanical ventilation the levels are higher. Children spend a large part of their day in these rooms and they have no way to assess or change the conditions.

At the Charité hospital in Berlin, doctors and the architecture firm GRAFT redesigned two intensive care rooms in 2013. They installed lighting that simulates the day-night cycle, dampened noise and hid visible medical equipment behind wall panels. The delirium rate in these rooms was 46 percent. In the standard rooms it was 76 percent (Charité / GRAFT, published 2023, PMC). 30 percentage points less from room design alone. ICU delirium extends hospital stays and costs five-figure amounts per case.

Joseph Allen measured in the COGfx study how air in office buildings affects thinking (Allen et al., 2016, Environmental Health Perspectives). In well-ventilated buildings cognitive test scores were twice as high as in conventionally ventilated ones. Crisis response was 97 percent better, strategic thinking 131 percent.

The findings are neither new nor isolated. Roger Ulrich showed in 1984 that hospital patients with a view of trees need less pain medication and are discharged sooner (Ulrich, 1984, Science). The study has been replicated hundreds of times. The WHO estimates that 13 percent of childhood asthma in Europe is attributable to damp housing (WHO Europe, 2011). The evidence spans decades and hundreds of studies.

For Concrete Human I developed a system that evaluates the research on these effects by building type and user group. The weight of data is overwhelming. What’s missing is not research but its arrival in the planning process. The research is organized by discipline. Anyone planning a school building would need to work through acoustics, lighting research, indoor climate and materials science in parallel. Each field has its own journals and its own terminology. In practice nobody does that.

The decisions that determine room quality are made in the floor plan and the building services. Many of them cost nothing extra. Whether a patient looks out the window at trees or at a fire wall is a question of planning. Yet these decisions are almost never based on the available evidence.