Challenges in IAQ for Indoor Spaces: A Comparison of the Reference Guideline Values of Indoor Air Pollutants from the Governments and International Institutions

Since people spend most of their time inside buildings, indoor air quality (IAQ) remains a highlighted topic to ensure in the built environment to improve public health, especially for vulnerable users. To achieve a better indoor environment quality (IEQ), some countries’ governments or regional institutions have developed and published reference guideline values of various air pollutants to prevent the IAQ from becoming adverse to occupants. Beyond guidelines by World Health Organization (WHO), in some countries, there are specific institutional requirements on the IAQ, and others integrated it into the building regulation for the built environment. This paper is based on the literature research, summarized from previously conducted works by the authors, on the chemical reference values of IAQ-related regulations and guidelines published by several Governments or related institutions from various regions around the World. Despite these efforts at standardization and legislation, many indoor air quality monitoring activities conducted in several countries still fall short of the main indications produced. By comparing the reference values of 35 pollutants, both physical and chemical ones, which are proposed in documents from 23 regions included so far, the IAQ research and prevention actions on progress in different regions should be included in monitoring plans with guidelines/reference values in their current state. The outcome of the paper is to define the current trends and suggest some perspectives on the field of interest for improving the indoor air quality of generic spaces at an international level. It becomes evident that, at the global level, IAQ represents a complex political, social, and health challenge, which still suffers from the absence of a systematic and harmonized approach. This is not a new situation; the issue was raised more than 40 years ago, and despite efforts and a pandemic, the situation has not changed

Does the energy-environmental Kuznets curve hypothesis sustain in the Asia-Pacific region?

As mitigating the effects of energy consumption on the environment is a crucial issue for the Asia-Pacific region, this study investigates the energy-environmental Kuznets curve (EEKC) hypothesis among the 19 Asia-Pacific regions. The study also test the hypothesis for the low-, middle-, and high-income groups of the region. The panel regression and cointegration models are used for this purpose. Both models suggest that the EEKC hypothesis does sustain for the whole Asia-Pacific region. However, the test performed on the income groups revealed that the hypothesis only holds for the high-income group and the low- and middle-income groups do not satisfy the hypothesis. This is likely indicating that the transition in the energy consumption along the EEKC is only occurring in the developed countries of the Asia-Pacific region

The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology

Miriam Zacchia, Giovanna Capolongo, Luca Rinaldi, Giovambattista Capasso Division of Nephrology, Department of Cardio-Thoracic and Respiratory Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy Abstract: The thick ascending limb (TAL) of Henle’s loop is a crucial segment for many tasks of the nephron. Indeed, the TAL is not only a mainstay for reabsorption of sodium (Na+), potassium (K+), and divalent cations such as calcium (Ca2+) and magnesium (Mg2+) from the luminal fluid, but also has an important role in urine concentration, overall acid–base homeostasis, and ammonia cycle. Transcellular Na+ transport along the TAL is a prerequisite for Na+, K+, Ca2+, Mg2+ homeostasis, and water reabsorption, the latter through its contribution in the generation of the cortico-medullar osmotic gradient. The role of this nephron site in acid–base balance, via bicarbonate reabsorption and acid secretion, is sometimes misunderstood by clinicians. This review describes in detail these functions, reporting in addition to the well-known molecular mechanisms, some novel findings from the current literature; moreover, the pathophysiology and the clinical relevance of primary or acquired conditions caused by TAL dysfunction are discussed. Knowing the physiology of the TAL is fundamental for clinicians, for a better understanding and management of rare and common conditions, such as tubulopathies, hypertension, and loop diuretics abuse.  Keywords: TAL, sodium handling, potassium handling, acid–base homeostasis, urine concentration&nbsp

COVID-19 and living space challenge. Well-being and public health recommendations for a healthy, safe, and sustainable housing

Background and aim of the work: The ongoing pandemic of COVID-19 is a strong reminder that the lockdown period has changed the way that people and communities live, work, and interact, and it’s necessary to make resilient the built environment, both outdoor and mainly the indoor spaces: housing, workplaces, public buildings, and entertainment facilities. How can we re-design the concept of Well-being and Public Health in relation to the living places of the future? Methods: According to the previous statements and scenario, this paper aims to integrate the building hygiene and well-being, focusing the possible responses, both existing and for the new buildings, taking home a strong message from this “period” of physical distancing. Results: The Well-being and Public Health recommendations for a healthy, safe, and sustainable housing are framed into the following key points: 1. Visible and accessible green elements and spaces; 2. Flexibility, adaptability, sharing, and crowding of living spaces, and compliant functions located into the buildings; 3. Re-appropriation of the basic principles and archetypes of sustainable architecture, thermal comfort and Indoor Air Quality (IAQ); 4. Water consumption and Wastewater Management; 5. Urban Solid Waste Management; 6. Housing automation and electromagnetic fields; 7. Indoor building and finishing materials. Conclusions: The Well-being and Public Health recommendations for a healthy, safe and sustainable housing may provide a useful basis for Designers, Policy Makers (fostering tax incentives for building renewal), Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform living places in healthier and Salutogenic spaces. (www.actabiomedica.it)

COVID-19 and cities. From urban health strategies to the pandemic challenge. a decalogue of public health opportunities

Contesto e scopo del lavoro. La pandemia in corso di COVID-19, che al giorno d'oggi ha superato 2,5 milioni di infezioni notificate nel mondo e circa 200.000 morti, è un forte promemoria che l'urbanizzazione ha cambiato il modo in cui persone e comunità vivono, lavorano e interagiscono, ed è necessario rendere i sistemi e le capacità locali resilienti per prevenire la diffusione di malattie infettive. Come possiamo riprogettare il concetto di sanità pubblica in relazione all'ambiente costruito e alle città contemporanee? Metodi. Secondo le dichiarazioni e lo scenario precedenti, l'obiettivo di questo documento è integrare gli obiettivi strategici di Urban Health, concentrando le possibili risposte, sia immediate che a medio-lungo termine, agli attuali aspetti ambientali, sociali ed economici del "periodo" di distanziamento fisico. Risultati. Le azioni immediate sono 01. programmare la flessibilità degli orari delle città; 02. pianificare una rete di mobilità intelligente e sostenibile; 03. definire un piano di servizi di vicinato; 04. sviluppare una digitalizzazione del contesto urbano, promuovendo le comunità intelligenti; 05. ripensare l'accessibilità ai luoghi della cultura e del turismo. Le azioni a medio lungo termine sono 06. progettare la flessibilità interna degli spazi abitativi domestici; 07. ripensare le tipologie di edifici, favorendo la presenza di spazi semi-privati ​​o collettivi; 08. rinnovare la rete dei servizi di assistenza di base; 09. integrare i piani di emergenza ambientale esistenti, con quelli relativi alle emergenze sanitarie; 10. migliorare la consapevolezza delle parti interessate sui fattori che influenzano la salute pubblica nelle città. Conclusioni. Il decalogo delle opportunità di sanità pubblica può fornire una base utile per progettisti (architetti e urbanisti), responsabili politici, esperti di sanità pubblica e agenzie sanitarie locali, nel promuovere azioni e politiche volte a trasformare le nostre città in ambienti di vita più salutari e salutogenici.Background and aim of the work. The ongoing pandemic of COVID-19, which nowadays has exceeded 2.5 million notified infections in the world and about 200,000 deaths, is a strong reminder that urbanization has changed the way that people and communities live, work, and interact, and it’s necessary to make the systems and local capacities resilient to prevent the spread of infectious diseases. How we can re-design the concept of Public Health in relation to the built environment and the contemporary cities? Methods. According to the previous statements and scenario, aim of this paper is to integrate the Urban Health strategic objectives, focusing the possible responses, both immediate and medium-long term, to the current environmental, social, and economic aspects of the ‘period’ of physical distancing. Results.Immediate Actions are 01. program the flexibility of city schedules; 02. plan a smart and sustainable mobility network; 03. define a neighborhood services’ plan; 04. develop a digitization of the urban context, promoting the smart communities; 05. re-think the accessibility to the places of culture and tourism. Medium-long term Actions are 06. design the indoor flexibility of domestic living spaces; 07. re-think building typologies, fostering the presence of semi-private or collective spaces; 08. renovate the basic care services’ network; 09. integrate the existing environmental emergency plans, with those related to the health emergencies; 10. improve stakeholders’ awareness of the factors affecting Public Health in the cities. Conclusions. The Decalogue of Public Health opportunities may provide a useful basis for Designers (Architects and Urban Planners), Policy Makers, Public Health experts and Local Health Agencies, in promoting actions and policies aimed to transform our cities in healthier and Salutogenic living environments

A proposal of hygienic and sanitary standards for the new Building Code in Italy

The traditional emphasis of Public Health on the type and quality of housing today merges with other wider determinants of health such as: the neighbourhood, the community and the "place" where a home is located, but also the policies that make access to a healthy home within everyone's reach. At the neighbourhood scale, context-related aspects heavily influence the internal quality and real usability of the buildings themselves, with particular reference to factors such as the quality of the site, the relationship between the building and the context, the presence and quality of the greenery and open spaces surrounding the building, as well as all measures that make it possible to reduce the building's impact on the environment, to protect it against environmental pollution, and to manage the building in an integrated manner for maintenance purposes. Creating healthy living environments means referring to the different dimensions mentioned above, and this not only requires the attention of Public Health operators, but also implies an integration of vision and objectives among various professional skills and competences that puts health at the center of all policies. This proposal, which starts from the analysis of existing local hygiene regulations and scientific literature, aims to take stock of a number of areas considered fundamental for the assessment of building hygiene aspects, with particular reference to the eco-sustainability of buildings and adaptation to climate change. The aspects identified can be considered as a starting point for the preparation of integrated building and hygiene regulations based on documented effective practices for the protection of Public Health

Flexibility during the covid-19 pandemic response: Healthcare facility assessment tools for resilient evaluation

Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the ex-traordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies