This insightful article by Preeti Tarkar, published in Materials Today: Proceedings in 2022, delves into the crucial concept of “Green Hospitals” within the broader framework of sustainable construction. The study addresses the escalating concerns surrounding resource degradation and increasing pollution, which pose significant challenges to global sustainability. It particularly focuses on the building sector, which accounts for a substantial 40-45% of energy consumption in modern cities and is a primary generator of Green House Gases (GHG). Given the healthcare sector’s rapid growth and its continuous, 24/7 operations requiring constant electricity, hospitals are identified as major consumers of energy and natural resources, producing 2.5 times more carbon emissions than commercial buildings.
Purpose and Significance: The primary purpose of this research is to highlight the importance of sustainable construction and operations within the healthcare sector. It aims to define the concept of a “Green Hospital,” discuss various rating systems for green buildings in India and globally, and outline the benefits of green manufacturing in hospitals. Crucially, the study also examines the role of green hospitals in energy conservation within the Indian context and discusses environmental degradation and energy consumption. The application of green building principles in healthcare is underscored as vital for sustainable growth, addressing critical national issues such as biomedical waste treatment, energy efficiency, water efficiency, and the reduction of fossil fuel use. Furthermore, implementing green concepts in hospitals is shown to enhance patient well-being, health, and recovery.
Defining Green Hospitals: The article presents several definitions for green hospitals. The Office of Federal Environmental Executive defines sustainable and green buildings as those that increase efficiency in energy, water, and material use across their complete life cycle, while reducing environmental impacts on human health. Similarly, Karliner and Guenther define a green and healthy hospital as one that promotes public health by continuously reducing its environmental impact, striving to eliminate its contribution to the burden of disease. This is achieved by recognizing the link between human health and the environment through its governance, strategy, and operations, and by engaging in efforts to foster community environmental health, health equity, and a green economy.
Key Features of Green Hospitals: The paper elaborates on several features that characterize green hospitals:
- Energy Conservation: Hospitals are significant electricity consumers, requiring energy for humidity and temperature regulation, water heating, ventilation, and clinical processes. Green hospitals emphasize the use of renewable energy sources like solar, wind, geothermal heat, organic matter, and water flows, which improve access to basic health services while significantly reducing high operational costs and GHG emissions.
- Green Building Design: Sustainable design practices include using regional and local building materials, ensuring accessibility via public transportation, incorporating natural ventilation, planting trees on-site, and utilizing features like water harvesting, alternative energy, natural lighting, and green roofs.
- Waste Management: Green hospitals implement sustainable practices to reduce both biomedical and non-biomedical waste and emissions. This involves applying ecological techniques such as “reduce, recycle, and reuse,” improving purchasing practices (e.g., environmentally preferred products), avoiding unnecessary packaging, and minimizing waste transport. An example cited is the Embassy Medical Centre Colombo, which converts sewage waste into carbon-neutral renewable energy using a high-temperature thermophilic anaerobic digester.
- Water Conservation: Hospitals consume large amounts of water. Green hospitals employ techniques like reusing recycled water for non-drinking purposes and collecting rainwater through harvesting systems. The Sambhavna Trust Clinic in Bhopal, India, is highlighted for its rainwater harvesting system that fulfills water demand during dry periods.
- Green Techniques: These techniques are based on the “four R’s: reduce, reuse, recycle, and renewable”. This includes minimizing the use of natural resources and embodied energy in building materials, reusing structurally sound construction materials, utilizing recycled materials, and focusing on renewable energy sources like solar energy and natural light. The preference for LED lamps over CFLs is also noted due to their lack of toxic substances and longer lifespan.
Benefits of Green Hospitals: Green hospitals offer both tangible and intangible benefits:
- Economic (Tangible) Benefits: Significant reductions in water and energy bills are observed, with green hospitals potentially reducing water usage by 20-30% and energy consumption by approximately 30-40%.
- Environmental (Intangible) Benefits: These include pollution control, leading to improved water and air quality, and the protection of ecosystems and biodiversity.
- Social (Intangible) Benefits: Green hospitals enhance the quality of life and comfort for occupants, contributing to improved hygiene and health, faster patient recovery, and potentially reducing employee absenteeism due to better aesthetic qualities and natural connectivity.
Green Rating Systems: The article details various green building rating systems, both globally and specifically in India, which address aspects like sanitation, indoor environmental quality, water conservation, site selection, energy efficiency, and building materials.
- In India:
- Green Rating for Integrated Habitat Assessment (GRIHA): Developed jointly by the Ministry of New and Renewable Energy and TERI, this is India’s own star rating system for buildings, with 34 criteria. SVAGRIHA is a simplified version for smaller buildings.
- Indian Green Building Council (IGBC): Spearheaded the green building movement in India in 2001. It has developed the IGBC Green Healthcare Facilities Rating System, designed for various healthcare facilities, offering four certification levels (Certified, Silver, Gold, Platinum) based on points accrued from six dimensions.
- Bureau of Energy Efficiency (BEE): Star Rating: Established by the Government of India in 2002, BEE launched the Energy Conservation Building Code (ECBC) in 2007. It also developed a 1-to-5-star rating system for energy-efficient buildings, including hospitals, based on their actual specific energy usage.
- ASSOCHAM: GEM Rating: This program promotes sustainable and environmentally friendly buildings, aligning with BEE ECBC and NBC 2016, providing sustainability certifications to various establishments, including urban developments and hospitals.
Several green hospitals are already operational in India, with examples including Kohinoor City Hospital, Max Balaji Hospital, and Aster Medicity Hospital.
Constraints to Creating Green Hospitals: Despite the numerous benefits, the article identifies significant barriers to the widespread adoption of green hospitals:
- Accreditation and Licensing: Difficulty in meeting existing accreditation and licensing body conditions alongside environmentally sound choices.
- Regulatory Compliance: Challenges in complying with various safety, health, and building codes.
- Continuous Operations: Hospitals’ 24/7 nature and the need for uninterrupted healthcare facilities require redundant backup systems, making sustainable practices more complex.
- Infection Control Protocols: Rigid infection control protocols often conflict with sustainable practices, particularly regarding the use of toxic chemicals and high ventilation rates.
- Waste Management: The significant amount of biomedical waste generated (approx. 0.5 kg per bed per day) poses a dumping challenge for sustainability.
- High Consumption: Hospitals consume 210% more electricity per square foot than other commercial buildings and large amounts of water (80-150 gallons per bed per day).
- Short Interior Lifespan: The interior structure of hospitals requires frequent renovations, impacting the life cycle of the building and sustainability efforts.
- Lack of Customer Demand and Legislation: A lack of consumer demand and the absence of mandatory legislation in India, coupled with the higher initial investment compared to non-green buildings, also act as barriers.
Conclusion: In conclusion, the article posits that green buildings are a necessity for today’s environment to promote and ensure sustainability. While green hospitals offer substantial environmental, economic, and social benefits, they face various constraints and challenges. Nevertheless, the concept of a green hospital is a tangible reality being increasingly emulated worldwide, including in India.
APA Reference:
Tarkar, P. (2022). Role of green hospitals in sustainable construction: Benefits, rating systems and constraints. Materials Today: Proceedings, 60, 247–252. https://doi.org/10.1016/j.matpr.2021.12.511
