Primum non nocere when translated states first, do no harm. This is a fundamental medical precept and is absolutely essential to create a trusted relationship between a physician and patient. It is a hallowed expression of hope, intention, humility and recognition that human acts with good intentions may have unwanted consequences. It is a reminder to the physician that he must consider the possible harm that any intervention might cause. In the built environment, it has been our experience that the best intentions often overlook both unwanted and unanticipated consequences. As such, occupant fears and health-concerns often arise and create a situation where their trust disappears and as a result, business operations may become jeopardized. When this occurs, we have found that the only way to re-establish trust with the building occupants is through the introduction of an independent, credible, and believable environmental advocate. BHS is regularly engaged to fill this role of environmental advocate for the protection and re-assurance of occupants’ safety and health through medically-based enterprise risk management. By applying these principles, we are able to help our clients subdue the crisis, achieve their desired results, prevent a loss of resources, avoid reputational damage, and mitigate adverse consequences.
In the role of Environmental Advocate, BHS’ physician collaborates with our building science and construction professionals on the activities and building dynamics which triggered the crisis and issue(s) of concern. This integrated understanding of the situation permits BHS to administer effective and credible risk communication related to the occupants’ specific concerns; thus permitting BHS to resolve the crisis based on relevant medical and scientific literature, and integrated with factual information and assessments of the building’s role in the issue.
In one instance, the occupants of buildings at the National Security Agency (NSA) were sufficiently concerned that the built environment was harmful to their health that a Congressional mandate was issued for environmental advocacy services of a physician-led team. The purpose was to determine if a group of government buildings’ indoor environmental and/or other work-related conditions were adversely affecting some employees, manifested as either health symptoms, illnesses, and / or impaired performance. Among other activities, 57,000 environmental data points were collected in 71 study areas within 12 buildings. Data were derived from three sources: (1) an epidemiological questionnaire; (2) extensive indoor environmental and air quality sampling; and (3) individual Health Hazard Evaluations of volunteers and workplace testing. In the final report, as independent, credible environmental advocates, we were able to utilize our health-based approach to resolve the occupants’ concerns and dispel their fears based on factual findings. See additional details in the article entitled Indoor Environmental and Air Quality Characteristics, Building-Related Health Symptoms, and Worker Productivity in a Federal Government Building Complex, Published: 2014-09-25, in the Archives of Environmental & Occupational Health.
At a major institution’s headquarters building, BHS was sought out and engaged in the role of Environmental Advocate with the confidence and support of staff. The scope was to provide health and building science oversight of all asbestos and hazardous materials abatement activities during the life of the modernization renovation. Our ability to have our physician address occupant health concerns coupled with our building scientists addressing the scientific principles behind the engineering controls protecting the occupants, we were able to gain the trust of the staff that with vigilant oversight we would be able to ensure their health and safety. Additionally, we were asked by management to make additional health and safety recommendations that were over and above the asbestos regulatory requirements. Moreover, the staff concerns were so elevated that BHS was responsible for reviewing the daily asbestos sampling results for work performed overnight and providing a building “All Clear” notice to staff via the agency’s intranet by 6:00 AM each morning. As a result, the large number of staff that threatened to work remotely during the renovation remained in the building with no disruption to operations.
At a large, historic government office building, housing approximately 420 employees, an occupied renovation project that included the abatement of hazardous materials, including asbestos, prompted occupants to express health-risk concerns. Additionally, the employess expressed a lack of trust in the remediation contractor based on their “internet-research” of proposed engineering protocols to contain asbestos-related activities. An employee advocacy panel was created by management and BHS was selected for the role of environmental advocate to assist the employees in understanding the principles behind engineering controls that would prevent exposure to any harmful agents in addition to our physician addressing their health concerns. In working with employee advocacy panel, BHS developed a sampling protocol in the employee occupied areas, which was completely isolated from the construction areas, in order to provide assurance that there was no adverse exposure to any hazardous materials during the time when remediation activities were underway. In certain instances, and due to unforeseen conditions, more intense, daily involvement and crisis management were required.
In the role of environmental advocate, our clinical medicine approach combined with years of experience in learning and understanding building dynamics enables us to confidently address the health and safety concerns of building occupants.