Starting from a previous experience carried out by the working group “Building and Environmental Hygiene” of the Italian Society of Hygiene and Preventive Medicine (SItI), the aim of the present work is to define new strategic goals for achieving a “Healthy and Salutogenic City”, which will be useful to designers, local governments and public bodies, policy makers, and all professionals working at local health agencies. Ten key points have been formulated: 1. climate change and management of adverse weather events; 2. land consumption, sprawl, and shrinking cities; 3. tactical urbanism and urban resilience; 4. urban comfort, safety, and security perception; 5. strengths and weaknesses of urban green areas and infrastructures; 6. urban solid waste management; 7. housing emergencies in relation to socio-economic and environmental changes; 8. energy aspects and environmental planning at an urban scale; 9. socio-assistance and welfare network at an urban scale: importance of a rational and widespread system; and 10. new forms of living, conscious of coparticipation models and aware of sharing quality objectives. Design strategies, actions, and policies, identified to improve public health and wellbeing, underline that the connection between morphological and functional features of urban context and public health is crucial for contemporary cities and modern societies.

Postoperative infections are a concern, especially in total knee and total hip arthroplasty. We evaluated the air quality in orthopaedic operating theatres in southeastern Italy to determine the level of bacterial contamination as a risk factor for postoperative infection. Thirty-five hospitals with operating theatres focused on total knee and total hip arthroplasty participated. We sampled the air passively and actively before surgeries began for the day (at rest) and 15 min after the surgical incision (in operation). We evaluated bacterial counts, particle size, mixed vs turbulent airflow systems, the number of doors, number of door openings during procedures and number of people in the operating theatre. We found no bacterial contamination at rest for all sampling methods, and significantly different contamination levels at rest vs in operation. We found no association between the number of people in the surgical team and bacteria counts for both mixed and turbulent airflow systems, and low bacterial loads, even when doors were always open. Overall, the air quality sampling method and type of ventilation system did not affect air quality.

Planning for preparedness, in terms of multi-hazard disasters, involves testing the relevant abilities to mitigate damage and build resilience, through the assessment of deterministic disaster scenarios. Among risk-prone assets, open spaces (OSs) play a significant role in the characterization of the built environment (BE) and represent the relevant urban portion on which to develop multi-risk scenarios. The aim of this paper is to elaborate ideal scenarios—namely, Built Environment Typologies (BETs)—for simulation-based risk assessment actions, considering the safety and resilience of BEs in emergency conditions. The investigation is conducted through the GIS data collection of the common characteristics of OSs (i.e., squares), identified through five parameters considered significant in the scientific literature. These data were processed through a non-hierarchical cluster analysis. The results of the cluster analysis identified five groups of OSs, characterized by specific morphological, functional, and physical characteristics. Combining the outcomes of the cluster analysis with a critical analysis, nine final BETs were identified. The resulting BETs were linked to characteristic risk combinations, according to the analysed parameters. Thus, the multi-risk scenarios identified through the statistical analysis lay the basis for future risk assessments of BEs, based on the peculiar characteristics of Italian towns.

The profound qualitative changes of indoor air and the progressive increase in the absolute number of pollutants, combined with the scientific awareness of the health impacts deriving from spending more than 90% of one’s time inside confined spaces, have increased the attention onto the needs of well-being, hygiene, and the health of users. This scientific attention has produced studies and analyses useful for evidence-based insights into building performance. Among the main pollutants in the indoor environment, Volatile Organic Compounds (VOCs) play a central role, and the use of box-models using the mass balance approach and Computational Fluid Dynamics (CFD) models are now consolidated to study their concentrations in an indoor environment. This paper presents the use of both types of modelling for the prediction of the VOC concentration in the indoor environment and the proposal of a guide value for the Indoor Air Quality (IAQ)-oriented building design, specifically related to the indoor VOC concentration due to building materials. Methodologically, the topic is addressed through environmental sampling, the definition of the parameters necessary for the numerical models, the simulations with the box-model and the CFD, and the comparison between the results. They show a good correspondence between the modelling tools used, highlighting the central role of ventilation and allowing a discussion of the relationship between regulatory limits of emissivity of materials and Indoor Air Guide Values for the concentration of pollutants.

The relationship between users and the built environment represents a fundamental aspect of health. The factors that define the properties linked to health and well-being are increasingly becoming part of building design. In these terms, building information modelling (BIM) and BIM-based performance simulation take on a priority role. Among the key features for the design of Healthy Buildings, indoor air quality (IAQ) plays a central role. There are numerous indoor pollutants with significant health effects; volatile organic compounds (VOCs) are to be mentioned among these. The paper presents the proposal of an integrated workflow in the BIM process for the check and control of VOC emissions from building materials and their concentration in confined environments. The workflow is developed through the systematisation of IAQ parameters for the open BIM standard, the integration in the BIM process of a numerical model for the prediction of the VOCs concentration in the indoor environment, and the development of model checkers for performance verification. The results show a good adhesion between the numerical model and the implementation in BIM, providing the designer with a rapid control instrument of IAQ in the various phases of the building design. The present study is the first development focused on TVOC, but implementable concerning other aspects of IAQ, as needed for the effectiveness of performance building-based design for health and wellness issues.

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A validated method for the digital representation of historic construction through HBIM permits assessment of compliance with workmanlike practices and structural performance. The construction of an appropriate model is closely linked to survey methodology, to the integrated application of multiple techniques of direct and indirect survey and non-destructive tests. The paper specifically deals with the complementarity between photogrammetry based on UAV (Unmanned Aerial Vehicles) with TLS (Terrestrial Laser Scanner). Finally, through this methodology, the HBIM model set for structural use allows the analysis of local mechanisms in order to verify the performance of the building. The methodological approach to the relationship between constructive survey and construction of the HBIM model to understand and evaluate the building organism from a structural point of view is exposed using Villa Palma-Guazzaroni in Terni as a case study. The Villa is representative of architectural heritage resulting from an original unitary intervention and subsequently affected by several modifications that, without obscuring many of the original values, have nevertheless altered the building and its architectural characteristics.

This work focuses on the economic implications of the relationship between life expectancy, the number of years lost to disability and per-capita total health expenditure. The primary goal of the paper is to identify and plot the correlation between healthcare expenditure and the global increase in life expectancy, in order to assess if, and how, the way longer average lifespans are achieved affects healthcare sustainability. Datasets regarding the United States, the European Union and the five largest emerging healthcare systems (i.e., Brazil, the Russian Federation, India, China and South Africa) were obtained from the Institute for Health Metrics and Evaluation and the WHO Health Expenditure Statistics Repository. All analysis was performed on 2017 data. The results of the analysis showed the number of years lost to disability to be a linear function of life expectancy at birth (male R2 = 0.61; female R2 = 0.47), and per-capita total health expenditure to be an exponential function of the number of years lost to disability (male R2 = 0.60; female R2 = 0.65). This implies that improving life expectancy via social policies bears negative consequences in terms of healthcare sustainability, unless the number of years lost to disability is reduced too. Further studies should narrow the sample of countries and causes of years lost due to disability, to better inform future policy efforts.