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This chapter documents the everyday built environment as a central determinant of infectious disease risk, arguing that contemporary buildings must be understood not merely as shelters but as dynamic socio-technical systems that actively shape exposure, transmission, and health outcomes. Drawing on interdisciplinary evidence from building physics, microbiology, epidemiology, environmental psychology, and public health, the chapter reframes infection as an architectural and engineering challenge as much as a biomedical one. It traces the historical evolution of indoor environmental thinking—from early ventilation practices motivated by miasma theory, through the energy-driven tightening of buildings that contributed to sick building syndrome (SBS), to the post–COVID-19 recognition of airborne transmission as a dominant pathway for respiratory disease. The chapter clarifies the conceptual and clinical distinctions between sick building syndrome and building-related illness (BRI), demonstrating why traditional indoor environmental quality frameworks are insufficient for addressing pathogen-specific risks such as SARS-CoV-2, tuberculosis, Legionella, and influenza. Through synthesis of contemporary aerosol science, the chapter explains the continuum of respiratory particle behavior and shows how airflow patterns, ventilation rates, humidity, filtration, and spatial configuration determine whether exhaled pathogens are diluted or accumulated. Carbon dioxide is presented as a practical proxy for rebreathed air fraction and operational risk management, while the limits of ventilation alone are acknowledged, supporting the need for layered controls including HEPA filtration, ultraviolet germicidal irradiation, and adaptive building operation. Beyond engineering, the chapter integrates research on the microbiome of the built environment, the psychosocial dimensions of indoor exposure, and the neurogenic mechanisms underlying chemical sensitivity, illustrating that occupant health arises from complex biological, physical, and perceptual interactions. Socioeconomic inequities in housing quality and infrastructure are examined as critical drivers of disproportionate disease burden, positioning building standards as instruments of public health equity. The chapter concludes by advancing the concept of the “infection-resilient environment,” advocating for performance-based design, responsive building systems, and ethical recognition of clean indoor air as a public good essential to future resilience.

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Introduction, Relationship Between Built Environment and Public Health, Sick Building Syndrome, and How Small Changes in the Built Environment Lead to Big Public Health Effects

  • 章节

  • 发表日期：

    2026年

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  • Raja Singh,
  • Nirupam Madaan,
  • Anil Dewan

摘要

This chapter documents the everyday built environment as a central determinant of infectious disease risk, arguing that contemporary buildings must be understood not merely as shelters but as dynamic socio-technical systems that actively shape exposure, transmission, and health outcomes. Drawing on interdisciplinary evidence from building physics, microbiology, epidemiology, environmental psychology, and public health, the chapter reframes infection as an architectural and engineering challenge as much as a biomedical one. It traces the historical evolution of indoor environmental thinking—from early ventilation practices motivated by miasma theory, through the energy-driven tightening of buildings that contributed to sick building syndrome (SBS), to the post–COVID-19 recognition of airborne transmission as a dominant pathway for respiratory disease. The chapter clarifies the conceptual and clinical distinctions between sick building syndrome and building-related illness (BRI), demonstrating why traditional indoor environmental quality frameworks are insufficient for addressing pathogen-specific risks such as SARS-CoV-2, tuberculosis, Legionella, and influenza. Through synthesis of contemporary aerosol science, the chapter explains the continuum of respiratory particle behavior and shows how airflow patterns, ventilation rates, humidity, filtration, and spatial configuration determine whether exhaled pathogens are diluted or accumulated. Carbon dioxide is presented as a practical proxy for rebreathed air fraction and operational risk management, while the limits of ventilation alone are acknowledged, supporting the need for layered controls including HEPA filtration, ultraviolet germicidal irradiation, and adaptive building operation. Beyond engineering, the chapter integrates research on the microbiome of the built environment, the psychosocial dimensions of indoor exposure, and the neurogenic mechanisms underlying chemical sensitivity, illustrating that occupant health arises from complex biological, physical, and perceptual interactions. Socioeconomic inequities in housing quality and infrastructure are examined as critical drivers of disproportionate disease burden, positioning building standards as instruments of public health equity. The chapter concludes by advancing the concept of the “infection-resilient environment,” advocating for performance-based design, responsive building systems, and ethical recognition of clean indoor air as a public good essential to future resilience.