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    HOSPITA

    LS

    The implementation of sustainable energy systems is an objectiveof the European Unions energy policy. This policy aims to supportand promote secure energy supplies with a high quality of serviceat competitive prices and in an environmentally compatible manner.

    The European Commission DG for Energy and Transport initiates,coordinates and manages energy saving policy actions focusing on

    energy efficiency, maintaining and enhancing security of energysupply and international co-operation. A central policy instrumentis the support and promotion of energy Research, TechnologicalDevelopment and Demonstration (RTD), principally through theENERGIE sub-programme under the European Unions FifthFramework Programme for RTD. This includes the HOSPITALSproject (EU Contract NO: NNE5-2001-00295).

    The HOSPITALS project aims to demonstrate the significantreductions that can be achieved in the total energy demand of theEuropean health care building sector. These energy demandreductions will contribute to significant reductions in CO2

    emissions.

    The hospitals project covers a range of strategies to save energy inbuildings, with a focus on hospital buildings. This brochure

    contains general information, guidelines and strategies forBioclimatic Design of HOSPITALS.

    The brochure aims to illustrate methods of obtaining large energysavings using bioclimatic design strategies from the first stage ofbuilding design.The amount of energy saved and the resulting reduction in CO2emissions are quantified. The brochure can be used by all thoseinvolved in the process of procuring and designing a health carebuilding.The primary target groups of the HOSPITALS project areadministrators, facilities managers, designers and contractors of

    health care buildings.The HOSPITALS initiative aims to demonstrate that renewableenergy technologies may be used with very positive results withinthe European health care building sector and in this way encouragethe exploitation of renewable energy.

    List of contents:

    Building Orientation and Form Building Envelope and Materials Integration of Renewable Energies Green Roofs Water

    Daylight Strategies

    BIOCLIMATIC DESIGNCONCEPTS

    H

    O

    S

    P

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    A

    L

    S

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    Objectives:

    - the reduction and control of solar radiation;- the provision of natural ventilation and natural cooling of the

    external building surfaces by evaporative cooling.

    Actions:

    - minimize the surface area of the south facing facade;- at the same time provide for natural lighting and shading;- avoid excessive solar gain during the cooling season;- use the roof as an active skin.

    It is important to consider the local

    climate during the first stage ofbuilding design.An energy conscious design whichresults in an energy efficientbuilding has to be based on thelocal climate.In a new hospital, the shape andthe orientation of the buildingshould be first defined consideringthe climate of the area, the wind,the temperature and the solarradiation.

    It should be decided which areasof the hospital need more solarexposure and which hospital areas have a high internal heat loadand need less solar exposure. The aim is the reduction of theannual energy demand.It is important to balance the various requirements. Patient comfortis clearly of paramount importance. Environmental impacts, energyconsumption and aesthetics are also important but the primary aimwhen designing a new hospital should not be reducing the energydemand to zero. Nor should the form of the building be consideredonly in terms of the aesthetic result.

    The section view of the Meyer Hospital shows that it has beendesigned partly sunk into the hill. This diminishes the impact of thebuilding on the site and contributes to energy conservation byproviding shelter so that the hospital is shielded from the prevailingwinds by the hill and the trees.

    During the design of the building effort was focused on detailedplanning and the design of the health care environment. Thepsychological effects of the environment were taken into carefulaccount. This approach was considered essential for the neonatalintensive care environment and its effect on babies, their familiesand carers.

    View of Deventer Hospital

    Section view ofMeyer Hospital

    Building orientation and form

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    Glazing and Double Skin Facade

    A building has to guarantee a thermallycomfortable indoor environment for theactivities that are conducted inside. Tooptimise thermal comfort it is necessaryto reduce the loss of thermal energythrough the building envelope.

    A Double Skin Facade is an additionalexternal skin for a building that canoptimize the indoor climate and reducethe energy demand of the building. Thebrochure Double Skin Facade Designis

    available for details.

    The building envelope of the newhospital building at FachkrankenhausNordfriesland has been designed withhigh insulation levels and with specialattention paid to the windows.There is a double skin facade withwindows which can be opened in theinner skin, parts of the outer skin orboth. The windows are designed assources for supplementary venting anddaylighting as well as visual comfort.

    Building materials have been very carefully selected, particularlythe materials exposed inside the building as these will affect theindoor air quality.The selection of building materials was based on criteria for:emissions, adsorption, surface roughness and cleaning.There will not be any PVC materials used within the building andthe use of metals is kept to a minimum.

    The innovative elements of the building envelope and materials aresummarised below:

    - Transparent insulation- Glazing with reduced U-values- Double skin facades- Selection of low-emission and

    low adsorption materials

    External view ofFachkrankenhaus

    Nordfriesland

    Internal view of FachkrankenhausNordfriesland

    Building envelope and materials

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    Wall insulation

    Energy losses are normally stated in terms of heat flow through asquare meter of wall per unit of time. The losses depend mainly onthe temperature difference between the inside and outside face ofthe wall and the thermal resistance of the material, or combinationof materials, from which the wall is made.

    Energy losses take place through conduction,convection and radiation. The main way ofreducing losses is to prevent heat conduction byadding thermal insulation to the envelope.

    Cavity insulation: This is an inexpensive way

    of insulating a wall but it can only be used when acavity wall is present. Retrospective insulation ofthe cavity can occasionally create problems.Inspection of the walls is recommended before adecision is made to insulate a cavity.Retrospective insulation of a cavity wall can bedone by injecting expanded clay granules, mineralwool flakes or polystyrene beads through a holeinto the cavity.

    External insulation: This changes theappearance of the exterior considerably. A single,thick insulation layer can be applied, which makes

    it possible to achieve any desired insulation value.The main advantage is that cold bridges can beeasily removed and prevented.

    Internal insulation: This is fitted on the insideof the walls of a building. The size of the rooms is, of course,reduced by internal insulation. Inside insulation can give goodresults when it is carefully executed in order to preventcondensation caused by cold bridges.

    Building envelope and materials

    100 mm exterior insulation used for Torun Hospital.

    wo options for insulating the walls ofards at the Meyer Hospital have beentudied.he two drawings above show theptions with different thicknesses ofavity wall insulation.

    he thicker insulation reduces thenergy required for heating resulting inn annual energy saving of about 12%.

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    Environmentally friendly insulation materials

    Conventional insulation materials provide good levels of insulationbut may create environmental problems including:

    consumption of limited natural resources e.g. petrochemicalbased materials

    high embodied energy, particularly during their manufacture health problems during installation, e.g. irritating fibres health problems once the insulation has been completed, e.g.

    fibre migration, off-gassing, microbial contamination anddegradation

    disposal problems due to synthetic and toxic ingredients

    Environmentally friendly materials usually have fewer negativeimpacts on the environment.

    natural insulation materials are made from renewable plant oranimal sources, minimizing the impact on the environment due toconsumption of raw materials

    low embodied energy - manufacturing processes are simpleusing litt le energy

    there are no health problems during installation natural insulation materials are fully biodegradable microbial contamination and / or degradation may lead to health

    problems

    NOTE: Health risks may exist with both conventional andenvironmentally friendly materials when they are not installed andused properly.

    Key Points

    - For a new hospital design: simulate the thermal behaviour of the building to define the optimuminsulation thickness and type. The best position for the insulation material is in a cavity wall.

    - In a refurbishment, insulate internal surfaces (the depth of the room is reduced); External insulation willchange the appearance of the building considerably.

    - Insulation material placed on the external surfaces of the walls should be well protected from rainwater.

    - It should be remembered that thermal bridges can significantly reduce the efficiency of the insulationused.

    Cellulose Fibres

    Rock Wool

    Installation of wall insulationTable: comparing different materials for thermal conductivity. The table alsoindicates whether there are emissions of toxins or acid rain during manufacture ofthe insulation and the quantity of energy required for manufacture.Legend: 1 = low; 2 = medium; 3 = high; 4 = very high.

    Thermal Production Use

    M aterial conductivity Toxins Acid rain Energy use Recycleability Health Risks

    (W/m K)

    Rock Wool 0.03-0.04 3 2 2 2 2

    Glass Wool 0.032-0.04 3 2 2 2 2

    Polystyrene Foam 0.033-0.035 4 3 4 1

    Phenolic Foam 0.036 4 3 4 3

    Wool 0.037 0 0 1

    Cellulose Fibres 0.037 0 0 1

    Urea-formaldehyde Foam 0.038 4 3 4 4

    Corkboard 0.040 0 0 1 1

    Vermiculite (expanded) 0.047-0.058 0 0 2

    Foamed Glass 0.050-0.052 2 2 3

    Softboard 0.055 0 0 1 1Wood-wool Slabs 0.093 1 1 4 1

    Compressed Straw Slabs 0.101 0 0 1 1

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    Integration of Renewable Energies

    xamples of PV systems used as ahading device for an office buildingabove) integrated into a vertical surfacet Fraunhofer ISE Freiburg (below) andstalled into an atrium, at the Universityf Florence, Italy (bottom)

    Above: Meyer Hospital. The surface of the sunspace will incorporate a semitrans-parent PV system with a rated capacity of 31 kWp of renewable energy.The Meyers sunspace is orientated to the south with unobstructed solar accessto the main glazing in order to maximize the collection of winter sunshine.

    The design objectives consider not only the energy and environmental aspects butalso the social impacts: the primary objective is to create a pleasant socializingspace which can be used for semi-outdoor activities through much of the yearwithout requiring any extra energy. This social space is well integrated with theadjacent green park. The PV installation was financed by the Ministry ofEnvironment after a public and national (Italian) competition called PV in the Roof:High Architectural Integration

    Buildings consume over half the energy used globally and produceover half of all greenhouse and ozone depleting gasses. Today,

    there is a widespread understanding that we are over-using theearths limited resources and producing unacceptable levels of CO2in order to provide energy.Use of Renewable Energies is an expensive alternative at themoment but the number of examples of low energy buildings isgrowing in Europe also thanks to the financial support of EUCommission programs.

    Photovoltaic (PV) cells

    PV-cells convert sunlight directly into electricity. The cells are madeof semiconductor materials such as crystalline silicon.Photovoltaics can provide tiny amounts of power for e.g. watchesor large amounts for the electric grid, as well as any required powerlevel in between.PV systems integrated into building facades allow energyproduction to be combined with other functions of the buildingenvelope, such as shading, weather shielding or heat production.Substantial cost savings can be made through combining thesefunctions, e.g. in expensive facade systems where the claddingcosts may equal the costs of the PV modules. Additionally nohighvalue land is required and no separate support structure isnecessary. Electricity is generated at the point of use. This avoidstransmission and distribution losses and reduces the utilitycompanys capital and maintenance costs.

    Building integration does not just mean mounting PV modules on abuilding.Real integration can involve much more; it includes all the steps inthe process of new construction or retrofitting a building, startingfrom planning the production of the construction materials throughto operation and recycling.Multiple integration is perhaps the most appropriate expression.

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    Solar Collectors at Aabenraa Hospital

    Left: FachkrankenhausNordfrieslandThe large ceilingsurface has a shallownorth facing slope;

    here a white curtainis used to reduce solarradiation. On the southfacing steeply slopingroof section, poly-crystalline PV modulesare integrated into theglazing to act as solarshading while gene-rating electricity.

    Buliding integration of solar energy technologies

    The design of high-performance buildings involves combininggood design with energy efficiency and solar technologies toreduce energy consumption.

    Solar technologies tap directly into the infinite power of the sun anduse that energy to heat, light, and power buildings. Solartechnology combines building design and energy efficienttechnologies with solar thermal panels for heating water or solarelectric panels (photovoltaics) for powering electrical items such asappliances, lights and computers.

    Solar water-heating systems

    Solar water-heating systems use solar collectors, generallymounted on a south-facing roof, to heat either water or non-toxicantifreeze that is circulated from the collector to water storagetanks. The water storage tanks are similar to those used in aconventional gas or electric water heating system.

    At Aabenraa hospital three solar collector systems wereimplemented, one for each of the ward sections, B and C and onefor the surgical section K. All the systems were roof mounted. Forarchitectural reasons and in order to avoid glare the solar collectorswere mounted so that they were not visible from outside thebuilding. Two different system types were considered: a drain back

    system and a standard system with anti-freeze liquid. Bothsystems have advantages and disadvantages, which wereevaluated in order to identify the most attractive system. Thestandard system with anti-freeze liquid was chosen, because thisallowed the existing hot water tanks to be used rather thanreplaced as would have been required for adrain back system.Special attention was given to the risk oflegionella bacteria. Risks were minimised byusing an electrical backup system to ensurethat the high water temperatures required foravoiding legionella growth were always

    achieved.Each system includes approximately 50 m2

    solar collectors, which provides an annualenergy yield of about 27 MWh per system.This provides about 60% of the annual energyrequirement for water heating.

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    To reduce heat losses it is necessary to insulate all opaqueelements in a building, including the roof.

    A greenroof can insulate a roof and at the same time help to protectthe environment by diminishing the environmental impact of thebuilding. Green roofs can provide a fresh architectural approachwith visually appealing organic architecture.It is assumed that a good environment has a positive influence onthe recovery of patients. Hospital buildings should therefore beconsidered as a part of the treatment of patients.Selecting building materials with low levels of emissions such asgreen roofs can lead to an improved indoor climate, which willbenefit the patients.

    Notes

    - When refurbishing a flat roof which issuffering from water infiltration, careshould be taken to ensure that theinsulation material is replaced with asufficient gradient.

    - It should be remembered that theadvantage of pitched roofs is thatrainwater flows off easily; they thereforerequire less waterproofing than flatroofs.

    - A flat green-roof may be used as agarden by patients, and is recommen-ded as an environmental benefit.

    - Avoiding the use of traditional roofconstruction materials reduces thematerials that have to be transported:

    transport of materials accounts for a high proportion of carbondioxide emissions;

    - the choice of an environmentally friendly material as an insulationmaterial usually has an extra-cost. It is important to evaluate the

    extra cost and the pay-back period and relate this to reductions incarbon dioxide emissions.

    Green Roofs

    green terrace solution is planned forhe Meyer Hospital. The final design,ith increased amounts of insulation

    material in the cavity walls and a greenoof - reduces the annual energy de-

    mand for heating by 36% per patientoom.

    Section of the greenroof used at Meyer Hospital

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    The rational use of water is an important issue for saving waterresources. It has to be taken into account from the first stage of the

    design.

    Collected rain water can contribute to maximizing the thermalcomfort during the summer season when used in external spacesor atria to provide water to fountains, ponds and pools. Thesearchitectural elements are able to mitigate and influencemicroclimate and provide patients with a relaxing area and view.

    How does water influence the microclimate?Evaporation occurs whenever the vapour pressure of water ishigher than the partial pressure of the water vapour in the adjacentatmosphere.The evaporation of water from liquid to vapour is accompanied bythe absorption of a large quantity of sensible heat from the air thatlowers the dry bulb temperature of the air while the moisturecontent of the air is increased.The efficiency of the evaporation processdepends on the temperatures of the airand water, the vapour content of the airand the rate of airflow past the watersurface.

    The main disadvantage of a pond or afountain is the increased moisturecontent in the ventilation air supplied to

    the indoor spaces.

    Psychological aspects are very important for hospital patients.Patients need a friendly place to recover from sickness.

    The building, plusthe specializedmedical team andthe environment,is an importantpart of that place.Plants and waterin the buildingsand external are-as give patients

    contact with na-ture, providing arelaxing hospitalenvironment inwhich to recover.

    Water

    On this page:

    Lake and pond in FachkrankenhausNordfriesland

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    An energy conscious building aims to optimise the use of passivesolar energy, natural ventilation and natural light to create a

    comfortable and energy efficient working environment.

    The use of daylight for interior illumination can reduce energy usewithin buildings and has a positive effect on visual comfort.

    If considered at the design stage, the use of daylight allows for asignificant reduction in electricity used for lighting and can reducethe overall energy consumption. Daylighting depends on theavailability of daylight, location, size and orientation of windows.

    Several strategies can be used to achive visual comfort when usingdaylight including: Rooflights, Atria, Glazing, Transparent Insu-lation, Lightpipes and Lightducts, Shading.

    Integration of rooflights

    Integration of rooflights is an effective daylighting strategy. The skyis generally brighter at its zenith than near the horizon: this is thereason why horizontal rooflights admit more daylight per squaremetre of glazed area than vertical windows (three times more thana vertical window).

    Daylight Strategies

    Illustrations showing the daylight distribution in two rooms facing theglazed courtyard at Aabenraa Hospital: The daylight levels were notreduced by the glazing of the courtyard; on the contrary the daylightlevels and distribution were improved after glazing the courtyard. Theuse of energy for lighting during daytime is expected to be reduced byapproximately 50% compared to a conventional design.

    hading devices at Aabenraa Hospital. Daylight strategies (roof windows)used in the atria at Aabenraa Hospital.

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    Sunpipes

    Sunpipes are among the more mechanically complexdaylighting devices.

    Sunlight is collected by heliostats (mirrors controlledby a tracking device), concentrated by mirrors orlenses, then directed inside the building throughshafts or fibre optic cables.

    Sunpipes depend on direct sunlight and are relativelyexpensive to install: for these reasons they will becost-effective only in regions where blue skies andclean air can be guaranteed for most of the year.

    Shading

    The type, size and positioning of any shadingdevice will depend on climate, building use,and the source of the light to be excluded(direct sunlight, diffuse sky light, or perhapsreflected light from outside).

    Left and above: pictures of the sun pipesused at Meyer Hospital for daylighting.Sun pipes were installed to give goodluminance levels in each patients room.Each room accommodates two patients

    and has two windows, one looks outsideand is day lit, the other is illuminated bysun pipes.At first sight the sun pipe installation givesthe impression of being lamp lit.

    Shading system atFachkrankenhausNordfriesland Hospital

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    The five hospital sites are:

    AABENRAA HOSPITAL, DENMARKLiane Timm Schwarz, The County of South JutlandEsbensen Consultants A/S (Energy consultant)S&I Architects A/S (Architect)

    TORUN CITY HOSPITAL, POLANDKrystyna Zaleska, Roman NadolnySpecjalistyczny Szpital Miejski, im. M. Kopernika w Toruniuul. Batorego 17/1987-100 Torun, PolandTel. +48 56 610 0324e-mail: [email protected]

    MEYER CHILDRENs HOSPITAL, ITALYRenato Colombovia Luca Giordano, 7 MI-50132 Firenze, ItalyTel.: +39 055 5662319e-mail: [email protected] Sala Associates (Energy consultant)

    CSPE (Architects)

    FACHKRANKENHAUS NORDFRIESLAND, GERMANYSnke Thiesen / Eberhard SchwarzKrankenhausweg 3DE-25821 Bredstedt, GermanyTel.: +49 4671 90 4-0e-mail: [email protected] Consultants A/S (Energy consultant)Detlefsen + Lundelius (Architect)

    DEVENTER HOSPITAL, THE NETHERLANDSCees van MilPO Box 5001, Ceintuurbaan 6NL-7400 GC Deventer, The Netherlands

    Tel.: +31 570 64 6528e-mail: [email protected]

    DMINISTRATIVE AND FINANCIALOORDINATORane Timm Schwarz,

    he County of South Jutlandkelbkvej 2K-6200 Aabenraa, Denmarkel.: +45 74 33 50 50mail : [email protected]

    CIENTIFIC AND TECHNICAL COORDINATOR

    laf Bruun Jrgensen, Esbensen Consultants A/Sarl Jacobsens Vej 25 D500 Valby, Denmarkel.: +45 33 26 73 02mail : o.b. [email protected]

    P1 INTEGRATED DESIGN PROCESSlaf Bruun Jrgensen, Esbensen Consultants A/S

    P2 EUROPEAN DESIGN WORKSHOPSlaf Bruun Jrgensen, Esbensen Consultants A/S

    ert Johannesen, S&I Architects A/Suchwaldsgade 35K-5000 Odense C, Denmarkel.: +45 66 11 59 11mail:[email protected]

    hiel Boonstra, DHV Building and IndustryO. Box 80007, NL-5600 JZ, Eindhovenhe Netherlandsel.: +31 40 250 9216mail : [email protected]

    arco Sala, Marco Sala Associatesa Pippo Spano 15

    50129 Firenze, Italyel.: +39 055 5048394mail : [email protected] t

    P3 MONITORING AND EVALUATIONhristel Russ,raunhofer Institut for Solare Energy Systemseidenhofstr. 2, DE-79110 Freiburgel.: +49 761 458 8512mail: [email protected]

    ww.ise.fhg.de

    P4 FACILITIES MANAGEMENTPHYSICAL WORKING CONDITIONSees van Mil, Deventer Hospitalhiel Boonstra, DHV Building and Industryberhard Schwarz,achkrankenhaus Nordfriesland

    P5 DISSEMINATIONlaf Bruun Jrgensen, Esbensen Consultants A/Senato Colombo, MEYER Children Hospitaloman Nadolny, Torun City Hospital

    upporting Organizationuropean Commission Directorate -eneral for Energy and TransportU Contract. No.: NNE5-2001-00295

    inted by Ihle Grafisk Produktion A/S

    rights reserved.o part of this publication may be reproduced in any form or

    any means, without permission from the publisher.

    Information about The Fifth Framework Programme is available at the following website:http://cordis/lu/fp5/home.htmlFuther information on DG for Energy and Transport act ivities is available at the internetwebsite address: http://europa.eu.int/comm/energy/res/index_en.htm

    The HOSPITALS internet website address is http://www.eu-hospitals.net