are major employers with a considerable role in the community, and it is important to analyze this significant industry. The environment of healthcare facilities is unique. It has multiple stakeholders on both sides, as the givers and the receivers of care. There are ill and injured individuals, their families and friends, and the employees that deliver care to them. Many of the most vulnerable individuals pass through the doors of healthcare facilities each day.

In order to provide optimal care, more research is needed to determine the impacts of the built environment on human health. The scientific evidence for embarking on a green building agenda is not complete, and at present, scientists have limited information. There is general information that pleasant places that emit low levels of chemical materials are good for the environment and good for health, but, at best, science can make only vague statements. For example, there is no guideline to determine how much use of natural daylight as a source of illumination is necessary to realize benefits. Overall, the major point that I took away from the workshop is that the scientific community needs to think strategically about its funding in this area. There is an opportunity of great promise, yet more information about the complexities involved in building a green facility is needed. A number of speakers pointed out that hospitals, which regularly collect information on patient outcomes, are ideal living laboratories to advance knowledge as the United States embarks on replacing many facilities from the early postwar era. Through implementation of controlled studies, investigators can address the research gaps and discern the complexities of building green on human health. The challenge will be to conduct meaningful research in this area that examines the interplay of the built environment and health. Finally, the workshop participants discussed research directions that will help promote an environment for overall health.

This workshop summary captures the discussions and presentations by the speakers and participants; they identified the areas in which additional research is needed, the processes by which change can occur, and the gaps in knowledge. The views expressed here do not necessarily reflect those of the Institute of Medicine, the roundtable, or their sponsors.

Paul G. Rogers, Chair

Roundtable on Environmental Health Sciences, Research, and Medicine