UChicago Aims to Avoid Chemicals of Concern in New Cancer Center

The early stages of designing a new facility are filled with hundreds of decisions for the health care institution. These range from room sizes and standards to programmatic elements, such as the number and types of spaces needed to foster clinical collaboration. Health systems also must choose furniture, carpet, paint, and other interior materials.

Many factors shape these decisions: budget, schedule, availability, brand standards, and more. Association corporate affiliate member CannonDesign is helping organizations create healthier buildings and boost health outcomes for patients and staff through sustainable and nontoxic material choices.

CannonDesign partnered with association member University of Chicago Medicine (UCM), in Chicago, to build the health system's AbbVie Foundation Cancer Pavilion. This facility, set to open in 2027, will unify more than 200 cancer experts from across the health system. It also aims to close gaps in cancer education, prevention, and screening on the city's South Side, where cancer is the second leading cause of death. The pavilion is designed to serve a wide spectrum of patient, clinician, research, and community needs by radically enhancing the patient experience; driving the academic health system's culture through immersive collaboration; and responding to future shifts in technology, diagnostics, and treatment.

UChicago started the project by exploring a harsh reality of any cancer center: that everyone coming to the Cancer Center is terrified. They are either about to receive a diagnosis that could change their life or undergo treatment that could save their life. If everyone coming to the Cancer Center is terrified, the team asked: Could this facility be part of the treatment? Could we design a place that integrated healing and curing into the building itself?

During the early stages of design, in 2022, CannonDesign leaders posed the question: "What if we didn't put any cancer-causing chemicals in the cancer center?" This set off complex and thoughtful conversations that prompted decision-makers to look more closely at what would make up their new facility.

Most Interior Materials Contain Carcinogens

During the construction of a typical hospital, there are approximately 55 chemicals of concern commonly found in walls, floors, ceilings, and furniture. In health care facilities, over 75% of interior carcinogens are found in five common materials: wall coverings, paints, solvents, carpeting, and vinyl flooring. Decisions regarding these materials are essential, especially considering these chemicals:

• Formaldehyde: This chemical is found in certain glues and adhesives and as a preservative in some paints and coating products. It also can be found in certain pressed wood materials, such as particleboard.
• Perfluorinated compounds (PFCs): PFCs make materials stick- and stain-resistant, and are particularly common on furniture, carpet, and clothing.
• Phthalates: This group of chemicals makes certain types of plastic more flexible. Phthalates can be found in everything from carpet backing to vinyl flooring, wall coverings, and upholstery textiles.

The installation of these materials and chemicals creates concentrations up to 1,000 times higher than recommended levels, raising concerns about indoor air quality and patient health.

A Little Material Research Goes a Long Way

We now have more research and knowledge than ever about the materials used in our everyday lives that contain known carcinogens. Thanks to years of collaboration among architects, designers, and manufacturers, we can source, track, and specify healthy materials that avoid these carcinogens and other chemicals of concern.

The challenge is not in finding healthy alternatives-there are flooring options made without formaldehyde and nontoxic furniture brands. The real challenge is overcoming unfamiliarity with the alternatives and negative perceptions about their cost, durability, and other factors.

While the thought of eliminating every single chemical can feel overwhelming, we start with 12 product categories on our "Building Materials Watchlist." By triaging the approach to healthy materials, we can prioritize and target select health outcomes.

Then, we provide large samples for clients to install temporarily in their existing facilities to test with their maintenance staff and cleaning equipment. This gives us a powerful feedback loop and alleviates any concerns about using these new materials. Health care institutions traditionally have used those materials containing carcinogens because they withstand repeated use and cleaning and do not hold on to potential harmful bacteria or viruses.

Lastly, we track materials used through submittals and reporting to ensure the old toxic materials don't sneak back into the project due to cost concerns or unwillingness to try new materials.

Design Teams and Health Care Institutions Can Partner on Informed Selections

With resources from Habitable, Six Classes, Living Future, and mindful MATERIALS, we identify high-risk and harmful toxins to discern how the products are made, their effects on the human body, and their alignment with industry health standards. These tools also can help health care institutions choose more sustainable materials and understand how they affect the environment throughout their entire life cycle.

Still, identifying and committing to avoiding harmful materials is just the first step. We also can use this research to identify building materials that can boost patient outcomes. Start with this basic list of chemicals to avoid in your interior materials: formaldehyde, phthalates, per- and polyfluoroalkyl substances, halogenated flame retardants, polyvinyl chloride, antimicrobials, and isocyanates. Ask manufacturers directly if their products contain any of those seven classes of chemicals. Ideally, tell them you can't purchase anything containing those chemicals.

When building or renovating facilities, health care organizations should:

1. Set health goals early in the design process and focus on how construction improves patient outcomes.
2. Audit current standard materials for harm before beginning new construction and renovation projects.
3. Prioritize the most problematic chemicals and highest-emitting materials.
4. Use the transparency tools available (Habitable, Six Classes) to download Environmental Product Declarations for your products.
5. Order samples of your top 12 most installed products or finishes. Having samples of healthy materials on hand increases the likelihood that healthy materials will be used for installation.
6. Install test swaths of large samples to pilot them for durability and maintenance. This will help you overcome worries about trying new materials.
7. Finally, and most importantly, don't be shy about asking your architects, designers, and manufacturers specifically about the health of materials.

When it opens in 2027, the UCM AbbVie Foundation Cancer Pavilion will be more than the first freestanding structure in Illinois dedicated solely to cancer treatment and research. It will mitigate the longstanding gaps in care prevalent on the South Side of Chicago. It also will be a new model for designing a "cancer-free cancer center" that avoids the harmful materials that typically go into such facilities. The result will be a place of healing where people don't need to be terrified to arrive.