Imagine, Cancer Treatment Centers Built Without Carcinogens: Green Guide For Health Care Co-Director Robin Guenther, AIA

Bill Walsh | April 20, 2005 | Policies

Robin Guenther

New York-based architect Robin Guenther has devoted a 25-year career to designing healing environments. Founder & Principal of New York's Guenther5 Architects[1], member of the 2006 AIA Guidelines for Design & Construction of Health Care Revision Committee[2], and Co-Coordinator of the newly released Green Guide For Health Care,[3] Guenther talks about the green building movement's first health-based building guidelines.

HBN: This year's EnvironDesign9 conference is a sort of debut for the Green Guide For Health Care (GGHC). What is the significance of the GGHC?

GUENTHER: It's really a fabulous guidance tool that has emerged from an intense three-year development process. The Green Guide for Health Care is a self-certification metric tool that allows the health care industry to measure its environmental performance in facilities construction and operation. It is the first such program that incorporates health-based criteria. We developed it in cooperation with the American Society for Health Care Engineering and the US Green Building Council, using LEED[4] as a basic framework, and then adding elements to address the specific construction and operational issues of the health care market. It is also significant that although it is purely voluntary and not a certification system, 4500 registrants downloaded the document and 20 facilities are now enrolled as pilot projects. We are definitely meeting a need identified by health care institutions and the architects who serve them, though I think that people interested in healthy buildings would find this tool applicable well beyond the health care sector.

HBN: Why does a health care facility need unique construction and operational standards to be green?

GUENTHER: Relative to other building owners, health care providers have far less flexibility in balancing ecological and operational performance. For example, compromised air quality can be a matter of life and death, not personal discomfort. So typical energy saving strategies in the mechanical systems are often rejected on operational grounds. "We save lives, not energy" is how the skeptics put it.

That connection, however, leads to powerful ideas. Health care facilities are quite naturally setting the pace for integrating human health concerns into green building criteria. Take evidence-based design, quantifying the relationship between physical environment and therapeutic outcome. Documenting that people feel better due to the design elements of a health care facility has enormous implications for designers, manufacturers, and for the entire sustainability agenda. And then there is the very simple notion of not using materials manufactured with carcinogens in facilities that seek to cure people of cancer. It's inherent in the medical profession's creed - "first, do no harm."

HBN: Isn't that approach almost counterintuitive to the green building movement, which has its roots in energy conservation, and to a large extent puts a premium on reducing energy usage when evaluating design elements or materials?

GUENTHER: Yes and no. Take LEED, for example. The most controversial health issue at the moment in LEED is the PVC question. Lots of experts from different disciplines criticized[5] the USGBC's draft report on PVC building materials because, in essence, its utilization of Life Cycle Analysis and Risk Assessment gave excessive weight to energy-related issues over issues concerning toxic impacts on human health.

On the other hand, even though many of the Green Guide's unique health-based design and operational strategies that are not presently in LEED are based in the arena of "evidence-based research," we found that they fit comfortably within the LEED framework. The health issue is implicit in LEED. It's just not explicitly articulated in the current version.

HBN: Has its health-based focus made the GGHC as controversial as the PVC debate within the USGBC?

GUENTHER: For certain people, yes. For most people, no. I'll admit I am shocked about the Vinyl Institute's (VI) portrayal of the Green Guide as a controversial document that is captive to some sort of irrational anti-PVC conspiracy. The irony being that not only is there no exclusive anti-PVC credit in the Green Guide, but our approach to toxic substances appears to be in line with one of the recommendations of the USGBC TSAC draft report which the VI applauded. The USGBC report specifically recommended "working toward eliminating a class of pollutants"[6] and the GGHC recommends avoiding products that are made from or are responsible for releasing a class of chemicals known as Persistent and Bioaccumulative Toxic Chemicals (PBTs) - like lead, mercury and dioxin. Who could be against that? A physician I know put it into perspective. He said we have to expect this. Tobacco companies defend cigarette smoking, PVC companies will always defend PVC, right?[7]

HBN: A recent book[8] on sustainable design did a great job of analyzing why it is so hard to change - people, professions, society. What is your philosophy of change in your profession?

GUENTHER: Materials used to be silent about their science, but they are silent no longer. As an architect, the only thing scarier than being the first one to specify a building material is being the last one to do so.



The Healthy Building Network will be at the EnvironDesign9 conference , scheduled for April 20 to 22, 2005, at the Marriott Marquis in New York City. If you're going to be there, stop by our table. For more information, visit


[1] Guether5 Architects



[4] The LEED (Leadership in Energy and Environmental Design) Green Building Rating System®. The GGHC Construction section builds on many of the credits in LEED NC (New Construction). The Operations section utilizes many credits from LEED EB (Existing Buildings).


[6] "Assessment of Technical Basis For A PVC-Related Materials Credit in LEED," page 99.


[8] Jason McLennan, "The Philosophy of Sustainable Design," See "The Philosophy of Sustainable Design: A New Book Predicts An End to PVC Use"