Healthy Spaces Podcast: Season 3, Episode 4 - Vital Innovations

[00:00:00] VO: All around the world, healthcare spending has been steadily increasing since the 1980s, becoming a significant burden on government spending and family budgets. But what if some of these costs could be avoided? 

[00:00:21] John McKeon: around 75 to 80% of our health outcomes is related to our built environment and our behaviors in our built environment and our communities. , when you realize that this. Gonna have to be a huge shift in, in the paradigm of design professionals. If you think you have architects who blueprint buildings, construction professionals, interior design professionals, asset managers, and then you have facilities managers. Um, and all those people who design, construct, and maintain our built environment have a role in, in our healthcare. 

[00:00:53] VO: And as climate change brings on more diseases, which are spreading faster than ever before, scientists are continuously developing innovative life-saving treatments. But what does this mean for the climate control industry?

[00:01:11] Holly Paeper: Over the last couple of decades, the fastest growing area is something called biologics or biopharmaceuticals. And so instead of starting with a chemical, you're actually starting with a living organism. They tend to be heat sensitive, susceptible to contamination and, and just more fragile in general. That’s where we come in. We've got systems that control the rate of freezing or thawing or even just storing the drugs in a way that maximizes their effectiveness. 

[00:01:38] VO: You just heard from Dr. John McKeon, CEO of iAir Institute and Allergy Standards, and Holly Paeper, President of Life Science Solutions at Trane Technologies.

I'm Dominique Silva and you're listening to Healthy Spaces, the podcast exploring how technology and innovation are transforming the spaces where we live, work, and play.

And in today's episode, we're asking how climate technology can help keep people healthier.

We'll find out how climate technology is facilitating the production of newer and more effective medicines. We'll also discover how improving environmental quality can foster our well-being, with some practical tips from Dr. John.

A recent study by the University of Hawaii uncovered empirical evidence that almost 60% of human diseases caused by pathogens, such as malaria and pneumonia, have been aggravated by climate change. Globalization and changing weather patterns are some of the reasons why emerging infectious diseases risk to spread even faster, which in turn will lead to an increase in demand for vaccines and blood transfusions.

And as President of Life Science Solutions at Trane Technologies, these are things my first guest thinks about on a daily basis.

And if you're not quite sure what life sciences means - you're not the only one.

But fear not - here's Holly to explain what it’s all about and her team’s role.

[00:02:56] Holly Paeper: I'm the president of our life sciences business at Trane Technologies, and so I think to boil it down, um, really simply, we make vaccine and blood storage equipment, um, for everything from biotech to pharmacies.

[00:03:23] Dominique: so you've already, um, started answering my question right, a little bit about what life sciences mean, but can you talk to us a little bit about. What that industry looks like, right? So it’s not just vaccines or pharmaceuuticals how would you talk us through it?

[00:03:42] Holly Paeper: At the most basic level, you know, life sciences is about the study of living organisms. Um, and, and to even make it simpler, the piece that we focus on is a subset of what essentially keeps us alive. Um, it includes markets like pharmaceutical manufacturing, um, organ and tissue donation, blood banks, plasma donation, all the way to the patient where it could be in hospitals or clinics or, or things that we, we touch and feel as, as patients. Organizations that are customers of ours - it's everything from household names that everybody would recognize with big pharma companies or big hospitals or pharmacies, uh, to the thousands of companies that you wouldn't recognize. Um, the organizations that are behind the scenes that make this whole industry work. And, and our piece of that, I would say is very specific. Sophisticated equipments. Um, and it ranges of temperatures from four degrees C all the way to negative 80 degrees C and colder. So really, really cold.

[00:04:46] Dominique: Oh, I just got a, a chill when you said that minus 80 degree. I don't even, I can't even imagine what that's like. All right, so I think you described the industry in the perfect way. It's the study of the living organism. It's all the way from producing lifesaving medicines and vaccines all the way to making sure they get to the people who need them. So, Holly, maybe let's start with. Step one, which is the production. You already gave us a little bit of an idea of the huge temperature ranges that are needed to produce medicines and vaccines, but what makes this manufacturing process so challenging? 

[00:05:27] Holly Paeper: The pharmaceutical industry has actually changed a ton over time and, and specifically the last couple of decades. They used to primarily be synthetic. So meaning using chemicals, shelf-stable chemicals that were transformed into the pills that we've all either seen or taken. Now and over the last couple of decades, the fastest growing area is something called biologics or biopharmaceuticals. And so instead of starting with a chemical, you're actually starting with a living organism. And the new category of drugs is transforming everything. Um, it's, it's transforming the treatment of numerous health conditions like cancer or anemia, autoimmune disorders, diabetes. So they're generally more effective at treating these conditions with very limited side effects. However, making this new era of, of drugs is really tricky. Um, they tend to be heat sensitive, susceptible to contamination and, and just more fragile in general. So, and in addition to being more fragile, they also need to move around the world to get to patients. And so that, that's where we come in. Um, you know, we've got systems that control the rate of freezing or thawing or even just storing the drugs in a way that maximizes their effectiveness. And so we, you know, provide this temperature assurance everywhere in the world. But, but generally speaking, the way to be thinking about manufacturing is, is really this long kind of process that, that used to be very controlled with, with shelf-stable things. And now you're, you're doing something very fragile as it moves through there. Um, it's something that we spend a lot of time innovating around and thinking about because the, it, it just takes a lot of sophistication to move from idea all the way to the patient.

[00:07:12] Dominique: So let's talk a little bit about the impact of the industry on the planet. Right. So I did a little bit of reading and I read that the pharmaceuticals and life sciences industry accounts for almost 5% of worldwide greenhouse gas emissions. And there's a similar percentage in terms of contribution towards toxic air pollutants. So really when you think about it, this is one of the most carbon-intensive industries in the world. What are we doing? What are companies like Trane Technologies doing to help this industry to become more sustainable?

[00:07:51] Holly Paeper: Sustainability in this space is, is really fascinating. From one perspective you can think about climate change and its impact on disease. And so infectious diseases we all know are on the rise and we're, and are spreading to new regions of the world. Some of it's because of warmer temperatures that allows them to thrive, but there's also research around the temperature impact on animal migration, and then as a result, the interaction of these animals with new species, which means new diseases. And so it also points to the need for more vaccines, more medications, and the solutions of course, that allow them to be made and distributed safely. We are in the business of providing reliable temperature assurance to make sure that these medicines can be made effectively with very little impact to the environment and to get to the patient where and when they need them. So we, we actually monitor the temperature of the drugs for our customers to make sure that they're throwing away less medication and that patients are more likely to get medicine that works. Ultimately it means using less energy to make drugs. Besides that, um, we, we've got, you know, the traditional pushes to use lower GWP and natural refrigerants in our cold chain products. We’re also uniquely focused on redundancy and longevity, meaning you need less equipment to do the same job, so you're using less energy and that they last longer, so you're just disposing less. I would say the other piece that is really fascinating and that we're working hard around innovation is adding passive renewable cooling capability to, to help the industry reduce dependency on very energy intensive liquid nitrogen and dry ice, which is often used for the cold chain. So in addition to all of the stuff that we're doing to be more sustainable and, and provide these solutions to our customers as a broader company, I think we're partnering with these large organizations to help them with their sustainability roadmaps. Advising them on ways that they can accelerate their sustainability journey too.

[00:09:57] Dominique: I love how you were thinking about this from an end-to-end point of view. It's not just about, Hey, how do we use less energy? How do we use more renewable energy? But really starting at how do we reduce waste so that we don't have to produce more in order to account for the waste, which is also a very similar thinking that we're seeing on food production systems as well, which we explored in, um, our previous episode on this podcast. Small plug there in case you haven't heard it. I'd love to, um, ask you specifically the last question that I have on my list, which is how you see the role of the life sciences industry evolving over the next five to 10 years and what innovations you are most excited about.

[00:10:38] Holly Paeper: I would first start with cell and gene therapy, and so this is a really exciting thing happening around precision and personalized medicine that are helping us target diseases and conditions in a revolutionary way. The challenge is the cost to manufacture these has got to come down in order to make them more broadly available. And so this is an area that, that we're innovating around to contribute to that effort and help with technology at colder temperatures, smaller equipment and more important and, and sophisticated temperature monitoring. I think the second category I would say is around RNA type immunotherapies. Um, and that's really technologies that leverage the body's immune system and drive a fast discovery of new viruses and diseases and the solutions to those. So, um, a, a ton of companies are investing in this type of technology to solve problems that have previously been resistive to cure such as cancer. So, for instance, you know, a new mRNA plus a previous cancer drug together might yield 40% reduction in recurrence of the most aggressive type of cancer versus just the drug alone. And so these vaccines and drugs require, as we've all learned here over the last couple of years, sophisticated cold chain. And we, of course, continue to innovate here with the largest pharma companies on the next generation of what this looks like. I think the third category is around AI and artificial intelligence. And here what it looks like is faster time from drug discovery to market approval. Picture a connected manufacturing process that that can be adjusted to maximize yields, models that predict results faster and more easily, and trials to be shortened by years. So a clinical trial or a trial for a drug might be four or five years Today. Tomorrow it might be one year. And so for companies like us, it means innovation to help our partners be faster and more flexible with the equipment that they use. And so, lots of things happening in the industry. You know, one thing is for certain where, you know, we and the industry will be continued to push for more efficiency, more energy efficiency and more sustainable solutions, you know, and, and of course we're innovating to make sure that not only we meet whatever regulations kind of pop up, but we're exceeding them. It's kind of who we are and what we do as a company.

[00:13:07] VO: There's no shortage of innovation happening in life sciences.

From newer, more efficient lab equipment aiding mRNA development to AI reducing the length of trials - it seems the industry is poised to welcome in a fresh new wave of advances to benefit our health in the coming years.

But what developments are in the pipeline for the places where we live and work?

After all, these are the spaces that have been identified as key contributors to various health issues.

Here to explain is CEO and founder of iAIR institute and Allergy Standards, Dr John McKeon.

And to start, he describes how his journey began as an emergency room doctor.

[00:13:54] John McKeon: My story always started, uh, working in a pediatric emergency room and seeing a lot of kids with asthma and allergy and speaking to their parents, and when you think about it, when a child has to go to the emergency room with a flare up of their allergies or a flare up of an asthma attack, a parent has to go with them and has to take a day off work, or they're missing school, it's in the middle of the night. So it's, it's a kind of a family issue. And the mums would often ask me, look, doctor, is there something that we can do to stay well, rather than you treating us when we become sick. And when you're talking about staying well and the, the definition of being well and it's no longer just being well as the absence of disease. It talks about emotional health and psychological health and we now know so much more about how our indoor environment impacts on our health outcomes. But back then I was talking about the indoor environment because we spend 80, 90% of our time indoors. And we know there's a lot of research that indoor air pollution can be more polluted than outdoor air. But really with allergic asthma, you're talking about the indoor environment, you’re talking about the trigger factors that actually set off your symptoms.  And there are guidelines about patient education, environmental control, and I would, uh, ask patients, look, do you know, are there triggers in your indoor environment? And these can be things like dust mite allergen or other allergens. There's also chemical irritants and VOCs and formaldehyde. And it can come from all the incidental furniture that we bring into indoor environment. So it gets quite difficult when I would list out all the types of products that can help remove allergens and irritants or don't bring these products in because they may contain or outgas irritants or allergens. And the expression we use is we we're drowning in information. but we're all starving for wisdom and insights So they would quickly get overwhelmed when I talk about pillows and vacuum cleaners and furnace filters and air handling units, and cleaning products and building materials—pain, flooring. And one of the mums said to me, look, doctor, it would be a great idea if somebody could test these products and if they could help in a way or the wouldn't cause harm, there'd be a label on them, an asthma and allergy friendly label, and that's essentially the company I founded, allergy standards that test consumer products. And from there, if you think of a home, a healthy home and everything that goes into the home, you quite quickly start to look at indoor environments. So then we actually start to look at certification testing of spaces and the built environment. And then we got into education around that. And now we've got into research. 

[00:16:31] Dominique: You touched on public health, And I think when it comes to public, the importance of public health, there is no more recent lesson than COVID-19 pandemic. Um, Even though we haven't really talked a lot about COVID-19 during this season of the podcast, I'd love to take a couple of minutes with you to reflect on some of the lessons learned, right. From a public health resilience perspective. I know that throughout the pandemic, our health systems came under immense pressure, right? In many countries, really unable to respond to the sudden increase in demand for people who were getting sick. very quickly This constant notion of health and wellbeing is really, really important. What are some of the lessons you took away from that?

[00:17:25] John McKeon: Although we all want to look forward let's not discard the lessons that were learned from COVID. I'll give you one example related to public health. The reason why still to this day when somebody sneezes we say bless you, was from the bubonic plague in London over 300 years ago. It actually started it with an upper airways disease. So if you started sneezing, it meant you're on this disastrous track to die this horrible death. So we don't have bubonic plague but people, society still say bless you when you sneeze. So I think some of the, uh, COVID hopefully is way behind us. The shifts, the fundamental shifts in society will persist for a long time. That people now can connect with indoor air, the invisible has become visible. So, so I think that's a bit, a big shift. Um, the whole idea of public health, people may not realize that public health is actually the fourth discipline of all the disciplines of medicine and surgery and I think air, outdoor air and indoor air is now going become a public health issue and also your point you make about industry having a role in public health and wellness in society. There, there are some serious challenges in, in our healthcare system. A lot of people say we don't really have a healthcare system, we have a sickness reimbursement program. It really isn't sustainable to grow a society having that amount of money, having to go into, into treating sickness, and no one person or one group is gonna solve it. You think of many of the breakthroughs in society recently in banking, in travel, like Skype wasn't a telephone company, the first VoIP. Um, you've got the, the Irish brothers Coolson who do stripe the payment thing that they weren't a bank. So the breakthroughs are gonna come from somebody else outside the actual traditional healthcare system, and I think industry has a role as that. I think allied healthcare professionals have a role in that. And then going back to your point about COVID. A lot of the disparities in society were there, and COVID. just put a magnifying glass on those. And I think climate change and sustainability and health inequity, uh, they, they were all just exaggerated by COVID. And it sped up that it fell disproportionately to the sick in society. It fell disproportionately to underserved in society. So I think there are a lot of, a lot of very good lessons from COVID around public health, but also, again, it's not just the doctors can do it, but the discussion within personal responsibility and taking control of your health is really part of the, the ongoing future of wellness.

[00:20:01] Dominique: Let's talk a little bit about the role that the built environment industry plays in driving positive public health outcomes. So I'd love to hear your thoughts on that. Not just in terms of how they can do it, but in your view, what challenges still need to be overcome?

[00:20:20] John McKeon: Well first, first of all, is to realize that the built environment and professionals related to the built environment really impact on, on our health and our health outcomes. There’s a lot of research. S D O K recently showed, uh, some research that 90% of the USA healthcare budget is spent on medications and access to doctors, but around 75 to 80% of our health outcomes is related to our built environment and our behaviors in our built environment and our communities. But the tiny, tiny amount of the USA healthcare budget goes to managing the built environment. And that can talk about, uh, access to lighting and cycling and all, all sorts of things, our built environment. When you realize that, there is going to have to be a huge shift in the paradigm of design professionals. If you think you have architects who blueprint buildings, construction professionals, interior design professionals, asset managers, and then you have facilities managers. All those people who design, construct, and maintain our built environment have a role in our healthcare. And if you almost wanna think about it, that if you, at one end of the spectrum, you've got disease and crisis and illness, you have the red end, for example very, very reactive people like me, emergency room doctors, and um, surgeons. As you come down that spectrum you come to, you know, your physicians, your general practitioners, then you have your asthma nurses. And as you keep kind of going down more green preventative proactive area, you have your dietician, you have your yoga teacher, your exercise teacher, uh, your health and wellness coach. And if you keep going down and down and down to one end, then you do have architects and design professionals. So they, all those people need to come into the conversation. We're very proactive in managing our wellness. So we should now speak to our construction and design professionals at buildings and be proactive with them as well and get more engaged. 

[00:22:21] VO: With the memory of the COVID-19 pandemic still fresh in many people's minds, it's no surprise that indoor environmental quality is still a key concern among public health officers and building occupants alike

And as we heard before, climate change is leading to the spread of more chronic and respiratory diseases, which will continue to put pressure on the public health system. 

So how might climate change keep the issue of public health resilience front and center of people's minds?

And how might it prompt a renewed focus on IEQ among our building professionals?

[00:22:56] John: first of all, some of the things we spoke a little bit about societal shifts through covid have have changed and that crisis period is over. But I think the societal, uh, shift hasn't changed. I think, for example, people, are they gonna go back into the office? I think if I'm gonna ask people to come back into my office, I'm gonna have to prove to them that it's as, as safe and healthy as staying at home. So the onus now, for many reasons, for example, facilities management in buildings and office workers does now become a strategic HR issue. We're all knowledge workers. We're not in some Victorian thing pulling levers and doing like that, that a robot could do. So therefore, how well we feel biophilic, design, lighting, comfort, physiology of building. All that is very much, under the radar. Um, and then to bring in the kind of climate change, it, it will fall in kind of two areas. First of all, the underserved community, uh, the sustainability initiatives, the burden will fall to them because they can’t afford some of the changes need to be made in buildings. So there's that kind of area around what are we gonna do there about diversity, equity, inclusion, And then you have the top end. You've got the Grade A High Performance Office buildings. you're talking about the flights to premium. So if you are gonna have a downtown office building, it's gonna have to be grade A or forget it. You know, you hear people using I E Q, indoor environmental quality. It's not just air quality. But there is a paradigm shift. You said there's a, a mindset shift and then a skillset shift with regards to the people that design and construct buildings. Um, and then your point about climate change. We know climate change is impacting on say, allergy seasons. There's longer allergy seasons. There is more rainfall in some areas, so it's putting stress on buildings, water and rain, aggression, moisture, aggression, water vapor management, um, fluctuations in chamber. So you need heating more, you need cooling more. That impacts on comfort, physiology, moisture balancing. Uh, there's an energy crisis. So how do you actually have energy efficient buildings, uh, but not deteriorate, airflow and air quality. Um, so there's, a huge amount of, of, of air drivers, macro geopolitical drivers in the indoor environment issue.

Dominique: Um, It's been a really great conversation. You know, a little bit of optimism, a little bit of doom and gloom. Um, we've talked about opportunities. We've talked about challenges. So for all of our listeners listening in on this conversation right now and thinking, well, what can I as an individual do to help contribute to the solution, what would be your advice?

[00:25:47] John McKeon: Well, first of all, thank people for listening in because like all these things, it starts with awareness. So it's, it is getting educated understanding, what role does the built environment play? On my health. And then if I'm a professional in this area, whether it's design or construction or building ventilator professional, everybody's listening to the podcast is, is getting aware, doing the research, looking at some of them. We also have our Iair Academy. Iair is the Indoor Air Innovation and Research Institute, and we, we have educational programs on those. The other thing, once you kind of get engaged in the issue and do your research and see how, how you can do what, one small thing we do is we have CO2 monitors on our desk. Um, CO2 is a good proxy for ventilation if there's people in the room. Just to start, for your listeners, just get a CO2 monitor. It'll, it'll begin your journey. They're only at 20, $20. Um, because I think the role of sensors. It for the people on this call is something that anything in a building that can be measured will have a sensor. Every sensor then will be connected and every sensor will be smart. Um, and we'll get those feedback loops, those biofeedback loops, and it will impact on behaviors. How many people are in that room? Do we need more ventilation? Filtration? How does energy relate to that, comfort, physiology. Um, and one thing I didn't know until recently is that SMART it actually means something. It's self-monitoring, analysis, and reporting technology, So smart buildings with this self-monitoring won't just be for energy efficiency and your toaster talking to your fridge or whatever it is. Um, they will be smart for healthy buildings, smart and healthy. So that would be my, my takeaways for your audience is, uh, do more research, engage, uh, go to our academy, do some of our courses, get a monitor. Really start to, if you, if, if you don't measure something, you can't manage it. And we know all those. You can only change what you can see and track, et cetera. 

[00:28:06] VO: A big thank you to Holly and John for joining us on today's episode to discuss climate control technology and its role in building strong and resilient healthcare systems.

And thank you for listening.

If you want to find out more information about our conversation today, make sure you check out the show notes, which includes a discount from the iAir Academy. And remember to rate and review Healthy Spaces in your favorite podcast app.

And join us next time when we'll be talking to innovators who are working relentlessly to improve the thermal comfort of the most vulnerable communities.