- Good afternoon and welcome to the Architecture for Health Lecture Series.

It's great to have you with us, and you're in for a special treat today.

Our speaker today is Paul Sabal.

Paul is coming to us today from St. Louis, Missouri as the Director of Architecture and Healthcare for Vestal Corporation.

Paul is an old friend to us here at the Center for Health Systems and Design, and I must say it's wonderful to have him back.

Paul is a registered Architect and Interior Designer, and he's board certified in healthcare architecture by the American College of Healthcare Architects.

He trained in architecture at the University of Oregon and got his Bachelor of Architecture degree and has a 41-year history now, I guess, with most of it in healthcare.

Along the way, now, this is interesting, his curriculum had a lot of engineering.

Those of you that are thinking about extra classes that you might wanna take or fill in elective spots, Paul took a lot of engineering and it's opened some doors for him.

Pay attention to this.

He served as a member of the American Society for Healthcare Engineering Healthcare Construction Certificate Task Force.

That's a big certificate that they offer, one of a few that they have developed.

And he has been a board member of the Missouri Society for Healthcare Engineers.

So Paul is one of those crossover types.

He's got the architecture and the engineering in the healthcare specialty.

It's made him a valuable player in several arenas.

Most recently, Paul has been working with Fortune 500 companies, expanding their presence in Mexico.

Now, if you've been with the Center or aware of our mission in recent years, we're focused on design for health, not just healthcare.

Healthcare is part of design for health, but designing for health is so much more.

And Paul is here today to talk about designing for health, not just healthcare, but some of the things that can be done for occupational health and safety, in particular, for his clients that are moving into Mexico.

So, without any further delay, would you please join me, welcoming Paul Sabal to our platform.

(audience applauding) Welcome my friend.

- Thank you.

Ray, thank you very much for inviting me back.

Thank you to the students and thank you to the university.

It's been a pleasure joining you over the years, and that was a real treat to get this invitation.

So, real quickly, let me start with a story.

At the Constellation Brands Brewery in Nava, Mexico, a couple of years ago, a worker was struck by a laser guided vehicle.

Now, for those of you who don't know, a laser guided vehicle is a semi-autonomous vehicle that's used for transporting raw materials and also finished goods from rail cars and trucks to production lines and or to warehousing spaces in the packaging building.

Now, they have lots of robust safeguards that prevent them from running into things, running into people, running into equipment, running into each other.

But for some reason on this day, there was a failure of those safeguards and a worker was struck and injured very gravely.

She was transported to an onsite medical facility at the brewery where she was triaged, was stabilized, and then she was transported by a CBI ambulance to a regional healthcare facility in Nava.

And unfortunately, her injury resulted in an amputation below her knee.

So in Mexico where, you know, there's a lot of workplace injuries.

Manufacturing is a dangerous occupation.

In 2021, according to the International Labor Organization statistics on safety and health at work, there are approximately 450,000 accidents and illnesses in Mexico directly related to occupation.

About 2,500 of those, 2,500 per 100,000 were nonfatal and about 8 in 100,000 were fatal.

You know, compared to US, US has about the same accident and illness, nonfatal accident illness ratio, but fatalities are about half as much in the US.

Unfortunately, Mexico statistics are a little harder to come by than in the US.

Bureau of Labor Statistics reports out to a lot of different organizations, and those statistics are made available to the general public.

Mexico is a little more difficult to gain by, but, and also, what I've noticed through research is that the last three years, a lot of illness reporting has been skewed, of course, by COVID.

So why are we talking about breweries?

Okay, so the last 40 years of my career, I've been planning and programming and designing hospitals and outpatient care facilities, and now I'm really doing a lot of brewing and food service and distilling manufacturing or distilling facilities in Mexico.

But what I've learned, those concerns around patient care, staff, caregiver safety, wellbeing, are directly translatable into the industrial setting, and it's very much needed for the care of these manufacturing workers.

So today we're gonna have a little brief history of worker health.

Now this is gonna be US-based worker health.

Again, digging through kind of the history of worker health in Mexico is a little more complex and deserves a deeper dive in its own kind of talk.

But we will touch on worker health in Mexico and kind of the impact of the federal health system on their health.

And then we're gonna talk about our biggest client, Constellation Brands, what they're doing to mitigate and to transform the health of their workers.

And then we'll wrap up the conversation just talking about what we're doing there, why we are in Mexico in the first place.

So, you know, a real quick overview of occupational health is the industrial revolution happened, right?

You had populations moving from rural communities, agricultural jobs, into evolving and growing population centers, cities, and to work in factories.

And factories were primitive, they were dangerous.

Children were working there, they were working around the clock.

There were machines that could cause a lot of accidents.

There were chemicals that could cause a lot of diseases, You know, then in the early part of the 20th century, there started to be some disasters because of lack of regulation.

Right after that, you started to see growing concerns around and growing development around building codes and standards.

And then as workers wanted more and more better working conditions, there were rise of labor unions, the development.

And after that, of course, the development of government organizations.

And then the professions started stepping in to develop their own health and safety organizations.

Finally, mid century started to start seeing worker compensation laws starting to be passed by different states and by the federal government, which allowed workers then to sue their workers, sue their employers for compensation, for injury and illness.

And then finally, in 1952, after a large mining disaster in Illinois, 111 miners were killed in a mining accident, the Coal Mine Safety Act passed, and that really kind of served as the model for OSHA.

Now, those of you out in the virtual world probably are very aware of OSHA.

OSHA has a big impact on the design of healthcare environments.

And OSHA was finally passed in the US in 1970 and became a government organization through the Bureau of Labor or the Department of Labor in 1971.

It covers all industries.

It has a big, big footprint in manufacturing and in construction, and it has its own research arm through the CDC, which is continuously looking at ways of designing new regulations around materials, noxious chemicals, worker repetitive motions in order to improve the health and safety of workers.

So, digging into the history though of occupational health, you come across be Bernardino Ramazzini, who in 1700 published a book called "The Diseases of Workmen."

Now, Ramazzini was interesting an Italian doctor and educator, he spent time with workers in their workplace to see what was causing diseases, what was causing injury.

And he was really first to tie, excuse me, first to observe and connect specific injuries with specific types of work.

And he had a lot of discussions in his book around repetitive motions and trauma.

Now, think of carpal tunnel syndrome.

That's a big 20th century workplace injury, right?

You know, you don't, of course, trips, falls, you know, getting cut, getting smashed.

Those are big injuries.

But just think of that, you know, you're doing something over and over and over again.

What did that do to your body?

So how do you change things in order to prevent those types of injuries?

And then in the US, Dr. Alice Hamilton, who was a graduate, an early graduate of Michigan School of Medicine, she went to work in the early 1900s for the Bureau of Labor.

She became a special investigator, and her focus started to be on dangerous materials.

So she went to, started the lead industry.

You know, this is the time when batteries were starting to be developed.

And so there was a lot of lead mining going on, and these workers were getting sick.

So she was started utilizing kind of the emerging ideas around epidemiology and hygiene to tie these industrial processes to distinct disease conditions.

And interestingly, she was the first woman faculty member at Harvard School of Medicine.

So down in Mexico, Mexico has a population 130 million.

We're at 350 million ish here in the United States, about $58 billion US healthcare budget compared to what we're at about 3.8 trillion healthcare budget, something like that in the US, they spend about 6.2% of their gross national product on healthcare compared to, I guess we're around pushing 18%, maybe 20% in the US now, little over $1000 per capita on healthcare expenditure, as opposed to maybe around $12,000 a year in the US right now.

So you can see there's a lot less spending on healthcare in Mexico.

Mexico has a government funded healthcare system.

So it's a socialized medicine.

It's really kind of a, it's fractured.

It's like in three parts.

So the first part is really the government health insurance.

And so two components of that are the employer-based medicine.

So just like any employer in the US would provide a healthcare program or a health in insurance program to their employers, you know, that either the employee pays for or the employer pays for.

So that's the IMSS system.

And then the other system, the ISSTE system is really for government employees and for the military.

Now, there's also a parallel private system in Mexico, so private clinics, private hospitals, private doctors, So those with the means can actually pay directly for those services.

And then just recently in 2020 a third part of the healthcare system came online, which it's called the Institute for Health and Wellbeing, which is really kind of a patchwork of social program is being put in place for the poorest of poor and also for the rural health.

So all these, the government healthcare systems are really to provide basic care.

Now, as far as workers go, there's a similar organization, similar guidelines like for OSHA in Mexico.

And these systems are regulated through their bureaus of their own bureau of labor.

And there's 41 specific NOMs and NOMs are Mexican standards.

So instead of a patchwork of codes and guidelines like we have in the United States, all that is under federal guidelines in Mexico called NOMs.

Everything from how a ladder is designed to how to make tequila is defined in the NOMs.

And so there's 41 specific NOMs around worker safety, PPE, structural requirements, health standards.

What I found interesting though is that it requires a mutual understanding and mutual responsibilities between the employer and the employees.

So the employees have responsibilities for safety, they have responsibilities for health as much as the employer does.

So if an employee falls down, you know, they have to basically show the employee that there was...

They weren't the reason they fell down, right?

So it's a little bit onerous to the employees or more so than what we would find in the US.

Okay, from a facility standpoint, each state has main facilities that workers, and anybody who has health insurance is basically assigned to.

So you're in a sector and you go to a specific facility to access healthcare.

Primary clinics provide basic care.

The MDs are gatekeepers.

They're allocating those precious dollars from, or presses pesos from the federal government, just kind of like the US.

If you live in a large metropolitan area, you've got pretty good access to care.

The rural health in Mexico is only about 16, 17% of the population.

So it's a very dispersed rural population.

And so there are satellite clinics, and in rural health, you get into a lot of traditional medicine, alternative care or homeopathic remedies.

So there's those kinds of things that, again, are worth study, but we're not gonna go there today.

Telemedicine is certainly being explored and certainly can provide a lot of good opportunities in the rural parts of Mexico.

However, the broadband infrastructure and just computer ownership doesn't really allow kind of a broad distribution and access to even telemedicine.

Surprisingly, though, in Mexico, specialty care is actually pretty good.

So advanced care specialty care is actually pretty advanced.

And the workers that I talked to, they're really pleased with that, but mostly systems overwhelmed because there's very few people paying into the system.

And that's really, you know, supporting the overall maintenance of all these healthcare systems or healthcare insurances.

Also, primary care pay is low and because they're allocating resources very carefully.

You may not get the care you need to actually live a long life.

And there is an RX portion of these insurances.

It doesn't cover everything that's needed.

And in talking to workers in Mexico, it's really impossible for them to get the quality care they need due to lack of funding, proper types of resources, facilities, tools.

There's a complete absence of burn care in Mexico, and pension system is completely underfunded, so that adds more stress to an already stressed healthcare system.

Now here is a interesting group of statistics here about workers health issues.

15 to 49 years old and 50 to 69 years old.

You'll notice diabetes is right on top of both of these groups.

Diabetes is the leading cause of death in Mexico, leading cause of disability in Mexico, leading cause of early retirement in Mexico.

And it is the main cost for the healthcare system.

This is contributed to by a huge obesity problem in Mexico, no pun about in the World Health Organization, 2017, for five years ago, estimated about 28.4% of the population was obese.

About 64.4% was overweight.

So they were leading Latin America in both obesity and overweight population.

Columbia Public School of Health, just this year in June published an article putting that percentage at 32.4% just right behind the United States in obesity rates for the country.

Certainly this has to do with economic progress.

You have higher wages, can spend more money on food, you know, more calories, and there's just a change in the diet from fresh foods to highly processed foods, just like what's going on in the US.

So very much parallel like that.

And then hypertension, heart disease, you know, you see those as contributing health issues, but also violence and car accidents.

So you have some interesting interlopers there for health issues in Mexico.

Great article, if you have a time to look at it, a national public radio did a podcast called Goats and Soda kind of really breaks down this kind of change in the nutrition in Mexico and these raising rates of obesity and diabetes.

All right, so why are we talking about beer then?

So, Constellation Brands is our largest client.

They're a Fortune 500 company.

They produce beer, wine, spirits, largest US importer.

I'm sure you know them very well.

They make all the Modelo brands, all the Corona brands, branded beers and products, everything they make in Mexico, they ship to the United States.

There's a whole Modelo group in Mexico that makes beer for Mexico and South America.

It was split up during the merger of Anheuser Bush and InBev a number of years ago, but I won't get into that.

So they currently operate three or two breweries in Mexico, Nava, which is near the Texas border near Eagle Pass and Obregon, which is near Ammro Co. and the Co. Cortez.

And we just finished the planning, the master planning for a brand new brewery in Vera Cruz, Mexico.

And they've selected a contractor.

We finished the scheduling and we start design next month on that project.

So Nava Mexico is the largest brewery in the world.

This is 1000 acre brewery.

It's also the largest glass of bottle plant in the world.

But in addition to all that beer production, there's standalone administration, buildings, conference centers, there's a hotel on site, there's medical clinics, dining facilities, full recreational facilities, and then they make all their own energy and they treat all their own water, fresh water and waste water.

And you can see by this is where Corona Seltzer is made, Chilito, everything, if I can highlight, that's where Corona Seltzer gets made right there.

So this is the brewing facility.

This is the packaging facility.

This is the glass facility in the background there.

And you can see by the green space that we have ample room for future expansions.

And then in Obregon, Mexico, we have, oh, let me go back a minute.

This brewery produces 30 million hectoliters of beer a year.

That's over 8 billion bottles of beer a year.

That all comes to the US.

Now, it seems like a lot, but that's only about couple cases per person.

So it's not, when you start breaking it down, it's not that much.

But, and then in Obregon, we're on the third phase of the construction of this brewery.

This is a 20 million hectoliter a year brewery.

So what we've also designed into these breweries are parts of, or design aspects, components, areas to really help these workers that work there.

There are about 1400 workers in Obregon.

We provide, or Constellation brands provides transportation to and from the brewery, all three shifts every day for every worker if they want to do that.

We have a large bus drop off area we're working right now in this last phase of design to actually cover this area.

The drop off is right at the Union office building so that the workers can talk to their union representative if they have any workplace issues that they need to resolve.

And then everything is well lit and they have hard walking services to everywhere in the brewery.

And this is really a centralized, so that walking distance are pretty equal distance from this area.

Meals are a big part of what Constellation Brands provides for their workers.

So we have about 90% union employees.

The brewery provides one meal per shift per day.

Now, in response to these rising obesity rates and rising diabetes rates, they've actually hired nutritionist on staff to develop menus, you know, to revamp their menus, to address the proper amount of calories and types of food for their workers to counteract these big effects of sugary drinks and sugary snacks.

They've completely changed what's in the vending machines.

We have two comedor available in Obregon.

And you can see from the design, you know, we're in addition to these dining areas, we have sanitation for easy hand washing.

These workers are coming in from production areas, so they're encouraged to hand wash their hands immediately before eating.

We also are providing quiet rooms.

So they have a places to step away from the noise of their production spaces for a little bit of respite, and they also have a billiards room for recreation with their fellow employees for some socializing also, these spaces are completely non-industrial.

So the whole idea is to create a space that is dignified as restorative, you know, and reinforces also the CBI brands and takes them completely out of their industrial world and puts them into a completely different place to enjoy their meals.

And then we talked early on about the onsite medical clinic.

Now I can tell you that the whole idea around factory clinics, factory hospital is an old concept and worthy of a talk all its own.

For Constellation Brands our onsite clinics are somewhere between a primary care clinic and an urgent care clinic, and they're really for providing basic care.

Immunization, they can get COVID vaccinations, flu vaccinations.

They can get, they have yearly checkups that are available also first, obviously for first aid emergency care if there's an accident.

But they also do audiology testing.

So they're testing hearing because there're a lot of loud stuff goes on on these breweries.

Drug testing, they have a pharmacy on site.

And then we've also provided parking spaces for mobile modalities so that they can bring in mammography vehicles, they can bring in dental vehicles, and they can bring in laboratory vehicles.

So the benefits obviously less time away from work for the workers, better for the employer.

And it allows for the employee, for the doctors on site to really target, you know, and identify illnesses early for these workers.

And then if any of these workers have chronic illness, diabetes, for instance, it helps with the management of those illnesses and those workers' health.

It helps the employers spend less money on healthcare, obviously.

But interestingly enough, they're developing wellness programs and wellness education programs for their employees that they can take back to their homes and their families and their communities to try to turn the tide of some of these health issues that they're dealing with in the country.

And most of all, it helps build trust between the Constellation Brand between the employee and the employer.

So here's the clinic.

It's located on the first floor of the packaging building.

The packaging building is the most populated building.

It's, so most workers, most equipment, most potential injuries.

But it's adjacent to the main employee entry.

So employees can stop by on their way in or on their way out, and also directly adjacent to the production floor.

So that if there are any incidences or a worker wants to stop by during a break, they have easy access.

So pretty simple basic care.

They do have pipe medical gases on site, and they are able to deal with a lot of different types of worker injuries there, inhalation injuries, cuts, falls, scrapes to bruises, things like that.

Also, there's a new NOM that's been recently been issued by the government to deal with workers' mental health.

And so we have provided a multi-use space that can be used for wellness training, wellness education, yoga, meditation for allowing for groups of workers to take a break and to reduce the stress of their workplace.

CBI has big initiatives around advancing and promoting women in the workplace.

So of course we have designed in lactation suites throughout the brewery that are private, that are dignified, that have access to potable water, running, water, dish washing, facilities, refrigeration.

And these are in all the heavily populated spaces within the brewery.

Now, you might laugh the idea of employee break room, but this is like a new concept actually, where we are working, and again, we're designing in employee break areas everywhere where we have large employee concentrations.

So besides taking a break in the dining area, they have an opportunity to really step away from work, make a private call, do a little socializing, take a refreshment, again, creating these non industrial environments to step away from what they're really looking at.

And then real quickly, CBI has made a big investment in recreation and in fitness, and this is for employees and for families.

And you can see all the types of spaces that they've created.

And they have internal leagues between the packaging building people and the brewhouse people.

And they compete against other industrial facilities.

And these are creative and inviting and lit, and again, non-institutional, non-industrial settings for the employees and for their families.

And this is a large, these are separate fields, they're maintained.

There's bars, there's workout facilities, everything for promoting health for these workers.

Now, we can't talk about industrial health without talking about industrial safety and CBI maintains onsite and also corporate, EH and S employees that we, and they have very strict standards, a lot of standards around PP and E. You see that of course in hospitals, you understand what that means.

It's a little more robust in an industrial setting.

We're very, we, our company maintains full-time safety officers that actually review our drawings, our designs for compliance with the Mexican NOMs and also with the CBI corporate safety standards.

Oh, and also our teams are all OSHA trained, where MSHA trained, which is a Mine Safety Health Act.

And before we step foot on any construction site, we go through construction site safety training.

So, you know, and I show you this picture because we've seen a lot of nice pictures, some of the corporate areas of the brewery, a lot of the brewery is highly industrial, dangerous, downright nasty.

And we do all we can to segregate those workers from trucks and from machinery, identify clear pathways and mitigate injuries in every way we can.

So, great pictures.

And you can see fall protection, you can see ladder safety, you can see walkway segregation, you can see level segregation.

But all those kinds of things get designed in to mitigate those types of injuries.

All right, so other initiatives.

CBI pumps a lot of money into their communities.

They fund educational healthcare and cultural institutions and facilities in those cities.

They have big initiatives around sustainability, around water conservation, globe, greenhouse gas emissions, and the diversion of brewing and alcohol byproducts out of waste streams.

Like we talked before when we were looking at lactation suites, they're advancing women in the workplace and they have a big initiative around prosperity to disadvantaged communities.

And of course, because they produce a lot of beer, they're very conscious of the social responsibility of alcohol consumption.

Okay, we're about, what are we about?

Six minutes away from wrapping up.

So let's talk quickly about Vestal Corporation in Mexico.

So our company is about 160 total staff.

About 60 of us are in Mexico.

We're an integrated design services company, which is a fancy way of saying we do everything architecture, all the engineering disciplines plus process engineering.

My team, the architectural team does all the industrial master planning for our company and for a lot of our clients and our engineering teams provide specialty types of engineerings, very unique to the demands of industrial facilities.

So computational fluid dynamics, pipe stress analysis, high seismic zone design.

And so these are kind of esoteric design and engineering components that make us an attractive partner in Mexico.

We've been working in Mexico for 20 years.

We've worked for a lot of Fortune 500 companies.

We have big arch staff, has a big brewing food and beverage background.

We have master brewers on our staff and we've been working for Nestle, for Nabisco, for Pirelli Tire, for a lot of global brands expanding in Mexico.

We also partner, part of our strategy is partnering with large multinational general contractors who are active in Mexico, who want the quality of US design team as part of their projects.

And we have strategic relationships with process engineers and equipment partners specifically in the brewing and distilling industries.

We know how to design for Mexico.

That seems kind of a strange statement, but you can't get the same types of materials, the same types of products, the same manufacturers in Mexico that you can get in the US or in Europe.

So we have to design for what's there, which reduces the cost, improves speed to market and improves quality in Mexico.

Also, our teams are all bilingual, we're bi cultural.

We have full-time translators on site.

I mean on staff.

We produce everything in both English and Spanish.

And all of our drawings in Mexico are all metric.

And that picture is a great shot from the rooftop tariffs of our building in Guadalajara, by the way.

So are we certainly utilize a big technology solutions for working with our Mexico teams.

We use, we adopted MS teams.

I'm sure a lot of my counterparts and my colleagues in the virtual world know this.

We shifted to Microsoft teams right ahead of the pandemic, thank goodness allowed us to stay very active during the pandemic.

We think this really facilitates the idea of team.

It's agile across all devices, encourages communication.

We use it for all of our internal communication.

It allows for easy file access for our remote teams, reinforces our company culture and really, really makes remote work efficient.

Our company was one of the founding members of the Lean Construction Institute, St. Louis Community of Practice.

And we utilize lean processes at both the department and a project level.

And we utilize Project Scrums, which are quick meetings throughout the day, 15 minutes meetings where we talk about what did you do yesterday?

What are you doing today?

What are you doing tomorrow?

What's getting in the way of you accomplishing your work?

So it's a way of us really monitoring progress both on projects.

I use it specifically to monitoring the progress of my team, which not only is in St. Louis but is in throughout Mexico.

And we use the Kanban Board, which is a, what you see here is to really take, really understand what tasks are moving through the department.

And then another idea is called GEMBA, which is a Japanese way of saying, get outta your chair and go see the place, right?

And so we end up traveling a lot, all of our teams, and not just leadership, but if somebody needs to go some somewhere to see something, we send them.

Our teams of Mexico travel within Mexico.

Our teams in US spend a lot of time in Mexico mostly we spend about a week a month in Mexico.

And then of course we utilize Revit for our one source of truth for modeling.

We've recently adopted BIM Collaborate Pro, which puts all of our models into the cloud, which really then makes it more efficient for sharing between our teams.

We also have a large digital technology team, which is part of each discipline, part of each office and part of each project team.

They manage model quality, they establish all of our standards for the company, train staff, and launch all of our new software platforms.

And then real quickly, we consolidate, we use Revizto, which is a program which I encourage you all to examine.

It's for consolidating models.

We consolidate models from about 15 different process engineers, equipment manufacturers, designers, furniture vendors.

We use it for clash detection, not cash detection, clash detection, quality control.

And we utilize it aggressively during design reviews.

And then finally, since we're working remotely, we've adopted a platform called Reconstruct, which really allows us to marry the model to reality capture to the schedule, to really understand what is there and what should be there.

And allows us to do that all by working remotely.

So that's a little bit about worker health in Mexico, a little bit about the history of occupational health, what our big client is doing, and then why we are in Mexico and the kind of things that make us successful there.

So with that, I wanna thank you and I'm open for questions and answers.

(audience applauding) - [Ray] Are there questions for Paul?

- [Audience Member] And Paul, and then welcome back.

- Thank you.

- And after five years you've come back for another excellent presentation and then really different topic.

- [Paul] Very different.

- So workplace health, we were on the topic before in the research center and then maybe we have the chance to collaborate in the future.

And my question for you is that, you know, when you look at workplace health, because it's such a different context, right?

Compared to the United States, what are the major costs for the workplace health problem or safety problem for a lot of accidents that you know, happening over there?

Is that stress or work or that kind of things?

- [Paul] So the major, and I have to tell you that, that gleaning information from the Mexican government about those subjects is a lot different than figuring it out from like the Bureau of Labor Statistics in the US.

So Bureau of Labor Statistics is pretty transparent, although what gets published in 2022 is probably two years old, right?

You can get the raw data from OSHA in the US and you can spend the time digging through it or you can wait for a third party to publish something.

But I can tell you that like the US in manufacturing, you have falls, you have crushing, you know, something falling on you, right?

And you have something bumping into you.

So those are kind of the major things, right?

And I would say those are the what we see.

And then just cuts and bruises, right?

We're also seeing maybe a little bit of burns from steam and you know, kind of hot surfaces.

There's sterilizers and things like that, that get used in the brewing process.

But I would say that's probably the majority of those.

And then repetitive motions.

So picking up things, moving improperly, those are causing those kinds of workplace injuries.

- [Audience Member] Right, it's good to know.

And then I can see that your knowledge in healthcare facility design being transferred to the BM manufacturer design as well.

- [Paul] I don't represent myself to be an expert in this.

I think this is gained from observation for the last couple of years.

I have counterparts and in constellation brands that have helped me understand this better.

And what I'm enjoying is, and what I've enjoyed about preparing for this presentation is really taking a deeper dive into it and understanding it more.

I think the ideas around factory health, factory health clinic, factory hospital are ideas that were adopted by industry early and they were put aside and I think they have a place now to be re adopted.

And I think figuring out ideas around best practices I think would be an intriguing study.

- [Audience Member] And also you're providing healthy diet on site as well.

That's a great idea, yeah.

- [Paul] There's the, I can't quote it right now.

I have it in my research that the whole idea about having health educators on site is transformative to those populations.

So if these health educators can access workers during their breaks, during their time they're eating or even during on the buses while they're going to and from work to talk about the foods they eat, getting exercise, you know, doing these transformative things that would improve their health actually has lasting consequences more than trying to tax sugary drinks or to limit portion sizes or things like that.

- [Audience Member] Especially for a beer company right?

That is great talk.

Thank you Paul.

- [Paul] Thank you very much.

- [Ray] Other questions?

Okay, I'll ask, but my question is to our audience.

- Okay.

- You know, around here our focus on design for health is in three dimensions, right?

Can you call them out?

The three aspects of designing for health.

- [Audience Member] Design for health one, design for health two, design for health three.

- We split our program into three areas.

Healthcare is one of the three.

The other two, protecting health and developing health.

Did you see anything in Paul's presentation about the beer company that was about protecting health?

Didn't you see a lot of information there about worker safety?

Did you see anything in there about services, other materials available to workers to help them develop better health?

You just talked about (indistinct).

Did you hear about facilities that are being developed to provide restorative care once there's a need for repair of injury or repair or addressing an illness or a disease?

Did you hear about facilities being developed for restorative purposes?

Here's a classic example of the point that we make here at the center, Paul, it's a textbook case for us, designing for health applies to every building type.

You can't name a building that doesn't impact the health of the people in it.

Now here we've got an industrial site and the presentation easily segments into the three pieces.

Things that were done in the design purposefully to protect the health of the people in the building, to improve and develop better health for the people on the project.

And the capacity to deal with injury or illness developed on the part of the people in the industry.

Classic textbook case designed for health and that's what you told us you were gonna talk about and it was nicely delivered.

It's a textbook example that covers all three areas of what we teach, what we focus on here at the Center for Design for Health.

It's an excellent presentation.

Final question.

We have about a minute left.

- [Gaida] Yeah, thank you for your great presentation.

- [Paul] My pleasure.

- And I have a question about the education area.

Like six years ago I was in a college and they provide a lot of recreation area for students, but actually nobody used them.

So who do you think it's his role to encourage the worker to use this recreation area?

Do you think it's like they should provide time to play basketball or they have to divide their worker to teams to encourage them to use the recreation area?

- [Paul] My understanding is that it's very well utilized.

Okay, so it's utilized a lot on time off.

They play soccer, basketball, tennis, There's a walking track, there's an outdoor gym area.

There's a covered shell space, a covered multi-use space for like quinceaneras and for family gatherings, even for talks.

There's a beautiful two story bar that's available.

There's covered barbecue spaces for families.

My understanding is it gets utilized very heavily by the employees of that brewery.

So I don't think that there's necessarily any kind of need to encourage them.

- Paul, it's a great answer to a great question.

Thank you Gaida.

And with that, our time is up.

Thank you so much for being here.

One final thank you to Paul.

- Thank you everybody.

(audience applauding) Thank you buddy.

- Nicely done.

- Thank you.

- Beautifully done.

(upbeat music)