Sustainable Flooring
HEALTHCARE - TOP 5 GREEN BUILDING STRATEGIES
EPA Publication 909-F-07-001
What? Hospital flooring must satisfy numerous requirements including: comfort, low-
maintenance, infection control, low cost, safety, and aesthetics. Sustainable
flooring alternatives are available to meet these demands and reduce
environmental impacts during manufacturing and installation.
Enhanced Community Reputation:
• Visible and attractive
• Demonstrates environmental
stewardship
Environmental /Staff/Patient
Benefit:
• Less impact on the environment
and building occupants
• Can improve employee satisfaction
by reducing staff fatigue, and slip,
trip, and fall incidents
• Can reduce maintenance
Cost Competitive:
• Reduces environmental
impact during installation
• Less chemical use and reduced
accidents can lower maintenance costs
Assemble diverse product review team including relevant staff
Identify most recent products available
Quantify benefits: lower maintenance chemicals and labor; improved air
quality, safety improvements
Emory University
University of Florida
How?
Case
Studies
Green Guide for Health Care (GGHC) Criteria: Construction: Materials & Resources and Operations:
Environmental Services and Environmentally Preferable Purchasing www.aahc.org
This is one of 5 Building Healthy Hospitals case studies developed by EPA's Pacific Southwest Regional Office,
with Resource Conservation Challenge and Pollution Prevention funds.
www.epa.qov/reqion09/waste/p2/pro1ects/hospart.html
Indoor Air • Sustainable Flooring • Process Water Efficiency • Lighting Efficiency • Energy Efficiency
Building Healthy Hospitals
2007
This fact sheet was produced by EPA's Pacific Southwest Regional Office. Mention of trade names, products, or services does not
convey, and should not be interpreted as conveying official EPA approval, endorsement, or recommendation.
Printed on 100% recycled paper, 50% post-consumer content - process chlorine-free
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Sustainable Flooring
HEALTHCARE - TOP 5 GREEN BUILDING STRATEGIES
The number and variety of sustainable flooring materials is in a state of flux with new daily
offerings from manufacturers and an equally wide range of applications and user
experiences to consider and digest. The following table summarizes the commonly available
sustainable flooring materials and provides brief descriptions, cost ranges, and applicability
in healthcare facilities.
SUMMARY OF SUSTAINABLE FLOORING MATERIALS
Flooring Material
Bamboo is aesthetically
pleasing, durable, and made
from a rapidly renewable,
abundant resource.
Cork is harvested from the
bark of the cork oak tree every
9-11 years, leaving the tree to
remain living an average of
100-120 years.
Linoleum is a natural product
made from linseed oil, wood
flour, rosin, jute and limestone.
Rubber is a hard-flooring
alternative made from natural
material.
Forest Stewardship Council
(FSC) Certified wood
flooring comes from recycled,
sustainably harvested, and/or
local family forestry operations.
Description
Installed similar to
hardwood, bamboo
is available in a
variety of lengths
and finishes
Cork is available as
floating floors
(earth series and
classic series),
parquet tiles,
EcoCork, wall tiles,
and underlayment.
Installed similar to
other sheet flooring.
Durable, no-wax
maintenance, and
more slip-retardant
than other types of
hard surface
flooring.
Conventional
hardwood flooring;
available in solid
and laminated
veneers
Cost
(per ft2)
$3.75 -
$6.50
$5.00 -
$8.00
$3.75 -
$7.50
$3.00 -
$5.00
$4.50 -
$12.00
Healthcare Application and
Maintenance Considerations
Very durable products and appearance
is similar to other natural wood
products familiar to the public.
Available product can vary significantly
in quality; source certification is less
easy from some suppliers though most
well-known manufactures offer it.
Some products are susceptible to very-
high moisture applications.
Cork is comfortable, reduces noise, and
is easy to maintain. However, porous
surface can be difficult to clean to strict
infection control standards at healthcare
facilities.
Use of this material in areas where
frequently exposed to sitting water (or
high risk of temporary flooding) is not
recommended; increasingly common in
healthcare.
Some facilities do not approve of its
aesthetic in common areas. Some
concerns for individuals with multiple
chemical sensitivities (MCS).
Available as engineered or solid and
prefinished or unfinished product; not
commonly found in healthcare settings
outside of decorative use in lobbies and
waiting rooms.
Note: Costs vary constantly for flooring choices and the number and variety of sustainable choices is ever-
increasing; check with your designer and contractor for current offerings.
Building Healthy Hospitals 2
An EPA P2 Project
This fact sheet was produced by EPA's Pacific Southwest Regional Office. Mention of trade names, products, or services does not
convey, and should not be interpreted as conveying official EPA approval, endorsement, or recommendation.
2007
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Sustainable Flooring
HEALTHCARE - TOP 5 GREEN BUILDING STRATEGIES
CASE STUDY 6: MARMOLEUM—A NATURAL LINOLEUM FLOORING
Applicability: New construction, major renovation, or remodeling projects.
Environmental
Impact:
Other Benefits:
Reduce chemical and hazardous material use in flooring
manufacturing process; reduced chemical use associated
with maintenance.
Varies by flooring materials (long term maintenance
requirements, improved safety through reduced slip, trip,
and fall incidents, etc.)
Background
Both the University of Florida and Emory evaluated potential flooring
materials for installation at their respective buildings against the
following informal performance criteria:
• aesthetically pleasing;
• durable enough to withstand heavy pedestrian traffic and
frequent equipment rolling loads;
• easy to clean and maintain; and
• provides a safe walking surface for staff, patients, and visitors.
Of those listed above, Emory found the most difficulty in finding sustainable flooring
materials that are both durable and easy to clean to strict infection control standards of
healthcare facilities. Furthermore, when materials do meet these criteria—such as bamboo
or FSC certified hardwood—the preferred choices are not more expensive to purchase
compared to conventional flooring materials.
After separate analyses and despite Emory's challenges, both facilities installed Marmoleum,
a natural linoleum flooring material.
MARMOLEUM PRODUCT SAMPLES
Vibrant colors with texture
Lightly marbled texture
Courtesy of Forbo® Flooring.
Solid color, no texture
Building Healthy Hospitals 3
An EPA P2 Project
This fact sheet was produced by EPA's Pacific Southwest Regional Office. Mention of trade names, products, or services does not
convey, and should not be interpreted as conveying official EPA approval, endorsement, or recommendation.
2007
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Sustainable Flooring
HEALTHCARE - TOP 5 GREEN BUILDING STRATEGIES
Performance
Emory installed Forbo® Marmoleum in the clinical areas of Winship Cancer Institute and the
University of Florida installed the Forbo® Marmoleum in it physical therapy rooms and
various other locations. Like other hard flooring products, Marmoleum comes in a variety of
colors and patterns to ensure the products fits with the aesthetic design of the building. In
2 years of use at Emory, the material has endured the high-traffic and frequent equipment
rolling loads in the clinical areas. And despite problems with the underlayment preparation
(unrelated to the Marmoleum) at the University of Florida's Sports and Orthopedic Surgery
and Sports Medicine Institute, the Forbo® Marmoleum has performed well. Lastly, both
facilities have received feedback from staff and patients surveyed that they are "as
comfortable" or "more comfortable" on the floor compared to similar areas with
conventional flooring with the walking surface in terms of slipping and stability.
At Emory, the success of using Marmoleum at the Winship Cancer Institute was a
combination of pre-installation design considerations, wear-prevention, and proper cleaning
and maintenance. Emory generally found no additional maintenance effort with the
Marmoleum when following strategies recommended by Forbo's® General Floor Care
Guidelines:
• Color Selection. The selected color of a floor covering can play a significant role in
the apparent cleanliness of the floor. Emory chose to install patterns and colors to
minimize the visible appearance of dirt being tracked into the Winship Cancer
Institute.
• Entrance Mats. Forbo® estimates that as much as 80 percent of dirt entering a
building comes in on occupants' footwear; therefore, use of entrance mats can
considerably reduce floor soiling. Emory employs entrance mats at all building
entrances and cleans them regularly as part of routine maintenance tasks.
• Staining from Mobile Equipment. Equipment with dark rubber tires or casters are
commonly used (and frequently moved around) in healthcare facilities. Although the
discoloration is generally less marked with linoleum flooring than with vinyl flooring,
precautions should always be taken to minimize the risk of staining. Emory did not
change the wheels of any rolling equipment and did not report floor marks or
additional effort related to mark removal
• Physical Damage. All resilient flooring materials are susceptible to certain types of
physical damage. Stationary objects such as furniture should have adequate floor
protectors. If the pressure exerted by an object on the floor covering exceeds the
floor covering's rated capacity, permanent indentations can occur. Emory takes the
Building Healthy Hospitals 4 2007
An EPA P2 Project
9 -
This fact sheet was produced by EPA's Pacific Southwest Regional Office. Mention of trade names, products, or services does not —•
convey, and should not be interpreted as conveying official EPA approval, endorsement, or recommendation.
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Sustainable Flooring
HEALTHCARE - TOP 5 GREEN BUILDING STRATEGIES
same precaution with its Marmoleum flooring as with other flooring instructing its
staff:
• Do not slide heavy objects across the floor.
• When moving heavy objects, protecting the floor covering with thin sheets of
masonite or plywood.
• Proper Use of Floor Care Chemicals. The chemicals used to clean flooring directly
impact the appearance, wear, and longevity of the product. Quaternary ammonium
compounds are commonly used in hospital disinfection programs. When mixed and
used properly, quaternary ammonium compounds will have little or no effect on the
physical properties of most flooring materials. Phenolic disinfectants are very caustic
and may damage floor coverings or other surfaces that they come into contact with.
Forbo's warranty does not cover damage caused by phenolic disinfectants. Linoleum
flooring should never be cleaned or stripped with high pH chemicals because
permanent damage may occur. Abrasive powders or cleansers should not be used
on Forbo floor coverings. Emory finds that proper cleaning techniques is the most
important factor to maximizing the life of the Marmoleum and premature wear of the
flooring is most likely a result of inappropriate cleaning and maintenance techniques.
Cost
Neither Emory nor University of Florida provided specific cost information on this product.
4-4-4-4- Case Study Vitals
The following summarize success criteria for implementing this project at other healthcare
facilities:
• Evaluate sustainable flooring materials to the specific performance needs of each use
area, such as administrative, patient care, and common areas. Determine which
sustainable flooring product(s) can be installed in each area.
• The success of installing sustainable flooring materials is contingent on a
combination of pre-installation design considerations, wear-prevention, and proper
cleaning and maintenance.
Building Healthy Hospitals 5 2007
An EPA P2 Project
9 -
This fact sheet was produced by EPA's Pacific Southwest Regional Office. Mention of trade names, products, or services does not —•
convey, and should not be interpreted as conveying official EPA approval, endorsement, or recommendation.
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