How Do We Make Healthy Buildings the Next Public Health Revolution?

Joseph Allen

M arianne O’Hare : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter. This week we welcome Joseph Allen, f ounder of the
Healthy Buildings Program at the Harvard School of Public Health,
seeking adoption of building standards tha t are aimed at promoting
and protecting health.

Joseph Allen: This is a strategy that's good for all infectious diseases and whatever
curveball COVID throws at us next.

Marianne O’Hare : We hear from FactCheck.org’s Managing Editor Lori Robertson and we
end with a bright idea improving everyday lives. Now, here are your
hosts Mark Masselli and Margaret Flinter.

[ Music ]

Mar k Masselli: Our guest believe s our buildings can make us sick or keep us well and
that we need to make healthy buildings the next public h ealth
revolution. But how do we reach this goal and what are their hurdles?

Margaret Flinter: Joseph Allen holds a Doctor of Science degree. He's an Associate
Professor and D irector of the Healthy Buildings Program at Harvard
University's T . H . Chan Sch ool of Public Health. H e co - wrote Healthy
Buildings : How Indoor Spaces Drive Performance and Productivity.

Mark Masselli: Well, Joseph, welcome to Conversations on Health Care. We're big
fans. But before we dive deeply into the topic, let's just start with
you r definition of a healthy building and why they are so important.

Joseph Allen: Well, so it's great to be here. Thanks for inviting me. I think it comes
down to something that's really quite simple before we define what a
healthy building is and why it's s o important. The reality is we spend
the vast majority of our time indoors . We are an indoor species, yet
we spend all of our time I think thinking about out things like outdoor
air pollution, and how the outdoor environment impacts our health.
But the rea lity is that the indoor environment has this massive impact
on our health. But the way we design operat e and maintain our
buildings hasn't been always designed around what we know the
science tells us an indoor environment can be designed to promote
health , not just protect us from disease that's important, but also
pr omote our health and well - being, and so we'd been in the sick
building era for the past 40 years.

Margaret Flinter: Well, Joseph, before you took your role at Harvard, I understand that
you've worked as a forensic investigator of sick buildings, which is
very intriguing as an idea sounds like real CSI stuff. Tell us a little bit of
the story. How did you get into this line of work and study?

Joseph Allen: Yeah, so that's an interesting longer s tory. I went to school for b iology
at Boston College. Then for years, I went back and did the work I was
doing while I was in college, I was a private investigator in New York

Joseph Allen

City, so doing a different kind of investigation or forensic
investigation. Went back to grad school, got my degrees in public
health , and it was there a fter I left and got my degrees I started
working for a consulting company that started to do with these
investigations of sick buildings, and they were forensic investigations.
Everyt hing from what would see m as minor, but it's not things like
eye irritation or malaise, or something's off in a building to the very,
very serious . H ospitals w h ere multiple people had died from
Legionnaires disease or an investigation with the US Army abou t 11
infant deaths at the base that they thought might be attributable to
the housing.

In all of these, the goal, my goal and with my team was to determine
if there was a cause , an environmental cause related to the building
performance that was causing th ese cancer clusters or disease
outbreaks, sometimes deaths. I f we did find something, not only just
finding it, but putting the controls to resolve it to be sure no one else
was impacted.

Mark Masselli: Well, Joseph, I love this proposition that clean buil dings should be the
next public health revolution. I know people are eager to know how
would that work and are you looking for public dollars to make all this
happen?

Joseph Allen: Well, we have some public dollars available. But let's start with the
reaso n why we have to have that happen. In the 1970s, we started
tightening up our building envelopes in response to the energy crisis .
We stopped designing buildings for people. Public health lost its seat
at the table in the architectural design and engineeri ng community , s o
it wasn't a surprise that we had this sick building era. W e were
confronted with all of our buildings that many of them that
underperform in this era. T his is why that revolution, the healthy
building revolution has to change because it sh ould be obvious that
we need to design buildings in a way that promote human health.

I think what's become obvious because of COVID , a virus that spread
nearly entirely indoors, that the indoor environment is really
impacting all of us all the time and has been under app reciated. T hat's
the genesis, short g enesis of w hy we need this revolution to happen .
How do we make it happen? I think the new work with the White
House just over the past couple of months one elevating this
conversation. The White House, w e worked with them they put out a
clean air and buildings challenge . T hat sets the stage. This is important
from our top pulpit , bully pulpit in the United States t hey're saying
this i s important. I think that's key.

For things like schools , w e have the Am erican Rescue Plan Funds ,
hundreds of billions of dollars still on the table in terms of f ixing our
school infrastructure. Much of it not spent yet , so there are still

Joseph Allen

opportunities out there. I don't think it's enough. I think we're just
getting going , th ere have been bills proposed in Congress to give tax
incentives for companies that would upgrade their ventilation
systems or put an air quality monitoring. I think there's a lot of clever
levers we can pull to help promote or advance this healthy building s
movement. But the very first one was the recognition that it's
important. I've been talking about this for 20 years, there's some
leading companies doing but it wasn't till COVID that we really g ot
healthy buildings on the map. Now that people are talkin g about it,
we can put in some of these bigger policies.

Margaret Flinter: Well, you are so right the way that COVID has made this a front and
center issue, whether you're inviting people to your home for a
holiday dinner or you're a health care facility d ealing with whether
rooms stay open or have to be shut down after somebody comes in .
COVID has made this a front and center issue. But you said several
months ago, December of last year I think it was , that the playbook,
the country's playbook to fight COV ID is outdated a nd you had a
number of ideas. L et's check in with you. What's your thinking now on
what we're doing right and what we're doing wrong with regards to
our indoor spaces or anything else regarding the COVID pandemic?

Joseph Allen: Yeah, so the re were a couple of things. Just like in that article, I say we
shouldn't use a 2019 playbook in 2020 . I think it was inappropriate to
use our old playbook in 2022. Things like contact tracing, that's just
not working anymore a nd we have new tools, specifi cally vaccine,
better therapeutics . W e now have rapid tests, we've been calling for
these for a long time. Y es, in that mix was again a call for better
ventilation. I've written 50 s omething Op - eds since the pandemic first
started . Every single one mention s ventilation , so t his had to be part
of the playbook.

Actually, this is what has changed , t here has been a big shift. The
Biden administration's pandemic plan has now elevated healthy
buildings, clean air and buildings as one of the pillars along with
vac cination, then therapeutics, masking, testing, and now clean air
and buildings. W e're starting to see som e of these as the new
playbook. But it’s things we've known all along, to be honest . We
knew we needed those rapid tests early. We knew we needed a
vac cine we got that through Operation Warp Speed . We knew we
needed therapeutics, they're coming along.

Ventilation of buildings were not discussed for full year, really, except
by a small group, right. But it's now entered into the mainstream in
terms of thi s 2020 playbook. B y the way, this should not go away
when COVID goes away. This is a strategy that's good for all infectious
diseases and whatever curveball COVID throws at us next.

Mark Masselli: Well, you've also entered the mainstream and you're a proli fic writer,

Joseph Allen

and you've written some things that really caught people's attention
particularly focused in on the Transportation Security Administration,
and really requesting that -- and its mass mandates for flights. But you
l aid out very clearly in your o p - ed in The Washington Post some ways
the airlines could diminish the really small risk from flying during
COVID. I wonder if you could share some of those ideas. J ust really
out of curiosity has the airline industry reached out to you in terms of
efforts that they've been taking?

Joseph Allen: Yeah, so let’s grounded in what the article was and why . I mean , so
I've been studying in 2013 I was one of the lead authors of a national
academies report on infectious disease transmission in airports and
airplanes , s o it's something I've been talking about researching for a
long time. T he article, I think, might surprise people. T he key point is
that you really don't get sick on airplanes. A lot of people are going to
say, w ait a second, I always get sick when I tr avel, and maybe you do
you change time zones, you don't sleep that well, you maybe take a
bus to conference room , a hotel room. But it turns out the time on
the airplane is very low risk and why , it gets back to what we talked
about for buildings g ood vent ilation and filtration.

In fact, to put some numbers on it, in school you might get two or
three air changes per hour, your home make it happen air change per
hour . In an airplane, you're getting 10 , 20 p lus air changes per hour .
A ir comes off the engine, fresh outdoor air comes inside, you get a 50 -
50 mix of re - circulated air, the re - circulated air all goes through HEPA
filters, high grade filters. T he time o n the airplane is actually low risk.

But I flagged one thing in that article, and it's the same thi ng I flagged
10 years ago . During boarding and when you get off the plane, the
systems aren't always running. N ow you have a lot of people exerting
a lot high emission rate, small volume tube with no ventilation or low
ventilation, low filtration. That's a high risk type. That's an area where
I think masks should stay on, or airplane airlines need to be running
ventilation systems at the gate. We've been saying this for 10 years.

I haven't been talking to them. Specifically I don't advise any airlines
or ma nufacturers o ther than I've been talking about this loudly for a
long time to anyone who listens . Our studies have shown it for a long
time that the ventilation rates are low when the airplane i s parked at
the gate .

Margaret Flinter: That is a very good ta ke home message I think that all of our listeners
are going to remember from this show , s o thank you for that. Let me
ask you another question a nd that is about some of the financial
implications of making changes to buildings, certainly looking at a
numbe r of indicators that are worrying people about inflation. Being,
at a four year high interest rates rising, some indications, possibly we
could be entering a recession.

Joseph Allen

I'm sure you're hearing the argument that we really don't have the
financial resources at this time to pay for healthy buildings or for the
redesign to make them healthier. I have a feeling you've probably
looked at the economic cost of not doing what you recommend needs
to be done. What do you say to people that say this is too expensive
a n d we can't get this done?

Joseph Allen: Yeah, I’ll make the business case for this I think really clearly for
anyone, any executives that are listening, but let's just talk about the
COVID risk first. I mean, if you haven't -- this has now become
existenti al, if you don't handle your buildings properly, you're going to
have cases it's people can get sick and your building , people may die
because of spread in your building . Y ou have brand damage issues.
T here's a lot of good reasons people's health being num ber one, that
we have to do this, and COVID change d that.

Let me talk about the business case, even beyond COVID. This is going
to surprise a lot of people. F irst, our research has shown if you make
these healthy building investments, the costs are o n the order of $40
per person per year, against the benefit of $ 6 ,000 to $7,000 per
person per year in gains from productivity. That's the individual level .
You can look at the data in our book, I wrote it with Harvard Business
School Professor John Macom b er. W e looked at what happens if a
business puts in these healthy building strategies, we estimate that
even including the cost, upfront cost, the CapEx cost, bottom line
benefits to the company on the order of 10% , they have an i ndividual
benefits, business ben efits.

Th en third, a new study at MIT, out of our -- from our friends at down
the road at MIT, showing that healthy buildings actually command a
higher lease or rental rate than their peers controlling for other
factors. A ctually healthy buildings are a no - brainer, right , i t's good
health decision b ut it's also a good business decision, just a good
financial decision, despite what I think is maybe seen as common
knowledge that well, this must be expensive. The reality is sick
buildings are expensive, health y buildings are great business, a great
business decision.

Mark Masselli: Well, and that's -- I want to pick up on two points, one on the healthy
buildings. I want to go back to your answer around the airlines.
T hey're getting 10 changes per hour. Tell me what’s the standard
should be in our home a nd you were suggesting the homes were
much lower. T hen also in a healthy building what should we expect?
W e have people coming back to offices, what are some of the markers
a nd also maybe is there anything that we should be looking at CO2
readings that might be helpful for -- what's the gauges that we might
be looking at as a layperson in terms of simple questions that we can
ask our employers about? Are you meeting these standards?

Joseph Allen

Joseph Allen: Yeah, great questi ons in there. O ne of the things we did was set a
target air change per h our target , target ventilation rate. As far as I
know, I don't think -- I think a lot of the major organizations have not
really put out a number. I think that's been a problem , s o let 's just get
right to it . I wrote an article in JAMA recommending four to six air
changes per hour. To put some numbers on this , typical US home
median gets about half an air change per hour . A ir changes, you think
about the volume of room of air in a room getting changed out. If it’s
an air change per hour is going to take at least an hour, two hours to
clean out all that air s o we want four to six air changes per hour.

Schools designed for three air changes per hour , b ut a design
standard, not a performanc e standard , m ost have degraded over
time, most schools get about one and a half air changes per hour, not
nearly enough. A irplanes , now you're talking 10 , 20 air change per
hour getting a lot of turnover, and for reference a surgical suite would
get 12 air changes per hour . W e pegged our four to six this is what
happens in a typical patient room in a hospital targets four to six air
changes per hour. T hat's kind of a target that we like that,
conceptually it makes a lot of sense.

Y ou have these respiratory aerosols that we all admit all the time,
they'll build up indoors in under ventilated , under filtered places , y ou
have to remove them, you need some rapid turnover. Now your last
question is really good in terms of what can somebody do . I think the
first t hing to do is simply ask the question, and you'll know how your
building ’ s performing based on that answer. They'll look confused,
like they'd never heard it before , t hey're going to be right on top of it.
You want more outdoor air , y ou want MERV 13 filter s or higher.
Typically, we use a MERV 8 filter captures a very small percent of
particles. These are filters designed to protect equipment, not people .
You want a MERV 13.

Three, you can supplement this with portable air cleaners , s o you
want higher ventil ation rates. MERV 13 filters are better, maybe
portable air cleaners. Your last point is you can get a portable air CO2
monitor like I have in my office right now. That's too high , I'm going to
open my window , that’s over a thousand parts per million . I li ke to see
this under 800 parts per million of CO2, that'll tell you you're really
well ventilated.

Now, there's a caveat , it’s a long answer but there’s important caveat
here. CO2 tells you about the ventilation performance . I t does not tell
you about filt ration performance , s o you could have high CO2 just
went up, I'm talking a lot, I have a high e mission rate right now , my
windows were not open, I just popped them open, we'll check back
on this later. But you can have high CO2 with good filtration and it not
be a risk. B ut if low CO2 under 800, you're in good shape.

Joseph Allen

Margaret Flinter: Well, that was a lot of very actionable information that I think people
will find really useful. I wonder if I can ask you to comment on health
care as one sector. You talked a little bit about the surgical suites . I'm
remembering back to the campaign, which is ongoing Health Care
Without Harm , where we encourage everybody in health care to
really step up around the environmental impact the health care can
have and making a dif ference in that.

It seems from what you're saying that hospitals, community health
centers, clinics, doctor's offices, health care offices, maybe should
really be held to a higher bar than what they are today, by
themselves, by public opinion a nd if all th at fails by accreditation and
licensor people . W hat's your sort of interaction with the health care
community around them really needing to step forward and be
leaders in this and also probably educating patients about what to do
at home as well?

Joseph Al len: Yeah, I think you hit it right there. I mean, firstly I love the work of
Health Care Without Harm for they've been doing terrific work for a
long time. I think it's a leadership opportunity for the health care
industry in a couple of levels, right . Yo u think about the work, the
original work Health Care Without Harm saying, let's just have healthy
materials in our space . How could we possibly using materials with
toxic chemicals in them . We have to change our practices . E ven going
back to mercury therm ometers back two decades, right . T hen now
we're talking about well how do you create healthy building centers
such that we don't just want good ventilation in the places where we
have aerosol generating procedures, or we think we need respiratory
protectio n . It turns out, we're all -- we know this, we're all emitting
these viruses all the time if you're infected , s o we want good air
quality everywhere in the building, right , s o there's a leadership
moment .

We can't -- we also -- there’s a real opportunity t o o to take a
leadership position in merging this healthy building movement with
the green building movement , right . We can't just dump a lot of air
and not really think about our energy expenditure knowing that
hospitals are our major draw on our energy sy stem dominated by
fossil fuel combustion, contributing to local air pollution impacts and
climate change. T here's an opportunity to find this sweet spot to say,
well how do we create a healthy building space while also reducing
energy . I t can be done while using healthier materials, while
educating the people who come through our doors that instead of
just coming for treatment, we can push some of these upstream
where you live has a massive impact on your health.

Can we push all of this into affordable hous ing, such that we're
providing not just housing, but actually healthy housing, that's green

Joseph Allen

housing, that's also reducing the demand or environmental footprint ,
s o we can do all of that and health care system , I mean, you have the
leadership position and t he trusted voice, right. W hen you act, people
follow it, this is the way it should be done with a holistic health lens. I
don't think healthy buildings have been part of the health care
conversation all the time.

Mark Masselli: Well, I really want to pick up on your theme about leadership. I think
it's so important. Y ou were talking earlier about the Biden
administration t hough I don't think they've connected all the dots, I
think they're hopeful that the schools and the municipalities will use
that money w isely. But what additional leadership is really going to be
required, and then talk to us about your ec osystem of allies that you
have b ecause it really is going to take a whole village of people to be
engaged in this process . W ho would you appoint people to in terms of
our listeners, to keep an eye on , certainly your writing is one of them.
Talk to us a little bit about other folks that we may want to be
listening to.

Joseph Allen: Yeah, I mean, this sounds biased because it's people in my field, right .
I' m in a small field, right , I'm an E ditor of the journal Indoor Air,
people probably didn't know there's a journal called Indoor Air. It's
been around for a long time. T hat field has been -- we don't get a lot
of funding, we haven't got a lot of attention, we finally forced our way
to get some attention during the COVID crisis to say this is actually an
indoor air issue. T here's lots of great untapped expertise in that
domain . I would say if you're in the healthcare space, or you're
thinking about your next infectious disease grant or whatever it is, or
healthy materials , there’s a whole group of people that have spent
their careers focusing on healthy building strategies that has tie - ins to
physical activity and health, nutrition and health, air quality and
health, infectious disease and health it has all these cross linkages, but
I don't think groups necessarily think about our field right off the bat, I
think you should .

In terms of what other groups, something I would like to see more of
in this kind of cl ean air and buildings work or healthy buildings work,
particularly from the government sector, is a little more public private
partnership. I think we've seen massive success with the vaccine and
therapeutic and even masks and testing where the government is
essentially guaranteed a market here. W e haven't really started to
connect the public and these private organizations with public for the
public good , and thinking about our building level strategies. There's
lots of good companies out there , small comp anies, big engineering
companies that would love to be connected with the market. They
have the knowhow and the skill set , but we haven't always played
matchmaker , and I thin k we could do a lot more there.

Joseph Allen

Mark Masselli: I think people are a little lost he re in terms of what should be the
standard. You did a wonde rful job there. Thanks so much.

Margaret Flinter: I've got to tell you that we have certainly realized the impact of having
a shutdown rooms because of exposure to COVID, and the huge
economic cost of that as well so lots of -- - [Crosstalk]

Mark Masselli: Maybe just one quick one , for healthcare facilities that have to
shutdown rooms because there was somebody there. Is there a
standard that you would use about the time they can come back and
start utilizing the space again?

Joseph Allen: Yeah, I think most people would be surprised to learn that it doesn't
take long to air out of space, right . Think about this air change per
hour idea. You got a couple air changes in the air, which doesn't take
all that long if you have a good system . It could be as quick as 20
minutes, 30 minutes . You're going to remove a lot of that virus. If you
have someone who is infectious, and they're known infectious, even
within an hour and that's a long time . B ut you can do a good job of if
you have four to six air changes you're going to be pretty good after
30 minutes, right . It's not like this is going to linger for days and days
clean the surfaces down , get a couple air changes in there , and you
should be good to go.

Mar k Masselli: Great, perfect . Thanks so much.

Margaret Flinter: Thank you, Joseph Allen . You have given us a lot to think about in
terms of healthy buildings , and what all of us can do to advocate for
more of them. T hanks t o our audience for joining us. You can learn
more about Conversations on Health Care and sign up for our email
updates at www.chcradio.com . Joseph, thank you so much for joini ng
us today.

Joseph Allen: Thank you . I enjoy ed the conversation.

[Music]

Ma rk Masselli: At Conversations on Health Care, we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, no nprofit consumer advocate
for voters that aim to reduce the level of deception in US politics. Lori,
what have you got for us this week?

Lori Robertson: In the wake of mass shootings in Buffalo, New York and Uvalde, Texas
some officials have cited mental i llness as a reason for the
unprovoked attacks. But as we've explained before, having a mental
illness isn't predictive of who will perpetrate a mass shooting. Back in
2019 we answered a question from a reader about the relationship
between mental illness a nd mass murder following two mass

Joseph Allen

shootings in Texas and another in Ohio. At the time, then President
Donald Trump suggested mental illness was one of the primary
culprits . “ Mental illness and hatred pulls the trigger, not the gun ,” he
said during a televi sed address following two of the shootings.

Once again, there is another set of mass shootings and politicians are
making similar claims. On May 24, an 18 year old killed 19 children
and two teachers at an elementary school in Uvalde, Texas. A week
and a h alf before another 18 year old killed 10 people at a grocery
store in Buffalo, New York in a racially motivated attack. In a speech at
the National Rifle Association Convention in Texas on May 27 , Trump
again focused on the role of mental health in mass sh ootings.

Texas Governor Greg Abbott also brought up mental health in a press
conference the day after the Uvalde massacre even as he
acknowledged that the shooter did not have a known history of
mental illness. “ We as a state, we as a society need to do a better job
with mental health. ” Abbott said, adding, “ Anybody who shoots
somebody else has a mental health challenge. ”

As we explained in our 2019 article, people with mental health
disorders are more likely than those without such conditions to
commit act s of mass violence, but many mass shooters do not have
mental illnesses. It has not been shown that mental illness is the
primary cause of mass murder. Abbott's belief that anyone who
commits a mass shooting must have a mental health problem is
common. But experts told us it was flawed .

Beth McGinty, a mental health and substance abuse policy researcher
at Johns Hopkins University told us that those who commit violent
acts aren't mentally well, drawing a distinction between mental illness
and mental wellnes s. But that doesn't mean that the person meets
the criteria for a mental illness or that treatment would have
eliminated that person's violent act. She told us that it's important to
improve the mental health system, but it wouldn't significantly reduce
ma ss shootings or interpersonal violence overall.

Rather than focusing on mental health diagnoses, experts suggest
paying attention to disturbing behavior as the best predictor of
violent behavior is prior violent behavior. For more on this issue, see
our we bsite FactCheck.org . I'm Lori Robertson, Managing Editor of
FactCheck.org.

Margaret Flinter : FactCheck.org is committed to factual accuracy from the country’s
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you’d
like check, email us at www.chc.radio.com . We’ll have FactCheck.org’s
Lori Robertson check it out for you here on Conversations on Health Care.

Joseph Allen

[Music]

Margaret Flinter : Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Smoking bans
across the country have yielded countless health benefits in myriad
ways, reducing smoking related illness and death. W hile smoking in
most buildings and public establishments has been banned across the
country for years, it's still a ubiquitous practice in most of the nation's
casinos, subjecting employees and patrons of these establishments to
secondhand smoke exposure.

The State of Colorado recently passed a ban on smoking in the state's
casinos, and the results have been dramatic. Once smoking was
banned. The number of emergency ambulance calls dropped by 20% .
Dr. Stanton Glantz , Director of the Center for Tobacco Contr ol,
Research and Education at the University of California, San Francisco,
says it's really a pretty simple equation. Long term exposure to
secondhand smoke increases the risk of the development of blood
clots that can bl ock arteries causing an attack.

Dr. Stanton Glantz : There's the long term effects of increasing atherosclerosis but there's
also this acute triggering effect , and even a few minutes of
secondhand smoke exposure is enough to make your blood platelets
get stickier. W hen that happens, they are more likely to form a blood
clot and if that blood clot lodges in an artery in your heart it causes a
heart attack . Y ou could have people who never smoked in their life
who walked into a smoky casino and the short term exposure in that
casino could actual ly trigger a heart attack.

Margaret Flinter: The American Heart Association has applauded the first of its kind
study supporting the smoking ban in casinos and hopes that operators
of casin os around the country take note.

Dr. Stanton Glantz: The clear impl ication of this work is continuing to permit smoking in
casinos sending people to the hospital and it's not doing it next month
or next year. It's doing it right now . A 20% change in the number of
ambulance calls , I mean that's very substantial.

Margaret F linter: A smoking ban in casinos populated by thousands of people,
eliminating secondhand smoke exposure to those people and
significantly reducing smoking related medical emergencies. Now
that's a bright idea.

[Music]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Joseph Allen
Mark Masselli: Peace and h ealth .
[Music]
Marianne O’Hare : Conversations on Health Care is recorded at WESU at Wesleyan
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