Abstract
This paper examines the effect of hospital design upon the working environ ment, as perceived by junior nursing and administrative staff. Two London teaching hospitals were selected for investigation: the Royal Free Hospital (RFH), a modern, artificially ventilated building, and the Middlesex Hospital (MH), which is older and relies on natural ventilation. Staff were selected ran domly and asked to complete a questionnaire over a 2-month period. Both staff groups at the RFH experienced a higher symptom rate than did those at the MH; this was related to a low perceived quality of the working environ ment, and was characterised by the perception of dryness, heat and low envi ronmental control. The increased rate of symptoms may have resulted from inadequate function of the air-conditioning services at the RFH, due to econ omy measures introduced by the hospital managers. There was no increase in the rate of absenteeism from work.

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