Fathimah Zakiyah Othman, Mohd Nasir Taib, Mariam Felani Shaari


In hospital buildings, fires are a significant risk, and occupants’ failure to evacuate can result in death. Therefore, efficient hospital fire evacuation is important. Hospital evacuation routes are among the most challenging to design due to complex indoor environments and restricted circulation. Additionally, not every hospital user has spatial familiarity due to the restricted public access, making it difficult to navigate unfamiliar evacuation routes. Human wayfinding, which involves wayfinding cognition performance, has a big impact on how effectively one can carry out navigational tasks. To ensure safe evacuation, aspects of hospital physical design, in particular evacuation routes, must be improved. However, when outlining the ideal evacuation route design, hospital building guidelines rarely take wayfinding cognition aspects into account. A neuroscientific understanding of the relationship between hospital evacuation route designs and wayfinding cognition is timely given the emergence of neuroarchitecture research which applies neuroscientific methodologies in architectural studies for more accurate assessment of human behaviour. This article proposes a neuroarchitecture framework outlining a clear relationship between these aspects through critical review of the literature whereby potential applications of EEG brainwaves are also highlighted. Findings can promote hospital evacuation route designs that optimize wayfinding cognition performance to ensure occupants’ safety.


electroencephalogram (EEG); evacuation route design; fire evacuation; hospital; wayfinding cognition

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Anoor, M.M., Jahidin, A.H., Arof, H., and Megat Ali, M.S.A. (2020). EEG-based intelligent system for cognitive behavior classification. Journal of Intelligent Fuzzy System, 39, 177.

Azzazzy, S., Ghaffarianhoseini, A., Ghaffarianhoseini, A., Naismith, N., and Doborjeh, Z. (2021). A critical review on the impact of built environment on users’ measured brain activity. Architectural Science Review, 64, 319.

Banaei, M., Hatami, J., Yazdanfar, A., and Gramann, K. (2017). Walking through Architectural Spaces: The Impact of Interior Forms on Human Brain Dynamics. Frontiers in Human Neuroscience, 11(Sep), 1-14.

Barnagarwala, T. (2022). More than 120 Indians have died in hospital fires since August 2020. Quartz India. Retrieved from on 3 Jan 2023.

Brown, D.C. and Blessing, L. (2005). The relationship between function and affordance. Proceedings of the ASME Intl. Design Eng. Tech. Conferences & Comp. and Info. in Engineering Conferences. 24 September 2005. CA. ASME, 1-6.

Choudhary, A.H., Kausar, M., Satpathy, S., and Sharma, D.K. (2020). Fire safety related challenges faced by existing hospitals: A review. Medico-Legal Update, 20, 419.

Dalton, R.C., Holscher, C., and Montello, D.R. (2019). Wayfinding as a social activity. Frontiers in Psychology, 10(Feb), 1-4.

Darraj, A., Hudays, A., Hazazi, A., and Alghamdi, A. (2023). The Association between Emergency Department Overcrowding and Delay in Treatment: A Systematic Review. Healthcare, 11, 1-11.

Daw, M.A. and Mahamat, M.H. (2023). Retrieved from Research Square: on 2 Feb 2023. Note: pre-print.

Daylamani-Zad, D., Spyridonis, F., and Al-Khafaaji, K. (2022). A framework and serious game for decision making in stressful situations; a fire evacuation scenario. International Journal of Human Computer Studies, 162(Jan), 102790.

Eberhard, J.P. (2008). Brain Landscape: The Coexistence of Neuroscience and Architecture. UK: Oxford Uni Press.

Erkan, I. (2018). Examining wayfinding behaviours in architectural spaces using brain imaging with electroencephalography (EEG). Architectural Science Review, 61, 410.

European Commission Joint Research Centre (2021). Risk of oxygen-related fires in hospitals treating Covid-19 patients European Commission. Retrieved from _related_fires_in_hospitals_treating_covid_19_patients on 5 Jan 2023.

Friedman, N.P. and Robbins, T.W. (2022). The role of prefrontal cortex in cognitive control and executive function. Neuropsychopharmacology, 47, 72.

Hofinger, G., Zinke, R., and Kunzer, L. (2014). Human factors in evacuation simulation, planning, and guidance. Transportation Research Procedia, 1(2), 603-611.

Huang, H.M., Huang, T.C., and Cheng, C.Y. (2021). Reality matters? exploring a tangible user interface for augmented-reality-based fire education. Universal Access in the Information Society, 21(4), 927=939.

Jamshidi, S. and Pati, D. (2021). A Narrative Review of Theories of Wayfinding Within the Interior Environment. Health Environments Research Design Journal, 14(1), 290-303.

Jamshidi, S., Ensafi, M., and Pati, D. (2020). Wayfinding in Interior Environments: An Integrative Review. Frontiers in Psychology, 11(Nov), 1-24.

Kalantari, S., Tripathi, V., Kan, J., Rounds, J.D., Mostafavi, A., Snell, R., and Cruz-Garza, J.G. (2022). Evaluating the impacts of color, graphics, and architectural features on wayfinding in healthcare settings using EEG data and virtual response testing. Journal of Environmental Psychology, 79(Mar), 101744.

Karandinou, A. and Turner, L. (2017). Architecture and neuroscience; what can the EEG recording of brain activity reveal about a walk through everyday spaces? International Journal of Parallel, Emergent and Distributed Systems, 32, S54-S65.

Kinsey, M.J., Gwynne, S.M.V., Kuligowski, E.D., and Kinateder, M. (2019). Cognitive Biases Within Decision Making During Fire Evacuations. Fire Technology, 55(2), 465-485.

Kuligowski, E.D. (2016). “Human Behavior in Fire.” SPFE Handbook of Fire Protection Engineering. NY: Springer New York, pp. 2070-3494.

Kuligowski, E.D., Gwynne, S.M.V., Kinsey, M.J., and Hulse, L. (2017). Guidance for the Model User on Representing Human Behavior in Egress Models. Fire Technology, 53(2), 649-672.

Li, L. and Smith, D.M. (2021). Neural Efficiency in Athletes: A Systematic Review. Frontiers in Behavioral Neuroscience. 15, 1.

MacGregor, J.N., Ormerod, T.C., and Chronicle, E.P. (2001). Information Processing and Insight: A Process Model of Performance on the Nine-Dot and Related Problems. Journal of Experimental Psychology: Learning Memory and Cognition, 27(1), 176-201.

Maier, J.R.A., Fadel, G.M., and Battisto, D.G. (2009). An affordance-based approach to architectural theory, design, and practice. Design Studies, 30(4), 393-414.

Muhammad Salleh, N., Salim, N.A., Jaafar, M., Sulieman, M. Z., and Ebekozien, A. (2020). Fire safety management of public buildings: a systematic review of hospital buildings in Asia. Property Management, 38(4), 497-511.

Naghibi Rad, P., Shahroudi, A., Shabani, H., Ajami, S., and Lashgari, R. (2019). Cognitive and perceptual influences of architectural and urban environments with an emphasis on the experimental procedures and techniques. Frontiers in Behavioral Neuroscience, 13(Aug), 1-10.

Natapov, A, Parush, A., Laufer, F., and Fisher-Gewirtzman, D. (2022). Architectural features and indoor evacuation wayfinding: The starting point matters. Safety Science, 145(Sep), 105483.

Neubauer, A.C. and Fink, A. (2007). Intelligence and neural efficiency. Behavioral and Brain Sciences, 30(7), 135.

Nilsson, D. (2009). Exit choice in fire emergencies – Influencing choice of exit with flashing lights. Sweden: Department of Fire Safety Engineering and Systems Safety, Lund University.

Olanrewaju, A., Fang, W.W., and Tan, S.Y. (2018). Hospital Building Maintenance Management Model. International Journal of Engineering & Technology, 7(2.29), 747.

Othman, F.Z., Taib, M.N., Shaari, M.F., and Zaiki, Y. (2023). Potential Application of Brainwaves to Optimise Evacuation Wayfinding Performance During Fires. 2023 19th IEEE International Colloquium on Signal Processing & Its Applications (CSPA), Kedah, Malaysia, 190-194.

Pan American Health Organization (PAHO) (2018). Hospitals Don’t Burn. World Health Organization (WHO). Retrieved from on 3 Jan 2023.

Rosen, B.Q. and Halgren, E. (2022). An estimation of the absolute number of axons indicates that human cortical areas are sparsely connected. PLoS Biology, 20(3), 1-13.

Shaari, M. F., Ahmad, S. S., Ismail, I. S., and Zaiki, Y. (2020). Addressing Recent PISA Rankings: The potential role of preschool physical environment design quality in Malaysia. Environment-Behaviour Proceedings Journal, 5(13), 93-99.

Shaari, M. F., Zaiki, Y., Ahmad, S. S., and Ismail, I. S. (2020). The Influence of Modified Open-Plan Preschool Spaces on Cognitive School Readiness in Malaysia. Environment-Behaviour Proceedings Journal, 5(13), 123-130.

Sime, J. (1983). Affiliative behaviour during escape to building exits. Journal of Environmental Psychology, 3(1), 21-41.

Slone, E., Burles, F., Robinson, K., Levy, R.M., and Jaria, G. (2015). Floor Plan Connectivity Influences Wayfinding Performance in Virtual Environments. Environment and Behavior, 47(9), 1024-1053.

Stogios N. et al. (2021). Autonomic nervous system dysfunction in schizophrenia: impact on cognitive and metabolic health. npj Schizophrenia, 7(1), 1-10.

UK Home Office (2019). Detailed analysis of fires attended by fire and rescue services, England, April 2018 to March 2019. United Kingdom National Statistics. Retrieved from uploads/system/uploads/attachment_data/file/831136/detailed-analysis-fires-attended-fire-rescue-england-1819-hosb1 919.pdf on 1 Jan 2023.

Vijayan, V.T. and Embi, M.R. (2019). Probing Phenomenological Experiences Through Electroencephalography Brainwave Signals Iin Neuroarchitecture Study. International Journal of Built Environment and Sustainability, 6(3), 11-20.

Vilar, E., Rebelo, F., Noriega, P., Teles, J., and Mayhorn, C. (2015). Signage Versus Environmental Affordances: Is the Explicit Information Strong Enough to Guide Human Behavior During a Wayfinding Task? Human Factors and Ergonomics in Manufacturing & Service Industries, 25(4), 439-452.

Wang, Y., Kyriakidis, M., and Dang, V. N. (2021). Incorporating human factors in emergency evacuation – An overview of behavioral factors and models. International Journal of Disaster Risk Reduction, 60, 102254.

Wood, M.H., Hailwood, M., and Koutelos, K. (2021). Reducing the risk of oxygen-related fires and explosions in hospitals treating Covid-19 patients. Process Safety and Environmental Protection, 153(Dec), 278-288.

Zaiki, Y., and Wong, T. W. (2021). Targeting genetic tool for long non-coding RNA of cancer stem cells with aptamer-guided nanocarriers. Expert Opinion on Drug Delivery, 18(12), 1791-1793.

Zaiki, Y., Lim, L., and Wong, T. W. (2022). Critical material designs for mucus- and mucosa-penetrating oral insulin nanoparticle development. International Materials Reviews, 1, 1-19.


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