Sick Building Syndrome

Sick building syndrome (SBS) is a term applied to a situation in which some or all the people occupying a building (usually working or living in it) experience unpleasant health and comfort effects such as headache; dizziness; nausea; irritated eyes, nose, or throat; dry cough; or skin irritation. The term is sometimes applied to the symptoms themselves also. These effects may be localized to a part of the building or be present throughout. The definition of SBS requires that the symptoms disappear soon after leaving the building and that they cannot be ascribed to a specific cause or illness. SBS is differentiated from building-related illness, which describes diagnosable illness whose cause can be attributed to airborne contaminants within a building. SBS is usually assumed to be caused by poor indoor air quality (IAQ). It was first identified in the 1970s, and a 1984 report by the World Health Organization suggested that up to 30% of new and remodeled buildings may have problems with IAQ sufficient to cause health symptoms. Inadequate building ventilation is the most common cause; the appearance of SBS in the mid-1970s has often been attributed to [Page 973]decreased ventilation standards for commercial buildings to increase energy efficiency during the oil embargo of 1973. Chemical contaminants are also potential contributors to SBS; these include volatile organic compounds emitted by carpeting, upholstery, cleaning agents, and other sources and combustion products including particulate matter and carbon monoxide produced from heating devices such as fireplaces and stoves. Biological contaminants such as molds, pollen, viruses, bacteria, and animal or bird droppings can also contribute to SBS.

Investigation of SBS requires first ascertaining whether the complaints are actually due to IAQ; if so, the investigation will gather information about the building's ventilation, heating and air conditioning system, possible sources of internal contaminants, and possible pathways for exterior pollutants to enter the building. Air sampling alone rarely provides sufficient information to solve the problem, because in SBS buildings contaminant concentration levels rarely exceed existing standards. The most common solutions to SBS include removing a known source of pollution, increasing ventilation rates and air distribution, and adding air cleaning devices.

SBS is a difficult condition to study because its symptoms are commonplace and could have many causes, such as allergies or stress, and may be influenced by psychological factors, such as dislike of a job or workplace. In addition, because many different aspects of the indoor environment can contribute to SBS, it is often difficult to identify the cause or causes for a particular case, and extensive renovations may fail to solve the problem. There is also a natural opposition between the interests of building owners and occupants in a case of suspected SBS. The occupants may believe SBS is causing their health symptoms and demand building inspections and modifications, while the owner may not believe that the building is the cause of their symptoms and may therefore be reluctant to pay for any inspections or alterations. Because of the aforementioned difficulties in verifying SBS and identifying its cause, the ‘truth of the matter’ may never be unequivocally determined. In addition, some clinicians believe that SBS is not a meaningful term and should be abandoned, while others have argued that investigations into SBS should include evaluation of psychological and social as well as physical, environmental, and biomedical factors.

...