Sick building syndrome is the phrase used to refer to the situation in which building occupants experience adverse health effects that appear to be linked to their time spent in a particular building, when no other specific cause or illness can be identified. Another illness, dubbed building related illness, occurs when, by contrast, symptoms of a diagnosable illness are present and are directly attributable to airborne building contaminants. In either case, complaints may come specifically from those who spend time in a particular room or portion of a building, such as the occupants of a particular floor, or all building occupants may be affected.
Building occupants’ complaints may include headaches; eye, nose, and throat irritation; dry cough; dry, itchy skin; dizziness; nausea; difficulty concentrating; fatigue; and sensitivity to odors. If the cause of these symptoms is not known and most of the occupants report relief from their symptoms soon after leaving the building, sick building syndrome may be the culprit. If the occupants’ complaints include cough, chest tightness, fever, chills, and muscle aches, and if these symptoms are clinically definable and have clearly identifiable causes, requiring a prolonged recovery time after the occupants leave the building, building related illness may be responsible.
One of the causes of sick building syndrome is inadequate ventilation. Up until about the mid-1900s, building ventilation standards required approximately fifteen cubic feet per minute of outside air for each building occupant, but after the 1973 oil embargo these standards were revised. Energy conservation measures called for a reduction in the amount of outdoor air per occupant to five cubic feet per minute. Often, these reduced outdoor air ventilation rates have proved to be inadequate to maintain the health and comfort of building occupants. As a result, the American Society of Heating, Refrigerating and Air-Conditioning Engineers recently revised its ventilation standards for Acceptable Indoor Air Quality, specifying minimum ventilation rates and indoor air quality requirements for commercial and institutional buildings.
Chemical contaminants from indoor sources may also cause poor indoor air quality. Adhesives, carpet, upholstery, manufactured wood products, copy machines, pesticides, and cleaning agents emit volatile organic compounds, including formaldehyde. Smoking, unvented kerosene and gas space heaters, woodstoves, fireplaces, and gas stoves are also known contributors to poor indoor air quality. Outdoor chemical contaminants that may be pulled indoors and affect indoor air quality include motor vehicle exhaust, building exhaust, and combustion products from neighboring garages.
In addition, biological contaminants may contribute to poor indoor air quality. These include bacteria, molds, pollen, and viruses. Biological contaminants may breed in stagnant water that accumulates in ducts, humidifiers, and drain pans, and where water has collected on ceiling tiles, carpet, or insulation. Even insects and bird droppings can be a source of contamination. Physical symptoms resulting from exposure to a biological contaminant include coughing, chest tightness, chills, fever, muscle aches, and allergic reactions causing cold-like symptoms. One notorious indoor bacterium, Legionella, caused Legionnaire’s Disease and a milder form of legionellosis called Pontiac Fever, both of which received considerate media attention in recent years.
These potential causes of poor indoor air quality may act alone or in combination to result in sick building syndrome or building related illness. Accordingly, an extensive investigation may be required in order to identify and eliminate the causes of occupants’ health concerns. An indoor air quality investigation includes information gathering, hypothesis formation, and hypothesis testing. It includes a study of the building occupants, the HVAC system, possible pollutant pathways, and possible sources of contamination. Once the source of the problem is identified, a plan must be devised to alleviate the problem.
Routine maintenance of HVAC systems is one step that may be taken in order to improve a building’s indoor air quality. In addition, water-stained ceiling tiles and carpeting should be replaced, indoor smoking should be restricted, possible contaminants should be stored in well ventilated areas, the use of products emitting contaminants should be restricted to non-occupancy hours, and new products that may emit contaminants should be given time to off-gas their pollutants before people occupy the building. Increasing ventilation rates is also a cost-effective method of reducing indoor pollution.
Chemically injured employees who work in sick buildings have the right to request a timely investigation of their health complaints and resolution of any related compensation claims. Some employees who develop sick building syndrome may only be able to continue working if their employers provide them with reasonable accommodations, as required under the Americans with Disabilities Act. Such accommodations may include restricting or banning the use of toxic office supplies and products and pesticides in the immediate work area, as well as all common areas; increasing the flow of outside air; providing an alternative work space in a less toxic area, even if that is in another building, or allowing the employee to work at home and providing all necessary equipment if reasonable accommodation in the original work area is impossible; and job restructuring, if none of the other options is adequate to address the employee’s issues.