Building-Related Symptoms
Building-Related Symptoms: Also Known As Sick Building Syndrome

Building-Related Symptoms: Also Known As Sick Building Syndrome

What building-related symptoms are
Causes of building-related symptoms
Symptoms associated with building-related symptoms

What Building-Related Symptoms Are

As opposed to building-related illness where there are specific health complaints that are caused by a known problem, building-related symptoms (BRS), also called sick building syndrome (SBS) symptoms are nonspecific and cannot be traced to a particular cause. Building-related symptoms are generally characterized by the following:

  • People in the same building complain of mucous membrane irritation, (such as eye, nose, or throat irritation) headache, dizziness, and difficulty in concentrating.

  • The symptoms are relieved soon after leaving the building.

  • The cause of the symptoms is not known.

When there are many people who complain that their symptoms seem to be associated with a particular building, that building may be labeled "sick." The problem with labeling a building as sick is that there is no agreement on the criteria that can differentiate between "sick" and "healthy" buildings. For example, there is no agreement on the number, pattern, severity, or frequency of symptoms; no agreement on how to measure symptoms, and not even agreement on what symptoms should be measured.

However, most people agree that indoor air quality (IAQ) complaints began to increase following the oil embargo of 1973. That is when homes and offices began introducing energy conservation measures such as insulation, non-opening windows, and super efficient HVAC systems, which did not exchange as much air as before (only 5 cfm per person as opposed to the 20 cfm recommended by ASHRAE). Perhaps energy conservation has led to less ventilation, allowing indoor pollutants to build up inside homes and buildings. However, during that same period, many changes occurred in office work, such as the use of computers and other new work technologies, which forced a change in office procedures and productivity. Coupled with the conservation measures and changing technology, there has been a dramatic increase in the number of workers in white-collar jobs. Because of these changes, ergonomic and organizational stress problems have also increased. Further complicating ongoing attempts to understand BRS, some observers have noted that BRS complaints are more common in air-conditioned than naturally ventilated offices.

According to Occupational Safety and Health Administration (OSHA), it is estimated that 30 percent of non-industrial buildings have IAQ problems.1 In addition, the World Health Organization (WHO) also has estimated that nearly one in three new and remodeled buildings worldwide will have IAQ complaints that lead to problems such as low morale, loss of productivity, and even absence from work. While the large majority of these will be comfort, rather than health related problems, 10 percent to 25 percent will be categorized as BRS (or SBS). In a random sampling of US office workers, 24 percent said there were air quality problems in their work environments, and 20 percent believed these problems affected their work performance.2

Causes of Building-Related Symptoms

Despite all the research done over the past 20 years about cases of BRS, it has been estimated that the cause has not been identified in more than 75 percent of cases.3 Buildings that have been alleged to have BRS problems include schools, laboratories, hospitals, and large, complex government buildings. Many of these are thought to be prone to IAQ problems because of their complicated and specialized HVAC systems. Buildings in the southeastern U.S. have additional IAQ concerns because of the hot, humid weather during their longer summers.

In newly constructed or recently remodeled home and office spaces, reports of indoor air problems during the first six months of occupation are common. Many of these health complaints are thought to be due to volatile organic compounds (VOCs), off-gassing from new building materials, and interior furnishings. However, in buildings that have been "sick" for years, the explanation may be with other problems such as mold contamination. A NIOSH study linked about half the cases of SBS to poor ventilation and the other half to a combination of things such as4:

  • Poor quality air in the area around the building

  • Pollutants from office equipment such as copying machines and other electrical equipment

  • Microbes such as mold and fungi

Common Indoor Air Pollutants 

Symptoms Associated With Building-Related Symptoms

The number of people complaining of sick building-related symptoms is on the rise. Across the country, doctors are reporting that the number of patients they are seeing with BRS has increased by 40 percent in the past 10 years.5 Part of this could be due to increased awareness about the problem of poor indoor air quality. For example, media coverage of indoor air problems has increased the number of informational requests received by NIOSH. Following one network television report on the subject, NIOSH received over 6,000 phone calls and nearly 800 requests for investigations.6

In addition to indoor air pollutants, BRS also has been found to be related to work characteristics such as workload, job reorganizations and job satisfaction. Common symptoms associated with BRS include7:

  • Headaches

  • Nasal/sinus congestion

  • Runny nose

  • Sneezing

  • Eye problems (dry, itching, tearing, or sore eyes, blurry vision, burning eyes, problems wearing contact lenses)

  • Throat problems (throat irritation, sore throat, hoarseness, dry throat)

  • Neurological symptoms (difficulty remembering or concentrating)

  • Dizziness

Some people suffer more from the effects of BRS than others. For example, those who work at video display terminals for more than four hours a day miss work due to BRS 20 percent more than those who do not spend as much time at computers.7 According to a study, women miss 1.8 times as many days as men, smokers are absent 1.4 times more days than nonsmokers, and people with allergies miss 1.8 times more days than those without allergies.8

References

  1. Katz DM. "Indoor-Air Perils Called 'Silent Crisis'." National Underwriter. January 29, 1997;No. 3.

  2. Kreiss K. "The Sick Building Syndrome: Where Is the Epidemiologic Basis? Am J Pub Health. 1990;80:1172-73.

  3. Rothman AL, Weintraub MI. The sick building syndrome and mass hysteria. Neurologic Clinics. 1995;13(2):405-412.

  4. Saltzman A, Silberner J. "When each day is a sick day; How to get a breath of fresh air in a polluted office." U.S. News and World Report. March 13, 1989:65-67.

  5. Conlin M, Carey J. Is your office killing you? Business Week. June 5, 2000;issue 3684:114-128.

  6. National Institute for Occupational Safety and Health (NIOSH). NIOSH Facts: Indoor environmental quality (IEQ), 1997: www.cdc.gov/niosh/ieqfs.html.

  7. Wallace LA. Sick building syndrome. In: Bardana, E.J., Montanaro, A. (Eds). Indoor Air Pollution and Health. Marcel Dekker, New York. 1997:83-103.

  8. Levin H. "Physical factors in the indoor environment." Occupational Medicine: State of the Art Reviews. Philadelphia, Hanley and Belfus, inc. 1995 Jan-Mar;10(1):74.