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PubMedDate not supplied

[The sick building syndrome].

The term "sick building syndrome" (SBS) has been used for several years to describe a number of mostly unspecific complaints of some occupants of air-conditioned buildings. Based on the literature, a definition of the SBS is given and some results of larger SBS studies carried out in Germany, Denmark and the United Kingdom are described. These studies show that SBS is a multifactorial event which may include physical, chemical, biological as well as psychological factors. In many cases, the occurrence of SBS in a building is due to insufficient maintenance of the HVAC system. SBS-induced investigations in a building should be carried out stepwise, the measurement of indoor air pollutants not being the first step. Strategies to avoid SBS must take into account factors specific to the building, the HVAC system and the equipment as well as psychological factors.

Air Microbiology↗

PubMedDate not supplied

The sick-building syndrome.

The sick-building syndrome is a poorly defined term whose use should be discontinued. In the majority of cases, engineering problems and pollutant sources can be identified that contribute to the generation of complaints. Although psychosocial factors are likely to exacerbate underlying complaints, they should not distract from identifying solutions.

Air Pollutants↗

PubMed1998

The sick building syndrome: a diagnostic dilemma.

Sick building syndrome (SBS) is usually defined as an increased occurrence of non-specific symptoms among populations in determined buildings. This definition differs from those of other medical syndromes in that it refers to a system (a building inclusive of its population) rather than to a clinical state in a single individual. Such a definition should make the term SBS impossible to use as a diagnosis applied to individual persons. In spite of this, it is often used in this way, and the aim of the article is to discuss problems with this practice. It is a case study based on an office building with long-standing building-related health problems. Information concerning the building and its inhabitants comes from a large number of separate documentary sources. The study demonstrates that the diagnostic use of SBS suffers from serious weaknesses. It is proposed that such diagnostics could even have a normative force serving to maintain and reinforce building-related, non-specific health problems. It is therefore suggested that the term sick building syndrome should be abandoned.

Absenteeism↗

PubMed1999

The sick building syndrome.

The phenomenon of 'sick building syndrome' is associated with several factors rather than a single readily and directly observable cause and various symptoms and behaviours rather than one clinical syndrome. Like another modern occupational ill health problem--repetitive strain injury--its existence may be questioned or doubted by the employers of staff who work in modern buildings. This article looks at what makes a building sick and how a sick building can affect its occupants. It guides staff in the recognition of the syndrome and suggests ways to reduce the risks of working in a building whose poor design or maintenance constitutes a hazard for occupants.

Environmental Exposure↗

PubMedDate not supplied

The natural history of concurrent sick building syndrome and chronic fatigue syndrome.

An outbreak of chronic fatigue syndrome linked with sick building syndrome was recently described as a new association. Whether chronic fatigue syndrome acquired in this setting tends to remit or, as sporadic cases often do, persist, is unknown. To clarify the natural history of chronic fatigue syndrome in association with sick building syndrome the 23 individuals involved in the outbreak were interviewed four years after the onset. In the previous interview one year after the onset of symptoms, 15 (including 5 with chronic fatigue syndrome and 10 with idiopathic chronic fatigue) of the 23 noted fatigue. Three years later 10 of the 15 were "fatigue free" or "much improved". Five were only "some better", "the same", or "worse". Three of the five people previously diagnosed with chronic fatigue syndrome were "much improved" (two) or "fatigue free" (one). The remaining two were seriously impaired, homebound and unable to work. The 10 individuals with substantially improved fatigue (three of the five with chronic fatigue syndrome and seven of the 10 with idiopathic chronic fatigue) were more likely to have noted improvement in nasal and sinus symptoms, sore throats, headaches, and tender cervical lymph nodes when compared to those with a lingering significant fatigue (p < 0.001). Upper respiratory symptoms and headaches improved in those with reduced fatigue but remained problematic in those with persisting significant fatigue. We conclude that the fatigue related to sick building syndrome, including chronic fatigue syndrome, is significantly more likely to improve than fatigue identified in sporadic cases of chronic fatigue syndrome.

Fatigue Syndrome, Chronic↗

PubMed1992

Field studies on the sick building syndrome.

Field studies of the sick building syndrome have generally used questionnaires developed to define symptoms present over weeks and months, such as those asking ". . . do you usually . . .?" Although such studies have implicated ventilation systems as a major contributor to indoor air quality complaints, no specific exposures have been identified. An alternative approach is based on the short-term quantification of symptoms and characterization of the indoor environment with direct-reading or short-term sampling techniques. This paper summarizes the development of such a method in two studies in problem buildings and its subsequent application in a study in nonproblem buildings. The method correctly identified the postulated cause in a first building and generated a hypothesis for intervention in the second. In the nonproblem buildings, the levels of complaints appear related to the levels of VOCs, lighting, hours spent at desks, and crowding. This approach has suggested that dose-response relationships do exist in the sick building syndrome. Weaknesses of this approach include an inability to adequately address microbial characterization of indoor environments and the social and organizational predictors of complaints that are recognized to be of importance.

Air Pollution, Indoor↗

PubMed1996

Sick building syndrome, work factors and occupational stress.

The sick building syndrome has been associated with certain buildings and environmental characteristics and is estimated to affect up to 30% of new or renovated buildings. Investigations have concentrated on physical factors, and it is only recently that psychological factors have been examined. Work and personal factors have also been considered. Occupational stress has been found to be correlated with symptoms of the sick building syndrome, but much of the research has been of a cross-sectional nature, and it does not indicate whether stress is an active element or an outcome. There is a clear need for further research in this area to examine stress, personality and physical factors associated with the sick building syndrome longitudinally. There is also a clear need to assess the validity of the historical and self-report methods used to assess the sick building syndrome.

Causality↗

PubMed1999

[Sick building syndrome: three case reports].

SBS--sick building syndrome--is a set multi-organ symptoms related to long-term staying in "sick buildings". These are modern, energy saving, air tight buildings with reduced ventilation. As a result of such construction, harmful, air-borne substances issued by interior decoration materials, air-conditioning systems and working people are cumulated. The study presents three cases of allergic patients whose original allergic illnesses got aggravated as an effect of: 1) staying in a freshly redecorated room, 2) staying in a fully air-conditioned room, 3) long-term exposition to bacteria and fungi allergens developing in old, used up filters of a car air-condition system.

Adult↗

PubMed2001

["Sick building syndrome"--a new problem of occupational medicine].

"Sick building syndrome" (SBS) is a group of symptoms experienced by people working in various buildings. This term or another one "building-related illness" (BRI) is used to define illnesses related to non-industrial and non-residential buildings, mainly modern offices, in which people spend many working hours. Specific BRI applies to a group of illnesses with a fairy homogeneous clinical picture and known etiology (infectious, immunological or allergic). Non-specific BRI applies to a group of heterogeneous and non-specific, work-related symptoms, including irritation of skin and mucous membranes of the eyes, nose and throat, headache, fatigue and concentration difficulties. BRI seems to be related to inadequate ventilation, humidity and temperature changes, chemical and biological contaminants from indoor and outdoor sources. Sick building syndrome is considered as an important problem of occupational medicine, bearing in mind that 50% of the entire workforce in industrialized countries work in this type of buildings, and nearly 20-30% of this group of workers report symptoms suggesting the prevalence of sick building syndrome.

Air Pollution, Indoor↗

PubMedDate not supplied

Possible sources of sick building syndrome in a Tennessee middle school.

Sick Building Syndrome has been reported with increasing frequency during recent years. Buildings that have sustained water damage harbor various molds, some of which may be toxic. Students and staff at Central Middle School in Murfreesboro, Tennessee, reported symptoms similar to those associated with Sick Building Syndrome. Upon investigation, investigators noted that a black fungal growth occurred throughout the building on wet cellulose ceiling tiles. Fungal growth of this type is consistent with the genus Stachybotrys. Stachybotrys spores contain macrocyclic trichothecenes, which may cause harm when inhaled or ingested. Bulk sampling of the black mold was initiated, and the samples were cultured in a moist chamber. Testing of the samples confirmed the presence of Stachybotrys spp., a finding that implies that air sampling procedures should ensue. Professional remediation of this potentially hazardous fungal contaminant is therefore recommended.

Adolescent↗

PubMed2005

Bioaerosols and sick building syndrome: particles, inflammation, and allergy.

PURPOSE OF REVIEW: Sick building syndrome is a poorly understood condition that can be vexing to clinicians and public health investigators alike. Concerns about possible causes have recently shifted to bioaerosols, especially indoor mold contamination. Recently, controversy over the health effects of indoor bioaerosols has intensified in the media and in medical forums. Allergists and other clinicians are increasingly being asked to evaluate cases of sick building syndrome attributed to bioaerosol exposure. Although allergy may play a role, it is unlikely to fully explain the nonspecific symptoms of the condition. This review of recent literature will attempt to put into context the roles of allergy and nonallergic mechanisms in sick building syndrome. RECENT FINDINGS: Epidemiological and toxicological studies have provided further evidence of a possible link between bioaerosol exposure and sick building syndrome, but continue to have methodological limitations. Cross-sectional studies of building occupants have found associations between bioaerosols and symptoms of the condition, but case definitions and exposure assessment remain problematic. Attempts to develop better exposure assessment and biomonitoring methods have made limited progress. Toxicological studies of inhalation of bioaerosols continue to indicate potential toxicity, but at doses that are not comparable to human exposures indoors. SUMMARY: Epidemiological studies suggest an association between bioaerosols and sick building syndrome, and toxicological studies have provided some evidence supporting biological plausibility. However, the extent to which bioaerosol exposure may explain the nonspecific symptoms of the condition is unclear. Nonspecific inflammatory responses to bioaerosols, modified by psychosocial factors such as stress, may be a promising area for continued research.

Aerosols↗

PubMedDate not supplied

Neurological symptoms of the sick building syndrome: analysis of a questionnaire.

Sick building syndrome (SBS) is an excess of work-related irritations of the skin and mucous membranes and of symptoms such as headache and fatigue in those working in modern air-conditioned buildings. We aimed to analyse the neurological symptoms, especially headache, in workers with potential SBS. The most frequent symptoms were headache and dry eyes. Sex was a major factor of difference: women report more symptoms than men. A positive correlation emerged between the number of symptoms and the asthenia scale score. Only 11 (8.2% of the whole sample) and 37 (27.4%) workers met all the IHS criteria for migraine and tension-type headache respectively. At least one symptom of SBS was present in 92.6% of workers. A negative correlation emerges between air conditioning and headache during working hours. No correlation emerges between the workplace comfort indicator and SBS and asthenic symptoms while a negative correlation was found between migraine and tension-type headache and comfort in the workplace. SBS symptoms are very frequent among all workers but headache is the primary symptom.

Adult↗

PubMed1995

Beyond air quality--factors that affect prevalence estimates of sick building syndrome.

If the prevalence of sick building syndrome (SBS) is estimated before intervention begins, then a reduction in the estimate may later be used to measure success of the intervention, and in particular, those efforts toward improving air quality. However, the measure of success will be distorted if factors other than air quality affect the SBS prevalence estimate. In this study the background prevalence of SBS was estimated and study factors identified that alone affected the estimate. Two symptom questionnaires were randomly administered to workers from 39 offices before routine physical examinations; one questionnaire described the SBS study, the other did not. SBS was defined as a symptom in the prior 24-hour or 7-day recall period that was more severe at work and not related to suspected confounders--allergy, cold, flu. Prevalence and prevalence ratios were estimated along with 95% confidence intervals (CI). Symptoms were reported by 45% of 1088 workers surveyed, but most reported them as more severe outside work or related them to confounders. SBS prevalence was 5%. It was 3.2 times higher (95% CI: 1.8, 5.7) among workers cognizant of the study relative to those blinded, 2.2 times higher (95% CI: 1.2, 4.1) for the 7-day relative to the 24-hour recall period, and 2.5 times higher (95% CI: 1.4, 5.0) for females. SBS prevalence did not differ by workday or age. Since study factors alone affected prevalence estimates, a standardized assessment method seems necessary for SBS.

Confounding Factors, Epidemiologic↗

PubMed1994

Sick building syndrome--a case study in Zagreb.

Sick building syndrome was investigated in a newly built office building. Information about health complaints from the employees was obtained by means of a self-administered questionnaire. Measurements of microclimate conditions and air pollution levels confirmed that the employees' complaints were justified. Because of a high percentage of complaints, the questionnaire was evaluated by means of factor analysis. The results showed logical grouping of the complaints and/or symptoms, suggesting credibility of the answer. Factor analysis proved to be an appropriate tool for detecting and evaluating sick building syndrome.

Adult↗

PubMedDate not supplied

[Sick building syndrome--a result of modern lifestyle].

Sick building syndrome (SBS) is a term used to describe situation in building when more than 30% of occupants suffer from various symptoms which tend to increase by severity during the time people spend in "sick" building and disappear when they leave the building. Typical cases of SBS report vague symptoms, which cannot be objectively measured, and sufferers usually show no clinical signs of illness. Symptom heterogeneity suggests that they do not represent a single disorder. The objective of our study was to establish if SBS is present in our town because new buildings have been built lately producing the artificial environment--exclusively artificial lightning and mechanical ventilation. A total of 812 subjects were included in our study. The investigation of SBS was performed by standardized questionnaires to determine the prevalence of symptoms and complaints. Questionnaires were used to collect data on perception of environment conditions and health during the period they work in this building. The subjects were divided in three groups according to sex, level of education and ownership. Our data suggested that the incidence of symptoms was higher in employers than in owners of the offices. Moreover, the prevalence of SBS was very high-up to 74.76%. It is obvious that certain physical, psychological and organizational factors are involved in the incidence of symptoms, but our investigation suggests that physical factor has a dominant role in development of symptoms, particularly low humidity and low air flow. In addition, our judgment is that SBS exists in our city, probably in the whole country and, therefore, it must be investigated properly.

Adult↗

PubMed1994

Concurrent sick building syndrome and chronic fatigue syndrome: epidemic neuromyasthenia revisited.

Sick building syndrome (SBS) is usually characterized by upper respiratory complaints, headache, and mild fatigue. Chronic fatigue syndrome (CFS) is an illness with defined criteria including extreme fatigue, sore throat, headache, and neurological symptoms. We investigated three apparent outbreaks of SBS and observed another more serious illness (or illnesses), characterized predominantly by severe fatigue, that was noted by 9 (90%) of the 10 teachers who frequently used a single conference room at a high school in Truckee, California; 5 (23%) of the 22 responding teachers in the J wing of a high school in Elk Grove, California; and 9 (10%) of the 93 responding workers from an office building in Washington, D.C. In those individuals with severe fatigue, symptoms of mucous membrane irritation that are characteristic of SBS were noted but also noted were neurological complaints not typical of SBS but quite characteristic of CFS. We conclude that CFS is often associated with SBS.

Adult↗

PubMed1995

Sick building syndrome and gender bias: imperiling women's health.

Sick building syndrome (SBS) is a contemporary health problem of serious magnitude. It is also an example of how gender bias can result in psychologizing (and therefore, ignoring), very real health threats to women. Characterized by symptoms which include mucous membrane irritation, eye irritation, headaches, feelings of lethargy and the inability to concentrate, sick building syndrome affects hundreds of thousands of office workers on a daily basis. The preponderance of victims of sick building syndrome are women. The threat to women's health posed by SBS is an under researched area, despite early research findings that women are disproportionately affected. This paper argues that gender bias has undermined the effectiveness of both research and intervention in addressing SBS, thereby perpetuating the threat to the health of female office workers. Implications for social workers are addressed.

Air Pollution, Indoor↗

PubMed1996

Fungal colonization of fiberglass insulation in the air distribution system of a multi-story office building: VOC production and possible relationship to a sick building syndrome.

Complaints characteristic of those for sick building syndrome prompted mycological investigations of a modern multi-story office building on the Gulf coast in the Southeastern United States (Houston-Galveston area). The air handling units and fiberglass duct liner of the heating, ventilating and air conditioning system of the building, without a history of catastrophic or chronic water damage, demonstrated extensive colonization with Penicillium spp and Cladosporium herbarum. Although dense fungal growth was observed on surfaces within the heating-cooling system, most air samples yielded fewer than 200 CFU m-3. Several volatile compounds found in the building air were released also from colonized fiberglass. Removal of colonized insulation from the floor receiving the majority of complaints of mouldy air and continuous operation of the units supplying this floor resulted in a reduction in the number of complaints.

Air Conditioning↗