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Sick building syndrome: what to look out for

The United States Environmental Protection Agency (EPA) states that most Americans spend 90% of their time indoors, increasing their exposure to indoor airborne allergens.

The level of particulate matter and infectious organisms in an enclosed environment affects the air quality. 

Air quality influences the development of respiratory allergies and the frequency of chronic asthmatic attacks. When the air quality drops, occupants in a room or building may become ill. This illness is called sick building syndrome because of its characteristic pattern and non-specific nature. People with sick building syndrome may not detect this condition on time without adequate knowledge.

In this article, we’ll cover exactly what sick building syndrome is, its characteristic signs, and how to treat it.

What is sick building syndrome?

Sick building syndrome is acute health distress or discomfort associated with the duration of stay in a building with no specific causative factors. The characteristic pattern is the presence of distressing symptoms when an individual is inside a building and the relief of symptoms outside the building. For instance, a worker may have complaints of difficulty breathing, swollen eyes, or itching at work, but notice that those symptoms are not present during the weekends or holidays. Also, laboratory tests and other clinical investigations may not identify the cause of those symptoms.

Scientists have linked sick building syndrome to poor indoor air quality in a building or an enclosed space.  The Consumer Product Safety Commission (CPSC) states that 30% of new or renovated buildings have poor indoor air quality.

The physical symptoms of sick building syndrome differ from person to person, depending on the individual’s immune sensitivity. People with an existing predisposition to allergies or asthma may present with more severe symptoms than those without allergies.

Here are some common sick building syndrome complaints, according to Healthline:

  • Dry cough
  • Throat irritation
  • Difficulty breathing
  • Burning sensation in the nose
  • Chest tightness
  • Runny nose
  • Sneezing
  • Itchy skin rashes
  • Headaches
  • Dizziness
  • Fatigue
  • Irritability
  • Nausea
  • Body aches

If you notice these symptoms whenever you are in a building or an enclosed space, try to determine if the symptoms disappear when you’re outside the building. 

Sick building syndrome is a diagnosis of exclusion, which means the doctor must exclude other potential causes of the symptoms before making this diagnosis.

Sick building syndrome: what causes it?

Sick building syndrome is caused primarily due to poor air quality and is affected by multiple factors like the type of building materials used. 

Here are some of the causative factors of sick building syndrome:

Inadequate ventilation

The concentration of air pollutants or particles generated by the occupants and the building materials affects the air quality of enclosed space.

Ventilation ensures proper air circulation so that the average level of air pollutants in a building is controlled and kept at minimal levels insignificant to trigger any symptoms. Buildings with poor air purifying systems have a higher risk of retaining air particles that stimulate acute health distressing symptoms.

Researchers revealed that when the ventilation rate in a room is below 10 liters a second, the occupants are more likely to develop sick building syndrome.

Indoor chemical contaminants

Building materials such as carpets, upholsteries, wood products, and cleaning chemicals may emit chemicals called volatile organic compounds (VOCs). These compounds, which include formaldehyde, are toxic and trigger acute distress in some people.

Other sources of VOCs are outdoor combustion fumes and motor vehicle exhaust. Buildings with air vents that are not well-positioned are prone to the inflow of these toxic chemical pollutants from external or outdoor sources.

The concentration of these chemical contaminants in a building or room determines the severity of symptoms that manifest.

Biologic contaminants

Buildings that are old or built with substandard materials in the ceiling or the air conditioning system may have many small collections of water in humidifiers or drains. Stagnant water over time encourages the breeding of micro-organisms such as molds, fungi, bacteria, and viruses. These microbes release spores and pollens, which can trigger allergic symptoms in some people.

Sick building syndrome: solutions

The use of allergy medications such as antihistamines might bring symptom relief, but this does not solve the problem. A combination of the following methods is essential to resolve sick building syndrome, according to the EPA.

Building investigation

This requires a thorough evaluation of the building to determine the indoor air quality, the source of pollutants, and the condition of the heating, ventilation, and air conditioning (HVAC) systems. An expert is required to conduct this investigation to identify the causes of poor indoor air quality accurately.

Replace source of contaminant

After an extensive building investigation, the contaminant sources may have been identified. This is when to replace potential problems like old carpets, ceiling tiles and ducts, and VOC-laden materials.

Increase ventilation rate

Use HVAC systems that promote air distribution appropriately and use local exhaust ventilation for particular rooms or spaces in a building with higher amounts of air pollutants and worse air quality.

Use air-purifying devices

Improve the air quality in a room by using mechanical air filters like high-efficiency particulate air filters (HEPA) that can filter and remove air particles responsible for acute health discomforts.

Education of building occupants

Building managers are responsible for educating occupants on ensuring optimal air quality in the rooms and offices. For instance, overcrowded rooms are more prone to poor air quality because of higher levels of airborne particles. Also, crowded rooms are often not well ventilated, which can contribute to sick building syndrome. Therefore, building managers must enforce a minimum number of room occupants.

We’ve highlighted the causes of sick building syndrome, so what do you look out for now?

The presence of acute health crises such as wheezing, sneezing, dry cough, or inability to concentrate in a building may suggest sick building syndrome, especially if the symptoms stop when you leave the place. However, it’s very important to consult your healthcare provider for proper medical evaluation and diagnosis.

Dr. Christopher Oseh


Dr. Christopher Oseh is an experienced primary care physician, health blogger, content marketing professional, and self-published author.

He specializes in creating content for health care providers and health technology companies. He has been featured on Harvard Medical school blog and has created content for a variety of health technology clients.

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