STORY BY

Shannon Rasp

You're at work. Your chest feels tight, eyes are watery, and you're dizzy and nauseated. But you're not having your performance review, you aren't asking for a raise, nor must you come up with a last-minute slick presentation for the brass. In fact, stressed or not, you feel like this at work every single day. In fact the whole office seems to be stuck in a never-ending cycle of flu-like symptoms. What's going on?

According to the World Health Organization (WHO), up to 30 percent of all buildings around the world may suffer from poor indoor air quality because the buildings aren't operated or maintained as they were originally designed to be. The poor air quality could occur because the building itself was poorly designed, or its occupants could be causing the problem by smoking, using gas space heaters, or simply using the photocopiers too often.

This occurs so often that the WHO coined a phrase for it. "Sick building syndrome" is used to describe situations in which a building's occupants experience acute, adverse health effects and/or discomfort that appear to be linked to spending time in the building and have no specific link to an illness or cause.

Reduced indoor air quality is usually the culprit, often caused by

• inadequate ventilation
• chemical contaminants from indoor sources, such as carpets, photocopiers, adhesives, and manufactured wood products
• chemical contaminants from outdoor sources, such as air entering the building that contains vehicle exhaust fumes, plumbing fumes, and building exhausts
• biological contaminants such as bacteria, mold, pollen and viruses, which collect in air ducts, air conditioning units, or humidifiers.

These elements can be exacerbated by inadequate temperature control, humidity, or poor lighting.

A different kind of 'sick'

Molds may be found in air and dust samples of any moist environment and usually co-exist with other microorganisms, so trying to identify a single agent as the cause of the syndrome is particularly difficult.

In addition, airborne mold particles are not often linked to human disease. "The reports concerning molds as causes of animal and human disease are consistently related to ingestion of the compounds, rather than exposure via inhalation," says Luis Ostrosky-Zeichner, MD, an assistant professor in the infectious diseases department at The University of Texas Medical School at Houston. "For example, Stachybotrys [stak-ee-baw-tris] does produce mycotoxins that are known to cause a distinctive syndrome in horses after ingestion of Stachybotrys -infected grain. On the other hand, the link between simply being in physical proximity to fungus-infested and presumably toxin-laden walls or other surfaces is much less clear."

Many people believe that asbestos and radon cause sick building syndrome, but that actually isn't the case. Exposure to these materials over a prolonged length of time can cause serious health problems, whereas sick building syndrome usually manifests relatively quickly.

Diagnosing a building

So there you sit, sick and miserable. Your boss probably won't look kindly upon your request to work in a large plastic bubble, so what can you do, short of quitting your job?

First, it must be established that your symptoms are the result of sick building syndrome rather than allergies or chronic disease. The way to do that is by asking for a building investigation, which aims to identify and solve indoor air quality problems permanently while also preventing the creation of other problems.

An investigator must figure out if a complaint is actually related to indoor air quality, identify the cause of the complaint, and determine the most appropriate corrective actions. This is done by gathering information, pinpointing a suspected source (or sources) of the problem, and testing.

Interestingly, air sampling seldom provides useful information for investigators. While certain basic measurements, such as temperature, relative humidity, carbon dioxide, and air movement can provide a useful "snapshot" of current building conditions, sampling for specific pollutant concentrations is often not required to solve the problem and can even be misleading.

Curing your building

So your company has brought in an investigator who has identified the probable source or sources of the problem. Now what?

The natural first step, of course, is to remove or modify the source of the pollutant:

• routine maintenance of temperature control systems
• replacing water-stained ceiling tile or carpeting
• banning smoking from the workplace
• limiting or venting the air from outside entering the building
• properly storing substances such as paint, adhesives, solvents and pesticides.

Also, increasing ventilation rates and air distribution often can be a cost-effective means of reducing indoor pollutant levels. Heating and air conditioning systems should be designed, at a minimum, to meet ventilation standards in local building codes. Many systems, however, are not operated or maintained to ensure that these design ventilation rates are provided.

Air cleaning can be a useful way to improve ventilation, but has certain limitations. Particle control devices such as the typical furnace filter are inexpensive but do not effectively capture small particles. High-performance air filters capture the smaller particles but cost more to install and operate. Mechanical filters, meanwhile, do not remove gaseous pollutants.

Finally, education and communication are important elements in both remedial and preventive indoor air quality management programs. When building occupants, management, and maintenance personnel fully communicate and understand the causes and consequences of the problem, they can work together more effectively to prevent problems or to solve existing ones.

Quacks

Sick building syndrome is difficult to diagnose, but there's no shortage of people willing to use it to make money. "There are a lot of people trying to make money by supposedly eliminating the causes of the illness without having the appropriate scientific background," Ostrosky-Zeichner warns. " Sensationalism, litigation, and the wish to place blame on something have greatly overshadowed science in this matter. While there may be such a thing as illness due to 'sick building syndrome,' further in-depth studies are required to better understand the issue."

UPDATED: 1-21-2006

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