Sick building syndrome
Sick building syndrome (SBS) is a condition in which people develop symptoms of illness or become infected with chronic disease from the building in which they work or reside.[1] In the scientific literature, SBS is also known as Building Related Illness (BRI) or Building Related Symptoms (BRS) or Idiopathic Environmental Intolerance (IEI).
Sick building syndrome
The main identifying observation is an increased incidence of complaints of symptoms such as headache, eye, nose, and throat irritation, fatigue, dizziness, and nausea. The 1989 Oxford English Dictionary defines SBS in that way.[2] The World Health Organization created a 484-page tome on indoor air quality back in 1984 when SBS was attributed only to non-organic causes, and suggested that the book might form a basis for legislation or litigation.[3]
The outbreaks may or may not be a direct result of inadequate or inappropriate cleaning methods.[2] SBS has also been used to describe staff concerns in post-war buildings with misplanned building aerodynamics, defects in the construction materials or assembly process and-or inadequate maintenance.[2] Certain symptoms tend to increase in severity with the time people spend in the building; often improving over time or even disappearing when people are away from the building.[2][4] SBS is also used interchangeably with "building-related symptoms", which orients the name of the condition around patients' symptoms rather than a "sick" building.[5]
Attempts have been made to connect sick building syndrome to various causes, such as contaminants produced by outgassing of some types of building materials, volatile organic compounds (VOC), improper exhaust ventilation of ozone (byproduct of some office machinery), light industrial chemicals used within, or lack of adequate fresh-air intake/air filtration (see minimum efficiency reporting value).[2] Sick building syndrome has also been attributed to heating, ventilation, and air conditioning (HVAC) systems. However, there have been inconsistent findings on whether air conditioning systems result in SBS or not.[6]
Diagnosis[edit]
While sick building syndrome (SBS) encompasses a multitude of non-specific symptoms, building-related illness (BRI) comprises specific, diagnosable symptoms caused by certain agents (chemicals, bacteria, fungi, etc.). These can typically be identified, measured, and quantified.[34] There are usually four causal agents in BRi: immunologic, infectious, toxic, and irritant.[34] For instance, Legionnaire's disease, usually caused by Legionella pneumophila, involves a specific organism which could be ascertained through clinical findings as the source of contamination within a building.[34]
Management[edit]
SBS, as a non specific blanket term, does not have any specific cause or cure. Any known cure would be associated with the specific eventual disease that was cause by exposure to known contaminants. In all cases, alleviation consists of removing the affected person from the building associated. BRI, on the other hand, utilizes treatment appropriate for the contaminant identified within the building (e.g., antibiotics for Legionnaire's disease).
Improving the indoor air quality (IAQ) of a particular building can attenuate, or even eliminate, the continued exposure to toxins. However, a Cochrane review of 12 mold and dampness remediation studies in private homes, workplaces and schools by two independent authors were deemed to be very low to moderate quality of evidence in reducing adult asthma symptoms and results were inconsistent among children.[44] For the individual, the recovery may be a process involved with targeting the acute symptoms of a specific illness, as in the case of mold toxins.[45] Treating various building-related illnesses is vital to the overall understanding of SBS. Careful analysis by certified building professionals and Medical Doctors can help to identify the exact cause of the BRI, and help to illustrate a causal path to infection. With this knowledge one can, theoretically, remediate a building of contaminants and rebuild the structure with new materials. Office BRI may more likely than not be explained by three events: "Wide range in the threshold of response in any population (susceptibility), a spectrum of response to any given agent, or variability in exposure within large office buildings."[46]
Isolating any one of the three aspects of office BRI can be a great challenge, which is why those who find themselves with BRI should take three steps, history, examinations, and interventions. History describes the action of continually monitoring and recording the health of workers experiencing BRI, as well as obtaining records of previous building alterations or related activity. Examinations go hand in hand with monitoring employee health. This step is done by physically examining the entire workspace and evaluating possible threats to health status among employees. Interventions follow accordingly based on the results of the Examination and History report.[46]
Epidemiology[edit]
Some studies have found that women have higher reports of SBS symptoms than men.[17][10] It is not entirely clear, however, if this is due to biological, social, or occupational factors.
A 2001 study published in the Journal Indoor Air, gathered 1464 office-working participants to increase the scientific understanding of gender differences under the Sick Building Syndrome phenomenon.[47] Using questionnaires, ergonomic investigations, building evaluations, as well as physical, biological, and chemical variables, the investigators obtained results that compare with past studies of SBS and gender. The study team found that across most test variables, prevalence rates were different in most areas, but there was also a deep stratification of working conditions between genders as well. For example, men's workplaces tend to be significantly larger and have all-around better job characteristics. Secondly, there was a noticeable difference in reporting rates, specifically that women have higher rates of reporting roughly 20% higher than men. This information was similar to that found in previous studies, thus indicating a potential difference in willingness to report.[47]
There might be a gender difference in reporting rates of sick building syndrome, because women tend to report more symptoms than men do. Along with this, some studies have found that women have a more responsive immune system and are more prone to mucosal dryness and facial erythema. Also, women are alleged by some to be more exposed to indoor environmental factors because they have a greater tendency to have clerical jobs, wherein they are exposed to unique office equipment and materials (example: blueprint machines, toner-based printers), whereas men often have jobs based outside of offices.[48]