Sick Building Syndrome

What is Sick Building Syndrome?

As it turns out, a house can be a cause for many health issues. Sick building syndrome describes a situation, when health problems are caused by being in a particular building or office space. In this case, symptoms can´t be explained with anything else and usually affects more than one person. The symptoms vary from just having minor discomfort to even life threatening conditions. The symptoms can sometimes be caused just by being in a certain area of the building^[1].

Causes

There are many causes for sick building syndrome. In most cases the syndrome is caused by the materials used in construction of the building. Also everything in the building can affect this syndrome. In some cases location of the building can be cause for having symptoms, for example, when the building is located near a chemical factory. Mostly certain types of buildings are affected, like office buildings, museums and schools. On rare occasions also living spaces can be affected. Long work hours and strain can also cause a variety of disorders, like computer vision syndrome ^[1,2].

Chemical contamination

One of the possible causes for symptoms is contamination with chemicals. These can be:

• Pollution from vehicles
• Dust
• Radon
• Formaldehyde
• Asbestos
• Lead paint

All of these chemicals can enter the building through poor ventilation system, open windows or doors or other openings.

Indoor sources for chemical contamination can be:

• Volatile organic compounds- adhesive agents, carpets, copy machines, manufactured wood, cleaning agents.
• Tobacco smoke
• Smoke and other byproducts from stove, fireplace or heater
• Synthetic fragrances
• Personal care products^[1]

Biological contamination

Biological contaminants are:

• Bacteria
• Viruses
• Fungus
• Bird, insect and rodent droppings

Stagnant water can be a perfect place for virus, bacteria and fungus to breed. Moisture can accumulate in humidifiers, air conditioners and drainpipes. Air conditioning systems and hot air hand dryers can spread the pathogens in the building^[1].

Other causes

• Poor ventilation can cause discomfort and increase the indoor pollution
• Electromagnetic radiation from TV, computers and microwave ovens ionize the air. Long time exposure to magnetic fields can be a possible cause for cancer.
• Psychological factors can cause somatic symptoms. Stress and dissatisfaction with work and bad interpersonal relationships can cause health problems.
• Poor lighting
• Lack of ergonomics can cause musculoskeletal disorders, like carpal-tunnel or radial-tunnel syndrome.
• Too much humidity
• Absence of sunlight^[1,3]

Symptoms

The symptoms of sick building syndrome are very variable. Some symptoms can be present every day, while others occur on some occasions. They might differ between people in the same building. Usually these symptoms disappear or become less severe shortly after leaving the building. Symptoms of sick building syndrome are:

• Headache
• Fatigue
• Nausea
• Trouble focusing
• Pain, for example muscle pain, back pain or cramps (for example frozen shoulder syndrome, stiff person syndrome)
• Irritation of skin and eyes
• Blocked or runny nose
• Sneezing, cough or trouble breathing
• Hoarse voice
• Patients with asthma can experience more often recurrence of asthma attacks
• Personality changes

On many occasions the exact cause for these symptoms are not know. It can be just one triggering factor or a combination of them^[3,4].

Building related disease

Building related disease is a type of sick building syndrome. In this case, symptoms are associated with being in a certain building and getting infected by an airborne infection. Building related diseases can cause a variety of symptoms and conditions:

• Allergic alveolitis
• Legionnaire´s disease
• Pneumonia
• Asthma
• Lung disease related symptoms- cough, pain in the chest, trouble breathing
• Nosebleeds
• Cancer
• Miscarriage
• Humidifier fever- flu-like symptoms caused by breathing in contaminated droplets of water from humidifier^[1]

Diagnosis

There are no specific tests that could diagnose if a patient is suffering from sick building syndrome. Usually all complaints can be explained by being at a certain place, most likely- the patients workplace.

Buildings can be tested to find possible risk factors or pathogens. The tests that can be done are:

• Sampling the air and evaluation of air contamination
• Surveying workers of their symptoms and connecting them with possible causes
• Identifying the causes, for example copy machines, kitchen equipment, cleaning agents
• Measure the temperature, humidity levels
• Air quality can be assessed by measuring the CO levels in the air
• Examining the ventilation and plumbing system for possible contamination
• Measuring the light in workplace ^[1,3]

Prevention

The action to prevent sick building syndrome has to be taken in many levels. First of all the possible causes have to be determined and averted. Also the government has to take legislative measures to improve the work conditions. Measures that have to be taken in the workplace:

• Improvement of ventilation system. The heat, ventilation and air condition has to meet the standard requirements. The minimum requirement is 8.4 air exchanges every 24 hours.
• Replacing or removing the source of pollution
• Improve air quality by applying air filters, creating open office design, bringing plants in the office space and having enough natural light.
• Building needs time to ventilate after construction is finished. Allowing people to occupy it immediately after building has been finished is potentially dangerous
• Ensuring proper ergonomics in the work place
• Instructing employees on how to take care of their health- healthy nutrition, sports activities, stretching while at work, taking a break from the computer every hour, to prevent dry eye syndrome.

Government can influence the quality of buildings and take measures to prevent sick building syndrome:

• Educating the employers and employees about potential symptoms and causes of sick building syndrome
• Educating employers and employees about sick building syndrome
• Restricting smoking in the workplace
• Introducing requirements for safe workplace, including air quality, light requirements and ergonomics
• Creating a safe support system for employees who have health issues^[1].

References

1. Information about causes and symptoms; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796751/
2. Patient information: http://www.webmd.com/men/features/sick-building-syndrome#3
3. Symptoms and risk factors: http://www.nhs.uk/conditions/Sick-building-syndrome/Pages/Introduction.aspx
4. Causes, presentation and prevention: http://patient.info/doctor/sick-building-syndrome-pro