What Is Sick Building Syndrome?

Whether you are returning after a weekend off or months of working at home, you might feel reluctant to head back to the office — especially if your work environment makes you feel uncomfortable. If you often notice yourself feeling unwell while you are in the office, it may be easy to write it off as job-related stress. However, there may be something more going on, especially if you are not the only one experiencing symptoms.

One possible reason you feel unwell at work might be due to poor indoor air quality. One study found about one in four U.S. office workers deal with perceived air quality problems at their jobs, and one in five of those say that indoor air pollution affects their ability to do their work. These air quality problems do not always have a clear cause, but that does not keep them from causing symptoms, such as headaches, dizziness and nausea. 

If you and your coworkers find yourselves feeling sick in the office — and then feeling better soon after you leave — you may be experiencing sick building syndrome (SBS).

What is sick building syndrome?

Sick building syndrome is a condition in which people suffer unexplained health symptoms that appear to be linked to time spent in a specific building. Oftentimes, the structure associated with SBS is an office building. Symptoms often increase in severity with more time spent in the building and improve with time spent away. 

SBS often impacts the health and comfort of multiple people in the building, though symptoms can vary greatly from one person to the next. Individuals suffering from SBS may experience:

  • Headaches;
  • Dry cough;
  • Dizziness;
  • Nausea;
  • Fatigue;
  • Itchy or dry skin;
  • Allergies;
  • Cold- or flu-like symptoms;
  • Increased asthma attacks;
  • Eye, nose or throat irritation;
  • Voice hoarseness;
  • Sensitivity to smells;
  • Difficulty concentrating;
  • Personality changes.

SBS symptoms can also decrease work productivity and increase the number of sick days taken by employees. There is no clear cause for SBS symptoms, so there is no single way to test for the condition or treat symptoms that occur. In some cases, medical tests and building inspections may help determine a diagnosis, but the true cause of SBS symptoms may never be found.

SBS is often linked to problems with indoor air quality. It is also possible for symptoms from other sources, such as allergies, stress, illness contracted outside the building or other psychological factors, to be misattributed to SBS. However, it is also possible for symptoms from these ailments to be made worse by poor indoor air quality.

A history of SBS

In 1984, a World Health Organization committee released a report suggesting that at least 30% of new and remodeled buildings may be linked to excessive health complaints related to indoor air quality. One of the main reasons for poor air quality in these buildings is a lack of ventilation. When there is little to no air exchange between indoor and outdoor air, pollution can start to build up to unhealthy levels. 

During the first half of the 1900s, building ventilation standards required about 15 cubic feet per minute (cfm) of fresh outside air per building occupant. These standards changed after the oil embargo of 1973 when national energy conservation practices lowered the fresh air requirement to 5 cfm per occupant. This reduced ventilation rate helped lower energy consumption, but it came at the cost of indoor air quality. 

The 1984 WHO report pointed out that the lack of ventilation in newer structures had started to impact the health and comfort of building occupants. Poor ventilation caused by ineffective heating, ventilating and air conditioning (HVAC) systems is thought to be one of the driving factors of SBS.

Building-related illness (BRI) is another term used to describe situations in which a building affects the health of its occupants. However, BRI symptoms are more clearly defined and easier to diagnose than SBS symptoms. They also can be attributed to an identifiable cause, typically a specific airborne contaminant.

What causes SBS?

By definition, SBS does not have a clearly identifiable cause. However, that does not mean we are clueless about where SBS symptoms come from. It simply means that building inspections and healthcare consultations are often not enough to definitively connect a specific source with an individual’s SBS symptoms. 

Biological pollutants and SBS

Examples of biological pollutants include mold and bacteria, which can often grow in stagnant water in air ducts, humidifiers or anywhere that water has been allowed to accumulate. Some species of mold, such as Aspergillus, Penicillium, Stachybotrys and Cladosporium, release mycotoxin spores into the air. Research suggests that these mycotoxins may play a role in the development of SBS symptoms. Mycotoxin exposure is associated with damage to the digestive, nervous, respiratory and reproductive systems.

Biological contaminants can also include dust mites, cockroaches and bird droppings. Dust mites and cockroaches are common sources of indoor allergens. Those sensitive to these pollutants may experience worsened symptoms of allergies and asthma when in an affected building. Bird droppings, on the other hand, can carry disease-causing fungi and parasites that may affect anyone near enough to breathe them in. 

Chemical pollutants and SBS

Like biological pollutants, chemical contaminants can come from both indoor and outdoor sources. These can include volatile organic compounds (VOCs), carbon monoxide and other harmful gases. VOCs, such as formaldehyde, can be found in many building materials, including adhesives, manufactured wood products, carpeting and upholstery. They can also be found in many pesticides and cleaning products.

Chemical pollution from the outdoors can come from sources that include vehicle exhaust, tobacco smoke and wildfire smoke. Outdoor air pollution can enter a building through poorly sealed windows and doors, air intake vents and other openings. 

Different types of pollution may affect people in different ways. Additionally, some may be more sensitive to certain pollutants than others. Those with more severe SBS symptoms may have a higher sensitivity to lower concentrations of the pollutants present in their building. 

Psychological influences and SBS

While SBS symptoms are typically linked to problems with indoor air quality, psychological factors may also play a role. Excessive work stress, low job satisfaction and poor interpersonal relationships and communication may all contribute to SBS symptoms. Likewise, poor indoor lighting, a lack of natural light, bad acoustics, excessive humidity and poor ergonomics may all make SBS symptoms worse.

Some researchers argue that the psychological and social characteristics of a workplace may have more influence over SBS symptoms than physical factors. However, it is more likely that the two elements work together to contribute to symptoms.

One 2014 study found that general symptoms were most often associated with unpleasant odors, excessive workload and interpersonal conflicts. Upper respiratory symptoms, on the other hand, tended to be linked to crowded workspaces, air dryness perception and dustiness on the floor.

People in some lines of work are more likely to experience SBS than others. This can include those that do clerical, service, health, hospital and social work. People that work outdoors, such as those in agricultural or forestry jobs, are less likely to experience SBS.

What are the best solutions for SBS?

Since SBS symptoms do not have a clear cause, the best solution often involves looking for ways to improve the overall air quality inside the building. One of the best ways to do this is to increase ventilation and air circulation in the building. This can involve repairing or upgrading HVAC systems or using fans and open windows to increase airflow. Improved air circulation can also help keep pollutants from accumulating in certain areas, such as bathrooms and copy rooms.

You can also improve indoor air quality by finding and removing any mold or other biological toxins present in the building. Mold may be found in HVAC systems, water-stained carpets and ceiling tiles, and consistently humid areas, including bathrooms and kitchens. To decrease other biological toxins, you can:

  • Make sure that the building is dusted regularly;
  • Use integrated pest control methods (a combination of source control and pesticides) to minimize cockroaches and other pests;
  • Look for bird droppings in areas near building openings, such as windows or air intake valves.

Finding and removing sources of chemical pollutants is just as important as doing the same for biological contaminants. You may do this by:

  • Switching to low- or no-VOC cleaning products and paints;
  • Storing any unused chemicals in sealed containers in well-ventilated areas;
  • Only using pesticides, paints, heavy-duty cleaners and other toxic chemicals when there are not many other people in the building;
  • Creating a designated smoking area away from any doors, windows or air intake valves;
  • Allowing time for building materials in new or remodeled areas to off-gas pollutants before people start working there.

You can also use air filtration to complement the above source control methods and help remove remaining airborne contaminants. Installing an air purifier in your office and upgrading the filters in your HVAC system (if possible) may help remove both biological and chemical pollutants from the air.

Psychological and social factors should also be considered when dealing with SBS. For example, some people may benefit from increased natural light and the addition of indoor plants. Finding ways to increase employee job satisfaction and decrease stress or frustration may help improve any symptoms stemming from non-physical sources.

Addressing SBS symptoms requires communication between a building’s occupants, maintenance crew and owners. Any air quality issues that are detected should be dealt with as quickly as possible. By removing sources of indoor air pollution, you can help reduce employee exposure to biological and chemical contaminants that may be contributing to SBS.