Sick Building Syndrome: Part1, Intro

This is part 1 of the book by the London Hazards Centre that looks at how buildings can cause SBS.

'I work in a clean area in a sealed building with air conditioning. I am always ill and tired, with headaches and sore eyes. We have no windows and all fluorescent lights. There are about 90 of us who work in this place, and we are all stuck in this atmosphere since there is no other work on the island.' (Cowes, Isle of Wight)


This letter to the London Hazards Centre requesting information on sick building syndrome is typical of complaints received from people around the country. What must it be like to go to work knowing that you'll feel lousy by the end of the day, drained of energy and perhaps with sore eyes, respiratory problems and a headache to cap it all? Yet this is just what happens to an increasingly large number of workers in supposedly 'clean' jobs and industries, such as office workers and those in the micro-chip electronics industry. Problems of fluctuating temperatures, draughts, stuffiness, bad lighting and noise have always been found in offices but the energy-saving measures introduced in the 1970s with the rise in oil prices have exacerbated them.

 

Re-circulation of air and pollutants


Many buildings are now designed to reduce the intake of 'fresh' outside air because it is cheaper to re-circulate air that has already been warmed up in winter, or cooled in the summer, than to take in outside air and heat or cool it. Doors, window frames and other seals in the building are made as air-tight as possible, windows cannot be opened, and the amount of outside air brought into the ventilation system may be reduced - perhaps to zero, so that only recirculated air is being breathed. Such buildings are known as 'sealed' or 'tight' buildings. Sometimes air inlets have been found to be bricked up. And the power of fans that distribute air from the air handling unit into the distribution ductwork may be reduced, or some fans may be turned off altogether for periods of time to save on energy costs.

Other changes have also taken place in the past two decades. More synthetic materials are used in construction, insulation and furnishings. Synthetic materials may release a variety of toxic chemicals, the best known being formaldehyde. The increasing use of machines also adds to indoor pollution, for instance the ozone from photocopiers, the noise from printers, and the electromagnetic radiation from visual display units. With the lack of fresh air resulting from energy-saving measures, chemical pollutants are not diluted and are continually recirculated throughout the building. And, of course, 30 per cent or so of the workforce may be smokers...

Air-conditioning systems themselves can harbour pollutants and micro-organisms and so add to the contamination of the workplace. For example, dirt enters with the air supply and builds up in the ductwork over time, or may have been lying in the system since it was installed. Often there is no-one in an organisation who really understands how the systems work. In addition, maintenance and cleaning of systems seem to be the exception rather than the rule, through negligence or because the various parts of the system are inaccessible (Wilson et al 1987; Jones and O'Sullivan 1988; Robertson 1988).


In the following chapters, much emphasis is placed on air-conditioning and ventilation systems since inadequate ventilation has been considered to be a causal factor in 50 per cent of sick buildings in the United States and in 68 per cent of Canadian investigations (Melius 1984; Collet and Sterling 1988). However, precise causal factors are rarely found in sick building investigations. Many reports conclude that inadequate ventilation was the cause of sickness because no other factor could be found, and improving the ventilation helped to remedy the situation. But improving the ventilation would in turn reduce the amount of contamination with chemicals or micro-organisms, so that increased ventilation can be seen as an effective treatment rather than a cause (Jones 1989).
Taking symptoms seriously

The symptoms of sick building syndrome are discussed in Chapter 2. They include eye and nose irritation, runny or stuffy nose, fatigue, headache, nausea, sore throat and general respiratory problems. Environmental tobacco smoke is often blamed for these symptoms, particularly since it can be seen or smelt, but many other less visible pollutants, as well as environmental conditions, can cause similar problems. For example, identical symptoms to those described above are suffered by people who are exposed to formaldehyde, ammonia, nitrogen oxides, cotton dust and fibreglass particles; by those who are allergic to dusts and microbial spores; and by those exposed to low relative humidities for long periods of time (Robertson 1988).

Sick building syndrome is often not taken seriously by the management since managers are less likely to suffer the symptoms. Managers often have larger offices, furnished with more expensive materials such as natural wool and real wood which are less likely to give off noxious gases, less equipment such as photocopiers and word-processors, and the freedom to move about and out of the building. Since the symptoms of sick building syndrome are common in any population, managers may wrongly treat the complaints as mere whingeing by workers. One example is given of a building where people working in the basement had been complaining for some time that the atmosphere was hot and stuffy with no fresh air and with heat and odours emanating from an adjacent kitchen. It wasn't until a senior executive fell asleep during a meeting in the basement that the employers decided to do something about the problem (Tong 1989).

The two main reasons why sufferers of sick building syndrome know that it is not an individual problem but one connected with the workplace are, first, that a substantial proportion of fellow workers will be suffering from similar symptoms (hysteria, the management might say) and, second, the timing of the symptoms. A cardinal feature of sick building syndrome is that symptoms become worse after the person has been in the building for a few hours, particularly after the weekend or a break away from the workplace, and improve after leaving the building and at weekends. Humidifier fever, another building-related illness, also follows this pattern, and for this reason humidifier fever is considered together with sick building syndrome; the two may well be interconnected.
Air monitoring

Getting management to take the problem seriously may be the first hurdle, but other pitfalls can arise when 'experts' are brought in to monitor the air. There may be literally thousands of chemicals in the air, so the cost of measuring the levels of all of them is out of the question. Consequently, a few of the more common pollutants may be looked for, depending on the situation and likely causes of pollution. The levels of pollutants that are considered 'acceptable' are derived mainly for industrial exposures (and are in any case considered by many to be too high) and rarely in cases of sick building syndrome are these levels exceeded. So, say the experts, our results show that the levels of ozone, nitrous oxides, formaldehyde etc. are well below toxic levels, and chemical exposure is not the problem here. However, such an approach ignores the fact that effects of chemicals are additive or may even be synergistic, i.e. the combined effect of being exposed to two (or more) agents may be greater than the sum of their individual effects. The health risks of long-term exposures to low levels of a variety of pollutants are poorly understood.