Related to air pollution and perhaps to MCS, another environmental condition has come to be known as the "tight-building" or "sick-building" syndrome (SBS). Recognized since the 1970s, this condition is very much an outgrowth of our late-twentieth-century cost consciousness and emphasis on energy efficiency. The World Health Organization (WHO) defines sick-building syndrome as an excess of work-related irritations of the skin and mucous membranes and of a variety of other symptoms, especially headache, fatigue, and difficulty concentrating. SBS is associated with newly constructed or remodeled, tightly sealed, climate-controlled buildings, hence the name.
To improve energy efficiency, ventilation systems in newer or remodeled homes have been designed to pull in less fresh outdoor air and recirculate more indoor air. Although they are more energy and cost efficient, such systems result in elevations in the concentrations of indoor pollutants and other contaminants. Not surprisingly, SBS occurs more frequently in buildings where ventilation rates are set near the minimum, and for that reason the American Society of Heating, Refrigeration, and Air Conditioning Engineers has repeatedly recommended increases in the minimal supply of outdoor air per person per minute. The issue is far from settled or clearly understood, however, since data from a recent research investigation published in the prestigious New England Journal of Medicine did not demonstrate any improvement in the symptoms of sufferers when supplies of fresh air were increased.
Whatever the actual causes, the extent of the problem is not believed to be small. The WHO estimates that SBS occurs in as many as 30 percent of new and remodeled office buildings. This translates into a problem that may affect approximately one million modern commercial buildings in the United States. If this is indeed so, between 30 million and 70 million employees are potential victims.
Upper respiratory tract symptoms, including stuffy or runny noses, coughing, sneezing, sore throat, shortness of breath, and chest tightness are among some of the many symptoms of people complaining of SBS. Headache, excessive tiredness, sore eyes, itching, dry skin, and skin rash have also been ascribed to the syndrome. Curiously, women tend to be more affected than men, and nonsupervisory personnel more than management-level employees. Unlike the case with multiple chemical sensitivities, the manifestations of sick-building syndrome do not include food intolerances or gastrointestinal problems. Typically, all symptoms of SBS improve or disappear entirely whenever the sufferer is away from the building environment.
The precise agents responsible for SBS are not known. However, a closed environment allows for the proliferation of a wide variety of germs and for the concentration of allergens and other irritating airborne particles, all or a combination of which may be responsible. Examples of potential problem-causers include cigarette smoke, perfumes, pesticide fumes, molds, mites, carbonless paper, fabric particles, and fiberglass, to name just a few.
As in the case of multiple chemical sensitivities, diagnosing sick-building syndrome and finding its particular causes can be difficult. While no specific, objective diagnostic laboratory tests are available, samples of air may be taken to determine levels of carbon dioxide, the major component of exhaled air. If nothing else, an elevated level would suggest inadequate ventilation. Finding clusters of individuals who are suffering with symptoms of the syndrome rather than isolated cases is another strong supportive piece of evidence that something may be amiss in their common environment.
It goes without saying that better designed and maintained ventilation systems are needed to improve the internal environments of many of our modern office buildings. Closer attention to the choice of construction materials as well as to the products we use in the workplace (just as in the home) can also go far in reducing the levels of potential toxins and allergens.
