SICK BUILING SYNDROME

INTROUCTION
The sick building syndrome (SBS) is used to describe a situation in which the occupants of a
building experience acute health- or comfort-related effects that seem to be linked directly to the
time spent in the building. No specific illness or cause can be identified. The complainants may
be localized in a particular room or zone or may be widespread throughout the building.

HISTORY:

 In 1970 following the observation of Bensazak the attention of medical profession was
drawn to the development of allergic respiratory disorder in employees working in AC
offices.
 In 1976 outbreak of legionnaire’s disease in philadelphi.ue to contaminated cooling
towers. Several epidemics have been reported worldwide.
 In 1986 the term “sick building syndrome” was coined by WHO.

SIGN AND SYMPTOMS

Cough, chest pain, shortness of breath on mild exertion, edema, palpitations, nosebleeds,
cancers, pregnancy problems and miscarriages. Extrinsic allergic alveolitis, Legionnaire's
disease, humidifier fever, pneumonia and occupational asthma are also known to occur.

Legionnaire's disease is due to contamination of cooling towers by legionella organisms.

Humidifier fever is caused by breathing in water droplets from humidifiers heavily contaminated
with microorganisms causing respiratory infections, asthma and extrinsic allergic alveolitis. The
disease is noninfective in nature. The patient may have flu-like symptoms. It is sometimes called
Monday Fever. Permanent lung damage does not occur.

The symptoms can be clinically defined and have clearly identifiable causes. The complainants
may require prolonged recovery time after leaving the building.

It is important to note that complaints may also result from other cause like a preexisting illness
or other allergies, job-related stress or dissatisfaction and psychosocial factors.
ETIOLOGY
The following are some of the factors that might be primarily responsible for SBS:

1. Chemical contaminants:

 From outdoor sources: Contaminants from outside like pollutants from motor vehicle
exhaust, plumbing vents and building exhausts (bathrooms and kitchens) can enter the
building through poorly located air intake vents, windows and other openings.
Combustion byproducts can enter a building from a nearby garage. Radon, formaldehyde,
asbestos, dust and lead paint can enter through poorly located air intake vents and other
openings.
 From indoor sources: The most common contaminant of indoor air includes the volatile
organic compounds (VOC). The main sources of VOC are adhesives, upholstery,
carpeting, copy machines, manufactured wood products, pesticides, cleaning agents, etc.
Environmental tobacco smoke, repairable particulate matter, combustion byproducts from
stove, fireplace and unvented space heater also increase the chemical contamination.
Synthetic fragrances in personal care products or in cleaning and maintenance products
also contribute to the contamination.

2. Biological contaminants

 The biological contaminants include pollen, bacteria, viruses, fungus, molds, etc. These
contaminants can breed in stagnant water that has accumulated in humidifiers, drainpipes
and ducts or where water has collected on ceiling tiles, insulation, carpets and upholstery.
 Insect and bird droppings can also be a source of biological contamination. Biological
contamination causes fever, chills, cough, chest tightness, muscle aches and allergic
reactions. In offices with a high density of occupancy, airborne diseases can spread
rapidly from one worker to another. Air-conditioning systems can recirculate pathogens
and spread them throughout the building e.g., Legionnaire's disease due to legionella
organisms.

3. Inadequate ventilation

 In 1970, oil embargo led building designers to make buildings more airtight, with less
outdoor air ventilation, in order to improve energy efficiency. The ventilation was
reduced to 5 cfm/person. This reduced ventilation rate was found to be inadequate to
maintain the health and comfort of building occupants. Malfunctioning heating,
ventilation and air-conditioning systems (HVAC systems) also increase the indoor air
pollution. In order to have an acceptable indoor air quality (IAQ) with a minimum energy
consumption, The American Society of Heating, Refrigeration and Air-Conditioning
Engineers (ASHRAE) recently revised ventilation standards to a minimum outdoor air
flow rate of 15 cfm/person to avoid the problems related to inadequate ventilation. The
 standards are 20 cfm/person in office spaces and 60 cfm/person in smoking lounges. Poor
design and construction of buildings with more number of offices cramped in a building
to increase the salable area also contribute to inadequate ventilation.

4. Electromagnetic Radiation

 Gadgets like microwaves, televisions and computers emit electromagnetic radiation,

5. Psychological factors

 Excessive work stress or dissatisfaction, poor interpersonal relationships and poor

6. Poor and inappropriate lighting with absence of sunlight, bad acoustics, poor ergonomics and
humidity

 The symptoms of SBS are commonly seen in people with clerical jobs than in people
with managerial jobs because professionals or managers have better working conditions.
The symptoms are more common in females than in males probably because more
females are in secretarial jobs, they are more aware of their health or a lesser dose of
pollutants is required to manifest the effects. The symptoms are more common in air-
conditioned buildings than in naturally ventilated buildings and are more common in a
public sector building than in a private sector building.

PREVANTION AND CONTROL

 Increase the ventilation rates and air distribution. The heating, ventilation and air-
conditioning systems should be designed to meet ventilation standards in the local
building codes. The HVAC system should be operated and maintained properly to ensure
that the desired ventilation rates are attained. If there are strong pollutants, the air may
need to be directly vented to the outside. This method is especially recommended to
remove pollutants that accumulate in specific areas such as rest rooms, copy rooms and
printing facilities. The ASHRAE recommends a minimum of 8.4 air exchanges per 24 h.
 Increase & Improve Ventilation: Promoting natural air ventilation through open
windows is a cost-effective and straightforward solution to improve indoor air quality.
However, it might not always be possible. Therefore, facility managers must tap into
regularly maintained HVAC systems to keep the air quality optimal. Additionally, they
might consider installing air purifiers to collect the pollutants from the indoor air.
 When possible, use chemical-free, toxin-free products indoors. When chemicals have to
be used indoors, properly exhaust and ventilate during and immediately after use.
  Choose low-VOC products. By selecting paints and finishes that are low- VOC, you can
minimize the number of chemical contaminants within your building. Since indoor air
quality is a priority for so many schools, companies, and offices, it’s not difficult to find
carpeting, furniture, upholstery, cleaning agents, and more that are low-VOC and
contribute to improve indoor air quality

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