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Sick building syndrome
  1. P S Burge
  1. Correspondence to:
 Dr P S Burge
 Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK;

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The sick building syndrome (SBS) consists of a group of mucosal, skin, and general symptoms that are temporally related to working in particular buildings. It is the workers who are symptomatic, but the building or its services which are the cause. The common symptoms and a method of assessment are shown in box 2. The average number of work related symptoms per occupant is known as the building symptom index. It can be measured reproducibly by simple questionnaire surveys. The building symptom index shows a wide variation between different buildings (fig 1); “sicker” buildings often have conditions of air temperature, humidity, and lighting levels that fully comply with current standards. Some of the reproducible “facts” shown in studies in different countries are shown in box 1, and factors related to higher (sicker) building symptom indices shown in box 3. Box 4 shows the WHO standards for the management of building ventilation systems. Money spent on the building services is likely to be cost effective in terms of the lost productivity in symptomatic workers.

Figure 1

Range of building symptom indices in a group of buildings studied with the same questionnaire with a maximum of 10 symptoms (the actual BSI is dependent on the number of possible positive answers and differs between questionnaires).

Box 1: Reproducible observations related to sick building syndrome (?facts)

  • There is a wide range of symptom prevalences between the occupants of different buildings, not explained by personal factors.

  • Air conditioned buildings generally have a higher prevalence of symptomatic workers than naturally ventilated buildings.

  • The sick building syndrome occurs in buildings that fully comply with current design standards in terms of temperature, ventilation, and lighting.

  • Although various chemicals (particularly volatile organic compounds) have been related to symptoms in individual buildings, none have been shown to be a cause of SBS …

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