sick building syndrome sick building syndrome sick building syndrome (sbs) is a condition in which people develop symptoms of illness or become infected with chronic disease from the building in which they work or reside. sick building syndromespecialtyenvironmental medicine, immunology the main identifying observation is an increased incidence of complaints of symptoms such as headache, eye, nose, and throat irritation, fatigue, dizziness, and nausea. in fact the 1989 oxford english dictionary defines sbs in that way. the world health organization created a 484-page tome on indoor air quality back in 1984 when sbs was attributed only to non-organic causes, and suggested that the book might form a basis for legislation or litigation. the outbreaks may or may not be a direct result of inadequate cleaning or inappropriate cleaning methods. sbs has also been used to describe staff concerns in post-war buildings with misplanned building aerodynamics, defects in the construction materials or assembly process and-or inadequate maintenance. certain symptoms tend to increase in severity with the time people spend in the building; often improving over time or even disappearing when people are away from the building. sbs is also used interchangeably with "building-related symptoms", which orients the name of the condition around patients' symptoms rather than a "sick" building. attempts have been made to connect sick building syndrome to various causes, such as contaminants produced by outgassing of some types of building materials, volatile organic compounds (voc), improper exhaust ventilation of ozone (byproduct of some office machinery), light industrial chemicals used within, or lack of adequate fresh-air intake/air filtration (see minimum efficiency reporting value). sick building syndrome has also been attributed to heating, ventilation, and air conditioning (hvac) systems. however, there have been inconsistent findings on whether air conditioning systems result in sbs or not. signs and symptoms air quality monitor human exposure to aerosols has been documented to give rise to a variety of adverse health effects. building occupants complain of symptoms such as sensory irritation of the eyes, nose, or throat; neurotoxic or general health problems; skin irritation; nonspecific hypersensitivity reactions; infectious diseases; and odor and taste sensations. exposure to poor lighting conditions has led to general malaise. extrinsic allergic alveolitis has been associated with the presence of fungi and bacteria in the moist air of residential houses and commercial offices. a study in 2017 correlated several inflammatory diseases of the respiration tract with objective evidence of damp-caused damage in homes. the who has classified the reported symptoms into broad categories, including: mucous membrane irritation (eye, nose, and throat irritation), neurotoxic effects (headaches, fatigue, and irritability), asthma and asthma-like symptoms (chest tightness and wheezing), skin dryness and irritation, gastrointestinal complaints and more. several sick occupants may report individual symptoms which do not appear to be connected. the key to discovery is the increased incidence of illnesses in general with onset or exacerbation within a fairly close time frame – usually within a period of weeks. in most cases, sbs symptoms will be relieved soon after the occupants leave the particular room or zone. however, there can be lingering effects of various neurotoxins, which may not clear up when the occupant leaves the building. in some cases – particularly in sensitive individuals – there can be long-term health effects. cause ashrae has recognized that polluted urban air, designated within the united states environmental protection agency (epa)'s air quality ratings as unacceptable, requires the installation of treatment such as filtration for which the hvac practitioners generally apply carbon-impregnated filters and their likes. different toxins will aggravate the human body in different ways. some people are more allergic to mold, while others are highly sensitive to dust. inadequate ventilation will exaggerate small problems (such as deteriorating fiberglass insulation or cooking fumes) into a much more serious indoor air quality problem. common products such as paint, insulation, rigid foam, particle board, plywood, duct liners, exhaust fumes and other chemical contaminants from indoor or outdoor sources, and biological contaminants can be trapped inside by the hvac ac system. as this air is recycled using fan coils the overall oxygenation ratio drops and becomes harmful. when combined with other stress factors such as traffic noise, poor lighting, inhabitants of buildings located in a polluted urban area can quickly become ill as their immune system is overwhelmed. certain vocs, considered toxic chemical contaminants to humans, are used as adhesives in all common building construction products. these aromatic carbon rings / vocs can cause acute and chronic health effects on the occupants of a building, including cancer, paralysis, lung failure, and others. bacterial spores, fungal spores, mold spores, pollen, and viruses are types of biological contaminants and can all cause allergic reactions or illness described as sbs. in addition, pollution from outdoors, such as motor vehicle exhaust, can infiltrate into poorly designed buildings and contribute to poor indoor air quality, high ppm of co and co2. adult sbs symptoms were associated with a history of allergic rhinitis, eczema and asthma. a 2015 study concerning the association of sbs and indoor air pollutants in office buildings in iran found that, as carbon dioxide levels increase in a building, symptoms like nausea, headaches, nasal irritation, dyspnea, and throat dryness have also been shown to increase. certain work conditions have been found to be correlated with specific symptoms. for example, higher light intensity was significantly related to skin dryness, eye pain, and malaise. higher temperature has also been found to correlate with symptoms such as sneezing, skin redness, itchy eyes and headache, while lower relative humidity has been associated with sneezing, skin redness, and pain of the eyes. in 1973, in response to the oil crisis and conservation concerns, ashrae standards 62-73 and 62-81 reduced required ventilation from 10 cubic feet per minute (4.7 l/s) per person to 5 cubic feet per minute (2.4 l/s) per person, but this was found to be a contributing factor to sick building syndrome. as of the 2016 revision, ashrae ventilation standards call for 5 to 10 cubic feet per minute of ventilation per occupant (depending on the occupancy type) in addition to ventilation based on the zone floor area delivered to the breathing zone. psychological factors one study looked at commercial buildings and their employees, comparing some environmental factors suspected of inducing sbs to a self-reported survey of the occupants, finding that the measured psycho-social circumstances appeared more influential than the tested environmental factors. the authors of that study pointed to the self-reported nature of the observations as a limitation of the research. research has shown that sbs shares several symptoms common in other conditions thought to be at least partially caused by psychosomatic tendencies. the umbrella term "autoimmune/inflammatory syndrome induced by adjuvants" has been suggested. other members of the suggested group include silicosis, macrophagic myofascitis, gulf war syndrome, and post-vaccination phenomena. workplace greater effects were found with features of the psycho-social work environment including high job demands and low support. the report concluded that the physical environment of office buildings appears to be less important than features of the psycho-social work environment in explaining differences in the prevalence of symptoms. however, there is still a relationship between sick building syndrome and symptoms of workers regardless of workplace stress. excessive work stress or dissatisfaction, poor interpersonal relationships and poor communication are often seen to be associated with sbs, recent studies show that a combination of environmental sensitivity and stress can greatly contribute to sick building syndrome. specific work-related stressors are related with specific sbs symptoms. workload and work conflict are significantly associated with general symptoms (headache, abnormal tiredness, sensation of cold or nausea). while crowded workspaces and low work satisfaction are associated with upper respiratory symptoms. work productivity has been associated with ventilation rates, a contributing factor to sbs, and there's a significant increase in production as ventilation rates increase, by 1.7% for every two-fold increase of ventilation rate. printer effluent, released into the office air as ultra-fine particles (ufps) as toner is burned during the printing process, may lead to certain sbs symptoms. printer effluent may contain a variety of toxins to which a subset of office workers are sensitive, triggering sbs symptoms. specific careers are also associated with specific sbs symptoms. transport, communication, healthcare, and social workers have highest prevalence of general symptoms. skin symptoms such as eczema, itching, and rashes on hands and face are associated with technical work. forestry, agriculture, and sales workers have the lowest rates of sick building syndrome symptoms. from the assessment done by fisk and mudarri, 21% of asthma cases in the united states were caused by wet environments with mold that exist in all indoor environments, such as schools, office buildings, houses and apartments. fisk and berkeley laboratory colleagues also found that the exposure to the mold increases the chances of respiratory issues by 30 to 50 percent. additionally, studies showing that health effects with dampness and mold in indoor environments found that increased risk of adverse health effects occurs with dampness or visible mold environments. milton et al. determined the cost of sick leave specific for one business was an estimated $480 per employee, and about five days of sick leave per year could be attributed to low ventilation rates. when comparing low ventilation rate areas of the building to higher ventilation rate areas, the relative risk of short-term sick leave was 1.53 times greater in the low ventilation areas. home sick building syndrome can also occur due to factors of the home. laminate flooring can cause more exposure to chemicals and more resulting sbs symptoms compared to stone, tile, and cement flooring. recent redecorating and new furnishings within the last year were also found to be associated with increased symptoms, along with dampness and related factors, having pets, and the presence of cockroaches. the presence of mosquitoes was also a factor related to more symptoms, though it is unclear whether it was due to the presence of mosquitoes or the use of repellents. mold main article: mold health issues some studies have found that sick building syndrome may be associated with indoor mould or mycotoxin contamination. however, the attribution of sick building syndrome to mould is controversial and supported by little evidence. indoor temperature indoor temperature under 18 °c (64 °f) has been shown to be associated with increased respiratory and cardiovascular diseases, increased blood levels, and increased hospitalization. diagnosis while sick building syndrome (sbs) encompasses a multitude of non-specific symptoms, building-related illness (bri) comprises specific, diagnosable symptoms caused by certain agents (chemicals, bacteria, fungi, etc.). these can typically be identified, measured, and quantified. there are usually 4 causal agents in bri; 1.) immunologic, 2.) infectious, 3.) toxic, and 4.) irritant. for instance, legionnaire's disease, usually caused by legionella pneumophila, involves a specific organism which could be ascertained through clinical findings as the source of contamination within a building. prevention reduce the time you stay in the building if you live there, consider moving to a new place regular inspections to indicate for presence of mold or other toxins adequate maintenance of all building mechanical systems toxin-absorbing plants, such as sansevieria roof shingle non-pressure cleaning for removal of algae, mold, and gloeocapsa magma using ozone to eliminate the many sources, such as vocs, molds, mildews, bacteria, viruses, and even odors. however, numerous studies identify high-ozone shock treatment as ineffective despite commercial popularity and popular belief. replacement of water-stained ceiling tiles and carpeting only using paints, adhesives, solvents, and pesticides in well-ventilated areas or only using these pollutant sources during periods of non-occupancy increasing the number of air exchanges; the american society of heating, refrigeration and air-conditioning engineers recommend a minimum of 8.4 air exchanges per 24-hour period increased ventilation rates that are above the minimum guidelines proper and frequent maintenance of hvac systems uv-c light in the hvac plenum installation of hvac air cleaning systems or devices to remove vocs and bioeffluents (people odors) central vacuums that completely remove all particles from the house including the ultrafine particles (ufps) which are less than 0.1 μm regular vacuuming with a hepa filter vacuum cleaner to collect and retain 99.97% of particles down to and including 0.3 micrometers placing bedding in sunshine, which is related to a study done in a high-humidity area where damp bedding was common and associated with sbs lighting in the workplace should be designed to give individuals