Are You Really Sick Or Is Your Office Building The Real Culprit?

What could be more discouraging than to go to a doctor because you have been feeling really awful for some time only to be told that you're probably imagining your symptoms? Just think how justified you would feel if you could counter this conclusion with a list of thousands of individuals with similar symptoms. In recent years, several weird groups of symptoms have appeared which boggle the mind, lead to long investigations with confusing results, and often end in legal battles about vague injustices and even vaguer disease entities. Three such syndromes come to mind readily since the investigations, confusion, and legal technicalities have attracted considerable media attention. The most recognizable is Gulf War Syndrome whose supposed origin from chemical warfare during the "Mother of All Wars" is now being seriously questioned. The most inscrutable is Chronic Fatigue Syndrome because it usually cannot be traced back to any reliably specific occurrence. The most obvious is Sick Building Syndrome since symptoms invariably occur either exclusively or mainly within the confines of a specific edifice. I would like to lead you on a brief excursion into the mysteries of this latter syndrome; a spreading high technology nightmare.

Thom defined it as "an increased occurrence of nonspecific symptoms among populations in determined buildings" then claimed, "it refers to a system (a building inclusive of its population) rather than to a clinical state in a single individual."

In this syndrome the nonspecific nature resides in the multiplicity of symptoms reported and the variability with which they are expressed in any given individual. While perusing some of the more recent articles on the topic, I was amazed at the truly wide differences in symptomatology and the array of causes that have been reported.

Norback and colleagues speak of eye, skin and upper airway irritation, headache, and fatigue seen in consecutive cases. Investigation found that total indoor hydrocarbon concentration was significantly related to symptoms. Personal factors such as hyperreactivity and breathing problems were also strongly related, as were smoking, psychosocial factors, and static electricity. However, they were unable to correlate room temperature, humidity, formaldehyde or carbon dioxide concentration, atopy, age, sex, or outdoor exposure.

Ooi and Goh underscored the idea that work-related psychosocial stress is of prime importance when no recognized environmental problems could be discerned. They emphasized the importance of personal and organizational stress management.

I was impressed with the differences placed upon varying factors. Muzi et al speak of "irritative" symptoms predominantly involving the eyes and respiratory tract. Bourbeau et al claim that office workers moved from a sick building to one with improved ventilation having sealed windows with mechanical ventilation, air conditioning, and humidification experienced diminished symptoms. Morrow adds dizziness, confusion, and unusual odor or taste sensations. He goes on to implicate other factors such as light intensity, tobacco smoke, wall-to-wall carpeting, crowding, work satisfaction, gender, and the presence of volatile organic compounds. Crawford and Bolas claimed that up to 30% of new or renovated buildings are affected and Redlich et al take the syndrome through a myriad of degrees of seriousness ranging from uncomfortable to disabling, and capable of rendering whole workplaces nonfunctional. Schleibinger et al, implicate that the microbial production of volatile organic compounds like formaldehyde and acetone in HVAC systems may play an important role. Ahearn et al had previously described a building on the Gulf coast where there had been no catastrophic or chronic water damage yet investigation revealed dense fungal growth in the heating-cooling system, which, in spite of this, failed to raise the colony counts to a significant level in the air samples. However, colonized fiberglass insulation from the floor seemed to be aggravating. When removed the number of complaints diminished.

Bardana, called the syndrome a "pseudodiagnosis," implied that its characteristics have led to investigators linking it to similar vague diagnoses, and suggested a less implicating label of "idiopathic building intolerance." This tendency to link similar vague syndromes occurred in an article by Chester and Levine who concluded that fatigue related to sick building syndrome, including chronic fatigue syndrome, is significantly more likely to improve than that in sporadic cases of chronic fatigue syndrome. Brede-Weisflog goes so far as to refuse to accept the condition as an occupational disease.

If you work in a building where you seem to have a host of symptoms check with your fellow workers. If you're not the only one, the problem may reside in the contents of the building around you.

Cartoons and Poems following each article are created and copyrighted by Dr. Ackerman and cannot be copied or reproduced without his permission. Copyright © 2006 by Marvin Ackerman, M.D.

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