Sick Building Syndrome and Building Related Illness

Sick Building Syndrome

What is the difference between Sick Building Syndrome and Building Related Illness?

Do Buildings Get Sick?

Do Buildings Get Sick?

Sick Building Syndrome and Building Related Illness are two distinct diagnosis. People often use the term “sick building” when referring to a property, but buildings don’t get sick – people do. I believe if there are numerous people suffering from Sick Building Syndrome (SBS) it’s okay to refer to the building as “sick,” but that’s technically inaccurate. So what is the difference between SBS and Building Related Illness (BRI)?

Sick Building Syndrome (SBS)

Sick Building Syndrome includes the following symptomology:

  • complaints of acute discomfort (.e.g, headache; eye, nose or throat irritation; dry cough; dry or itchy skin; dizziness and nausea; difficulty concentrating; fatigue; and sensitivity to odors; rash)
  • unknown cause of symptoms
  • most symptoms vanish shortly after occupants leave the building

Sick Building Syndrome

Another rule-of-thumb has been developed that states unless 20% or more of occupants are suffering SBS symptoms, it is not SBS. I think this is a terrible rule-of-thumb, and it really only benefits occupants in smaller buildings. For instance, if you were suffering these symptoms in a household of 3 – it’s automatically Sick Building Syndrome. But if you and 198 other occupants are suffering an office building of 1,000 – it’s automatically not SBS?!?!  That’s ridiculous. If 199 people are suffering in any building you better start to believe there’s a serious problem. The 20% rule just doesn’t add up.

Building Related Illness (BRI)

Building Related Illness is, by definition, different than SBS. BRI is generally allergic reactions or infections, and symptoms and patterns are as follows:

  • complaints of specific symptoms such as cough, chest tightness, fever, chills, and muscle aches
  • symptoms can be clinically defined
  • cause of symptoms in known
  • complaints can continue after having left the building
Sick Building Syndrome

Building Related Illness is different than Sick Building Syndrome

Unless you’ve lived under a rock, this sort of case should sound familiar. Think post-Katrina FEMA cottages.  Think Chinese drywall. Or Chinese flooring with formaldehyde.

Humidifier fever, Legionnaires Disease, skin rashes, hypersensitivity pneumonitis, and other illness related to bacteria, fungus (mold), and viruses are often classified as Building Related Illnesses, not Sick Building Syndrome.

Often the words “malaise” and “lethargy” are used during BRI or SBS interviews. According to Managing Indoor Air Quality, “malaise is a vague feeling of uneasiness or physical discomfort,” and “lethargy is characterized by abnormal drowsiness or torpor, apathy, sluggishness and great lack of energy.”

At the heart of every Sick Building Inspection is an occupant survey that helps the investigator understand symptoms and develop a hypothesis about what in the building could be causing these symptoms.

Indoor Air Quality and Sick Building Syndrome

Indoor Air Quality is almost always associated with SBS (and BRI). Whether from insufficient ventilation, excessive accumulation of indoor air pollutants, or a combination thereof, IAQ is almost always intimately tied to the symptoms of SBS or BRI.

NIOSH Types of Problems with Sick Building Syndrome

Excerpt Chart from NIOSH – Types of Problems with Sick Building Syndrome

Ventilation is a crucial element in maintaining good IAQ. Point-source exhaust for known sources of contaminants (e.g., combustion appliances, paint/chemistry hoods, etc.) and moisture (e.g., stove top, shower, indoor pool, etc.) is a relatively easy way to reduce indoor pollutants. But when these systems are broken or occupants don’t know to operate them… rapid accumulation of indoor pollutants can lead to SBS.

The other half of the ventilation equation is the introduction of outside air. As we continue building tighter and tighter buildings for energy efficiency, we must also ensure sufficient outside air delivery. If you have a carbon dioxide (CO2) meter and watch it as an unventilated room fills with occupants… you can see CO2 levels rise rather quickly. CO2 can be used as an indicator for measuring ventilation effectiveness, but there are more advanced methods involving flow hood measurements.

Indoor and outdoor contaminants contributing to SBS or BRI may include any of the following (abbreviated list):

  • VOCs and formaldehyde from building materials or occupational environments
  • Microbial VOCs (MVOCs) from wet and actively growing colonies of mold or bacteria
  • mold spores and hyphae fragments
  • pesticides, fungicides and other biocides
  • fuel or refrigerant leaks
  • combustion byproducts
  • scented cleaning supplies or “air fresheners”
  • dander, insects and other biological allergens (e.g., cat, dog, mouse, rat, cockroach, dust mite, pollen, etc.)

Sick Building Syndrome and Building Related Illness

If a building owner or tenant suspects a sick building, an Industrial Hygienist (IH) is usually called in to perform interviews and conduct a sick building inspection. Different companies provide different levels of thoroughness in their inspections, so if you’re concerned you may be in a sick building be sure you select an IH that is qualified and motivated to be comprehensive and leave no stone unturned.

In 1984, the World Health Organization (WHO) issued a report suggesting that up to 30% of new and remodeled buildings my have excessive complaints about indoor air quality.  That’s NEW & IMPROVED buildings! This is an enormous number of buildings across the world, and the cost (medical and lost productivity) of SBS is staggering.

I’m glad to see the new LEEDv4 IAQ Assessment (LEED IAQ Testing) credit ensures that furnishings are installed prior to testing. Furnishings can really stink – and it used to be optional to have furniture installed during IAQ Testing. Sometimes it’s the occupants, sometimes it’s the building, sometimes it’s outside air, and sometimes it’s what we put into the buildings!

An adage to close with –

Sick Building Syndrome

Sick Building Syndrome

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6 Responses to “Sick Building Syndrome and Building Related Illness”

  1. Alex Stadtner says :

    Okay. The best way for you to get in the system is to fill out an online inquiry form.
    From there we can generate an estimate and start thinking about scheduling.
    Thank you,

  2. Ellie says :

    Thank you for your reply. Please let me know if you come to the DFW/Austin area!

  3. Alex Stadtner says :

    Hi Ellie,

    Thanks for listening to the show with Lloyd. I enjoyed the conversation, and it’s apparent that Lloyd has a vast knowledge of EMF issues. It’s always more impactful when you speak to someone who has actually experienced Electrical Hypersensitivity (EHS). They “get it.”

    I’m sorry to learn about your current case. Texas is my home state, and I make an annual pilgrimage back to Austin most winters. Our team has done EMF surveys all around the country and it might work out to do an EMF survey in the Dallas Ft Worth area, but maybe that’s not necessary.

    Your Coronet EMF meter is measuring in Telsa or MilliGauss, right? I imagine it’s just measuring low-frequency magnetic fields. If your entire home and neighborhood are elevated, I’d suspect it’s an underground utility or overhead power wires. If, however, when you turn off all your circuits or turn on all your lights and you see a big change, then that would be an indication of an internal wiring error. From the sound of it – I suspect it’s a neighborhood utility (power distribution).

    While some doctors disagree, in general I think it’s always a good sign when you feel better. So if your headache goes away in the car – that’s an important clue. I’m not sure what it means, but I’d pay attention to your symptoms and see if you cannot find more patterns. Where else do you feel better? Where do you sleep best? Does turning on/off circuits have any impact? Etc.

    If you can feel an impact of your neighbors’ AC turning on, that is most likely an indication of at least 2 wiring errors: 1) at your neighbors house, and 2) at your house. It would take some troubleshooting and more diagnostic work to find and fix the error, but you can almost always eliminate stray current from a neighbor… with enough detective work and corrective action.

    Thanks for writing in, and best of luck!

  4. Ellie says :

    A big thank you for the interview Alex did with Lloyd Burrel of Alex, you described the situation I feel in my home. What a relief to know I AM NOT CRAZY! I feel ‘electricity’ in my 2nd floor bed at night when my sprinkler system is on and my A/C goes on, OR, when my neighbor’s A/C goes on! I live in a zero-lot-line home, so next-door neighbors are very close. There is no metal in my bed. Ironically, I was sleeping on an earthing mat plugged into the ‘ground’ outlet next to my bed the first time I felt it.

    I had a ‘regular’ licensed and insured electrician come to do a survey. He said my service panel was not connected to the copper ground rod. He showed me where the ground rod was sticking up from the ground – nothing connected to it from my service panel, but AT&T had connected their line to it! And he showed me that the cold water ground (copper line) had been severed under a 1st floor bathroom sink. I had him correct both of the ground lines, even though I’ve read it isn’t a good idea to have the water pipes ‘grounded’. I’m trying to reduce EHS symptoms, as well as not get electrocuted. The electrician also said he got a high reading on the return netural (?) on his meter and suggested I call the local utility (Oncor) and have them check the neutral line. He said the way it read on his meter, I was paying 20-40% more for my electricity than I need to. They came out and said everything was okay on their side and I should call an electrician. ~sigh.

    I still feel ‘electricity’ when my neighbors A/C goes on. I have no wifi in the house. I have a Coronet EMF meter that shows a constant low level electromagnetic field throughout the house, 1st and 2nd floors. Could that be from the city-owned radio tower about 1/3 of a mile away, as the reading is the same as I walk around my neighboorhood. The only time my meter goes green, is when I sit inside my car. I actually slept in my car for a few hours the other night when I discovered that. I didn’t get great quality sleep, but my headache went away.

    What do you think? I know it’s hard to ‘diagnose’ long distance. Can you clone yourself and come to Ft. Worth, Texas? Can you recommend someone here?

  5. Alex Stadtner says :

    Yes. So many more chemicals in average cleaning supplies. It’s scary, really. And if you actually do emissions testing on a product you’ll find many more nasties than listed on any label. At least pesticides are better regulated.

    The 20% rule is ridiculous. But I think that’s a different matter than what the IAQ researchers are saying. Quite simply, LEED and GreenPoint Rated and CHPS and the Living Building Challenge should, in theory, make a healthier building. But there are many variables that aren’t fully addressed in those rating systems. So even a “green” building may not be a healthy building. I’ve seen green-color buildings because they were covered with mold!

    Thanks for commenting on our Sick Building blog.

  6. Conventional cleaning products contain many more toxic chemicals than just fragrance. A good example is disinfectants, which are actually pesticides.

    Can’t believe “Unless 20% or more of occupants are suffering SBS symptoms, it is not SBS”. Is this what IAQ researchers are referring to, when saying that green bldg standards still have a ways to go?

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