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Building Sickness

Introduction

This subject is one of many in occupational and environmental health, where there is no simple dogmatic answer that is applicable in all circumstances, and that enjoys a universal consensus. Learning about this subject and, more importantly, how to deal with it, therefore hinges on posing a number of relevant questions. These are then followed by answers, some of which are simple and clear but others, leave a lot of uncertainty and pose further questions. The following are some of the questions that you are invited to consider and debate: 
     
  • What is Sick Building Syndrome?
  • Is it ‘sick building’ or ‘building sickness’?
  • What symptoms if any should be in the definition?
  • Should the definition be based on a comparison with "normality"?
  • Is the definition one of exclusion?
  • How do we define spatial and temporal associations?
  • Other issues

What are the symptoms of building sickness ?

  • List a number ......headache, tiredness, dry itchy eyes, sore throat etc
  • How common are they? .....most of us experience most of them at some time or another
  • How specific are they? .....not very, though some may suggest local irritation e.g. to eyes, throat and chest.
  • Other issues

What people suffer from "building sickness" ?

What are the features of "sick buildings" ?

Physical characteristics

Physical Factors

  • Illumination
  • Temperature
  • Relative Humidity
  • Ventilation
  • Other 

Some Features which are often common to "Sick Buildings"

  • Airtight
  • Artificial ("Forced") Ventilation
  • "Fluff" - Carpets, Upholstery, Etc.
  • Large "Shelf" Areas
  • Light Construction
  • "Energy Efficient"
  • Poor Individual Control Over Micro Environment 

Chemical characteristics

Biological characteristics

Microbiological Factors

  • Living Infectious Agents
  • Microbial Toxins
  • Living Or Dead Allergens 
Other important characteristics ...of work organisation 

Psychological Factors

  • Control (Lack Of)
  • Other Stressors
  • Behavioural Sensitization I Conditioning (E.G. To Odours) 

Is there (are there) specific causes of "Sick Building Syndrome"?

  • Does science know the causes, but they are difficult to find?
  • Or does science not know (all) the causes?

How do we investigate the problem epidemiologically?

  • Questionnaire survey - symptoms
  • Questionnaire survey - exposures
  • "Objective" measurements
  • Bias, confounding and chance ......

How do we investigate the building, and other relevant aspects?

  • General
  • Physical
  • Chemical
  • Biological
  • Other 

How do we investigate the individual ?

Remember to consider symptoms and signs which may be indicative of other specific conditions such as occupational asthma. 

How do we remedy the problem ?

After you have given the matter some thought, consider some suggestions. What have the suggestions omitted? Do you agree with all of them? Why not?

How do we evaluate the remedy ?

    Repeat the initial assessment(s) of symptoms etc after an interval. 
    Is this enough to conclude the evaluation?

How do we prevent the problem ?

  • Prospective risk assessment
  • Risk reduction measures
  • Other

Other issues

Note:This tutorial as it stands mainly poses questions, to which you are invited to find the answers. You may wish to consult an account from Sweden which presents some of the answers. 
 

Note:

This page is still being refurbished.