Sick building syndrome, a crossroad in modern occupational medicine assessment

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Sick building syndrome (SBS) is a complex syndrome consisting of non-specific symptoms with an onset associated with subjects’ presence in some modern building and the disappearance of symptoms shortly after they leave it. The effects of SBS may be the result of a series of protective reactions of the human body triggered by various types of surrounding environment, further suggesting that the human response could be based on a three-phase biological model: sensory perception, low degree inflammatory reactions and environmental stress reactions. Besides stress created by the discomfort of people who develop symptoms, SBS is the cause of an extensive loss of productivity, sickness absenteeism, wasted time in complaints with all the legal punitive issues that arise from them. The subjects diagnosed with SBS are hard to follow-up over time due to workers often leaving their jobs and being lost from cohort databases. Achieving a reputation of a “sick building” may prove difficult to rehabilitate even after expensive repairs and upgrades. In extreme cases closure and even demolition can occur. SBS is an evolving concept and this review we will present part of this evolution and what are the major challenges for its definition.

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  • 1.ASHRAE Standard 62-1999 Ventilation for Acceptable Indoor Air Quality. American Society of Heating Refrigerating and Air-Conditioning Engineers Inc. Atlanta GA. 1999.

  • 2.Environmental Analytics L.L.C. Sick building syndrome. Arizona: Environmental Analytics L.L.C. 2009 ( accessed 16 November 2018).

  • 3.Wilson S Hedge A. The office environment survey: a study of building sickness. Building Use Studies Ltd 1987.

  • 4.Rostron J. Sick Building Syndrome – Concepts Issues and Practice. Abingdon UK:E & FN Spon. 1998.

  • 5.De Luca C Raskovic D Pacifico V. The search for reliable biomarkers of disease in multiple chemical sensitivity and other environmental intolerances. Int J Environ Res Public Health 2011; 8:2770-97.

  • 6.Molhave L. The sick buildings - a subpopulation among the problem buildings? In: Siefert B Esdon H Fischer M Ruden H Wegner J editors. Indoor air ‘87: proceedings of the 4th international conference on indoor air quality and climate Berlin. Berlin: Institute for Water Soil and Air Hygiene 1987; 5:469-73.

  • 7.Raw G J. Sick building syndrome: a review of the evidence on causes and solutions. London: HMSO 1992 (HSE Contract research report No 42).

  • 8.Raw GJ. Sick building syndrome: a review of the evidence on causes and solutions. HM Stationery Office; 1992.

  • 9.Hewitt Rn J Hewitt J. Sick Building Syndrome. Lulu Books USA. 2007.

  • 10.Potter I N The sick building syndrome. BSRIA Technical Note 4/88 1988.

  • 11.Baechler MC Hadley DL Marseille TJ. Sick building syndrome - sources health effects mitigation. Noyes Data Corporation Park Ridge NJ 07656 (USA); 1991.

  • 12.Davidoff AL Fogarty L. Psychogenic origins of multiple chemical sensitivities syndrome: a critical review of the research literature. Arch Environ Occup Health 1994; 49:316-25.

  • 13.Huss A Küchenhoff J Bircher A. Symptoms attributed to the environment–a systematic interdisciplinary assessment. Int J Hyg Environ Health 2004; 207:245-54.

  • 14.Levallois P. Hypersensitivity of human subjects to environmental electric and magnetic field exposure: a review of the literature. Environ Health Perspect 2002; 110:613.

  • 15.Sparks PJ. Idiopathic environmental intolerances: overview. Occupational Medicine (Philadelphia Pa.) 2000; 15:497-510.

  • 16.Terr AI. Environmental illness: a clinical review of 50 cases. Arch Intern Med 1986;146:145-9.

  • 17.Karvala K Sainio M Palmquist E. Building-Related Environmental Intolerance and Associated Health in the General Population. Int J Environ Res Public Health 2018;15:2047.

  • 18.Zhang X Sahlberg B Wieslander G. Dampness and moulds in workplace buildings: associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study. Sci Total Environ 2012;430:75-81.

  • 19.Sahlberg B Mi YH Norbäck D. Indoor environment in dwellings asthma allergies and sick building syndrome in the Swedish population: a longitudinal cohort study from 1989 to 1997. Int Arch Occup Environ Health 2009;82:1211-8.

  • 20.Sahlberg B Norbäck D Wieslander G. Onset of mucosal dermal and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 2002. Indoor air 2012;4:331-8.

  • 21.Brauer C Kolstad H Ørbæk P. The sick building syndrome: a chicken and egg situation?. Int Arch Occup Environ Health 2006;79:465.

  • 22.Brauer C Mikkelsen S. The context of a study influences the reporting of symptoms. Int Arch Occup Environ Health 2003; 76:621-4.

  • 23.Handal G Leiner MA Cabrera M. Children symptoms before and after knowing about an indoor fungal contamination (Abstract). Indoor air 2004;14:87-91.

  • 24.Moffatt S Mulloli TP Bhopal R. An exploration of awareness bias in two environmental epidemiology studies. Epidemiology 2000:199-208.

  • 25.Roht LH Vernon SW Weir FW. Community exposure to hazardous waste disposal sites: assessing reporting bias. Am J Epidemiol 1985; 122:418-33.

  • 26.Lundin L. Allergic and nonallergic students’ perception of the same high school environment. Indoor Air 1999; 9:92-102.

  • 27.Tong D. “Sick Buildings”: What are They and What is Their Cause?. Facilities 1991; 9:9-17.

  • 28.Mendell MJ Fisk WJ Kreiss K. Improving the health of workers in indoor environments: priority research needs for a national occupational research agenda. Am J Public Health 2002; 92:1430-40.

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