Building sickness syndrome in healthy and unhealthy buildings: an epidemiological and environmental assessment with cluster analysis.
OBJECTIVE
Building sickness syndrome remains poorly understood. Aetiological factors range from temperature, humidity, and air movement to internal pollutants, dust, lighting, and noise factors. The reported study was designed to investigate whether relations between symptoms of sick building syndrome and measured environmental factors existed within state of the art air conditioned buildings with satisfactory maintenance programmes expected to provide a healthy indoor environment.


METHODS
Five buildings were studied, three of which were state of the art air conditioned buildings. One was a naturally ventilated control building and one a previously studied and known sick building. A questionnaire was administered to the study population to measure the presence of building related symptoms. This was followed by a detailed environmental survey in identified high and low symptom areas within each building. These areas were compared for their environmental performance.


RESULTS
Two of the air conditioned buildings performed well with a low prevalence of building related symptoms. Both of these buildings out performed the naturally ventilated building for the low number of symptoms and in many of the environmental measures. One building (C), expected to perform well from a design viewpoint had a high prevalence of symptoms and behaved in a similar manner to the known sick building. Environmental indices associated with symptoms varied from building to building. Consistent associations between environmental variables were found for particulates (itchy eyes, dry throat, headache, and lethargy) across all buildings. There were persisting relations between particulates and symptoms (headache, lethargy, and dry skin) even in the building with the lowest level of symptoms and of measured airborne particulates (building B). There were also consistent findings for noise variables with low frequency noise being directly associated with symptoms (stuffy nose, itchy eyes, and dry skin) and higher frequency noise being relatively protective across all buildings.


CONCLUSIONS
This is the first epidemiological study of expected state of the art, air conditioned buildings. These buildings can produce an internal environment better than that of naturally ventilated buildings for both reported symptoms and environmental variables. The factors associated with symptoms varied widely across the different buildings studied although consistent associations for symptoms were found with increased exposure to particulates and low frequency noise.
North West Lung Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK. rniven@gw.smuht.nwest.nhs.uk
R M
RM
Niven
A M
AM
Fletcher
C A
CA
Pickering
E B
EB
Faragher
I N
IN
Potter
W B
WB
Booth
T J
TJ
Jones
P D
PD
Potter
D000328:Adult; D000389:Air Conditioning; D000395:Air Pollutants, Occupational / Q000009:adverse effects; D016000:Cluster Analysis; D004391:Dust / Q000009:adverse effects; D004784:Environmental Monitoring; D004787:Environmental Pollution / Q000032:analysis*; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D008297:Male; D009623:Noise, Occupational / Q000009:adverse effects; D018877:Sick Building Syndrome / Q000453:epidemiology / Q000209:etiology*
D000395:Air Pollutants, Occupational; D004391:Dust