Attempts to conserve energy combined with new building products to create unhealthy indoor air quality in office buildings, causing many workers to develop a combination of symptoms that became known as sick building syndrome.
Sick building syndrome (SBS) first came to the public’s attention during the period 1974-1980 in both the United States and Europe. Large numbers of people who worked in office buildings and other public-access buildings began to complain of headaches, fatigue, dizziness, coughing, skin irritations, nausea, shortness of breath, and irritations of the eyes, nose, and throat. Given that most office workers spend nearly 90 percent of their lives indoors, one likely culprit for these symptoms was the environment in which they worked. Among the first suspected sources were infectious bacteria and viruses transmitted by touch and by airflow. Although microbial contaminants did cause problems in some cases, the symptoms were very broad, and not all were conducive to bacterial infection.
Because many of those affected complained of working in stuffy buildings with stale air, the quality of air in these indoor environments was examined. The National Institute of Occupational Safety and Health
SBS emerged in part as a consequence of the energy crisis in the United States and other nations during 1973 and 1974. At that time, oil prices increased from $3 to $30 per barrel because of an embargo on oil shipments to the United States and Europe organized by nine Arab countries under the leadership of Kuwaiti oil minister Abdul Rahman al-Attiki. As a result, heating-fuel costs rose dramatically, and this prompted increased efforts toward energy conservation in enclosed, temperature-controlled buildings. One method of conserving energy was to reduce the rate of air exchange between indoors and outdoors, thereby reducing the amount of outdoor air that needed heating or cooling by mechanical systems. Existing buildings were tightened—that is, they were sealed against air leakage and the amount of planned ventilation air exchange within them was limited. New buildings were designed with these energy-conserving features. Although limiting the fresh air that entered buildings did conserve energy, it also allowed concentrations of air contaminants to rise to harmful levels inside the buildings.
Prior to the early 1970’s, people generally took indoor air quality for granted, just as they had taken outdoor air quality for granted decades earlier. Heavy smog that produced life-threatening conditions in Donora, Pennsylvania, in 1948 and in London, England, in 1952 clearly demonstrated the harmful effects that outdoor air pollution could have on health. Most people gave very little thought to the quality of the air indoors, however, even though research conducted between 1940 and 1970 found that homes could have excessively high concentrations of smoke and sulfur dioxide if elements of their heating equipment, such as chimneys, were faulty. By 1960, research had also begun to show that infectious diseases were spread through the air while attached to small solid or liquid particles.
By 1970, outdoor air pollution was being addressed through emission standards included in legislation. The first conference to discuss indoor air quality was held in Maine in 1972, and scientists began to look more closely at sources of indoor air pollution, such as gas stoves. By 1974, indoor air quality was clearly seen as a problem of its own, and around this same time, factors conspired to create indoor air quality that was even worse than before.
Increased demand for housing and office space after World War II and the high labor costs associated with construction resulted in the use of cheap, mass-produced building materials, and furniture made of pressed wood, fiberboard, and plastics replaced many natural wood products. As these new materials cured over time, they produced gases that could cause health problems for anyone exposed to them. Additionally, new varieties of cleaning products, insecticides, and other products made of synthetic chemicals were in increasingly common use, and modern office photocopy machines and other convenient office equipment depended on chemicals. These new products created cleaner indoor environments and more efficient workspaces, but their cumulative presence—even in low concentrations—could exceed some individuals’ personal threshold levels to cause illness.
Prior to the 1973 oil embargo, the American Society of Heating, Refrigerating, and Air-Conditioning Engineers
The combination of the use of inexpensive, mass-produced building materials, the tightening of buildings to reduce the entry of outdoor air, and the growing numbers of synthetic chemicals in furniture, cleaning products, and office equipment products set the stage for the manifestation of poor indoor air quality. It was not surprising that the health problems collectively known as sick building syndrome affected many individuals whose offices were located in large buildings where hundreds or thousands of people worked.
The recognition of SBS raised the public’s awareness that indoor air should not always be judged on the basis of its odor alone. Pollutant concentrations inside buildings were recognized as being greater than corresponding outdoor concentrations. Although the seriousness of the problem was not immediately widely understood, several sectors began to respond as the problem of SBS came to light. Building engineers became concerned with preserving minimum ventilation levels while maintaining efficient heating and air-conditioning systems; industrial hygienists measured gaseous chemicals and particles suspended in air; architects redesigned office layouts; specialists in ergonomics coordinated lighting, furniture, and acoustics with a new understanding of how these factors stress workers; and public health agencies sampled air to relate pollutant concentrations to health effects. Representatives from all these disciplines began to work together to investigate and alleviate problems. Consulting firms hired teams of people with varied expertise to address the range of issues associated with SBS.
Adjustments were needed in the way buildings were ventilated and in the allowable limits of harmful pollutants. ASHRAE recognized that its recommended ventilation rates used by building designers for enclosed buildings were too low and subsequently raised its recommended outdoor air ventilation rates by 300 to 500 percent in offices where smoking was permitted and by 100 percent in offices that banned smoking. The design and operation of heating, ventilation, and air-conditioning (HVAC) systems were reconsidered following the recognition of SBS. Experts noted that drawing outdoor ventilation air from contaminated areas, as often happened in buildings near heavy vehicular traffic, severely compromised indoor air quality. HVAC systems that operated improperly were no better than underdesigned systems that allowed contaminants to accumulate.
Humidity control was also scrutinized more carefully after the recognition of SBS. Excessively dry indoor air was found to irritate the skin and respiratory systems of building occupants. Buildings with high-humidity environments supported the growth of mold, dust mites, and fungi. Faulty humidification systems acted as breeding reservoirs for infectious microbes, which were effectively distributed by air-handling systems in many buildings.
The building materials industry was also affected by the recognition of SBS, primarily in connection with formaldehyde, a serious toxic contaminant. After 1980, progress in urea-formaldehyde technology was effective in limiting the release of free formaldehyde from particleboard flooring, plywood, paneling, and fiberboard used in furniture and cabinets. The use of urea-formaldehyde foam insulation dropped significantly in the United States, from nearly 160,000 installations during 1977 to fewer than 5,000 installations by 1982. ASHRAE has adopted a standard of 0.1 parts per million of formaldehyde gas for indoor air.
Following recognition of SBS, allowable limits were set for gaseous indoor air pollutants. The U.S. Occupational Safety and Health Administration
The increased attention to indoor air quality that took place in the 1970’s led also to the development of high-resolution gas chromatography and high-performance liquid chromatography, which made possible the measurement of minute concentrations of volatile organic compounds, such as formaldehyde, in air samples.
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Baechler, M. C., et al. Sick Building Syndrome: Sources, Health Effects, Mitigation. Park Ridge, N.J.: Noyes Press, 1991. Covers basic areas of pollutant sources, health effects, and analysis methods for carcinogens found in sick buildings. Contains an especially good overview of SBS and a glossary of important terms. -
Gammage, R. B., S. V. Kaye, and V. A. Jacobs. Indoor Air and Human Health. Chelsea, Mich.: Lewis, 1985. Presents an excellent introduction to the history of indoor air quality, with discussion of events leading up to SBS. Provides a good list of references from the United States and Europe. -
Godish, T. Indoor Air Pollution Control. Chelsea, Mich.: Lewis, 1989. Well-written text is used in many college-level introductory courses on indoor air pollution. Includes illustrations, tables, and graphs. -
Knoppel, Helmut, and Peder Wolkoff, eds. Chemical, Microbiological, Health, and Comfort Aspects of Indoor Air Quality: State of the Art in Sick Building Syndrome. Boston: Kluwer, 1992. Contributors from the United States and Europe cover several aspects of indoor air pollution from different perspectives. Especially informative are the introduction and three separate chapters by Hal Levin. -
Leslie, G. B., and F. W. Lunau, eds. Indoor Air Pollution: Problems and Priorities. New York: Cambridge University Press, 1992. Collection of essays covers all important sources of indoor air pollution. Presents discussion of the problem from the perspective of researchers in the United Kingdom and Europe. Includes an interesting section on the type of worker most harmed by SBS. -
Murphy, Michelle. Sick Building Syndrome and the Problem of Uncertainty: Environmental Politics, Technoscience, and Women Workers. Durham, N.C.: Duke University Press, 2006. Examines the history of the recognition of SBS, with a focus on environmental politics and feminist activism. Includes bibliographic references and index. -
Rostron, Jack, ed. Sick Building Syndrome: Concepts, Issues, and Practice. London: E&FN Spon, 1997. Collection of essays covers all aspects of detecting and dealing with SBS. Includes index. -
Samet, Jonathan M., and John D. Spengler. Indoor Air Pollution: A Health Perspective. Baltimore: The Johns Hopkins University Press, 1991. Thorough discussion focuses on the health effects of smoke, formaldehyde, and other major pollutants. The chapter on building-related illnesses is especially interesting. The final chapter covers the legal aspects of indoor air pollution. -
Tate, Nicholas. The Sick Building Syndrome. Bernardsville, N.J.: New Horizon Press, 1994. Presents excellent discussion of SBS and a good overview of the ineffective manner in which federal agencies have addressed the problem. -
Walsh, Phillip J., Charles S. Dudney, and Emily D. Copenhaver. Indoor Air Quality. Boca Raton, Fla.: CRC Press, 1984. Provides an excellent introduction to indoor air quality, followed by specific chapters that investigate the major indoor pollutants in depth. Separate chapters deal with residential and large-building pollution problems.
EPA Is Charged with Regulating Toxic Chemicals
Clean Air Act Is Revised
Chlorofluorocarbons Are Banned in the United States
Radon Is Recognized as an Indoor Air Hazard
U.S. Congress Requires Governments to Inform the Public About Toxic Pollutants
U.S. Congress Approves More Clean Air Act Amendments
CDC Publicizes the Dangers of Secondhand Smoke
U.S. Government Facilities Must Comply with Environmental Standards