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November 2000
Vol. 9, No. 11, 51 – 52,
Health Perspectives
Does Your Job Make You Sick?

Indoor air-quality problems can cause chronic illness or even death.cartoon of a sick building

Fall means cooler weather, warmer clothing, and children heading back to school after three months of the idle bliss known as summer. While most employees endure the summer months with only a week or two of vacation, many try to steal an occasional lunch break outside—basking in the warmth of the noontime sun and balmy, sometimes oppressive, summer air. Air conditioners are churning and fans are also sometimes used to lower the indoor temperature by circulating air from the outside. However, as the weather turns cooler through the autumn, air conditioners will be shut down, windows will be closed, and the country’s workforce will be spending more time indoors. Consequently, if the workplace building has poor indoor air quality, people might begin to complain about congestion, sore throats, headaches, nausea, or dizziness. These symptoms are associated with sick building syndrome (SBS), a controversial illness that ranges in severity from minor annoyances to chronic debilitating disorders that can force a person to vacate a job and can severely impact one’s quality of life.

According to the Occupational Safety & Health Administration (OSHA), concern over indoor air quality increased in the 1970s when energy conservation measures in office buildings minimized the infiltration of outside air, contributing to the buildup of indoor air contaminants. The Environmental Health Center (EHC), a division of the National Safety Council, contends that the oil embargo forced engineers to design more airtight buildings in order to improve energy efficiency, but this reduced ventilation has since been determined “inadequate to maintain the health and comfort of building occupants.”

The U.S. Environmental Protection Agency (EPA) defines SBS as a “situation where building occupants experience acute health and comfort effects that appear to be linked to time spent in a building, but no specific illness or cause can be identified” (1). When an illness is diagnosed and the symptoms are attributed directly to airborne building contaminants, the U.S. EPA uses the term “building-related illness” (BRI).

Indicators of SBS include symptoms associated with acute discomfort, such as headaches; eye, nose or throat irritation; dry cough; dry or itchy skin; çizziness and nausea; inability to concentrate; and fatigue. Even though the direct cause of the symptoms is unknown, most sufferers report experiencing relief when they leave the building. Although BRI has similar symptoms—cough, chest tightness, fever and chills, and muscle aches—these symptoms can be clinically defined and their causes clearly identified. Also, in cases of BRI, patients often complain of a delayed recovery time after leaving the building.

The guilty party behind SBS is a brew of undetected dangers, all ultimately poisoning indoor air. Some common air pollutants include carbon monoxide and other contaminants entering the building through air-intake vents that are connected to exhaust-filled loading docks and parking garages. Similarly, the stack effect, which occurs when cigarette smoke gets sucked back into a building through revolving doors, is a hazard to building occupants. Other potential SBS culprits are building materials—including those in office furniture and equipment—and pesticides that emit volatile organic compounds (VOCs). These organic chemicals have been implicated as a cause of multiple chemical sensitivity (MCS), a controversial disease that can make people allergic to almost anything containing a synthetic chemical.

Historically, complaints associated with SBS were regarded as superfluous whining from lazy employees. But the 1976 outbreak of a mysterious lung ailment during an American Legion Convention held at the Bellevue-Stratford Hotel in Philadelphia forced the public to question the health effects of indoor air contaminants. The outbreak, which came to be known as Legionnaires’ disease, was due to the presence of a contaminating bacterium, Legionella pneumophila, in water used to cool the hotel’s air-conditioning system. Thirty-four people died from the infection and 221 were infected. This incident and others that have ended up in the legal arena began forcing employers to look at the construction and environmental management of office buildings (2).

Many employee complaints of physical ailments are legally dismissed because the work spaces meet the current OSHA standards. However, these standards were originally designed to protect workers in industrial environments against individual contaminants such as benzene and formaldehyde. OSHA has not outlined regulations specific to a white-collar work environment, which often contains a chemical soup of indoor air pollutants. According to the EPA, indoor pollutant levels are on average 2–5 times more concentrated than outdoor levels, which is why the agency has determined that indoor air quality is currently one of the top five environmental health risks.

When the current indoor air stan!ards are violated, death and subsequent lawsuits can result. Celeste Morrell’s case is an illustration of blatant standard violations. A caseworker in New York State’s Onondaga County Social Services Department, Morrell began complaining of nausea from a disturbing chemical odor when her department received a shipment of new wooden desks in 1988. Investigators discovered that the desks were constructed of particleboard assembled with formaldehyde-based glue. The amount of formaldehyde in the air was up to 5 times the OSHA standard for short-term exposure.

Morrell was diagnosed with formaldehyde poisoning and ordered not to work within 15 feet of the desks. Unfortunately, she soon dev

For more information:
“Is Your Office Killing You?” Michelle Conlin, Business Week, June 5, 2000. www.businessweek.com/2000/00_23/b3684001.htm

“Deciphering the Sick Building
Syndrome.” Ronald E. Gots, M.D., Ph.D. www.ictm.com/articles/ICTM122.html

“Indoor Pollution in the Office.” American Lung Association. www.lungusa.org/air/envindoorpro.html

Occupational Safety & Health Administration. www.osha.gov

Americans with Disabilities Act. http://dmla.clan.lib.nv.us/docs/NSLA/ada/explain.txt

“Multiple Chemical Sensitivities: Facts, Fiction, Disabilities and the Law.” Gail S. Restivo, ‘Lectric Law Library. http://lectlaw.com/filesh/csl01.htm

Note: All sites were accessed November 10, 2000.

eloped multiple myeloma, a form of cancer that her physician linked to her toxic office environment. Morrell filed a lawsuit against her employer and her case went to nonjury trial, where a judge is still deliberating it. In September 1999, six months after filing the lawsuit against Onondaga County, Morrell died at the age of 51.

Increasingly, local and state governments are recognizing the damaging effects of SBS and MCS and are forcing employers to accommodate sufferers, in addition to making employers responsible for providing social benefits in the form of compensation and medical assistance. MCS is covered on a case-by-case basis under the Americans with Disabilities Act, and many states, such as New Mexico and Maryland, recognize MCS as a legitimate claim for worker’s compensation.

Experts are telling employers that the best insurance against lawsuits and sick workers is to take preventive measures to ensure a safe workplace. New York’s Conde Nast Tower, for example, developed by the Durst Organization, provides an excellent example of environmental engineering. The building features solar panels, air intakes on every floor, and filters that eliminate 85% of incoming pollutants. Many office suppliers, as well, are starting to use safer materials—an important effort because of the dangerous elements found in many components and solvents used in office paints and carpeting.

According to the EHC, heating, ventilation, and air-conditioning (HVAC) systems should meet specifications outlined by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (Standard 62-1999, Ventilation for Acceptable Indoor Air Quality) (3). The EHC also emphasizes that removing or modifying the pollution source is the most effective approach to improving indoor air quality, although this is not always practicable. Regularly maintaining HVAC systems; storing paints, solvents, pesticides, and adhesives in closed containers in well-ventilated areas; and redirecting emissions from contaminant sources as appropriate are all measures that should be routine practices to safeguard against harmful indoor air pollutants.

Investing in a safe work environment might initially seem like an unnecessary cost burden to many employers. However, studies show that such reforms pay off in the long run and result in higher worker productivity and a decrease in employee sick leave, not to mention workers who can rest assured that their employers are concerned about their health and quality of life. “When everyone associated with the building, from occupants to maintenance, fully understands the issues and communicates with each other, they can work more effectively together to prevent and solve problems,” argues an EHC official.


  1. EPA Fact Sheet: Indoor Air Facts No. 4—Sick Building Syndrome (www.epa.gov/iaq/pubs/sbs.html).
  2. National Institute of Environmental Health Sciences (www.niehs.nih.gov/external/faq/legion.htm).
  3. American Society of Heating, Refrigerating, and Air-Conditioning Engineers (www.ashrae.org).

Note: All sites were accessed November 10, 2000. 

Julie McDowell is an editorial assistant with Today’s Chemist at Work.

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