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Sick Building Syndrome (SBS)

Whether it is work or home, most people find themselves spending the majority of their time indoors, in one or two particular buildings, but we rarely take the time to consider the impact these spaces can have on our health.

Sick building syndrome (SBS) is a name used to describe a situation where the occupants of a building experience a variety of symptoms and illnesses for which there may be no visible or obvious cause. It is known, however, that these illnesses can be connected to time spent indoors. These symptoms can vary in severity and can lessen once you leave the hazardous environment but constant day-to-day exposure can have a long-term impact on your health. Most cases of sick building syndrome can be attributed to poor indoor air quality (IAQ). Extended exposure can lead to respiratory issues, such as asthma and other serious lung and organ diseases.

Symptoms of Sick Building Syndrome (SBS)

SBS symptoms can often look a lot like a common cold or flu, leading many people to incorrectly self-diagnose. These symptoms can manifest in a variety of ways, possibly affecting your skin, respiratory system, and even neurological systems. The short term effects are usually mild and occupants often report relief after leaving the affected building.

Though this may not seem significant, we cannot dismiss that sustained exposure to elements of SBS can lead to more severe illnesses that include:

  • Cardiovascular disease
  • Liver damage
  • Effects on your central nervous system
  • Respiratory diseases

Short-term exposure symptoms can include:

  • Throat irritation
  • Breathing difficulties
  • Tightness in the chest
  • Runny nose
  • Sneezing
  • Dry, itchy rashes
  • Dizziness
  • Fatigue
  • Fever
  • And more…

Diagnosing Sick Building Syndrome

The wide range of symptoms that can be displayed as a result of sick building syndrome can make it difficult to identify. The symptoms are often wrongly attributed to other causes and their mild and intermittent nature makes them easy to dismiss. There are, however, a few good indicators to help identify sick building syndrome and prevent long-term exposure:

  • Multiple occupants of a building report ongoing complaints of symptoms such as headache, nose or throat irritation, nausea, or dizziness. Symptoms can vary from person-to-person but ongoing complaints can be a good indicator that there may be a problem.
  • The cause of the symptoms is unknown. Those experiencing symptoms should seek the help of a doctor to eliminate the possibility of other causes, such as seasonal allergies.
  • Occupants report relief after leaving the building. If the symptoms are the result of something in the environment, those affected may only suffer from symptoms while in the building. If the symptoms become chronic, they can persist even after leaving the building.
  • If contaminated air is suspected, IAQ testing can determine pollution levels as well as the sources of pollution

What Causes Sick Building Syndrome?

There is no one single cause for all cases of sick building
syndrome but most cases fall into two categories:

Chemical Contaminants

Chemical contaminants exist both inside and outside the building. Everyday things like carpeting, copy machines, or leaning products can emit volatile organic compounds (VOCs). In high enough concentrations, they can cause reactions leading to chronic or acute symptoms when inhaled by building occupants. Buildings can also be affected by contaminants from outside sources such as car exhaust or other pollutants through windows or air intake vents.

Biological Contaminants

Much like chemical contaminants, biological contaminants can be found indoors or outdoors. These include health hazards like bacteria, viruses, mold, or pollen. Under certain conditions, like high humidity, these contaminants can breed to dangerous levels and have serious long-term health effects.

Poor building ventilation is often what allows both biological and chemical contaminants to be found in high enough concentrations to impact health.

The Cost of Sick Building Syndrome


In the mid-1990s, it was estimated that SBS accounted for $15-40 billion in lost productivity in the US annually.

Most of this cost can be attributed to absenteeism, roughly 1-2 additional sick days per worker each year. In many jobs, however, it is impossible to measure the loss in productivity that results from employees experiencing SBS symptoms. The true cost is likely significantly higher than estimated.

Employee Turnover

While there is no direct data linking SBS to employee turnover, a 2017 study conducted by Mercer demonstrated a significant correlation between employee well-being and turnover rates across a variety of industries. Companies with a culture of nurturing well-being saw significantly smaller turnover rates.

Turnover can become a major expense for businesses and physical well-being is a major factor in workers’ overall job satisfaction.

Addressing the Issue

Unfortunately, it is often not until SBS becomes extremely disruptive that it is eventually addressed. The time, effort, and financial costs to properly investigate and deal with Sick Building Syndrome will vary from building to building but can become a significant expense to employers and building management if serious maintenance or renovations are required.

The full costs of Sick Building Syndrome are impossible to measure. You can’t put a price on people’s health and well- being. Maintaining a safe and healthy environment should be the top priority of any employer or building manager.

Treating Sick Building Syndrome

Treating a sick building looks a lot like treating a sick person. Before prescribing a treatment, you’ll first need to identify the cause of the symptoms. The goal is to address the issue so that it does not become a recurring problem.


The first step in addressing SBS is evaluating a building’s IAQ. There are a few basic factors you will want to consider:

  • Contaminant Sources – Identifying potential contaminants that could make occupants sick
  • Pollutant Pathways – Assessing how contaminants are making their way into the air inside the building
  • Ventilation – Determining if ventilation is sufficient to maintain safe, breathable air

A proper investigation of these factors will likely require the expertise of a specialist who can do a thorough walkthrough of the building and provide an assessment.

Removing Contaminants

In some cases, a contaminant can be identified and removed, eliminating the issue at its root. This is not usually the case, however. Contaminants that are external are not well controlled due to the typical type of filters within the HVAC system as they provide minimal efficiency for capturing harmful, smaller, and hazardous particles. For contaminants that remain within the building such as viruses, bacteria, and molds, however, it is always best to develop a mitigation plan that offers room-level mitigation.

Closing Pollutant Pathways

If it is determined that a contaminant is entering a building from an external source, it may be possible to close the pathways that allow polluted air into the building. Something as simple as an open window can serve as a pathway for contaminated air to enter a workplace.

In more complicated cases, closing pollutant pathways may require significant renovations to HVAC systems. The costs of these renovations can be prohibitive for some buildings.

Improving Ventilation

Many of the contaminants that can cause Sick Building Syndrome are commonplace and relatively harmless in low concentrations. If your building is not properly ventilated, indoor air is not being adequately replaced with filtered or fresh outdoor air. This can cause contaminant concentrations to increase to dangerous levels. By working with a specialist, you can determine if your building’s existing HVAC system is capable of meeting your ventilation needs.

If the air in your building is not being ventilated sufficiently, you may need to upgrade your HVAC. This upgrade can be costly and can require additional renovations.

Air filtration may offer a more cost effective alternative.

Air Filtration

If improving your ventilation is not an option or if the costs are prohibitive, air filtration offers a more cost effective solution for improving indoor air quality. Rather than circulating fresh air in and contaminated air out, air filtration systems are capable of capturing contaminants and recirculating clean air within an indoor space. Ideally, air filtration would complement the existing HVAC system, improving the very important but often not well understood importance of room air mixing.

Air filtration systems are not all equal, however.

In light of the COVID-19 pandemic, safe air has become more of a concern than ever before. As a result, a variety of new air filtration solutions, leveraging different technologies, have sprouted up. While some of these are sound, many make unfounded promises about their efficacy. When choosing a system make sure to work with an established expert and research the company to validate their credibility in air filtration technology. Also, thoroughly review and test data for true efficacy under real-world conditions.


Poor IAQ is a very real concern. The health and well-being of building occupants is at risk and it is important to take the proper steps to ensure everyone’s safety

Indoor air quality is an overlooked public health issue. To complicate this very real health crisis recommendations from governing bodies and the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) have only been made with no real set standards. Because of this, the responsibility falls on the employer, and building managers to take the necessary steps to address and maintain a healthy indoor environment.

If You’re Concerned About the Quality of the Air you Breathe, We’re Here to Help

Contact Erlab to learn more about your air quality.

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