Sick Building Syndrome

Sick Building Syndrome Facts

  • Sick building syndrome is a condition that occurs when a number of a building's occupants have a constellation of nonspecific symptoms without a specific identifiable cause, including
  • These symptoms should be temporally related to being in the building, resolve when the person is not in the building, and be found in a number of individuals within the building.
  • Sick building syndrome should not be confused with building-related diseases, which have a specific identifiable cause of the symptoms.

Building-Related Diseases Overview

Building-related diseases are distinct maladies that can be traced back to a specific cause. These can range from allergies from molds found in a building, to bacterial infections related to contaminated cooling towers, to cancers from prolonged exposure to carcinogens. One of the most famous examples of building-related disease occurred in 1976 when 182 people attending the American Legion convention became sickened with pneumonia and many died. Ultimately, the cause was found to be the building's cooling towers, which were infected with a previously unheard-of bacteria, Legionella pneumophila.

Sick Building Syndrome Vs. Building-Related Illness

Sick building syndrome, by definition, has no identifiable cause or problem. Building-related illnesses have an identifiable cause for the symptoms or diseases that are being identified in the building's occupants. Without investigation, it is impossible to know if the symptoms being experienced by the building's occupants have a cause or not. If there are multiple workers experiencing symptoms, management should be made aware so that an appropriate investigation can be performed. The company itself may do this, or there may be a need to consult the National Institute for Occupational Safety and Health (NIOSH).

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History of Sick Building Syndrome

The term sick building syndrome has been around since the 1970s. A number of theories exist as to why it started then. These include the energy crisis of the early 1970s that resulted in buildings being sealed up to prevent energy loss, decreased turnover of air within buildings to save money, increased use of chemicals in carpets and paints, poor lighting, increased use of computers, and even increased stress in the workplace.

Causes of Sick Building Syndrome

There are many theories on what causes sick building syndrome. Commonly cited causes are inadequate ventilation, chemical contaminants from indoor sources, and chemical contaminants from outdoor sources.

  • Inadequate ventilation is one the most often cited reasons. Prior to the energy crisis in the 1970s, most buildings were not sealed up as tightly and circulated air more frequently. After the energy crisis, buildings were made more energy efficient by sealing up areas where air leaked into or out of the building. Additionally, airflow was decreased in many buildings from 15 cubic feet per minute to 5 cubic feet per minute.
  • Common chemical contaminants inside the building are found in paint, adhesives, carpeting, cleaning agents, and upholstered furniture. These chemicals can emit volatile organic compounds (VOCs).
  • Common chemical contaminants from outside of the building can include exhaust from motor vehicles and other industrial plants in the area.

Sick Building Syndrome Symptoms and Signs

Commonly reported symptoms include headache, dizziness, nausea, skin irritation, mental fatigue, difficulty concentrating, and irritation of the eyes, nose, and throat. For these symptoms to be from sick building syndrome, they should resolve soon after leaving the building and should be found in a number of individuals in the building.

Assessment of Sick Building Syndrome

When assessing a building for possible sick building syndrome, it is best to start with a walk around to assess the occupants in the area affected, the condition of the heating, ventilating, and air conditioning (HVAC) system, and identify pollution sources and contamination sources. If management is unwilling or unable to perform an evaluation, the National Institute for Occupational Safety and Health (NIOSH) can be contacted for an evaluation. The important issue is to make sure that there is not an actual problem like contamination with molds or bacteria that requires remediation (building-related illnesses).

Treatment of Sick Building Syndrome

It is first important to make sure that there are no hazards in the building like mold or bacteria. If there is no identifiable cause for the occupants' symptoms and signs and there is a suspicion of sick building syndrome, the first step is to make sure the air handling system is clean and functioning well. Air filters may need to have more frequent replacement. The HVAC system may need to have the ventilation rates increased. If there are any chemicals being stored, they must be stored in appropriately ventilated areas. If chemicals are being used to clean, there must be good ventilation. It may be important to institute smoking restrictions.

Complications of Sick Building Syndrome

Many workers worry about long-term complications of working in a building that has a sick building syndrome. There are no documented studies that clearly demonstrate a causal link between having worked in a sick building and chronic medical conditions. The symptoms and signs associated with sick building syndrome should resolve soon after leaving the building.

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Prevention of Sick Building Syndrome

Maintaining the HVAC system to ensure that it functions properly and does not become contaminated is important in preventing sick building syndrome. Additionally, ensuring adequate airflow and distribution is critically important. All chemicals should be properly stored and only used with proper ventilation. Purchasing furniture and carpet made with low contents of volatile organic compounds (VOCs) and only painting with low-VOC paints can help prevent sick building syndrome. Also, make sure that air intakes for the building are not located where outdoor pollution from motor vehicles and manufacturing can cause contamination.

Reviewed on 8/31/2017

Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care


Joshi, S.M. "The sick building syndrome." Indian J Occup Environ Med 12.2 (2008): 61–64.

United States. Centers for Disease Control and Prevention. "Indoor Environmental Quality." June 20, 2013. <>.

United States. Centers for Disease Control and Prevention. "Indoor Environmental Quality (IEQ)." Mar. 9, 1995. <>.

United States. Environmental Protection Agency. "Indoor Air Facts No. 4: Sick Building Syndrome." Feb. 1991. <>.

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