Can a place make you sick? The short answer is: yes.

How do you know if your house or workplace is making you sick? Unfortunately, that’s a tougher question to answer.

There are a collection of symptoms and diagnoses that can result from environmental toxins in homes, workplaces, and other buildings. These illnesses most often come from biological contaminants (i.e. mold) or chemical contaminants (i.e. cleaning supplies or solvents). Cultural and relational ‘toxins’ like an abusive manager can also contribute to building-related illnesses.

In this article, we’re going to talk about Building Related Illness vs. Sick Building Syndrome, the symptoms to look out for, the causes, and what you can do to prevent and/or deal with building-related illnesses if you or your loved one is suffering.

How Do You Know If Your House Or Work Building Is Making You Sick?

There are so many different things that can potentially make an individual sick. Everything from food and foreign pathogens to genetics and trauma can cause mild to severe, short- and long-term illness. Many times, illness is rooted in a combination of several of those things.

But what about your home or place of work? Many people don’t think about the fact that the buildings we live, work, and sleep in can cause illness as well! If you or a loved one is experiencing mystery symptoms that you just can’t figure out, Sick Building Syndrome and Building Related Illness are definitely something to look into.

First, let’s look at what these two conditions are (and the differences between them), and then we’ll discuss how to test for and treat them. Going to your next doctor’s appointment armed with this information might just help you actually get the help you need.

Building Related Illness vs. Sick Building Syndrome

What Is Sick Building Syndrome (SBS)?

The EPA defines Sick Building Syndrome as: “situations in which 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.”

In other words, SBS is when multiple people who live and work in the same building are having symptoms, but the actual cause is unknown. With SBS, most symptoms disappear immediately or a few hours after leaving the building.

What Are Some Of The Symptoms Of Sick Building Syndrome?

  • Headaches
  • Coughing 
  • Sneezing
  • Shortness of breath 
  • Eye, nose, or throat irritation
  • Itchy skin
  • Dizziness
  • Nausea
  • Difficulty concentrating (brain fog)
  • Fatigue or lethargy
  • Sensitivity to odors
  • Other symptoms that disappear outside the building

What Are the Main Causes of Sick Building Syndrome?

Since it covers a wide variety of things and the actual causes are often unknown, SBS can be caused by a WIDE variety of different things, including:

AIR QUALITY:

  • poor ventilation
  • tobacco smoke
  • cleaning products and air “fresheners”
  • mold or fungus
  • pesticides
  • carbon monoxide
  • heat or low humidity

LIGHTING:

  • poor lighting
  • computer screens that cause eye strain

FURNITURE & BUILDING MATERIALS:

  • formaldehyde
  • asbestos
  • VOCs

MENTAL / RELATIONAL / CULTURAL:

  • high levels of stress from workload
  • relational stress with colleagues/coworkers
  • office layout (i.e. open offices)
  • low workplace morale
  • noisy environments
old building syndrome

What Does Building Related Illness (BRI) Mean?

A Building Related Illness is a clinically defined illness or diagnosis that is caused by a building or something IN a building and the cause is known. For many Building Related Illnesses, the illness and symptoms continue even after the individual leaves the building.

An example of a BRI is when victims of Hurricane Katrina became ill after being exposed to formaldehyde in FEMA’s emergency housing trailers.

What Kind Of Illness Results From BRI?

  • Asthma
  • Rhinosinusitis (inflammation in your nasal passages and sinuses)
  • Legionella infection (pneumonia caused by Legionella bacteria)
  • Hypersensitivity pneumonitis (a rare immune system disorder that affects the lungs)
  • Chronic Inflammatory Response Syndrome (mold toxicity)
  • Inhalational fever (a respiratory or immunological illness that results from breathing in bacteria, dust, fumes, fungi, or other aerosolized toxins)

To Sum It Up: What Are the Differences Between SBS and BRI?

SBS and BRI are both categories of illness where individuals or groups of people are made sick by something in a building (usually a home or workplace). There is a wide range of symptoms and diagnoses that exist under these umbrella terms, and there may be some overlap.

The two primary differences between SBS and BRI are:

  1. SBS consists of a set of symptoms, of which the cause is unknown. With BRI, the cause of the illness is known.
  2. With SBS, the symptoms/illness will usually go away when the individual(s) leave the building. With BRI, the illness caused by the building will usually stick around and require treatment, even after the individual has been out of the building for quite some time.
sick building syndrome causes

What About “Old Building Syndrome?”

Old Building Syndrome is another related term you might come come across, although there isn’t really a distinct definition for this one. The idea behind Old Building Syndrome is that there is a greater chance of having SBS and/or BRI with older buildings. This is because:

a) older buildings may have been built using toxic materials that are now outlawed or limited (i.e. lead)
b) since they’ve been around longer, there is a great chance that older buildings have water damage from leaks, flooding, etc., as well as more time for things like toxic mold to grow and spread. According to Occupational Safety and Health Administration (OSHA), more than a quarter of buildings in the U.S. are water-damaged.

It’s important to remember, though, that just because a building is old doesn’t mean that it’s not safe, and just because a building is new doesn’t mean it is safe. (After all, it only takes 24 to 48 hours after water damage for mold to start growing.)

Why is Sick Building Syndrome Controversial?

One of the biggest problems with SBS is that, by definition (“syndrome”), the true root cause is unknown. In addition to that, when looking at the list of potential causes above, one might logically conclude that SBS doesn’t have ONE cause, but many. Some people may experience SBS from just one primary root cause, while other people may suffer from SBS due to a combination of many different things.

The symptoms of SBS also overlap with a lot of other conditions and causes, which adds to the controversy. It may take some people quite a bit of time and investigation to do some process of elimination and eventually narrow down the true cause(s) of their illness. (More on that below.)

How Can You Test For Sick Building Syndrome?

If someone suspects a home, workplace, or other building to be the cause of SBS and/or BRI, it may require some significant investigation and testing. You might start by hiring an Industrial Hygienist (IH) to conduct interviews and inspections.

From there, you may need to do a series of other tests in order to start narrowing down the cause(s) of SBS and/or BRI. For example, with mold toxicity, you may complete an ERMI or HERTSMI-2 test.

In addition to testing the actual building, you may want to complete some tests on the individual as well. For example, there are several lab tests that can help determine whether someone is suffering from Chronic Inflammatory Response Syndrome as a result of toxic mold exposure.

Testing and/or diagnosing SBS and/or BRI may include some trial & error, and process of elimination. If you suspect that you or one of your loved ones is suffering from SBS or BRI, it’s important to be as patient as possible, seek the mental health support you need through the process, and make sure you’re working with doctors and Industrial Hygienists who are trustworthy and respectful.

building related illness meaning

What Does Indoor Air Quality (IAQ) Mean in Terms of Sick Building Syndrome?

Indoor Air Quality (IAQ) is an important factor for both SBS and BRI; it’s almost always a culprit in one way or another. If there are toxic chemicals and/or fungi in the air that are not getting properly disposed of, individuals are more likely to become ill the longer they remain in that building with poor IAQ.

Some Common Pollutants That Affect IAQ:

  • carbon monoxide 
  • nitrogen dioxide 
  • secondhand smoke
  • lead particles
  • Volatile organic compounds (VOCs) from cleaning supplies, furniture, paint, etc.
  • Mold, mildew

Most of the time, these factors that can negatively affect IAQ fall into one (or more) of three umbrellas:

  • Biological contaminants: bacteria, molds, pollen, and viruses 
  • Chemical contaminants from indoor sources
  • Chemical contaminants coming from outdoor sources
What is the treatment for sick building syndrome?

Overcoming Building-Related Illness And Sick Building Syndrome

If you strongly suspect SBS or BRI and/or have nailed down your home or workplace as being the definite culprit of your illness, the next question is: “Well, what do I do about it now!?” In fact, even if you AREN’T suffering from SBS or BRI at this time, the below steps are just generally good practices when it comes to creating and maintaining healthy living and working environments.

Getting Rid Of Pollutants That Cause Old Or Sick Building Syndrome

Some good practices when it comes to getting rid of pollutants are:

  • When there is flooding or leaking, dry it up IMMEDIATELY. Do whatever you need to do to dry that water within 24 hours in order to prevent mold and mildew growth (fix the leaks, use towels, open all the windows and doors to air it out, use fans, etc.). As difficult as it can be to clean up big water messes, it’s much MORE difficult to get rid of mold once it’s growing.
  • If mold or mycotoxins are found, get rid of it with Medical Grade Remediation. (Not all mold removal is created equal. If you’re sick, it’s important to do your research and get someone who can do it right the first time.)
  • Get rid of water-stained ceiling tiles, carpeting, etc.
  • Switch the lighting and computer screens to help with eye strain
  • Make changes to the office layout, culture, and any similar factors that could be affecting mental health

Improve IAQ With Proper Ventilation And Filtration

  • Have your HVAC serviced regularly and make sure it’s up to current code
  • Use high-quality HEPA air filters and change them regularly
  • In addition to your HVAC, use in-room HEPA air filters, especially in the rooms/areas where you spend a lot of time
  • Consider using local exhaust ventilation in high-contaminant areas such as bathrooms, copy rooms, etc.
  • Consider getting rid of the window air conditioner, which can be a breeding ground for toxic mold.
  • Institute smoking restrictions (i.e. outside smoking only)
  • Make sure you have the proper humidity levels (usually 40-70%)

Reducing Exposure To Contaminants

  • Vacuum (with a HEPA filter if possible) and dust regularly to get rid of dust and dirt which holds onto fungal spores and other microscopic toxins
  • Make sure all chemicals, paints, solvents, etc. are stored and used properly in well-ventilated areas and during periods of low- or non-occupancy
  • Get rid of toxic chemicals in cleaning supplies, personal care products, and furniture (they’re everywhere!)
  • Institute a perfume/fragrance ban (something more and more workplaces are doing nowadays)
  • Allow new building materials and/or furniture to off-gas. You can do this by leaving furniture outside for a few days if possible, or opening up windows and using fans to increase air flow before bringing in occupants.
how-to-prevent-building-related-illness

Treating Symptoms While Combating The Problem: Strategies For People Who Are Affected By VOC’s, Mycotoxins, and IAQ

When it comes to environmental toxins, there are a lot of factors that go into whether a person gets sick, how sick they get, and how long it takes them to recover. For those who are suffering from SBS and/or BRI, here are some strategies you may want to implement in order to cope with SBS/BRI as you investigate and treat your illness:

  • Open windows and doors periodically (or longer, if possible) in order to increase circulation and improve IAQ
  • Go for walks and/or take regular breaks outside
  • Discover natural solutions to increase IAQ for your home (using air purifiers, switching to non-toxic personal care products, etc.)
  • Give your eyes a break from the screens and get blue-light blocking glasses
  • Support your body’s natural detoxifying processes (and get lots of sleep!)
  • Consider a short-term functional detoxification protocol (like this one for a general detox or this one for mold). Just make sure you’re working with a doctor if you do these! Binders such as charcoal can strip your body of essential vitamins and minerals, so you shouldn’t take them within an hour of eating or for long periods of time.
  • Get the mental health support you need
  • Some individuals may need to go as far as to move homes and/or switch workplaces completely in order to recover

Is There A Way to Prevent Sick Building Syndrome and/or Building Related Illness?

Unfortunately, it’s virtually impossible to prevent SBS and BRI completely. You can’t always stop your home from flooding and you can’t control whether or not all the departments in your workplace use toxic chemicals.

However, by doing what IS in your control by taking the steps outlined above (cleaning up water immediately, reducing your exposure to chemicals as much as possible, etc.), you can definitely reduce the likelihood of acquiring and/or decrease the severity of SBS/BRI.

Common SBS and BRI Misdiagnoses

Unfortunately, SBS and BRI can have such a wide range of symptoms that it can take many individuals quite a while to get a diagnosis. If you are suffering from a mystery illness that you can’t seem to solve, it might be helpful to be aware of some of the common misdiagnoses that those with SBS/BRI are given:

  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Multiple Sclerosis
  • Depression
  • Stress
  • Allergy
  • Post Traumatic Stress Disorder
  • Somatization
  • Irritable Bowel Syndrome
  • Attention Deficit Disorder

Conclusion:

If you or others seem to develop asthma or flu-like symptoms when indoors, but the same symptoms dissipate once outside, you may be dealing with Sick Building Syndrome. Longer exposure can result in developing more serious conditions that exist under the Building Related Illness umbrella. SBS and BRI are more common than one might think, and it can be confusing to experience and difficult to get a diagnosis. Removing contaminants can alleviate these issues while greatly improving air quality and lead to a much healthier environment for you and your family.


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Image credits: Nolan Isaac, cottonbro, Edward Jenner, Liza Summer, Ekaterina, Chris Gallagher