Independent epidemiological studies in the UK, Denmark, Holland, Sweden and Germany have identified a group of common symptoms that are temporarily related to occupancy of office buildings. The principal symptoms are lethargy, headache, blocked nose and dry eyes, throat and skin. The average number of work-related symptoms per building occupant (the building symptom index) varies widely between buildings in all these studies. In general,air-conditioned buildings are sicker than naturally ventilated ones, despite indoor environments that conform more closely to environmental comfort standards. Sicker buildings are assessed by their occupants as drier and stuffier than healthier buildings, however, the sensation of dryness relates to increased temperature rather than water content of the air, and stuffiness does not relate to the air change rates. There is an association between the presence of humidifiers and chillers and sicker buildings. It is likely that either soluble products from micro-organisms, or the biocides used to control them, are the link between symptoms and air-conditioning. Control over the indoor environment depends on better design, and improved training, supervision and work practices of those maintaining the building plant.

Keywords:
Chillers, Temperature, Stress, Microbial contamination, Sick building syndrome, Epidemiology, Humidifiers
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1992
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