Sick Building Syndrome: A potpourri analysis

Federation of Insurance & Corporate Counsel Quarterly, Spring 1999 by Wood, Brian A, Al, Marc A

INTRODUCTION

If you have not yet dealt with issues relating to "sick building syndrome," you probably will in the near future, whether in a professional or personal capacity.1 In 1983, the World Health Organization defined sick building syndrome as "an excess of work related irritations of the skin and mucous membranes and other symptoms, including headache, fatigue, and difficulty concentrating, reported by workers in modern office buildings."2 The term "sick building syndrome" is a specific term of art. Nevertheless, it is not a medical diagnosis. Rather, it is a description of a typical complaint experienced only in buildings.3 It appears to be a reaction, at least in part due to stimulation of the common chemical sense, to a variety of chemical, physical, or biological stimuli. Its victims display all or some of a pattern of irritation of the mucous membranes, and the worst affected individuals have neurological symptoms as well.4

The classification is made based on the symptoms involved, the number of people having such symptoms, and the duration of the symptoms.5 The World Health Organization has classified the following complaints, or symptoms, under the category of sick building syndrome: (1) mucus membrane irritation - eyes, nose and throat; (2) toxic symptoms - headache, fatigue and irritability; (3) asthma and asthma-like symptoms - chest tightness and wheezing; (4) skin dryness; and (5) gastrointestinal complaints.6 The classification requires that more than twenty percent of the building occupants complain of such problems and that symptoms abate soon after the occupants leave the building.7

Sick building syndrome is a definition of exclusion; that is, if no cause can be associated with the complaints, the cause is considered to be sick building syndrome.8 The term "sick building syndrome" must be distinguished from "building-related illness." The latter is a separate term of art in which a particular building problem has to be linked to a particular illness.9 The term building-related illness is used when symptoms of a diagnosable illness are identified and can be attributed directly to air-borne building contaminants.l0 What initially may be described as sick building syndrome may, after a cause has been determined, be described as a building-related illness. Some commentators view sick building syndrome and building-related illness claims on a continuum, categorizing those claims that are subtle, more difficult to define and document, and less serious, as sick building syndrome, and categorizing the more serious clinically diagnosed and clinically defined claims as buildingrelated illness.11

Building-related illness is more significant in the legal area than sick building syndrome because of the definite causal link between the problem and the illness. Unlike those complaining of sick building syndrome, the complainants in building-related illness cases may require prolonged recovery times after leaving the building.12 Susceptibility to a building-related illness is influenced by a number of host (i.e., the building occupant or claimant) factors, including the host's age and immune system status.l3 Building-related illnesses often are potentially severe and can result in serious illness or death.14 Accordingly, identification and removal of the contaminant source is required to mitigate the building-related illness, especially in cases involving hypersensitivity responses. 15 Building-related illnesses have been traced to specific contaminant sources, including fungi infestation or microbial growth in cooling towers, air handling systems, and water-damaged furnishings.16

Both sick building syndrome and building-related illness must be distinguished from the term "multiple chemical sensitivity," which is not recognized as a medical condition.17 The theory underlying multiple chemical sensitivity is that cumulative exposure to toxic substances induces susceptibility to multiple substances, which in turn results in a total allergy syndrome. Conventional medicine has not found any convincing evidence to support the hypothesis upon which the theory is built or to support the various treatments which are prescribed, noting that few have been shown to be effective in controlled environments.18

Much of the history of sick building syndrome can be traced to the energy crisis of the 1970s.19 Before the mid-1970s, most commercial buildings had only one way of regulating the volume of air transmitted to the occupants, namely the windows which were opened or shut as the occupant desired, while homes had fairly significant airflow even with all doors and windows shut. Energy conservation efforts undertaken following the 1973 OPEC embargo changed all this. Voluntary and involuntary energy consumption reduction efforts required the reduction of heat loss or gain through the exterior of buildings and a reduction in the supply of outside air quantities into buildings. Buildings were made "tight" and commercial buildings became solely dependent upon mechanical ventilation to supply heating, cooling, and humidity. Windows were sealed shut. While many homes did not receive the benefit of such elaborate mechanical ventilation systems, they were nevertheless sealed and insulated.