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• W2028039863 abstract "In my opening remarks I asked, ″What is the most appropriate title for the conference?” Is the name ″sick building syndrome” appropriate? I don't believe it is, for buildings don't become ″sick”: people do. Buildings may become contaminated or develop ventilation problems, which cause illnesses or complaints of and by their occupants. Of several alternate titles that come to mind to describe buildings that cause health-related problems, the most appropriate may be either ″building-related complaints and illnesses” or ″building- and home-related complaints and illnesses.” The illnesses include asthma, allergic rhinitis, hypersensitivity pneumonitis, and Legionnaires' disease, all of which have been either induced or exacerbated by contaminated buildings. The varied symptoms are allegedly building related, and whatever the cause, include headache, fatigue, malaise, rhinitis, nausea, eye irritation, cough, etc. Much publicity has been given to buildings allegedly causing problems for their working occupants. By contrast, complaints attributed to a defective home environment are much less common, yet today's homes present many of the same problems presented by large buildings in which people are working. Throughout the western world, many homes are contaminated with debris from dust mites, cockroaches, fur-bearing animals, fleas, and birds, which do not pollute commercial buildings to the same extent. Smoking in the home exposes occupants to many pollutants, and many of the volatile organic compounds found in working environments are also found in homes; furthermore, homes are cleaned less efficiently and less frequently than are commercial buildings. Nevertheless, many more of my patients complain about the buildings in which they work than about their own homes. Similarly, the outdoor environment in most urban centers is polluted, both by naturally occurring pollutants (e.g., pollens, molds, other organic debris, algae, and terpenes) and by man-made pollutants (e.g., sulfur dioxide, ozone, hydrocarbons, and volatile organic compounds). Outdoor pollution alerts advise individuals at risk to seek shelter in their homes or work buildings, preferably in an air-conditioned environment. Yet, when complaints from occupants of buildings occur, most often they will indicate that their symptoms resolve when they go ″out of doors.” When there are complaints from occupants about an illness allegedly related to a building for which there is no identifiable cause, all three environments (i.e., the building, the home, and the outdoors) must be studied and monitored. Such environmental comparisons can determine whether there are appreciable differences between one environment and another. If there are such differences reasonably causing the complaint, they can be rectified; otherwise, other explanations must be pursued. Every speaker emphasized the importance of moral and scientific objectives when investigating an alleged building-related illness or complaint. Investigators must demonstrate concern for the occupants of the building, the employer, and the owner of the building. Failing to do so may contribute to iatrogenic illness with uncalled-for disability, unemployment, and litigation and/or inappropriate renovation of buildings. Buildings have been closed and owners put out of business because of misrepresentation of data and facts by physicians, lawyers, environmental consultants, and occupants of buildings. Problems associated with building-related illnesses and complaints should be studied and resolved by a team of trained personnel, which includes environmental consultants, engineers, physicians, and the interested parties, rather than by litigation. Adversarial conditions should be avoided at all costs. When building-related illness is confirmed, the primary responsibility of the physician is to remove the employees from the environment while advising the employer or building owner about appropriate resolution of the problem. When the problem is resolved, the building can be reoccupied, and the indoor environment can be monitored. The rarely occurring permanent injury or disability must be documented by the physician with facts and scientific evidence to establish a cause and effect. In summary, it is essential to use scientific methods in evaluating any building-related illness or complaint. Probative data are needed to conclude that there has been a cause-and-effect relationship between exposure and an illness or complaint, after which appropriate modifications of the environment should be made. The indoor, outdoor, and home environments should also be monitored simultaneously whenever possible. This will identify similarities and differences and enable the physician to determine whether the resolution of complaints on changing environments implicates the cause. The activities of the responsible consultant should represent all the participants (i.e., the employee, the employer, and the owner of the building in question). Finally, I believe that ″building- and home-related illnesses and complaints” is a more appropiate title for the conference than ″sick-building syndrome.” I thank the audience, whose attentiveness and interactivity demonstrate the interest in the subject of this year's conference. The faculty is especially commendable for the excellent reviews of their subjects confirming that, at present, the medical and scientific investigation of a ″sick” building is an art, as well as a science." @default.
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• W2028039863 title "Building- and home-related complaints and illnesses: Summary statement" @default.
• W2028039863 doi "https://doi.org/10.1053/ai.1994.v94.a56027" @default.
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