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Indoor Air Quality

Why Sick Building Syndrome Will Be Taken More Seriously Post-Pandemic

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By Itai Rosenzweig on January, 13 2021

Sick Building Syndrome is a real and very expensive global reality. We explore its causes & impact, and explain why global leaders and businesses are starting to take the threat of unhealthy indoor air more seriously.

What is Sick Building Syndrome? 

“Sick Building Syndrome” refers to situations in which individuals start to feel acute health effects linked to time spent in a building. Unlike ‘Building Related Illness’ (BRI), where symptoms and diagnosable illnesses can be identified and tied to specific contaminants, it’s not possible to associate Sick Building Syndrome with specific illnesses or causes.

Sick Building Syndrome might be suspected for example if:

  1. A number of otherwise healthy building occupants complain of uncomfortable symptoms like fatigue, headaches, throat irritation, concentration problems, dry coughs and more.

  2.  Building occupants felt relief upon leaving the building.

  3.  No other cause could be identified.

How Much Does Perception Have to Do with It?

As Sick Building Syndrome cannot often be tied to a specific cause other than time spent in a building, some regard the symptoms experienced as potentially psychologically rooted. 

However, studies have shown an association between the perception of poor indoor air quality, symptoms experienced and the indoor environmental context. For example, air conditioned buildings generally show a higher prevalence of symptomatic individuals than naturally ventilated buildings:



Aldes' Smart Ventilation: Get the Case Study

The Economic Cost of Sick Building Syndrome 

Whatever the causes of a particular case of Sick Building Syndrome, the phenomenon is real and comes with a huge knock-on economic cost - it also presents a real challenge for HR managers in terms of preventable employee absenteeism. 

In this research, it was estimated productivity-losses from building-related symptoms could be within the $20-$70 billion range annually for the US alone.

Sick Building Syndrome Causes

The EPA cites the following common contributing factors to Sick Building Syndrome:

  1. Poor Ventilation: Inadequate ventilation, which can also occur if HVAC) systems don’t effectively distribute air to all people in the building.

  2. Chemical contaminants: Pollutants from both indoor & outdoor sources can all contribute to Sick Building Syndrome (e.g. adhesives, carpeting, pesticides, VOcs, vehicle exhausts and more).

  3. Biological contaminants: Biological contaminant examples include bacteria, mold, pollen, and viruses - exposure to all of which can cause symptoms of Sick Building Syndrome.

Real Examples of Sick Building Syndrome

Case Study: Small Commercial Office Building in Richmond, Virginia

After several occupants complained of symptoms associated with Sick Building Syndrome in an office near Richmond, Virginia, USA, an inspection was carried out of the premises. It was found that the building’s ventilation system provided hardly any outside air to the office space. They also discovered that internally produced contaminants appeared to increase throughout the day without proper ventilation. 

Based on these findings, it was recommended that the building owners significantly increase the outdoor ventilation rate, and improve the air handling units’ hygiene. 



Case Study: Japanese Office Worker Suffers from Sick Building Syndrome

In this Sick Building Syndrome example, a 36-year old female office worker developed nausea and headaches during her working hours in a refurbished office in Japan. She tried to get help from health providers for months before being referred to a hospital where it was found that chemical exposure from building materials such as formaldehyde was likely to have induced a range of symptoms.

Sick Building Syndrome Solutions: The Importance of Education & Safe Indoor Spaces

A big part of preventing Sick Building Syndrome relies on taking proactive measures to improve indoor environments, such as preventing exposure from pollution in the first place and improving ventilation.

Atze Boerstra, MD of consulting engineering firm BBA Binnenmilieu and co-author of the Indoor Climate and Productivity in Offices, states that,

“doubling the outdoor air supply rate alone could reduce illness and the occurrence of the sick building syndrome roughly by 10%”.

Education about air quality and our indoor spaces also plays a key role: If building occupants and managers understand the causes and impacts of unhealthy environments, they can take action against it. Smart tech is also helping a lot here as a growing number of companies start to combine human feedback with accurate monitoring and automated control.

Protecting Indoor Spaces in the Wake of COVID-19

The COVID-19 pandemic has underlined the fact that health concerns in a building’s design and setup are a necessity rather than a ‘nice-to-have'. Companies everywhere are now asking how to make their buildings and offices safer. 



1. Recognition of the Indoor-Outdoor Air Pollution Continuum

Indoor air solution providers are developing solutions that protect an individual’s health and wellbeing 24 hours a day, increasing their value. (More info here).

2. Increased Government Attention

For example, the German Government is investing €500m (£452m; $488m) into improving ventilation systems across public buildings and has also confirmed eligible sites can apply for funding for CO2 sensors to prevent unhealthy air. 

3. New Building Standards

The International WELL Building Institute has developed a new standard called the WELL Health-Safety Rating

This is a scientifically-backed certification to show that a building is doing everything it can to keep occupants safe from the virus, managing air, and water quality, and promoting health-conscious policies, like providing flu shots and being smoke-free. (Adopters include the Empire State Building & Yankee Stadium).


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