Sick building syndrome
Sick building syndrome is the name given to a set of symptoms that appear inside one particular building and settle once you leave it.
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Sick building syndrome is the name given to a set of symptoms that appear inside one particular building and settle once you leave it. An office is the usual setting, but a school, a warehouse or your own flat behaves the same way. It is not a diagnosis in the ordinary sense: no test confirms it. It is better understood as a signal with two possible readings. Either something really is wrong with the premises, or you are unwell for a reason of your own and the building simply happened to be there. Both directions need checking, and the second one matters more, because behind it sit conditions that can actually be treated.
What it feels like
The complaints are ordinary, and not one of them means anything on its own:
- headache, a heavy head, a sense of stuffy air;
- dry, gritty, red eyes, particularly noticeable if you wear contact lenses;
- a dry or scratchy throat and a hoarse voice by the end of the day;
- a blocked or runny nose with no cold to explain it;
- dry, itchy skin, sometimes with a fine rash;
- throat-clearing, cough, wheeze;
- tiredness, drowsiness and that familiar feeling that your head will not work and you cannot concentrate.
What counts is not the list but its timetable. Worse by the middle or the end of the working day, easier at home in the evening, nothing at weekends or on holiday, and the whole thing starting again on the first day back: that is what a link to the building looks like. The second argument in its favour is colleagues at the next desks noticing something similar, especially if it began in several people at roughly the same time, after refurbishment, a move, new furniture or changes to the ventilation.
The reverse is just as telling. If your head aches the same everywhere, the tiredness survives a holiday and your nose is blocked around the clock, the building is almost certainly not to blame, however convenient that explanation would be.
What to check in the premises themselves
There is rarely a single cause. Several small ones usually add up, each tolerable on its own, and together they produce exactly this picture. These are worth looking at.
- Ventilation — how much fresh air genuinely comes in. Complaints cluster where windows do not open and the air supply is weak or has gone unserviced for years. Noticing stale air by mid-morning is a fairly reliable sign.
- Air conditioning and humidifiers — clogged filters, trays of standing water, units nobody has cleaned in years.
- Humidity. Air that is too dry produces precisely the set of symptoms people describe most often: dry eyes, dry throat, dry skin and static shocks.
- Temperature — the number matters less than how much it swings through the day, and than a jet of cold air landing straight on your head or back.
- Dust and fibres — carpeting, paper archives, old upholstery, building work next door, photocopiers in a shared room.
- Smells and fumes — fresh paint, varnish, glue, new furniture, cleaning products, air drawn in from a kitchen or an underground car park.
- Mould and damp — stains on walls and ceilings, a cellar smell, traces of leaks. This one has to be removed rather than aired out.
- Lighting — flickering tubes, glare on the screen, light that is too harsh or too dim. A fair share of the headaches and sore eyes starts here.
- Noise and crowding. The constant background of an open-plan office wears people down as much as poor air does, and produces the same complaints.
- Tobacco smoke — from a smoking area, a balcony or electronic cigarettes, drawn back inside through the ventilation.
What gets blamed on the building but is an illness
This is the part of the page that matters most. Headache, tiredness and trouble concentrating are the commonest complaints in all of medicine, and they have causes that a blood test finds and treatment fixes. If everything is put down to the office, those causes go unseen for months. The conditions that most often hide behind a “sick building” are:
- anaemia, especially from low iron: weakness, breathlessness on stairs, pallor, hair loss. In women with heavy periods it is the first thing to think of;
- thyroid disease. An underactive thyroid brings sluggishness, feeling cold, dry skin, weight gain and slowed thinking; an overactive one brings palpitations, sweating, anxiety and weight loss;
- depression and anxiety disorder. They very often turn up as physical exhaustion, headache and an inability to get going rather than as low mood. And if the job itself is unpleasant, the pattern of “worse at work, better at home” arranges itself;
- sleep apnoea. You sleep enough hours, but breathing stops many times a night. By day: exhaustion, morning headache, dozing off over tasks. Clues include snoring, pauses in breathing that others notice, and excess weight;
- allergy and asthma. Allergy to house dust mites, mould or animals gives a blocked nose, dry eyes and cough, and it is also tied to particular places. The difference is that here there is a real cause and real treatment;
- migraine. Light, noise, stuffy air and irregular meals are well-known triggers, and an office supplies all of them at once;
- dehydration, too little sleep, too much coffee and last night's alcohol — dull explanations that can be tested faster than any of the others.
Eyesight deserves a separate mention. Sore eyes and a headache by the end of the day in someone who works at a screen very often mean nothing more than the wrong glasses prescription or the beginnings of long-sightedness. An eye test is cheap and settles the question in one appointment.
Two things you must not miss
There are two situations in which “I feel ill in this room” is not about comfort but about danger. Both are rare, and both look like ordinary tiredness at first.
Carbon monoxide poisoning. The gas has no colour and no smell, and the first signs are headache, nausea, weakness, dizziness and confusion. Suspect it when several things line up: more than one person in the same room has a headache at the same time, everyone feels better within minutes of stepping outside, and the building has a gas water heater, boiler, stove, fireplace, generator or an engine running nearby. Pets being unwell at the same time is another warning. With that suspicion you do not investigate on the spot: open the windows, switch the appliance off if you can do so straight away, get everyone outside and call an ambulance — in Spain, Italy, Portugal, Poland and Ukraine the single number is 112. Medical assessment is needed even for those who feel better in the fresh air, because this is an easy thing to underestimate.
Hypersensitivity pneumonitis. This is inflammation of the lung in response to breathing in mould or bacteria from damp walls, humidifiers, air-conditioning systems or old carpets. What separates it from sick building syndrome is that cough and breathlessness move to the front: stairs become hard work, and a temperature sometimes appears a few hours after arriving in the building. This needs a doctor and a chest X-ray, because continued exposure leads to scarring of the lung tissue, and scarring does not reverse.
What you can do yourself in a fortnight
Before demanding that the ventilation be inspected, gather evidence. The conversation goes very differently with it.
- Keep a short diary: a fortnight, one line a day — where you were, for how long, what you felt, and how you would score the day from nought to ten. Weekends and holidays included. That record either shows a link to the building or it does not.
- Air the room whenever you can: briefly and often works better than once and at length.
- Go outside at lunch and on breaks, even in bad weather; of everything on this list it is the most dependable.
- Take screen breaks and look into the distance; if your eyes feel dry, ask the pharmacy about lubricating drops.
- Drink water through the day and keep coffee within reason.
- Sort out your own desk: light neither in your eyes nor on the screen, and no airflow aimed at your head.
- Clear the stacks of paper and boxes off the desk and out from under it — that is the most accessible dust in the room.
- For those two weeks at least, sleep as much as you need. Otherwise there will be nothing to read the diary against.
Who to talk to about the building
If the symptoms are not yours alone, going to the employer or the building manager works better than raising it one by one: several people with a fortnight of records is grounds for an inspection, whereas one dissatisfied employee usually is not. Ask for specific things: servicing of the ventilation and air conditioning, new filters, measurement of temperature and humidity, tracing the source of the damp, a look at the lighting. On working conditions you can approach the labour inspectorate or the equivalent authority in your country; what it is called depends on where you live. And if there is any gas appliance on the premises, servicing it and checking the flue is the owner's duty and cannot wait.
When to see a doctor, and what they will look for
It is worth booking an appointment if symptoms last more than a few weeks, get in the way of work, or persist even on holiday. Do not wait if a cough or breathlessness has appeared and is not clearing, if you are losing weight, if you have a persistent temperature, or if the headache is a new kind of headache: worse than before, or waking you at night.
The consultation usually covers how the symptoms track with time and place, your work and your home, your sleep, your mood and any medicines you take. After that the usual step is a routine blood test — full blood count, iron, thyroid hormones — because that short set covers most of the conditions that disguise themselves. Cough and breathlessness add breathing tests and a chest X-ray; suspected allergy means a referral to an allergy clinic; snoring with pauses means a sleep study. All of it serves one purpose: making sure there is no illness behind the symptoms. If there is none, then dealing with the premises really is what remains, and that is good news rather than a brush-off.
Online consultation
A conversation achieves more here than you might expect, because the main work is not examination but sorting out the circumstances. An Oladoctor doctor can help you see whether there is a genuine link to the building or whether the picture points elsewhere; suggest which tests are worth doing first so that you are not screened for everything at once; go through your fortnight of notes with you; and explain what to ask of your employer and what to look at when you get home. If what you describe suggests carbon monoxide, lung inflammation or anything else that needs examining in person, you will be told so straight away.
This material is for information only and does not replace medical advice.
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Discuss your symptoms and possible next steps with a doctor online.
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Discuss your symptoms and possible next steps for Sick building syndrome with a doctor online.
