Melissa Kaplan's
Chronic Neuroimmune Diseases
Information on CFS, FM, MCS, Lyme Disease, Thyroid, and more...
Last updated January 1, 2014

Pat B., a web designer in upstate New York, didn't think much of it when she got a sinus infection the first week at her new job. Two months later, she got another one. Then the muscle cramping began. "I would try to walk at lunch time and my hips would cramp so bad I had to go back," she recalls. "As soon as I entered the building, it felt like the breath was sucked out of me."

After batteries of tests, she went on a leave of absence and the symptoms leveled off. When she returned, her throat started burning the minute she stepped into the building.

"The ceiling tiles were moldy, everything was wet," she says. "I could smell formaldehyde and so could one other person." Eventually, Pat was diagnosed with interstitial lung disease, an ailment that had already killed a young, athletic male co-worker. She is convinced the building she worked in caused her illnesses.

Symptoms and Causes of Sick Building Syndrome
Actually, the National Institute for Occupational Safety and Health prefers the term "Indoor Air Quality." If 20% of the work force has symptoms -- including watering eyes; hoarseness; headaches; dry, itchy skin; dizziness; nausea; heart palpitations; miscarriages; shortness of breath; nosebleeds; chronic fatigue; mental fogginess; tremors; swelling of legs or ankles; and cancer -- the building may be labeled a "sick building." The telling factor is if the symptoms ease when workers are at home or on vacation.

The causes are many. In the 1970s, there was a movement amongst builders and regulatory authorities to button-up buildings to save on fuels for heating and air conditioning. Many buildings became virtually air-tight. According to the American Society of Heating, Refrigerating and Air-Conditioning Engineers, some polluting factors include indoor combustion (heaters, ranges, smoking) and buildup of carbon monoxide and inhalable particles; volatile organic compounds such as benzene, styrene, and other solvents; and airborne-allergens and pathogens, such as viruses, bacteria, fungi, spores, and protozoans. Added to that are new building materials (plywood, carpet glue) and fabrics (rugs, furniture) that "offgas" toxic fumes.

Prevalence of These Complaints
Time was, complainers were dismissed as hypochondriacs and neurotics, but companies and regulators are acknowledging now that the modern office environment can be toxic.

In 1980, NIOSH got 150 internal environmental quality complaints, 8% of total complaints. By 1990, 52% of complaints concerned sick-making work environments.

Kenny Oldfield, CIH, a hazardous materials trainer at the University of Alabama Birmingham Center for Labor Education and Research (CLEAR), says the nature of the problem may be changing slightly. "We may be seeing a decrease in offgassing," he says. "Just look in the paint department at Home Depot -- you will find kids' paint and low vapor emission paint. There is some indication this is being addressed."

However, the problem of biological contaminants is increasing, he says -- molds, bacteria, such ailments as Legionnaires' disease, now called legionella. Pat herself was finally diagnosed as having a fungal problem. "These are the result of poor maintenance," Oldfield says. "We need to see more upkeep on heating and air conditioning systems, but with the economy, we may see less."

Vincent Marinkovich, MD, an immunologist in private practice in Redwood City, Calif., who sees many sick-building patients, also criticizes maintenance. "Sometimes," he says, "the best filters in the building are the lungs of my patients." People come to him because he knows how to treat fungal infections with a nose spray he makes specially. The problem, he says, is that mold may colonize the patient's nose; thus, patients are carrying around the toxin, which keeps infecting them every day.

What Can Employers Do?
Pat had a terrible time getting anyone to believe her. Her employer -- ironically, an HMO -- showed her certificates from the Occupational Safety and Health Administration (OSHA) to the effect that the building was OK. She was offered a different office in the same building with the same air flow system. Eventually, she resigned.

The Building Owners and Managers Association International urges its members to create a healthy work environment, relatively free of contaminants and adjusted for temperature and humidity. To neglect such matters, building owners are told, means increased absenteeism and productivity -- thus, unhappy tenants. Every complaint, BOMA says, merits a response.

What to Do If Your Company Is Not Responsive
If you suspect your building might be contributing to your symptoms, Pat suggests:

• Take pictures of discolored or wet ceilings or furniture.

• Ask to record conversations with company personnel about the problem.

• Put your complaint in writing. Say you know your bosses care about their employees and their productivity.

• If you have already incurred lasting problems, you may be entitled to workers comp or disability. You may even try to get early retirement. Call OSHA for a clinic near you to be assessed. You may be asked to submit to a home inspection or psychiatric exam. Don't be offended, this is part of the process.

• Go to OSHA or the EPA directly to ask for an air-quality investigation. You may have to get more than one person to complain.

• Look for another job if you can't get satisfaction. Your health is too important to stay and stand your ground, perhaps for years.

"I feel better now," Pat says, three and a half years after quitting. "But my toes are still numb."

Star Lawrence is a medical journalist based in the Phoenix area.

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