A number of well identified illnesses, such as Legionnaire s disease, asthma, hypersensitivity pneumonitis, and humidifier fever, have been directly traced to specific building problems. These are called building related illnesses. Most of these diseases can be treated nevertheless, some pose serious risks.

Sometimes, however, building occupants experience symptoms that do not fit the pattern of any particular illness and are difficult to trace to any specific source. This phenomenon has been labeled sick building syndrome. People may complain of one or more of the following symptoms: dry or burning mucous membranes in the nose, eyes, and throat; sneezing; stuffy or runny nose; fatigue or lethargy; headache; dizziness; nausea; irritability an forgetfulness. Poor lighting, noise, vibration, thermal discomfort, and psychological stress may also cause, or contribute to, these symptoms.

There is no single manner in which these health problems appear. In some cases, problems begin as workers enter their offices and diminish as workers leave; other times, symptoms continue until the illness is treated. Sometimes there are outbreaks of illness among many workers in a single building; in other cases, health symptoms show up only in individual workers.

In the opinion of some World Health Organization experts, up to 30 percent of new or remodeled commercial buildings may have unusually high rates of health and comfort complaints from occupants that may potentially be related to indoor air quality.

WHAT CAUSES PROBLEMS?

Three major reasons for poor indoor air quality in office buildings are the presence of indoor air pollution sources; poorly designed, maintained, or operated ventilation systems; and uses of the building that were unanticipated or poorly planned for when the building was designed or renovated.

Sources of Office Air Pollution

As with homes, the most important factor influencing indoor air quality is the presence of pollutant sources. Commonly found office pollutants and their sources include environmental tobacco smoke; asbestos from insulating and fire retardant building supplies; formaldehyde from pressed wood products; other organics from building materials, carpet, and other office furnishings, cleaning materials and activities, rest room air fresheners, paints, adhesives, copying machines, and photography and print shops; biological contaminants from dirty ventilation systems or water damaged walls, ceilings, and carpets; and pesticides from pest management practices.

Ventilation Systems

Mechanical ventilation systems in large buildings are designed and operated not only to heat and cool the air, but also to draw in and circulate outdoor air. If they are poorly designed, operated, or maintained, however, ventilation systems can contribute to indoor air problems in several ways.

For example, problems arise when, in an effort to save energy, ventilation systems are not used to bring in adequate amounts of outdoor air. Inadequate ventilation also occurs if the air supply and return vents within each room are blocked or placed in such a way that outdoor air does not actually reach the breathing zone of building occupants. Improperly located outdoor air intake vents can also bring in air contaminated with automobile and truck exhaust, boiler emissions, fumes from dumpsters, or air vented from rest rooms. Finally, ventilation systems can be a source of indoor pollution themselves by spreading biological contaminants that have multiplied in cooling towers, humidifiers, dehumidifiers, air conditioners, or the inside surfaces of ventilation duct work.

Use of the Building

Indoor air pollutants can be circulated from portions of the building used for specialized purposes, such as restaurants, print shops, and dry cleaning stores, into offices in the same building. Carbon monoxide and other components of automobile exhaust can be drawn from underground parking garages through stairwells and elevator shafts into office spaces.

In addition, buildings originally designed for one purpose may end up being converted to use as office space. If not properly modified during building renovations, the room partitions and ventilation system can contribute to indoor air quality problems by restricting air recirculation or by providing an inadequate supply of outdoor air.

WHAT TO DO IF YOU SUSPECT A PROBLEM

If you or others at your office are experiencing health or comfort problems that you suspect may be caused by indoor air pollution, you can do the following:

Talk with other workers, your supervisor, and union representatives to see if the problems are being experienced by others and urge that a record of reported health complaints be kept by management, if one has not already been established.

Talk with your own physician and report your problems to the company physician, nurse, or health and safety officer.

Call your state or local health department or air pollution control agency to talk over the symptoms and possible causes.

Encourage building management to obtain a copy of Building Air Quality: A Guide for Building Owners and Facility Managers. Building Air Quality (BAQ) is simply written, yet provides comprehensive information for identifying, correcting, and preventing indoor air quality problems. BAQ also provides supporting information such as when and how to select outside technical assistance, how to communicate with others regarding indoor air issues, and where to find additional sources of information. BAQ is available for $24 from U.S. GPO, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 152507954; stock #055000003904.

Frequently, indoor air quality problems in large commercial buildings cannot be effectively identified or remedied without a comprehensive building investigation. These investigations may start with written questionnaires and telephone consultations in which building investigators assess the history of occupant symptoms and building operation procedures. In some cases, these inquiries may quickly uncover the problem and on site visits are unnecessary.

More often, however, investigators will need to come to the building to conduct personal interviews with occupants, to look for possible sources of the problems, and to inspect the design and operation of the ventilation system and other building features. Because taking measurements of pollutants at the very low levels often found in office buildings is expensive and may not yield information readily useful in identifying problem sources, investigators may not take many measurements. The process of solving indoor air quality problems that result in health and comfort complaints can be a slow one, involving several trial solutions before successful remedial actions are identified.

If a professional company is hired to conduct a building investigation, select a company on the basis of its experience in identifying and solving indoor air quality problems in nonindustrial buildings.

Work with others to establish a smoking policy that eliminates involuntary nonsmoker exposure to environmental tobacco smoke.

Call the National Institute for Occupational Safety and Health (NIOSH) for information on obtaining a health hazard evaluation of your office (800-35-N-EACH), or contact the Occupational Safety and Health Administration, (202) 2198151.

Federal Information Services

Federal agencies with indoor air quality information may be contacted as follows:

U.S. Environmental Protection Agency (EPA) Public Information Center 401 M St., SW Washington, DC 20460 (202) 260-7751

Indoor Air Quality Information Clearinghouse (IAQ INFO) P.O. Box 37133 Washington, DC 200137133 (800) 438-4318 (301) 585-9020

Operates Monday to Friday from 9 to 5 Eastern Standard Time (EST). Distributes EPA publications, answers questions on the phone, and makes referrals to other nonprofit and governmental organizations.

National Radon Hotline (800) SOS-RADON Information recording operates 24 hours a day.

National Lead Information Center (800) LEAD-FYI

Operates 24 hours a day, seven days a week. Callers may order an information package. To speak to an information specialist, call (800)4245323. Operates Monday to Friday from 8:30 to 5 EST.

National Pesticides Telecommunications Network National toll free number: (800) 858-PEST In Texas: (806) 7433091

Operates Monday to Friday from 8 to 6 Central Standard Time. Provides information about pesticides to the general public and the medical, veterinary, and professional communities.

RCRA/Super fund Hotline National toll free number: (800) 4249346 In Washington, DC area: (703) 4129810

Operates Monday to Friday from 8:30 to 7:30 EST. Provides information on regulations under both the Resources Conservation and Recovery Act (including solid and hazardous waste issues) and the Superfund law.

Safe Drinking Water Hotline (800) 4264791

Operates Monday to Friday from 8:30 to 5 EST. Provides information on regulations under the Safe Drinking Water Act, lead and radon in drinking water, filter information, and a list of state drinking water offices.

TSCA Assistance Information Service (202) 5541404

Operates Monday to Friday from 8:30 to 5 EST. Provides information on regulations under the Toxic Substances Control Act and on EPA's asbestos program.

U.S. Consumer Product Safety Commission (CPSC) Washington, DC 202070001 Product Safety Hotline: (800) 638-CPSC

Teletypewriter for the hearing impaired (outside Maryland): (800) 638-8270; Maryland only: (800) 492-8104. Recorded information is available 24 hours a day when calling from a touch tone phone. Operators are on duty Monday to Friday from 10:30 to 4 EST to take complaints about unsafe consumer products.

U.S. Department of Housing and Urban Development Office of Energy and the Environment Washington, DC 20410 HUD USER National toll free number: (800) 245-2691 In Washington, DC area: (301) 251-5154.

U.S. Department of Energy Office of Conservation and Renewable Energy 1000 Independence Ave., SW Washington, DC 20585

Conservation and Renewable Energy Inquiry and Referral Service (CAREIRS) PO Box 3048, Merrifield, VA 22116; (800) 523-2929.

Operates Monday to Friday from 9 to 5 EST. Provides consumer information on conservation and renewable energy in residences.

U.S. Public Health Service Division of Federal Occupational Health Office of Environmental Hygiene, Region III, Room 1310 3535 Market St., Philadelphia, PA 19104 (215) 596-1888; fax: 215-596-5024

Provides indoor air quality consultative services to federal agency managers.

Centers for Disease Control and Prevention Lead Poisoning Prevention Branch 4770 Buford Highway, NE (F42), Atlanta, GA 30341-3724 (800) 488-7330

Office on Smoking and Health Centers for Disease Control and Prevention U.S. Department of Health and Human Services

4770 Buford Highway, NE (K50), Atlanta, GA 30341-3724 (404) 488-5701

Occupational Safety and Health Administration Office of Information and Consumer Affairs Room N-3647 200 Constitution Avenue, NW, Washington, DC 20210 (202) 219-8151

Bonneville Power Administration Portland, OR 97208

General Services Administration 18th and F Streets, NW, Washington, DC 20405

Tennesee Valley Authority

Industrial Hygiene Branch

Multipurpose Building (1B), Muscle Shoals, AL 35660

State and Local Organizations

Your questions or concerns about indoor air problems can frequently be answered by the government agencies in your state or local government. Responsibilities or indoor air quality issues are usually divided among many different agencies. Calling or writing the agencies responsible for health or air quality control is the best way to start getting information from your state or local government. To obtain state agency contacts, write or call EPA s IAQ Information Clearinghouse, (800) 4384318.

CPSC REGIONAL OFFICES

Eastern Regional Center 6 World Trade Center Vesey Street, 3rd Floor Room 350 New York, NY 10048-0950 (212) 466-1612

Central Regional Center 230 South Dearborn Street Room 2944 Chicago, IL 60604-1601 (312) 353-8260

Western Regional Center 600 Harrison Street Room 245 San Francisco, CA 94107 (415) 744-2966

States in Region Connecticut, District of Columbia, Delaware, Florida, Massachusetts, Maryland, Maine, North Carolina, New Hampshire, New York, Pennsylvania, South Carolina, Rhode Island, Virginia, Vermont, West Virginia

Alabama, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Missouri, Mississippi, North Dakota, Nebraska, Ohio, South Dakota, Tennessee, Wisconsin

Alaska, Arkansas, Arizona, California, Colorado, Hawaii, Idaho, Louisiana, Montana, New Mexico, Nevada, Oklahoma, Oregon, Texas, Utah, Washington, Wyoming EPA REGIONAL OFFICES

Address inquiries to the Indoor Air Coordinators in the EPA regional offices at the following addresses:

Region 1 EPA John F. Kennedy Federal Building Boston, MA 02203 617-565-4502

Region 2 EPA (2AWM-RAD) 26 Federal Plaza New York, NY 10278 212-264-4418

Region 3 EPA 841 Chestnut Building Philadelphia, PA 19107 215-595-8322 215-597-4084 (radon)

Region 4 EPA 345 Courtland Street NE Atlanta, GA 30365 404-347-2864

Region 5 EPA AT-18L 77 W. Jackson Blvd. Chicago, IL 60604 312-353-2205

Region 6 EPA First Interstate Bank Tower 1445 Ross Avenue Dallas, TX 75202 214-655-7223

Region 7 EPA ARTX / ARBR-RAID 726 Minnesota Avenue Kansas City, KS 66101 913-551-7222

Region 8 EPA 999 18th Street, Suite 500 Denver, CO 80202-2466 303-293-1709

The following organizations have information discussed in this booklet. EPA s IAQ Information Clearinghouse, (800)438-4318, can provide the names of a variety of organizations that have information on all of the issues discussed in this publication.

American Association of Poison Control Centers 3800 Reservoir Rd., NW Washington, DC 20007

American Society of Heating, Refrigerating, and Air-Conditioning (ASHRAE) 1791 Tullie Circle NE Atlanta, GA 30329

World Health Organization Publications Center 49 Sheridan Avenue Albany, NY 12210

Your local American Lung Association (ALA) 1740 Broadway New York, NY 10019 (800) LUNG-USA

GLOSSARY

Acid aerosol Acidic liquid or solid particles that are small enough to become airborne. High concentrations of acid aerosols can be irritating to the lungs and have been associated with some respiratory diseases, such as asthma.

Animal dander Tiny scales of animal skin.

Allergen A substance capable of causing an allergic reaction because of an individual s sensitivity to that substance.

Allergic rhinitis Inflammation of the mucous membranes in the nose that is caused by an allergic reaction.

Building-related illness A discrete, identifiable disease or illness that can be traced to a specific pollutant or source within a building. (Contrast with Sick building syndrome ).

Chemical sensitization Evidence suggests that some people may develop health problems characterized by effects such as dizziness, eye and throat irritation, chest tightness, and nasal congestion that appear whenever they are exposed to certain chemicals. People may react to even trace amounts of chemicals to which they have become sensitized.

Environmental tobacco smoke Mixture of smoke from the burning end of a cigarette, pipe, or cigar and smoke exhaled by the smoker (also secondhand smoke or passive smoking).

Fungi Any of a group of parasitic lower plants that lack chlorophyll, including molds and mildews.

Humidifier fever A respiratory illness caused by exposure to toxins from microorganisms found in wet or moist areas in humidifiers and air conditioners. Also called air conditioner or ventilation fever.

Hypersensitivity pneumonitis A group of respiratory diseases that cause inflammation of the lung (specifically granulomatous cells). Most forms of hypersensitivity pneumon-itis are caused by the inhalation of organic dusts, including molds.

Organic compounds Chemicals that contain carbon. Volatile organic compounds vaporize at room temperature and pressure. They are found in many indoor sources, including many common household products and building materials.

Picocurie A unit for measuring radioactivity, often expressed as picocuries per liter of air.

Pressed wood products A group of materials used in building and furniture construction that are made from wood veneers, particles, or fibers bonded together with an adhesive under heat and pressure.

Radon and radon decay products Radon is a radioactive gas formed in the decay of uranium. The radon decay products (also called radon daughters or progeny) can be breathed into the lung where they continue to release radiation as they further decay.

Sick building syndrome Term that refers to a set of symptoms that affect some number of building occupants during the time they spend in the building and diminish or go away during periods when they leave the building. Cannot be traced to specific pollutants or sources within the building. (Contrast with Building related illness ).

Ventilation rate The rate at which indoor air enters and leaves a building. Expressed in one of two ways: the number of changes of outdoor air per unit of time (air changes per hour, or ach ) or the rate at which a volume of outdoor air enters per unit of time (cubic feet per minute, or cfm )