Sick Building Syndrome

Although you may not be able to see, smell, or feel the molecules of dirty air infiltrating your lungs and body, sick buildings harbor dangerous pathogens that you are inhaling with every breath and clinging to the largest organ on your body - your skin. If you have MCS or "multiple chemical sensitivities", you may be able to smell toxins and also manifest allergic reactions to toxins, viral particles, and fungal mold spores that spew forth from the air ducts (heat and air conditioning) of a sick building.

The term "Sick Building Syndrome" (SBS) is used to describe cases in which building occupants experience acute health and comfort effects that appear to be linked to time spent in a building, but where no specific illness or cause can be identified. Relief from symptoms occurs soon after leaving the building. The complaints may be localized in a particular room or zone, or may be widespread throughout the building. In contrast, the term "building related illness" (BRI) is used when symptoms of diagnosable illness are identified and can be attributed directly to airborne building contaminants.

A 1984 World Health Organization Committee report suggested that up to 30% of new and remodeled buildings worldwide may be the subject of excessive complaints related to indoor air quality. This condition is often temporary, but some buildings have long-term problems. Problems often result when a building is used or maintained in a manner not originally intended. Sometimes indoor air problems are also a result of poor building design or occupant activities.

ndicators of Sick Building Syndrome include:

• headache; eye, nose, or throat irritation; nosebleeds, dry cough; burning in trachea, sore throat, dry or itchy skin; dizziness and nausea; heart palpitations, shortness of breath and/or exhaustion after normal activity, muscle cramps and joint pain, tremors, swelling of the legs, trunk and ankles, difficulty in concentrating; chronic fatigue; sensitivity to odors, pregnancy problems (including miscarriages), and cancer

• Relief soon after leaving the building.

• The following have been cited causes of or contributing factors to sick building syndrome. These elements may act in combination, and may be in addition to other complaints such as inadequate temperature, humidity, or lighting. Even after a building investigation, however, the specific causes of the complaints may remain unknown.
  Inadequate ventilation: In the early and mid 1900's, building ventilation standards called for approximately 15 cubic feet per minute (cfm) of outside air for each building occupant. As a result of the 1973 oil embargo, however, national energy conservation measures called for a reduction in the amount of outdoor air provided for ventilation to 5 cfm per occupant. In many cases these reduced outdoor air ventilation rates were found to be inadequate to maintain the health and comfort of building occupants. Inadequate ventilation, which may also occur if heating, ventilating, and air conditioning (HVAC) systems do not effectively distribute air to people in the building, is thought to be an important factor in SBS. In an effort to achieve acceptable IAQ while minimizing energy consumption, the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) recently revised its ventilation standard to provide a minimum of 15 cfm of outdoor air per person (20 cfm/person in office spaces). Up to 60 cfm/person may be required in some spaces (such as smoking lounges) depending on the activities that normally occur in that space (see ASHRAE Standard 62-1989).
  
   
• Chemical contaminants from indoor sources: Most indoor air pollution comes from sources inside the building. For example, adhesives, carpeting, upholstery, manufactured wood products, copy machines, pesticides, and cleaning agents may emit volatile organic compounds (VOCs), including formaldehyde. Environmental tobacco smoke contributes high levels of VOCs, and other toxic compounds. Research shows that some VOCs can cause chronic and acute health effects at high concentrations, and some are known carcinogens. Low to moderate levels of multiple VOCs may also produce acute reactions. Combustion products such as carbon monoxide, nitrogen dioxide, as well as other inhaled particles, can come from unvented kerosene and gas space heaters, woodstoves, fireplaces and gas stoves.
  
   
• Chemical contaminants from outdoor sources The outdoor air that enters a building can be a source of indoor air pollution. For example, pollutants from motor vehicle exhausts; plumbing vents, and building exhausts (e.g., bathrooms and kitchens) can enter the building through poorly located air intake vents, windows, and other openings. In addition, combustion products can enter a building from a nearby garage.
  
   
• Biological contaminants Bacteria, molds, pollen, and viruses are types of biological contaminants. These contaminants may breed in stagnant water that has accumulated in ducts, humidifiers and drain pans, or where water has collected on ceiling tiles, carpeting, or insulation. Sometimes insects or bird droppings can be a source of biological contaminants. Physical symptoms related to biological contamination include cough, chest tightness, fever, chills, muscle aches, and allergic responses such as mucous membrane irritation and upper respiratory congestion. One indoor bacterium, Legionella, has caused both Legionnaire's Disease and Pontiac Fever.
  
  
   
• About Asbestos and Radon SBS and BRI are associated with acute or immediate health problems; radon and asbestos cause long-term diseases which occur years after exposure, and are therefore not considered to be among the causes of sick buildings. This is not to say that the latter are not serious health risks; both should be included in any comprehensive evaluation of a building's IAQ.
   

Toxic Mold

Within the last two decades, there has been significant recognition on the part of government agencies, communities, families, and individuals regarding the dangers associated with damp, moist, and wet indoor environments. At one time it was thought that bacteria or viruses were responsible for many of the health problems within buildings. Today, many home and workplace-related ailments are now being properly attributed wholly or, in part, to fungi and mold. As science and medicine continue to expand our knowledge of the effects of toxic mold, individuals are becoming much more aware of indoor air quality issues. For example, only relatively recently have individuals and families had enough education on the effects of mold to begin making cases for mold contamination.

The term �Toxic Mold� refers to the estimated 50 - l00 common indoor mold types have the potential for creating health problems including sinusitis, allergies, asthma and other respiratory ailments, and infections. Spores and microscopic fragments of mold growth are a natural component of both outdoor and indoor air. However, when molds germinate and grow, they can produce and release large amounts of spores through the air that then land on moist, organic materials. It is the elevated levels of mold spores in indoor living or working environments may increase the risk of adverse health effects. It is also believed that molds play a major role in cases of Sick Building Syndrome. Toxic mold has been found in homes, hospitals, schools, and office buildings.

Molds are microscopic fungi that need plant and animal matter in order to grow. These thinly spun threaded organisms produce spores that then allow them to spread themselves to different locations. Spores can be spread in the air, through water, or even among insects. Mold thrives and reproduces in damp, moist, or wet surroundings, frequently in areas where humans exist. When such conditions are present, mold is able to grow on such diverse materials as wood, carpet, insulation, cloth, and all types of food. The factors that determine the rate of this growth include amount of moisture, type of food or organic material, and the temperature.

Humans often come in contact with molds in moist areas in or around their homes or when mold spores become airborne. These airborne mold spores can come into contact with humans either through the skin or when ingested. Molds are determined to be �toxic� if they can adversely affect the health of humans. The effect on humans depends on the type of mold(s) involved, the metabolic byproduct of the mold, the amount of contact and length of exposure, as well as the level of susceptibility of the human victim. This last factor is important for children who can be affected much more easily than adults.

Mycotoxins
While they are growing, some molds produce chemicals that discourage growth of other microorganisms and may also cause health problems in people or animals. These chemicals are called mycotoxins. Mycotoxins tend to concentrate in fungal spores, and thus present a potential hazard to those who inhale these airborne spores. Molds that are capable of generating toxins (called "toxigenic mold"), however, do not always produce them in every situation. Scientists believe that certain very specific conditions must be present for a toxigenic mold to actually produce toxins, such as the right combination of temperature, moisture, type of material the mold is growing on and, perhaps, competition from other microorganisms. Dangerous mold species include Stachybotrys atra, Aspergillus versicolor, and several toxigenic species of Penicillium.

Stachybotrys chartarum
(aka Stachybotrys atra)
This is one of many types of black mold that may grow on water-damaged building materials. This mold requires a lot of water or moisture to grow, so finding it indoors indicates some significant moisture accumulation problems. It only grows on materials with high fiber and low nitrogen content, such as paper (including wallpaper and the paper covering of gypsum wallboard), wood or jute (frequently used for the backing of older carpets). This mold does not grow on shower tile or plastic. In the outdoor environment it is found in soil, rotting hay and leaf debris. This mold, among others, may produce mycotoxins.

Adverse Health Effects of Toxic Molds
While it is difficult to predict how exposure to multiple toxigenic molds can affect an individual (they can synergize the effects, for example), and to what degree, some of the most common types of adverse health effects resulting from mycotoxin exposure are as follows:
 

• Respiratory problems
  (including wheezing, shortness of breath, dry/hacking cough, respiratory distress, lung disease and bleeding from the lungs)
   

• Central nervous system problems
  (constant headaches, loss of memory, tremors, lack of coordination and depression)
   

• Digestive problems
  (including diarrhea, vomiting, intestinal hemorrhage, liver effects--such as necrosis and fibrosis)
   

• Reproductive problems
  (including infertility and changes in reproductive cycles)
   

• Vascular system problems
  (including increased vascular fragility and possibility of hemorrhaging into body tissues)
   

• Urinary system problems
   

• Nasal and sinus congestion
   

• Eyes-burning, watery, reddened, blurry vision, light sensitivity
   

• Nose and throat irritation
   

• Chronic fatigue
   

• Skin irritation (including rashes, burning sensations, and sloughing of skin)
   

• Aches and pains
   

• Immune system changes and suppression

• Fever

Unfortunately, not all types or species of molds have been tested for the presence of mycotoxins. The production of toxins varies according to the type of mold, the substrate on which it grows, and seasons of the year.


Testing for Mycotoxins
There are no laboratory tests of blood, urine or other body components that can determine if a person has been exposed to mycotoxins. Blood can be tested for antibodies to some specific types of fungi. However these tests only determine if a person who has become allergic to fungi has been exposed recently to that specific type of fungus. Allergy tests cannot determine if a person has been exposed to fungal toxins.