Sick Building Syndrome: Breathing in Design Flaws

Introduction

We usually have an instinct for telling when a building is an “unpleasant” or “noisy” space because of its built environment. We often attribute our discomfort to our own personal health conditions, stress, and the side effects of being indoors. The pattern of symptoms experienced by a group of people who work or live together may indicate that the problem lies not in the individuals but in the building.

Sick Building Syndrome is a term many people use to describe this type of pattern. Sick Building Syndrome should not be viewed as a distinct disease; instead, it represents a broad view of an indoor environment’s failure to support our health and comfort. Air Quality is at the heart of Sick Building Syndrome. Air quality, while invisible to us, has been proven to affect how we feel and behave, depending on how well a building is designed, who uses it, and how well it is maintained.

What Is Sick Building Syndrome?

There is a pattern of recurring illness or discomfort among people working and living in buildings, known as Sick Building Syndrome (SBS). Unlike an illness related to a building, SBS does not point to a single, clearly identifiable cause or medical diagnosis.

There are several common symptoms associated with SBS, including headaches, dizziness, fatigue, difficulty concentrating, eye, nose, and throat irritation, and skin discomfort. Significantly, these symptoms do not affect each person in the same way. What connects SBS cases is that they all involve a relationship with the building's indoor environment. The concept of SBS is less about determining the medical cause of these illnesses and more about understanding the environmental factors in indoor environments that make buildings unhealthy or uncomfortable over time.

Air Quality as the Central Thread

Multiple environmental factors impact Sick Building Syndrome, though indoor air quality is often a dominant factor. The air inside a building is shaped by multiple sources, pathways, and conditions that contribute to the accumulation or retention of pollutants.

Factors that contribute heavily to indoor air quality are:

• Inadequate ventilation: When buildings do not have sufficient fresh air exchange to dilute and remove indoor pollutants

• Volatile Organic Compounds (VOCs): Indoor air contamination from paints, varnishes, adhesives, furniture, and cleaning products

• Particulate Matter (PM): The tiny particles (PM_2.5 and PM₁₀) are a mix of outdoors vehicle emissions, indoor activities, and settled dust that is disturbed

• Carbon Dioxide (CO₂): Is often used as a proxy indicator for ventilation effectiveness rather than a pollutant itself.

• Temperature and Humidity: These parameters can impact both occupant comfort and the manner in which chemicals react with each other in indoor air

All of these factors are rarely found alone; therefore, over time, their interactions can lead to an indoor air quality issue that might seem "normal" to an occupant but actually negatively affects their well-being.

How Design and Use Shape Indoor Air

Many people think that air quality is mainly an engineering problem that gets resolved when the architect finishes the building, which is not true. Design choices directly affect how air behaves within a structure.

In addition, sealed building envelopes, deep building floor plates, narrow corridors, or high-occupant density will restrict "free" airflow and increase reliance on HVAC. As human occupancy levels change, some buildings are now used for more than one purpose (home/office), and many more are used well beyond their intended capacity. When this happens, the assumptions underlying a building's ventilation are often no longer valid.

In addition to the structure's design, the materials used to construct the building are equally important. The materials and furnishings of a building will continue to emit pollutants long after construction is complete. If the building lacks adequate ventilation or insufficient time for managing emissions, the emissions will persist and grow, contributing to discomfort in the indoor environment.

In general, Sick Building Syndrome is not the result of a single design flaw; rather, it stems from a disconnect between the design goals, how the building is occupied, and how it will be operated in the long term.

Indoor–Outdoor Air Interactions

While buildings do have some control over how much outside air enters through their ventilation systems, windows, doors, or pressure differentials, they also allow the transfer of pollutants from outside to inside. When buildings are located in areas subject to traffic emissions, industrial activities, construction dust, or diesel generator emissions, pollutants can accumulate inside the building over time.

Different building types experience these interactions differently:

• Homes can confine pollutants due to limited ventilation and prolonged occupancy

• Schools expose children to sustained indoor air conditions during critical developmental periods.

• Offices combine long exposure durations with high occupant density.

• Hospitals house vulnerable populations that are sensitive to even low levels of pollutants.

In each case, indoor air quality reflects not only internal sources but also the broader environmental context in which the building exists.

Exposure, Inequality, and Lived Experience

A significant component of Sick Building Syndrome is that while concentration can contribute to SBS, prolonged moderate levels of pollutants outside a given time frame may pose a greater risk of SBS development and severity than short-term elevated concentration exposures. As such, spaces with prolonged exposure to pollutants (Schools, homes & workplaces) are particularly vulnerable to the development of Sick Building Syndrome.

In addition to this concept of duration, the distribution of exposures within buildings is also unequal; many low-income areas, informal workspaces, and overcrowded housing environments experience significant amounts of indoor pollution accumulation as a direct result of their inability to obtain adequate amounts of fresh air to manage the level of indoor pollutants generated within such buildings.

Additionally, people in these types of building environments are typically subject to social and planning inequities that contribute to higher levels of indoor pollutants in those buildings (e.g., low-income areas, informal workspaces, and overcrowded housing). Therefore, it is of particular relevance to recognize that the effects associated with Sick Building Syndrome are the result of not just environmental conditions like poor ventilation and overcrowding, but, are also resulted within a nexus of socio-economic limitations that limit the individual's capacity for selection and ability to avoid living and/or working within unhealthy building environments through proper selection of housing or work environments.

In recognition of these interrelated realities, efforts to mitigate the impact of Sick Building Syndrome should account for these multiple perspectives and interrelated aspects associated with the design, location, and accessibility of indoor environments.

Conclusion: From Sick Buildings to Healthier Spaces

Although Sick Building Syndrome is a result of modern society, the actual cause lies in how we build and operate our buildings and how we think about the air inside them. By viewing air as an active participant in our indoor environment rather than an afterthought, we can begin working together as designers, operators, and occupants to improve it. Through careful planning, realistic assumptions about how our buildings will be used, continuous monitoring, and education about air quality, we will see our buildings move from passive containers for human beings to active contributors to the overall health of every human being who uses them. The places we create shape how we feel, how we operate, and how we live.

A Collective Responsibility

In this modern age, air quality is everyone's responsibility. Each action we take can contribute to a healthier planet. Planting trees, choosing public transportation, or supporting local clean air initiatives can make a difference. Awareness is the first step toward change.

Join us in advocating for cleaner air. Together, we can help nature regain its voice.

Let’s work together to ensure our world thrives in harmony with nature.