When Buildings Go Bad

By Jessica DuLong

Laments that were once written off as fabrications of discontented, hypochondriac employees have since proven to indicate a real and burgeoning health problem.

When staffers at the Developmental Evaluation Center in Raleigh, N.C. showed up for work in jeans earlier this month, they weren't preparing for a company picnic. Instead, the 30 state employees came to pack up crucial files and move out of a building that seemed to be making them sick.

A small, tight-knit office, the center's psychologists, therapists, social workers and teachers had talked during the previous few weeks about the odd ailments — tingling in the face, hands and feet, memory loss and vertigo — that were plaguing them. But, the cause of their symptoms was hard to pin down.

It was not until one co-worker went to the hospital suffering severe neurological symptoms that the staff began to realize just how serious their complaints might be.

Nearly half of the staff has gotten sick. And still today, doctors and environmental investigators don't know why.

The World Health Organization (WHO) estimates that one of every three workers toils in a workplace that makes them sick. Depending upon the cause and severity of the symptoms, the phenomenon has two names — sick building syndrome (SBS) or building related illness (BRI).

The term sick building syndrome, according to the Environmental Protection Agency (EPA), is used to describe cases where people report symptoms that seem to be linked with time spent in a building, yet can't be traced to one cause. Building related illness, on the other hand, describes cases where symptoms of diagnosable illness are identified and the contaminants are traced to the building.

Whatever the name, sick building complaints have harried companies since the seventies. But today, times have changed. Laments that were once written off as fabrications of discontented, hypochondriac employees have since proven to indicate a real and burgeoning health problem.

The first sign of trouble came in July of 1976 when a mysterious lung ailment struck during an American Legion convention in Philadelphia. The infection, now known as Legionnaires' Disease, killed 29 people and made more than 150 others ill.

Eventually, the disease was traced to a bacterium in the air-conditioning system. Yet, even with the clear cause and the deadly results, BRI continued to be seen as an unfortunate, but rare, occurrence.

In the face of new research and ongoing outbreaks of SBS and BRI during the last 20 years, medical experts, government agencies and workers have come to seriously reconsider the links between health and the workplace.

The problem with understanding SBS, according to Douglas Benner, M.D., Coordinator of Occupational Health at Kaiser Permanente in Northern California, is that the symptoms are often hard to pin down.

"It's a systemic reaction," Dr. Benner says. "Some people get dizzy when they're under stress, some people vomit with a certain smell. Some of the symptoms — dizziness, fatigue and numbness — can be due to many, many things."

The most common symptoms of SBS, according to the EPA, are headaches, irritation of the nose, mouth, eyes or throat, a dry cough, dry or itchy skin, dizziness, nausea, difficulty concentrating, fatigue and sensitivity to odors.

Because these complaints are quite common, and can arise for any number of reasons, people with SBS may not realize for some time that their problems are building related. To further complicate matters, differences in individual sensitivity levels make it difficult to trace the cause of such complaints.

People exposed to the same contaminants react differently, Dr. Benner explains. This "human variety in sensitivity" means that different people react at different levels, so standardizing safety can be a challenge.

But the good news, says Dr. Benner, is that in most cases, SBS rarely causes long-term damage.

Though that news should be reassuring for the staffers in Raleigh, it's not. Their situation just doesn't seem to fit the bill of "most cases."

While Dr. Benner and the EPA cite the most common signs of SBS as respiratory symptoms, employees in Raleigh have suffered neurological symptoms instead. The experts have yet to determine if exposure to whatever is making the workers sick has the potential to cause long-term damage, or if this case is the first of a new, more dangerous BRI.

"People are really worried," says Marcia Mandel, senior psychologist at the center. "We are worried about our friends and colleagues, and about ourselves — about what the effects might be."

The hardest part is not knowing. "They've told us they really don't know what they're looking for," says Mandel. "The folks at the EPA gave us information regarding research on neurotoxins and medication treatment. But, we don't know what it is, so we don't know what to do."

Since last Wednesday, the mood among the center employees has gone up and down. Mandel says that many have asked the question: "What if you don't find anything?" And so far, there's been no answer.

According to Dr. Benner, tracking down the cause of people's symptoms doesn't happen instantaneously. "Think of it as lab work for a patient," he says. "There's a panel of things — tests for the usual suspects. There's a particular way to collect specimens and to know what tests to do."

In the meantime, Mandel hopes that spreading the word about the situation at the center will help heighten public awareness to the problems of SBS and BRI. "Maybe now people will start taking this seriously," she says.

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