Building-Related Sickness - Causes, Effects, and Ways To Avoid It

TECHNICAL NOTE TN 2/2002
Building-related Sickness
Causes, effects, and ways to avoid it
Edited by Anu Palmer and Rosie Rawlings
ACKNOWLEDGEMENTS
BSRIA would like to thank the following sponsors for their

contribution which has led to the production of this Technical Note.
The former Department of Transport, Local Government

and the Regions
British Gas Properties

Graham Powell Consultants
Land Security Properties Ltd
Lloyds Register of Shipping
London Stock Exchange
NatWest Group
Price Waterhouse
Royal Bank of Scotland Plc
This publication is an update of the BSRIA publication Sick Building

Syndrome TN4/88. Further information was sourced from the BSRIA
report Implementing HSE SBS Guidelines, 79110/1, issued in
November 2000.
Dr Anu Palmer, Dr Rosie Rawlings, Nigel Potter and William Booth

contributed from BSRIA. The publication was edited and produced by
the Publishing and Information section at BSRIA.
This publication has been produced by BSRIA as part of a contract

placed by the former Department of Transport, Local Government and
the Regions. The contract was let under the Partners In Innovation
programme, which provides part-funding of collaborative research.
Any views expressed in it are not necessarily those of the Department.
The authors have sought to incorporate the views in the previously

published reports, but final editorial control of this document rests
with BSRIA.
All rights reserved. No part of this publication may be reproduced, stored in a

retrieval system, or transmitted in any form or by any means electronic or
mechanical including photocopying, recording or otherwise without prior written
permission of the publisher.
©
BSRIA TN 2/2002 June 2002 ISBN 0 86022 581 X Printed by The Chameleon Press Ltd
BUILDING-RELATED SICKNESS 1
©BSRIA TN 2/2002
CONTENTS
1 INTRODUCTION 3
2 DEFINITION AND SYMPTOMS 5
3 SIGNIFICANT PARAMETERS 7
4 HEALTHY BUILDING ISSUES 8

4.1 Thermal comfort 8
4.2 Ventilation 11
4.3 Relative humidity 13
4.4 Lighting 14
4.5 Noise and vibration 18
4.6 Negative ions 20
4.7 Micro-organisms 21
4.8 Respirable particulates and filtration 23
4.9 Volatile organic compounds 25
4.10 Gaseous contaminants 27
4.11 Tedious work schedules 30
4.12 Occupant controls 30
4.13 Stress 31
4.14 Response to complaints 31
4.15 Productivity 32
5 PROTOCOLS AND CHECKLISTS 33
6 GLOSSARY OF TERMS AND ABBREVIATIONS 37
7 REFERENCES 39
FIGURES AND TABLES
Figure 1 Effect of clothing on sedentary comfort (from BSRIA TN 4/88) 10

Table 1 Standard service illuminance for various activities/
interiors (from CIBSE Guide A) 15
Table 2 Recommended noise levels (from CIBSE Guide A) 18
Table 3 Typical ion concentrations for different outdoor
environments 20
Table 4 Eurovent filter grades 24
Table 5 Filter applications 25
Table 6 Gaseous pollutants in indoor air (adapted from WHO) 27
Table 7 Some by-products of tobacco smoke and their
occupational exposure limits 28
Table 8 Checklist for physical and air quality parameters 34
Table 9 Checklist for psychosocial factors 36
2 BUILDING-RELATED SICKNESS
©BSRIA TN 2/2002
INTRODUCTION
INTRODUCTION 1
1.1 INTRODUCTION This publication is an update of BSRIA Technical Note TN 4/88 Sick
Building Syndrome, which deals with the significant parameters,
symptoms and ways to alleviate building-related sickness.
The phenomenon of building-related sickness (once known as sick

building syndrome) has been reported since the early 1980s. It was
recognised by the World Health Organisation in 1986. It results from a
combination of physical, air quality and psychosocial parameters and
leads to a decline of the well-being of occupants. The symptoms are
interrelated, with sensory irritation often being one of the dominating
complaints. It has been estimated that up to 30% of refurbished
buildings and an unknown but significant numbers of new buildings
may cause symptoms related to building-related sickness. While the
actual number of cases is unknown, it can be concluded from the
existing studies that the problem is widespread.
One of the changes over the past decade or so has been the
development of health-related legislation. At the time of the previous
report the Health and Safety at Work Act 1974 was in place in the UK,
emphasising accident prevention. In contrast, the more recent work-
related health regulations, which are made under the 1974 act and
implement EC directives, take a different approach through
arrangements following an incident and stricter control. The new
legislation highlights the design of new buildings, changes for existing
buildings and occupant behaviour.
The Management of Health and Safety at Work Regulations 1992 came into
effect on 1 January 1993. They were revoked by the 1999 Regulations,
which came into effect on 29 December 1999. These regulations
implement the EC Directive 89/391, setting a requirement on all
employers to carry out a risk assessment, which must be reviewed if
necessary. The significant findings of the assessment must be recorded if
there are five or more employees. Following the risk assessment,
effective planning, organisation, control and review of measures and
appropriate health surveillance must be provided. Employers must
consider the possibility of building-related sickness an issue that should
be subject to risk assessment.
The Workplace (Health, Safety and Welfare) Regulations 1992, which

implement most provisions of the EC Directive 89/654, came into effect
on 1 January 1993 to apply to new buildings. On 1 January 1996 the
Regulations were modified to apply to all work places in existence.
Currently a civil claim on the basis of a breach of the regulations cannot
be made, with the specific exception of young persons and expectant
mothers.
At present a revision is under consultation to allow civil claims to rely

on the breach of the regulations. The regulations apply to building-
related sickness in a number of ways: the workplace should be
maintained in an efficient state; suitable and sufficient ventilation as well
©BSRIA TN 2/2002
1 INTRODUCTION
as lighting must be provided; and restrooms and rest areas must include
suitable arrangements to protect non-smokers from discomfort caused
by tobacco smoke (passive smoking).
In addition to the existing legislation, the Approved Code of Practice on

Smoking in the Workplace (AcoP) is under development. It follows an
example from California, where smoking is not permitted in public
areas, and other states in the US where similar actions are being
planned.
The Code will have a significant effect on pubs, restaurants, nightclubs

and cafes. While most employers have already banned or seriously
restricted smoking in offices, if the employers fail to provide a healthy
(smoke-free) working environment they can be sued if the health of
their staff deteriorates.
In 1995 the Health and Safety Executive (HSE) issued official

guidance: How to Deal with SBS – Guidance for Employers, Building
Owners and Building Managers1. The guidance was implemented in two
office buildings, which BSRIA monitored very closely. The purpose of
the monitoring was to evaluate the practical application of the
guidance by two building owner/operators. The results entitled
Demonstration Exercise Implementing HSE SBS Guidelines2 were
published in 2000.
This report has identified the parameters most likely to play a role in
building-related sickness. It also provides a discussion and guidelines
on good practice for all significant aspects of building-related sickness.
This is followed by a checklist that addresses the adequacy of the
working environment based on a good engineering, maintenance and
management practice.
Dr Anu Palmer and Dr Rosie Rawlings

BSRIA, June 2002
©BSRIA TN 2/2002
2 DEFINITION AND SYMPTOMS 2
2.1 DEFINITION AND The term problem building in relation to this publication can be used
SYMPTOMS to describe any building in which occupants are dissatisfied with their
indoor environmental conditions. The term building-related sickness
should be restricted to multi-factorial problems, where no single
factor exceeds the limits of generally accepted recommendations or
thresholds.
There have been a number of studies in the UK of building-related

sickness. The work, which covered a range of building types,
concluded that the problem is widespread. However, BSRIA does not
have information on the prevalence of symptoms in well-designed and
maintained buildings, which means that the proportion of sick
buildings within the problem building group cannot be evaluated.
It has been estimated that up to 30% of refurbished buildings, and an

unknown but significant number of new buildings, may harbour
symptoms of building-related sickness3. According to the World
Health Organization (WHO), 25-30% of office personnel complain of
building-related sickness symptoms4. The symptoms occur during
working hours and diminish when people leave the building for
weekends or holidays5.
It has been postulated that symptoms are more likely to occur in air-
conditioned buildings than in naturally ventilated buildings3,6 and are
related to the type of work and psychosocial aspects6. A number of
risk factors have been identified:7,8
● a large number of workers per room

● a lack of environmental control (temperature, outdoor air supply)
● mechanical cooling
● humidification
● re-circulation of air
● rotary heat exchangers
● photocopiers and printers close to workstations
● paper and visual display unit work
● carpets and other fleecy materials
● allergen hyper-sensitivity (such as paints, chemicals and other
materials)
● female gender
● low job category
● unfavourable psychosocial factors.
The symptoms are interrelated but can be divided into five groups:1,3,5
● sensory irritation of eyes, nose and throat, in the form of dryness,

pain, stinging sensations, hoarseness, changes in voice and sounds
from respiratory systems
● skin irritation such as blushing, pain, stinging or itching sensations
● neurotoxic symptoms in the form of headache, nausea, drowsiness,
tiredness, lethargy, reduced mental capacities, fatigue
©BSRIA TN 2/2002
2 DEFINITION AND SYMPTOMS
● unspecified hyperactivity reactions, such as runny eyes, runny

nose, asthma-like symptoms among non-asthmatic persons
● odour or taste sense, particularly changes in odour
or taste and unpleasant odour or taste.
A building deemed to be sick has either some or all of the above

complaints, with sensory irritation being one of the dominating
complaints. Indoor air quality and pollution are the most important
environmental factors9. When compared to other personal and
occupational factors, use of computer screens is the most significant
correlating factor in building-related sickness. Systemic symptoms, for
example from lower airways or stomach, should not be dominant.
©BSRIA TN 2/2002
SIGNIFICANT PARAMETERS 3
3.1 SIGNIFICANT The important objective is to identify those parameters that can cause
PARAMETERS discomfort, distress or even acute ailments broadly associated with the
symptoms related to building-related sickness. This report, however,
does not deal with specific diseases caused by legionella-type bacteria,
potable water contamination or specific air contaminants entering
buildings from, for example, nearby factories and exhaust fumes.
The parameters believed to be involved in the symptoms can be

divided into the following groups.
Physical and indoor air quality parameters are:
● temperature and air velocity

● fresh air ventilation rates
● relative humidity
● lighting
● noise
● negative ions
● micro-organisms and biocides
● respirable particulates
● volatile organic compounds
● gaseous pollutants.
Psychosocial parameters are:
● tedious work schedules

● control of local environment by occupants
● stress
● identity and role factors such as job satisfaction, role, conflict and
poor social relations
● response to complaints.
There are some direct links with fairly major individual faults
associated with building services. One of these is the role of high
temperatures in cases of chest tightness, headache, lethargy, ocular and
nasal complaints. Another example is inappropriate lighting resulting
in ocular or headache complaints.
In building-related sickness, the combined effect of several elements

exceeds the sum of their individual effects. This is not the case when
problems are related to reasons other than building-related sickness. It
is fairly apparent that thermal comfort and lighting are significant
factors but they should not be treated in isolation.
The fact that low ventilation rates can cause many of the symptoms
should also be addressed. As research has not highlighted specific causes,
the approach taken has been to address all the aspects listed above in
the following section.
©BSRIA TN 2/2002
4 HEALTHY BUILDING ISSUES
4.1 THERMAL COMFORT There is strong evidence from research of a correlation between
temperatures of 23ºC and above and the prevalence of symptoms of
building-related sickness. This occurs principally during the heating
season. High temperatures influence the perception of indoor air
quality10,11. Stuffiness, which correlates with overall warmth, is a
common complaint associated with building-related sickness. Cool
environments are regarded as fresh with no correlation to normal
room air velocities (in other words less than 0䡠35 m/s). While there is a
quantitative link between freshness and stuffiness with temperature,
there is no quantifiable link because air quality within the
environment will affect the overall sensation.
As temperature is one of the few parameters which bears a significant

correlation to the symptoms, particular emphasis should be attached to
it. For open-plan offices the recommended winter and summer
temperatures for a relative humidity of 50% are 21-23ºC and 22-24ºC,
respectively12. In this case specific relative activity and clothing levels
are assumed. Simultaneous heating and cooling should be avoided
unless close control of humidification is necessary and can be
provided13.
The commonly used dry-bulb air temperature is not the only

parameter involved in the assessment of thermal comfort. Hence it is
appropriate to reiterate the concepts adopted for assessing the
acceptability of a given environment in terms of thermal comfort
criteria.
The effective draught temperature (θ) is used to define difference in

temperature between any point in the occupied zone and the control
condition. The equation is14:
θ = (tx-tc) – 8 (vx-0䡠15)
where:
θ = effective draught temperature (K)

tx = local air stream dry-bulb temperature (°C)
tc = average (control) room dry-bulb temperature (°C)
vx = local air stream centreline velocity (m/s)
In order to assess the performance of any ventilation system, various

criteria representative of the human perception of comfort can be
applied to measurements of the magnitude of air velocity and air
temperature at representative locations throughout the occupied zone
of a room.
It is generally accepted that a high percentage of people are

comfortable in sedentary (office) occupations, where the effective
draught temperature is between –1䡠5 and +1 K and the air velocity is
less than 0䡠35 m/s. The air diffusion performance index (ADPI) is
defined as the percentage of the locations which meet these criteria.
©BSRIA TN 2/2002
HEALTHY BUILDING ISSUES 4
The ADPI and the average room temperature are used as the comfort
criteria in a mechanically ventilated space. It should be noted that the
ADPI reflects how uniform conditions are within the occupied space.
An APDI value of significantly less than 70% indicates poor
uniformity in conditions and that of more than 70% indicates
acceptable uniformity in conditions.
In addition to considerations of local air velocity, the average room

temperature should be appropriate for the dress, age and activity level
of the occupants. Other parameters such as relative humidity, head-to-
ankle temperature gradients and mean radiant temperature can be
included in studies of comfort conditions.
The predicted mean vote (PMV) and the predicted percentage of

dissatisfied (PPD) indices defined in EN ISO 7730-199415 specify
acceptable conditions for thermal comfort. Calculating the PMV
index can assess the thermal sensation for the human body. This is
derived from measurements or predictions of the dry bulb
temperature, relative humidity, asymmetric radiant temperature and air
velocity at a particular location.
For a given activity level of the occupant and the degree of clothing,
all of these parameters can be used to calculate the expected predicted
mean vote of an occupant, in other words a standard person in thermal
harmony with his or her environment would score zero.
A seven-point thermal sensation scale is used in the ASHRAE

Fundamentals to describe the relative thermal sensation experienced by
people:
● +3 hot
● +2 warm
● +1 slightly warm
● 0 neutral
● -1 slightly cool
● -2 cool
● -3 cold
The PMV index predicts the mean value of the thermal votes of a
large number of people exposed to the same environment. Individual
votes are scattered around this mean value and it is useful to predict
the number of people likely to feel too warm or too cool for a
particular environment. Thus the PPD, obtained from the PMV index,
provides information on the thermal comfort or thermal
dissatisfaction of people.
It should be noted that even with perfect conditions, a PPD value

lower than 5% cannot be achieved for similarly clothed people in the
same activity. The location of any zones of particularly high and low
predicted dissatisfaction can be deduced from PPD indices.
©BSRIA TN 2/2002
4 HEALTHY 6
BUILDING ISSUES 6
The optimum thermal comfort for sedentary occupants experiencing a

range of air velocities and clothing factors is shown as an example in
Figure 1. Different activity levels and humidity would provide a
different set of curves, as would the effect of mean radiant
temperatures.
Figure 1: The effect of clothing on

sedentary comfort (reproduced from
TN 4/8816).
There are three prime cases of symmetric radiation, which also cause
discomfort:
● local cooling: radiation exchange with adjacent cold surfaces,

such as single-glazed windows
● local heating: radiation exchange with adjacent hot surfaces, such
as heated ceilings
● incoming shortwave radiation, such as solar radiation through
glazing.
As with any quantity such as velocity, temperature, PMV and PPD,

caution should be exercised when considering the mean values in a
zone. Attention should be paid to values at individual occupied spaces.
There is evidence that changes in the indoor temperature during the

working day may be beneficial because the body’s metabolic rate rises
during the day17. Warmer air temperatures in the morning and cooler air
temperatures in the afternoon may be an effective way to reduce some
of the discomfort.
©BSRIA TN 2/2002
For most thermal parameters it has been possible to establish

psychophysical relationships between the intensity of the parameter
and a predicted percentage of people finding the conditions
unacceptable18. People may be dissatisfied due to general thermal
comfort (PMV, operative temperature) and/or dissatisfied due to local
thermal discomfort parameters (radiant temperature asymmetry,
draught, vertical air temperature difference, floor surface temperature).
At the moment there is no method for combining the percentages of

dissatisfied people to give an accurate prediction of the total number
of people finding the environment unacceptable. For example, it is not
known if the dissatisfaction resulting from general thermal discomfort
is additive with the percentages of those who are dissatisfied due to
local discomforts, or whether the total dissatisfied may be less than the
sum of the individual percentages (ie some people complaining about
more than one particular problem simultaneously). In ASHRAE
Standard 55 the approach has been to specify criteria corresponding to
10% dissatisfaction with general thermal comfort, to which a net
increase of another 10% dissatisfied due to local discomforts has been
added. This method brings the total level of thermal acceptability
down to 80%.
The EN ISO 7730-19945 standard is currently under revision and if

accepted, it will be published in 200318. Among the new developments
are recommendations for acceptable thermal environments to be
specified as classes, allowing for differences in national requirements
and for building designs to have different quality levels. This will
require and encourage better dialogue between the client and the
designer. The standard will be based on requirements for general
thermal comfort and local thermal discomforts.
4.2 VENTILATION Fresh air ventilation rates

Fresh air ventilation rates are the rates of outside air brought into the
building for the well-being of the occupants and dilution of odours
and other internally generated pollutants. The outside air may vary in
its freshness depending on the location of the building and the location
of the air intakes for the building. Filtered, re-circulated air is not fresh
air. All references in this document to fresh air mean outside air.
The ventilation should provide good indoor air quality and satisfaction
for occupants. Particularly the need for individual control should be
recognised and the correct operation of energy and indoor air quality
systems ensured20. As a secondary priority, the ventilation should
protect the building, installations and furnishings.
Indoor air quality is acceptable if, for less than 2% of the time12:
● not more than 50% of the occupants can detect any odour
● not more than 20% of the occupants can experience discomfort
©BSRIA TN 2/2002
● not more than 10% of the occupants suffer from mucosal

irritation
● not more than 5% of the occupants experience annoyance.
The American phrase for building-related sickness used to be tight

building syndrome, which would seem to imply that problems have
occurred as a result of reduction in the fresh air ventilation rates in
buildings for reasons of energy economy. However, building-related
sickness has been found to occur both at decreased21 and increased22
ventilation rates. If the sickness is attributable to indoor air quality in
terms of physical pollutants in the occupied environment, irrespective
of whether they are measurable, there are only two practical methods
of reducing their concentrations in the office environment.
The first is to reduce the emission of the pollutants if they can be

identified. The second is to provide sufficient fresh outside air to dilute
all the indoor-generated pollutants. This, of course, presupposes that the
outside air being brought into the building is not the source of the
problem. The traditional approach is to allocate a specified ventilation
rate as a function of the number of occupants per building or floor
area.
Ventilation requirements should reflect the total pollutant load present

in a building as a result of building constituents, occupants and their
activities. Additional ventilation is required to combat not only the
person-generated odours, as has been traditionally the case for offices,
but also for the materials used and stored in the office. It is therefore
possible that minimum ventilation rates on this basis could be tripled,
but further validation of this perceived odour appraisal is required.
The following ventilation rates are recommended by CIBSE Guide A12:
● 8 l/s/person in non-smoking areas

● 16 l/s/person in areas where some (25% of people) are smoking
● 24 l/s/person in heavy smoking areas (45% of people)
● 36 l/s/person in very heavy smoking areas (75% of people).
ASHRAE 62-1999 recommends ventilation rates of 8 l/s/person in

reception areas and 10 l/s/person in offices, telecommunication centres
and conference rooms. The difference between smoking and non-
smoking areas is not acknowledged, but it is mentioned that additional
smoke-removal equipment may be required in some places.
In a recent review23 of residential and non-industrial buildings (mostly

offices) increases in ventilation rates between 0 and 10 l/s/person
reduced occupant symptoms and improved perceived air quality.
Increases from 10 to 20 l/s/person may further reduce symptoms,
although these benefits are less certain.
In a long-term study24 sick building symptoms were monitored in an
©BSRIA TN 2/2002
office building before - as well as six months and three years after - an
improved ventilation system was installed. Prior to the changes the
initial intake of fresh outdoor air was 2䡠4 l/s/person. Over the first six
months it was increased to 28 l/s/person and then reduced to 15 l/s/
person, yet still meeting the ASHRAE recommendation.
Each-half floor was ventilated independently and air from the

photocopier rooms was not circulated. Smoking was restricted to
designated areas throughout the building, and after six months air from
the smoking areas was no longer re-circulated. After personal, psycho-
social and work-related factors were controlled, most symptoms
decreased by 40-50% among the office workers six months after they
moved in to the building.
A number of other factors were also assumed to contribute to the

decrease in the prevalence of the symptoms. A more stable temperature
was achieved as a result of the changed ventilation. During the three
years of monitoring, carbon dioxide levels decreased from a mean 810
ppm to 601 ppm (absolute levels of CO2) and humidity improved
from 22% to around 28%.
4.3 RELATIVE HUMIDITY The decision to humidify air in general purpose air-conditioned
offices is a balance of various aspects. Where humidity is to be
controlled, then current practice recommends a range between 40% to
60%. Upper and lower limits of relative humidity (rh) are based on
considerations of dry skin, eye irritation, respiratory health, microbial
growth, and other moisture-related phenomena.
The thermal comfort of an occupant of a building will not be greatly

affected by large changes in relative humidity. Relative humidity values
outside the range of 40-60% can be easily tolerated. Some of the
principal advantages and disadvantages of humidification are as follows.
Research shows that lower than 35% relative humidity over long
periods should be avoided because of the tendency for feelings of
dryness in the eyes, nose and throat. It is often thought, however, that
exclusion of humidification leads to dry air. Several studies have shown
that the perception of dry air is generally due to contaminated or too-
warm air rather than to physical dryness of the air25.
Static electricity increases at a humidity below 40%. Electrostatic

shocks are exacerbated in non-humidified or poorly humidified,
mechanically or naturally ventilated buildings during cold external
weather conditions. Textile floor coverings also increase risk.
Air with a higher humidity level is sooner perceived as odorous than

air with a relatively low humidity11. Increasing humidity in the range of
30-70% significantly augments the chemical and sensory emissions
from waterborne building varnish and paint26. High humidity provides
©BSRIA TN 2/2002
an ideal living environment for dust mites, increasing the risk of

asthma. The growth of micro-organisms is enhanced by the presence of
materials with high cellulose, such as fibreboard, dust, lint and skin
particles.
At humidity above 70% surface condensation and fungal

contamination are likely to be encountered.Viral viability is at a
minimum between 50 and 70% humidity.
The growth of micro-organisms can be rife, particularly in spray water

humidifiers and wetted surface humidifiers. A range of microbial
elements flourish in these environments is described in Section 4.7.
The use of biocides to control such growth has now been largely
condemned. Due to health risks, these types of humidifiers are rarely
installed in new buildings. More hygienic options, such as steam and
ultrasonic systems, are used instead.
Recent research27 indicates that increase in microbial population is

associated with the presence of available water rather than the presence
of high relative humidity. Growth can be minimised by removing
excess water from the supply air (preconditioning outdoor air). Fungal
growth can occur on any heating, ventilation and air conditioning
(hvac) surface material that is exposed to wet conditions during
normal operation27.
4.4 LIGHTING Light influences people through vision (picture creation, processing,
storage), biological clock (cycle control, circadian rhythms and
physical), and brain stimulation (energiser, short and long term,
psychophysical)28.
Safety should always be a primary consideration in the design of

lighting, but the functional and aesthetic qualities depend largely on
the application. If the requirements for performance or appearance are
met, then the safety requirements will almost always be achieved.
Lighting design should take into account the size, height and depth of
a room, the number of desks or workplaces, the type of work, use of
visual display units, colour and surface quality and the geographical
orientation of the building, particularly windows3. Windowless rooms
should be specified for limited, specific types of work.
The basic quantity of light or illuminance required for performing

tasks depends on the age and eyesight of the workers as well as on, for
example, the visual difficulty of the task including such factors as size,
contrast and degree of motion. Recommended values for various
working situations are presented in CIBSE Guide A12. The data are
reproduced opposite in Table 1.
©BSRIA TN 2/2002
Table 1: Standard service illuminance for various activities/interiors (reproduced from CIBSE Guide A12).
Standard service illuminance (lux) Characteristics of the Representative activities/interiors

activity/interior
Interiors used rarely, with visual tasks Cable tunnels, indoor storage tanks,
50 confined to movement and casual seeing walkways.
without perception of detail.
Interiors used occasionally, with visual Corridors, changing rooms, bulk stores,
tasks confined to movement and casual auditoria.
100
seeing calling for only limited perception
of detail.
Interiors used occasionally, with visual Loading bays, medical stores,

tasks requiring some perception of detail switchrooms, plant rooms.
150
or involving some risk to people, plant
or product.
Continuously occupied interiors, visual Monitoring automatic processes (in

tasks not requiring perception of detail. manufacture), casting concrete, turbine
200
halls, foyers and entrances.
Continuously occupied interiors, visual Packing goods, rough core making in

tasks moderately easy, ie large details foundries, rough sawing, libraries, sports
300 >10 min arc and/or high contrast. and assembly halls, teaching spaces,
lecture theatres.
Visual tasks moderately difficult, ie General offices, engine assembly, painting

details to be seen are of moderate size and spraying, kitchen, laboratories, retail
500 (5-10 min arc) and may be of low shops.
contrast. Also colour judgement may be
required.
Visual tasks difficult, ie details to be seen Drawing offices, ceramic decoration, and
are small (3-5 min arc) and of low meat inspection.
750
contrast, also good colour judgement
may be required.
Visual tasks very difficult, ie details to be Electronic assembly, gauge and tool
seen are very small (2-3 min arc) and rooms, retouching paintwork, general
1000 can be of very low contrast. Also inspection, cabinet making, supermarkets.
accurate colour judgements may be
required.
Visual tasks extremely difficult, ie details Inspection of graphic reproduction, hand

to be seen extremely small (1-2 min arc) tailoring, fine die sinking, fine work and
1500
and of low contrast. Visual aids and local inspection, precision assembly.
lighting may be of advantage.
Visual tasks exceptionally difficult, ie Assembly of minute mechanisms, finished

details to be seen exceptionally small fabric inspection.
2000 (<1 min arc) with very low contrasts.
Visual aids and local lighting will be of
advantage.
©BSRIA TN 2/2002
Note that 1 min arc equals 1/60 degrees. This is the angle at which the
tangent is given by the dimension of the task detail to be divided by
the viewing distance.
In addition to the illuminance value, many other factors, such as glare,

directional effects, variation of illuminance and colour rendering,
influence the suitability of lighting designs. Hence specialist designers
are needed for the detailed selection and layout of lighting systems.
Discomfort glare, which creates discomfort and distraction without
directly impairing vision, is more common than disability glare, which
causes a reduction in visibility of targets in the visual field29. Reflected
glare can be minimised with matt surfaces, indirect lighting, diffusers or
louvred luminaires. Depending on the chromatic temperature of
lighting and the intensity of illumination, the light can be perceived as,
for example, comforting, neutral and cold. For fluorescent lighting it
has been suggested that, for office environments, the preferred colour
temperature should be between 3500 and 4000 K with a colour
rendering index of 80 or greater.The same chromatic temperature
should be used in one room3.
The visually imperceptible flicker of some tubular fluorescent lamps has

been reported as a possible cause of illness among some office workers.
With conventional lamp control gear the flicker is twice the mains
frequency (100 Hz). High frequency electronic control gear, which
raises the flicker rate to between 35 kHz and 40 kHz, has been shown
to substantially reduce the incidence of headache and eyestrain among
some sufferers. It has been suggested that all new fluorescent lighting
installations should be upgraded when economically viable.
Particular attention to lighting should be addressed in areas where

visual display units are used. The primary causes of complaints about
lighting by users of computer screens are high-luminance reflections
from the screens, imbalance in the luminances of surfaces regularly
looked at by the worker (CIBSE Lighting Guide 7, 1993)30. It is
worthwhile therefore, to reiterate the guidance on lighting with respect
to visual display units.
As a computer screen is self-luminous, it needs no direct illumination.

Light falling on it can degrade the contrast of the display and, in
extreme cases, give rise to ceiling reflections, which make it difficult or
impossible to read the display. However, source documents will require
illumination, the quantity depending upon the size of detail to be
discerned and its contrast. A typical illuminance for good contrast
documents is 300 lux rising to 500 lux for poor contrast documents,
such as feint music paper. If the geometry and light distribution of the
lighting installation permits the computer screen to be viewed in
comfort, there is no reason to restrict the illuminance levels.
The correct positioning of the computer screen can do much to

reduce annoyance from the reflection of bright surfaces. In general,
©BSRIA TN 2/2002
this means that the operator and the visual display unit is parallel to any
fenestration. In the case of conventional ceiling-mounted diffuser
luminaires, the operator and the visual display unit should be parallel
with, and between, lighting rows and fittings. It is worth remembering
that light coloured surfaces, such as walls or clothing, may also give rise
to degrading reflections. A simple method of checking is to place a mirror
on the face of the screen and view it from the operator’s position.
During extended periods of writing and reading, unconscious

involuntary relief for the eyes occurs simply by looking away from the
task at distant objects.Windows, paintings and foliage may be useful as
visual rest or relief centres during prolonged work on a computer
screen. These objects should have a higher luminance than that of the
workstation, but the luminance ratio must not be exaggerated or the
contrast will be counter-productive30.
Two systems are commonly used to minimise screen reflections from

lighting installations: indirect lighting and ceiling-mounted luminaires.
Indirect lighting uses uplighters (usually equipped with high efficiency
discharge lamps) to bounce light from the ceiling. This method
reduces shadows, is bland in character, and requires a light-coloured
ceiling to avoid absorbing too much light. It can produce screen
reflections, but these are usually of large area and low brightness and
are not distracting.
Free-standing uplighters can be repositioned easily to optimise the

illumination. The alternative system uses ceiling-mounted luminaires,
most commonly with tubular fluorescent lamps but also high-pressure
discharge lamps. The latter have a carefully controlled light distribution
that does not emit light at angles likely to cause reflections. For
maximum effectiveness the lighting and computer screen layouts
should be related. It is advisable to check the degree of flexibility in
the lighting system with the lighting designer.
Excessive luminance from glazing is most readily controlled by

internal blinds or louvres. Consideration should also be given to
external shading devices.
Colours of the decor, walls, floors and other surfaces are related to
well-being, emotions and satisfaction of the occupants. Different
colours have different psychological effects, but the perception of
colours is strongly dependent on such things as personal preferences,
culture, geographical location and quality of lighting.
Warm effects (red, orange, yellow) support activity and energy, though
they can also lead to fatigue. Cold colours (blue, green, violet) support
relaxation and concentration. Light colours create a feeling of space
and brightness whereas dark colours create the opposite. Darker
surfaces absorb a greater proportion of light radiation whereas lighter
surfaces reflect it.
©BSRIA TN 2/2002
4.5 NOISE AND The acoustical environment within a building is the resultant of the
VIBRATION noise entering the space from outdoors, from adjacent areas, and from
the engineering services, as well as the noise generated within the
space by people and equipment. Whether or not the resulting
acoustical environment is disturbing or annoying to an occupant
depends on numerous factors. Many of these are physiological and
psychological, and vary from person to person. In general, annoyance
depends on the sound quality and its information content, on its
source and duration, on its relationship to expectations, the need for
communication, and on the activity of the individual, whether
sleeping, working, concentrating or relaxing.
Larger number of workers in a room cause higher levels of noise,

especially that with distracting content7. Particularly large and noisy
printers and photocopiers can in regular use result in neurological
complaints and unwanted distraction. Separate equipment rooms may
be a solution. Although textile surfaces can reduce noise levels they
can also have an adverse effect in contributing to complaints related to
building-related sickness (see Section 4.9).
Despite the complexity of the reaction to noise by individuals,

subjective studies have resulted in noise criteria that are considered to
be generally acceptable for a range of conditions of occupancy or
building usage. The noise rating (NR) curves are commonly used
criteria in the UK and Europe. They are based on annoyance and
speech intelligibility and are attempts to express equal human tolerance
in each frequency band. NR values for buildings range from NR 20
for such applications as sound-recording studios, to NR 50 and above,
which may result from some manufacturing processes. Normal speech
is unintelligible at distances greater than 0䡠4 m when ambient noise is
at a value of NR 65. Recommended NR values for typical
applications are given in Table 2.
Table 2: Recommended noise levels (reproduced from CIBSE Guide A12).
Situation NR value
Sound broadcasting (drama). 15
Sound broadcasting (general), television (general),

20
sound recording.
Bedrooms in private homes, television studios

25
hospital audiometric rooms, concert halls, theatres.
Lecture theatres, cinemas, hotel rooms,

boardrooms, large conference rooms, law courts, 30
churches, private living rooms.
©BSRIA TN 2/2002
Table 2: Continued.
Situation NR value
Sound broadcasting (drama). 15
Sound broadcasting (general), television (general),

20
sound recording.
Bedrooms in private homes, television studios

25
hospital audiometric rooms, concert halls, theatres.
Lecture theatres, cinemas, hotel rooms,

boardrooms, large conference rooms, law courts, 30
churches, private living rooms.
Hospital operating theatres, single and multi-bed

wards, waiting rooms, hotel ballrooms and banquet
rooms, reception rooms, open-plan offices, assembly 35
halls, libraries, banks, museums, classrooms, lecture
theatres.
Corridors, laboratories, hospital wash rooms,

toilets, kitchens, staff rooms and recreation rooms,
40
lobbies, restaurants, department stores, workshops
in educational buildings.
Hotel kitchens and laundries, department stores,

night clubs, public houses, cafeterias and canteens,
45
public washrooms and toilets, gymnasiums,
corridors in educational buildings.
Swimming pools, sports arenas, warehouses,

50
industrial garages.
Light engineering workshops, public garages and car

55
parks.
Heavy engineering workshops. 60
A recent study31 investigated human perception and building-related

illness symptoms when people were exposed simultaneously to
different levels of air pollution and ventilation noise. Ventilation noise
with neutral frequency spectrum from 42 dBA was moderately
increased to 45 dBA during a 4䡠4 h period in an office where the
occupants performed simulated office work.
While substantial adaptation to air quality was observed despite

increased eye irritation over time (with and without carpet), the results
showed no indication of adaptation to noise. The adaptation to noise,
however, is a function of the type and duration of noise. The results
showed that elevated air pollution and noise in an office can interact
and negatively affect office workers by increasing the prevalence of
building-related illness symptoms.
Vibration is another important aspect. Low frequency noise can have a

direct link with sick building symptoms, whereas high frequency noise
is inversely related to symptoms3. In the recent years the number of
infrasound-related sick building cases has increased. The explanation
may lie in the combination of tight sealing of modern buildings and
ventilation noise, which amplify the lower frequencies32.
©BSRIA TN 2/2002
The major sources of vibration that affect buildings come from internal
mechanical equipment, and from the traffic outside. The frequencies of
vibrations encountered in buildings lie mostly within the range of 5-50
Hz, with higher frequencies being in the audible range.
Of more direct relevance to building vibrations are the biological

effects on the human body, both physiological and psychological. The
human body is a very sensitive detector of vibration. Under certain
circumstances a standing person can detect amplitudes as small as 1
micron, and fingertips can detect amplitudes of 0䡠05 micron. The
Reiher-Meister scale, which is used for rating steady-state vibration,
provides the basic data concerning whole body sensitivity to vibration.
The degree of discomfort is a function of the magnitude, frequency and
direction of the vibratory motion and the individual response to it.
It is thought that infrasound may act by causing an allergic-type

response32. An allergic or hyperreactive response usually results from a
person’s threshold for a stimulus being lowered by repeated or long-
term exposure to that stimulus. It is possible that infrasound is such a
stimulus and can eventually produce the clinical symptoms of an
allergic or hyper-reactive response. Where a problem with respect to
vibration is suspected, specialist advice should be sought.
4.6 NEGATIVE IONS Air ions are air molecules that carry a positive or a negative charge,
depending on whether they have a loss or an excess of electrons,
respectively. They occur naturally in the atmosphere, such as from
sunlight, background radiation, lightning, and falling water. Small
mobile ions are believed to be most biologically active. Typical ion
concentrations for different outdoor environments are listed in Table 3.
As there usually is a surplus of positive over negative small ions both in
Table 3: Typical ion concentrations for different outdoor environments.
Outdoor environment Positive (ions per ml) Negative (ions per ml)
Coastal 2000 1800
Clean rural air 1200 1000
Lightly polluted urban air 800 700
City centre air 500 300
©BSRIA TN 2/2002
indoor and outdoor air, no fixed normal concentrations can be

defined33.
Within buildings the concentration of ions is lower than outdoors for

several reasons:
● In modern steel-frame buildings airborne charged particles

readily find a route to earth.
● In buildings with mechanical ventilation or air-conditioning
systems, the earthed metal ducts rapidly remove negative ions.
● Man-made fibres and materials have a high electrical resistivity
and are associated with high electrostatic charges, especially when
the relative humidity is low.
● The screens of visual display units are at a high positive potential
between 6 kV and 30 kV. Negative ions are attracted to the screen
from the surrounding area, in particular from the breathing zone
of the operator.
● Tobacco smoke consists of a very large number of small particles
between 0䡠01 and 1䡠0 microns. These act as condensation nuclei
for negative ions. They impinge on the room surfaces, removing
ions from air.
Some alleviation in terms of greater sense of well-being has been

noted by migraine sufferers when in an environment with air ionisers.
Air ionisers also reduce the number of airborne particles, and
deposition/staining occurs particularly in the vicinity of the ionisers.
There are many inter-connected factors, making it difficult to identify
symptoms of ill-health with specific causes. This may be why studies of
negative air ionisation have found benefits in some buildings and not
in others.
Raising the level of negative air ions does not seem to cause
deleterious effects, and for many individuals there may be no
perceived difference. It is therefore possible that small ions are
environmental parameters of secondary importance33.
4.7 MICRO-ORGANISMS Micro-organisms in incoming fresh air can cause infection or allergic
reactions, both by penetrating air-conditioning and mechanical
ventilation systems, and by being re-circulated in the occupied space.
There is no evidence to support the view that a well-installed air-
conditioning system would itself cause any of the known infections or
allergens. In many of the less severe ailments caused by micro-
organisms, such as humidifier fever, the precise organism(s) responsible
are not entirely clear. Poor design, installation and particularly
maintenance of water spray humidifiers, however, do cause concern in
terms of providing the correct ingredients for causing illness to the
occupants of buildings. While many of the cases have been established
to be attributable to an humidification system, another contributory
factor to building-related sickness may be as-yet unknown micro-
©BSRIA TN 2/2002
organisms. In addition to humidifiers, microbial growth can occur in,

for example, damp ducts, dehumidifiers, fan coil units, induction units,
dust, filters and building materials.
Some 15 % to 30% of cases of building-related illnesses have been

associated, if not directly linked, to indoor fungal or bacterial
contamination34. This report is not concerned with a specific
bacterium, such as legionella pneumophila, which can be diagnosed. In
the following the major illness-causing organisms are reviewed.
Fungal infections from, for instance, Aspergillus fumigatous, can penetrate

ventilation systems via poor or failed filters. This fungus usually
originates from bird droppings, and can be found in ventilation ducts
and houseplant soil. It usually affects only immuno-suppressed patients
and the elderly.
The classic bacterial infections include tuberculosis, legionnaires’

disease and Pontiac fever. The latter two arise from contaminated
cooling towers and warm water systems.
Viral infections attached to droplet nuclei include smallpox,

chickenpox, measles, mumps, influenza, adenovirus 4 and adenovirus 7,
and rhinovirus (the common cold). The infection route is principally
sneezing, and less often coughing, talking or singing. The median size
of the droplet nuclei is around 4 microns and can remain airborne for
some time. Re-circulation in mechanical ventilation systems could
provide the opportunity to spread or dilute such droplet nuclei.
However, from observations of human respiratory infections, only a
small portion of expelled virus is likely to remain airborne long
enough to be inhaled. In many cases this virus rapidly loses infectivity
in air.
Close proximity for long periods is the most common infection route.
Relative humidity does, however, affect the length of time airborne
viruses remain viable, but this depends on the particular virus.
Influenza and measles have a higher stability at a relative humidity
below 40%, while adenovirus has a higher stability with a relative
humidity greater than 75%. Occupational asthma, extrinsic allergic
alveolitis and humidifier fever are attributable to micro-organisms.
However, it is not known which micro-organisms precisely are the
problem. The implicated parties in humidifier fever have been:
● Amoeba: Naegleria gruberi

● Bacteria: Bacillus subtilis
● Endotoxin: coytophage species and flavo bacterium.
On a more general basis, surveys can be undertaken to determine

bacteria and fungi with the number of colony forming units. In
mechanical ventilation systems some typical fungi species include
penicillium sp, aspergillus sp, rhizopus sp, alternaria sp, mucor sp, and
©BSRIA TN 2/2002
saccharomyces sp. Guidance on what is an acceptable mixture and

number of colony-forming units is absent.
4.8 RESPIRABLE The occupational exposure limit35 is 4000 microgrammes per cubic
PARTICULATES AND metre (µg/m3) of respirable particulates (<10 microns) measured as an
FILTRATION 8 hour time-weighted average. In comparison, the Japanese mandatory
indoor environment limit is 150 µg/m3. Research indicates that
respirable mass concentrations in general office environments should be
at least limited to 150 µg/m3, and preferably 100 µg/m3. The
particulates most likely to be retained by the human body are in the
size range less than 1 micron, which penetrate the alveoli. The
respirable mass concentration is, therefore, not necessarily a good
indicator of the number of particles, especially in the small size range
(<0䡠5 micron). As for many indoor air pollutants, there are no
recommended limits or dose-response curves.
To a greater or lesser extent, outdoor and re-circulated air is dirty and

so the removal of airborne impurities from the supply air is required in
many applications. For most of these, removal of particulate and
fibrous matter is sufficient to:
● maintain hygienic conditions for the health and welfare of

occupants or for processes such as in food manufacture
● protect finishes, fabrics and furnishing; for example, to prevent
staining or avoid frequent redecoration
● protect equipment either within the air supply system; for
example, to prevent fouling of heat exchanger coils
● protect equipment in the space itself; for example, to maintain
dust-free conditions for assembly of delicate components.
The ability of filters to remove airborne matter from an air stream is

characterised by two parameters, average arrestance (Am) and average
efficiency (Em). Arrestance is a measure of the total weight of synthetic
dust captured by the filter. The weight of dust caught is expressed as a
percentage of the total weight of dust entering the filter. Arrestance
provides a good indication of a filter’s ability to remove the larger,
heavier particles found in outdoor air. It is primarily used as a measure
of the performance of coarse dust filters (G); see Table 4 overleaf.
The performance of fine dust filters (F) is rated by their efficiency. This
parameter is determined by measuring the filter’s ability to remove the
microscopically sized, stain-causing particles from the air stream passing
through it.
A grading system based on these two performance criteria has been

introduced by Eurovent (The European Committee of the
Manufacturers of Air Handling Equipment) and is shown in Table 4
overleaf. In addition to the nine grades of filter described, there is
another classification known as high efficiency particulate arrestance
©BSRIA TN 2/2002
(HEPA) filters, sometimes known as absolute filters. They are designed

to provide very high efficiency filtration of small particles in the sub-
micron size range. Typical applications include clean rooms, operating
theatres, research laboratories, laminar flow cabinets and nuclear
industry installations. Some general guidance on the application of the
various grades of filter is given in Table 5.
For general air-conditioning in office environments, Grade 6 filters are

recommended, with perhaps Grade 7 in the more prestigious
environments.
Cleaning is another method for controlling particulates. The ventilation

plant should be accessible for cleaning. Proper and regular cleaning of
carpets is another factor often overlooked, as is cleaning of the indoor
environment generally.
Table 4: Eurovent filter grades.
Filter grade Average arrestance Average efficiency

(Am) % (Em) %
G1 Am < 65 -
G2 65 ≤ 80 ≤ Am -
G3 90 < Am <80 -
G4 Am ≥ 90 -
F5 - 40 ≤ Em <60
F6 - 60 ≤ Em <80
F7 - 80 ≤ Em <90
F8 - 90 ≤ Em <95
F9 - Em ≥ 95
©BSRIA TN 2/2002
Table 5: Filter applications.
Grade Application
Pre-filters and for systems serving areas

not requiring any great degree of
2/3
cleanliness such as toilet supply systems
and light industrial applications.
For application as main filters where low

4
to moderate cleanliness is required.
Main filters for general application

where decor protection is not critical.
5
Suitable for paint spray installations.
As 5, but with added decor protection.

6 Intermediate filter to extend life of a
HEPA main filter.
As 5, but for use where protection of

7
decor is particularly important.
High protection from dust staining,

8 suitable for computer rooms and other
areas containing electronic equipment.
For high quality filtration but where

HEPA filters are not justified, for
9
example Class 3 clean room
applications.
4.9 VOLATILE ORGANIC Hundreds of volatile organic compounds (VOC), such as aromatics,
COMPOUNDS ketones, halogens, esters, alcohols, phenols, aldehydes, epoxides and
aliphatic hydrocarbons, have been identified in indoor air. Nearly all of
them are indoor-generated pollutants, exceeding the outside air
concentrations by factors of up to 100. The individual concentrations
are much lower than occupational exposure limits.
New buildings have higher total volatile organic compound (TVOC)

concentrations than established buildings36. Concentrations of many
aliphatic and aromatic organics have been shown to reduce to 10-20
percent of their original concentrations after three to four months of
occupancy. Some organics increase after occupancy, indicating the
influence of consumer products or activities. An example of this is a
study on new office buildings37 where selected pollutant levels and
ventilation rates were monitored before and during early occupancy.
Volatile organic compounds, carbon dioxide, carbon monoxide, radon
and formaldehyde were measured. Ventilation rates ranged from about
0䡠3 to 2䡠6 air changes per hour (ach).
©BSRIA TN 2/2002
On sampling for VOCs, the building ventilation system was operated

without outdoor air intake and the building was mostly unoccupied.
The VOC levels were at the lowest (0䡠15-0䡠30 mg/m3) when no
furniture was installed. Furniture and cable installation increased the
concentration of VOC’s up to 0䡠80 mg/m3. After the installations were
complete, the indoor VOC levels decreased to a level higher than they
were at the beginning (0䡠30-0䡠40 mg/m3).
Consumer products responsible for VOC emissions include wearing

and storing dry-cleaned clothes, cosmetics, secretarial products, spray
cans, smoking, air deodorisers, felt markers, detergents etc. Examples of
building and office materials are sealants, adhesives, particleboard, floor
wax, stains, polish, fabrics, foam, tape and carpets. High temperatures
may enhance sensory and physiological effects of volatile organic
compounds11,38.
The fresh air ventilation in new buildings is increased in some

instances during initial occupancy to alleviate the problem. Guidance
on the required increase in the fresh air ventilation rates is currently
unclear.
Another method for decreasing VOC levels is bake-out, which

accelerates the transfer of pollutant mass from sources to the outdoors.
This method is used more in the US than the UK. Experiments have
been carried out since the late 1980s, when the longest test periods
were 24 hours. A typical protocol involves maintaining the
temperature in a building at 35ºC for several days39 ideally on the entire
building or a well-isolated proportion of it40. Some researchers41,42,43
have found the VOC levels to increase after a bake-out to
concentration ranges measured prior to the bake-out.
One possible explanation for this is that a bake-out is able to reduce

the emissions from secondary contaminant sources (carpet and ceiling
tiles), which are in direct contact with indoor air, but not from the
primary sources (paints, caulks, adhesives)59. Hence the primary sources
re-contaminate the ‘cleaned’ materials over time. It has been
suggested39 that a bake-out would be best suited for very specific
mitigation and control tasks rather than used as a general indoor air
quality improvement technique.
It has been acknowledged that the building materials age during a

bake-out, but that the actual effects still need to be investigated. A
bake-out may not be feasible due to a number of reasons: the
occasional replacement of office equipment that introduces VOCs, the
building construction schedule, and the fact that artificially-aged
materials may not be positively perceived by the building owner.
Further work is required for complete assessment as currently

information on the comparison of TVOC levels in problem and
healthy buildings is limited.
©BSRIA TN 2/2002
4.10 GASEOUS There are many gaseous pollutants in the indoor environment. Some
CONTAMINANTS of the main office environment pollutants, excluding VOCs, are shown
in Table 6 with the concentrations of concern44.
Table 6: Gaseous pollutants in indoor air (adapted from the WHO44).
Pollutant WHO concentration Source

of concern (mg/m3)
Combustion products,
Carbon monoxide 5
tobacco smoke
Building materials,
Radon and daughters 70 Bq/m3
outdoors
Furniture, fittings,
Formaldehyde 0䡠12
insulation, paper
Photocopiers, laser
Ozone 0䡠08
printers, ionisers
Carbon dioxide 12 000 Occupants, smoking
Sulphur dioxide 1䡠35 External environment
Products from unvented combustion appliances have been omitted

from the above list, others principally include the oxides of nitrogen.
Carbon monoxide (CO), other than from vehicle exhaust fumes

entering the air supply system, is generally a result of cigarette, cigar
and tobacco smoking in the general office environment. The levels of
CO are low in comparison with accepted standards and not a good
indicator of pollution levels by smoking products.
There is a wide range of gaseous pollutants, along with vapours and

particulates, given off by smoking products. The HSE’s occupational
exposure limits35 for some of the by-products of tobacco smoke are
shown in Table 7 overleaf.
Radon
Radon and daughters are radioactive gaseous products which are
emitted from some granite rock structures. Early results from a
nationwide survey in the US have suggested that radon may be more
widespread in individual homes than in large buildings45. One reason
for this is that multi-storey buildings have proportionally less space in
direct contact with the earth when compared with homes. In any case,
radon remains a major concern.
©BSRIA TN 2/2002
Table 7: Some by-products of tobacco smoke and their occupational exposure limits35.
By-product Concentration limit (mg/m3)
Acrolein (acrylaldehyde) 0䡠23
Aromatic hydrocarbons:
Phenol 20
Toluene 191
Carbon monoxide 35
Nicotine 0䡠5 (long-term exposure)
Nitrogen oxides:
NO2 5䡠7
NO 31
The Environmental Protection Agency has estimated that 20 000 lung

cancer deaths a year in the US are related to radon exposure46. Other
researchers47 have reported a figure of 10-40% of lung cancers in the
general population. The WHO has estimated48 that 36 deaths occur
from cancer in a population of 1 million through lifetime exposure to
radon at 1 Bq/m3 (Becquerel per cubic metre). There is a positive
interaction between radon and smoking, as radon daughters attach to
aerosol particles.
Formaldehyde
Formaldehyde is emitted from a whole range of manufactured
products, mostly associated with furniture, partitioning, and paper
products. The original concern with formaldehyde arose from the ill-
effects observed after poor installation of urea-formaldehyde insulation.
In the initial investigations into building-related illnesses, formaldehyde
was believed to have been responsible.
The subjective symptoms were primarily related to upper airway

irritation including odour, taste, sore throat and nasal discharge. Eye
irritation was the most frequent non-respiratory complaint. These
complaints are very similar to the symptoms associated with sick
buildings. Many surveys have been undertaken to correlate exposure to
office illnesses. As correlation has not been found, investigations have
focused on other aspects. Concentrations of limited concern are
around 0䡠06 mg/m3.
Ozone
Ozone can be produced from photocopiers, laser printers and air
ionisers, although many of the sources tend to be in the industrial
sector. While ozone is toxic and has a very low exposure limit, it is
©BSRIA TN 2/2002
nevertheless highly reactive and decays rapidly, with a half-life of the

order of minutes. It is not considered to be a leading hazard in the
indoor environment.
Carbon dioxide
Carbon dioxide (CO2) as an individual pollutant in the indoor
environment does not pose a problem. Metabolic carbon dioxide
production from respiration is the principal source and the
concentration is a good indicator of the occupancy density coupled
with the ventilation rate in the building.
CO2 can be readily measured and used for the control of the fresh air
ventilation rate for buildings particularly where the occupancy density
varies significantly. Typically the CO2 concentration rises in the
morning as the building becomes occupied, and peaks before falling
over lunch. In the afternoon it peaks again before falling again as the
occupants leave.
There has been a great deal of research on the correlation of carbon

dioxide levels as a function of the body odours generated in indoor
spaces. There are indications that a significant majority (over 80%) of
occupants and visitors find an office environment acceptable if the
CO2 concentration is maintained below 800 ppm (ventilation rate
8 l/s/person). The comfort level generally is 1000 ppm.
If only dilution ventilation is used to control indoor air quality, the

comfort (odour) criteria related to human bioeffluents (sweat, urine)
are likely to be satisfied if an indoor to outdoor differential
concentration is not greater than about 700 ppm of CO2. Further
discussion on the subject is in CIBSE Guide B and ASHRAE 62-1999.
For outdoor air, the acceptable CO2 concentration typically ranges

from 300 - 500 ppm. High concentrations can be an indicator of a
contaminant source such as combustion.
Controlling emission rates and/or providing sufficient fresh air

ventilation rates are the only real control mechanisms for gaseous
pollutants. With the exception of radon, most of these pollutants appear
to be contained to acceptable limits in most office buildings, provided
the minimum fresh air flow rates are as recommended in the previous
section on fresh air ventilation rates.
There is some evidence that building-related sickness is less common

in active smokers than in non-smokers49. In a recent study49 a
progressive reduction in the building symptom index was achieved
through prohibiting smoking in an open-plan office. However, among
the smokers the sick building symptoms attributable to tobacco smoke
did not alter due to the persons continuing smoking at home. (The
building symptom index is the mean number of work-related
symptoms - maximum of ten - per worker.)
©BSRIA TN 2/2002
4.11 TEDIOUS WORK The prevalence of symptoms appears to be highest in clerical staff with
SCHEDULES rather boring activities, which seem incessant to the operatives. In these
cases, where concentration may wander, a greater examination of the
environment may take place and they will therefore be far more aware
of minor changes in environmental conditions, particularly when
inactive for long periods. Everybody accepts that such work has to be
undertaken, but it is also recognised that interlacing different activities
more frequently into the main tedious work programme partially
alleviates such problems. Management should be more aware of this
and try, where possible, to alleviate the strain. Even though it may not
always be possible to do anything, the psychology of having tried to
alleviate the boredom is often helpful.
More than half of all workers in industrialised countries work in

offices50. This generally involves the use of computer screens, which can
increase problems to persons using them continuously. Muscle ache,
repetitive strain injury, sore eyes and skin complaints are commonly
reported problems51.
4.12 OCCUPANT Environmental control with regard to temperature and outdoor air
CONTROLS supply is an important psychological factor and has a clear effect on
health and comfort. A higher perceived control improves health and
well-being7. A higher control also increases the possibilities for the
individual to adjust the environment, improving the person’s situation.
Fewer symptoms and increased productivity have been seen in cases
where the individuals enjoy more control52. This can be more difficult
to achieve in large and highly populated spaces than in small rooms.
In naturally ventilated one and two-person offices, the occupants will

usually have the benefit of a door, a light switch, a thermostat, openable
windows and often a choice of colour of walls and floor. Open-plan
air-conditioned offices rarely offer any of these options on an
individual occupant basis. The system design should incorporate
sufficient control for occupants to alter their internal environmental
conditions, where technically and economically feasible.
It is difficult for air-conditioning engineers to design an economical

system that is based on very flexible layouts. The exact location of walls
and partitions should ideally be specified at the design stage. Where this
is not possible, effective zone controllers should be incorporated in the
environmental systems to ensure that sub-sets of six to eight people
have environmental control.
Perceived comfort and control tend to come from systems which can
respond quickly when people find conditions unsatisfactory, rather than
from a particular individual control device52. The response, whether
manual, automatic or by management action, should be fairly rapid and
effective. On the other hand, too much control can result in
irresolvable conflicts and make things worse.
©BSRIA TN 2/2002
A control system enabling workers to influence the temperature locally

has been tested for a one-year period in an office in the UK53. It is
based on a periodic voting system by the occupants and designed
primarily for use in open-plan, air-conditioned offices with a
controlled hvac system. The trial demonstrated that it has potential to
provide a better control of the environment by the workers.
4.13 STRESS Occupational stress may be defined as a state of imbalanced relations

between the individual and the work environment5. Even if the work
itself cannot be improved, a great deal can be done about management
attitudes.
Reducing friction and aggravation to work-related aspects can alleviate

stress. Research undertaken suggests there is a significant link between
stress or tension and the incidence of building-related sickness.
However, whether stress is causative of sick buildings or whether sick
buildings cause stress is difficult to rationalise. Some researchers have
concluded that stress is more likely to occur from organisational
components of the work rather than the ambient environment.
Psychosocial aspects
Research on occupational stress has repeatedly shown that
psychosocial factors of the work environment play an important role
in health and well-being. It has been shown that psychosocial work
characteristics such as re-organisation, role conflict, workload, job
satisfaction and worry have a significant impact on the risk of
developing the symptoms of building-related sickness.
Other risk factors are, for example, lack of skill utilisation, lack of
possibilities to control the work situation and the environment, role
ambiguity, poor social relations and communication. In offices,
perceptions of productivity appear to be higher in smaller and more
integrated workgroups54. In reality it is naturally dependent on
personal experience and preference.
4.14 RESPONSE TO Frustration by the occupants is a factor all too often evident in
COMPLAINTS buildings, consequential to a lack of response to complaints made by
occupants. The complaints can cover a whole plethora of aspects, but
the importance of taking notice of complaints and responding to them
cannot be over-emphasised.
In many cases only slight remedial action may be required, in others

there may be expensive solutions which cannot be applied
economically or within a short time schedule. Psychologically,
however, it is far better to have investigated the complaint and
communicated the reasons why action cannot be carried out, than to
have ignored the complaint.
©BSRIA TN 2/2002
Management attitudes are a prime factor in this area. There is clear

national and international experience which has demonstrated that lack
of communication can close buildings down, often unnecessarily,
because of a build-up of rumours regarding ill-health attributable to a
particular building. It is useful to have a procedure for responding to
complaints where details, such as contact person, are listed.
4.15 PRODUCTIVITY Leaman and Bordass54 have identified four ‘killer’ variables for
productivity in buildings: personal control, responsiveness, building
depth, and workgroups. Poor productivity is also a function of poor
professional feedback, lack of integration in design processes, lack of
care for the primary occupants, inadequate or non-existent
instructions, and the tendency to ignore the bad news. Losses or gains
of up to 15 percent of the workforce turnover in a typical office
organisation might be attributable to the design, management and use
of the indoor environment.
The PROBE (Post-occupancy Review Of Buildings and their

Engineering) studies involved extensive surveys of a number of
buildings in the 1990s. The buildings were first surveyed when new
and re-visited later. The results showed perceived differences of up to
25 percent between comfortable and uncomfortable staff, with the
latter showing consistently lower productivity55.
©BSRIA TN 2/2002
5.1 PROTOCOLS AND Detailed building-related sickness checklists often have broad spectra
CHECKLISTS because of the case-specific nature of the sickness and the interaction
of several variables. The guidance on sick buildings issued by the
Health and Safety Executive (HSE) covers two parts, the first one
being identification and investigation of building-related sickness. In
the second part the focus is on creating a good environment. For
indoor air quality problems a number of detailed checklists exist3,56,57,58,
which may be helpful in covering hvac-related aspects in cases where
building-related sickness is suspected.
The purpose of this section is to give a simplified breakdown of ways

to minimise or avoid problems originating from a specific factor.
These aspects are covered in references 1,3,45,56,57,58 and 59 and are
not presented in order of importance.
The cost issues are not in the scope of this report. It is essential,
however, to remember that cost plays a significant role in minimising
the symptoms. The evaluation of the financial input required to
mitigate building-related sickness is not straightforward: the most
economic route may not be effective.
When building-related sickness is suspected, it is important to select a

person(s) in charge of the overall process and to involve the occupants
in the investigation. A systematic approach to the study is essential, such
that the investigation is started from the most likely sources of the
problem.
The following questions may help to identify some patterns in the

occurrence of the symptoms:
● When did complaints begin?

● What are the symptoms?
● How often and what time of the day do they occur?
● How long have the symptoms occurred?
● Do the symptoms ease when the occupants go home?
An initial walkthrough may reveal defects in operation of and/or

maintenance of equipment and general housekeeping.
Although indoor contaminant measurements are generally not

recommended as the first step in the investigation, they may be a part
of it, particularly if the case is headed for litigation59. It is important to
decide what, how, where and when to measure. The decision on which
contaminants are measured should be based on a careful consideration
of the physical symptoms reported and a review of the potential indoor
sources that may contribute to the occurrence of the symptoms.
Measurements should be taken in complaint and non-complaint areas

for comparison. Building-related contaminants tend to peak in the
morning (if the hvac system has been off overnight) whereas occupant-
©BSRIA TN 2/2002
related contaminants usually peak in the afternoon. It is also important

to keep in mind the difference between measurements that provide
average and peak values. The data should be carefully interpreted,
keeping in mind that indoor contaminants may not be the source of
the problem.
Checklists for physical, air quality and psychosocial parameters are

shown in Tables 8 and 9. For each parameter an action is
recommended so as to minimise or avoid related problems. A further
reference to guide values is also given.
Table 8: Checklist for physical and air quality parameters.
Parameter How to minimise or avoid related problems Reference
Thermal comfort Keep temperature at recommended limits 21-24ºC CIBSE Guide A12
Check thermostats and control set points
Minimise draughts Air velocity < 0䡠3 m/s in general for mechanical
systems
Check and clean heating/cooling equipment Follow manufacturers' instruction manuals

regularly
Minimise heat gains to reduce peak temperatures Vary occupant density and activity, turn electrical
equipment off when not needed for long periods,
improve lighting control, install blinds or windows
with solar control glass
Ventilation rates Keep ventilation rates at recommended limits 8 l/s/p CIBSE Guide A12
Check air movement patterns Use drawings and tests
Provide local extraction for photocopiers, kitchens

etc.
Check partition walls (if used) are low and allow

free air movement
Avoid locally high air velocity
Check and clean ventilation ducts regularly See Loyd (1997)60
Relative humidity Keep RH within recommended range 40-60% CIBSE Guide A12
(RH)
Check and clean humidifiers and/or dehumidifiers Follow manufacturer's instruction manual
regularly
©BSRIA TN 2/2002
PROTOCOLS AND CHECKLISTS 5
Table 8: Continued.
Thermal comfort Keep temperature at recommended limits 21-24ºC CIBSE Guide A12
Check thermostats and control set points
Minimise draughts Air velocity < 0䡠3 m/s in general for mechanical
systems
Check and clean heating/cooling equipment Follow manufacturers' instruction manuals

regularly
Minimise heat gains to reduce peak temperatures Var y occupant density and activity, turn electrical
equipment off when not needed for long periods,
improve lighting control, install blinds or windows
with solar control glass
Ventilation rates Keep ventilation rates at recommended limits 8 l/s/p CIBSE Guide A12
Check air movement patterns Use drawings and tests
Provide local extraction for photocopiers, kitchens

etc.
Check partition walls (if used) are low and allow

free air movement
Avoid locally high air velocity
Check and clean ventilation ducts regularly See Loyd (1997)60
Relative humidity Keep RH within recommended range 40-60% CIBSE Guide A12
(RH)
Check and clean humidifiers and/or dehumidifiers Follow manufacturer's instruction manual
regularly
Lighting Check positioning of lighting equipment, windows See CIBSE LG7

and VDU screens
Check type of lighting suitable for purpose (lamp See CIBSE Guides A12 and LG7
type, colour rendering index, colour temperature)
Avoid unnecessar y artificial lighting if natural

lighting sufficient
Check colours of the interior (colour, surface,

patterns)
Noise and Check noise within maximum limits See CIBSE Guide A12
vibration
Installation of screens
Different type of windows
Noisy equipment such as photocopiers, printers

and machiner y in separate rooms
Silencers on supply and extractor ducts
Soft furnishing (may have impact on allergic

persons)
Air quality Check source of outdoor intake air See CIBSE TM2161 and TN 12/200062 for design and
positioning of air intake
Filter intake air
Filter return air (if spores generated outdoors)
Check filters are of appropriate type and fitted See (CIBSE Guide A12) and manufacturer's instruction
correctly manual
Clean filters and hvac system regularly Follow manufacturer's instruction manual
Keep drain pans clean
Avoid high humidity (>60% RH)
Clean rooms regularly of settled dust
Choose low emission materials
Keep photocopiers and similar systems in separate

rooms with additional ventilation
©BSRIA TN 2/2002
5 PROTOCOLS AND CHECKLISTS
Table 9: Checklist for psychosocial factors.
Tedious work schedules, Alternate tasks and arrange manageable tasks

productivity, stress
Check ergonomics Correct posture, user-friendly tools and
products
Improve working environment Minimise sources of unwanted distraction,

try small and well-integrated workgroups
Control by occupants Education on correct operation of building
Provide override option in automatic systems
Provide more individual control over temperature,

ventilation, lighting etc.
Response to complaints Procedures for responding to complaints Complaint form, contact person etc.
Record any complaints and check them against the Occurrence of patterns
maintenance and operation records of equipment
Mitigation procedures are case-dependent63. As a good rule of thumb:
● Avoid over-optimism
● Think carefully about the possible downside risks of a proposal and
try to minimise them
● Keep things simple
● Seek comment and, where appropriate, undertake pilot projects.
Sometimes the attempts to solve the problems result in revenge effects,

which can be more severe than the original problems. The PROBE
studies 63 and other post-occupancy surveys have identified such effects.
Full fresh air-conditioning systems to improve air quality are taken as
an example. This may increase heating loads (a revenge effect) such that
humidification becomes likely. The problem could possibly be solved
by avoiding over-ventilation and considering heat recovery. The
PROBE studies63 point out that cleanliness may be a more important
factor and that ventilation should not be operated solely to satisfy
heating or cooling requirements.
Once the process is complete, the building should be re-tested and the
occupants re-interviewed to measure the effectiveness of any remedial
actions.
©BSRIA TN 2/2002
6 GLOSSARY OF TERMS AND ABBREVIATIONS 6
ALIPHATIC
Relating to or being an organic compound having an open-chain
structure
ALVEOLI
Tiny sacs at the ends of the finest bronchioles (qv) where gas
exchange takes place with the bloodstream
AROMATIC
An organic compound, which is a ring system usually containing
multiple conjugated double bonds
ASHRAE
American Society of Heating, Refrigerating and Air-Conditioning
Engineers
ASYMMETRIC
Not symmetrical
BIOCIDE
A substance that is destructive to many different organisms
CHROMATIC
Of or relating to colour or colour phenomena
CIBSE
Chartered Institution of Building Services Engineers
ENDOTOXIN
Toxin only released after the death of the bacterial cell
HEPA
High efficiency particulate arrestance (filters)
HSE
Health and Safety Executive
HVAC
Heating, ventilation and air-conditioning
LEGIONELLA
Name given to the genus of bacteria, which causes the condition
commonly known as legionnaires’ disease. Other diseases associated
with the bacteria are Pontiac fever and Lochgoilhead fever
LEGIONNAIRES’ DISEASE
Form of pneumonia caused by the legionella bacteria
©BSRIA TN 2/2002
6 GLOSSARY OF TERMS AND ABBREVIATIONS
MUCUS
A viscid slippery secretion that is usually rich in mucins and is
produced by mucous membranes which it moistens and protects
MUCOSAL
Secreting or containing mucus or relating to, or resembling mucus
NR
Noise rating
PMV
Predicted mean vote
PONTIAC FEVER
An acute, fever-producing, non-pneumonic illness caused by legionella
pneumophila and certain other species of legionella
PPD
Predicted percentage dissatisfied
PPM
Parts per million
PSYCHOPHYSICAL
Involving aspects of physical (as intensity of simulation) and mental
processes
PSYCHOSOCIAL
Involving aspects of social and psychological behavior
SBS
Sick building syndrome
VIRAL
Of, relating to, or caused by a virus
WHO
World Health Organization
©BSRIA TN 2/2002
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(Sick Building Syndrome) – Guidance for Employers, Building
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12 CIBSE, Guide A Environmental Design. Chartered Institution of

Building Services Engineers, London, 1999. ISBN 0 9009 5329 2.
13 CIBSE, Guide B Installation and Equipment Data. Chartered

Institution of Building Services Engineers, London. 2001 (revised),
ISBN 0 9009 5330 6.
©BSRIA TN 2/2002
7 REFERENCES
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Refrigerating and Air-Conditioning Engineers, Inc, Atlanta, USA.
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15 EN ISO 7730-1994, Moderate thermal environments – determination of

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16 Potter N, Sick Building Syndrome. Technical Note TN4/88. BSRIA.

1988, ISBN 0 8602 2212 8.
17 Pöllman L, Circadian and Circannual Variations in the Evaluation of

Thermal Comfort in a Constant Climate. Journal of the Indoor
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18 Olesen B W, Introduction to the New Revised Draft of EN ISO 7730.

Proceedings of Moving Thermal Comfort Standards into the 21st
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19 Toftum J, Human Response to Combined Indoor Environment Exposures.

Proceedings of Moving Thermal Comfort Standards into the 21st
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20 European Commission, Indoor Air Quality and the Use of Energy in

Buildings. Report no.17. EUR 16367 EN. 1996. ISBN 9 2827 6347 1.
21 Jaakkola J J K and Heinonen O P, Mechanical Ventilation in an Office

Building and Sick Building Syndrome, a Short-term Trial. Proceedings of
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22 Menzies R I, Tamblyn R M, Tamblyn R T, Farant J P, Hanley J and

Spitzer W O, Sick Building Syndrome: the Effect of Changes in Ventilation
Rates on Symptom Prevalence; the Evaluation of a Double-blind
Experimental Approach. Proceedings of Indoor Air’90, Toronto,
Canada. Vol 1, pp 519-524. 1990.
23 Seppänen O A, Fisk W J and Mendell M J, Association of Ventilation

Rates and CO2 Concentrations and Other Responses in Commercial and
Institutional Buildings. Indoor Air.Vol 9. No 4. pp 226-252. 1999.
24 Brisson C, Bourbeau J and Allaire S, Sick Building Syndrome Symptoms

Before, 6 Months and 3 years After Being Exposed to a Building with an
Improved Ventilation System. Proceedings of Indoor Air’96, Nagoya,
Japan. Vol 2. pp 259-264. 1996.
25 Sundell J, On the Association Between Building Ventilation Characteristics,

Some Indoor Environmental Exposures, Some Allergic Manifestations and
Subjective Symptom Reports. Indoor Air. Supplement no.2/94. pp 5-49.
1994.
26 Fang L, Clausen G and Fanger P O, Impact of Temperature and

Humidity on Chemical and Sensory Emissions from Building Materials.
Indoor Air. Vol 9. No 3. 193-201, 1999.
©BSRIA TN 2/2002
REFERENCES 7
27 Thomann W R and Tulis J J, Fungal Contamination of HVAC Surfaces:

the Role of the Dew Point in Microbial Amplification. Proceedings of
Indoor Air Quality’96, Baltimore, Maryland, USA. pp 25-29.
October, 1996. ISBN 1 8834 1341 9.
28 Faithfull M, Mr Bright and Mr Dim Go to Work. Lighting Equipment

News. pp 14-15. October, 1997.
29 Stone P T, Fluorescent Lighting and Health. Lighting Research

Technology. Vol 24. No 2. pp 55-61. 1992
30 CIBSE, Lighting Guide Lighting Guide 7, Lighting for Offices.

Chartered Institution of Building Services Engineers, London. 1993.
ISBN 0900953632.
31 Witterseh T, Wargocki P, Fang L, Clausen G and Fanger P O, Effects of

Exposure to Noise and Indoor Air Pollution on Human Perception and
Symptoms. Proceedings of Indoor Air’99, Edinburgh, Scotland. Vol 2.
pp 125-130. August, 1999. ISBN 1 8608 1296 1.
32 Burt T, Sick Building Syndrome – the Acoustic Environment.

Proceedings of Indoor Air’96, Nagoya, Japan. Vol 1. pp 1025-1030.
July, 1996.
33 Martinac I, Small Air Ions and Indoor Air Quality. AIRAH Journal.
Vol 50. No 3. pp 17-21. 1995.
34 Kowalski W J, Indoor Mold Growth – Health Hazards and Remediation.

Heating, Piping and Air Conditioning. Vol 72. No.9. pp 80-83.
2000.
35 Health and Safety Executive (HSE), Occupational Exposure Limits.

EH40/2000. 2000. ISBN 0 7176 1730 0.
36 Brown S K, Sim M R, Abramson M J and Gray C N, Concentrations

of Volatile Organic Compounds in Indoor Air – a Review. Indoor Air.
Vol 4. pp 123-134. 1994.
37 Dols W S, Persily A K and Nabinger S J, Environmental Evaluation of a

New Federal Office Building. ASHRAE symposium, Environments for
people. Proceedings of Indoor Air Quality’92. pp 85-93. 1992.
ISBN 0 9101 1094 8.
38 Mølhave L, Liu Z, JÖrgensen A H, Pedersen O F and Kjærgaard S K,

Sensory and Physiological Effects on Humans of Combined Exposures to
Air Temperatures and Volatile Organic Compounds. Indoor Air. Vol 3.
pp 155-169. 1993.
39 Borrazzo J and Girman J, Temperature Effects in Building Bake-out.

Proceedings of Indoor Air’93, Helsinki, Finland. Vol 6. pp 575-580.
July, 1993. ISBN 9 5122 4565 9.
©BSRIA TN 2/2002
7 REFERENCES
40 Hayward S B and Wesolowski J J, Guidelines for Reduction of Exposure

to Volatile Organic Compounds (VOC) in Newly Constructed or
Remodelled Office Buildings. Proceedings of Indoor Air’93, Helsinki,
Finland. Vol 2. pp 665-610. July, 1993. ISBN 9 5122 1565 9.
41 Hicks J, Worl K and Hall K, Building Bake-out During Commissioning:

Effects on VOC Concentrations. Proceedings of Indoor Air’90, Toronto,
Canada. Vol 3. pp 413-418. 1990.
42 Offermann F J, Loiselle S A, Ander G and Lau H, Indoor Contaminant

Emission Rates Before and After a Building Bake-out. Proceedings of
Indoor Air’93, Helsinki, Finland. Vol 6. pp 157-163. July, 1993.
43 Van Der Wal J, Hoogeveen A W and Wouda P, The Influence of

Temperature on the Emission of Volatile Organic Compounds from PVC
Flooring, Carpet and Paint. Indoor Air. Vol 7. pp 215-221. 1997.
44 World Health Organisation (WHO), Report on a WHO Meeting

21-24 August 1984, Indoor Air Quality Research. EURO Reports
and Studies 103. Regional Office for Europe. Copenhagen,
Denmark. 1986.
45 U S National Institute for Occupational Safety and Health, Building

Air Quality: a Guide for Building Owners and Facility Managers.
PB92-145374. December 1991.
46 Schmidt A, EPA’s Approach to Radon Risk Estimation. Proceedings of

Indoor Air’90, Toronto, Canada. Vol 1. pp 465-470. July-August,
1990.
47 Crameri R and Burkart W, The Radon Problem. Radiation Physical

Chemistry.Vol 43. No 2. pp 251-259. 1989.
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Copenhagen, Denmark. (Consultation meeting held at WHO
European Centre for Environment and Health, Bilthoven, the
Netherlands, 28-31 October 1996). 1998.
49 Raynal A, Robertson A and Burge S, The Effect of Progressive Reduction

of Smoking on Sick Building Syndrome Symptoms in a Large Office
Building. Proceedings of Indoor Air’99, Edinburgh, Scotland. Vol 1.
pp 80-85. August, 1999.
50 Dombrowsky Y and Hill J, Health Complaints in Air Conditioned

Buildings. AIRAH Journal. Vol 53. No 9. pp 22-29. 1999.
51 Clements-Croome D J and Jukes J, Computers and Health in the

Workplace. Proceedings of Healthy Buildings 2000, Espoo, Finland.
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52 Bordass B, Bromley K and Leaman A, Building Design,Technology and

Occupant Well-being in Temperate Climates. Brussels. February, 1993.
©BSRIA TN 2/2002
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53 Perry M and Raw G, Power to the Workers. Building Services Journal

CIBSE. Vol 21. No 12. pp 31-32. 1999.
54 Leaman A and Bordass B, Productivity in Buildings: the ‘Killer’Variables.

Building Research & Information. Vol 27. No 1. pp 4-19. 1999.
55 Leaman A, Probe 10: Occupancy Survey Analysis. Building Services

Journal. No 5. pp 44-59. 1997.
56 Fletcher J, Building Control & Environmental Quality – A Best Practice

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57 Fletcher J, HVAC Troubleshooting – A Guide to Solving Indoor

Environmental and Energy Consumption Problems. Application Guide
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58 Kendrik C, Martin A and Booth W, Refurbishment of Air-conditioned

Buildings for Natural Ventilation. Technical Note TN 8/98. BSRIA.
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59 Offermann F J, Professional Malpractice and the Sick Building Investigator.

Proceedings of Indoor Air Quality’96, Baltimore, Maryland, USA.
pp 132-136. October, 1996. ISBN 1 8834 1341 9.
60 Loyd S R, Guidance and the Standard Specification for Ventilation

Hygiene. FMS 1/97. BSRIA. 1997. ISBN 0 8602 2454 6.
61 CIBSE. Minimising Pollution at Air Intakes. Technical Memoranda

TM21. Chartered Institution of Building Engineers, London. 1999.
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62 Booth W B, Potter I N and Jones T J, Location of Fresh Air Intakes.

TN 12/2000. BSRIA. ISBN 0 8602 2560 7.
63 Bordass W, Bunn R, Cohen R, Standeven M and Leaman A, Probe:

Some Lessons Learned from the First Eight Buildings. CIBSE National
Conference. October, 1997.
©BSRIA TN 2/2002
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TECHNICAL NOTE TN 2/2002

BSRIA would like to thank the following sponsors for their

The former Department of Transport, Local Government

British Gas Properties

This publication is an update of the BSRIA publication Sick Building

Dr Anu Palmer, Dr Rosie Rawlings, Nigel Potter and William Booth

This publication has been produced by BSRIA as part of a contract

The authors have sought to incorporate the views in the previously

All rights reserved. No part of this publication may be reproduced, stored in a

2 DEFINITION AND SYMPTOMS 5

4 HEALTHY BUILDING ISSUES 8

5 PROTOCOLS AND CHECKLISTS 33

6 GLOSSARY OF TERMS AND ABBREVIATIONS 37

FIGURES AND TABLES

Figure 1 Effect of clothing on sedentary comfort (from BSRIA TN 4/88) 10

The phenomenon of building-related sickness (once known as sick

The Workplace (Health, Safety and Welfare) Regulations 1992, which

At present a revision is under consultation to allow civil claims to rely

In addition to the existing legislation, the Approved Code of Practice on

The Code will have a significant effect on pubs, restaurants, nightclubs

In 1995 the Health and Safety Executive (HSE) issued official

Dr Anu Palmer and Dr Rosie Rawlings

There have been a number of studies in the UK of building-related

It has been estimated that up to 30% of refurbished buildings, and an

● a large number of workers per room

● sensory irritation of eyes, nose and throat, in the form of dryness,

● unspecified hyperactivity reactions, such as runny eyes, runny

A building deemed to be sick has either some or all of the above

The parameters believed to be involved in the symptoms can be

Physical and indoor air quality parameters are:

● temperature and air velocity

Psychosocial parameters are:

● tedious work schedules

In building-related sickness, the combined effect of several elements

As temperature is one of the few parameters which bears a significant

The commonly used dry-bulb air temperature is not the only

The effective draught temperature (θ) is used to define difference in

θ = effective draught temperature (K)

In order to assess the performance of any ventilation system, various

It is generally accepted that a high percentage of people are

In addition to considerations of local air velocity, the average room

The predicted mean vote (PMV) and the predicted percentage of

A seven-point thermal sensation scale is used in the ASHRAE

It should be noted that even with perfect conditions, a PPD value

The optimum thermal comfort for sedentary occupants experiencing a

Figure 1: The effect of clothing on

● local cooling: radiation exchange with adjacent cold surfaces,

As with any quantity such as velocity, temperature, PMV and PPD,

There is evidence that changes in the indoor temperature during the

For most thermal parameters it has been possible to establish

At the moment there is no method for combining the percentages of

The EN ISO 7730-19945 standard is currently under revision and if

4.2 VENTILATION Fresh air ventilation rates

● not more than 10% of the occupants suffer from mucosal

The American phrase for building-related sickness used to be tight

The first is to reduce the emission of the pollutants if they can be

Ventilation requirements should reflect the total pollutant load present

The following ventilation rates are recommended by CIBSE Guide A12:

● 8 l/s/person in non-smoking areas

ASHRAE 62-1999 recommends ventilation rates of 8 l/s/person in

In a recent review23 of residential and non-industrial buildings (mostly

In a long-term study24 sick building symptoms were monitored in an

Each-half floor was ventilated independently and air from the