ABSTRACTBuilding Health Sciences, Inc. (BHS), investigated environmental conditions by many modalities in 71 discreet areas of 12 buildings in a government building complex that had experienced persistent occupant complaints despite correction of deficiencies following a prior survey. An online health survey was completed by 7,637 building occupants (49% response rate), a subset of whom voluntarily wore personal sampling apparatus and underwent medical evaluation. Building environmental measures were within current standards and guidelines, with few outliers. Four environmental factors were consistently associated with group-level building-related health complaints: physical comfort/discomfort, odor, job stress, and glare. Several other factors were frequently commented on by participants, including cleanliness, renovation and construction activities, and noise. Low relative humidity was significantly associated with lower respiratory and “sick building syndrome”-type symptoms. No other environmental conditions (including formaldehyde, PM10 [particulate matter with an aerodynamic diameter <10 μm], or mold levels, which were tested by 7 parameters) correlated directly with individual health symptoms. Indicators of atopy or allergy (sinusitis, allergies, and asthma), when present singly, in combinations of 2 conditions, or together, were hierarchically associated with the following: increased absence, increased presenteeism (presence at work but at reduced capacity), and increase in reported symptom-days, including symptoms not related to respiratory disease. We found that in buildings without unusual hazards and with environmental and air quality indicators within the range of acceptable indoor air quality standards, there is an identifiable population of occupants with a high prevalence of asthma and allergic disease who disproportionately report discomfort and lost productivity due to symptoms and that in “normal” buildings these outcome indicators are more closely associated with host factors than with environmental conditions. We concluded from the experience of this study that building-related health complaints should be investigated at the work-area level and not at a building-wide level. An occupant-centric medical evaluation should guide environmental investigations, especially when screening results of building indoor environmental and air quality measurements show that the building and its work areas are within regulatory standards and industry guidelines.
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