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Feb. 26, 2002 -- Sick building syndrome, the condition associated with itchy eyes, dry throat, headache, and lethargy, is more likely to occur with people who work in a naturally ventilated building than in one with modern air conditioning.

The illness has long been associated with the artificially controlled environment produced in air-conditioned buildings. But a first-of-its-kind study from 2000 suggested that if such buildings are well designed and properly maintained, they can produce a healthier internal environment than naturally ventilated ones.

Sick building syndrome still is a poorly understood condition, says Rob Niven, the study's lead researcher and a consultant chest physician at Wythenshawe Hospital in Manchester, England. Symptoms associated with the syndrome range from dry, irritated eyes and throat, and a runny nose to debilitating headache and lethargy. Although no one is sure how many buildings and people are affected, it can result in a significant number of sick days from work, he says. "Sick building syndrome can be severe enough to stop people working by the middle of the afternoon or even not come to work at all," he adds.

Researchers are still uncertain about the cause of these symptoms among office workers, but they are often linked to poor temperature and humidity control in air-conditioned buildings, leading to a hot, stuffy, dry environment.

"A Danish study also implicated the amount of dust in the air, and it is thought that in air conditioned buildings, toxins can accumulate and get into the dust particle," Niven says. "Naturally ventilated buildings were generally thought to be healthier."

The 2000 study, published in the journal Occupational and Environmental Medicine, looked at three "state of the art" air-conditioned buildings. In two of them, the levels of symptoms were found to be lower than in a naturally ventilated building used for comparison. The comparison building also showed particularly high concentrations of dust. The third air-conditioned building, however, had a high incidence of symptoms -- a fact which Niven suspects may have been caused by poor maintenance. A fifth, older air-conditioned building, already known to be associated with sick building syndrome, showed a high prevalence of symptoms.

Niven says the study shows that contemporary well-designed, air-conditioned buildings provide a healthier environment for office workers than naturally ventilated ones. "A really good air conditioning system can now perform significantly better at adjusting to changing temperatures and humidity than natural ventilation," he says. "We are not saying that naturally ventilated buildings cause sick building syndrome, but all offices generate huge amounts of heat from people and computers and other equipment, as well as dust. Today's more sophisticated air-conditioned offices are able to adjust to temperature changes during the day, and are also able to provide sufficient humidity."

But, he says, the key to avoiding sick building syndrome in any air-conditioned office is to ensure proper maintenance, such as making sure filters are changed regularly. "An office also generates massive amounts of dust from paper and people's clothes, and if it is taken into the air conditioning and then gets blown back, it is unhealthy."

The study also found for the first time that low-level noise may be an important risk factor for sick building syndrome. "Noise hasn't been associated with sick building syndrome in the past," Niven says. "The areas in offices where people complained of symptoms were more likely to have a low-frequency noise such as the low rumble of fans driving the air around. It's the sort of noise you probably wouldn't notice until it got switched off at the end of the day and suddenly you feel relieved. The theory is that low frequency noise makes people irritable so that they are more likely to notice other symptoms." High-frequency noises such as telephones, people talking and computers, he says, seem to protect against symptoms, probably by masking the effects of low frequency noise.

The study also supports previous findings that dust is implicated in sick building syndrome. But other factors sometimes associated with symptoms, such as chemical compounds given off by soft furnishings and electrostatic charge, were found to have no significance.

He advises office workers to do the following things to try to avoid sick building syndrome:

• Talk to health and safety personnel to ensure the building is adequately maintained.
• Get regular breaks in the fresh air.
• Take short breaks from the computer screen.
• Remember that there is no evidence air ionizers, personal air filters, or even plants protect against symptoms.

Cherrill Hicks is the former Health Editor of The Independent and the Sunday Express's magazine. Her work has also appeared in numerous magazines, and she has particular interest in women's and children's health.

© 2002 WebMD Inc. All rights reserved.

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