Features of the Tight Building Syndrome:
(1) complaints by occupants consistent with the sick building syndrome (headache, eye irritation, upper respiratory tract irritation, dizziness, lethargy and difficulty concentrating)
(2) symptoms remit when an occupant is away and recur when returning to the building
(2) no or inadequate fresh air in the building
(3) complete environmental monitoring is negative for chemicals, fungi and other known irritants
(4) exclusion of a psychogenic basis for the complaints
(5) improvement in symptoms by introducing fresh air into the building's environment
Theory:
(1) Modern building construction has resulted in tightly sealed buildings without drafts of outside air.
(2) Energy conservation causes the building maintenance supervisors to reduce the amount of outside air coming into ventilation system. As a result all or most of the air is continuously recirculated.
(3) Environmental irritants (chemical leached from construction materials, cleaning agents, fungal antigens) accumulate within the building.
Problems with making the diagnosis of tight building syndrome:
(1) Environmental monitoring can be very complex and expensive to do properly. In many situations only partial testing is performed, which means that a potentially correctable cause may be overlooked.
(2) Menzies et al evaluated a building with occupants with sick building complaints. The amount of fresh air in the ventilation system was adjusted with the occupants blinded to the change. The symptoms did not change with introduction of fresh air into the ventilation system. This would argue against simply requiring buildings to increase the delivery of fresh air, but rather to look for other possible explanations (for example, fungal antigens can cause symptoms when present in very small amounts). Increasing fresh air does little to address other environmental problems like indoor carpeting, which traps many things and which is almost impossible to clean deep below the surface.
