CONTENTS 1. Defining the Issues 1 Building-Related Illness 1 Sick Building Syndrome 1 Tight Buildings 4 Sick Buildings/Problem Buildings 5 Field Investigations 5 NIOSH Investigations 6 Canadian Investigations 8 Systematic Building Investigations-Symptom Prevalence 8 U.S. Studies 9 U.K. Studies 10 Danish Town Hall Study 11 Dutch Office Building Study 11 Swedish Sick Building Study 11 Skin Symptoms 14 Work Performance/Productivity 17 Multiple Chemical Sensitivity 18 Recapitulation 22 References 23 2. People-Related Risk Factors 29 Personal Characteristics 29 Gender 30 Atopic History and Other Health Factors 30 Psychosocial Phenomenon 31 Mass Psychogenic Illness 31 Psychosocial Risk Factors 33 Job Stress 33 Job Satisfaction/Dissatisfaction 34 Occupant Density : 35 Satisfaction with Physical Work Environment 35 Seasonal Affective Disorder 36 Significance of Psychosocial Factors Related to SBS 36 Tobacco Smoking 37 Environmental Tobacco Smoke 37 ETS Contaminant Concentrations 38 Irritant Effects Determined from Survey Studies 42 Irritant Effects in Controlled Exposure Studies 42 Role of ETS in SBS-Type Complaints 44 Tobacco Smoking and SBS Complaints 45 Recapitulation 46 References 47 3. Environmental Conditions/Environmental Systems 53 Environmental Conditions 53 Thermal Conditions 54 Comfort Relationships 54 Dissatisfaction with Thermal Comfort 55 Building Temperatures and SBS Symptoms 56 Humidity 57 Health and Comfort Relationships 57 Effect on Contaminants 59 Air Flow/Air Movement 59 Lighting60 Noise/Vibration 61 Air Ions 61 Physiological and Behavioral Studies 62 Clinical Studies 63 Building Studies 63 Electrostatic Charges 64 Electric and Magnetic Fields 65 Environmental Systems 67 Field Investigations 67 Systematic Building Studies 68 Type of Ventilation System 68 Ventilation Conditions - Symptom Prevalence Rates and Occupant Satisfaction/Dissatisfaction with Air Quality 68 Workstation Characteristics 73 Ventilation Conditions and Contaminant Levels 73 The HVAC System as a Source of Contaminants 75 Chemical Contaminants 76 Man-Made Mineral Fibers (MMMF) and Other Particles 78 Biological Contaminants 80 Entrainment/Re-Entry/Cross-Contamination 80 Entrainment/Re-Entry 81 Cross-Contamination 82 Recapitulation 83 References 84 4. Office Materials, Equipment, and Furnishings 93 Office Materials and Equipment 93 Carbonless Copy Paper 93 Product Characterization 93 Complaint Investigations 95 Exposure Investigations 95 Cross-Sectional Epidemiological Studies 98 Potential Causal Factors 98 Other Papers 100 Office Equipment . 101 Wet-Process Photocopiers 101 Electrostatic Copying Machines103 Laser Printers 105 Toners106 Diazo-Photocopiers 106 Microfilm Copiers 106 Spirit Duplicating Machines 107 Video-Display Terminals/Computers 107 SBS-Type Complaints107 Skin Symptoms 108 Ergonomic Problems/Job Stress . 110 Electromagnetic Radiation 111 Reproductive Hazards . 112 Human Exposure Studies 113 Floor Covering 114 Carpeting 114 Complaint Investigations115 Epidemiological Studies 116 Exposure Studies 116 USEPA Investigations 118 Emission Studies - Carpet Materials 120 Emission Studies - Adhesives 121 Emission Studies - Carpet Systems 123 Carpeting/Substrate Reactions 123 Sink Effects123 MOD Reservoir and Microbial Amplification 124 Electrostatic Shock Potential 124 Carpet Cleaning Agents 124 Vinyl Floor Covering 125 Complaint Investigations 125 Exposure Studies 125 Indoor Air Contaminants 126 Plasticizers 126 Emission Testing 127 Recapitulation 127 References 129 5. Gas/Vapor- and Particulate-Phase Contaminants 139 Bioeffluents 140 Health and Occupant Comfort Concerns 140 Circumstantial Evidence 140 Systematic Studies 142 Potential Biological Mechanisms 143 Human Pheromones 143 Formaldehyde 145 Complaint Investigations 145 Systematic Studies 146 Potentiation 147 Sources 148 Volatile Organic Compounds 148 TVOC Theory 149 Common Chemical Sense 149 Exposure Studies 149 Irritation and Odor Effects 152 Neurotoxic Effects 154 TVOC Sensitivity 154 Application of TVOC Concept 154 Systematic Building Studies 155 VOC Concentrations 157 Dust 158 Expression of Dust Concentrations 158 Systematic Studies 159 Airborne Dusts159 Surface Dusts 160 Dust Concentrations 161 Recapitulation162 References 163 6. Contaminants of Biological Origin 171 Hypersensitivity Diseases 171 Hypersensitivity Pneumonitis 172 Humidifier Fever 173 Legionnaires' Disease 173 Cooling Waters 174 Potable Water Systems 176 Asthma 176 Chronic Allergic Rhinitis 177 Allergy and Allergens as Risk Factors for SBS Symptoms 177 Dust Mites 178 Systematic Building Studies 178 Dust Mite Populations 180 Mold - 180 Presumptive Evidence of a Causal Link 180 Systematic Health Studies 182 Exposure Assessments 183 Macromolecular Organic Dust 185 Other Biological Contaminant-Related Health Concerns 186 Bacteria 186 Systematic Building Studies 187 Assessment of Bacteria in Indoor Spaces 187 Microbial Products 188 Endotoxins and Glucans 188 Mycotoxins 189 Microbial VOCs 192 Recapitulation 194 References 195 7. Diagnosing Problem Buildings 205 Role of Public and Private Groups 205 Role of Industrial Hygiene 206 Problem Building Investigation 207 American Investigative Protocols 207 The NIOSH Protocol 207 USEPA/NIOSH Protocol for In-House Personnel 209 California Protocol 211 AIHA Protocol 215 Investigative Protocols Used by Private Consultants/ Consulting Firms 217 The Building Diagnostics Protocol 217 Environmental Health and Engineering Protocol 221 Canadian Investigative Protocols 224 Public Works Canada Protocol 224 Ontario Interministerial Committee Protocol 226 European Investigative Protocols 227 Danish Building Research Institute Protocol 227 Nordtest Protocol 229 Features of Investigative Protocols 223 Multiple Stages of Investigations 233 Personnel Conducting Investigations 234 Site Visits 234 Assessment of Occupant Symptoms/Complaints 234 Use of Questionnaires/Checklists 236 Assessment of HVAC System Operation and Maintenance 237 Environmental Measurements 237 Source Assessments/Contaminant Considerations 238 Use of lAQ/Comfort Guidelines 239 Procedures for Evaluating Problems with HVAC Systems 243 Types of HVAC Systems 245 All-Air Systems 245 Air-Water Systems 245 All-Water Systems 246 HVAC System Evaluations 246 Assessing Building Ventilation 247 CO2 Techniques 248 Thermal Balance 250 Using Tracer Gases 251 Recapitulation 252 Appendix A. NIOSH IAQ Survey Questionnaire 254 Appendix B. AIHA Occupant Health and Comfort Questionnaire 256 Appendix C. Building Diagnostics Human Resource Questionnaire 259 Appendix D. Ontario Intel-ministerial Committee IAQ Survey Questionnaire 260 Appendix E. Danish Building Research Institute Indoor Climate Survey Questionnaire 266 References268 8. Measurement of Indoor Air Contaminants 273 Contaminant Measurement Considerations 273 Sampling Methods274 Gas Sampling Tubes 275 Electronic Direct-Read Instruments 276 Active Integrated Sampling 277 Passive Integrated Sampling 277 Quality Assurance/Calibration 277 Sampling Decisions 278 Location278 Time 278 Duration 279 Number 280 Administrative Practices 280 Procedures for Commonly Measured Chemical/Physical Contaminants 280 Carbon Dioxide 280 Carbon Monoxide 282 Formaldehyde 283 Volatile Organic Compounds 285 Airborne and Settled Dusts 288 Sampling Biological Aerosols 288 Sampling Approaches 289 Sampling Devices 290 Viable/Culturable Samplers 290 Comparative Studies 290 Total Spore/Particle Samplers 293 Recommended Bioaerosol Sampling Practices 294 Sampling Objectives 295 Sample Collection-Viable/Culturable Bioaerosol Sampling 296 Area vs. Agressive Sampling 296 Media Selection 296 Sampling Location/Numbers 297 Sampling Volume/Duration 297 Sampler Disinfection 298 Sampler Calibration 298 Sample Handling and Analysis 299 Sample Collection-Total Mold Spore/Particles 300 Quantification 300 Calibration ' 300 Data Interpretation 300 Recapitulation 302 References302 9. Source Control 307 Chemical Contaminants 309 Prevention/Avoidance 309 Emission/Source Characterization 309 Bioassays 310 Bad Products 310 Prospective USEPA Policies 310 Washington State Initiative 311 Private Initiatives 313 TVOCs and Source Control 315 Product Labeling 316 Design Considerations 317 Implementation of Design Criteria 318 Source Removal/Modification/Treatment 319 Source Removal 319 Source Treatment 320 Building Bake-Out 321 Source Modification 324 Biological Contaminants 325 Legionnaires' Disease 325 Biocidal Treatments 325 Source Modifications 327 Potable Water Systems 327 Effectiveness of Control Measures 328 Hypersensitivity Pneumonitis/Humidifier Fever 330 Remediation Measures 330 Avoidance 331 Asthma/Allergic Rhinitis 332 Microorganisms 332 Dust Mites 334 Surface Dusts 334 Source Removal 334 Reservoir Removal 334 Surface Cleaning : 335 Duct Cleaning 335 Recapitulation 336 References 337 10. Contaminant Control 347 General Dilution Ventilation 347 General Dilution Theory 348 Applicability of General Dilution Theory 348 Exceptions to General Dilution Theory 349 Systematic Ventilation Studies 349 Health and Comfort Concerns 349 Contaminant Concentrations 350 Controlling Human Bioeffluents 351 Ventilation Standards/Guidelines 352 Ventilation Rate Procedure 352 Indoor Air Quality Procedure 353 Perceived Air Quality Procedure 354 Ventilation Effectiveness 358 Flush-Out Ventilation .. . 359 Ventilation Innovations 361 Demand-Controlled Ventilation 361 Displacement Ventilation 363 Local Exhaust Ventilation 366 Entrainment/Re-Entry/Cross-Contamination 367Air Cleaning 368 Dust/Particulate-Phase Contaminants 369 Air Cleaner Performance 370 Evaluation of In-Use Performance 370 Control of Mold Spores/Particles 371 Gaseous Contaminants 372 Combined Filtration Systems 374 Air Cleaners as Contaminant Sources 374Recapitulation 375 References 378 Index 389