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June 13, 1986

"Sick building" syndrome plagues workers, dwellers

JAMA. 1986;255(22):3063. doi:10.1001/jama.1986.03370220021005

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When office workers report vague symptoms that appear during working hours and abate on weekends and vacations, employers and physicians may be inclined to downplay the complaints. Now, the differential diagnosis must include the newly emerging "sick building" syndrome.

Emil J. Bardana, MD, contends that energy-efficient, tightly constructed office buildings with artificial ventilation can harbor a number of toxic agents. Speaking from the Oregon Health Sciences University, Portland, where he is vice-chair of the Department of Medicine, Bardana says there are six categories of sick building problems. The first—and least common—is hypersensitivity pneumonitis, caused by various microorganisms that can breed in ventilation duct work, air filters, and similar sites.

The second condition is building-related infections, a prime example being legionnaires' disease, caused by Legionella pneumophilia. A recent report indicated that not even hospitals are immune to this problem (JAMA 1985;254:521-524). Causative organisms may be found in cooling systems, humidifiers, and