Relationship of SBS-Symptoms and Ventilation System Type in Office Buildings

This paper provides a summary of current knowledge about the associations of ventilation system types in office buildings with sick building syndrome symptoms. Most studies completed to date indicate that relative to natural ventilation, air conditioning, with or without humidification, was consistently associated with a statistically significant increase in the prevalence of one or more SBS symptoms, by approximately 30% to 200%. In two of three analyses from a single study (assessments), symptom prevalences were also significantly higher in air-conditioned buildings than in buildings with simple mechanical ventilation and no humidification. The available data also suggest, with less consistency, an increase in risk of symptoms with simple mechanical ventilation relative to natural ventilation. The statistically significant associations of mechanical ventilation and air conditioning with SBS symptoms are much more frequent than expected from chance and also not likely to be a consequence of confounding by several potential personal, job, or building-related confounders. Multiple deficiencies in HVAC system design, construction, operation, or maintenance, including some of which cause pollutant emissions from HVAC systems, may contribute to the increases in symptom prevalences but other possible reasons remain unclear.