Regulation and its role in the prevention of building-associated illness.

Many groups have as their common goal the maintenance of acceptable indoor air quality, which protects occupants from adverse health effects and discomfort, but no one group possesses the interest or expertise to deal with all of the IAQ issues. Nonetheless, conclusions can be made regarding available alternatives to mitigate indoor air quality problems, including building-associated illness. It has been suggested that congressional action is needed in three areas related to BAI and IAQ: Recognition that controlling outdoor air only--even if "health based"--will not result in substantial improvement of public health; Definition of responsibilities for achieving healthful indoor environments; and Resolution of jurisdictional disputes between various federal agencies. Through their studies of buildings whose occupants complained of building-associated illness, NIOSH and others have concluded that inadequate supply and distribution of outdoor air to indoor spaces are the most common causes of SBS. Nonetheless, there are no reports of follow-up studies which confirm that the recommended ventilation upgrades actually solved the IAQ problems. Other reports indicate that maintenance, energy management, and air distribution are as important as ventilation rate. Corrective action, therefore, should include these issues. Systematic research directed toward providing cost-effective and innovative solutions should be the driving force. Rather than regulation, governments should assist in funding the necessary research, providing educational, technical and legal assistance, and developing policy options directed at reducing indoor air pollutants. In those cases where the specific causes of IAQ problems can be identified, remedial actions should be immediately implemented utilizing available technology. It has been suggested that "sick buildings" resulted from too much emphasis on efficency and safety and not enough on occupant health and well-being. Because health has been defined as "a state of complete physical, mental and social well-being not merely the absence of disease or infirmity," greater emphasis should be given to the concept of control and maintenance of healthy indoor environments (i.e., "healthy buildings") through utilization of quality assurance measures. Also, human response, system performance, and service factors should be utilized to assure an acceptable building performance. Finally, building designers, contractors, owners, managers, and operators must be knowledgeable regarding indoor air quality problems and their consequences and work together to build and maintain healthy buildings. This includes developing training, education, monitoring, and preventive maintenance programs to assure accountability for the proper management of the building systems. The certification (or licensing) of those responsible for providing indoor air quality has been suggested.