The sick building syndrome and mass hysteria.

Significant overlaps of symptoms in SBS and MH exist including central nervous system manifestations, mucous membrane irritation, skin abnormalities, and eye symptomatology. Both occur with greater frequency in women with lower job rank and in patients with psychological and physical stresses. No specific cause has been identified in over 75% of the cases of SBS. Remotely, less than 25% have been alleged to be secondary to an environmental toxin but even removal of the inciting irritant does not improve the symptoms. Not surprisingly, litigation is lurking in the background with the chronic complainer. There has been no evidence of exposure to toxins or VOCs that exceed the NIOSH safety standards in any SBS cases. The importance of a thorough work up is to distinguish those cases that are secondary to bacteria or toxic contaminants and infection where significant morbidity and death have occurred in the building related illness. Although this is a separate entity it indicates that the building environment can be a significant cause of morbidity and mortality. Other variables such as temperature and humidity do influence the frequency of SBS symptomatology. It may be that we are not yet sophisticated enough to find the causes that are present within our current paradigms. Current levels of toxic data testing may not be sensitive enough to realize that they might be a cause of toxicity. It might be that at low levels with multiple toxins and VOCs present, the additive effects may cause toxic symptomatology whereas individually they do not. In summary, SBS is an emerging phenomena within our litigious society.(ABSTRACT TRUNCATED AT 250 WORDS)