Patients and the sick building syndrome.

Physicians encounter patients who have complaints related to indoor environments with increasing frequency. Physicians must distinguish between approaches to identify disease in individual patients, characterization of group effects, and analysis of environmental exposure characteristics. Simultaneously they must consider the influence of illness behavior, work stress, and organization function on the presentation of complaints. They must distinguish discomfort and irritation from disabling disease and communicate the implications of pathophysiology and the limits of knowledge to patients. Joint teams with engineers and industrial hygienists, and, at times, organizational analysis is an approach to problem solving for indoor environmental problems.