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Sick Building Syndrome: The killer within

People in the UAE spend considerable time indoors — either at home, in the office or in shopping malls. This exposes them to indoor pollutants that have the potential to cause considerable damage to health.

According to the World Health Organisation, exposure to air pollutants happens through inhalation of indoor air and this could lead to Sick Building Syndrome (SBS) and Legionnaires. Several studies confirm the relationship between indoor air quality and the occupants’ health, yet its seriousness is mostly undermined.

A study commissioned by the Environment Agency-Abu Dhabi and conducted by the University of North Carolina reveals that air pollution may have been responsible for more than 850 deaths in 2007 alone, an estimated seven per cent of all UAE fatalities. Of these, outdoor air pollution was responsible for 600 deaths while 250 could be attributed to indoor air pollution. The study suggests that anthropogenic air pollution, particulate matter (PM) in particular, causes considerable public health impact in the UAE. According to a Health Ministry report, 90 per cent of the 150,000 patients treated at Al Ain public health clinics suffered from diseases of the upper respiratory tract, bronchitis, asthma and other forms of respiratory disease.

The dire scenario, however, is not unique to the UAE as one-third of the world’s population suffers from Sick Building Syndrome or SBS. In both developing and developed nations, up to three million people worldwide die each year from air pollution.

Symptoms

Those suffering from SBS experience acute health and comfort effects that appear to be associated with time spent indoors and building condition. Symptoms include headache, eye, nose and throat irritation, skin rashes, dry cough, dry and itchy skin, rashes, dizziness and nausea. This could also lead to difficulty in concentrating, fatigue, aches and pains and sensitivity to odour.

Causes and effects

SBS can be identified through a single or a combination of factors. Some symptoms can be attributed either to known toxic effects of high levels of certain chemicals while others are typical of allergic reactions which could be triggered by allergens found in a building.Trouble usually begins with a poor building design. Then there are other factors such as construction operation, building maintenance and related systems, such as heating, ventilation and air-conditioning systems that might not be working at a desired level. However, the exact mechanism by which a building condition or its indoor air quality causes its occupants to become ill is still largely unknown. But the problem areas can easily be identified with a closer look at various indoor pollutants and factors that usually contribute to SBS.

For instance, volatile organic compounds (VOCs) — chemical compounds that evaporate at ambient temperatures within a building — often irritates the eyes, nose and throat, cause breathing difficulties and even increase the risk of cancer.

Yet another monster is the Carbon monoxide (CO), a colourless and odorless gaseous asphyxiant, often called ‘silent killer’. Once breathed in, it combines with Red Blood Cells (RBCs) and prevents them from carrying oxygen and suffocates the person.

Sulphur dioxide (SO2) — another gas with a strong odour — is also an irritant to the respiratory system. Children, the elderly and those with chronic lung disease and asthmatics are most at risk from these effects.

Nitrogen dioxide (NO2), which is produced from combustion of fuels, can also be fatal if inhaled in high concentrations. Its long-term, low-level exposure can also destroy lung tissue and lead to emphysema and make people more susceptible to respiratory infections. Clearly, even one or a combination of these could be a recipe for disaster.

Similarly, many older buildings contain a significant amount of highly toxic substances posing a risk for heavy metal poisoning. The two most common heavy metals present in buildings are lead and mercury. According to World Health Organization (WHO), lead-based paints are major source of lead poisoning. Mercury is being added to the paint mainly to prevent build-up of mold on walls, as it is an effective anti-fungal agent. However, it can also damage health in a number of ways, from impairing detoxification to causing serious neurological damage and birth defects.

Lead too features in this long list of indoor pollutants. According to estimates, around 70-90 per cent of homes in the UAE still contain asbestos sheets despite a government ban. When high concentrations of asbestos fibres are inhaled over a long time, it can lead to health problems. Inhalation of asbestos fibres into the lungs can also cause malignant lung cancer and mesothelioma. Besides chemicals, biological contaminants such as mold, viruses, bacteria and dust mites are also reported to be the cause of a majority of SBS cases. They can cause illness through infection, allergy, hypersensitivity and toxicity.

But today’s buildings mostly suffer from emission of volatile organic compounds (VOCs) due to extensive use of particle board, which is often used in place of solid wood in modern furniture. Particle board is a major source of VOCs due to the high content of adhesives used in manufacturing them.

Carpeting is another source of VOCs in many buildings because paint, varnishes, glues, backing materials, flame retardants, and dyes are used in manufacturing them. The VOCs that emit from new carpet include acetone, toluene, xylene, formaldehyde, and benzene derivatives, all of whom cause irritation, affect breathing, and produce various neurological symptoms including cancer.The various chemical-based products routinely used inside a building can be equally harmful. Products used to clean buildings, fresheners, marker pens and printer ink contain VOCs, formaldehyde, methyl ethyl ketone (MEK) and other chemicals.

A Dubai-based Pediatrician says building contaminated by indoor chemicals harm both children and adults, particularly pregnant women. According to him, numerous chemicals present in the building can enduringly interfere with our biological and immunity systems and could cause health ailments.

Initiatives

The Health Authority - Abu Dhabi (HAAD) has issued a guideline for all private and public healthcare facilities in Abu Dhabi to control occupational and indoor air quality. Another Health Ministry guideline says schools in the UAE should manage indoor air quality and implement a procedure for managing students’ exposure to high air pollution. Similarly, Ministerial Order No. 39/2006 prohibits import and use of asbestos in public or private buildings.

Such guidelines notwithstanding, lack of effective mechanism to identify SBS inside buildings is the biggest challenge. The government is keen to develop and implement green building initiative that will help prevent SBS and, to a greater extent, control the phenomenon. In Dubai, the Emirates Green Building Council and Estidama of Abu Dhabi Urban Planning Council have already taken initiatives to promote implementation of sustainable building practices by implementing Green Building Codes. These will be a prerequisite and applicable to all new buildings in the UAE. Dubai and Abu Dhabi governments have already announced that the code will be implemented in all new government buildings starting 2011.

The good news is that the realisation has set in at all levels and even corporate bodies are chipping in to minimise the damage. Hewlett Packard, for instance, is making efforts to bring environment-friendly products for their users. They are trying to ensure that volatile organic compound, ozone and particle airborne emissions remain within accepted indoor air quality guidelines of international standards.

Majority of paint manufacturers are launching environment-friendly, lead-free paint. Berger Paints recently launched “Breath Easy” green brand paints which have no added lead, mercury and chromium with minimum aromatic content and considerable low levels of VOCs.

Furthermore, Berger Paints is manufacturing less solvent-based coating products and water-based paint and coating in order to prevent emission of chemicals and heavy metals. Identifying generally applicable measures to prevent, eliminate or reduce SBS is an uphill task. Moreover, what works in one building may not work in another and cost-effective investigation is the key to progress in this regard. Extensive research is being conducted in many developed countries with special emphasis on SBS, its cause and its link with the age, gender and a variety of other psychological 
factors.

The earlier the conclusions are arrived at the better it will be for the inhabitants of the UAE and elsewhere.