of the building determines the circulation of air (and air contaminants) in and out of the building. If the ventilation system is not efficient enough at dissipating the pollutants that are brought into the building, they will stay there longer, thus affecting health, said Anthony Bernheim, principal of green design at the architectural firm of SMWM. According to Bernheim, several major factors affect indoor air quality: the quality of the outside air, the location of outside air intakes, construction materials, furnishings, equipment, filtration and ventilation efficiency, occupants, and maintenance. The following types of chemical compounds are found in indoor air:

• Volatile organic compounds, which may be emitted from building materials and fabrics, new furniture, cleaning materials, vinyl wall coverings, and office equipment

• Microbial volatile organic compounds, such as mold and mildew

• Semivolatile organic compounds, which come from fire retardants and pesticides

• Inorganic gases, such as ozone, carbon monoxide, and nitrogen dioxide

• Particulate matter from burning fuels in cars and from burning combustion products

In the early 1990s, a Scandinavian researcher, Lars Molhave, introduced the term total volatile organic compounds to reflect the burden of volatile organic compounds in indoor air. This term has received considerable acceptance among indoor air quality experts, noted Bernheim (Hudnell et al., 1992).

Building-related illnesses include symptoms associated with sick building syndrome as well as specific building-related illnesses, such as Legionnaire’s disease. Symptoms associated with sick building syndrome include headache, nausea, nasal and chest congestion, wheezing, eye problems, sore throat, hoarseness, fatigue, chills and fever, muscle pain, and neurological symptoms, such as difficulty remembering or concentrating, dizziness, and dry skin. These symptoms do not necessarily keep people away from work, but they are often a source of complaints and undoubtedly contribute to lost productivity and dissatisfaction with the work environment, said Bernheim. The symptoms are not easily attributable to any particular chemical in the building and generally subside when people leave the building.

Sharp distinctions between health and comfort are not always readily apparent and may not be appropriate. Attempts to draw distinctions contribute to contradictory and inconsistent research findings, noted Schettler. Many researchers in this field think that complaints of building-related symptoms are worthy of investigation, even if a definable disease cannot be identified, said Schettler.