Something in the air

>> A look inside the buildings that make you sick

by NAOMI BLOCH

The image of a sick patient with a ball of fungus larger than a golfball growing in his chest is one that will take Royal Victoria Hospital a long time to live down. The daily revelations about the hospital's ventilation problems have many Montrealers suspiciously eyeing vents in their own workplaces, imagining what furry fungal beasts might be spreading through the ducts, shooting off spores at unsuspecting respiratory systems.

But mould is not the only indoor pollution problem to catch media attention. The latest report occurred earlier this week, when eight workers were rushed to hospital after experiencing dizziness and nausea apparently caused by solvent used at their paper-products manufacturing plant in Boucherville.

How many of our ailments can we blame on the quality of the air we're breathing indoors? Some estimates claim that, on average, North Americans spend more than 90 per cent of their lives indoors, and a World Health Organization report suggests that a good 30 per cent of new and remodelled buildings generate a notable number of air-quality complaints.

In the '70s, an increasing number of patients complained of headaches and allergic-like reactions whose sources could not be traced. Some of the reactions included fatigue, headache, dizziness, nausea, irritation of mucous membranes and sensitivity to odours. Over several years, these reactions were linked to common symptoms of people in specific buildings--symptoms that dissipated when these people left the buildings. The complaints, when tied to a particular building, became known as sick-building syndrome.

A related diagnosis, building-related illness, is made when something in a building's environment leads to an identifiable illness. A fungal growth the size of a golfball in someone's chest is a shining example. However, sick-building syndrome is meant to categorize a whole variety of symptoms attributed to indoor air-quality problems, which can be treated by solving the environmental issues rather than treating the patient.

Ill winds

The question is, when is the problem you and when is it the building? Try entering the inventory of sick-building symptoms into a medical database and you'll find a collection of diseases that would take weeks to sift through. In 1997, after someone reported smelling a "noxious gas" in one of the terminals at the National Airport in Washington, DC, officials ordered an emergency evacuation. Hundreds of people got sick. A hazardous-materials crew bedecked in full-body protective gear combed the building and finally found the culprit--bananas rotting in a garbage can.

Which is not to say that your work premises or residence can't make you sick. "In office buildings, the problem is often lack of air--air that's not properly recycled," says Jacques Coulombe of the Commision de la santé et de la sécurité du travail (CSST), Quebec's occupational health office. "And when people are trying to work on a budget, they'll neglect concerns like air circulation."

In an effort to save energy, newer buildings are tightly sealed and modern ventilation systems recycle a large portion of inside air. Often, fresh air may not even reach the occupants. Energy costs in older buildings are reduced by adding insulation, sealing windows and weather-stripping. Problems may arise due to contaminants released from office equipment and furnishings, but more commonly from improperly designed or maintained heating, ventilating and air-conditioning (HVAC) systems, as happened at the Royal Vic. Frequently, no single pollutant is present in unhealthy amounts, but some experts believe that because there are so many pollutants present, the total effect may be unhealthy.

"The most important thing about people with sick-building-syndrome symptoms is that they will recover very fast when they leave the building: in maybe six to eight hours," explains Dr. Louis Patry, an occupational health physician at Direction de la santé publique de Montréal-Centre. "There are many problems that could cause sick-building syndrome: problems with humidity in the air, problems with carbon dioxide--and it depends on the person."

Stress, badly designed work stations and bad lighting can be confused with sick building syndrome, and fellow worker complaints might subconsciously lead you to feel symptoms you didn't feel before. Still, there are a number of key components to sick building syndrome and building-related illness to look out for.

Volatile Organic Compounds

VOCs include a variety of chemicals (formaldehyde, ozone, styrene) which, when released, may have both short-term and long-term health effects. They're found in a significant number of products including solvents, upholstery, construction materials and copy-machine toners. Short-term effects include eye, nose and throat irritation, headaches and nausea. On a long-term basis, exposure to high levels of some of these substances--an unlikely occurrence in office buildings--may produce damage to the liver, kidney and the central nervous system.

CSST inspector Daniel Gendron says that they place priority on urgent occupational health concerns such as VOC hazards. "One time, there was a problem at a slaughterhouse on the South Shore," describes Gendron. "Someone had come at night and put some sealant on the floors of the shop. The place was completely closed up. When the morning shift came, the workers felt really sick. An inspector came and told them to ventilate immediately and to leave the door open. The problem was one we could easily identify. It didn't need some big solution. After that, we checked the air and everything was okay. So at the end of the day, the second shift of workers could go into the shop, no problem."

Carbon Monoxide

Carbon monoxide is an odourless gas regulated under outdoor air-pollutant laws, but the headaches it can cause indoors are even bigger. In many office buildings, afternoon levels of carbon monoxide can be greater than the recommended daily standard for outdoor air quality.

Garages and loading docks in buildings are a major source of carbon monoxide. If improperly vented, or if there's a leak in the duct work, the gas can escape into a building's offices. For those who haven't seen the potential results of carbon monoxide poisoning in some poignant Hollywood suicide scene, symptoms include fatigue, confusion, headache, dizziness and nausea. It can impede coordination and worsen heart problems.

Cigarettes, by the way, are another nice source of CO, and also contain over 4,000 other harmful chemical agents including formaldehyde. Of course, what with the Quebec Tobacco Act stipulating that smoking can only take place in properly ventilated, closed rooms, this isn't an really an occupational issue anymore, right?

Biological agents

Among other things, biological agents include bacteria, viruses, fungi, pollen, dust mites and moulds. Offices can be especially vulnerable to microorganisms because fungi and bacteria find nourishment in inadequately maintained air-circulation systems and in dirty washrooms.

Biological agents are present in the air almost everywhere, and stories of mould in buildings appear to be endless. The basement of Concordia University's Visual Arts building downtown has been evacuated on several occasions for problems with mould. A letter in Concordia's Environmental Health and Safety Office files from 1995 states that "the basement of the VA building is proving to be uninhabitable. Mould is seen growing on the upholstery of the chairs, and there are plans to move the cinema department to another space." According to Concordia industrial technician Lina Filacchione, the basement was evacuated again recently. "But now it's clean again. With mould, if you have to fix a leaking foundation, it can be expensive," says Filacchione. "But you have to do that. If you don't stop the water infiltration, you'll always get mould. But the university is usually pretty good for that. We have money put aside for that."

Tenant-rights activist Ted Wright has similar residential tales. "There was one case on St-Urbain where the tenants had to continually use a Javel mixture on the walls because they would put things against the wall and stuff would immediately start to grow," recounts Wright. "There was another case of mould where the landlord offered the tenant $1,000 to move out and was very relieved with the deal. It can be a really expensive problem to fix."

Mould can trigger allergic reactions, cause rashes, watery eyes, hoarseness, coughing, dizziness, lethargy, breathing problems and digestive problems. "Sometimes people with asthma will have difficulty controlling their health problems if there's mould in the building," says Patry. "Sometimes they'll have to increase their medication. They'll have very strong reactions."

Occasionally, in buildings where a humidifier or air conditioning system is contaminated, certain moulds and bacteria can lead to lung disease known as hypersensitivity pneumonitis. Symptoms are similar to the flu: chills, fever, weakness, muscle pains, cough and shortness of breath develop within a few hours after exposure. The symptoms gradually disappear once the source of contamination is removed.

And that's the key when it comes to sick-building syndrome: your best bet for long-term health is to cure the building. HVAC systems need to be regularly monitored and maintained to ensure that air is relatively clean and includes an appropriate amount of fresh outdoor air. Measuring for levels of carbon dioxide, the gas humans exhale, is a good indicator of a building's ventilation rate. When occupants complain of lack of oxygen or stuffiness, high levels of carbon dioxide will often be found.

Employees who are unable to convince their employers to take sick-building complaints seriously can anonymously call the CSST Prevention and Inspection Service (976-2911 for downtown Montreal). "When there are calls from office buildings, we'll go," says Gendron. "But unless we have a specific complaint, I won't ask my inspector to go to see if the air's okay in a specific office building. I'll say, 'Go to the shop where there's sandblasting,' or where they're using fibreglass." If a CSST inspector evaluates a building and finds that repairs are necessary, the accountable party must make corrections in the time allotted or face legal penalties.

If you feel you might have sick building syndrome or a building-related illness, you can ask your family physician for a referral to one of the five occupational health clinics in Montreal. When looking for an inspector to assess either residential or commercial air-quality concerns, beware: sheisters are everywhere. Residents with some disposable income can find a qualified inspector by contacting the Canada Mortgage and Housing Corporation (283-2222 or 283-4464), but options for tenants short on cash are limited.