What Is Sick Building Syndrome?

Why It Matters for Building Performance, Wellness, and Your Bottom Line

You’re indoors right now, and you probably will be 90% of today. But did you know the air you’re breathing could be making you sick? Sick building syndrome (SBS) is an underrecognized but impactful issue tied to poor indoor air quality (IAQ).

What is sick building syndrome?

SBS is a building-related illness where people experience fatigue, brain fog, headaches, or illness specifically while inside a building, often improving after they leave. SBS is not always caused by a single factor, making it tricky but critical to address.

What causes SBS?

SBS can arise from a variety of environmental and structural factors that compromise office indoor air quality issues. Understanding these causes is essential for identifying potential risks and implementing effective solutions to create healthier, more productive spaces. Below is a list of common contributors to SBS that building owners, architects, and consultants should be aware of when designing, maintaining, or occupying a building:

• Poor ventilation or HVAC maintenance
• High concentrations of indoor air pollutants (VOCs, cleaning chemicals, off-gassing materials)
• Excess humidity and mold in HVAC systems
• Acoustic discomfort and noise-related stress
• Lack of natural light/overexposure to artificial light
• Chemical pollutants in buildings
• Dust and allergens in offices

What are the symptoms of SBS?

Symptoms of sick building syndrome tend to worsen the longer you remain inside a specific building and improve once you leave the environment. These symptoms are common and can have many different causes. They’re unlikely to indicate sick building syndrome if you experience them constantly or in a variety of different locations. Symptoms can include:

• Fatigue in the workplace
• Headaches
• Dizziness or nausea
• Eye irritation at work
• Dry cough indoors
• Skin irritation
• Difficulty concentrating (“brain fog”)

What are the effects of SBS?

While the immediate symptoms of SBS are often temporary and improve after leaving the affected environment, prolonged exposure can lead to more serious, long-term health and performance consequences. The following list outlines some of the potential long-term outcomes associated with chronic exposure to conditions that cause SBS:

• Chronic respiratory issues
• Employee burnout and absenteeism
• Building reputation loss/tenant turnover

SBS can significantly impact the health and productivity of building occupants. Headaches, fatigue, respiratory problems, and difficulty concentrating can reduce comfort, diminish work efficiency, and can contribute to increased absenteeism.

Architects and consultants are also affected, as buildings associated with SBS reflect poorly on design and consultancy practices, potentially leading to reputational damage, liability concerns, and the need for costly redesigns or retrofits. Addressing factors like poor ventilation, inadequate lighting, and the presence of indoor pollutants becomes critical not only for safeguarding occupant well-being but also for ensuring that built environments support optimal performance and long-term satisfaction.

How can you prevent SBS?

Preventing SBS requires a proactive approach that begins in the design phase and continues throughout the life of the building. Making thoughtful choices during the design and construction process can minimize the risk of SBS from the start. Specifying materials with low volatile organic compounds (VOCs) helps reduce the presence of harmful chemicals in indoor air, improving overall air quality.

Prioritizing indoor air quality (IAQ) from the outset and maintaining it over time can also help prevent SBS. Integrating IAQ goals into early mechanical, electrical, and plumbing (MEP) discussions ensures that ventilation and filtration systems are designed to support healthy air exchange from day one. Additionally, collaborating with commissioning agents throughout the project helps verify that systems are installed and function as intended, aligning with IAQ performance goals.

Maintaining a healthy indoor environment requires continuous attention. Upgrading filters and ventilation systems can enhance air circulation and remove pollutants more effectively, while scheduling regular IAQ assessments helps identify and address potential issues before they impact occupants. Incorporating air purification or monitoring equipment provides an added layer of protection, offering real-time insights into air quality and allowing for timely interventions if conditions decline. Together, these measures ensure that indoor environments remain safe, comfortable, and supportive of long-term occupant health.

Why does this matter?

Awareness of SBS is crucial because we spend approximately 90% of our lives indoors, making the quality of our indoor environments a significant factor in our overall health and well-being. Ignoring indoor air quality not only poses clear health risks, such as respiratory issues, fatigue, and chronic discomfort, but also threatens productivity through increased absenteeism and decreased cognitive performance.

Ensuring Compliance with WELL & LEED Standards

There are also legal and liability risks for building owners, designers, and employers who neglect to provide safe, healthy spaces. As the market increasingly shifts toward standards like WELL Building, LEED, and other sustainable design certifications, prioritizing indoor air quality is no longer just a best practice—it is an expectation. Embracing these frameworks helps ensure regulatory compliance, supports occupant satisfaction, and aligns with the growing demand for buildings that promote long-term health and environmental responsibility.

SBS is a serious indoor health challenge, but it is also one that can be effectively prevented with thoughtful design, diligent maintenance, and a commitment to indoor air quality. By understanding the factors that contribute to SBS and implementing proactive strategies, from selecting low-emission materials to regularly assessing and improving air systems, building owners, architects, and consultants can create spaces that safeguard occupant health and enhance productivity.

Turn Your Sick Building into a Healthy Building with K&W

Ketchum & Walton partners with teams from design to commissioning to support healthier indoor environments. With the right attention and care, we can ensure that buildings remain assets, not liabilities, for those who live and work within them. Reach out to talk through air quality solutions that keep your building and its people performing at their best.

Signs Your Building May Be Causing SBS

✔️ Occupants frequently report headaches, dizziness, or fatigue while inside the building

✔️ Increased complaints of dry or irritated eyes, nose, throat, or skin

✔️ Symptoms improve shortly after leaving the building

✔️ Noticeable stale, stuffy, or unpleasant odors indoors

✔️ Poor or inadequate ventilation

✔️ Presence of visible mold, mildew, or excessive dust

✔️ High humidity levels or persistent dampness in certain areas

✔️ Recent use of new carpets, furniture, paints, or other materials that may emit VOCs

✔️ Inconsistent indoor temperatures or drafts that create discomfort

✔️ Increased absenteeism or decreased productivity among occupants

✔️ Building occupants reporting allergy-like symptoms not present elsewhere

✔️ Lack of regular HVAC maintenance or indoor air quality assessments

If you checked multiple items on this list, it may be time to investigate your building’s indoor air quality and consider taking steps to address potential sources of sick building syndrome.