Time to Prepare

Follow these steps when preparing an indoor air quality plan:

• Get a "healthy building baseline" for each facility. Information about high-risk areas and activities, air-exchange systems, microbial matrix, and incidence and prevalence of absenteeism, gathered over time, should be systematically recorded. Extensive testing is not necessary, but some basic testing may be helpful. Standardized information is important to understanding the building from a medical and public health perspective and is an inexpensive investment of time and resources.

• Future problems may be preempted by preventive responses that evolve out of the baseline survey. Discovery of fungal growth activity (especially microbes associated with disease), areas of high moisture incursions, improper filters in air-handling systems, inadequate response patterns for moisture control, inadequate venting systems for art departments and food-service areas, and problematic pesticide policies are situations that may be identified in the baseline survey. In some cases, standardized responses may increase general comfort within the building and decrease the risk of a minor problem escalating into actual sick building syndrome.

Because administrators operate without regulation in the area of sick buildings, emotions run high; the ability to respond rapidly and confidently is vital. A health-oriented response will mean a lot to concerned occupants and the community. The district needs the community to see that it is prepared to work with competent health professionals to protect building occupants.

"Helplessness" and "confusion" are feelings associated with the issue of sick building syndrome. It is a problem that does not always have a regulatory solution, and is bound into areas of engineering and medicine that will challenge the best of school administrators. A careful management style and knowledgeable use of technologies in medicine, toxicology and property maintenance are a school administrator's best allies in preparing to prevent or deal with these challenges.

Defining Sick Building Syndrome

There is no regulatory definition for sick building syndrome; it simply means that the environment of a building is inspiring complaints of discomfort and/or disease.

Fundamentally, the causes of sick buildings relate to the architecture and engineering methods utilized in school construction following World War II. Schools previously built of glass, rock and wood, with high ceilings, cross-ventilation via transoms over the doors, and windows and radiators that could be adjusted by teachers were no longer being built. These buildings were replaced with factory-like buildings that featured a temperamental, eccentric system of master controls for the indoor environment, with no regard for people within the property or to the environment outside of the building. Some school facilities are in a situation where discomfort and disease can be attributed to general maintenance and operations of the building.

Health symptoms in sick buildings are highly variable, but generally fall into three categories:

1. Radical Reaction. A number of people become clearly and suddenly ill. This usually is caused by too limited air exchange combined with a "smoking gun," such as a new chemical cleaner, misbatched chlorine in a pool area, a weather inversion that prevents a kiln from venting properly, or failure of a mechanical air exchange system.
   
2. Generally Unhealthy Atmosphere. Many occupants experience ongoing, subtle discomfort or illnesses, including sore eyes, throat or nasal membranes; a feeling of lethargy; a higher incidence of upper-respiratory infections; asthmatic reactions; low-grade headaches; a continuum of muscle pain and general discomfort. Much of this relates to oxygen deprivation, typically caused by oxygen being displaced by other compounds and occasionally by infestation of microbes as a result of excessive moisture remaining within the property.
   
3. Hypersensitive Reaction or Multiple Chemical Sensitivity Reaction. One or two individuals become extremely ill. This can result if even minimal exposures occur to someone who is highly sensitive to certain chemicals. Typically, these complaints should be viewed as warnings that some low-level toxin is in the area.

Although sick building syndrome usually relates to the general characteristics of the building, itself, there are some specific situations that account for most indoor air problems:

• Combustibles; any possible introduction of carbon monoxide and ultra-fine particulates.
• Moisture retention as it may relate to mold (look for growths on drywall).
• Moisture as it may relate to airborne infectious agents (standing water and consequent growths).
• Volatile organic compounds (VOCs), usually within cleaning agents or building materials, which may give off unpleasant, sometimes toxic gases.
• Formaldehydes in new carpet, pressed wood or other building products.
• Any new or newly exposed particleboard.
• Applied poisons (pesticides, insecticides, rodenticides, herbicides).

A Proactive Approach

Administrators are dealing with a generation of post-World War II properties that are prone to indoor air quality problems, particularly buildings constructed or remodeled during the 1970s energy crisis, which influenced the tighter construction of buildings. A school district should take several preventive steps before a problem strikes.

First, initiate patterns for preventing air quality problems. Second, establish a baseline profile of the building to facilitate an efficient, inexpensive and confidence-inspiring response. Building occupants and the community need to see a clear and confident administrative approach should a problem arise in the future.

The proactive survey of the building should involve a limited amount of basic testing, particularly a professional review of the microbial matrix within the building, i.e. fungal growth activity (the number of colony-forming units or species of microbes) presently colonizing within the building.

Understanding what is in the indoor air environment can help administrators determine if there is or will be a problem or, more importantly, can help to quickly isolate the exact nature of a problem. Administrators should also consider hiring an outside contractor to review how air-handling and mechanical engineering systems are managed, how the filtering system, the air-dispersion system and the air-dilution patterns in the building are operating. Finally, a reliable epidemiological profile of comparative absenteeism should be developed and archived.

Administrators also need to be ready to implement a smooth, confidence-building reporting system for occupants regarding air quality or sick building concerns. The capability of the district to respond quickly can be the key to understanding and gaining control of the issue at hand. Again, the costs for responding to indoor air problems decrease dramatically if baseline data is available and a plan is in place.

Firsthand Experience

Concerns over air quality issues and the impact these issues were having on the health of staff and students resulted in the temporary closing of an elementary school in a twin cities suburb. Built in 1962, the building had 585 students in K-5. The district's decision to temporarily close the school in the fall of 1996 was commended by parents, staff and students as proactive and responsive to an unidentified and potentially serious problem. The school was closed for 39 days and students were housed in five other locations while steps were taken to improve the school's air quality.

Additional air quality concerns arose in the Fall of 1999 and the search for reasons for staff and student illnesses began. Old carpet had been removed from four classrooms during the summer, asbestos tile was also removed, and new carpet installed. Teachers who returned to these rooms in late summer to prepare for the new year soon began experiencing a variety of respiratory symptoms, including headaches, throat irritations and shortness of breath. In early fall, one of the teachers was moved to another classroom with her students, and subsequently all four classrooms had been vacated.

The first air-quality tests were conducted in the fall, focusing on volatile organic compounds (VOCs), molds and carbon dioxide levels. Much of the testing was conducted in the four classrooms that had the new carpet, because many of the people experiencing health problems had been in those rooms.

The district identified the following problems:

• There was inadequate air circulation and insufficient fresh air being provided to the building. The air circulation system was operating at about 40% of its designed capability.
• Molds were found in the tunnels below the univent air supply and heating systems.
• Carbon dioxide levels were too high in many of the classrooms.
• VOC levels were dramatically higher in rooms that had new carpet installed.

Prior to reopening the school, the district made several facility improvements to improve air circulation:

• Thirteen existing exhaust fans were replaced with new fans.
• Six passive exhaust vents were replaced with powered exhaust fans.
• Univent systems in classrooms were modified to ensure a minimum of 25% fresh-air intake at all times.
• Daytime/evening cycles were eliminated to allow the air exchange system to run 24 hours a day.

To further improve air quality:

• The new carpet in the four classrooms was removed and replaced with floor tile.
• Ceiling tile in the four classrooms was replaced to eliminate a possible source of harmful off-gassing.
• Stained ceiling tiles (from water leaks) were removed throughout the building to eliminate a possible source of mold/mildew.
• Openings to the tunnel system were sealed to isolate mold from the occupied environment.
• Air-purification systems were installed in five classrooms where VOC levels had been the highest and where most people had experienced health problems.
• Vacuum cleaners with improved filtration were purchased to clean the remaining carpets.
• Steps were taken to reduce or appropriately use cleaning and wax solutions in the building.