Sick School Syndrome
April 23, 2004 02:57:09 AM PDT , KidsHealth.org

Some days, it seems as if your child spends almost as much time at school as she does at home. As a parent, you worry about whether she does her homework, understands her lessons, and gets along with her classmates.
But should you be concerned about whether her school building is making her sick? The federal government, in a 1995 study, found that half of the nation's schools have poor ventilation and significant sources of pollution inside the buildings. For children with asthma, particularly, indoor pollutants can be a problem.

What Is Sick School Syndrome?
When a building has indoor air problems, it is known as a sick building. Sick building syndrome (SBS) has gotten a lot of attention in the past decade or so, and it's no surprise that "sick schools" have also been put in the spotlight. When a school is deemed sick, it means that the people inside experience health problems that have no other obvious cause and that these symptoms or problems disappear or improve when they leave the building.

There are no strict criteria for diagnosing sick school syndrome; health experts make a diagnosis by examining the child and assessing whether her symptoms seem related to entering or leaving the school building. Sick school syndrome is often wrongly blamed for several illnesses and disorders ranging from winter flu outbreaks to attention deficit hyperactivity disorder. Therefore, it is important for health experts to look for other explanations for a child's symptoms before attributing them to the school environment.

Sick school syndrome is different from building-related illness (BRI), which is any illness that is associated with a building but that can be specifically diagnosed as caused by an identifiable biological or chemical agent. People who have BRI develop an illness related to something specific in the building, and they usually require time to recover from (or sometimes to develop symptoms of) the illness. Examples of building-related illnesses include carbon monoxide poisoning; asbestos, lead, or mercury poisoning; or legionnaires' disease.

Another similar illness is known as multiple chemical sensitivity (MCS). People with MCS get sick when they come into close contact with certain substances, including tobacco smoke, formaldehyde, pesticides, and other pollutants that don't significantly affect most other people. MCS is considered a chemical hypersensitivity or allergy.

With sick school syndrome, usually many people become ill, not just one. And the illness is not caused by a specifically identifiable factor; for example, if several kids get sick after a spill in chemistry class, it is not considered to be due to sick school syndrome.

What Causes It?
Sick school syndrome can be hard to nail down because there is usually no easily identifiable cause for the variety of problems and symptoms that people are experiencing. The most frequent contributing factor, though, is poor indoor air quality.

"The most common problem is that buildings don't have enough ventilation," said Kristy Miller, spokeswoman for the indoor environments division of the U.S. Environmental Protection Agency (EPA).

"Without ventilation, too much moisture leads to mold and bacteria," she says. "Also, using chemicals or paints and not ventilating properly can make people sick. Ventilating is fundamental."

Buildings are more tightly sealed today than they were 50 years ago, mainly because of energy concerns, and this can result in poorer air quality indoors. In addition, synthetic building materials and furnishings and pesticides add to indoor chemical pollution.

Both new and old buildings can be affected. With new buildings, the combination of the tight seal and the presence of chemical materials are often at fault. With older buildings, according to Miller, ventilation systems may have been turned off or allowed to fall into disrepair.

Moisture can also contribute to the development of a sick building, Miller notes. If a roof leaks and carpets are damp, they can become a breeding ground for bacteria, mold, and fungi that can make people sick. In addition, housekeeping supplies, copy machine chemicals, and pesticides can add to the problem.

The problem may also result from a simple miscalculation, like allowing school buses to idle outside an air vent that brings fresh air into the building.

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