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C O N T E N T S

1. Introduction
   Re-circulation of air and pollutants
   Taking symptoms seriously
   Air monitoring
   Camden Housing Aid Centre
   How do buildings get to be sick?
   Chain of events
   About this book
   
2. 2: A-Z of symptoms and illnesses
   Table 1: Medical syndromes associated with buildings
   Allergy
   Asthma
   Breathing difficulties
   Chest infections
   Colds
   Cough
   Eye problems
   Dizziness
   Extrinsic allergic alveolitis
   Headache
   Hypersensitivity pneumonitis
   Humidifier fever
   Hysteria
   Influenza
   Lethargy
   Nasal problems
   Nausea
   Respiratory infections
   Sick building syndrome
   Skin problems
   Stress
   Throat problems
   Wheezing
   
3. Legionnaires' disease
   Legionella bacteria
   Legionella infections
   Table 2: Symptoms of legionnaires' disease and Pontiac fever
   Sources of infection
   Aerosols
   Table 3: Possible sources of Legionella bacteria
   Wet cooling towers
   How cooling towers work
   Design of cooling towers
   Water treatment
   Use of biocides
   Cleaning and disinfecting
   COSHH Regulations
   Replacement of wet cooling towers
   Air-conditioning equipment
   Air inlets
   Humidifiers
   Air cooling mechanisms
   Ductwork
   Hot and cold water services
   Other equipment
   Responsibility and record-keeping
   Training
   What to do in an outbreak
   The law and legionellosis
   Changes in legislation
   Registration or licensing of cooling towers
   Punishing the offenders
   Checklist for Legionnaires' disease
   
4. Causes of sick building syndrome
   Table 4: Types of problem found in 203 indoor air quality investigations carried out by NIOSH
   Airborne pollutants
   Ammonia
   Asbestos
   Benzene
   Biocides
   Carbon dioxide
   Carbon monoxide
   Detergent dust
   Ethanol (ethyl alcohol)
   Fibreglass
   Formaldehyde
   Hydrocarbons
   Hydrogen chloride
   Methanol (methyl alcohol)
   Micro-organisms
   Motor vehicle exhaust
   Nitrogen oxides
   Ozone
   Paint
   PCBs (polychlorinated biphenyls)
   Pesticides
   Photochemical smog
   Radon
   Solvents
   Sterilant gases
   Sulphur oxides
   Tobacco smoke
   Vinyl chloride
   Air-conditioning systems
   Table 5: Air-conditioning systems
   Outside air inlets
   Mixing chamber
   Filters
   Cooling and biological contamination
   Control systems
   Delivery and circulation of air
   Exhaust air
   Types of problem found
   Air quality and thermal comfort
   Table 6: Comfort levels recommended by the Chartered Institution of Building Services Engineers (CIBSE 1986)
   Temperature
   Humidity
   Ventilation
   Air movement
   Fresh air
   Thermal radiation
   Noise
   Lighting
   Ions
   Radiation and visual display units
   Stress
   
5. Investigation, remedies and prevention
   A systematic approach for trade unionists
   Obtain information on sick building syndrome
   Provide members with information
   Conduct a questionnaire survey
   Inspect the building
   Obtain information from management
   Determine objectives
   Negotiate with management
   Re-survey the membership
   Relocation/new building
   If there is no union
   Surveys and air monitoring
   The thermal environment
   Ventilation
   Air flow
   Pressure
   Natural ventilation and circulation
   Lighting
   Noise
   Dust
   Gases and vapours
   Air ions
   Radiation
   Microbiological contamination
   Smoking in offices
   Conclusion
   
Appendix 1: Office work environment survey questionnaire
Appendix 2: Checklist for building inspection
Appendix 3: Cleaning and maintenance of air-conditioning systems
Appendix 4: Design of new air-conditioning systems
Appendix 5: Sick building syndrome and the law