HR Magazine - October 2000: Sick Buildings

Vol. 45, No. 10

At this moment, a threat that you can't see and have trouble identifying could literally be sucking the life out of your business -- and your employees.

The year was 1989, and the Environmental Protection Agency (EPA), guardian of environmental health and safety, was making headlines it would have preferred to avoid. In increasing numbers, workers at its Washington, D.C., headquarters were complaining that something in the building was making them sick. As commentators chortled over the EPA’s predicament, the agency approached the problem methodically, scientifically and dispassionately—and unfortunately, as EPA administrators now admit, disastrously.

"We were interested in understanding the statistics before taking action," recalls Steve Page, director of EPA’s Office of Radiation and Indoor Air. "We sent people to doctors and called in scientists; they told us they couldn’t link the problems to the building. When we passed along the inconclusive findings five weeks later, it was devastating to the people who knew that they weren’t OK."

More testing, sleuthing and time went by without pinpointing the cause. The end result was a mass epidemic of symptoms, a debilitating dip in morale and productivity and, finally, an evacuation of the building. EPA still doesn’t know why some people became ill and others didn’t. But from an HR perspective, it really doesn’t matter.

"The first thing we should have shown is concern for our employees," Page says. "Instead of studying it to death, we should have used common sense and immediately evacuated the area. Today, I would assume that anyone complaining is sincere. I would presume they’re right, act on the concern quickly and communicate the steps I’m taking. When their health is on the line, people want to be updated. They want to know if the coast is clear."

A Malaise of Huge Proportions

The EPA experience is only the tip of the iceberg. Since the 1970s when the OPEC oil embargo spurred construction of energy efficient buildings, literally millions of workers have blamed office environments for their discomfort and illness. Thousands of others are suffering from life-threatening illnesses and diseases that they attribute to their buildings.

If you don’t currently have any problems at your location, consider yourself lucky—at least for the moment. Odds are that a building malady is in the air; you’re only in remission.

We spend 90 percent of our time indoors, much of that at work; according to the Occupational Safety and Health Administration (OSHA) and the EPA, many of us are breathing air that’s making us sick or uncomfortable. Both agencies rank indoor air quality (IAQ) among the most serious environmental problems in the United States.

OSHA estimates that about 1.34 million U.S. office buildings have problems with air quality. Every day, more than 20 million American workers face an unnecessary health threat because of indoor air pollution in the workplace. The agency links thousands of heart disease deaths, hundreds of lung cancer deaths, and many cases of respiratory disease, Legionnaire’s disease, asthma and other ailments to IAQ.

EPA estimates that between 20 percent and 35 percent of all workers in modern mechanically ventilated buildings may experience air-quality discomfort or illness. Further, the agency agrees with an estimate from the World Health Organization that up to 30 percent of all new and remodeled buildings worldwide have excessive air-quality problems that can lead to sick building syndrome or building-related illness.

Yet, in spite of these disturbing figures, the government and private sector have offered little guidance to employers. (See "A Dearth of Guidance" on page 39.)

Sick Building Syndrome and Building Related Illness

Individuals with sick building syndrome (SBS) experience acute health and comfort problems that seem to be linked to being in a building, but the cause cannot be pinpointed. By comparison, building-related illness (BRI) involves symptoms that can be clinically diagnosed and linked directly to the source.

Both conditions are attributed to pollutants and bad ventilation or circulation that allow airborne chemical contaminants, mold, fungi and bacteria to linger and be inhaled by occupants.

With BRI, you can clearly detect a biological contaminant, a fungus, a bacteria or workers reacting to a toxic gas or vapor. People develop clinically demonstrable illnesses, such as Legionnaires’ disease or radon poisoning. When they leave the building, they don’t get better.

In contrast, SBS is defined by the symptoms of the occupants rather than by success at linking their complaints to specific pathogenic or toxic compounds. Large percentages of people—more than 80 percent in some buildings—experience irritation and annoyance. Symptoms include headaches, unusual lethargy, eye irritation, nose and throat irritation, tightness in the chest, nausea, wheezing, lapses of memory and skin irritation.

"It’s progressive throughout the day, and we don’t know what agent in the air is causing it," says Alan Hedges, a professor at the Department of Design and Environmental Analysis at Cornell University’s College of Human Ecology in Ithaca, N.Y. "That’s why we talk about the interaction of agents and multiple chemical sensitivity. We don’t know why these people are reacting the way they do."

Experts in both SBS and BRI agree most problems are not life threatening. "The really serious complaints are in the 5 percent range," says Neil Jurinski, a consultant at NuChemCo. Inc. in Alexandria, Va. "Most are in the comfort range. But from an HR perspective, they’re important. You can’t tell workers ‘We’ve got an uncomfortable building to work in.’ "

Sometimes a pollutant can trigger serious health conditions, such as heart disease, cancer or recurring respiratory illness. An employee who inhaled fumes from a mineral spirit stain at media giant Gannett Inc. is an example. "She’s one of the cases where someone has an exposure event," explains Celia Booth, director of safety and loss prevention at Gannett Co. Inc. in Arlington, Va. "Something triggers their illness—a cleaning agent, a paint solvent, a pesticide. Something happens that pushes an otherwise borderline person over the edge. They develop multiple chemical sensitivity. It may be difficult to prove medically, and there may be some psychological overlay, but it happens. In her case, it was life-threatening."

Overall, Booth estimates that 95 percent of IAQ problems are not life-threatening, but the impact on employee morale and the bottom line is significant. "Don’t downplay the people who experience minor irritations," she warns. "Their performance is degraded even before they bring a complaint to you."

If anything, Booth may be understating the impact. U.S. companies could save as much as $58 billion annually by preventing sick-building illnesses and an additional $200 billion in worker performance improvements by creating offices with better indoor air, say researchers William J. Fisk and Arthur H. Rosenfeld of the Lawrence Berkeley National Laboratory in Berkeley, Calif. The researchers also found that the financial benefits of improving office climates can be eight to 17 times greater than the costs of making those improvements.

"You have a substantial number of employees each day who are working sub-optimally," agrees Hedges. "Companies are wasting money by making poor design and maintenance decisions about the environment. There’s a marginal cost at the outset, but the payoff down the road is substantial."

Most Likely Candidates

What’s astounding is the sheer number of workers who attribute some illness or discomfort to their work environment.

In a healthy building, as many as 25 percent of the workers will have symptoms of illness; in sick buildings, more than 50 percent have symptoms, says Cornell’s Hedges, who has been investigating indoor air quality for 20 years.

Hedges says certain patterns or profiles emerge from his research: "People with allergies and migraines, perhaps 30 percent of the population, are more likely to have symptoms; women are more likely than men; younger workers more than older." Workers with their own space are less likely to have symptoms than those in open areas. Similarly, executives and managers are less likely to have symptoms than lower-level workers, he adds.

Within this framework, Hedges reports that worker satisfaction levels influence the number of complaints. Unhappy workers are significantly more likely to experience symptoms and complain about them. "The more dissatisfied you are, the more likely you’ll complain," he observes.

Jurinski, who has hundreds of site studies under his belt, agrees. "Where disgruntled employees prevail, your problems are legion: One person complains to another; soon everyone’s ill. Everyone blames the workplace. Before you know it, doctors and lawyers are involved and costs are escalating."

Enter HR

When someone complains, HR faces the daunting challenge of trying to understand the causes in an environment plagued by uncertainty and lack of uniform standards or guidance. Headaches, for example, may be caused by new furnishings emitting vapors, carbon monoxide, poor lighting, working on a computer for too long, stress at home or on the job or some combination of factors.

But according to Hedges, job-related stress is the crucial variable that trumps all others, rather than stress caused by role ambiguity, conflict with supervisors or life stresses such as divorce or death. "We’re overlooking a major factor when we fail to address adequately the psychological underpinnings of the complaints," he says. "It’s more of an HR problem than anything else, stemming from mismanagement, misinformation and mistrust. Typically when people complain, you get polarization. Management brings in the hygienist who says ‘There’s nothing here.’ Employees don’t believe it, and before you know it you have an ‘us vs. them’ scenario."

Then the rumor mill goes into overdrive and problems escalate out of control, raising the odds of a breakout of mass psychogenic illness. "For the most part, you have no idea what you’re breathing," Hedges says. "If someone tells you it could be damaging your health, you’re going to react. Pretty soon, people imagine things."

Take It Seriously and Build a File

An effective response from HR starts with letting employees know that you believe what they’re telling you—even if you have reason to suspect the sincerity of their motives. "Employees with performance issues tend to make complaints and there’s a tendency not to want to believe them," Gannett’s Booth says. "Good performers don’t complain. So you start with a negative attitude. But even if you think the person is not being 100 percent honest, believe them until you have a reason not to."

Begin investigating immediately. "If employers start seeing more than one complaint, they should start documenting and investigating," says Thomas Segalla, an attorney with Saperston & Day PC in Buffalo, N.Y. "Don’t get into a situation where you should have known about something and did nothing."

When employees complain, don’t panic, advises Steve Laughlin, head of environmental affairs for HBO in New York. "When they’re upset, you need to convey that every problem can be solved; nothing is so hazardous that you can’t marshal an organized response." And you have to be a good listener.

"The person may not really be complaining about the air," he says. "They may really feel mishandled by management or are angry with the senior people. But even if that’s the case, you have to respond so that they’re comforted knowing you take their problems seriously and are taking care of them."

Take Immediate Action

Demonstrate concern for employees by taking immediate steps. If you hire an outside firm to conduct tests, don’t duplicate the EPA’s mistake of waiting until results come back to take action.

A case in point: When employees began complaining about a musty smell in the Tottenville, Staten Island, branch of the New York Public Library, administrators reacted quickly. When they discovered an unhealthy mold, they evacuated the building. And they hired a credible consultant who explained complex science in everyday language.

Bringing in an expert to handle questions showed that the library was "concerned and interested in trying not to whitewash the problem," says Norman Holman, senior vice president for the Branch Libraries at the New York Public Library.

Holman hired contractors to rebuild the ductwork, change the building design, replace the wall materials and carpeting and wash down the entire structure. His staff developed internal procedures for identifying molds in the future. Then they began a systematic study of other branches, uncovering and removing molds in some buildings.

Getting Help

Since most organizations lack the in-house resources to deal with IAQ problems, they reach out to environmental health and safety specialists such as Jurinski, an industrial hygienist. Jurinski looks for chemical, biological or physical causes. "At least half the time, you can figure out the source and remedy it in a cost-effective way," he says. "It can be as simple as a ventilation problem or a water leak that has caused mold to grow."

Even when people suspect a combination of chemical substances as the cause of their illness, there’s usually one major culprit, he says. "Many times there’s one overriding problem. Solve that, and you’ve got it fixed."

Environmental firms are hired guns, but they take pride in their independence. "We’re like Dragnet’s Joe Friday," explains John Tiffany, president of Tiffany-Badar Environmental in Bedminster, N.J. "We call them as we see them. I’m not going to cook the books one way or the other."

Although consultants aren’t part of your organization, that doesn’t mean they should work alone. In fact, they report better results when they work closely with HR. "We’re most successful when the HR person is part of the team," says Catherine Coombs, an industrial hygienist with Seven Winters Associates in Norwalk, Conn. "Difficulties arise when the consultant has a box of tricks and starts to run up thousands of dollars when owners don’t understand what’s going on."

After conferring with the management team, Coombs typically meets with the people who reported being uncomfortable, takes some simple measurements, looks at the mechanical system and the design drawings, and does some benchmarking against areas where people are not reporting problems.

Finding a suitable consultant can be dicey because there are no licensing or certifying authorities. "The danger is that there are companies trying to make work for themselves," says HBO’s Laughlin. "Someone can always come in and find dust or dirt."

"What you’d like is someone with a track record in this field," says Tiffany. "Ask for references; find out if they’re active in the professional societies." He also suggests that there may be advantages to using an interdisciplinary firm. "I’m an industrial hygienist and my business partner is a mechanical engineer. A lot of times, I’m finding nothing from a health viewpoint, but from a mechanical viewpoint, he finds the air is stuffy from lack of ventilation."

Tiffany says one-day site surveys cost between $3,000 and $5,000. When an employee registers a complaint at Gannett, one of Tiffany’s clients, Gannett pays about $5,000 and gets a one-day site study that includes interviews, rudimentary testing and a written report.

For its money, Gannett also buys some peace of mind for its employees. Laughlin recently received numerous complaints about headaches and sneezing, so he brought in Tiffany to check the airflow balance. Tiffany found the problem; HBO corrected it, and the complaints stopped.

The incident is instructive: Laughlin says that even the best airflow system can be thrown out of whack over time because people tend to fiddle with vents and thermostats. As a result, even a well-maintained building will occasionally go off track—but it’s not that expensive to get it functioning properly, he says.

The problem, he says, is "seldom truly a monster," although employers must be prepared to track down the "monsters" when they rear their heads. Most often, the culprit is more mundane.

"Unless you know the source of the problem, always look first for the most obvious answers," says Laughlin. "Discomfort usually originates with airflow, lighting or heating. So start with air monitoring. That usually solves it. If not, then begin to drill down deeper and deeper. Each time you do so, of course, it’s more costly."

Workers’ Comp: Your Ace in the Hole

When in doubt about the cause of an illness, let an independent third party make the call. "If [an employee] is experiencing serious discomfort, I say ‘Let’s file a workers’ comp complaint and get you evaluated,’ says Gannett’s Booth. "The claim removes the decision about the cause of the illness to the insurance company. I don’t want HR to have to be the bad guy and tell the employee there’s nothing here. Once you turn it over to the insurance company, they’re accountable. If they deny the claim, they must be prepared to substantiate their decision."

On average, 10 Gannett workers complain of serious building-related illnesses annually. (The company employs 49,000 worldwide.) Of those 10, workers’ comp finds in favor of one.

When a workers’ comp investigation finds for the employee, Gannett offers a "let’s make a deal" proposition, says Booth. "We may decide to move the person to another station, let them telecommute or, if they choose to leave the company, pay for outplacement." Telecommuting is an option only for positions that do not require employees to be on site.

Legal Implications

Court cases involving IAQ are sprouting up with increased frequency in most jurisdictions across the country. Most, however, are settled without trial or appeals, leaving few legal precedents for guidance. Plaintiffs continue to have a difficult time showing a direct link between the building and their illness, leaving their claims vulnerable to dismissal before they reach a jury.

If plaintiffs get by that stumbling block, defendants recognize that juries are unpredictable and verdicts can be huge. In the end, defendants are willing to pay nuisance value, so they come up with a pot of money and settle, says attorney Segalla. "They never admit liability."

When workers’ compensation settles an employee’s claim, the employer is off the hook. The worker then has the option of suing the chemical company, vendor, contractor or other third party that created the illness-causing condition. But if the employer had reason to know of a potentially dangerous or unhealthy condition and did not notify such a third party, the employer may be liable.

Of course, if it’s proven that a third party vendor or manufacturer caused illnesses that cost the employer through workers’ comp benefits, the employer may sue for reimbursement.

Segalla says employers must be careful to avoid retaliating against workers who report building-related illnesses. Also, employers must provide accommodations to employees who become disabled because of a building-related illness.

Communicate Openly and Continuously

When handling worker complaints of IAQ, don’t even think about withholding information, advises Pat May, director of administration for the Washington, D.C., office of the American Library Association.

May should know—she lives with IAQ issues daily: Two of her staff members are highly allergic to mold, mildew and perfumes; another has asthma. Whenever something in the office affects these employees, May contacts the property manager—and lets the employees know she’s followed through.

May also keeps workers apprised of the property manager’s maintenance program, which includes periodic air sampling and checks of the air conditioners and cleaning of vents. "We always let them know when the testing is going on and when the maintenance is scheduled, and I share the air quality tests with them," she says.

Recently, the office suffered extensive water damage, triggering the risk of molds and other potentially toxic fungi. "We kept the employees informed. I sent e-mail messages each day telling them the steps we were taking. We alerted them of potential problems of chemicals used to combat the mold and gave them an opportunity to work at home that day. A couple of them took us up on it."

You have to keep people in the loop, observes consultant Tiffany, a veteran of more than 700 workplace studies. "When we finish our work, we submit a summary that can be distributed to the workers. If it’s a big concern, we have an open meeting and let the people vent on me instead of the HR guy."

Often, lack of knowledge, combined with fear, can cause mild hysteria. Tiffany recalls situations where he was able to dispel fears of cancer by providing clear, understandable information to worried workers. "I’ve had people call me and say ‘Come in and test at night; we don’t want the workers to know you’ve been here.’ I say that’s not a winning strategy. If you let us come during the day with all the bells and whistles, you look good, like you’re taking all the steps to solve the problem."

Cornell’s Hedges can attest to the value of good communication. He used a comprehensive communications plan to defuse a building on the verge of a major blowup caused by panic over real and perceived illnesses. "We implemented a feedback system; so when you registered a complaint, maintenance sent back a notice that it had been received and explained what they did to resolve it. We also instituted a ‘visiting system.’ Most people don’t know how a ventilation system works. We took people on tours, got them to meet people who ran it. It alleviated fears, and within three months the complaint rate was negligible."

Call to Action

People don’t like to talk about or admit they have sick buildings. Like a car that’s a lemon, once a building is branded sick, the moniker tends to stick. Some people envision either huge cost outlays or being forced to abandon the building if word gets out.

"It’s a scary issue for people to be open about," says Fay Feeney of Safety Leadership in Hermosa, Calif., a member of the Society for Human Resource Management Workplace Health and Safety Committee. "People try to handle their problems in a confidential manner, so there’s not enough open exchanges about best practices."

"Don’t be scared away," says Peter Iwanowicz, director of environmental health for the American Lung Association of New York State. "People tend to bury themselves in the sand instead of taking care of the problems. There are a lot of steps that HR can take to monitor and improve air quality that aren’t very expensive and will help improve employee health and productivity."

One inexpensive option is to purchase a carbon dioxide meter—a $1,000 investment. Too much carbon dioxide in the air is a tip-off that the air is foul. Once CO ₂ gets beyond a certain level, people start to complain of discomfort.

"It’s a good base indicator that air is not circulating properly," says Jurinski. "When we investigate, we often discover that CO ₂ is not the cause; it leads us to the other stuff in the air that’s not being exhausted and causing the problem."

Another suggestion is to keep your building clean and well maintained. Experts say good maintenance can cut identifiable problems by as much as 50 percent. Even when you can’t identify the source, remember that most complaints are triggered by thermal discomfort. So blow air at the problem. Find a way to give workers personal control over their air supply, and, "poof," the problem may disappear.

Other tips from EPA’s Building Air Quality Action Plan (which is available at www.epa.gov/iaq/base/actionpl.html) include the following:

Name an indoor air quality manager who knows the building well and who is responsible for maintaining a checklist of things that need to be done.

Give the manager responsibility for walking through the building regularly looking for potential problems.

Go after existing problems that you know about first, such as trucks idling at loading docks near ventilation ducts.

Be mindful of events like remodeling, painting, pest control and renovations that introduce new elements into the environment and can trigger symptoms.

Maintain good communications with building occupants.

Contact: workforcereadiness@shrm.org

Robert J. Grossman, a contributing editor of HR Magazine, is a lawyer and a professor of management studies at Marist College in Poughkeepsie, N.Y.