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Building-related illness and building-related symptoms

Amy Ahasic, MD, MPH
Carrie A Redlich, MD, MPH
Section Editor
Mark D Aronson, MD
Deputy Editor
Daniel J Sullivan, MD, MPH


In industrialized countries, people spend more than 90 percent of their life indoors, and more than half of employed adults work in offices or similar nonindustrial environments [1-4]. Symptoms and illnesses related or attributed to indoor environments are common. A variety of factors associated with the environment and with the patient impact these symptoms, which may reflect new disorders, exacerbation of preexisting conditions (eg, rhinitis, asthma), and/or disorders caused by specific workplace exposures (eg, occupational asthma, hypersensitivity pneumonitis). Building-related symptoms can have a substantial impact on health. It is important for the clinician to recognize when symptoms are related to the patient's workplace, as these should be treated as occupational illnesses.

This topic will discuss building-related illnesses and symptoms, including epidemiology, potential exposures, host and building factors, and an approach to the patient with work-related illness. The discussion will focus on nonindustrial indoor work environments and schools, although many of the same exposures also exist in homes.


Several terms have been used to categorize syndromes of symptoms related to the indoor environment. Building-related symptoms or illnesses are considered work related if the indoor work exposures caused the illness or exacerbated a preexisting condition.

Building-related illnesses — Building-related illnesses (BRIs) are disorders that are associated with a particular building or indoor environment and meet diagnostic criteria for a specific illness. In some cases, a discrete causative agent can be implicated, but more often this is not possible. (See 'Building-related symptoms' below.)

BRIs can vary in severity and acuity. Examples are listed in the Table and include the following (table 1):

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Literature review current through: Dec 2017. | This topic last updated: Jun 14, 2016.
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