pulmonary disorders
Building Related Illnesses
Diagnosis of Building Related Illness
Evaluation of patient factors Workplace evaluation The diagnosis of building-related illness is based on the exposure history and clinical findings (including symptom onset, timing, and progression). Increased use of medications, medical visits, and sick days used should be documented. Symptoms that are temporally associated with a specific building or environment and that improve when the patient is away from the environment is an important clue that should be noted. As in any other clinical encounter, specific illnesses, such as Asthma or The exposure assessment includes a description of the work and other environments the patient frequents, including the size of the space, number of workers, ventilation, job tasks, and potential sources of exposure such as dust, chemicals, gases, cleaning products, mold, and other microbial agents. The patient should be asked about any changes in the workplace or work processes that may coincide with onset or exacerbation of symptoms. Similar symptoms in other occupants of the building, though not always present, can be a clue to building-related illness. Commonly encountered building settings include offices, schools, restaurants, entertainment venues, and healthcare facilities. Recent renovations, refurnishing, or construction should be documented and evaluated as a potential source of exposure. A workplace evaluation can be helpful in identifying contributing factors to building-related illness or symptoms. A workplace evaluation helps to identify potential exposures, such as water incursion, mold, dust, odors, and temperature extremes, as well as to get a sense of the overall indoor environmental quality, including ventilation and fresh air intake. Sources of information about the indoor environment include the employer, previous workplace evaluations, safety data sheets, previous environmental monitoring reports, and union representatives. Extensive air and surface sampling, such as for mold, is generally not necessary and is often costly. Most building-related illnesses are related to more than one exposure combined with inadequate ventilation. 