The main identifying observation is an increased incidence of complaints of such symptoms as headache, eye, nose, and throat irritation, fatigue, dizziness, and nausea.

[2] The World Health Organization created a 484-page tome on indoor air quality in 1984, when SBS was attributed only to non-organic causes, and suggested that the book might form a basis for legislation or litigation.

[5] Attempts have been made to connect sick building syndrome to various causes, such as contaminants produced by outgassing of some building materials, volatile organic compounds (VOC), improper exhaust ventilation of ozone (produced by the operation of some office machines), light industrial chemicals used within, and insufficient fresh-air intake or air filtration (see "Minimum efficiency reporting value").

[10] Extrinsic allergic alveolitis has been associated with the presence of fungi and bacteria in the moist air of residential houses and commercial offices.

[11] A study in 2017 correlated several inflammatory diseases of the respiratory tract with objective evidence of damp-caused damage in homes.

When combined with other stress factors such as traffic noise and poor lighting, inhabitants of buildings located in a polluted urban area can quickly become ill as their immune system is overwhelmed.

These aromatic carbon rings / VOCs can cause acute and chronic health effects in the occupants of a building, including cancer, paralysis, lung failure, and others.

[10] Some work conditions have been correlated with specific symptoms: brighter light, for example was significantly related to skin dryness, eye pain, and malaise.

[15][citation needed] Greater effects were found with features of the psycho-social work environment including high job demands and low support.

Workload and work conflict are significantly associated with general symptoms (headache, abnormal tiredness, sensation of cold, or nausea).

[22] Printer effluent, released into the office air as ultra-fine particles (UFPs) as toner is burned during the printing process, may lead to certain SBS symptoms.

Fisk and Berkeley Laboratory colleagues also found that the exposure to the mold increases the chances of respiratory issues by 30 to 50 percent.

[34] For instance, Legionnaire's disease, usually caused by Legionella pneumophila, involves a specific organism which could be ascertained through clinical findings as the source of contamination within a building.

[citation needed] Improving the indoor air quality (IAQ) of a particular building can attenuate, or even eliminate, the continued exposure to toxins.

However, a Cochrane review of 12 mold and dampness remediation studies in private homes, workplaces, and schools by two independent authors were deemed to be very low to moderate quality of evidence in reducing adult asthma symptoms and results were inconsistent among children.

[44] For the individual, the recovery may be a process involved with targeting the acute symptoms of a specific illness, as in the case of mold toxins.

Careful analysis by certified building professionals and physicians can help to identify the exact cause of the BRI, and help to illustrate a causal path to infection.

A 2001 study published in the Journal Indoor Air, gathered 1464 office-working participants to increase the scientific understanding of gender differences under the Sick Building Syndrome phenomenon.

The study team found that across most test variables, prevalence rates were different in most areas, but there was also a deep stratification of working conditions between genders as well.

Many building material manufacturers were actively working to gain control of the chemical content and to replace criticized additives.

A dissertation at the Karolinska Institute in Stockholm 1999 questioned the methodology of previous research, and a Danish study from 2005 showed these flaws experimentally.

In 2006 the Swedish National Board of Health and Welfare recommended in the medical journal Läkartidningen that "sick building syndrome" should not be used as a clinical diagnosis.

However, the concept remains alive in popular culture and is used to designate the set of symptoms related to poor home or work environment engineering.

The insurers needed a defense based upon Standards of Professional Practice to meet a court decision that declared that in a modern, essentially sealed building, the HVAC systems must produce breathing air for suitable human consumption.

ASHRAE empirical research determined that "acceptability" was a function of outdoor (fresh air) ventilation rate and used carbon dioxide as an accurate measurement of occupant presence and activity.

The 1989 issue of ASHRAE 62.1-1989 published the whys and wherefores and overrode the 1981 requirements that were aimed at a ventilation level of 5,000 ppm of carbon dioxide (the OSHA workplace limit), federally set to minimize HVAC system energy consumption.