Sick Building Syndrome

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This article is part of the Tobacco portal on Sourcewatch funded from 2006 - 2009 by the American Legacy Foundation.

The term "sick building syndrome" (SBS) is used to describe situations in which occupants of buildings experience acute illness and discomfort that appear to be linked to time spent in a building, but no specific illness or cause can be identified. Symptoms are said to include headache; eye, nose, or throat irritation; dry cough; dry or itchy skin; dizziness and nausea; difficulty in concentrating; fatigue, and sensitivity to odors. The exact cause of the symptoms is not discoverable, but sufferers report relief soon after leaving the building.[1]

The term (in its first manifestation) seems to have been invented by Canadian tobacco lobbyist Theodor D Sterling as "building sickness" in about 1981. He and other lobbyists also began to use the term Tight Building Syndrome which aligned with their claims that smokey atmospheres weren't the problem, but the lack of an inadequate rate of exchange between indoor and outdoor air was the fundamental problem. This was probably, at least partially true during the energy crisis when building owners 'locked their buildings up tight' to prevent the loss of heating during the winter.

The later term "Sick Building Syndrome" was certainly generally popularise after 1985 with Gray Robertson and his staff at ACVA and the later Healthy Buildings International because this term also played on the fears of Legionnaire's Disease which had been caused by a bacteria in water-cooled air conditioners. It was a very rare form of pneumonia-- but it was built up to appear to be a potential deadly epidemic with economic consequences to building owners.


"Sick Building Syndrome" came to the attention of the public largely through the highly organized and funded efforts of the tobacco industry, who promoted the notion of "Sick Building Syndrome" to deflect attention from secondhand smoke as a point-source pollutant linked to health complaints and discomfort of occupants in offices and factories.

Tobacco companies maintained that secondhand smoke, also known as Environmental Tobacco Smoke or ETS, plays a minor role in "sick-building syndrome," and that instead ETS served merely as an indicator of larger problems present within the building. The industry, through paid surrogate third-party air quality companies like ACVA Atlantic and Healthy Buildings International, pointed to chemical agents, like radon and bioaerosols in the indoor environment, as the main causes associated with complaints of illness among workers. The industry used "Sick Building Syndrome" thus to deflect the focus on tobacco smoke as a primary indoor pollutant and to point out that any attempt to address the discomfort of building occupants by banning smoking was "misdirected and inadequate."[2]

Documents & Timeline

1981 Gray Robertson and Peter Binnie arrive in the USA from the UK and set up ACVA (Air Conditioning & Ventilation Associates). Also in this year Theodor D Sterling (not connected with ACVA) recommended that the tobacco industry utilise the Legionella scare by promoting the idea of the "tight building syndrome" and talk about buildings being 'sick'. This became one of the foundation scares used by the (Indoor Air Quality) IAQ testing business.

A later (undated) Press Release says

"Robertson estimates that as many as half of the office buildings, hospitals, government buildings and other major structures in the US may be suffering from this problem, which he terms "Sick Building Syndrome." Trained in bacteriology and chemistry in his native England, Robertson is co-founder and president of a Virginia firm called ACVA Atlantic Inc.

Established in 1981 as the first company of its kind in the US, ACVA specializes in inspecting, diagnosing and cleaning up "sick" air-handling systems in major buildings.

"We already know that dirty air conditioning is a significant health hazard," says Robertson, who manages ACVA with his partner, microbiologist/zoologist Peter Binnie. "The first fatal epidemic of Legionnaires' Disease was traced to bacteria growing in a dirty air-conditioning system. [2]

1985 A memo from Susan Stuntz (a Tobacco Institute Vice President in charge of "Issues Management') discusses presentations and testimony given by industry air quality consultant Gray Robertson at public hearings about ventilation. Robertson owned ACVA Atlantic, the environmental engineering firm the Tobacco Institute hired to analyze the air quality in buildings. Robertson testified at public hearings for smoking restrictions on the presence of second-hand tobacco smoke, that, rather being a problem itself, was only an indicator of larger ventilation problems. A handwritten note on the memo states, "This really does help us broaden the issue beyond tobacco smoke."[3]

1985 Sep 17 Gray Robertson was now part of the Tobacco Industry's Scientific Witness Team (SWT) and doing media tours for the Tobacco Institute. The TI is assisted in conducting these tours by PR firm <B Fleishman Hillard who's staff advise Issues Manager Susan Stuntz at the Tobacco Institute about the idea of distributing "newspaper mats" [sic].

[Newspaper mattes are fully prepared ready-to-print, high-quality article proofs which low-cost local newspapers can use without typesetting or correction.]

Advise are the ACVA newspaper mats in their final form (with one minor edit, as noted). They will go out ASAP to all the markets Gray (Robertson) already has covered to date; subsequently, mailings will hit each market immediately after Gray's visit.

We are mailing to dailies up to 100,000 circulation and all weeklies; dailies will get a mat and an 8x10 photo, and weeklies will get a mat and two halftone photo slicks. We will send you a computer printout of the newspapers receiving the materials in each market.

Also enclosed are tapes and excerpts/transcripts from some excellent radio interviews in Chicago and Peoria. They include: WBBM-AM, Chicago (transcript sent to you last week), WMAQ-AM, Chicago, and WMBD-AM, Peoria. You'll notice that the talk-show host at WMAQ was particularly helpful from TI's standpoint. Attached are copies of some of the mattes:

  • Scientist Diagnoses "Sick Buildings" -- [Where he was exploiting confusion with Legionairre's Disease]

    The issue of "sick buildings' first gained national attention a decade ago, when bacteria growing in the air conditioning system of a Philadelphia hotel caused a fatal epidemic that came to be known as "Legionnaires' Disease." Far from an isolated epidemic, researchers at the Centers for Disease Control estimate that Legionnaires' Disease may strike more than 20,000 Americans every year.

  • Scientist Asks: Is Your Office Making You Sick?

    Asbestos and other dangerous fibers may be circulated as well. "There's no question that dirty air conditioning is a significant health hazard," Robertson says, citing often-fatal Legionnaires' Disease, which first was discovered in the air conditioning system of a Philadelphia hotel in 1976. [3]

1986 Reginald B. Simmons, an employee of Healthy Buildings International (HBI), started to encourage businesses not to ban smoking but to look for other causes of air pollution. He later gave courtroom testimony in which he told how the industry applied the notion of "Sick Building Syndrome" to deflect attention from secondhand smoke. Gray Robertson, owner of HBI, frequently used the term "Sick Building Syndrome," and with the tobacco industry's assistance and funding, widely promoted this "syndrome" throughout the United States to deflect attention from tobacco smoke as a point source of indoor air pollution as cause of illness for people inhabiting buildings.

Reginald Simmons worked for HBI in 1986, when the company first started associating with the Tobacco Institute. He noted that HBI experienced a vast increase in workload after that time, hiring and training many more workers to inspect buildings all over the world. Simmons described the ground rules that were laid down for sampling air in all of the buildings inspected for the Tobacco Institute:

Mr. [Peter] Binnie [Vice President of HBI] had a number of instructions and ground rules for us to follow that applied to all of the buildings we inspected, private and public: (1) when taking air samples for nicotine tests, we were instructed to take air samples in lobbies and other easily accessible areas where the circulation was best, thus reducing the readings; (2) if asked, always recommend to clients that any air pollution problem could be solved by better ventilation; (3) banning or restricting tobacco use or smoking was never to be recommended; and, (4) every inspection report was to be reviewed and undergo final editing by either Mr. Binnie or Mr. Robertson before it was sent out.

Simmons stated that the results of his reports were altered after he submitted them to his superiors:

Q. Were your reports ever edited or changed after you submitted your reports to Mr. Binnie or Mr. Robertson?

A. It is my understanding that the reports were always edited by Mr. Binnie or Mr. Robertson.
Q. How do you know that your reports were changed after you submitted them to Mr. Binnie or Mr. Robertson?
A. On many occasions involving inspections of both public and private buildings, I would later see the inspection reports in the main files and note that Mr. Binnie or Mr. Robertson had changed the data and the conclusions. For example, when I had recommended a restriction or banning of smoking, Mr. Binnie would edit it out of the final inspection report. It was also a standard practice for Mr. Binnie to reduce the actual results of two significant tests that were done on buildings: (1) the test for airborne particle count ("APC"); and (2) the test for weighing airborne particles ("WAP")...
Q. Are the results of these tests important?
A. Yes. These two tests are critical for providing accurate information about airborne particles in the final inspection reports for buildings.
Q. To your knowledge, did clients ever learn that the results of these tests were reduced?

A. No. The clients, both public and private buildings owners and tenants, were never advised of the alteration of the data.

Simmons testified that the Tobacco Institute and its members sent HBI employees all over the world to perform building inspections, and that money was no object:

...we stayed in the most exclusive and expensive hotels and were told we could have anything and everything we needed. We were provided drivers that took us to each city and took care of all of our personal needs... On weekends, we were allowed to go anywhere we wanted at the expense of Philip Morris. For example, one weekend they took some of us, myself included, to the St. Moritz Resort where we all went skiing; other team members went to Venice and Florence, Italy, for the weekend ... I personally turned in, for my group's two weeks in Scandinavia, approximately $12,500 of expenses for hotels, meals, and miscellaneous purchases. Money was never an issue when working for the Tobacco Institute or its members ... [4]

1986 Oct 7 Elia Sterling organised the Vancouver Chapter of ASHRAE to sponsor a public meeting to "discuss" a no-smoking in workplace by-law, which was promoted as having the benefit:""Reducing involuntary exposure to tobacco smoke may prove to be one of the most effective ways to reduce unnecessary illness and premature death in the late 20th century". This idea was attacked by a Dr Spellman and Elia Sterling.

Dr. Sterling expanded on Dr. Stellman's talk, by pointing out that in most studies of sick buildings, smoking did not appear to be the source of the health or comfort problem.

Dr. Sterling quoted the Canada Health and Welfare and the NIOSH reviews of so called sick buildings which found that less than 5% (CHW) and less that 2% (NIOSH) of reports of building studies claim that problems were related to smoking. (These figures were accepted without argument by all discussants and by the audience during subsequent comments). Dr. Sterling further pointed out that the by-law was intended more to control smokers than to protect nonsmokers. [SNIP]

Mr. Elia Sterling was called on by the speaker for a final summary. Mr. Elia Sterling again reiterated that the by-law was hitting at the wrong place at the wrong time. He again reviewed the fact that most building problems were not related to smoking and that the by-law did not address itself to air quality. [4]

1994 Dec The activities of HBI were exposed by a US House of Representatives Subcommittee looking at the problem of ETS. This was a result of the work of Rep. Henry Waxman.

Subcommittee on Health and the Environment - Majority Staff Report: Dec. 20 1994
Healthy Buildings International (HBI) began its relationship with the tobacco industry in 1985. At that time, the company was a small and obscure indoor air firm. In addition to the president and vice president, it had only two technical employees and operated under the name ACVA Atlantic. Over the next nine years, however, HBI grew to be an international presence in the indoor air field. This was due in large measure to the patronage of the tobacco industry. During this period, the Tobacco Institute, Philip Morris, R.J. Reynolds Tobacco, and the Center for Indoor Air Research (a tobacco-industry research organization) paid HBI millions of dollars for its services.
    The tobacco industry went to great lengths to promote HBI. The Tobacco Institute paid the expenses of a public relations firm, Fleishman-Hillard, to arrange media tours for HBI throughout the United States. From September 1990 to November 1992, Philip Morris covered all the expenses of, and paid HBI a substantial fee for, the publication of a magazine entitled "Healthy Buildings International Magazine." The magazine, which included glossy color photographs, was published in eight languages (English, French, German, Spanish, Italian, Swedish, Dutch, and Finnish) and disseminated worldwide.
    A report circulated within HBI in late 1991 or 1992 describes "the HBI concept" that the tobacco industry paid so much to promote. According to this document, "the key objective of the HBI concept is to broaden the debate on indoor air quality to deflect the ETS challenge." The document states that "HBI is now positioned as an authority on IAQ issues" [and has] "brought balance to the IAQ [indoor air quality] debate" [by promoting] "acceptance that ETS is in fact a minor contributor."
    HBI performed at least two vital services for the tobacco industry. First, it conducted scientific research for the industry that purported to show that ETS is not a significant source of indoor air pollution. The most significant of these research studies was done in 1989, when HBI was paid over $200,000 by the tobacco industry's Center for Indoor Air Research (CIAR) to study ETS levels in 585 office environments. The results of this study were summarized in a final report to CIAR in January 1990 presented to EPA in public comments in September 1990, and formally published in 1992.
    In addition to conducting research for the tobacco industry, HBI regularly testified for the industry in opposition to federal, state, and local restrictions on smoking. Over most of the last decade, HBI was the tobacco industry's principal defender on ETS matters. According to the records of the Tobacco Institute, HBI testified 129 times for the Tobacco Institute from August 1985 through September 1994 -- an average of more than once per month. In some months, HBI testified as many as six times. HBI's appearances for the Tobacco Institute included testimony before Congress (including this Subcommittee on June 27, 1986, and March 17, 1994), before state legislatures, and before local governments. [5]


2000 Lawyers William V Custer and Elizabeth T Kertscher at Goldstein Frazer & Murphy were still advising their Atlanta corporate clients on how to avoid law suits over Sick Building Syndrome. They tell their clients (and send a copy to the tobacco industry) saying that:

In April 1991 the EPA defined Sick Building Syndrome as a situation "in which building occupants experience acute health and comfort effects that appear to be linked to time spent in a building, but no specific illness or cause can be identified."

SBS-related complaints include eye, nose and throat irritation, cough, headache, nausea, skin irritation, fatigue,depression, upper respiratory difficulties and taste and smell difficulties. These complaints may stem from a virtually endless number of potential causation agents.

These include biological agents, volatile organic compounds, lighting, and particulates, as well as psychological factors. These agents can be introduced by virtually any activity including new building products, cleaning agents, pest control, renovation, and the like. Many times a particular cause is never identified.

Certainly, chemicals and environmental contaminants can, in sufficient doses, cause injury or illness . However, in evaluating a potential SBS claim, it is important to realize that, in certain circumstances, psychological components may play an important role in an SBS claimant's experience of physical symptoms. [6]

These two Dixie lawyers managed to write a 23 page outline of the scientific and legal details of SBS without once mentioning the term "tobacco smoke" or ETS.

Sourcewatch resources

External resources

<tdo>search_term="Sick building syndrome" confidential</tdo>


  1. U.S. Environmental Protection Agency Indoor Air Facts No. 4 (revised) Sick Building Syndrome, Indoor Air Quality. Accessed April 30, 2009
  2. Philip Morris ETS, Indoor Smoking and Indoor Air Quality: Planning for the 1990s Draft; report. April 22, 1992. Philip Morris Bates No. 2023371119-2023371157
  3. Stuntz S., Tobacco Institute. Ventilation Testimony Memorandum. July 5, 1985. Bates No. TIDN0013592. Esp. see note in marginalia.
  4. United States Department of Justice Testimony of Reginald B. Simmons Civil Action No. 99-CV-02496 (GK). Undated, but recorded in trial in 2004