INTRODUCTION Energy crisis in year 1970s leading the engineer and building manager to design and maintain indoor

environment more efficiently by sealing up the building and thus cause less ventilation rate to safe the electricity (WHO, 1986). The indoor air quality (IAQ) in any building can be compromised by microbial contaminants (mold, bacteria), chemicals (such as carbon monoxide, formaldehyde), allergens, or any mass or energy stressor that can induce health effects (John et al.2000). The sick building syndrome (SBS) has become common issues in Malaysia recent years due to the construction of buildings designed to be energy-efficient with air conditioning system (Berardil, 1991) but poor maintenance and services of Heating, Ventilation and Air Conditioning (HVAC) system resulting the increasing of indoor air pollutants (IAP) levels. Studies have demonstrated that SBS is influenced by the type of ventilation system, with the prevalence of SBS being higher in buildings with mechanical ventilation systems compared to normal ventilation system (Burge et al. 1987). Few researches in Tropical Country focus to demonstrate the age of the building and IAP characteristics with the prevalence of SBS and other health effects. New building normally reported to have high concentration of total volatile organic compounds (TVOC) while old building recorded poor ventilation rate with the increasing of Carbon Dioxide (CO2) level. Some studies found that there were several related risk factors for these symptoms such as the number of person inside the workplace area, type of job performed, workplace area and conditions, building design and age (Bornehag et al., 2001; Gyntelberg et al., 1994; Teeuw et al., 1994; Mendell, 1993). The prevalence of SBS symptoms was associated with the level of indoor air pollutants (IAP) and the quality of indoor air inside of the building. Ideal indoor air quality (IAQ) means the air we breathe everyday inside the building does not contain any contaminant either in the form of biological (mould, fungi or bacteria), chemical (gaseous which might become poisoning if excessively present in the breathing air like Carbon Dioxide (CO), Carbon Monoxide (CO), or Volatile organic compounds (VOCs)) or physical contaminants like dust (particulate matter; PM10, PM2.5 or ultrafine particle). All of these contaminants could potentially cause adverse health effect to the exposed human when there was a contact to the skin or entering the respiratory system. Indoor air quality level is one of the indicators to determine the air quality of the office environment in term of the ventilation efficiency and adequacy. Thus, to ensure that all the air pollutants are reduced to the acceptable level, the ASHRAE Standard 62 for Natural and Mechanical Ventilation states that the minimum allowable rate recommended for the office building is 20 cfm/person (ASHRAE, 2005). The sick building syndrome (SBS) is used to describe a situation in which the occupants of a building experience acute health effects that seem to be linked to time spent in a building. There is usually no specific illness or cause identified. The complaints may be localized in a particular room or zone, or may be widespread throughout the building. Frequently, problems result when a building is maintained in a manner that is inconsistent with its original design or prescribed operating procedures, or when occupant activities create a problem .

FACTOR THAT RESPONSIBLE FOR SICK BUILDING SYNDROME The following have been cited causes of or contributing factors to sick building syndrome: CHEMICAL CONTAMINANTS

From Outdoor Sources: Contaminants from outside like pollutants from motor vehicle exhaust, plumbing vents and building exhausts (bathrooms and kitchens) can enter the building through poorly located air intake vents, windows and other openings. Combustion byproducts can enter a building from a nearby garage. Radon, formaldehyde, asbestos, dust and lead paint can enter through poorly located air intake vents and other openings. From Indoor Sources: Most indoor air pollution comes from sources inside the building. For example, adhesives, carpeting, upholstery, manufactured wood products, copy machines, pesticides, and cleaning agents may emit volatile organic compounds (VOCs), including formaldehyde. Combustion products such as carbon monoxide, nitrogen dioxide, as well as respirable particles, can come from unvented kerosene and gas space heaters, woodstoves, fireplaces and gas stoves.The most common contaminant of indoor air includes the volatile organic compounds (VOC). The main sources of VOC are adhesives, upholstery, carpeting, copy machines, manufactured wood products, pesticides, cleaning agents, etc. Environmental tobacco smoke, respirable particulate matter, combustion byproducts from stove, fireplace and unvented space heater also increase the chemical contamination.Personal care products or in cleaning and maintenance products also contribute to the contamination.

BIOOGICAL CONTAMINANTS The biological contaminants include pollen, bacteria, viruses, fungus, molds,and moreover. These contaminants can breed in stagnant water that has accumulated in humidifiers, drainpipes and ducts or where water has collected on ceiling tiles, insulation, carpets and upholstery. Insect and bird droppings can also be a source of biological contamination. Biological contamination causes fever, chills, cough, chest tightness, muscle aches and allergic reactions. In offices with a high density of occupancy, airborne diseases can spread rapidly from one worker to another. Air-conditioning systems can recirculate pathogens and spread them throughout the building for example Legionnaire's disease due to legionella organisms. INADEQUATE VENTILATION In 1970, oil embargo led building designers to make buildings more airtight, with

less outdoor air ventilation, in order to improve energy efficiency. The ventilation was reduced to 5 cfm/person. This reduced ventilation rate was found to be inadequate to maintain the health and comfort of building occupants. Malfunctioning heating, ventilation and air-conditioning systems (HVAC systems) also increase the indoor air pollution. In order to have an acceptable indoor air quality (IAQ) with a minimum energy consumption, The American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE) recently revised ventilation standards to a minimum outdoor air flow rate of 15 cfm/person to avoid the problems related to inadequate ventilation. The standards are 20 cfm/person in office spaces and 60 cfm/person in smoking lounges. Poor design and construction of buildings with more number of offices cramped in a building to increase the salable area also contribute to inadequate ventilation. ELECTROMAGNETIC RADIATION Gadgets like microwaves, televisions and computers emit electromagnetic radiation, which ionizes the air. Extensive wiring without proper grounding also creates high magnetic fields, which have been linked to cancer.

INAPPROPRIATE LIGHTING WITH ABSENCE OF SUNLIGHT, BAD ACOUSTICS, POOR ERGONOMIC and HUMIDITY The symptoms of SBS are commonly seen in people with clerical jobs than in people with managerial jobs because professionals or managers have better working conditions. The symptoms are more common in females than in males probably because more females are in secretarial jobs, they are more aware of their health or a lesser dose of pollutants is required to manifest the effects. . The symptoms are more common in air-conditioned buildings than in naturally ventilated buildings and are more common in a public sector building than in a private sector building.
SYMPTOMS

SBS symptoms can be on upper respiratory and mucous membrane symptoms for example irritated eyes, nose, sinus, or throat. And the other symptoms are on the lower respiratory for example cough, tight chest, wheeze, or difficulty in breathing (Michael et al. 2000). The symptoms experienced are non-specific and predominantly upper respiratory in origin (nasal, eye, and throat) but headache and lethargy, potentially more multifactor in origin, are also experienced. This study investigates the different age of the building as the important factor influence SBS with hypothesis if the

building is old; the IAP will be increase thus the SBS prevalence will recorded high.

Example of SBS symptoms : Irritated eyes Runny nose Nasal congestion Scratchy throat Coughing Rashes Fever Nausea Headaches Dizziness Confusion Fatigue Difficulty in concentrating sensitivity to odors

If an individual have asthma, air pollutants and irritants may trigger more frequent and severe attacks. If their symptoms disappear when they leave home for several hours but recur once they return, something in the air could be the irritant.The symptoms of SBS can appear on their own or in combination with each other and they may vary from day to day. Different individuals in the same building may have different symptoms. They usually improve or disappear altogether after leaving the building. As for Building Related Illnesses (BRI), the definition is symptoms of diagnosable illnesses or cause that can be identified and attributed directly to airborne building contaminants. Indicators of BRI include complaints of cough, chest tightness, chills, fever and muscle aches. Occupants may need prolonged recovery times after leaving the building. Building-related illnesses (BRI) are illnesses that arise in nonindustrial and non-residential buildings.

1. The diseases include those that are due to agents that cause infectious, immunologic and allergic symptoms, as well as a heterogeneous group of work-related symptoms that include irritation of the skin, mucous membranes of the eyes, nose, and throat, headache, fatigue, and difficulty concentrating. 2. Both physical environment (e.g. indoor air quality) and psychosocial factors have been found to be associated with BRI. 3. The symptoms of BRI that are attributed to the physical environment of specific buildings are part of the sick building syndromes (SBS). Physical factors associated with building-related illnesses can range from temperature, humidity, and air movement to dust, lighting and noise,3 while chemical factors include pollutants arising from paint, carpets, new furniture, environmental tobacco smoke (ETS), drapes, cosmetics asbestos and insecticides. Microorganisms are the major biological factor associated with building-related illnesses. Inhalation of bacterial, fungal and microalgal spores may be allergenic. Fungi growing on building with moisture problems, especially Stachybotrys and Penicillium, produce mycotoxins that cause cough, irritation of eyes, skin, and respiratory tract; joint ache; headache; and fatigue. 4. Highly respirable particles (diameter < 1 m) in indoor air can serve as carriers for toxic compounds produced by molds in water damaged buildings. 5. Indoor fungal spores may contain glucans and antigenic proteins that trigger an immune response which cause changes in blood levels of inflammatory markers such as neutrophils, macrophages, complement and eosinophils. 6. Aerobiological surveys have shown that allergenic algae are found in the air, and the dominant group is the blue-green algae. 7. Extracts from airborne algae can cause positive inflammatory skin reactions and bronchial provocation. 8. In a study in Spain, the dominant airborne algae were green algae and small diatoms. 9. Illnesses such as headaches, fatigue, dizziness ad respiratory infections among students have been shown to be associated with bad ventilation, mouldy walls and leaky pipes of their school buildings. 10. The dust content in the air can induce inflammatory responses in school occupants, causing eye irritation and nose congestion. 11. Legionellae isolated from cooling tower water for air-conditioning system have been incriminated as causal agents of SBS.

12. Mycobacterium from indoor air has been shown to be potent inducers of inflammatory responses 13. There have also been cases of food poisoning due to the soil bacterium Bacillus cereus in schools and childcare centers 14. Parasites, especially their spores, inhabiting the soil, moist places and collections of water in a building can be sources of infection for the residents of the building. Amoeba can affect the survival and growth of bacteria and fungi in moisture-damaged buildings. 15. In an ongoing project, parasites such as Acanthamoeba and Naegleria have been isolated from dust samples of air conditioners (Ithoi, pers. comm.). In addition, animals such as rodents may harbour hantaviruses, which can cause infection. 16. IAQ is a challenge to environmental health issues as the pollutant that cause it are not only physical attributes and chemicals but also microbiological agents. They can have significant influence on health resulting in drop in productivity and economy of a country. The society at large can be placed at risk as poor management of buildings can be a source of disease outbreak. The developed countries such as the USA, Australia and Canada have special teams working on IAQ. These teams have good networking skills and established linkages with many other relevant agencies (e.g. NIOSH, Health and Aged Care, NGOs, Development Unit, Department of Environment) that contribute towards improving indoor air quality.

A research had been conducted with the title " Indoor Air Quality (IAQ) and Sick Buildings Syndrome (SBS) among Office Workers in New and Old Building in Universiti Putra Malaysia, Serdang" by Nur Fadilah R, Juliana J. The table showed the comparison of the prevelance of SBS symptoms from both buildings. Headache, stuffy or runny nose or sinus, tired or strained eyes and dizziness or lighted headed recorded the highest percentage for new building with 37.3% for each symptoms. While for the old building, the dizziness or light headed recorded the highest percentage which was 36.3% followed by headache with 31.3%, and tired or strained eyes with 30%. The lowest SBS symptom for both buildings is chest tightness which was 8.5% and 11.3% for new and old building, respectively. Chi-Square test was performed for all of the symptoms and the

results showed that there was statistically significant difference for stuffy. However, runny nose or sinus between new and old buildings and there was no significant difference for the other symptoms between new and old buildings.

PREVENTION AND TREATMENT INCRESES THE VENTILATION RATES AND AIR DISTRIBUTION The heating, ventilation and air-conditioning systems should be designed to meet ventilation standards in the local building codes. The HVAC system should be

operated and maintained properly to ensure that the desired ventilation rates are attained. If there are strong pollutants, the air may need to be directly vented to the outside. This method is especially recommended to remove pollutants that accumulate in specific areas such as rest rooms, copy rooms and printing facilities. The ASHRAE recommends a minimum of 8.4 air exchanges per 24 h. REMOVAL OR MODIFICATION OF POLLUTANT SOURCE This method can be carried out by a routine maintenance of HVAC systems, replacing water-stained ceiling tiles and carpets, using stone, ceramic or hardwood flooring, proper water proofing, avoiding synthetic or treated upholstery fabrics, minimizing the use of electronic items and unplugging idle devices, venting contaminants to the outside, storing paints, solvents, pesticides and adhesives in close containers in well-ventilated areas and using these pollutant sources in periods of low or no occupancy. Allowing time for building material in new areas to off-gas pollutants before occupancy and smoking restrictions are some measures that can be used. AIR CLEANING OR AIR TREATMENT Air cleaning can be a useful addition to control air pollution. Air cleaning can be performed by ensuring un-congested interiors with open office designs, use of frosted glass and skylights that give access to natural light, terrace gardens, community spaces and indoor plants that absorb carbon monoxide and formaldehyde from the air. Air filters are also effective in removing some if not all of the pollutants. Recommended for the air treatment include the use of filtration, electronic cleaners, chemical treatment with activated charcoal or other sorbent. Humidity control in the range of 20%-60%. Temperature control in the range of 68-76 F.

EDUCATION AND COMMUNICATION Its also an important parts of any air quality management programme so as to work more effectively and efficiently to prevent and solve the health problems. It also will help them to really understand what is the responsibility they have to

take to make sure all person that involved is safe.

LEGISLATION Banning of smoking in the workplace or restricting smoking to designated wellventilated areas away from the work stations and creating no-smoking zones with the help of laws. Therefore it help to decrease the indoor sources that will cause Sic Building Syndrome. In some European countries, workers have a statutory right to be involved with the employer's plans for changes in the work place. RESEARCH A field of study originating in Germany called Bau-biologie or Building biology has been initiated. The principles of Building biology are as follows: Site Status The building site should be geologically undisturbed. Residential areas should be away from industrial centers and main traffic routes and housing should have sufficient green space and should be in harmony with the surrounding environment. Construction Concepts Natural, unadulterated and nontoxic building material should be used, walls, floors and ceilings should not be susceptible to mold or fungi, the basement should be waterproof and well -ventilated, the earth's natural magnetic field should not be altered or distorted, production, installation and disposal of building materials should not lead to environmental pollution, building activities should not lead to exploitation of nonrenewable, rate resources. For example using non toxic paint and primers which is without using toxic chemical like drying agent formaldehyde. In malaysia LEE & SONS ENTERPRISED SDN.BHD.is one of the supplier of non toxic paint.

INTERIORS Lighting and color must mix well with the surroundings and not jar the senses, man-made electromagnetic radiation must be reduced as much as possible, interiors should be done by using natural materials without toxic content and

should be economically designed, there should be no toxic outgases or harsh smells, indoor humidity should be naturally regulated, air pollutants should be filtered and neutralized, thermal insulation should be balanced with heat retention, use of solar heating should be encouraged, moisture content in new buildings should be low, protective measures against noise pollution and harmful infrasonic and ultrasound radiation must be ensured, natural balance of atmospheric electricity and ion concentration should be maintained.

Ventilation Includes the use of natural, dilution, local exhaust, or increased ventilation efficiency. The most effective engineering control for prevention of indoor air quality problems is assuring an adequate supply of fresh outdoor air through natural or mechanical ventilation. SHRAE in its 62-1989 standard recommends 20 cubic feet per minute (CFM) of outdoor air per occupant for offices. For smoking lounges, up to 60 CFM of outdoor air per occupant should be provided. When possible, use local exhaust ventilation and enclosure to capture and remove contaminants generated by specific processes. Room air in which contaminants are generated should be discharged directly outdoors rather than recirculated. Ventilation Efficiency Can Be Increases

Ensuring that outdoor air-supply dampers and room air-vents are open; Removing or modifying partitions or obstructions that block fresh-air flow; Rebalancing the system to prevent inflow or outflow of contaminated air due to pressure differentials between rooms; Preventing poor distribution of make-up air by proper placement of air inlets and exhausts Using room fans to improve mixing and dilution of pollutants. Outside air intakes should not be located in close proximity to potential sources of contamination (automobile garages, cooling towers, building exhausts, roadways).

PREVENTION AND TREATMENT FOR MICROBIOLOGY CONTAMINANT

Eliminate or Control Its known as potential sources of microbial contaminants by prompt cleanup and repair of all areas where water collection and leakage has occurred including floors, roofs, HVAC cooling coils, drain pans, humidifiers containing reservoirs of stagnant water, air washers, fan coil units, and filters. Remove and Discard Remove and discard porous organic materials that are contaminated (e.g., damp insulation in ventilation system, moldy ceiling tiles, and mildewed carpets). Clean and Disinfect Nonporous Surfaces Use where microbial growth has occurred with detergents, chlorine-generating slimicides, or other biocides and insuring that these cleaners have been removed before air handling units are turned on. Maintain Indoor Air Relative humidity below 60% (50% where cold surfaces are in contact with room air). Adjust Intake of Outdoor Air This method to avoid contamination from nearby soil, vegetable debris, cooling towers, or sanitary stacks unless air is adequately conditioned. Adjust Combustion Sources Such as furnaces or water heaters to assure proper burning and exhaust to an area where re-entrainment will not occur. Minimize Exposure By limiting occupancy of contaminated airspace, limiting use of offending sources to specific areas or times, or evacuating contaminated areas until they can be ventilated adequately.

Isolate If feasible, areas of renovation, painting, carpet laying, pesticide application, etc., from occupied areas that are not under construction. If possible, perform this work during evenings and weekends. If ventilation is turned off during weekends or other periods, ensure that system is on so that contaminant concentrations are sufficiently diluted prior to occupancy. Supply Adequate Ventilation Done this during and after completion of work to assist in diluting the contaminant levels. Personnel affected with hypersensitivity should be thoroughly evaluated and the problem identified and corrected before returning them to the workplace. If, after the remedial action, the illness persists in the workplace, the affected personnel should be considered for permanent reassignment to another area.

Eliminate or reduce contamination of the air supply with cigarette smoke

REFERENCES

1)

Aerias. (n.d.). Retrieved from

http://www.aerias.org/DesktopModules/ArticleDetail.aspx?articleId=109&spaceid=2
&subid=13

2)

EHSO's Sick Building Syndrome Information Pages. (n.d.). EHSO - Environmental

Health &

Safety Online - Free EHS Guidance Contents Page. Retrieved from http://www.ehso.com/ehshome/sickbldg.php

3)

Morgan, M. T. (2003). Environmental Health (3rd ed.).

4)

Nur Fadilah R, Juliana J (2012). Indoor Air Quality (IAQ) and Sick Buildings Syndrome (SBS)

among Office Workers in New and Old Building in Universiti Putra and the Environment Journal, 3(2).

Malaysia, Serdang.Health

5)

OSHA Technical Manual (OTM) - Section III: Chapter 2: Indoor Air Quality Investigation. (n.d.). Occupational Safety and Health Administration - Home. Retrieved from http://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_2.html

6)

Sick building syndrome - NHS Choices. (n.d.). NHS Choices - Your health, your from

choices. Retrieved

http://www.nhs.uk/Conditions/Sick-building-syndrome/Pages/Introduction.aspx

7)

Sick Building Syndrome. (n.d.). EXTOXNET - The EXtension TOXicology NETwork. Retrieved from http://extoxnet.orst.edu/faqs/indoorair/sick.htm

8)

Stephen Ambu, Wan-Loy Chu, Joon-Wah Mak, Shew-Fung Wong, Li-Li Chan, (2008). Environmental Health And Building Related Illnesses.

Siew-Tung Wong

9)

Syazwan Aizat I. (2009). Indoor Air Quality and Sick Building Syndrome in Buildings. Global Journal of Health Science.

Malaysian

10) The sick building syndrome. (n.d.). National Center for Biotechnology Information. from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2796751/

Retrieved

11) Wright, R. T. (2005). Environmental Science (9th ed.).