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"Healthy Buildings '88 is part of the wave of growing interest in indoor climates that we've observed in the general public as well as among researchers, politicians and building contractors." "The time is right for this conference, considering everything we've been involved with as far as sick buildings are concerned. It's time to pool our collective knowledge!" So says Q,rofessor Thomas Lindwall of Sweden's Karolinska Institute. Professor Lindwall is chairman of the scientific committee at the international conference, Healthy Buildings '88, which will be held in Stockholm, Sweden between September 5-8. Approximately 500 delegates are expected to participate in the 17 scientific workshops planned for the four-day conference. "Healthy Buildings '88 marks the first time that a collective attempt has been made to produce recommendations for achieving healthy buildings," emphasizes Thomas Lindwall. Sick buildings represent a serious problem for three reasons. Firstly, because those who have been afflicted are already suffering, in some cases extensively. Secondly, some of the sick buildings - radon buildings - increase the risk of such diseases as lung cancer. Thirdly, the symptoms and discomforts experienced by the occupants of sick buildings are warning signals that something is technologically amiss in the building. "We've got to learn from our mistakes." Bridge the gap The conference hopes to bridge the gap between theory and practice. The knowledge possessed by researchers must be made available to practicioners, building contractors and administrators and vice versa. "A two-way flow of information will result in a good hygienic standard," Thomas Lindwall hopes. Sick buildings are a new environmental problem that has developed during the last 15 years. The industrial working environment has been debated greatly, and the outdoor environment has been the subject of much discussion, while little has been said about internal air quality. Knowledge of the problems connected with sick buildings has been lacking. Only recently have the problems associated with the working environment currently being experienced in many office buildings come to light. "We know that people suffer discomforts and display medical symptoms from these buildings. Some also find that previous conditions become aggravated, for example those who suffer from allergies or other other types of hypersensitivity. In some cases, a poor indoor climate can actually cause the illness itself, for example dust-

related allergies. "A World Health Organization (WHO) workgroup estimated that in 1984 as much as 10-30 percent of all newly constructed buildings were sick. The exact number of people affected by these buildings is unknown." Illness is expensive Sick buildings cost money. This is true not only in terms of the money required to make them healthy and to operate them, but in human costs as well - people are suffering. Absenteeism is likely to increase and work productivity drop in sick buildings. Work satisfaction disappears and work itself proceeds much more slowly when employees are disturbed by some obscure source of irritation. Consideral time is lost in workgroups that attempt to rectify the undefined problems that affect offices. "Many researchers want to conduct experimental investigations of this phenomenon," says Thomas Lindwall. "But ethical reasons sometimes present an obstacle." Are allergies increasing? No one is able to say today with any accuracy exactly how many buildings or how many people are affected by the obscure condition known as the sick building syndrome. Many assume that allergies are increasing in Sweden and that this is linked to sick buildings, among other things. "It hasn't been verified that allergies are increasing," stresses Professor Lindvall. "But we highly suspect that this is the case! "We know that certain substances cause irritation and discomfort at concentrations that can occur indoors. Other substances can be quite harmless on their own but give rise to over sensitive reactions when they occur in combination. To what extent is still unknown. "Until recently, only a few surveys of indoor air pollutants had been made," says professor Thomas Lindwall. "People spend the majority of their time indoors. Estimates of the environmental influence indoors based on surveys of outdoor air pollutants are irrelevant." Serious risk When the formaldehyde debate intensified in Sweden during the 1970s, the substance, which is released from splinter wood, was thought to be carcinogenic. Tests carried out on mice confirmed that it could cause cancer. "The practical issue involved whether or not the low concentrations in question constituted a risk for humans. Today the problem has been partially solved. Splinter wood has been improved considerably. But formaldehyde can still play a role in connection with symptoms displayed

by sensitive individuals, namely in combination with other irritants present in indoor air. "Major health surveys are very expensive. How much do we need to know in order to determine the seriousness'of the problem?," asks professor Lindvall. "What we already know ought to provide sufficient food for thought! "We're on the verge of a new period of widespread residential construction. Much needs to be done, and there'Bs very little time in which to do it. Do we have the time we need?" Practical and scientific The purpose of Healthy Buildings '88 is to establish a platform on which existing knowledge of the ways in which healthy buildings can be constructed and managed can be based. Conference organizers have heeded the wishes of the building sector regarding which issues need to be clarified. "Those of us in the scientific committee have reworked the proposals submitted by practicioners into a format suitable for scientific investigation. The issues must be of significance to the subject area. "Each workshop will address 2-3 questions during the course of the conference." Conclusions and recommendations will be compiled and published in a series of articles and reports. One of the problems in this context is that researchers themselves find it difficult to agree in a number of issues. Not black, not white As a preliminary exercise to Healthy Buildings '88, a seminar was held in Upplands Vasby, where researchers from the Nordic countries discussed and reached a consensus on two statements regarding recycled indoor air and humidity in indoor air. Nevertheless, these statements are surrounded by numerous reservations. "We have, however, agreed on certain core issues," says professor Lindwall. "Systems using recycled indoor air shouldn't be used, for example. But occasionally this is justifiable. In these cases, the system must be inspected thoroughly and kept clean. But this isn't being done today. We're in complete agreeent on this point. "In-house inspections are an important means of achieving a healthy building. Construction standards could be another. These questions are so important that they've been assigned a special workshop. "We intend to illuminate the entire complex of problems comprehensively at Healthy Buildings '88. This can't be dealt with in terms of black and white. Nuances are always present," stresses professor Lindwall. "Even a risky technological solution can function in the hands of skilled builders and administrators. But those with a lesser degree of skills would do wise to concentrate on reliable and well-tested solutions. These types of solutions will be identified at the conference."