Case Studies
White Coats & Hard Hats – Our Physicians' Perspective
Comprehensive Integrated Capabilities: Uniquely BHS
What is often the first response to occupant complaints attributed to building conditions?
All too frequently, complaints of work-related illness and of indoor environmental and air quality (IEAQ) issues are investigated only from the perspective of the building, office or residence: its environmental discomfort conditions, construction, structure and systems' performance. With increasing media attention to "sick buildings" or "wet damp spaces," the focus has shifted to examining how the building dynamics may be affecting its occupants and determining any deficient building condition.
Occupant symptoms attributed to building conditions present a unique challenge.
Occupant health actually drives the investigation: occupants' perception of their health forms the foundation of their productivity, measured in terms of absenteeism and presenteeism (the employee is actually at work but working below capacity). Business interruption, decreased morale, and even the extreme situation of vacating the premises, may be the result of worker-perceived building-induced illness or discontent. For the building owner, such stigma damages can lead to permanent financial impairment. A health-based approach to occupant/building complaint investigations, rather than a building-based approach, then, becomes good business. As we noted earlier, healthy buildings mean healthy people and, by design, healthy business.
Those qualified to address building conditions can only resolve building issues, not occupant health issues.
What, then, is a physician's view of an integrated investigation effectively designed to evaluate occupant/building complaints? First, such an investigation requires reassessing your IEAQ response strategies, in order to insure that the situation is resolved to the occupant's satisfaction, thus minimizing the impact to their productivity. Essential to an efficient and successful response is a multi-professional incident response team which combines medical expertise with building science knowledge: "white coats and hard hats." The combined health and technical expertise of the team, inspires confidence and credibility, thereby gaining the trust, respect and support of all concerned and mitigating the risk of incident escalation.
When do occupants label a building a "sick building?"
When there are occupant complaints, or symptoms, which are attributed to the building. This is usually the first indication of a problem. In other words, health concerns arise first and are the driver of the incident. Yet, the usual response is for air testing and examination of the building, followed by remediation: health is essentially ignored.
Is medical expertise a key component of your incident response plan? If not, why not?
From the perspective of a physician, a great deal of the usual response is unfocused at best, unnecessary at worst, but costly in either case. With early medical oversight, every step of the investigation can be focused on the true underlying driver of the incident: occupant health.
Additionally, many situations are not easily diagnosed by simply looking at the building and interpreting sampling and testing results. Therefore, having a physician who is able to speak with the symptomatic occupant(s) and develop a working hypothesis about the possible causes of the complaint(s), permits formulation of a directed investigation. Not only does this ensure the health and safety of the building occupants, but it also eliminates costly, misdirected testing, evaluations, lost time and unnecessary remediation. Every worker is impacted by a variety of factors, in addition to the work environment, which may influence their perception of how the workplace is affecting their health. Recent research conducted by Building Health Sciences at a twelve-building government facility has confirmed the criticality of this new investigative methodology. This health-based solution path coupled with identification of the "root cause" will satisfactorily resolve the incident. BHS' unique approach of combining "white coats and hard hats" on its incident response team, has proven to be extremely efficient and cost-effective in resolving IEAQ incidents. At the same time it mitigates the escalation of the incident by ensuring the health and safety of occupants.
What, then, is the White Coats and Hard Hats?
The initial response to an IEAQ incident often sets the tone for the path to resolution. Participation by the right health and environmental experts can make a dramatic difference in the risks and costs associated with any building failure including water damage or mold-related evaluations and remediations. Absent the presence of a physician, incident resolution may be incomplete. Even more problematic and more risky are the remediation activities which take place behind plastic, but in plain view of employees and other occupants who are often kept uninformed. Thus, health-based risk communication emerges as one of the first and most essential requirements. Someone with health expertise, IEAQ knowledge, communication skills and believability must be an integral part of the multi-professional incident response team, if one hopes to prevent panic, and incident escalation.
Some of BHS' case studies illustrate our unique approach:
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