The Office Environment Model: A Conceptual Analysis of the Sick Building Syndrome

This paper examines the phenomenon sick building syndrome and related concepts, and proposes a theoretical model, the Office Environment Model, to explain the relationship between office environment and health. The sick building syndrome should be thought of as a figurative concept of everyday language, rather than as a single disease entity. This is because the phenomenon consists of several types of relations between different environmental determinants and health. Based on Popper's framework of three worlds, the model divides the office environment ontologically into physical and social, and the health outcomes into physiological and psychological. The outcome is further categorized into two dimensions: anatomic site (eyes, respiratory tract, skin, and central nervous system), and hypothesized underlying mechanism (mechanical irritation and inflammation, immunological reaction, toxicity, infection, and environmental psychological stress). The model stipulates the following types of causal relations. The physical environment causes physical and psychological effects via physiological and/or psychological processes. The social environment causes physical and psychological effects via psychological processes. The physical and social environment may have synergistic effects, and constitutional factors such as gender and atopy are additional determinants of the outcomes, as well as possible modifiers of the relations between environment and health. To understand the health effects of the office environment, it is necessary to focus separately on different determinant-outcome relations, bearing in mind that the different determinants affect human health concurrently and sometimes the effects may be synergistic.