Sick building syndrome has different interpretations in different regions, but it is formally recognised in Malaysian regulation through an occupational health instrument. The Industry Code of Practice on Indoor Air Quality 2010 (check out our explainer article about ICOP 2010 here) sits under the Occupational Safety and Health Act 1994, drawing its force from the general duties that Sections 15, 17 and 18 place on employers, self-employed persons and occupiers toward people at their place of work. ICOP 2010 lists sick building syndrome among the health effects of poor indoor air quality and gives it a working definition, which governs how an accredited Indoor Air Quality Assessor in Malaysia is expected to detect the condition.
For a broader explainer on sick building syndrome, check out our article here. Also note that this article will explore what is legally required by Malaysian law, which is a complaint-based trigger system. My position will always be that building owners and employers should run IAQ testing and IAQ monitoring regardless of any complaints, because there are far more benefits than simply remaining compliant and not getting fined.
How ICOP 2010 defines sick building syndrome
ICOP 2010’s definition of sick building syndrome describes occupants who experience acute health effects or discomfort that appear linked to time spent in a particular space or building, where no specific illness or cause can be identified, with complaints that may cluster in one room or zone, or spread through the whole building. The named symptoms are familiar – eye and nose irritation, fatigue, cough, rhinitis, nausea, headache and sore throat in any combination. Because the condition is defined by the absence of a single identifiable cause, no single finding can confirm its presence. An assessor cannot point to one pathogen or one exceeded reading and call the result sick building syndrome, which is why the code sets up an assessment that reads the measured state of the air alongside what occupants report feeling when they’re in the vicinity.
Inside Malaysia’s formal IAQ assessment
The process begins the moment a complaint arrives. The building owner or management carries a standing duty to investigate any signs and symptoms that may be related to air quality, and the first move is a walkthrough inspection guided by a formal checklist defined in ICOP 2010, which runs through odours, damp and mould, staining, stuffy or stale air, overcrowding, poorly maintained filters, the state of the ventilation plant and the placement of fresh air intakes. Whoever conducts it is expected to use professional judgement to adapt the checklist to the particular premises, so the walkthrough already involves interpretation from the first step. Obvious causes are corrected on the spot, and where the cause cannot be identified or resolved, a full assessment by an IAQ Assessor registered with the Director General of Occupational Safety and Health needs to be conducted, the point at which sick building syndrome turns from definition to procedure.
A full IAQ assessment in Malaysia brings together 3 elements:
- the measurement of physical parameters and air contaminants
- a symptom survey with occupants
- A repeat of the initial walkthrough inspection
ICOP’s occupant symptom questionnaire
The symptom survey is the part that carries the sick building syndrome definition into the field. The code defines a standardised occupant questionnaire that follows the format of the Finnish Institute of Occupational Health’s MM-40 survey listed among ICOP 2010’s references:
- Background: occupation, hours spent at the main workstation and how the area is air conditioned
- Environmental nuisances over the past 3 months, rated weekly, sometimes or never: draught, room temperature, stuffy air, dry air, unpleasant odours, passive smoking and dust
- Past and present asthma, sinusitis, and eczema
- Present symptoms over the past 3 months, rated on the same weekly-to-never scale and each with a column asking whether occupants believe the symptom comes from the work environment: headache, heavy-headedness, fatigue, drowsiness, dizziness, nausea, cough, stuffy nose, dry throat, skin irritation, eye irritation, and itching scalp
2 features in the questionnaire do the detection work: the per-symptom question above about the work environment ties each complaint back to the workplace, and a later question asks when relief comes, whether after leaving the workstation, after leaving the building or with no noticeable pattern. Read together, those 2 answers test the exact thing in the definition, whether the symptoms track time spent in the building. A worker whose headaches ease within an hour of leaving and who attributes them to the office is describing the pattern, and the questionnaire is constructed to reveal this pattern across a population of occupants. A single complaint won’t say much, but if 100 people say they feel funky in a certain space around a certain time, that’s where the questionnaire starts earning its keep. Paired with the measurement side of the assessment, the questionnaire patterns give enough detail to form a picture of what occupants are experiencing.
Every assessment ends in an Acceptable or Unacceptable verdict on air quality. Unacceptable means the building fails, and the code sets out what triggers that verdict:
- a physical parameter falls outside acceptable ranges for temperature, humidity or air movement
- a contaminant exceeds its limit, the 8-hour averages for carbon monoxide, formaldehyde, ozone, respirable particulates and total volatile organic compounds, the counts for bacteria and fungi, and the 1000ppm ceiling on carbon dioxide that flags inadequate ventilation
- the safe work procedure for a prescribed activity is missing
- there are medical findings among occupants related to indoor air quality
- any other situation related to indoor air quality that the assessor deems relevant
The medical findings item is the one that matters for sick building syndrome. It means an assessor can rule the air unacceptable on medical findings related to the air quality alone, even when every measured reading sits inside the limits. Moreover, an occupant showing significant symptoms of sick building syndrome or a building related illness must be referred by the employer for medical examination, which turns the human evidence into a formal obligation.
Once the assessment is done, the IAQ Assessor has one month to present a report to the building owner or management. And where the report finds the air unacceptable, corrective measures must follow within a month of its receipt, and records must be kept – 5 years for ordinary records, 30 years for the IAQ report.
Why Malaysia treats sick building syndrome as a workplace issue
ICOP 2010 is a code under the Occupational Safety and Health Act, so its job is to help employers and building owners meet their duty of care to the people working in a building. That’s why it only covers workplaces that run on mechanical ventilation and air conditioning, offices and enclosed work areas – rather than homes or factories – and why the duty falls on the people who own and manage those premises. Sick building syndrome sits here as one of the workplace health problems the code deals with, next to building related illnesses and Legionnaires’ disease.
When Malaysia wrote the code, it drew on standards already proven elsewhere, chiefly the ASHRAE ventilation standard, indoor air quality guidance from Hong Kong and Singapore, the Canadian building owners’ guide and our own MS1525 energy standard, with the occupant questionnaire following the Finnish MM-40.
This is how Malaysia defines and handles sick building syndrome in practice. Under ICOP 2010, a complaint that the air feels wrong sets off an IAQ assessment that records what occupants report, measures the conditions they are reporting on, looks for patterns and weighs the two into a verdict. That verdict can fail a building and force it to be rectified within a month.
Airscan carries out indoor air quality assessments for buildings across Malaysia, from the measurements and the occupant survey through to the ventilation improvements that bring a failed building back within range. Get in touch today if you want to know more about the air quality in your building.
