Environment International, VoL15, pp. 81 - 84, 1989 0160-4120/89 $3.00 +.00 Printed in the U.S.A. All rights reserved. Copyright O1989 Pergamon Pressplc SKIN COMPLAINTS IN BUILDINGS WITH INDOOR CLIMATE PROBLEMS B. Stenberg Department of Dermatology, Ume~iUniversity,S-901 85 Ume~i,Sweden E187-416 (Received4 November 1987; Accepted I May 1989) The Sick Building Syndrome (SBS), as defined by the World Health Organization (WHO), is a combination of both common and unspecific symptoms. Few studies have been published with detailed descriptions of clinical findings. One of the few dermatological references with a close relation to sick buildings is the so-calleki "low humidity occupational dermatoses." Since 1982, an increasing number of outpatients from buildings with indoor climate problems have been investigated at the Department of Dermatology in UmeA, Sweden. The most common findings regarding work-related diseases have been seborrheic dermatitis, facial erythema, periorbital eczema, rosacea, urticaria, and "itching folliculitis." It is suggested that physical, chemical, and psychological factors are of importance in producing these symptoms. INTRODUCTION Since the 1970s, work-related skin symptoms ap- pearing in the office environment have been reported with greater frequency. Working with carbonless- copy paper has been cited as a common cause of muco sal, dermatological, and general symptoms. Only occasionally has an immunological mechanism been proven. Calnan (1979) has reviewed typical findings related to working with carbonless-copy paper. Eye, nose, and throat irritation; dermatitis of the face and hands; irritation and dryness of the lips; and head- ache and drowsiness are typical symptoms. Symp- toms that Calnan believed were of toxic nature were most often noticed in workplaces where large amounts of paper were handled in small, warm, badly venti- lated rooms. Simultaneously, another phenomenon with very similar symptoms was identified, and the building itself was said to be the cause. This phenomenon has appeared under different names, with the "sick build- ing syndrome" (SBS) being the most commonly used. SBS, as defined by WHO (1983), is characterized by irritation of mainly the upper airways and eyes; dry and ¢rythematous skin; and systemic symptoms such as headache, nausea, and fatigue. The presence of dermatological symptoms in SBS, however, is disput- able. In some reports, such symptoms are not in- cluded. During the past six years, an increasing number of patients have boon referred to the UmeA clinic from different workplaces where indoor air problems have been reported by the local medical service. Since the clinical findings tend to fall into a small number of well-defined groups, this report summarizes the find- ings with the hope of providing some guidance for further studies of skin symptoms reh, ted to indoor air quality. MATERIAL AND METHODS Clinical investigations of 77 outpatients from seven workplaces during the period 1982 to 1986 will be reported. The reasons for referring patients to the UmeA clinic include complaints and symptoms re- lated to work within a certain building or part of a building. Patients have been investigated both at the clinic and at their place of work. Patients with ec- zema had patch tests for standard and office allergens performed. Standard allergens include about 20 sub- stances that are known to be common causes of con- tact allergy, e.g., rubber chemicals, metals such as 81