A questionnaire for studies of sick building syndrome. A report to the Royal Society of Health Advisory Group on sick building syndrome.

This report describes the development of a standard questionnaire for use in investigating sick building syndrome (SBS) in specific cases and in research projects. The questionnaire itself is packaged with the report. It is intended to be used for screening surveys to determine the prevalence of SBS in a particular building. It may be necessary to adapt the questionnaire if it is going to be used for a specific research project or to gather data on particular potential causes of SBS. The focus has been on achieving standardisation within the United Kingdom. International standardisation is more difficult: there are two main reasons for this. First, translation can never be perfect and words that are nominally equivalent may be used with rather different meanings in different countries. Second, many countries have a database of expected scores based on their own questionnaires. If all these countries were to adopt the same questionnaire, the value of their existing databases would be much reduced - in fact, they could be of no value at all unless some research was carried out to indicate how the new questionnaire related to the old one. This is not to say that a degree of international standardisation should not be attempted, only that it is likely to take longer than progress at national level.

At an early stage, The Royal Society of Health (RSH) working group made the following basic decisions.

• The new questionnaire should contain items on symptoms, indoor environment ratings and confounding factors such as gender, job type, age and location in the building.
• The questionnaire should be accompanied by a brief guide explaining how to use it and how to analyse and interpret the data.
• The work of the group should be cross-referenced to related work being carried out by the Chartered Institution of Building Services Engineers to develop procedures for evaluating buildings in relation to health.

An important principle governing the group's considerations was that no questionnaire can claim absolute validity as a measure of SBS. However, the crucial thing is that, every time a study is done, the same questionnaire should be used so that it has relative validity. This is particularly important in troubleshooting investigations, where a building needs to be compared with some kind of standard in order to determine how 'sick' the building is at the start of the investigation.

The working group felt that piloting the questionnaire was unnecessary because it is made up of questions already piloted in previous questionnaires. However, it would be advisable to carry out a survey of a wide range of buildings in order to obtain a new comparison database for the complete questionnaire. The RSH is currently giving this further consideration.  

The working group decided that the questionnaire and accompanying guidance should be published and that the questionnaire should be freely available for any competent person or body to use. If the questionnaire was subject to a copyright charge, users would tend to get around the copyright by slightly changing the questionnaire: this would destroy the point of having a standard questionnaire.