Dry Eye Dx and Tx

Combating Sick Building Syndrome

Dry Eye Dx and Tx

Combating Sick Building Syndrome

By Katherine M. Mastrota, MS, OD, FAAO

I grew up in New York City. The ubiquitous availability of public transportation at any hour of the day or night and the close proximity to just about anything I ever needed has left me devoid of one coming-of-age precious tool of freedom: a driver's license. I am also a very "sensitive" car passenger, easily cast into nausea by the motion of the vehicle, so I always sit in the front seat next to the driver. Hence, in a hired car en route to a lecture, I met Ray, my driver.

Ray is a healthy, active 42-year-old who drives for the limousine company he owns. When I told Ray I was on my way to lecture about dry eye, he said, "I used to have that." "Used to?" I asked, my interest immediately piqued. "How was your dry eye cured?" His response was, "I quit my job."

In his previous career, Ray was ensconced in an office cubicle in the Big Apple, where he could not always open a window for a breath of air. Had the change in work environment accompanying his career change "cured" Ray? Surely there are many other variables to consider, but for Ray, this move to a more out-of-doors occupation freed him from ocular discomfort and allowed him to return to comfortable contact lens wear. Could Ray have been suffering from sick building syndrome (SBS)?

What is SBS?

The term "sick building syndrome" describes a group of symptoms that appear to be associated with time spent in a building but cannot be linked to a specific illness or cause. Symptoms include headache, dry cough, dry or itchy skin, dizziness, nausea, difficulty concentrating, fatigue, sensitivity to odors and, of specific interest, nose, throat or eye irritation.

Symptoms of SBS are likely the result of a combination of factors, which may include:

• Chemical pollutants from adhesives, carpeting, upholstery, manufactured wood products, copy machines, pesticides and cleaning agents, which may emit volatile organic compounds (VOCs), including formaldehyde
• Ozone produced by printers and photocopiers
• Biological pollutants, such as viruses, bacteria, dust mites, pollen and toxic black mold
• Inadequate ventilation from malfunctioning heating, ventilation and air-conditioning systems
• Other factors, such as poor lighting, fluorescent lighting, absence of sunlight, humidity, temperature, noise, poor office design or poor ergonomics.

Even psychological factors—excessive work stress, job dissatisfaction, poor morale, poor interpersonal relationships, poor communication—can contribute to symptoms of SBS.

Environmental Modifications

The U.S. Environmental Protection Agency recommends several measures to combat SBS. Core workplace modifications include increased ventilation, air cleaning and pollutant removal. One nontraditional method for improving indoor air quality is phytoremediation.

Phytoremediation is the use of plants to remove, metabolize or degrade toxic environmental materials. The American Society for Horticultural Science reviewed several species of houseplants considered viable phytoremediation candidates for homes and offices where volatile formaldehyde is a concern. Along with our traditional treatments, perhaps we should nurture the gardener in our patients and prescribe a pretty philodendron to add to their environment to help manage ocular surface complaints. CLS

For references, please visit and click on document #193.

Dr. Mastrota is secretary of the Ocular Surface Society of Optometry. She is center director at the New York office of Omni Eye Services and a consultant to Allergan, B+L, Ista Pharmaceuticals, Merck, Noble Vision and Ocusoft. Contact her at