Reducing Indoor Air Pollution as a Strategy for Mitigating Sick Building Syndrome: A Systematic Prisma-Based Review of Intervention Strategies and Health Outcomes

Reducing Indoor Air Pollution as a Strategy for Mitigating Sick Building Syndrome: A Systematic Prisma-Based Review of Intervention Strategies and Health Outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Reducing Indoor Air Pollution as a Strategy for Mitigating Sick Building Syndrome: A Systematic Prisma-Based Review of Intervention Strategies and Health Outcomes Ekemini Essien, Ekerete Umoh This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8763269/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Poor inndoor air quality represents a critical public health challenge affecting billions of individuals who spend approximately 87–90% of their time in enclosed spaces. This systematic review examines the relationship between indoor air pollution and Sick Building Syndrome (SBS), synthesizing evidence on intervention strategies and health outcomes following PRISMA guidelines. Through comprehensive database searches of Web of Science, PubMed, JSTOR, and Google Scholar (2010–2025), 156 high-quality sources were analyzed, including 98 empirical studies, 35 systematic reviews, 15 case studies, and 8 meta-analyses across diverse building types and climatic regions. The review integrates theoretical foundations from environmental health psychology, building science, and occupational medicine to establish comprehensive understanding of SBS etiology and intervention effectiveness. Findings demonstrate substantial health improvements through integrated mitigation strategies: 40–60% reduction in SBS symptom prevalence, 25–35% enhancement in cognitive performance, 15–20% increase in productivity, and 30–50% decrease in absenteeism following comprehensive air quality interventions. Environmental outcomes include 20–40% reduction in volatile organic compound (VOC) concentrations, 35–55% improvement in particulate matter control, and 45–70% enhancement in ventilation effectiveness. Advanced technologies, including demand-controlled ventilation systems achieve 88% energy efficiency improvements while maintaining CO2 concentrations below 1000 ppm, and mechanical ventilation with heat recovery demonstrates 90% efficiency with 19% heating energy reduction. However, implementation barriers persist: initial capital costs increase by 8–15%, maintenance complexity requires specialized expertise, and regulatory frameworks remain inconsistent across jurisdictions. These challenges are offset by compelling economic benefits including 25–40% reduction in healthcare costs, 15–25% productivity premiums, 3–5 year payback periods, and 10–18% property value appreciation. The review identifies critical research gaps in long-term intervention sustainability, pollutant mixture synergistic effects, climate-specific adaptation strategies, and implementation in resource-constrained settings. This comprehensive synthesis establishes indoor air quality management as fundamental to SBS mitigation, providing evidence-based frameworks for building professionals, policymakers, and public health practitioners to create healthier indoor environments supporting human wellbeing and sustainable building performance. indoor air quality Sick Building Syndrome ventilation systems building health environmental health pollutant control PRISMA review intervention strategies occupant wellbeing sustainable buildings Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8763269","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":585407429,"identity":"c7047690-a36c-4a30-85c3-21d9d46207a4","order_by":0,"name":"Ekemini Essien","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABAElEQVRIiWNgGAWjYDACdiT2AQYGGyDF2HgArxZmMGkA05IG0tJAvBYgOAzTixvwNzMf3fBxx5/Efv7jDw983HHebm37YaAtNTbRuLRIHGZLuznzjEHizBk5BgdnnrmdvO1MIlDLsbTcBhxaDJh5zG7zthkkbrjBw3CYt+12stkBoBbGhsN4tPB/u/0XqGX/+eMPDv9tO5dsdv4hIS08bLcZQbYwJBgcZmw7YGd2g4AtQL+Y3extMzaecQPol9625ASzG0BbEvD4hb+9+dmNn21ysv39xx9/+NlmZ292Pv3hgw81Nji1wIAjTEEimJFAQDkI2GMwRsEoGAWjYBTAAAApZGqYRqSIQAAAAABJRU5ErkJggg==","orcid":"","institution":"Akwa Ibom State Polytechnic","correspondingAuthor":true,"prefix":"","firstName":"Ekemini","middleName":"","lastName":"Essien","suffix":""},{"id":585407430,"identity":"b225c22f-0f3a-48b3-b282-7304ec46aee1","order_by":1,"name":"Ekerete Umoh","email":"","orcid":"","institution":"Akwa Ibom State Polytechnic","correspondingAuthor":false,"prefix":"","firstName":"Ekerete","middleName":"","lastName":"Umoh","suffix":""}],"badges":[],"createdAt":"2026-02-02 09:53:38","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8763269/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8763269/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":105614433,"identity":"4518a16c-65e9-4111-bcc1-bd4b87ada179","added_by":"auto","created_at":"2026-03-28 04:54:52","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1185278,"visible":true,"origin":"","legend":"","description":"","filename":"ManuscriptIndoorAirQualitySBSSystematicReviewPRISMAFormat.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8763269/v1_covered_e81ebf5c-aac2-4d81-bc9e-0232de302018.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eReducing Indoor Air Pollution as a Strategy for Mitigating Sick Building Syndrome: A Systematic Prisma-Based Review of Intervention Strategies and Health Outcomes\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"indoor air quality, Sick Building Syndrome, ventilation systems, building health, environmental health, pollutant control, PRISMA review, intervention strategies, occupant wellbeing, sustainable buildings","lastPublishedDoi":"10.21203/rs.3.rs-8763269/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8763269/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePoor inndoor air quality represents a critical public health challenge affecting billions of individuals who spend approximately 87\u0026ndash;90% of their time in enclosed spaces. This systematic review examines the relationship between indoor air pollution and Sick Building Syndrome (SBS), synthesizing evidence on intervention strategies and health outcomes following PRISMA guidelines. Through comprehensive database searches of Web of Science, PubMed, JSTOR, and Google Scholar (2010\u0026ndash;2025), 156 high-quality sources were analyzed, including 98 empirical studies, 35 systematic reviews, 15 case studies, and 8 meta-analyses across diverse building types and climatic regions. The review integrates theoretical foundations from environmental health psychology, building science, and occupational medicine to establish comprehensive understanding of SBS etiology and intervention effectiveness. Findings demonstrate substantial health improvements through integrated mitigation strategies: 40\u0026ndash;60% reduction in SBS symptom prevalence, 25\u0026ndash;35% enhancement in cognitive performance, 15\u0026ndash;20% increase in productivity, and 30\u0026ndash;50% decrease in absenteeism following comprehensive air quality interventions. Environmental outcomes include 20\u0026ndash;40% reduction in volatile organic compound (VOC) concentrations, 35\u0026ndash;55% improvement in particulate matter control, and 45\u0026ndash;70% enhancement in ventilation effectiveness. Advanced technologies, including demand-controlled ventilation systems achieve 88% energy efficiency improvements while maintaining CO2 concentrations below 1000 ppm, and mechanical ventilation with heat recovery demonstrates 90% efficiency with 19% heating energy reduction. However, implementation barriers persist: initial capital costs increase by 8\u0026ndash;15%, maintenance complexity requires specialized expertise, and regulatory frameworks remain inconsistent across jurisdictions. These challenges are offset by compelling economic benefits including 25\u0026ndash;40% reduction in healthcare costs, 15\u0026ndash;25% productivity premiums, 3\u0026ndash;5 year payback periods, and 10\u0026ndash;18% property value appreciation. The review identifies critical research gaps in long-term intervention sustainability, pollutant mixture synergistic effects, climate-specific adaptation strategies, and implementation in resource-constrained settings. This comprehensive synthesis establishes indoor air quality management as fundamental to SBS mitigation, providing evidence-based frameworks for building professionals, policymakers, and public health practitioners to create healthier indoor environments supporting human wellbeing and sustainable building performance.\u003c/p\u003e","manuscriptTitle":"Reducing Indoor Air Pollution as a Strategy for Mitigating Sick Building Syndrome: A Systematic Prisma-Based Review of Intervention Strategies and Health Outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-10 06:52:08","doi":"10.21203/rs.3.rs-8763269/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4a73f04a-944f-4304-b09d-51dc478495c7","owner":[],"postedDate":"February 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-28T04:54:30+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-10 06:52:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8763269","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8763269","identity":"rs-8763269","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}