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Sick Building Syndrome-Reply

Jeffrey Engel, MD
JAMA. 1996;275(21):1635. doi:10.1001/jama.1996.03530450024017.
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In Reply.  —I agree with Dr Atkins' statement that the sick building syndrome has not been demonstrated to be of an allergic origin. I also concur with her advice regarding correction of air-handling systems in a building, rather than removing people from the workplace, as the treatment of choice for this illness. These points are particularly important when dealing with an epidemic associated with a unique environmental exposure.However, the case for discussion was a single person with symptoms occurring 4 times a year, certainly not a history suggestive of an epidemic or a problem at the workplace. My comments were intended to broaden the differential diagnosis beyond infectious causes and remind readers that acute illnesses mimicking infections may be due to exposures to noxious stimuli other than microorganisms. Certainly, if the woman in this case can identify an environment that she encounters 4 times a year that triggers the


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