The existing literature contains strong evidence that characteristics
of buildings and indoor environments significantly influence rates of
respiratory disease, allergy and asthma symptoms, sick building sympto
ms, and worker performance. Theoretical considerations, and limited em
pirical data, suggest that existing technologies and procedures can im
prove indoor environments in a manner that significantly increases hea
lth and productivity. At present, we can develop only crude estimates
of the magnitude of productivity gains that may be obtained by providi
ng better indoor environments; however, the projected gains are very l
arge. For the U.S., we estimate potential annual savings and productiv
ity gains of $6 billion to $19 billion from reduced respiratory diseas
e; $1 billion to $4 billion from reduced allergies and asthma, $10 bil
lion to $20 billion from reduced sick building syndrome symptoms, and
$12 billion to $125 billion from direct improvements in worker perform
ance that are unrelated to health. Sample calculations indicate that t
he potential financial benefits of improving indoor environments excee
d costs by a factor of 18 to 47. The policy implications of the findin
gs are discussed and include a recommendation for additional research.