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The natural history of concurrent sick building syndrome & Chronic Fatigue Syndrome (CFS)

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By Chester AC, Levine PH • • February 15, 1998

An outbreak of chronic fatigue syndrome linked with sick building
syndrome was recently described as a new association. Whether
chronic fatigue syndrome acquired in this setting tends to
remit or, as sporadic cases often do, persist, is unknown. To
clarify the natural history of chronic fatigue syndrome in
association with sick building syndrome the 23 individuals
involved in the outbreak were interviewed four years after the

In the previous interview one year after the onset of
symptoms, 15 (including 5 with chronic fatigue syndrome and 10
with idiopathic chronic fatigue) of the 23 noted fatigue.
Three years later 10 of the 15 were "fatigue free" or "much
improved". Five were only "some better", "the same", or
"worse". Three of the five people previously diagnosed with
chronic fatigue syndrome were "much improved" (two) or
"fatigue free" (one). The remaining two were seriously
impaired, homebound and unable to work. The 10 individuals
with substantially improved fatigue (three of the five with
chronic fatigue syndrome and seven of the 10 with idiopathic
chronic fatigue) were more likely to have noted improvement in
nasal and sinus symptoms, sore throats, headaches, and tender
cervical lymph nodes when compared to those with a lingering
significant fatigue (p < 0.001). Upper respiratory symptoms
and headaches improved in those with reduced fatigue but
remained problematic in those with persisting significant

We conclude that the fatigue related to sick building
syndrome, including chronic fatigue syndrome, is significantly
more likely to improve than fatigue identified in sporadic
cases of chronic fatigue syndrome.

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