There are no strict criteria for diagnosing sick school syndrome; health experts make a diagnosis by examining the child and assessing whether the symptoms seem related to being in school. Sick school syndrome is often wrongly blamed for several illnesses and disorders ranging from influenza to ATTENTION DEFICIT HYPERACTIVITY DISORDER.

Therefore, it is important for health experts to look for other explanations for a child's symptoms before attributing them to the school environment.

The most frequent contributing factor to sick school syndrome is poor indoor air quality, usually because of poor ventilation. Without ventilation, too much moisture leads to mold and bacteria. Buildings are more tightly sealed today than they were 50 years ago because of energy concerns, and this can result in poorer air quality indoors. In addition, synthetic building materials and furnishings and pesticides add to indoor chemical pollution.

In new buildings the combination of the tight seal and the presence of chemical materials are often at fault. With older buildings ventilation systems may have been turned off or allowed to fall into disrepair. Moisture can also contribute to the development of a sick building. If a roof leaks and carpets are damp, they can harbor bacteria, mold, and fungi that can make children sick. Housekeeping supplies such as copy machine chemicals and pesticides can add to the problem.

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