Shabnam Akbari Namdar1 and Solmaz Tabe Afshar  
1Assistant Professor, Department of Architecture, Islamic Azad University, Tabriz, Iran  
2PhD student, Department of architecture, Tabriz Branch, Islamic Azad University, Tabriz, Iran  
ABSTRACT: In the taxonomy of creatures, human is a complex being, a feature that  
makes him vulnerable, such that if he lacked the power to reason and intelligence, he  
would certainly not be able to deal with the threats of the nature. Creating a shelter, from  
Research Article  
its primitive form for cave dwellers to today's luxurious buildings, all point to the man's  
PII: S238315531900005-8  
need for privacy that primarily guarantees his security, but a closer look at this physical  
boundary between man and nature, which is known as residence, reveals that there are a  
plethora of problems, questions, and requirements besides security, ranging from the  
extent to which nature suffers as a result of construction to the health problems that this  
demarcation creates for humans. Evidently, not being attentive to the environment will  
result in health problems, but since sustainable architecture is not necessarily considered  
a moral obligation to care for the health of residents, developing building regulations and  
design policies with an emphasis on human health seems essential. One of such problems,  
whose consequences are clearly noticeable in current societies and families, is the lack of  
access to natural daylight as a result of increased unorganized constructions and  
regardless of environmental conditions, and ultimately the emergence of dysfunctional  
buildings for their residents in the community, which in turn will eventually bring about  
irreversible physical and mental problems. In this article, the notion of “Sick Building  
Syndrome” (or SBS for short), and its underlying causes are reviewed by conducting a  
series of studies on authoritative and up-to-date sources, articles, and books. Here, the  
role that natural daylight plays as one of the major elements whose lack or absence will  
lead to the formation of a sick building in society, along with the factors and elements  
contributing the increased prevalence of this type of building are studied in the scope of  
architectural designing. The authors believe that identifying the reasons for the rise of  
acute health problems in our current society and promoting builders and architects to use  
appropriate and low-cost solutions, will greatly alleviate these problems.  
Received: 08 Aug. 2019  
Revised: 25 Nov. 2019  
Published: 15 Dec. 2019  
Corresponding author’s E-  
KEYWORDS: Sick Building Syndrome, SBS, Daylight, Architecture & Health,  
Architectural Design  
occupants of the building experience discomfort and  
even severe health problems proportional to the  
The term “syndrome” is derived from the Greek  
language, essentially meaning concurrence, while  
today, it mostly refers to a group of symptoms which  
consistently occur together [1].  
duration of residence in the building, even when a  
specific illness or cause is not identifiable [2].  
SBS is often related to the problems in indoor air  
quality, among which the most effective factors are  
often in fact a combination of potential factors,  
including indoor air pollution, lack of sunlight and  
daylight, poor ventilation and heating, poor  
acoustics and the presence of pathogenic elements  
such as asbestos. Biological contaminants are also of  
concern, for example, lack of sunlight along with  
high humidity provides grounds for the formation of  
molds and fungal contaminations [3].  
If one wants to achieve optimality in design,  
harmony with nature should be primarily pursued,  
where humankind first found its origin a few  
thousand years ago. In the meantime, sunlight and  
daylight are heavily involved in keeping us in touch  
with nature while inside the building. Although this  
may seem simple and obvious at first, it would be  
Sick Building Syndrome (SBS) was recognized as  
medical condition by the World Health  
Organization in 1982. The World Health  
Organization defines SBS as a group of nonspecific  
symptoms including symptoms such as eye, nose  
and throat irritation, mental fatigue, headache,  
nausea, dizziness and skin irritations among other,  
some of which appear to be related to working or  
living building [2].  
SBS should not convey the notion that the  
building itself is sick, but that the people in it may  
have one, some, or all of the symptoms that falls into  
SBS as per the definition offered by World Health  
Organization. Sick Building Syndrome is an  
umbrella term used to describe situations in which  
Citation: Akbari Namdar Sh and  
S Tabe Afshar  
(2018). Sick building syndrome: natural daylight case  
Journal of Art and Architecture Studies  
study. J. Art Arch. Stud., 8 (2): 30-36.  
ISSN 2383-1553  
J. Art Arch. Stud. 8(2): 30-36, Dec 15, 2019  
J Art Arch Stud. 8(2): 30-36, 2019  
very important to know that many of the health accounting for natural light, especially in  
problems caused for building occupants may be the metropolitan areas, is the primary cause a wide  
result of the underestimation of the significance of degree of stresses, increased number of some acute  
daylight by urban designers and architects. Thus, it diseases, reduced work and educational productivity  
seems that not carefully considering the basic design and even increased duration of hospital stay [4].  
Farzaneh and Akbari Namdar, 2019  
Figure 1. Source control measures and ventilation strategies; Model of causes of sick building syndrome;  
Relation between indoor air quality and indoor environmental  
Reduced employee productivity  
although the subject of daylight in its rational form  
It is generally acknowledged that humans are in entered the architectural realm from the late  
better mood during daylight, as most surveys on nineteenth and early twentieth centuries. Aside from  
employees and office buildings show that employees the necessity to preserve energy and protect fossil  
prefer windowed environments to windowless ones. fuels, the issue of sunlight gained more significance  
During sunlight, humans feel energetic and lively, when Dr. Niels Finsen received the 1903 Nobel Prize  
but during the winter days we feel bored and even in Medicine for proving that sunlight could cure  
melancholy [5].  
tuberculosis. He also developed a method for  
treating cutaneous tuberculosis using ultraviolet  
Decreased performance and learning in light. Yet the remaining fact is that the light factor  
educational environment  
with a focus on human health is still often  
Devotion to environmental quality factors in the disregarded in design.  
designing academic educational spaces has a great  
impact on the performance of the main users of  
these spaces, i.e. students. In this sense, one of the  
most effective environmental quality factors is the  
introduction of daylight in the designing of  
educational classes [6].  
Daylight and natural sunlight  
Visible light is a spectrum of electromagnetic  
waves that is visible to the human eye, varying from  
405 terahertz bordering the red light, to 790  
terahertz on the purple light. The human body has  
evolved in the daily cycle of light and darkness and  
has fully adapted to natural light, which is the result  
the visible light spectrum being combined, though  
the sensitivity of the human eye and even skin to any  
of the colors of the visible light spectrum is different.  
More importantly, daylight is not a constant flow of  
light, but a dynamic thing that is a function of time  
and place and contains information about the  
outside environment, including the situation of the  
day and the extent of coldness and heat. Therefore,  
the spectral quality of sunlight, which cannot be  
accurately produced artificially, makes it an entirely  
different type of light compared to what is produced  
by any electrical source [7].  
Delays in patient recovery rate  
In the mid-twentieth century, the famous  
English nurse Florence Nightingale was one of the  
major proponents of increasing the amount of  
natural daylight (sunlight) in homes and wards. She  
acknowledged that patients admitted to the well-lit  
wards were in higher morale and much happier than  
those admitted towards without proper daylight.  
Known as The Lady with The Lamp, she went so far  
as to offer architectural designs for low-rise hospital  
wards that received sunlight not from one direction  
but from two, thus achieving access to sunlight in  
the entire ward space [7].  
The relationship of humankind with sunlight  
and natural light throughout history has often  
manifested in the form of religion and mysticism,  
such as belief in the sun god in ancient Egypt, which  
in some cases can be seen quite clearly on stone  
walls and masonry structures and even caves,  
Daylight and health  
The relationship between health and daylight  
can be studied from both mental and physical  
perspectives. Natural light carries information  
regarding the day. This light gives us information  
J Art Arch Stud. 8(2): 30-36, 2019  
about the outside environment when we are indoors daily life cycle leads to the emergence and spread of  
because our body is involved in daily shifts diseases and abnormal behaviors in many plants,  
throughout the year and this circadian cycle directly animals and humans. According to Salamat News, as  
affects the digestive system, sleep pattern, hormone quoted by ISNA, deficiency and insufficiency of  
secretion and even body temperature. The integrity vitamin D is common in approximately 30 to 50% of  
of the body's biological clock is closely attributed to the world's population, although its prevalence  
the amount of light it receives from the environment varies in different geographical areas and varying  
during the day. As a result, receiving enough nutritional and climatic conditions. Despite medical  
daylight is very important for reducing stress, as it advances, vitamin D deficiency is still highly  
affects people's mental states [7].  
epidemic. 50 to 95% of the vitamin D in the body is  
People became more attentive to the importance supplied to the skin through sunlight, while the rest  
of daylight when Dr. Niels Finson received the 1903 is supplied through food and supplements [8].  
Nobel Prize for proving that sunlight could, in fact,  
cure tuberculosis. In 1984, Dr. Rosenthal and  
Urban design policies and designing  
colleagues discovered that the improvement in their requirements  
patients' depression was more due to sunlight than  
A healthy person is not necessarily someone who  
to the inhibition of the release of the melatonin is free of any disease, but health is actually being in a  
hormone, as inhibiting the release of this hormone balanced state and appropriate physical, mental and  
through prescription drug did not reduce social condition. Therefore, providing a living  
environment that meets the health requirements of  
It has been proven that, physically, sunlight is residents should be considered with higher priority  
the main source of vitamin D. The medicinal and compared to visual criteria. Based on the  
therapeutic properties of vitamin D were identified aforementioned discussion, the acceptable level of  
at the beginning of the twentieth century. The daylight often manifests as one of the important  
deficiency of this vitamin at first will lead to a factors of SBS within healthcare in the two scopes of  
decrease in bone density and hence rickets. urban design and architecture [9].  
Furthermore, there is a direct relation between  
In the field of architecture, in most buildings,  
vitamin D deficiency and the function of human the issue of light and health is mostly overlooked and  
cardiovascular system. In fact, vitamin D deficiency visual criteria are often valued higher. Nowadays,  
is an environmental factor that, regardless of the there is practically no requirement set for architects  
genetic factor, leads to heart failure and high blood in this regard, as most of the criteria are associated  
pressure in people. Increased rates of high blood with the safety of openings and exits. A severe lack of  
pressure in winter compared to summer is standardized criteria for improving the health of  
potentially owing to reduced levels of vitamin D in residents is more visible in this field than in the field  
the body as a result of reduced exposure to sunlight. of urban design and, of course, is accompanied with  
Although there is a plethora of dietary supplements more complexity. It is trivial that daylight affects  
for compensating for vitamin D deficiency, sunlight human mood, yet its extent and type depend on the  
has been shown to be the main source of vitamin D, very same human. No any two people see a building  
which no supplement or diet can replace it [8].  
Moreover, relation between vitamin  
and a room in the same way, so despite the fact that  
there is no alternative to the architect's  
deficiency and an increased risk of various cancers understanding of the needs and desires of people  
has been previously shown. However, it should be who want to live, work or play in a specific building,  
noted that depending on the quality, time and place there must be climate-appropriate standards that on  
of sunlight, its effect can be either positive or the one hand offer information on changes in the 24-  
negative. For example, excessive exposure to direct hour cycle, and on the other hand give residents the  
sunlight in a hot and dry climate can increase the ability to control their environment. Well-structured  
risk of skin cancer. Sunlight provides, through and consistent rules, standards, and guidelines that  
photosynthesis and other processes, the chemical can also be generalized offer the architect reliable  
elements needed for our survival that are dependent starting platforms in the design process. Criteria for  
on light. There are fundamental biological, the placement of stairs and emergency exits should  
hormonal, and physiological functions within beings be devised in line with the orientation of the  
that are synchronized through various cycles and are building, the location of the bedrooms and living  
essential for the life of cells, plants, animals, and rooms, the depth of the rooms as well as the size and  
humans. When there is no sunlight, disruption of the location of windows and shutters and the use of  
Farzaneh and Akbari Namdar, 2019  
special techniques with the purpose of providing the  
desired natural light inside the building. Having in  
mind that dazzling and excessive light is also  
annoying to residents and can even reduce visibility  
and increase health risks, the key point in designing  
based on daylight is to control lighting levels as well  
as control the direction of radiation and even the  
manner of light distribution by its occupants.  
Figure 4. Two sided roof monitor system.  
There are strategies in relation to the provision  
of indoor lighting through side windows, casements  
or skylights that the architect should consider in  
accordance with the particular design of the  
building. The corresponding methods include  
engineering the size and slope of the side windows  
and openings, the use of attic side windows with no  
visibility from outside, reflecting platforms in the  
side windows for reflecting light from the ceiling to  
the depth of the room, light guide towers, prismatic  
system employing light refraction and reflection  
incandescent light of winter, light tube system for  
directing sunlight to the lower floors in multi-story  
buildings, as well as intelligent systems for adjusting  
indoor lighting using sunlight. In any case, this issue  
requires the creativity of the architect, as it must be  
classified in the construction design standards [9].  
Figure 5. Alight pipe system with its various sunlight  
collection and light transport systems.  
Figure 6. Rule of thumb for spacing skylights to obtain  
uniform light distribution beneath multiple skylights.  
Figure 2. Light-redirecting louver system.  
Figure 3. Prismatic panel inserted within a side window  
redirecting incoming sunlight.  
Figure 7. A single-sided roof monitor system designed to  
allow winter sunlight to enter but not summer sunlight.  
J Art Arch Stud. 8(2): 30-36, 2019  
physiological health of the occupants of the building  
and their overall health in various ways. Natural  
daylight through windows and various forms of  
openings provides the connection for occupants  
trapped in buildings with the outside space, allowing  
them to closely sense the nature. Lack of sunlight  
can even be literally considered a poison as it leads  
to reduced levels of vitamin D in human body.  
Although severe SBS problems are often associated  
with the duration of time residents stay indoors and  
will gradually alleviate after leaving the building, not  
being attentive to this issue may lead to a plethora of  
severe problems such as heart failure, vascular  
complications and even the emergence of some  
serious diseases, as people nonetheless spend a  
significant share of their lives indoors.  
Figure 8. A single sided sawtooth system provides  
directional distribution of daylight inside the room.  
An expert look at the manner of construction in  
the country reveals that the issue of daylight and  
health in design in most cases has fallen victim in  
expense to mass production and economic greed of  
estate owners. Although a significant share of this  
problem can be attributed to regulatory problems,  
more importantly, the development of criteria  
focusing on the health of residents, accompanied  
with a solid administrative guarantee, seems to be  
the key to solving this problem. In this regard,  
regulation and criteria related to urban design and  
architecture policies should be included as standards  
and instructions in the agenda of activists of housing  
and urban development.  
Figure 9. Daylight penetration resulting from the  
combination of an oblique clerestory and a side window.  
Furthermore, an architect should use natural  
daylight management strategies inside buildings,  
considering the parameters of direction, intensity,  
distribution and controllability in the process with  
the aim of optimizing design. In this sense, not  
issuing work permits for non-professionals and  
having continuous monitoring of design and  
implementation processes can prove be very  
Figure 10. Daylight penetration from  
lightshelf system.  
a combined  
In spite of all these solutions, designers may not  
be able to provide daylight in all parts of the  
building, and hence they can embed daylight-  
catching rooms, balconies, atriums and terraces in  
their design, where the occupants of the building can  
access direct sunlight.  
Authors’ contribution  
All the authors contributed equally to the work  
Competing interests  
The authors declare that there is no competing  
It is evident that with the development of new  
industrial cities, various mental and physical  
disorders related to the living environment are  
emerging, problems that can be identified as a  
combination of factors under the notion of Sick  
Building Syndrome (SBS). Daylight is one of the  
most significant of such factors, the presence or  
absence of which affects the mental and  
[1] Mahmoudi  
M (2016). Sick Building Syndrome,  
Springer International Publishing Switzerland,.DOI:  
Farzaneh and Akbari Namdar, 2019  
[2] Jansz J (2017). Sick Building Syndrome, Elsevier  
International Encyclopedia of Public Health (Second  
[6] Ashrafi E, Sadeghi Naeini H (2016). Determination of  
Effective Factors on Reduction of Sick Building  
Syndrome in Designing Educational Environment,  
International Journal of Advanced Biotechnology and  
[3] Bahubail M A (2013). Sick Building Syndromes and  
Their Effects on Homes within Riyadh City,  
Department of Architecture and Building Sciences,  
College of Architecture and Planning, King Saud  
University.,Vol.25,Arch .& Planing (2), pp .69-78,  
Riyadh(2013/1434H.) Google Scholar  
[7] Boubekri (2007). Daylight, Architecture and  
People’s Health. WIT Transactions on Biomedicine  
and Health, 11 (6)  
[8] Naibi, B (2007). The effect of indoor lighting on  
quality of life and human moral behaviors, Quarterly  
Journal of Ethics in Science and Technology, 2007,  
Nos. 3 and 4  
[4] Sabah A, Abdul-Wahab (2011). Sick Building  
Syndrome in Public Building and Workplaces  
[9] Boubekri  
M (2008). Daylight, Architecture and  
[5] Tregenza P, Wilson (2011). Daylighting  
Health Building Design Strategies, Elsevier. Google  
Architecture and Lighting Design. London: Routledge  
Taylor and Francis Group Google Scholar