Based on the definition by the United States Environmental Protection Agency, sick building syndrome (SBS) is when occupants of a building experiences acute health problems which are linked directly to the time spent in the building. According to WebMD, to classify a building as a “sick building”, 20 percent or more of the building occupants should have symptoms of watery eyes, irritated skin, dizziness, nausea, heart palpitations, shortness of breath, nosebleeds, chronic fatigue, tremors, swelling of limbs or cancer. What are the causes of sick building syndrome? In Malaysia alone, some buildings from the 1970s were designed to reduce ventilation rate and maintain the indoor environment to save electricity during the energy crisis. This resulted in poor ventilation system and high indoor air pollutant concentrations. Another common source of contaminant includes volatile organic compounds (VOC) which are found in adhesives, upholstery, carpeting, manufactured wood products, pesticides on indoor plants, cleaning agents, and even photocopy machines. Smoke particles from cigarettes, stove, fireplace and incense results chemical contamination. Synthetic fragrances in personal care products and cleaning equipments are also likely contaminants. 1.2 SICK BUILDING SYNDROME IN MALAYSIAN HEALTHCARE FACILITIESUnfortunately, studies have shown that no building is immune to SBS, even hospitals. It is ironic that a building designed for healing ends up making people sick. Despite the advance in the concepts of sustainable architecture, healthcare facilities have been slow to adopt the practice. Due to the nature of their operation, healthcare facilities present big challenges in prevention of SBS. One of the most distinct issue is the age of the buildings. In Malaysia, most hospitals and clinics are over 30 years old. The data below were obtained from a scientific online journal from HealthWay Malaysia on Sick Building Syndrome in the country. From these, there are obvious differences in the amount of contaminants in old and new buildings. According to the Code of Practice on Indoor Air Quality set by the Department of Occupational Safety and Health (DOSH) Malaysia, all buildings must ensure a certain standard of air ventilation quality to ensure the health and safety of the occupants. The raising public awareness in regards to the importance of air ventilation should encourage old buildings must improve on their ventilation system and new buildings to discover new ways to further reduce the effects of SBS. Chart 1.2 Concentration levels of CO2, CO, TVOC and particulate matter in old and new buildingsChart 1.3 SBS Occurrence in Old and New BuildingsIn environments of mechanical air conditioning and artificial lighting, hospital and clinic users are constantly exposed to physiological effects of fumes created by cleaning agents, anesthetic gases, laboratory chemicals, pharmaceutical products, mold, and building materials like vinyl and high-VOC paint. Working long term in these situations becomes an occupational hazard which potentially interferes with performance. 1.3 HEALING ARCHITECTUREThe very term “Healing Architecture” implies that the built environment have a direct effect on the users’ psychological and emotional well-being. Healing architecture for healthcare facilities explains a physical setting that aids in reducing stresses and anxiety of patients and their families in the process of healing. Therapeutic architecture is designed to be human-centered and life-enhancing in terms of incorporating elements to allow users to interact with the built environment physically, physiologically and psychologically. Diagram 1.1 Optimal Healing Environments The main goal of healing architecture is to encourage the process of self-heal. Psychological, emotional and spiritual health play a big part in a patient’s health and well-being. In order to promote self-healing process, environmental stressor such as noise, lack of privacy, unpleasant odors and light glare should be eliminated. To do that, patients can be offered options including privacy curtains, lighting levels and music, to enhance their sense of being in-control. Reducing stress in both patients and medical staff is crucial to reduce medical error, inability to concentrate, and psychological illnesses such as depression and anxiety.