Notes: Background. In the Danish Town Hall Study" it has previously been shown that the sick building syndrome is a widespread phenomenon. This has given rise to speculations as to whether biologically active components in dust or whether absorbed organic gases and vapours in the indoor climate may be partly responsible for the sick building syndrome. Therefore, we wished to study whether qualitative conditions in dust, of a physical, chemical, and biological nature, are related to the prevalence of symptoms of the sick building syndrome. Material and methods. The study included 12 town halls in the Copenhagen area. A total of 870 persons participated, 584 women and 286 men. All the participants filled out a questionnaire regarding health and working conditions, and dust samples were collected with a special vacuum cleaner in the working environment of the participants, after which the contents of inorganic and organic particles as well as of human source fragments the (hair, nails, skin) and various fibres were determined. Results. There was a significant correlation (P〈0.05) between the prevalence of gram-negative bacteria in the indoor climate dust, and general symptoms (fatigue, heavy-headedness, headache, dizziness, concentration problems) (corr.coeff.=0.73), as well as symptoms from the mucous membranes of the upper respiratory tract (corr.coeff.=0.76). Also, there was a significant relation between the prevalence of particles in the dust and the prevalence of symptoms from the mucous membranes (corr.coeff.=0.81). There was a strong and significant correlation between the total amount of volatile organic components (TVOC) and lack of concentration (corr.coeff. =0.85) and feeling heavy-headed (corr.coeff.=0.72). Macromolecular dust (potentially allergenetic material) was significantly correlated to the prevalence of headache and general malaise/dizziness (corr.coeff.=0.66), while the ability of the dust to liberate histamine was significantly related to the prevalence of general malaise, dizziness (corr.coeff.=0.65) and lack of concentration (corr.coeff. =0.58). Further analyses including a number of potential confounders did not change the results of the above analyses. Conclusion. The results of this study support the hypothesis that qualitative properties of dust are important to the sick building syndrome. The study was based on relatively few buildings, but nevertheless strong correlations were found. In perspective, epidemiological intervention studies should be carried out to investigate whether minimizing the amount of both dust and bacteria in the indoor climate affect the prevalence of sick building syndrome.