The influence of personality, measured by the Karolinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings

Evaluating prevalence and risk factors of building-related symptoms among office workers: Seasonal characteristics of symptoms and psychosocial and physical environmental factors

Background

Psychosocial and environmental factors at the workplace play a significant role in building-related symptoms (BRSs). Environmental factors change during summer cooling and winter heating using air-conditioning systems. Thus, significant risk factors in each season need to be clarified.

Methods

A nationwide cross-sectional study was conducted during summer in Japan and seasonal differences between summer and winter were evaluated. Self-administered questionnaires were distributed to 489 offices. Possible risk factors for BRSs associated with the work environment, indoor air quality, and job stressors were examined by multiple regression analyses.

Results

Among people having at least one BRS, the prevalence of BRSs in summer (27.8%) was slightly higher than that in winter (24.9%). High prevalence was observed for eye and nasal symptoms related to dryness and general symptoms related to psychological distress in both seasons. Analyses revealed that dryness of air was an important and significant risk factor associated with BRSs, and job stressors were significantly associated with general symptoms in both seasons. Conversely, humidity was a significant risk factor of general symptoms in summer (odds ratio, 1.20; 95% confidence interval, 1.02–1.43). Carpeting, recently painted walls, and unpleasant chemical odors in summer and noise, dust and dirt, and unpleasant odors such as body or food odors in both seasons were significant risk factors for BRSs.

Conclusions

Improvements in the physical environmental qualities in an office throughout the year are important along with the reduction in psychological distress related to work.

Electronic supplementary material

The online version of this article (doi:10.1186/s12199-017-0645-4) contains supplementary material, which is available to authorized users.

Prevalence and risk factors associated with nonspecific building-related symptoms in office employees in Japan: relationships between work environment, Indoor Air Quality, and occupational stress

A nationwide cross-sectional study of 3335 employees was conducted in 320 offices in Japan to estimate the prevalence of building-related symptoms (BRSs) and determine the risk factors related to work environment, Indoor Air Quality, and occupational stress. Data were collected through self-administered questionnaires. The prevalences of general symptoms, eye irritation, and upper respiratory symptoms were 14.4%, 12.1%, and 8.9%, respectively. Multiple logistic regression analyses revealed that eye irritation was significantly associated with carpeting [odds ratio (OR), 1.73; 95% confidence interval (CI), 1.24-2.41], coldness perception (OR, 1.28; 95% CI, 1.13-1.45), and air dryness perception (OR, 1.61; 95% CI, 1.42-1.82). General symptoms were significantly associated with unpleasant odors (OR, 1.37; 95% CI, 1.13-1.65), amount of work (OR, 1.24; 95% CI, 1.06-1.45), and interpersonal conflicts (OR, 1.44; 95% CI, 1.23-1.69). Upper respiratory symptoms were significantly associated with crowded workspaces (OR, 1.36; 95% CI, 1.13-1.63), air dryness perception (OR, 2.07; 95% CI, 1.79-2.38), and reported dustiness on the floor (OR, 1.39; 95% CI, 1.16-1.67). Although psychosocial support is important to reduce and control BRSs, maintaining appropriate air-conditioning and a clean and uncrowded workspace is of equal importance.

Gender, airborne chemical monitoring, and physical work environment are related to indoor air symptoms among nonindustrial workers in the Klang Valley, Malaysia

Objectives:

The purpose of this study was to analyze the relationship of airborne chemicals and the physical work environment risk element on the indoor air symptoms of nonindustrial workers.

Design:

A cross-sectional study consisting of 200 office workers. A random selection of 200 buildings was analyzed for exposure and indoor air symptoms based on a pilot study in the Klang Valley, Malaysia.

Methods:

A set of modified published questionnaires by the Department of Occupational Safety and Health (DOSH), Malaysia and a previous study (MM040NA questionnaire) pertaining to indoor air symptoms was used in the evaluation process of the indoor air symptoms. Statistical analyses involving logistic regression and linear regression were used to determine the relationship between exposure and indoor air symptoms for use in the development of an indoor risk matrix.

Results:

The results indicate that some indoor air pollutants (carbon monoxide, formaldehyde, total volatile organic compound, and dust) are related to indoor air symptoms of men and women. Temperature and relative humidity showed a positive association with complaints related to the perceived indoor environmental condition (drafts and inconsistency of temperature). Men predominantly reported general symptoms when stratification of gender involved exposure to formaldehyde. Women reported high levels of complaints related to mucosal and general symptoms from exposure to the dust level indoors.

Conclusion:

Exposure to pollutants (total volatile organic compounds, carbon monoxide, and formaldehyde) and physical stressors (air temperature and relative humidity) influence reported symptoms of office workers. These parameters should be focused upon and graded as one of the important elements in the grading procedure when qualitatively evaluating the indoor environment.

Coping and self-image in patients with symptoms attributed to indoor environment

This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.

Dampness and moulds in workplace buildings: associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study

There are few longitudinal studies on health effects of dampness and moulds in workplace buildings. We studied associations between dampness and indoor moulds in workplace buildings and selected biomarkers as well as incidence and remission of sick building syndrome (SBS). The study was based on a ten-year prospective study (1992-2002) in a random sample of adults (N=429) from the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, dermal symptoms and any symptom improved when away from the workplace (work-related symptoms) was 7.2%, 11.6%, 6.4% and 9.4% respectively. The 10-year remission of general, mucosal, dermal symptoms and work-related symptoms was 71.4%, 57.1%, 70.4% and 72.2% respectively. Signs of dampness in the floor construction in any workplace building during follow up (cumulative exposure) was associated with incidence of mucosal symptoms (OR=2.43). Cumulative exposure to moldy odor was associated with incidence of work-related symptoms (OR=2.69). Cumulative exposure to dampness or moulds was associated with decreased remission of work-related symptoms (OR=0.20 for water leakage, OR=0.17 for floor dampness, and OR=0.17 for visible indoor mould growth). Working in a building repaired because of dampness (repaired building) or mould was associated with decreased remission of work-related symptoms (OR=0.32). Any dampness or moulds at baseline in the workplace building was associated with increased bronchial responsiveness (BR) and higher levels of Eosinphilic Cationic Protein (ECP) in serum and Eosinophilic counts in blood at baseline. Cumulative exposure to dampness and moulds, and work in a repaired building, was associated with increased BR at follow-up. In general, dampness and moulds in the workplace building is associated with increased incidence and decreased remission of SBS, as well as increased bronchial responsiveness and eosinophilic inflammation.

Pilot study of personality traits assessed by the Karolinska Scales of Personality (KSP) in asthma, atopy, and rhinitis

Asthma and atopy are common diseases. To study associations between personality and asthma, atopy, rhinitis, and personality traits were measured on the Karolinska Scales of Personality for 193 persons working in 19 buildings with suspected indoor air problems. In addition, information on history of atopy, asthma, and rhinitis was collected by postal questionnaire. In analyses, asthma was associated with higher impulsiveness scores, and atopy in non-asthmatics was associated with higher social desirability scores and lower irritability, guilt, and impulsiveness scores. Non-atopic rhinitis was associated with scores on several anxiety-related scales, while atopic rhinitis was not associated with scores on the Karolinska Scales of Personality. This exploration implies that asthma, atopy, and rhinitis may be associated with various but different personality trait scores. The finding of such personality trait associations in persons with non-asthmatic atopy raises the question of a potential role of an emotional conflict in atopy and the role of personality in asthma, atopy, and rhinitis.

The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study

There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear.

PRACTICAL IMPLICATIONS

We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.

A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China

There are few longitudinal studies on sick building syndrome (SBS), which include ocular, nasal, throat, and dermal symptoms, headache, and fatigue. We studied the associations between selected microbial components, fungal DNA, furry pet allergens, and incidence and remission of SBS symptoms in schools in Taiyuan, China. The study was based on a two-year prospective analysis in pupils (N=1143) in a random sample of schools in China. Settled dust in the classrooms was collected by vacuum cleaning and analyzed for lipopolysaccharide (LPS), muramic acid (MuA), and ergosterol (Erg). Airborne dust was collected in Petri dishes and analyzed for cat and dog allergens and fungal DNA. The relationship between the concentration of allergens and microbial compounds and new onset of SBS was analyzed by multi-level logistic regression. The prevalence of mucosal and general symptoms was 33% and 28%, respectively, at baseline, and increased during follow-up. At baseline, 27% reported at least one symptom that improved when away from school (school-related symptoms). New onset of mucosal symptoms was negatively associated with concentration of MuA, total LPS, and shorter lengths of 3-hydroxy fatty acids from LPS, C14, C16, and C18. Onset of general symptoms was negatively associated with C18 LPS. Onset of school-related symptoms was negatively associated with C16 LPS, but positively associated with total fungal DNA. In general, bacterial compounds (LPS and MuA) seem to protect against the development of mucosal and general symptoms, but fungal exposure measured as fungal DNA could increase the incidence of school-related symptoms.

Gender and the Physical and Psychosocial Work Environments are Related to Indoor Air Symptoms

OBJECTIVES

To assess gender differences in self-reported symptoms, psychosocial, subjective, and objective physical environments.

METHODS

Staff (N=173) in four university buildings were investigated by questionnaires, blood samples, and objective assessment of indoor environment (temperature, air velocity, relative humidity, CO2, and dust [PM 10]). Analyses were performed by linear and logistic regressions.

RESULTS

Women reported health symptoms more often than did men and complained more about physical but not psychosocial factors. Men's symptoms and complaints were more specifically associated to air velocity and humidity. For both genders, symptoms were related to both strain (P=0.02) and perceived physical environments (P=0.01). Lower relative humidity in the range of 15% to 35% was associated with perception of too low temperature and dry air.

CONCLUSION

Gender, psychosocial, and physical environment factors were related to symptoms and perceived indoor climate.

Projective drawings for assessing stress among subjects with medical symptoms compatible with sick building syndrome, and validation of a modified version of the Stress Load Index from the Drawing Personality Profile: a pilot study

It was hypothesized that subjects with medical symptoms would show more signs of stress in projective drawings. A Stress Load Index, including five signs of stress in drawings, was evaluated. A questionnaire with an instruction to draw "a person in the rain" was sent to a cohort of 195 subjects, and the drawings were analysed blindly for eight stress items. Men had a higher index than women (p < .05) and drew clouds more often (p < .05). Drawing of clouds was associated with headache (adjOR = 4.28; 95% CI 1.75; 11.68). Drawing of puddles was associated with ocular symptoms (adjOR = 3.22; 95% CI 1.38, 7.50), facial dermal symptoms (adjOR= 2.94; 95% CI 1.28, 6.81), and tiredness (adjOR = 2.44; 95% CI 1.05, 5.67). Drawing of long rain strokes was associated with nasal symptoms (adjOR = 2.28; 95% CI 1.05, 2.06) and headache (adjOR = 3.20; 95% CI 1.28, 8.05). Age and stress load were predictors of sick building syndrome symptoms (p < .05). In conclusion, a nonverbal projective drawing test detected sex differences which represent directions opposite to those with verbal methods. These need empirical assessment.

Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce

A random sample of 1000 subjects (20-65 years of age) received a postal questionnaire regarding sick building syndrome (SBS), including the three-dimensional model of demand-control-support (DCS). The response rate was 70% (n = 695), and 532 were occupationally active. Female gender and atopy were the main predictors of symptoms. Eye symptoms were more common at low social support combined with strained work situation [odds ratio (OR) 2.37], and at high social support combined with active work situation (OR 3.00). Throat symptoms were more common at low social support combined with either passive (OR 1.86) or strained situation (OR 2.42). Tiredness was more common at low social support combined with either passive (OR 2.41), strained (OR 2.25), or active situation (OR 1.87), and at high social support combined with active work situation (OR 1.83). Low social support combined with either passive (P = 0.01) or strained job situation (P = 0.01) was associated with a higher symptom score (SC). The lowest SC was found at a relaxed work situation, irrespective of social support. In conclusion, female gender, low age, asthma, atopy and psychosocial work environment are associated with symptoms. The three-dimensional model can predict symptoms compatible with SBS, but in a more complex way than earlier research indicated. Practical Implications A multi-disciplinary approach, including psychosocial stress factors as well as personal factors such as gender, age, atopy and asthma, and indoor exposures, should be applied in studies on symptoms compatible with sick building syndrome (SBS). Males and females perceive psychosocial work conditions differently, and may react differently to job stressors. The psychosocial work environment can be as important as gender and atopy as a predictor of SBS symptoms.

Associations among sick building syndrome, psychosocial factors, and personality traits

A mailed questionnaire assessed personality traits of a cohort of 194 subjects followed from 1988 to 1998 measured by the Karolinska Scales of Personality and Sense of Coherence Scale, medical symptoms, and 3 VAS scales on Perceived Psychosocial Work Satisfaction. Subjects initially worked in 19 Swedish buildings with indoor environmental problems. There was a relatively high correlation between SOC scores and KSP scale scores (R2=.54 in men and .55 in women), and there was a sex-KSP interaction on the association between the two sets of scores. An increase of symptom score (SC difference) during the follow-up period was associated with higher psychic anxiety (p<.01 for both men and women), higher socialization (p<.01 for men) and lower inhibition of aggression (p<.05 for men), in stepwise multiple linear regression models. Moreover, the perceived satisfaction scores were associated with personality scale scores, and subjects with a higher sense of coherence reported higher work satisfaction (p<.01). In conclusion, personality aspects seem to play an important role for reporting medical symptoms, work satisfaction, work stress, and climate of cooperation at work, but different personality aspects could be important in men and women.