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

A longitudinal study on the effects of hygro-thermal conditions and indoor air pollutants on building-related symptoms in office buildings

We conducted a longitudinal epidemiological study for over 1 year in Tokyo and Osaka, Japan, beginning June 2015, to examine the association between indoor environmental factors and building-related symptoms (BRSs) in office workers. Data were obtained from 483 subjects (225 females and 258 males) in 24 office rooms in 11 office buildings. Environmental monitoring was conducted for hygro-thermal conditions and carbon dioxide and sampling was performed for indoor air pollutants. Questionnaires were concurrently administered to collect information on participants' perceptions of their comfort and health and the conditions of the work environments. Multivariable analyses revealed that upper respiratory symptoms were significantly correlated with a decrease in both relative [odds ratio (OR): 0.77; 95% confidence intervals (CI): 0.62-0.95; p = 0.014] and absolute humidity (OR: 0.89; 95% CI: 0.81-0.97; p = 0.008). Statistically, significant evidence was found that average relative humidity of <38% (OR: 2.68; 95% CI: 1.36-5.27; p = 0.004) showed the most significant association with increased risk of upper respiratory symptoms. Air concentrations of carbon dioxide showed no significant correlation with BRSs at mean concentrations <1000 ppm in most buildings surveyed. Most indoor air pollutant concentrations were relatively low or lower than the values set by indoor air quality guidelines and the values of thresholds for sensory irritation. Air concentrations of indoor air pollutants showed no significant correlation with BRSs. Our data emphasize the importance of appropriate humidity control during low humidity in winter.

Effects of occupant behaviors on perceived dormitory air quality and sick building syndrome symptoms among female college students

We performed a cross-sectional survey of 2143 female students in a university in Tianjin, China regarding perceived air quality (PAQ) and sick building syndrome (SBS) symptoms in the student dormitory. The prevalence of general, mucosal, and skin symptoms was 22.1%, 21.9%, and 26.3%, respectively. The three most prevalent PAQ complaints were "dry air" (48.9% often), "stuffy odor" (18.2%), and "other unpleasant odors" (5.1%), and they were significant risk factors for 11-12 out of 12 SBS symptoms (adjusted odds ratios [AOR]: 1.6-5.8). Survey data of 1471 undergraduates, whose dorms were of uniform layout and furnishing, were used to further investigate the influences of occupancy level and occupant behaviors on PAQ and SBS symptoms. Frequent use of air freshener/perfume was a significant risk factor for "dry air," less frequent room cleaning and higher occupancy density were significant risk factors for "stuffy odor," and less natural ventilation was a significant risk factor for both "stuffy odor" and "pungent odor." These factors were also significantly associated with some SBS symptoms. In particular, the use of air freshener/perfume exhibited a significant dose-response pattern with "fatigue" (sometimes: AOR 1.3; often: AOR 2.0) and with "irritated, stuffy, or runny nose" (sometimes: AOR 1.6; often: AOR 2.2).

Changes in Reported Symptoms Attributed to Office Environments in Sweden between 1995 and 2020

Non-specific building-related symptoms (NBRSs) describe various symptoms in those affected. Questionnaires are the first step in investigating suspected NBRSs in office environments and have been used for over two decades. However, changes in reporting of symptoms among office workers over time are currently unknown. The overall aim was thus to investigate if reported symptoms and perceived causality to the office environment have changed during 25 years of using the MM 040 NA Office questionnaire. A cross-sectional study of 26,477 questionnaires from 1995-2020 was conducted, where 12 symptoms and perceived causality to office environment were examined using logistic regression analyses of 5-year groups adjusted for sex and atopy. Reporting trends in the year groups varied slightly among symptoms, but eight symptoms were statistically significant in the 2015-2020 group compared to the 1995-1999 group. Seven symptoms had increased: fatigue, heavy-feeling head, headache, difficulties concentrating, itchy/irritated eyes, congested/runny nose, and dry/red hands. One symptom decreased: hoarseness/dry throat. Perceived causality of symptoms to the office environment decreased to a statistically significant degree in 2015-2020 for 11 symptoms, and there was an overall trend of decreasing perceived causality throughout the year groups for most symptoms. The observed time trends suggest a need for up-to-date reference data, to keep up with changes in symptom reporting in office environments over time.

Building and Health: Mapping the Knowledge Development of Sick Building Syndrome

At present, with more and more attention paid to the impact of buildings on the health and well-being of occupants, sick building syndrome (SBS) has become a global concern. Since the introduction of SBS by the World Health Organization (WHO) in 1983, thousands of research literatures have been published in this field. This paper systematically arranges knowledge development of SBS through bibliometric analysis, exploring the most influential countries, institutions, journals and scholars, as well as the main subject categories and keywords. Main path analysis (MPA) was used to list development trajectory under inheritance relationship of SBS knowledge, including symptom analysis, risk factors of SBS and the improved impact of ventilation on SBS and productivity. Furthermore, it is an emerging research trend to propose SBS solution in the building design stage.

Indoor air quality and sick building syndrome in a university setting: a case study in Greece

The perceived Indoor Air Quality (IAQ), the prevalence of Sick Building Syndrome (SBS) symptoms and its contributing risk factors were assessed in a university during the period of the economic crisis in Greece. Data was collected from 613 employees via questionnaires. Hierarchical linear regression analysis was performed. The most prevalent perceived IAQ complaints were 'Dust and dirt' (63.2%), 'Room temperature too low' (24.9%) and 'Varying room temperature' (24.4%). The most frequently reported SBS symptom was 'Fatigue' (34.1%). The prevalence of General, Mucosal and Dermal symptoms was 40.8%, 19.8% and 8.1%, respectively. Several contributing risk factors were identified, such as IAQ Discomfort Scale, atopy, sleep problems, female, exposure to biological and chemical agents, PC-use, Psychosocial Work Scale and job satisfaction. Poor perceived IAQ and high prevalence of SBS symptoms were reported from the university staff in a temperate climate country. SBS seemed to be multifactorial.

Evaluation of the relationship between sick building syndrome complaints among hospital employees and indoor environmental quality

Background:

Sick building syndrome (SBS) is defined as a condition occurring in people who live or work in a modern building and who suffer from complaints such as headache, fatigue, lack of concentration, and irritation of the skin and mucous membranes.

Objectives:

The aim of this study is to examine the complaints associated with SBS in the employees of our hospital and evaluate the relationship between the characteristics of the work environment and the complaints of SBS.

Methods:

890 workers participated in the study. The complaints of the participants were rated and the sum of all complaints was recorded as the Total Complaint Score (TCS). The mean TCS of the participants was compared according to demographic characteristics and work environment characteristics.

Results:

The most common complaints among the employees were fatigue (40%), and general muscle and joint pain (31.4%). There was a statistically significant difference in TCS according to the position (p < 0.001). The mean TCS was significantly higher in females [13 (0–81)] than in males [6 (0–59)] (p < 0.001). The mean TCS increased with the presence of odor, new wall paint, the presence of fungus/mold on walls, and the presence of rotting/mold smell (p < 0.001, for all). TCS positively correlated with stress level, social relationship, noise level, comfort, cleanliness, number of employees in the same room, presence of odor, new wall paint, presence of rotting/mold, and use of chemical materials for cleaning in the room (p < 0.001, for all), and negatively correlated with room size and number of windows (p = 0.006, p < 0.001, respectively).

Discussion:

The present study found that the female gender, a high level of education, a high level of stress, a low level of social relationships and work environment characteristics were associated with the complaints of SBS among the employees. Accordingly, we believe that hospital management should be informed in order for the managers to take precautions and make new regulations.

Sick building syndrome among healthcare workers and healthcare associates at observed general hospital in Slovenia

OBJECTIVE

The aim of this study was to assess the possible associations between self-perceived sick building syndrome (SBS) symptoms among healthcare workers and healthcare associates and self-perceived parameters of indoor work environment quality.

METHODS

The cross-sectional study was conducted from February to April 2019. Validated standardized evaluation tools (MM 040 NA Hospital 2007 and MM 040 NA Office 2007) were used for estimating the prevalence of SBS among observed populations. Chi-square and Mann-Whitney U tests for assessing possible associations in SBS symptoms between healthcare workers and associates were used.

RESULTS

The response rate was 69.8%. The results showed a lower prevalence of six or more SBS symptoms in healthcare associates (6.4%) compared to healthcare workers (12.0%). Healthcare workers perceived the most frequent risk factors for SBS to be poor air quality, an inappropriate level of relative humidity, and inappropriate room temperature, while the least frequently self-perceived risk factors were inappropriate lighting and noise levels.

CONCLUSIONS

This study represents a platform for further analyses - the identification of health risk factors with environmental monitoring.

Association of subjective health symptoms with indoor air quality in European office buildings: The OFFICAIR project

The aim of this study was to explore the association between the building-related occupants' reported health symptoms and the indoor pollutant concentrations in a sample of 148 office rooms, within the framework of the European OFFICAIR research project. A large field campaign was performed in 37 office buildings among eight countries, which included (a) 5-day air sampling of volatile organic compounds (VOCs), aldehydes, ozone, and NO₂ (b) collection of information from 1299 participants regarding their personal characteristics and health perception at workplace using online questionnaires. Stepwise and multilevel logistic regressions were applied to investigate associations between health symptoms and pollutant concentrations considering personal characteristics as confounders. Occupants of offices with higher pollutant concentrations were more likely to report health symptoms. Among the studied VOCs, xylenes were associated with general (such as headache and tiredness) and skin symptoms, ethylbenzene with eye irritation and respiratory symptoms, a-pinene with respiratory and heart symptoms, d-limonene with general symptoms, and styrene with skin symptoms. Among aldehydes, formaldehyde was associated with respiratory and general symptoms, acrolein with respiratory symptoms, propionaldehyde with respiratory, general, and heart symptoms, and hexanal with general SBS. Ozone was associated with almost all symptom groups.

Review of IAQ in Premises Equipped with Façade–Ventilation Systems

Poor indoor air quality affects the health of the occupants of a given structure or building. It reduces the effectiveness of learning and work efficiency. Among many pollutants, PM 2.5 and 10 dusts are extremely important. They can be eliminated using mechanical ventilation equipped with filters. Façade ventilation devices are used as a way to improve indoor air quality (IAQ) in existing buildings. For their analysis, researchers used carbon dioxide as a tracer gas. They have shown that façade ventilation devices are an effective way to improve IAQ, but require further analysis due to the sensitivity of façade ventilation devices to the effects of wind and outdoor temperature. In addition, legal regulations in some countries require verification in order to enable the use of this type of solution as a way to improve IAQ in an era characterised by the effort to transform buildings into passive houses (standard for energy efficiency in a building).

PM2.5 and Trace Elements in Underground Shopping Districts in the Seoul Metropolitan Area, Korea

We measured PM_2.5 in 41 underground shopping districts (USDs) in the Seoul metropolitan area from June to November 2017, and associated 18 trace elements to determine the sources and assess the respiratory risks. The PM_2.5 concentrations were 18.0 ± 8.0 μg/m³ inside USDs, which were lower than 25.2 ± 10.6 μg/m³ outside. We identified five sources such as indoor miscellanea, soil dust, vehicle exhaust/cooking, coal combustion, and road/subway dust, using factor analysis. Almost 67% of the total trace element concentration resulted from soil dust. Soil dust contribution increased with the number of stores because of fugitive dust emissions due to an increase in passers-by. Vehicle exhaust/cooking contribution was higher when the entrances of the USDs were closed, whereas coal combustion contribution was higher when the entrances of the USDs were open. Although miscellanea and coal combustion contributions were 3.4% and 0.7%, respectively, among five elements with cancer risk, Cr and Ni were included in miscellanea, and Pb, Cd, and As were included in coal combustion. The excess cancer risk (ECR) was the highest at 67 × 10^-6 for Cr, and the ECR for Pb was lower than 10^-6, a goal of the United States Environmental Protection Agency for hazardous air pollutants.

Psychosocial factors and indoor environmental quality in respiratory symptom reports of pupils: a cross-sectional study in Finnish schools

OBJECTIVES

Poor indoor environmental quality (IEQ) in schools is related to higher respiratory symptoms of pupils, but little is known about the importance of other factors. This study examined the associations between different psychosocial factors and other pupils' individual and allergic characteristics, beyond school IEQ, and reporting of respiratory symptoms in pupil-administered and parent-administered questionnaires.

SETTING

All primary and secondary schools in two areas of Helsinki, Finland.

PARTICIPANTS

Primary school pupils (grade 3-6, n=8775, 99 school buildings) and secondary school pupils (grade 7-9, n=3410, 30 school buildings) reported their respiratory symptoms, as well as psychosocial factors and individual characteristics. Parents of primary school pupils (grade 1-6, n=3540, 88 school buildings) also filled in questionnaires, but the response rate was low (20% in 2017 and 13% in 2018).

MAIN OUTCOME MEASURE

Respiratory symptoms were reported in relation to the school environment and in general (without such relation) by pupils or parents.

RESULTS

Worry about IEQ and low school satisfaction, and asthma and hay fever were related to higher reporting of respiratory symptoms in three samples. The variance between schools in respiratory symptoms was low (intraclass correlation=0.6%-2.4%). Psychosocial factors, especially worry about school's IEQ, explained more of the variance between schools in symptoms than IEQ among secondary school pupils and parents, but not among primary school pupils for symptoms in general. Worry about IEQ also modified the associations between IEQ and respiratory symptoms, but only in parental reports.

CONCLUSION

In addition to IEQ, psychosocial factors and pupils' individual and allergic characteristics were related to higher reporting of respiratory symptoms in all three samples. Psychosocial factors explained more variance between schools than IEQ, although it was 2.4% at most. Other factors beyond IEQ should be considered when interpreting symptom reporting in indoor air questionnaires.

Microclimate in Rooms Equipped with Decentralized Façade Ventilation Device

Many building are characterized by insufficient air exchange, which may result in the symptoms of sick building syndrome (SBS). A large number of existing buildings are equipped with natural ventilation, whose work is disturbed by activities going to energy-saving. The thermomodernization activities are about mounting new sealed windows and laying thermal isolation, which reduces the amount of infiltrating/exfiltrating air. In many cases, the mechanical ventilation cannot be used due to a lack of a place in building or architectural and construction requirements. One of the solutions to improve the indoor microclimate is the decentralized façade ventilation. In the article, the internal air parameters in an office room equipped with decentralized façade ventilation device were analyzed. The room was equipped with a decentralized façade unit, which cyclically supplied and removed air from the room. The time of the supply/exhaust was changed to 2 min, 4 min, and 10 min. The temperature and the humidity of the indoor air and the outdoor air and the concentration of carbon dioxide inside the room were measured. The analysis showed that despite the lack of a heater in the device, the air temperature in the workplace and in the central point of the room was in the range of 20–22 °C. The air humidity was in the range of 27–43%.

Working Conditions and Sick Building Syndrome among Health Care Workers in Vietnam

Background: Little is known about risk factors for sick building symptoms (SBS) among health care workers (HCWs) who often face the workload, exposure to chemicals, and biological contaminants in the workplace. This study aims to evaluate the correlation between SBS and the symptoms among HCWs. Methods: A total of 207 HCWs were recruited in a large hospital-based cross-sectional survey between March and June 2017, southern Vietnam. Face-to-face interviews were conducted for collecting data on demographics, SBS-related symptoms, working environments, and conditions. Indoor environmental conditions were measured. SBS scores, ranging from 0 to 24, were determined by a sum of the scores of general symptoms, mucosal irritation, and skin symptoms; multivariate regression analyses and the Lindeman, Merenda, and Gold (LMG) test were used to investigate the predictors and its impact on the SBS. Results: A mean SBS score was 9.7 (range: 1–21). Compared with males, females were more likely to report higher SBS scores (10.2 vs. 7.9, p < 0.001). Being female, atopy, varying temperature room, stuffy “bad” air dust, and dirt had higher SBS scores of 2.0; 1.8; 1.7; 1.9; 3.8, respectively. LMG test showed that dust and dirt, and stuffy “bad” air were the predominant risk factors for SBS. Conclusions: Our study reveals that working conditions are important and significantly associated with SBS. Taken together with our findings, the working condition criteria approach trained for architects, builders, owners, and maintenance of the building is highly recommended for indoor air quality improvement. Furthermore, larger-sample studies about working condition are urgently needed to better manage SBS.

Prevalence of sick building syndrome symptoms and its associated factors among bank employees in Pokhara Metropolitan, Nepal

A cross-sectional study was conducted to assess the prevalence of sick building syndrome symptoms and its associated factors among bank employees. Data were collected through a self-administered MM040NA questionnaire among 234 employees of commercial banks in Pokhara Metropolitan, Nepal. The prevalence of general, ocular, respiratory, and dermal sick building syndrome symptoms was 47.6%, 11.9%, 11.9%, and 8.1%, respectively. The perceived indoor physical environment was a significant predictor of sick building syndrome symptoms. Besides this, age, disturbance from temperature and work pressure were significantly associated with general symptoms. Ocular symptoms were significantly associated with disturbance from noise at their workplaces and support from fellow workers. Respiratory symptoms were significantly associated with the time spent working with a photocopy machine. Proper maintenance of room temperature, noise control, good ventilation system, and promotion of supportive psychosocial working environment at banks is important to prevent and control the suffering of employees from SBS symptoms.

Associations between indoor environmental quality in schools and symptom reporting in pupil-administered questionnaires

BACKGROUND

The associations between indoor environmental quality (IEQ) in homes and symptom reporting of children have been extensively studied, but only few large-scale studies have been done in schools. We examined associations between expert-assessed IEQ in schools and pupils' reporting of different symptoms, and whether associations were stronger if participants relate symptoms to the school environment.

METHODS

The questionnaire survey was done in all primary and secondary schools in two areas of Helsinki, Finland. Primary school pupils (grade 3-6, n = 8775, 99 school-buildings) and secondary school pupils (grade 7-9, n = 3410, 30 school-buildings) reported their symptoms. Symptoms were combined into respiratory, lower respiratory, eye, skin, and general symptom groups. Surveys were also done among the parents of the primary school pupils (grade 1-6, n = 3540, 88 school buildings), but results are reported only in the supplement due to the low response rate (20% in 2017 and 13% in 2018). The associations between IEQ and symptoms were analyzed using multilevel logistic regression analysis.

RESULTS

Several of the IEQ indicators were highly correlated and indicators were therefore mainly analyzed by combining them into a summary score and into latent classes. Dose-response associations were found between IEQ problems and higher reporting of respiratory and general symptoms among both primary and secondary school pupils. Some associations were also observed with lower respiratory and skin symptoms, but not with eye symptoms. The associations were somewhat stronger with symptoms related to the school environment compared to symptoms reported without such relation: for a unit change in IEQ summary score and respiratory symptoms in primary schools, odds ratios were 1.07 (95% CI 1.02-1.06) and 1.04 (95% CI 1.04-1.10), and in secondary schools 1.09 (95% CI 1.01-1.09) and 1.05 (95% CI 1.02-1.17), respectively.

CONCLUSIONS

Expert-assessed IEQ problems in schools were associated with increased reporting of especially respiratory and general symptoms. The associations were only somewhat stronger in magnitude for symptoms reported in relation to the school environment compared to symptoms reported without such relation.

Analysis of the indoor environment of agricultural constructions in the context of sustainability

This research paper focuses on agricultural constructions, a special type of constructions with an important role in industry and agriculture. Food production is an important social factor that is vital to human survival, so its qualitative aspect is a key determinant of living standards and is also important in terms of sustainability. The need to create a suitable environment (welfare) for animals, as a factor in terms of health and productivity, is drawing increasing attention. The environment continuously and directly affects animals, so it is quickly reflected in their productivity and medical condition. The objective of this research paper is to present an analysis of the interactions between agricultural constructions' outdoor and indoor environment by monitoring an actual operational construction designed for animal rearing, from the point of view of animal welfare and sustainability, taking into account thermal protection and indoor climate.

Perception of indoor air quality (IAQ) by workers in underground shopping centers in relation to sick-building syndrome (SBS) and store type: a cross-sectional study in Korea

Background

We examined the indoor air quality (IAQ) perceptions of workers and their relationships with the symptoms of sick-building syndrome (SBS) and store types in underground shopping centers.

Methods

In 2017, 314 store workers in nine underground shopping centers in Seoul, Korea, were assessed. The all participants’ stores were partially opened onto a passage. Using questionnaires, they were asked about their demographics, job characteristics, 16 SBS symptoms, and seven IAQ perceptions. The SBS symptoms were categorized as skin, eye irritation, respiratory, or general. An IAQ perception score was calculated by adding the number of positive responses to each type of IAQ and categorized into three levels.

Results

The prevalence of SBS symptom groups in the previous month was 43.6% for skin symptoms, 62.4% for eye irritation symptoms, 65.6% for respiratory symptoms, and 64.7% for general symptoms. Participants who perceived IAQ were more likely to have SBS symptoms (odds ratio: 1.81–7.84). The type of store employing the workers was associated with several IAQ perceptions. Subjects who worked in clothing and fashion-accessory stores were more likely to have high IAQ perception scores than those who worked in food services.

Conclusions

About half of the store workers in underground shopping centers had experienced SBS symptom groups in the previous month. The SBS symptom groups were associated with almost all IAQ perceptions. Because IAQ perception was associated with store type, studies of IAQ in working areas might need to improve store workers’ health in underground shopping centers.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6988-6) contains supplementary material, which is available to authorized users.

Sick Building Syndrome and Other Building-Related Illnesses

Sick building syndrome (SBS) and building-related illnesses are omnipresent in modern high-rise buildings. The SBS is a complex spectrum of ill health symptoms, such as mucous membrane irritation, asthma, neurotoxic effects, gastrointestinal disturbance, skin dryness, sensitivity to odours that may appear among occupants in office and public buildings, schools and hospitals. Studies on large office buildings from USA, UK, Sweden, Finland, Japan, Germany, Canada, China, India, Netherlands, Malaysia, Taiwan, and Thailand, substantiate the occurrence of SBS phenomena. The accumulated effects of a multitude of factors, such as the indoor environmental quality, building characteristics, building dampness, and activities of occupants attribute to SBS. A building occupant manifests at least one symptom of SBS, the onset of two or more symptoms at least twice, and rapid resolution of symptoms following moving away from the workstation or building may be defined as having SBS. Based on the peer-reviewed documentation, this chapter elaborates the magnitude of building-related health consequences due to measurable environmental causations, and the size of the population affected. The mechanisms and causative factors of SBS and illnesses include, for example, the oxidative stress resulting from indoor pollutants, VOCs, office work-related stressors, humidification, odours associated with moisture and bioaerosol exposure. Related regulatory standards and strategies for management of SBS and other illnesses are elaborated.

The mystery of dry indoor air - An overview

"Dry air" is a major and abundant indoor air quality complaint in office-like environments. The causality of perceived "dry air" and associated respiratory effects continues to be debated, despite no clear definition of the complaint, yet, has been provided. The perception of "dry air" is semantically confusing without an associated receptor but mimics a proto-state of sensory irritation like a cooling sensation. "Dry air" may also be confused with another common indoor air quality complaint "stuffy air", which mimics the sense of no fresh air and of nasal congestion. Low indoor air humidity (IAH) was dismissed more than four decades ago as cause of "dry air" complaints, rather indoor pollutants was proposed as possible exacerbating causative agents during the cold season. Many studies, however, have shown adverse effects of low IAH and beneficial effects of elevated IAH. In this literature overview, we try to answer, "What is perceived "dry air" in indoor environments and its associated causalities. Many studies have shown that the perception is caused not only by extended exposure to low IAH, but also simultaneously with and possibly exacerbated by indoor air pollutants that aggravate the protective mucous layer in the airways and the eye tear film. Immanent diseases in the nose and airways in the general population may also contribute to the overall complaint rate and including other risk factors like age of the population, use of medication, and external factors like the local ambient humidity. Low IAH may be the single cause of perceived "dry air" in the elderly population, while certain indoor air pollutants may come into play among susceptible people, in addition to baseline contribution of nasal diseases. Thus, perceived "dry air" intercorrelates with dry eyes and throat, certain indoor air pollutants, ambient humidity, low IAH, and nasal diseases.

Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services

There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire’s disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management.

Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan

Sick building syndrome (SBS) is a combination of symptoms that can be attributed to exposure to specific building conditions. The present study recruited 389 participants aged 20–65 years from 87 offices of 16 institutions to examine if personal factors, work-related psychosocial stress, and work environments, were associated with five groups of SBS symptoms, including symptoms for eyes, upper respiratory tract, lower respiratory tract, skin, and non-specific systems. Indoor environmental conditions were monitored. Data were analyzed using multivariate logistic regression (MLR) analyses and were reported as adjusted Odds Ratios (aOR). SBS symptoms for eyes were associated with older age, sensitivity to tobacco, and low indoor air flow. Upper respiratory symptoms were related to smoking, low social support, longer work days, and dry air. High indoor air flow was associated with reduced upper respiratory symptoms (aOR = 0.29; 95% confidence interval (CI) = 0.13–0.67). Lower respiratory symptoms were associated with high work pressure, longer work hours, chemical exposure, migraine, and exposure to new interior painting. Recent interior painting exposure was associated with a high estimated relative risk of low respiratory symptoms (aOR = 20.6; 95% CI = 2.96–143). Smoking, longer work days, low indoor air flow, indoor dryness, and volatile organics exposure, were associated with other non-specified symptoms including headache, tiredness, difficulty concentrating, anger, and dizziness. In conclusion, there are various SBS symptoms associated with different personal characteristics, psychosocial, and environmental factors. Psychosocial factors had stronger relationships with lower respiratory symptoms than with other types of SBS symptoms. Good ventilation could reduce risk factors and may relieve SBS symptoms.

Assessment and biomonitoring indoor environment of buildings

Ensuring hygiene and health protection is one of the basic construction requirements. Such requirements are examined when commissioning new constructions and examining defects in constructions already in use. One substantial defect is biocorrosion which represents a synergistic process with a complex variety of factors. It is caused by biochemical manifestations of various micro-organisms (micromycetes). Micromycetes producing mycotoxins therefore play an important role regarding the so-called 'Sick Building Syndrome' that has become a global problem nowadays. The case study presented here aims to demonstrate the effectiveness of the diagnostic methods used in assessing the presence of micromycetes in a building's internal atmosphere and on the internal surfaces of a construction built using traditional construction methods. The methodology of comparing methods is based on their effectiveness, taking into account the identification of type and intensity of micromycetes presence in the air and on the material surfaces in the monitored areas.

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.

External eye symptoms in indoor environments

Eye irritation, for example dry or irritated eyes, is generally among top three reported symptoms in office-like environments, in particular among workplaces with cognitive demanding visual display unit (VDU) work. The symptoms are especially among middle and advanced ages and particularly among women more than men. The symptoms are also among the most commonly reported complaints in the eye clinic. To be in a position to interpret the high prevalence of eye symptoms, a multidisciplinary and integrated approach is necessary that involves the external eye physiology (separate from internal eye effects), eye diseases (evaporative dry eye (DE), aqueous-deficient DE, and gland dysfunctions), and risk factors that aggravate the stability of precorneal tear film (PTF) resulting in hyperosmolarity and initiation of inflammatory reactions. Indoor environmental, occupational and personal risk factors may aggravate the PTF stability; factors such as age, contact lenses, cosmetics, diet, draft, gender, low humidity and high temperature, medication, outdoor and combustion pollutants, and VDU work. Psychological stressors may further influence the reporting behavior of eye symptoms. The impact of the risk factors may occur in a combined and exacerbating manner.

Outdoor air pollution, meteorological conditions and indoor factors in dwellings in relation to sick building syndrome (SBS) among adults in China

Indoor environment is associated with the sick building syndrome (SBS), but little is known about the contribution of outdoor air pollution and meteorological conditions to SBS. We studied associations between outdoor air pollution, meteorological parameters and selected indoor exposure and building characteristics at home and weekly SBS symptoms in a standardized questionnaire study among 3485 randomly selected adults in China. Outdoor factors included particulate matters with diameter <10μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), outdoor temperature (T), relative air humidity (RH), and wind speed (WS) during last three months. Multiple logistic regression was applied calculating odds ratios (OR) with 95% confidence interval (95% CI). Asthma or allergic rhinitis (atopy) was associated with all types of SBS symptoms except fatigue. Indoor factors played a major role in SBS symptoms. Mold/dampness on the floor/ceiling was associated with fatigue OR=1.60 (1.11-2.30) and headache OR=1.80 (1.07-3.04). Moldy odor was associated with fatigue OR=1.59 (1.07-2.37) and dermal symptoms OR=1.91 (1.21-3.02). Window pane condensation in winter was associated with fatigue OR=1.73 (1.30-2.31) and throat symptoms OR=1.53 (1.01-2.31). Damp bed clothing was related with throat symptom OR=1.62 (1.09-2.40). Home redecoration was associated with fatigue OR=1.49 (1.07-2.06). Frequent window opening was associated with less nose symptoms OR=0.54 (0.36-0.82) and mechanical ventilation in the bathroom reduced dermal symptoms OR=0.66 (0.44-0.99). Females were more susceptible to redecoration and window pane condensation than men. No associations with SBS were observed for outdoor air pollutants or meteorological parameters in the final models combining indoor and outdoor factors, although SO2, T, and RH were associated with some SBS symptoms (fatigue, eyes and nose symptoms) in the separate outdoor models. In conclusion, indoor mold/dampness, air pollution from redecoration and poorer ventilation conditions in dwellings can be risk factors for SBS symptoms in an adult Chinese population, especially among females.

Prevalence and risk factors of sick building syndrome among office workers

BACKGROUND

Sick building syndrome (SBS) is a group of symptoms relatively common among office workers; such symptoms could have an impact on the workers' productivity. The aim of this study is to measure the prevalence of SBS symptoms among office workers in the Faculty of Medicine, Ain Shams University, Cairo, Egypt, and to determine the possible risk factors.

PARTICIPANTS AND METHODS

A cross-sectional study was carried out at the Ain Shams Faculty of Medicine including 826 workers. Data were collected through a self-administered questionnaire that included sociodemographic and occupational histories, work environment, and symptoms related to SBS.

RESULTS

Fatigue and headache were the most prevalent symptoms (76.9 and 74.7%, respectively). Using univariate analysis, poor lighting, poor ventilation, lack of sunlight, absence of air currents, high noise, temperature, humidity, environmental tobacco smoke, use of photocopiers, and inadequate office cleaning were associated statistically with SBS symptoms (P<0.05). High work load and poor job satisfaction were also associated significantly with SBS symptoms (P<0.05). Logistic regression analysis showed that poor ventilation, poor lighting, environmental tobacco smoke, high temperature, poor job satisfaction, and inadequate office cleaning were the risk factors of SBS.

CONCLUSION AND RECOMMENDATIONS

SBS was highly prevalent among office workers and was influenced by physical and psychosocial working conditions. Good ventilation, reducing room temperature, effective cleaning routines, providing proper lighting, restricting smoking in the workplace, and improving psychosocial working conditions are important ways to reduce SBS symptoms.

Pollutant exposures and health symptoms in aircrew and office workers: Is there a link?

Sensory effects in eyes and airways are common symptoms reported by aircraft crew and office workers. Neurological symptoms, such as headache, have also been reported. To assess the commonality and differences in exposures and health symptoms, a literature search of aircraft cabin and office air concentrations of non-reactive volatile organic compounds (VOCs) and ozone-initiated terpene reaction products were compiled and assessed. Data for tricresyl phosphates, in particular tri-ortho-cresyl phosphate (ToCP), were also compiled, as well as information on other risk factors such as low relative humidity. A conservative health risk assessment for eye, airway and neurological effects was undertaken based on a "worst-case scenario" which assumed a simultaneous constant exposure for 8h to identified maximum concentrations in aircraft and offices. This used guidelines and reference values for sensory irritation for eyes and upper airways and airflow limitation; a tolerable daily intake value was used for ToCP. The assessment involved the use of hazard quotients or indexes, defined as the summed ratio(s) (%) of compound concentration(s) divided by their guideline value(s). The concentration data suggest that, under the assumption of a conservative "worst-case scenario", aircraft air and office concentrations of the compounds in question are not likely to be associated with sensory symptoms in eyes and airways. This is supported by the fact that maximum concentrations are, in general, associated with infrequent incidents and brief exposures. Sensory symptoms, in particular in eyes, appear to be exacerbated by environmental and occupational conditions that differ in aircraft and offices, e.g., ozone incidents, low relative humidity, low cabin pressure, and visual display unit work. The data do not support airflow limitation effects. For ToCP, in view of the conservative approach adopted here and the rareness of reported incidents, the health risk of exposure to this compound in aircraft is considered negligible.

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.

Effect of Traffic Exposure on Sick Building Syndrome Symptoms among Parents/Grandparents of Preschool Children in Beijing, China

INTRODUCTION

Sick building syndrome (SBS) includes general, mucosal and skin symptoms. It is typically associated with an individual's place of work or residence. The aim of this study was to explore the effect of traffic exposure on SBS symptoms in Beijing, China.

METHODS

From January to May, 2011, recruitment occurred at kindergartens in 11 districts in Beijing. Self-administered questionnaires were distributed by teachers to legal guardians of children and then returned to teachers. The questionnaire asked them to recall the presence of 12 SBS symptoms from the previous three months. Living near a highway or main road (within 200 meters) was used as a proxy for traffic exposure. Multivariable logistic regression was used to test the association between traffic exposure and a higher number of SBS symptoms, controlling for key covariates.

RESULTS

There were 5487 valid questionnaires (65.0% response rate). Univariate analysis showed that living near a main road or highway (OR = 1.40), female gender (OR = 1.44), and environmental tobacco smoking (ETS) (OR = 1.13) were significant risk factors for general symptoms. Grandparent's generation (OR = 0.32) and home ownership (owner vs. renter) (OR = 0.89) were significant protective factors. The adjusted odds ratio (aOR) for the association between living close to a highway and general symptoms remained significant in the multivariable model (aOR = 1.39; 95% CI = 1.21: 1.59). ORs and aORs were similar for mucosal and skin symptoms.

CONCLUSIONS

This study found traffic exposure to be significantly associated with SBS symptoms. This finding is consistent with current literature that indicates an association between adverse health effects and living near highway or main road.

Allostatic load model associated with indoor environmental quality and sick building syndrome among office workers

This study investigates whether indoor environmental quality (IEQ) influences allostatic load (AL) and whether AL can be a predictor for sick building syndrome (SBS). We also assessed and compared the associations between AL and SBS versus 8-hydroxydeoxyguanosine (8-OHdG) and SBS. A total of 115 office workers from 21 offices completed self-reported SBS questionnaires, and provided 11 biomarkers for their AL. Multiple linear regressions and logistic regression analysis were applied to examine the correlations between IEQ and AL or 8-OHdG and between AL or 8-OHdG and SBS, respectively. Our data revealed that the neuroendocrine system was correlated with CO₂, the difference between indoor and outdoor CO₂ levels (dCO₂), and the indoor-outdoor ratio of CO₂ (CO₂ I/O). Metabolic system effects were associated with illumination. The relationships between illumination, CO₂, dCO₂, CO₂ I/O and 8-OHdG were consistent with those and AL in specific systems. Furthermore, we found that risks for SBS syndromes were related with neuroendocrine and metabolic system of the AL. 8-OHdG was associated with eye dryness or irritation, eye tiredness and vomiting. We conclude that IEQ significantly influences AL and that AL can be a predictor for reporting SBS with information on system-specific effects.

Odors and sensations of humidity and dryness in relation to sick building syndrome and home environment in Chongqing, China

The prevalence of perceptions of odors and sensations of air humidity and sick building syndrome symptoms in domestic environments were studied using responses to a questionnaire on the home environment. Parents of 4530 1–8 year old children from randomly selected kindergartens in Chongqing, China participated. Stuffy odor, unpleasant odor, pungent odor, mold odor, tobacco smoke odor, humid air and dry air in the last three month (weekly or sometimes) was reported by 31.4%, 26.5%, 16.1%, 10.6%, 33.0%, 32.1% and 37.2% of the parents, respectively. The prevalence of parents’ SBS symptoms (weekly or sometimes) were: 78.7% for general symptoms, 74.3% for mucosal symptoms and 47.5% for skin symptoms. Multi-nominal regression analyses for associations between odors/sensations of air humidity and SBS symptoms showed that the odds ratio for “weekly” SBS symptoms were consistently higher than for “sometimes” SBS symptoms. Living near a main road or highway, redecoration, and new furniture were risk factors for perceptions of odors and sensations of humid air and dry air. Dampness related problems (mold spots, damp stains, water damage and condensation) were all risk factors for perceptions of odors and sensations of humid air and dry air, as was the presence of cockroaches, rats, and mosquitoes/flies, use of mosquito-repellent incense and incense. Protective factors included cleaning the child’s bedroom every day and frequently exposing bedding to sunshine. In conclusion, adults’ perceptions of odors and sensations of humid air and dry air are related to factors of the home environment and SBS symptoms are related to odor perceptions.

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.

Asthma related to workplace dampness and impaired work ability

PURPOSE

To examine the long-term effects on work ability among patients previously diagnosed with occupational asthma (OA) or work-exacerbated asthma (WEA) or symptoms in relation to workplace dampness.

METHODS

A questionnaire follow-up was used to study 1,098 patients (of whom 87 % were female) examined because of a suspected occupational respiratory disease caused by building dampness and mold. Self-rated work ability and early withdrawal from work were the two outcomes of the study. As determinants, we investigated the influence of the asthma diagnosis given in the initial examinations (OA or WEA), the number of persistent indoor air symptoms, and the psychosocial factors at work.

RESULTS

With a mean follow-up of 7.8 years, 40 % of the OA patients, under 65 years of age, were outside worklife versus 23 % of the WEA patients and 15 % of the patients with only upper respiratory symptoms at baseline. The diagnosis of OA was associated with a nearly sixfold risk for early withdrawal from work in a comparison with a reference group with upper respiratory symptoms. A perceived poor social climate at work and poor experiences with supervisory co-operation were associated with impaired work ability outcomes. Those with multiple, long-term indoor air symptoms considerably more often perceived their work ability to be poor when compared with those with less significant symptoms.

CONCLUSIONS

Adverse work ability outcomes are associated with asthma in relation to workplace dampness. The study raises the need for effective preventive measures in order to help workers with indoor air symptoms sustain their work ability.

Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce

PURPOSE

Medical symptoms called sick building syndrome (SBS) and sick house syndrome (SHS) are usually investigated separately: in this study, SBS and SHS were explored simultaneously. The significance of personal factors, perceptions of air quality, and psychosocial work situation in explaining SBS and SHS were investigated.

METHODS

A random sample of 1,000 subjects (20-65 year) received a postal questionnaire including questions on personal factors, medical symptoms, and the psychosocial demand-control-support model. The response rate was 70 % (n = 695), of which 532 were occupationally active.

RESULTS

In logistic regression models, atopy, poor air quality at work, and low social support, especially low supervisor support, were associated with both SBS and SHS when age, gender, smoking, and BMI were introduced. The general work-related symptoms (headache, tiredness, nausea, and sensation of a cold) were also related to low control over work.

CONCLUSIONS

The perception of poor physical environmental conditions is associated with common medical symptoms that are both work and home related. The associations between medical symptoms and poor air quality are still present, even when controlling for the psychosocial environment.

Indoor air pollutants in office environments: assessment of comfort, health, and performance

Concentrations of volatile organic compounds (VOCs) in office environments are generally too low to cause sensory irritation in the eyes and airways on the basis of estimated thresholds for sensory irritation. Furthermore, effects in the lungs, e.g. inflammatory effects, have not been substantiated at indoor relevant concentrations. Some VOCs, including formaldehyde, in combination may under certain environmental and occupational conditions result in reported sensory irritation. The odour thresholds of several VOCs are low enough to influence the perceived air quality that result in a number of acute effects from reported sensory irritation in eyes and airways and deterioration of performance. The odour perception (air quality) depends on a number of factors that may influence the odour impact. There is neither clear indication that office dust particles may cause sensory effects, even not particles spiked with glucans, aldehydes or phthalates, nor lung effects; some inflammatory effects may be observed among asthmatics. Ozone-initiated terpene reaction products may be of concern in ozone-enriched environments (≥0.1mg/m(3)) and elevated limonene concentrations, partly due to the production of formaldehyde. Ambient particles may cause cardio-pulmonary effects, especially in susceptible people (e.g. elderly and sick people); even, short-term effects, e.g. from traffic emission and candle smoke may possibly have modulating and delayed effects on the heart, but otherwise adverse effects in the airways and lung functions have not been observed. Secondary organic aerosols generated in indoor ozone-initiated terpene reactions appear not to cause adverse effects in the airways; rather the gaseous products are relevant. Combined exposure to particles and ozone may evoke effects in subgroups of asthmatics. Based on an analysis of thresholds for odour and sensory irritation selected compounds are recommended for measurements to assess the indoor air quality and to minimize reports of irritation symptoms, deteriorated performance, and cardiovascular and pulmonary effects.

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.

Indoor productivity measured by common response patterns to physical and psychosocial stimuli

Productivity is the essential organizational outcome. It is vaguely understood and difficult to quantify, especially at the individual level in office companies. Our objective was to quantify and describe the part of productivity, which is systematically influenced by the indoor environment. We, therefore, introduce the concept 'indoor productivity,' which is defined by measuring operations. We used the multivariate method Marker Object Projection to transform questionnaire data into an 'indoor productivity index' (IPI), which reflects the relative impact of the variables that systematically influence indoor productivity. The reasoning behind IPI is that indoor productivity cannot be separated from experienced indoor environment and wellness at work. IPI is calculated for each respondent based on own, colleagues', and two fictive respondents' answers. Conservatively, IPI was calculated to constitute about 25% of what determines the productivity of an individual. By using IPI as dependent variable in multiple regression analyses, the relative contribution of all indoor variables was identified. Physical indoor variables were as important as psychosocial ones. During the cold seasons, 'dry air' was the most important factor reducing IPI.

[Variations of indoor environment and the prevalence of sick house syndrome over three-year period in detached houses in Sapporo]

OBJECTIVES

The purpose of this study was to investigate annual variations in indoor environmental chemical, fungal and dust mite allergen levels, with regards to variations in sick house syndrome (SHS) symptoms over a three-year period.

METHODS

Detached houses were randomly selected from a building plan approval application, and a questionnaire survey was conducted in 2003 in Sapporo, Japan. Indoor environmental measurements and a self-administered questionnaires survey were conducted on the selected houses in 2004, 2005 and 2006. The same protocol was used for the three-year period to measure the levels of chemicals, fungi and dust mite allergens. A personal questionnaire to assess SHS was distributed to all inhabitants of the dwellings along with one questionnaire to assess housing characteristics.

RESULTS

In 2004, 2005 and 2006, the owners of 104, 64 and 41 houses, respectively, agreed to participate in this study. Forty-one houses and the 127 inhabitants who participated in this three-year survey period were included in the analysis to evaluate the associations between differences in environmental measurements and SHS. The levels of formaldehyde, acetone, toluene, Alternaria and Cladosporium tended to decrease, whereas those of limonene and Aspergillus tended to increase over the three-year period. Increasing levels of Cryptococcus and the dampness index in individual houses correlated with increasing SHS symptom scores in the inhabitants after mutual adjustment.

CONCLUSIONS

Although the average levels of chemicals and fungi were relatively low, the results show the relationship between annual variations in indoor environmental measurements and variations in SHS symptom scores.

Study on the removal of indoor VOCs using biotechnology

With the improvement of living standard and civil building innovation, large numbers of building materials and decoration are being used. The emission of gaseous organic pollutants such as formaldehyde, benzene, toluene and xylene from these materials may trigger immediate or persistent potential harm to human health. In this study, with the combination of bake-out exhaust, biological treatment was applied to deal with volatile organic compounds (VOCs). Four bacterial strains were isolated from the biotrickling filter and were identified according to physiological and biochemical tests as well as bacterial fatty acids. As a result, they were characterized as Pseudomonas sp., Kocuria sp., Arthrobacter sp. and Bacillus sp. Under the conditions of gaseous flow rate of 600 L/h, surface liquid velocity of 3.14 m/h, pH 6-7 and temperature of 30 degrees C, VOCs could be degraded by using biological method before they were exhausted to the environment. For formaldehyde, benzene, toluene and xylene in the air stream with the concentration of 0-6.5 mg/m(3), 2.2-46.7 mg/m(3), 0.5-28.2 mg/m(3) and 4.1-59.0 mg/m(3), VOCs removal efficiencies of biotrickling filter ranged in about 100%, 65-70%, 93% and 85-90%, respectively.

Psychosocial work environment and medical symptoms among Swedish commercial airline cabin crew

BACKGROUND

Associations between stress measured by the demands-control model, iso-strain model, and stress-related symptoms among cabin crew were studied.

METHODS

A questionnaire about psychosocial work environment and symptoms was answered by 918 (82%) flight attendants, stewards, and pursers at one airline company in 2005. Adjustment was made for age, gender, smoking, job category, and flight length using multiple logistic regression.

RESULTS

Weekly headaches, concentration difficulties, fatigue, and gastrointestinal symptoms were reported at rates of 18%, 10%, 56%, and 13%, respectively. Pursers scored higher on control than the others and they had lower associations between the strain measured by the demands-control model and symptoms than stewards and flight attendants. All symptoms were more common in the high strain situation than in the low strain (reference). An active situation was related to an excess of symptoms. Low social support in the iso-strain model increased risk of symptoms.

CONCLUSIONS

Demands-control and iso-strain models are useful in studying stress-related symptoms in cabin crews. The dimension of social support adds explanatory value.

Dampness, food habits, and sick building syndrome symptoms in elementary school pupils

OBJECTIVES

We investigated dampness/mold in schools and dwellings, and food habits and subjective symptoms in elementary school pupils, in order to clarify the effect of dampness and food habits on subjective symptoms in elementary school pupils.

METHODS

Questionnaires were used to investigate dampness in classrooms and dwellings in Hokkaido, Japan, and its effect on subjective symptoms in 1,077 pupils in 8 elementary schools. We used a dampness index for both the home and classroom; the index was the sum of the presence of four dampness indicators: (1) visible mold, (2) moldy odor, (3) water leakage, and (4) condensation on windowpanes. The questionnaire also contained queries about food habits, as follows: the frequency of eating breakfast, whether the energy provided by the school lunch was sufficient, and whether eating too many snacks and/or sweets were consumed. Adjusted logistic regression was used to determine whether dampness and food habits were related to the subjective symptoms.

RESULTS

In fully adjusted models, the home dampness index was significantly related to cough, general symptoms, and having at least one symptom; the classroom dampness index was significantly related to nasal symptoms. In addition, usually not eating breakfast was significantly related to eye symptoms, and too many snacks and/or sweets was significantly related to eye, nasal, and general symptoms.

CONCLUSIONS

Both home and classroom dampness can affect pupils' health. Home dampness, in particular, was significantly related to cough and general symptoms, and classroom dampness was significantly related to nasal symptoms. Furthermore, favorable food habits have a positive effect on pupils' subjective symptoms.

Regional differences in residential environments and the association of dwellings and residential factors with the sick house syndrome: a nationwide cross-sectional questionnaire study in Japan

This study was conducted to clarify regional differences in residential factors and the association of those factors with dwellings having sick house syndrome (SHS) problems. The survey was conducted in six areas of northern and southern Japan. In terms of regional differences, dampness was not as severe in the dwellings in Sapporo as compared with that in areas in the south. SHS was defined using five categories of nasal, throat and respiratory, skin and general symptoms, which appeared frequently or not frequently and improved upon leaving the home. The dampness index was estimated by the sum of the presence of several indicators: condensation on the window panes and/or wall, visible mold growth, moldy odor, slow-drying wet towels in the bathroom, and water leakage. The dwellings where inhabitants showed any symptoms of SHS comprised 3.7% of all surveyed dwellings. We found significant associations between SHS and dampness index, odors, and stuffiness of the air. For dampness, the adjusted odds ratio (OR) increased with increased dampness index, adjusting for the age of the house, pets indoors, stuffiness of the air, and odors. These results showed an increased risk when several dampness indicators appeared simultaneously.

PRACTICAL IMPLICATIONS

To evaluate the associations of residential environments and Sick House Syndrome (SHS), this cross-sectional questionnaire study was conducted on 2297 dwellings in six areas in Japan from 2003 to 2004. The dwellings where inhabitants showed any of nasal, throat and respiratory, skin and general symptoms comprised 3.7% of all surveyed dwellings, and an increased risk for SHS was found when several dampness indicators, 'condensation', 'visible mold growth', 'moldy odor', 'slow drying wet towels in the bathroom' and 'water leakage', appeared simultaneously.

Relation of dampness to sick building syndrome in Japanese public apartment houses

OBJECTIVES

The effect of dampness on sick building syndrome (SBS) symptoms has not been fully investigated in Japan. The purpose of this study is to elucidate the possible effects of dampness on SBS symptoms among residents in Japanese public apartment houses.

METHODS

A questionnaire was used to investigate the degree of dampness in public apartment houses in Asahikawa, Japan, and its effect on SBS symptoms, involving 480 residents in 64 buildings. Dampness indicators were as follows: condensation on the windowpanes, condensation on the walls and/or closets, visible mold in the bathrooms, visible mold on the walls, window frames, and/or closet, moldy odor, slow drying of the wet towels in bathrooms, water leakage, and bad drainage in bathrooms.

RESULTS

All dampness indicators except for visible mold in bathrooms had significantly higher odds ratios (ORs) for all or any SBS symptoms after adjustment. The dampness index, the number of positive dampness indicators, was significantly related to all SBS symptoms after adjustment.

CONCLUSIONS

There are serious problems relating to dampness in Japanese public housing, which affects the health of residents. There is a need to educate the residents about the relationship between dampness and SBS, and building problems should be rectified.

Nasal hyperreactivity in allergic and non-allergic rhinitis: a potential risk factor for non-specific building-related illness

Self-reported non-allergic nasal symptom triggers in non-allergic ('vasomotor') rhinitis overlap with commonly identified environmental exposures in non-specific building-related illness. These include extremes of temperature and humidity, cleaning products, fragrances, and tobacco smoke. Some individuals with allergic rhinitis also report non-allergic triggers. We wished to explore the phenotypic overlap between allergic and non-allergic rhinitis by ascertaining self-reported non-allergic nasal symptom triggers among allergic rhinitics. Sixty subjects without work-related respiratory exposures or symptoms, aged 19-68 years, stratified by age, gender and (skin test-proven) allergic rhinitis status, were queried with regard to self-reported non-allergic nasal symptom triggers (aggregate score 0-8). In this sample, the number of self-reported non-allergic triggers was bimodal, with peaks at 1 and 5. Forty-two percent of seasonal allergic rhinitic subjects reported more than three non-allergic triggers, compared with only 3% of non-allergic non-rhinitics (P < 0.01). Subjects over 35 years were more likely to report one or more non-allergic triggers, particularly tobacco smoke (P < 0.05). Allergic rhinitics reported more non-allergic symptom triggers than did non-allergic, non-rhinitics. As indexed by self-reported reactivity to non-specific physical and chemical triggers, both non-allergic rhinitics and a subset of allergic rhinitics may constitute susceptible populations for non-specific building-related illness.

PRACTICAL IMPLICATIONS

Judging by self-report, a substantial subset of individuals with allergic rhinitis--along with all individuals with nonallergic rhinitis (by definition)--are hyperreactive to non-allergic triggers. There is overlap between these triggers (elicited in the process of obtaining a clinical diagnosis) and environmental characteristics associated with ''problem buildings.'' Since individuals with self-identified rhinitis report an excess of symptoms in most epidemiologic studies of problem buildings (even in the absence of unusual aeroallergen levels), rhintics may be acting as a ''sentinel'' subgroup when indoor air quality is suboptimal. Together, non-allergic rhinitics plus allergic rhinitics with prominent non-allergic triggers, are thought to constitute approximately one-sixth of the US population.