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Loraas DM. Breathing Uneasily: Employees' Stories of Coping With Poor Indoor Air Quality in the Workplace. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024:19375867241248598. [PMID: 38680107 DOI: 10.1177/19375867241248598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
OBJECTIVES This phenomenological study aimed to elucidate the lived experiences of employees suffering from poor indoor air quality (IAQ) in their university workplace. It addresses gaps in understanding IAQ's personal impacts from occupants' perspectives. BACKGROUND Prior research on sick building syndrome and indoor air pollution utilized quantitative methods to assess physical health outcomes. However, few studies have adopted qualitative approaches to uncover the meanings ascribed to adverse IAQ experiences and their influences on psychosocial well-being. METHODS In-depth semi-structured interviews were conducted with five university employees who attributed their chronic illnesses to poor IAQ in their 60-year-old office building with a history of IAQ concerns. Verbatim transcripts were analyzed using qualitative techniques including thematic coding to extract key themes conveying shared experiences. RESULTS Employees depicted the building itself as fundamentally "sick" and stigmatized, compelling complex coping behaviors hindering productivity. Communication breakdowns, mistrust in leadership, and strained workplace relationships were prevalent. A sense of betrayal, powerlessness, and a sense of detachment from the workplace emerged with home as a refuge. CONCLUSIONS Although technically adequate, poor IAQ profoundly damaged perceived health, quality of life, relationships, and satisfaction. The accounts emphasize IAQ's psychosocial dimensions, advancing theoretical links between indoor environments and well-being. Supportive policies, transparency, communication, participatory processes, and human-centered strategies emerge as ways to nurture productivity, well-being, and organizational health.
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Köteles F, Nordin S. Do somatic symptom distress and attribution predict symptoms associated with environmental factors? J Psychosom Res 2024; 179:111637. [PMID: 38442536 DOI: 10.1016/j.jpsychores.2024.111637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE Not much is known on the development of symptoms associated with environmental factors (SAEF), also known as (idiopathic) environmental intolerances. Findings from qualitative studies suggest that appearance of symptoms might be the first step, followed by the acquisition of a specific attribution. The current study investigated cross-sectional and longitudinal (three years) associations between attribution and symptoms with respect to symptoms associated with chemical substances, certain indoor environments (buildings), sounds, and electromagnetic fields (EMFs). METHODS We used data from the first two waves of the population-based Västerbotten Environmental Health Study (n = 2336). Participants completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15), the Environmental Symptom-Attribution Scale, and answered single questions on the four aforementioned SAEFs. RESULTS Using binary logistic regression analyses, all four SAEFs showed significant cross-sectional associations with somatic symptom distress and the respective attribution. In the longitudinal analysis, development of SAEF-Sound and SAEF-Chemicals were predicted by both somatic symptom distress and attribution. SAEF-EMFs was predicted only by attribution, whereas neither somatic symptom distress nor attribution forecasted SAEF-Buildings. CONCLUSION Overall, these findings suggest that attribution (i.e., a specific expectation) plays a substantial role in the development and maintenance of many SAEFs.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Köteles F, Nordin S, Claeson AS. Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms. J Psychosom Res 2023; 173:111476. [PMID: 37643562 DOI: 10.1016/j.jpsychores.2023.111476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The objective of the present study was to investigate the associations between somatosensory amplification, modern health worries (MHWs), and symptoms among patients with building-related symptoms (BRS). METHODS Patients with self-reported and medically confirmed BRS (n = 83) were included in this cross-sectional study. The Somatosensory Amplification Scale (SSAS) was used to quantify the tendency to amplify somatic sensations and perceive them as unpleasant and dangerous. Concerns about harmful effects of modern technologies were assessed with the Modern Health Worries Scale (MHWS). Symptoms commonly found in different forms of environmental intolerance were assessed with the Environmental Hypersensitivity Symptom Inventory (EHSI). RESULTS Patients with BRS were characterized by more frequent and more severe environmental hypersensitivity symptoms compared to a reference population. Females and those with co-morbid self-reported chemical intolerance reported even more symptoms. MHWS and SSAS scores showed weak to moderate associations with symptoms, even after adjusting for socio-economic variables. However, neither the mean MHWS score or the SSAS score of our sample differed from normative scores. CONCLUSION Patients with BRS are not characterized by elevated levels of MHWs and somatosensory amplification, thus other, psychosocial and/or environmental, factors may have contributed to the development of the condition. However, the associations between severity of symptoms and MHWs and somatosensory amplification suggest that psychosocial characteristics may substantially influence symptom experience in this group.
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Affiliation(s)
- Ferenc Köteles
- Institute of Health Promotion and Sport Sciences, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Eidstø E, Selinheimo S, Lampi J, Salmela A, Pekkanen J. The Continuum of Severity of Functional Impairment Due to Indoor Air Symptoms: Prevalence and Determinants. J Occup Environ Med 2023; 65:717-724. [PMID: 37231645 PMCID: PMC10487355 DOI: 10.1097/jom.0000000000002884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The aim of the study is to study functional impairment due to indoor air-related symptoms and associated characteristics. METHODS A questionnaire survey of a random sample of Finnish people aged 25 to 64 years. Analyses were done using multivariate multinomial logistic regression. RESULTS A total of 23.1% reported indoor air-related symptoms, 1.8% severe functional impairment due to symptoms, 5.3% moderate, 11.1% mild, and 4.9% reported no impairment. Those with severe functional impairment showed the strongest associations with comorbid diseases, for example, asthma and irritable bowel syndrome, perceived sensitivities to several environmental factors, like chemicals, and likelihood of having symptoms in multiple organs, while those with no or little functional impairment showed weak or even inverse associations. Similar results emerged with severity of indoor air-related symptoms. CONCLUSIONS Individuals with indoor air-related symptoms are a very heterogeneous group. This should be better considered in future research and clinical practice.
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Affiliation(s)
- Einar Eidstø
- From the Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland (E.E., S.S., J.P.); Finnish Institute of Occupational Health, Helsinki, Finland (S.S.); and Department of Health Security, Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland (J.L., A.S., J.P.)
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5
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Claeson AS, Edvardsson B, Liljelind I. Stress and Sleep in Relation to Severity of Building Related Symptoms. J Occup Environ Med 2023; 65:541-545. [PMID: 36952319 DOI: 10.1097/jom.0000000000002844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVE This study investigates different aspects of stress and sleep in medically examined individuals with varying severity of building-related symptoms (BRS). METHODS Three questionnaires were used to assess acute and long-term stress and sleep (Perceived Stress Scale; Shirom Melamed Burnout Questionnaire, and Karolinska Sleep Questionnaire). RESULTS Individuals with BRS, regardless of severity, did not differ in level of perceived stress (indicator of short-term stress). The indicators of long-term stress differed between the groups where an increased severity was associated with higher levels of burnout and sleep problems. CONCLUSIONS The study suggests an association between symptom severity and measures of long-term stress and sleep quality. This has implications for the treatment of persons affected by BRS, because not only the environment needs to be treated, but also the concurrent signs of distress, such as burnout or sleep problems.
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Affiliation(s)
- Anna-Sara Claeson
- From the Department of Psychology, Umeå University, Umeå, Sweden (A.C); and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (B.E., I.L.)
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Nordin S, Köteles F, Witthöft M, Van den Bergh O, Nyback MH, Sainio M. Impact of comorbidity on symptomatology in various types of environmental intolerance in a general Swedish and Finnish adult population. ENVIRONMENTAL RESEARCH 2023; 229:115945. [PMID: 37080270 DOI: 10.1016/j.envres.2023.115945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/23/2023] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
Comorbidity with various health conditions is common in environmental intolerances (EIs), which restricts understanding for what symptoms that are associated with the intolerance per se. The present objectives were to study (i) prevalence of a broad range of specific symptoms in chemical, building-related, electromagnetic field- (EMF) related, and sound EI, irrespective of comorbidity, (ii) prevalence of symptoms in body systems in exclusive EIs, and (iii) increased risk of symptoms in body systems in exclusive EIs that cannot be referred to functional somatic syndromes, inflammatory diseases or mental disorders. Cross-sectional data (n = 4941) were used from two combined population-based surveys, the Västerbotten (Sweden) and Österbotten (Finland) Environmental Health Studies. Categorization of EI cases and controls were based on self-reports. Symptoms were assessed with the Environmental Hypersensitivity Symptom Inventory, and these were converted to 27 symptoms of the International Classification of Primary Care, 2nd edition, in eight chapters of body systems. The results showed, with few exceptions, that all assessed specific symptoms were significantly more prevalent in all four EIs than in referents. Although a large overlap between EIs, characteristic body system symptoms were eye and respiratory symptoms in chemical and building-related intolerance, skin symptoms in EMF-related intolerance, and general and unspecified, digestive, eye, cardiovascular, neurological, and psychological symptoms in sound intolerance. After controlling for various comorbidities, all studied body system symptoms were positively associated with chemical intolerance, fewer with sound intolerance, only one with building-related intolerance, and none with EMF-related EI. In conclusion, a broad range of symptoms are reported in all four EIs implying common mechanisms, but symptoms of certain body systems are more likely to be reported in a certain EI that cannot be explained by comorbidity.
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Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
| | - Ferenc Köteles
- Károli Gáspár University of the Reformed Church in Hungary, Budapest, Hungary.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, And Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany.
| | | | | | - Markku Sainio
- Outpatient Clinic for Functional Disorders, Helsinki University Hospital, Helsinki, Finland.
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Seppälä T, Finell E, Kaikkonen S. Making sense of the delegitimation experiences of people suffering from indoor air problems in their homes. Int J Qual Stud Health Well-being 2022; 17:2075533. [PMID: 35545878 PMCID: PMC9116269 DOI: 10.1080/17482631.2022.2075533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose Little is known about the delegitimation experiences of people who associate their health problems with the indoor air quality of their homes (i.e., indoor air sufferers). From other contexts, it is known that people suffering from contested illnesses frequently report delegitimation from authorities and laypersons. Therefore, we analysed delegitimation experiences among indoor air sufferers, focusing on how they explain why others delegitimize them. Method Two types of qualitative data—semi-structured interviews with eight people and essays written by 28 people—were subjected to a thematic analysis. Results Thematic analysis revealed three themes: 1) lack of understanding; 2) others’ lack of morality; and 3) social discrimination and inequality. Conclusion This study demonstrates that indoor air sufferers are vulnerable as individuals and as a group, and suggests that authorities working with people suffering from indoor air problems in homes must pay more attention to sufferers’ ability/willingness to trust people and the system responsible for their care.
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Affiliation(s)
- Tuija Seppälä
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Eerika Finell
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Suvi Kaikkonen
- Department of Finnish, University of Helsinki, Helsinki, Finland
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Odor perception and symptoms during acrolein exposure in individuals with and without building-related symptoms. Sci Rep 2022; 12:8171. [PMID: 35581334 PMCID: PMC9114406 DOI: 10.1038/s41598-022-12370-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/09/2022] [Indexed: 12/01/2022] Open
Abstract
Building-related symptoms (BRS) is a significant work-related and public health problem, characterized by non-specific symptoms occurring in a particular building. The cause of BRS is unknown, but certain reactive compounds are suggested risk factors. The aim of this controlled exposure study was to investigate whether BRS cases report more odor annoyance and symptoms and show altered autonomous nervous system (ANS) response during exposure to the reactive aldehyde, acrolein in comparison with referents. Individuals with BRS (n = 18) and referents (n = 14) took part in two exposure sessions (80 min). One session contained heptane alone, and the other heptane and acrolein. Perceived odor annoyance; eye, nose, and throat symptoms; and ANS response were measured continuously. BRS cases did not experience more odor annoyance; eye, nose, and throat symptoms; or altered ANS response in comparison with referents during the exposures. Supplementary analyses revealed that BRS cases that also reported chemical intolerance perceived more symptoms than referents during acrolein exposure. Acrolein exposure at a concentration below previously reported sensory irritation detection thresholds is perceived as more irritating by a subgroup of BRS individuals compared with referents. The results of this study indicate that a subset of individuals with building related symptoms (BRS) has a lowered sensory irritation threshold towards acrolein exposure. Future guidelines on chemical exposures to acrolein should take time and individual sensitivity into account.
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Idarraga MA, Guerrero JS, Mosle SG, Miralles F, Galor A, Kumar N. Relationships Between Short-Term Exposure to an Indoor Environment and Dry Eye (DE) Symptoms. J Clin Med 2020; 9:E1316. [PMID: 32370240 PMCID: PMC7290742 DOI: 10.3390/jcm9051316] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/21/2020] [Accepted: 04/26/2020] [Indexed: 01/05/2023] Open
Abstract
Air composition influences Dry Eye (DE) symptoms as demonstrated by studies that have linked the outdoor environment to DE. However, there is insufficient data on the effect of short-term exposure to indoor environments on DE symptoms. We conducted a prospective experimental research, in which an older building served as an experimental site, and a newer building served as the control site. Indoor air quality was monitored in both buildings. One-hundred-and-ninety-four randomly selected individuals were interviewed in the afternoon exiting the buildings and de-identified responses were recorded. Self-reported DE symptoms were modeled with respect to experimental and control buildings, adjusting for potential confounders. The experimental site had 2-fold higher concentration of airborne particulate matter (24,436 vs. 12,213 ≥ 0.5 µm/ft3) and microbial colonies (1066 vs. 400/m3), as compared to the control building. DE symptoms were reported by 37.5% of individuals exiting the experimental and 28.4% exiting the control building. In the univariate analysis, subjects exiting the experimental building were 2.21× more likely to report worsening of DE symptoms since morning compared to the control building (p < 0.05). When adjusting for confounders, including a history of eye allergy, subjects from the experimental building were 13.3× more likely to report worsening of their DE symptoms (p < 0.05). Our findings suggest that short-term exposure to adverse indoor environmental conditions, specifically air pollution and bioaerosols, has an acutely negative impact on DE symptoms.
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Affiliation(s)
- Maria A. Idarraga
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
| | - Juan S. Guerrero
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
| | - Samantha G. Mosle
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
| | - Frank Miralles
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
| | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA; (M.A.I.); (J.S.G.)
- Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL 33125, USA
| | - Naresh Kumar
- Environmental Health Division, University of Miami, Miami, FL 33136, USA; (S.G.M.); (F.M.); (N.K.)
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Nordin S. Mechanisms underlying nontoxic indoor air health problems: A review. Int J Hyg Environ Health 2020; 226:113489. [DOI: 10.1016/j.ijheh.2020.113489] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
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Nordin S. Reply to the letter to the editor by Tuuminen et al. (2020), "Indoor air nontoxicity should be proven with special techniques prior claiming that it may cause a variety of mental disorders.". Int J Hyg Environ Health 2020; 229:113544. [PMID: 32345528 PMCID: PMC7177101 DOI: 10.1016/j.ijheh.2020.113544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/16/2020] [Indexed: 10/27/2022]
Affiliation(s)
- Steven Nordin
- Department of Psychology, Umeå University, SE-90187, Umeå, Sweden.
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Haanes JV, Nordin S, Hillert L, Witthöft M, van Kamp I, van Thriel C, Van den Bergh O. "Symptoms associated with environmental factors" (SAEF) - Towards a paradigm shift regarding "idiopathic environmental intolerance" and related phenomena. J Psychosom Res 2020; 131:109955. [PMID: 32058864 DOI: 10.1016/j.jpsychores.2020.109955] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/13/2020] [Accepted: 02/05/2020] [Indexed: 02/07/2023]
Abstract
Health conditions characterized by symptoms associated with chemical, physical and biological environmental factors unrelated to objectifiable pathophysiological mechanisms are often labelled by the general term "idiopathic environmental intolerances". More specific, exposure-related terms are also used, e.g. "multiple chemical sensitivities", "electromagnetic hypersensitivity" and "candidiasis hypersensitivity". The prevalence of the conditions varies from a few up to more than 50%, depending on definitions and populations. Based on evolving knowledge within this field, we provide arguments for a paradigm shift from terms focusing on exposure and intolerance/(hyper-)sensitivity towards a term more in line with the perceptual elements that seem to underlie these phenomena. Symptoms caused by established pathophysiologic mechanisms should not be included, e.g. allergic or toxicological conditions, lactose intolerance or infections. We discuss different alternatives for a new term/concept and end up proposing an open and descriptive term, "symptoms associated with environmental factors" (SAEF), including a definition. "Symptoms associated with environmental factors" both is in line with the current knowledge and acknowledge the experiences of the afflicted persons. Thus, the proposed concept is likely to facilitate therapy and communication between health professionals and afflicted persons, and to provide a base for better understanding of such phenomena in healthcare, society and science.
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Affiliation(s)
- Jan Vilis Haanes
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, NO-9038 Tromsø, Norway; Department of Community Medicine, University of Tromsø, NO-9037 Tromsø, Norway.
| | - Steven Nordin
- Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
| | - Lena Hillert
- Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden.
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University, DE-55122 Mainz, Germany.
| | - Irene van Kamp
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, 3720 BA Bilthoven, The Netherlands.
| | - Christoph van Thriel
- Leibniz Research Centre for Working Environment and Human Factors, TU Dort-mund University, DE-44139 Dortmund, Germany.
| | - Omer Van den Bergh
- Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, BE-3000, Belgium.
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Vuokko A, Karvala K, Suojalehto H, Lindholm H, Selinheimo S, Heinonen-Guzejev M, Leppämäki S, Cederström S, Hublin C, Tuisku K, Sainio M. Clinical Characteristics of Disability in Patients with Indoor Air-Related Environmental Intolerance. Saf Health Work 2019; 10:362-369. [PMID: 31497334 PMCID: PMC6717934 DOI: 10.1016/j.shaw.2019.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 11/28/2022] Open
Abstract
Background Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
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Affiliation(s)
- Aki Vuokko
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Kirsi Karvala
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | | | | | - Marja Heinonen-Guzejev
- University of Helsinki, Department of Public Health, Faculty of Medicine, Helsinki, Finland
| | - Sami Leppämäki
- Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Sebastian Cederström
- Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Katinka Tuisku
- Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland
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Karvala K, Sainio M, Palmquist E, Claeson AS, Nyback MH, Nordin S. Building-Related Environmental Intolerance and Associated Health in the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092047. [PMID: 30235805 PMCID: PMC6163389 DOI: 10.3390/ijerph15092047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 09/15/2018] [Accepted: 09/17/2018] [Indexed: 01/13/2023]
Abstract
People frequently attribute adverse symptoms to particular buildings when exposure to pollutants is low, within nonhazardous levels. Our aim was to characterize building-related intolerance (BRI) in the general population. Data were derived from two population-based questionnaire surveys, the Västerbotten and Österbotten Environmental Health Study. We identified cases of BRI if respondents reported symptoms emerging from residing in certain buildings, when most other people had none. The questionnaires covered lifestyle factors, perceived general health, BRI duration and symptom frequency, the emotional and behavioral impact of BRI, coping strategies, and physician-diagnosed diseases. From the total of 4941 participants, we formed two case groups, 275 (5.6%) fulfilled criteria for self-reported BRI, and 123 (2.5%) for BRI with wide-ranging symptoms. Individuals in both case groups were significantly more often female, single, and perceived their general health as poorer than the referents, i.e., those reporting no BRI symptoms. The mean duration of BRI was 12 years. In both case groups, avoidance behavior was found in over 60%, and nearly half of the sample had sought medical care. BRI with wide-ranging symptoms was associated with elevated odds for all studied comorbidities (somatic and psychiatric diseases and functional somatic syndromes). The perceived health of individuals with BRI is poorer and comorbidities are more frequent than among referents. BRI seems to be similar to other environmental intolerances and shares features with functional somatic syndromes.
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Affiliation(s)
- Kirsi Karvala
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland.
| | - Eva Palmquist
- Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden.
| | | | | | - Steven Nordin
- Department of Psychology, Umeå University, 901 87 Umeå, Sweden.
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Claeson AS, Palmquist E, Nordin S. Physical and chemical trigger factors in environmental intolerance. Int J Hyg Environ Health 2018. [DOI: 10.1016/j.ijheh.2018.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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