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Fu P, Zhao Z, Norback D, Zhang X, Yung KKL. Associations between indoor environment and lifestyles and sick building syndrome symptoms among adults in Taiyuan and Urumqi of China. INDOOR AIR 2022; 32:e13081. [PMID: 35904392 DOI: 10.1111/ina.13081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/30/2022] [Accepted: 07/03/2022] [Indexed: 06/15/2023]
Abstract
The complex and uncertain causes of sick building syndrome (SBS) have become one of the most challenging and hot issues worldwide. Studies on the correlation between indoor environment and SBS based on local characteristics are relatively limited in China. We studied typical SBS risk factors related to the indoor environment and lifestyle in two northern Chinese cities. The study population was drawn from parents of pre-school children in randomized daycare centers in Taiyuan, Shanxi, and Urumqi, Xinjiang, China (N = 6838). Data on SBS and indoor environment were obtained from cross-sectional questionnaires. Odds ratios (OR) were estimated by multilevel logistic regression and adjusted using gender, atopy, own smoking, home size, and dampness index. Results showed that location, homeownership, year of construction completion, changes in the indoor environment (new furniture and decorations), and changes in indoor air (smoking, burning mosquito repellent and incense, cooking fuels including electricity, natural gas, coal, and wood) might contribute to different levels of SBS in Chinese adults, including eye, nasal, throat, dermal symptoms, and headache and tiredness. The results of the subgroup analysis suggest city and gender differences in susceptibility. Daily cleaning, window opening, and improved ventilation effectively improved SBS. People should improve their indoor environment and lifestyles based on sensitivity factors, gender, and geographic characteristics to reduce SBS risks.
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Affiliation(s)
- Pengfei Fu
- Department of Biology, Hong Kong Baptist University, Hong Kong, SAR, China
- Golden Meditech Center for NeuroRegeneration Sciences, Hong Kong Baptist University, Hong Kong, SAR, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
- Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Typhoon Institute/CMA, Shanghai, China
- Key Laboratory of Meteorology and Health, Shanghai, China
| | - Dan Norback
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Ken Kin Lam Yung
- Department of Biology, Hong Kong Baptist University, Hong Kong, SAR, China
- Golden Meditech Center for NeuroRegeneration Sciences, Hong Kong Baptist University, Hong Kong, SAR, China
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Tsantaki E, Smyrnakis E, Constantinidis TC, Benos A. Indoor air quality and sick building syndrome in a university setting: a case study in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:595-615. [PMID: 32633551 DOI: 10.1080/09603123.2020.1789567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Efthymia Tsantaki
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Emmanouil Smyrnakis
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros C Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Alexis Benos
- Laboratory of Primary Health Care, General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Sakellaris I, Saraga D, Mandin C, de Kluizenaar Y, Fossati S, Spinazzè A, Cattaneo A, Mihucz V, Szigeti T, de Oliveira Fernandes E, Kalimeri K, Mabilia R, Carrer P, Bartzis J. Association of subjective health symptoms with indoor air quality in European office buildings: The OFFICAIR project. INDOOR AIR 2021; 31:426-439. [PMID: 32966653 DOI: 10.1111/ina.12749] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Ioannis Sakellaris
- Department of Mechanical Engineering, University of Western Macedonia, Kozani, Greece
- Atmospheric Chemistry & Innovative Technologies Laboratory, INRASTES, National Center for Scientific Research "DEMOKRITOS", Athens, Greece
| | - Dikaia Saraga
- Department of Mechanical Engineering, University of Western Macedonia, Kozani, Greece
- Atmospheric Chemistry & Innovative Technologies Laboratory, INRASTES, National Center for Scientific Research "DEMOKRITOS", Athens, Greece
| | - Corinne Mandin
- CSTB-Centre Scientifique et Technique du Bâtiment, Université Paris Est, Marne-la-Vallée Cedex 2, France
| | - Yvonne de Kluizenaar
- The Netherlands Organization for Applied Scientific Research (TNO), The Hague, The Netherlands
| | | | - Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, Como, Italy
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, Como, Italy
| | - Victor Mihucz
- Cooperative Research Centre for Environmental Sciences, Eötvös Loránd University, Budapest, Hungary
| | | | | | - Krystallia Kalimeri
- Department of Mechanical Engineering, University of Western Macedonia, Kozani, Greece
| | - Rosanna Mabilia
- Department of Biology, Agriculture and Food Science, National Research Council, Roma, Italy
| | - Paolo Carrer
- Department of Biomedical and Clinical Sciences-Hospital "L. Sacco", University of Milan, Milano, Italy
| | - John Bartzis
- Department of Mechanical Engineering, University of Western Macedonia, Kozani, Greece
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Hoang Quoc C, Vu Huong G, Nguyen Duc H. Working Conditions and Sick Building Syndrome among Health Care Workers in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103635. [PMID: 32455776 PMCID: PMC7277514 DOI: 10.3390/ijerph17103635] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 01/09/2023]
Abstract
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.
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Affiliation(s)
- Cuong Hoang Quoc
- Pasteur Institute, Ho Chi Minh City 700000, Vietnam;
- Correspondence: ; Tel.: +84-0913-918-918
| | - Giang Vu Huong
- Public Health Faculty, Hong Bang Medical Center, Hai Phong 180000, Vietnam;
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Lim FL, Hashim Z, Md Said S, Than LTL, Hashim JH, Norbäck D. Fractional exhaled nitric oxide (FeNO) among office workers in an academic institution, Malaysia--associations with asthma, allergies and office environment. J Asthma 2015; 53:170-8. [PMID: 26300213 DOI: 10.3109/02770903.2015.1077861] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia. METHODS Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations. RESULTS One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001). CONCLUSION Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.
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Affiliation(s)
- Fang Lee Lim
- a Department of Environmental and Occupational Health
| | | | | | - Leslie Thian Lung Than
- c Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences , Universiti Putra Malaysia , UPM Serdang , Selangor , Malaysia
| | - Jamal Hisham Hashim
- d United Nations University-International Institute for Global Health (UNU-IIGH), UKM Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Federal Territory of Kuala Lumpur , Malaysia .,e Department of Community Health, Faculty of Health Sciences , National University of Malaysia, Jalan Raja Muda Aziz , Kuala Lumpur , Malaysia , and
| | - Dan Norbäck
- f Department of Medical Sciences , Occupational and Environmental Medicine, Uppsala University and University Hospital , Uppsala , Sweden
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Zhang X, Li F, Zhang L, Zhao Z, Norback D. A longitudinal study of sick building syndrome (SBS) among pupils in relation to SO2, NO2, O3 and PM10 in schools in China. PLoS One 2014; 9:e112933. [PMID: 25398002 PMCID: PMC4232599 DOI: 10.1371/journal.pone.0112933] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 10/16/2014] [Indexed: 11/18/2022] Open
Abstract
There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO2), nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), particulate matter (PM10), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010-2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO2 were found positively associated with prevalence of school-related symptoms. Indoor O3 was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM10 was found to be positively associated with new onset of skin, mucosal and general symptoms. CO2 and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO2 was positively associated with new onset of skin symptoms, while outdoor NO2 was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM10 was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM10, SO2 and NO2, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.
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Affiliation(s)
- Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Fan Li
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Li Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
- * E-mail:
| | - Dan Norback
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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