Association between Sick Building Syndrome and Indoor Environmental Quality in Slovenian Hospitals: A Cross-Sectional Study

Prevalence of occupational heat stress across the seasons and its management amongst healthcare professionals in the UK

Occupational heat stress (OHS) is an issue in healthcare facilities (HCFs) in the United Kingdom (UK). The aims of this study were to evaluate perceived levels of OHS during two seasons and its perceived consequences on healthcare professionals (HCPs) and to assess the efficacy of heat stress management (HSM) policies. An anonymous online survey was distributed to HCPs working in HCFs in the UK. The survey returned 1014 responses (87% women). Descriptive statistics and content analysis of survey data identified that OHS in HCFs is frequently experienced throughout the year and concerned most HCPs. Over 90% perceived OHS impairs their performance and 20% reported heat-related absenteeism. Awareness of HSM policies was poor and 73% deemed them not adequate. To help reduce the financial loss and impact on staff performance, health and well-being and patient safety, it is recommended that revisions and widespread dissemination of HSM policies are made.

Ecological Study of Sick Building Syndrome among Healthcare Workers at Johor Primary Care Facilities

INTRODUCTION

Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics.

METHODS

A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room).

RESULT

Most of the areas illustrated poor air movement (<0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (>500 CFU/m³). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables.

CONCLUSION

SBS is prevalent among healthcare workers at health clinics.

Respiratory Symptoms and Skin Sick Building Syndrome among Office Workers at University Hospital, Chiang Mai, Thailand: Associations with Indoor Air Quality, AIRMED Project

Sick building syndrome (SBS) is the term used to describe the medical condition in which people in a building suffer from symptoms of illnesses for no apparent reason. SBS was found to be associated with indoor air quality (IAQ) but there are a variety of determinants (buildings, in particular). Identifying and controlling factors related to SBS is crucial for improving worker health and efficiency. A cross-sectional study was conducted to investigate (1) the prevalence of respiratory symptoms and skin SBS and (2) their associations with IAQ among office workers in administrative offices in an academic medical institute. A self-reporting questionnaire assessing the worker's characteristics, working conditions, and perception of working environments was used. The building assessment was via a walk-through survey and IAQ measurement. Of 290 office workers, 261 (90%) in 25 offices of 11 buildings took part in the survey. The highest prevalence of SBS was nasal symptoms (25.3%). We found that to reduce the risk of SBS, optimal air temperature levels in air-conditioned offices should be lower than 23 °C, with relative humidity between 60% and 70%. Lowering indoor CO₂ levels below 700 ppm may be indicative of adequate ventilation to prevent SBS by reducing worker discomfort and indoor contaminants (e.g., formaldehyde).

Assessment of sick building syndrome using visual analog scales

BACKGROUND

Despite there is no recommendations for assessing symptoms of sick building syndrome, the use of visual analog scales (VAS) seems attractive and appropriate. We aimed to demonstrate the benefits of using VAS for evaluating subjective symptoms of sick building syndrome.

METHOD

We compared an exposed group to a control group with a one-year follow-up. To assess chronology of symptoms, employees were asked to complete four VAS at different times: after vacations (time 1), beginning of the week-beginning of the day (time 2), beginning of the week-end of the day (time 3), and end of the week-end of the day (time 4). Measurements were repeated before and after ventilation work for the exposed group and at the same time in the control group without intervention. Confounding factors were assessed.

RESULTS

We included 36 employees (21 in the exposed group and 15 in the control group). Both groups were comparable. Prior to ventilation work, the exposed group had more subjective symptoms than the control group with a chronology of symptoms. After ventilation work, symptoms did not differ between groups, and most symptoms decreased within the exposed group.

PRACTICAL IMPLICATION

The use of VAS provided reliable data for assessing sick building syndrome and showed a dose-response relationship between occupational exposure and symptoms.

Occupant health in buildings: Impact of the COVID-19 pandemic on the opinions of building professionals and implications on research

The objectives of this study are to investigate building professionals' experience, awareness, and interest in occupant health in buildings, and to assess the impact of the COVID-19 pandemic on their opinions, as well as to compare the research on occupant health in buildings to professionals' opinions. To address these objectives, a mixed research methodology, including a thorough review of the literature (NL = 190) and an online survey (NS = 274), was utilized. In general, there is an increasing research interest in occupant health and a heightened interest in health-related projects, among professionals, following the COVID-19 pandemic. Specifically, among the nine different building attributes examined, indoor air quality was the most researched building attribute with a focus on occupant health and was also presumed to be the most important by the professionals. Professionals considered fatigue and musculoskeletal pain to be the most important physical well-being issues, and stress, anxiety, and depression to be the most important mental well-being issues that need to be the focus of design, construction, and operation of buildings to support and promote occupant health, while eye-related symptoms and loss of concentration were the most researched physical and mental well-being symptoms in the literature, respectively. Finally, professionals indicated that COVID-19 pandemic had significant effect on their perspectives regarding buildings' impact on occupant health and they believed future building design, construction and operation will focus more on occupant health because of the pandemic experience.

Toward Sustainable Healthcare Facilities: An Initiative for Development of “Mostadam-HCF” Rating System in Saudi Arabia

Saudi Arabia vision 2030 emphasizes the applications of sustainability concepts in all aspects of life in Saudi society. Accordingly, the Mostadam rating system for existing and new buildings was recently launched to achieve appropriate, sustainable building standards. In the medical field, sustainable healthcare facilities are an extension of the concept of sustainable buildings in terms of important sustainable healthcare parameters. Therefore, the sustainable development of healthcare facilities has great impacts on growing economic, social and environmental issues, which, in turn, improve Saudi society’s public health. Moreover, the COVID-19 pandemic has further exposed the urgent need for sustainable healthcare facilities to control the outbreak of such dangerous pandemics. Accordingly, the retrofitting of the existing healthcare facilities and the shift toward new sustainable ones have become an important objective of many countries worldwide. Currently, the concepts related to sustainable healthcare facilities are rapidly varying their scopes toward wider perspectives. Therefore, a new local rating system for healthcare facilities based on the potential and resources of sustainable healthcare facilities in Saudi Arabia should be developed. The present paper investigates the development of a new version of the Mostadam rating system, known here as “Mostadam-HCF”, in relation to the local Mostadam rating system and in accordance with the LEED version 4.1 (BD + C: Health-care). This important step can help the existing and the new healthcare facilities in Saudi Arabia to obtain, firstly, national accreditation and, consequently, to be internationally accredited. Moreover, the initiative of sustainable healthcare facilities can also help in fighting the current COVID-19 pandemic and the other possible future viruses in Saudi Arabia.

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.

Indoor Airborne Microbial Concentration and Dry Eye

PURPOSE

To examine associations between indoor airborne microbial concentration and dry eye (DE) measures.

DESIGN

Prospective, observational, cross-sectional study.

METHODS

A total of 157 individuals with normal external ocular anatomy were recruited from the Miami Veterans Affairs eye clinic. Subjects underwent a clinical evaluation that included assessment of DE symptoms and signs. Indoor air was sampled using bioaerosol impactors with nutrient and soy media, and samples were incubated for 48 hours at 37 C with 5% CO₂. Number of microbial colonies (CFU) was recorded. Outcome measures were DE symptoms and signs.

RESULTS

A total of 157 unique subjects participated in home and clinical visits and of these, 93 completed a 6-month follow-up of home and clinical visits. Older homes were found to have higher CFU compared to newer homes. A 1% increase in humidity was associated with a 3% increase in nutrient CFU (95% confidence interval [CI] = 0.01 to 0.04; P < .001). Instrumented CFU significantly associated with 2 DE measures: corneal epithelial disruption and lower eyelid meibomian gland (MG) dropout, adjusted for age and sex (odds ratio [OR] = 28.07, 95% CI =1.8, 443.8, P < .05; OR = 39.6, CI = 1.8, 875.2, P < .05 for soy, respectively). After adjusting for other confounders, CFU and age remained significantly associated with MG dropout. Other DE measures did not significantly associate with CFU.

CONCLUSIONS

Individuals with higher CFU counts in the home had more severe MG dropout, after adjusting for age and other confounders. This finding suggests that home CFU exposure may impact MG dropout, one of the DE measures, and may be a target for intervention.

The Indoor Microclimate of Prefabricated Buildings for Housing: Interaction of Environmental and Construction Measures

The current knowledge shows that the interior microclimate of residential buildings that were constructed between 1950 and 1990 using panel construction, not only in the Czech Republic but also in Europe, and were renovated in accordance with applicable legislation related to thermal comfort and energy is significantly affected by gaseous pollutants. At increased concentrations and exposure times, these pollutants negatively affect the interior microclimate and at the same time have a negative effect on the health of users. After the implementation of remediation measures, which are mainly focused on improving the thermal technical parameters of the building envelope, the concentration of CO2 in the indoor environment increases. Carbon dioxide is one of the most important active factors and in terms of the quality of the interior microclimate, it is considered a reliable indicator of whether the interior microclimate can be considered a healthy and favorable environment. It is thus clear that the set and de facto systematized measures in the renovation of the housing stock from the second half of the 20th century has led to energy savings on the one hand, but on the other hand, this has contributed to the hygienic damage of housing units and an unhealthy interior microclimate. The paper aims to define the interaction of interdisciplinary contexts that have led to an increase in the indoor air quality (IAQ) of renovated residential panel buildings.

Impact of Air Pollution and Weather on Dry Eye

Air pollution has broad effects on human health involving many organ systems. The ocular surface is an excellent model with which to study the effects of air pollution on human health as it is in constant contact with the environment, and it is directly accessible, facilitating disease monitoring. Effects of air pollutants on the ocular surface typically manifest as dry eye (DE) symptoms and signs. In this review, we break down air pollution into particulate matter (organic and inorganic) and gaseous compounds and summarize the literature regarding effects of various exposures on DE. Additionally, we examine the effects of weather (relative humidity, temperature) on DE symptoms and signs. To do so, we conducted a PubMed search using key terms to summarize the existing literature on the effects of air pollution and weather on DE. While we tried to focus on the effect of specific exposures on specific aspects of DE, environmental conditions are often studied concomitantly, and thus, there are unavoidable interactions between our variables of interest. Overall, we found that air pollution and weather conditions have differential adverse effects on DE symptoms and signs. We discuss these findings and potential mitigation strategies, such as air purifiers, air humidifiers, and plants, that may be instituted as treatments at an individual level to address environmental contributors to DE.