Non-Specific Symptoms In Office Workers: A Review And Summary Of The Epidemiologic Literature

Epidemiologic research into the causes of non-specific symptoms among office workers has produced a variety of conflicting findings which are difficult to synthesize. This paper first discusses methodologic issues important in the interpretation of epidemiologic studies, and then reviews the findings of 32 studies of 37 factors potentially related to office worker symptoms. Among environmental factors assessed, there were generally consistent findings associating increased symptoms with air-conditioning, carpets, more workers in a space, VDT use, and ventilation rates at or below 10 liters/second/person. Studies with particularly strong designs found decreased symptoms associated with low ventilation rate, short-term humidification, negative ionization, and improved office cleaning, although studies reviewed showed little consistency of findings for humidification and ionization. Relatively strong studies associated high temperature and low relative humidity with increased symptoms, whereas less strong studies were not consistent. Among personal factors assessed, there were generally consistent findings associating increased symptoms with female gender, job stress/dissatisfaction, and allergies/asthma. For other environmental or personal factors assessed, findings were too inconsistent or sparse for current interpretation, and there were no findings from strong studies. Overall evidence suggested that work related symptoms among office workers were relatively common, and that some of these symptoms represented preventable physiologic effects of environmental exposures or conditions. Future research on this problem should include blind experimental and case-control studies, using improved measurements of both environmental exposures and health outcomes     

Significance of humidity and temperature on skin and upper airway symptoms

The objective of the present study was to assess the effect of absolute and relative humidity, temperature and humidification on workers' skin and upper airway symptoms, and perceptions in the office environment. Associations between physical factors, and symptoms and perceptions were assessed in logistic regression models. At temperatures between 18 and 26 degrees C, relative humidity of 17-40%, and absolute humidity of 3.3-5.6 g H2O/kg air, skin symptoms and nasal dryness and congestion were alleviated by both kinds of humidity. Pharyngeal dryness increased when temperatures rose and was alleviated with a rise in relative humidity. Eye symptoms showed no dependence on humidity. Any kind of humidity increased odor sensation. Stuffiness increased when the air was humidified. In non-humidified conditions (21.3-22.7 degrees C, 20.0-31.7%, 3.3-5.6 g H2O/kg air), skin and nasal symptoms showed no association with humidity or temperature. Pharyngeal dryness diminished when humidity rose. In addition, the association between humidity and odor disappeared. In humidified conditions (21.5-23.7 degrees C, 26.6-41.2%, 4.2-7.0 g H2O/kg air), nasal dryness and congestion were alleviated by both absolute and relative humidity, and odor perception increased. Skin dryness and rash, pharyngeal dryness, and nasal dryness and congestion are alleviated in higher humidity. Steam humidification results in a risk for increased perception of odor and stuffiness.     

The Effect Of A Passive Adsorption Sheet On Reducing Organic Pollutants In Indoor Air

The effect of a thin, passive, adsorbent sheet containing activated carbon on reducing the concentration of volatile organic compounds in indoor air is investigated. A mathematical model is established to describe the conditions in a hypothetical room containing building materials, furniture, an activated carbon sheet, etc. The results of the modelling show that the activated carbon sheet can reduce the concentration of the organic vapour in the room air by a factor of 1.6 – 200, depending on the resistances to mass transfm in the laminar gas film surrounding the activated carbon sheet and in the voids of the sheet. The maximum value 200 is a theoretical limit, if both the film and void resistances could be eliminated. Minimization of the film and void resistances is important to achieve high effect of the activated carbon sheet. This could be done by e.g. dividing a single sheet into several smaller pieces, hanging the sheets at some places where the airflow is relatively high, and making the sheets thin and loose. For some of the model parameters, estimated or assumed values were used in the calculations. Experimental work regarding sorption equilibria and mass transport properties of the species and materials involved is needed for more accurate results.     

Health and Indoor Climate Complaints of 7043 office Workers in 61 Buildings in the Netherlands

During the winter of 1988/1989, the relationships between the prevalence of work-related health and indoor climate complaints and a number of building, management, workplace and personal characteristics have been investigated in a study in more than 60 office buildings located throughout the Netherlands. To collect the information, a questionnaire was prepared on health and indoor climate complaints and personal and workplace characteristics. A checklist was used to obtain information on building characteristics More than 7000 questionnaires were completed by the regular users of the buildings investigated. The results showed that the prevalence of symptoms was higher in air-conditioned buildings than in naturally or mechanically ventilated buildings. some other variables were also related with most work-related complaints after adjustment for selected management, personal, workplace and job characteristics. These included gender, work satisfaction in general, presence of allergies and/or respiratory symptoms, and personal control over temperature at the workplace. No differences were found in symptom prevalences between buildings with spray and steam humidification. The combination of air-conditioning and humidification did not lead to further increases in the prevalence of complaints as compared to buildings with only airconditioning or only humidification.     

The Effects Of Air Temperature And Relative Humidity On Thermal Comfort In The Office Environment

The objective of this study was to assess the effect of air humidification and temperature on thermal comfort in sedentary office work. A blinded twelve-period cross-over trial was carried out in two similar wings of an office building, contrasting 28–39% steam humidification with no humidification, corresponding to 12–28% relative humidity. The length of each period was one working week. The study population was 169 workers who judged their thermal sensations in a weekly questionnaire. The percentage of dissatisfied was lowest when the air temperature was 22 °C. At 22 °C an increase in relative humidity raised the mean thermal sensation only slightly. At 20 °C when the air was humidified there were fewer workers who judged their air temperature as being too low. On the other hand, at 24 °C humidification increased the percentage of workers who judged their air temperature to be too high. The percentage of dissatisfied increased rapidly when the air temperature was outside of its optimum value, 22 °C. The percentage of workers complaining about draft increased when the air temperature was lower than 22 °C. Thus we consider that the temperature range from 20 to 24 °C during wintertime may be too wide without individual temperature control from the point vzew of thermal comfort. We recommend that the air temperature should be kept between 21 and 23 °C if no individual control is available. The best solution would be individual temperature control permitting adjustment of the temperature at 22 ± 2 °C.     

Volatile Organic Compounds in Ventilating Air in Buildings at Different Sampling Points in the Buildings and their Relationship with the Prevalence of Occupant Symptoms

Total volatile organic compounds (TVOC) are determined in intake, room-supply and room air in 86 office rooms in 29 office buildings in northern Sweden. Measurements of formaldehyde were also made in room air. Building and room characteristics were identified and symptom reports collected from 1087 office workers. Concentrations of TVOC and formaldehyde in room air were low, with mean values of 71 µg/m³ and 31 µg/m³, respectively. The TVOC concentration was generally lower in room air than in supply air or intake air. The “loss” (difference in measured values) of TVOC from supply to room air was associated with raised concentrations of formaldehyde and raised prevalences of occupant symptoms. High TVOC concentrations in room air were associated with reduced prevalences of occupant symptoms.     

Impact of Temperature and Humidity on the Perception of Indoor Air Quality

Abstract Sensory responses to clean air and air polluted by five building materials under different combinations of temperature and humidity in the ranges 18-28°C and 30-70%RH were studied in the laboratory. A specially designed test system was built and a set of experiments was designed to observe separately the impact of temperature and humidity on the perception of air quality/odour intensity, and on the emission of pollutants from the materials. This paper reports on the impact on perception. The odour intensity of air did not change significantly with temperature and humidity; however, a strong and significant impact of temperature and humidity on the perception of air quality was found. The air was perceived as less acceptable with increasing temperature and humidity. This impact decreased with an increasing level of air pollution. Significant linear correlations were found between acceptability and enthalpy of the air at all pollution levels tested, and a linear model was established to describe the dependence of perceived air quality on temperature and humidity at different pollution levels.     

Symptoms and Perceived Indoor Air Quality among Occupants of Houses and Apartments with Different Ventilation Systems

The purpose of the study was to evaluate the occurrence of symptoms and the perception of poor indoor air quality among the occupants of houses and apartments with different ventilation systems. The study population consisted of the 473 occupants of 242 dwellings in the Helsinki metropolitan area who responded to a self-administered questionnaire (response rate 93.1%) after a two-week period of indoor air quality measurements. The symptoms of interest were those often related to poor indoor air quality including dryness or itching of the skin; dryness, irritation or itching of the eyes; nasal congestion (“blocked nose”) nasal dry-ness; nasal discharge (“runny nose”); sneezing; cough; breathlessness; headache or migraine; and lethargy, weakness or nausea. Perception of coldness; warm-ness; draught; dryness; stuffiness; and sufficiency of air exchange was also requested. The age-standardized period prevalences of the symptoms and complaints were systematically more common among the occupants of the apartments than those of the houses. The occupants of the houses with natural ventilation seemed to have more symptoms and complaints than those with balanced ventilation. However, in the apartments with balanced ventilation the occupants reported, in general, more symptoms and complaints than those with natural ventilation.     

室内空气品质及相关研究

介绍室内空气品质的国内外有关研究成果,包括IAQ问题引起关注的缘由,IAQ的影响因素、评价方法及改善IAQ的相关措施。     

Effects of a Furniture-integrated Breathing-zone Filtration System on Indoor Air Quality,Sick Building Syndrome,and Productivity

A field experiment evaluated the effect of a furniture-inte-grated breathing-zone filtration (BZF) system on indoor air quality, worker comfort, health, and productivity. The BZF system tested filters office air to remove volatile organic compounds and airborne particulates. The BZF system was installed on one floor of a 29 story air-conditioned office building. Another floor of the building served as a control. Comparisons of pre-installation and three month post-instal-lation surveys showed improvements in indoor air quality, sick building syndrome symptoms, and self-reported pro-ductivity with the BZF system References     

The Office Environment Model: A Conceptual Analysis of the Sick Building Syndrome*

Abstract This paper examines the phenomenon sick building syndrome and related concepts, and proposes a theoretical model, the Office Environment Model, to explain the relationship between office environment and health. The sick building syndrome should be thought of as a figurative concept of everyday language, rather than as a single disease entity. This is because the phenomenon consists of several types of relations between different environmental determinants and health. Based on Popper's framework of three worlds, the model divides the office environment ontologically into physical and social, and the health outcomes into physiological and psychological. The outcome is further categorized into two dimensions: anatomic site (eyes, respiratory tract, skin, and central nervous system), and hypothesized underlying mechanism (mechanical irritation and inflammation, immunological reaction, toxicity, infection, and environmental psychological stress). The model stipulates the following types of causal relations. The physical environment causes physical and psychological effects via physiological and/or psychological processes. The social environment causes physical and psychological effects via psychological processes. The physical and social environment may have synergistic effects, and constitutional factors such as gender and atopy are additional determinants of the outcomes, as well as possible modifiers of the relations between environment and health. To understand the health effects of the office environment, it is necessary to focus separately on different determinant-outcome relations, bearing in mind that the different determinants affect human health concurrently and sometimes the effects may be synergistic.     

Impact of Temperature and Humidity on Perception of Indoor Air Quality During Immediate and Longer Whole-Body Exposures

Abstract Acceptability of clean air and air polluted by building materials was studied in climate chambers with different levels of air temperature and humidity in the ranges 18–28°C and 30-70% relative humidity (RH). The acceptability of the air quality immediately after entering a chamber and during the following 20-min whole-body exposure was assessed by 36 untrained subjects who maintained thermal neutrality by modifying their clothing. The results confirm the significant decrement of the acceptability with increasing temperature and humidity, as shown in a previous study with facial exposures. The odour intensity was found to be independent of temperature and humidity. A linear relation between acceptability and enthalpy of air was again observed by this experiment. No significant difference was observed between the immediate acceptability and the acceptability during the following 20-min exposure, i.e., no adaptation took place. Both the immediate assessment of acceptability and the assessments during the 20-min exposure were independent of the air temperature and humidity to which the subjects were exposed before entering the chamber. The results further indicate that a notable decrement of the ventilation requirement may be achieved by maintaining a moderate enthalpy of air in spaces.     

Comparison Of Tenax And Carbotrap For VOC Sampling In Indoor Air

The most important features of Tenax and Carbotrap, solid sorbents used widely for sampling organic pollutants in air, have been tested under the conditions requested for surveys in indoor spaces and for determinations of VOC emitted from indoor sources by chamber experiments. The performances of samplers, tested with 10 nonpolar and polar (mostly lipophilic) hydrocarbons, present as vapours in 0.5 to 2.0 litre air samples, include: (a) accuracy and reproducibility of the measured concentration, (b) background or “blank” of samplers, (c) stability upon storage (at ambient and below ambient temperatures) of clean samplers and of samplers loaded with VOC, and (d) performance stability after several sampling desorption cycles. The results fulfil the requirements for both adsorbents, though each presents some different drawbacks. In particular (a) Tenax samplers show a “blank” (90 percentile) of 16 ng of benzene and 5 ng of toluene, Carbotrap samplers roughly twice as much; (b) the samplers may be stored for one month either before or after use and (c) they may withstand many cycles without discernible deterioration.     

Class separation of buildings with high and low prevalence of SBS by principal component analysis

In this study, we were able to separate buildings with high and low prevalence of sick building syndrome (SBS) using principal component analysis. The prevalence of SBS was defined by the presence of at least one typical skin, mucosal and general (headache and fatigue) symptom. Data from the Swedish Office Illness Study describing the presence and level of chemical compounds in outdoor, supply, and room air, respectively, were evaluated together with information about the buildings in six models. When all data were included the most complex model was able to separate 71% of the high prevalence buildings from the low prevalence buildings. The most important variable that separates the high prevalence buildings from the low prevalence buildings was a more frequent occurrence or a higher concentration of compounds with shorter retention time in the high prevalence buildings. Elevated relative humidity in supply and room air and higher levels of total volatile organic compounds in outdoor and supply air were more common in high prevalence buildings. Ten building variables also contributed to the separation of the two classes of low and high prevalence buildings.     

Mechanical Ventilation in Office Buildings and the Sick Building Syndrome. An Experimental and Epidemiological Study

The effects of mechanical ventilation on the sick building syndrome (SBS) were studied in an office building with 2150 employees, where the mechanical ventilation and indoor air quality were commonly blamed for causing symptoms typical of the SBS (nasal, eye, and mucous membrane symptoms, lethargy, skin symptoms and headache). The mechanical ventilation rates in the building were high (mean 26 l/s/person). To test the hypothesis that mechanical ventilation causes the SBS, a controlled experimental study was carried out by shutting off the ventilation in one part of the building and reducing the ventilation rate by 75% and 60% in two areas while leaving one part unaltered as a control. The experimental reduction of the ventilation rate did not alleviate the symptoms. On the contrary, the reduction of the ventilation rate caused a slight but statistically significant relative increase in symptoms (p < 0.05). In the cross-sectional analysis of the baseline data the SBS symptoms did not associate significantly with the ventilation rate (range 7–70 l/s/person). In the linear regression model, a positive correlation was found between temperatures above 22°C and the occurrence of symptoms (p < 0.05). Subjects exposed to environmental tobacco smoke had more symptoms than those not exposed (p < 0.01). Women reported more symptoms than men (p < 0.001). In addition, any prior history of allergic diseases (p < 0.001) and a negative attitude towards the social atmosphere at work (p < 0.001) were significant determinants of the SBS.     

Field Evaluation of CO2 Detector Tubes for Measuring Outdoor Air Supply Rate in the Indoor Environment

Indoor carbon dioxide (CO₂) concentration can be used to estimate the degree of air recirculation and outdoor air supply rate. Three types of CO₂ detector tubes were evaluated by using Fourier Transform Infra-Red (FTIR) Spectroscopy as a reference method. Two types of detector tubes (Draeger CH 30801 and Kitagawa 126 B) showed a good correlation with the reference method (r = 0.98), the 95% confidence interval of the slope being 0.89-1.06 and 0.80-0.95, respectively in linear regression analysis. The third type (Gastec 2LL.) showed lower correlation (r = 0.91) and a wider 95% confidence interval (0.52-0.80) of the slope. A t CO₂ concentrations in the range 800-1000 5 l/l(ppm), control values suggested for the indoor environment, the Draeger and the Gastec tubes underestimated the CO₂ concentration, while the Kitagawa tube showed a correct value. The difference in reading between observers was similar for all three brands of detector tubes (5-7%), expressed as relative standard error No significant influence of the air humidity or temperature on the readings could be demonstrated. It is concluded that some brands of CO₂ detector tubes can be used to measure indoor carbon dioxide concentration with sufficient precision and accuracy. Since the relative error is relatively large at lower CO₂ concentrations, the use of such tubes for the determination of air recirculation in ventilation systems should be avoided. As a crude estimate of the outdoor air supply rate, however, CO₂ detector tubes may be used. In order to minimize the error in reading, the type of detector tube and the need for recalibration should be considered. When using CO₂ measurements as an estimate of outdoor air supply rate, the influence of age and work-load on the individual's emission of CO₂ and the time needed to reach equilibrium, should also be taken into consideration.     

The Stockholm Indoor Environment Questionnaire: a sociologically based tool for the assessment of indoor environment and health in dwellings

The aim was to develop and validate a standardized questionnaire - the Stockholm Indoor Environment Questionnaire (SIEQ). The validation procedure was based on sociological principles and test procedures for validation. The indicators of indoor environment are air quality, thermal climate, noise, and illumination. The indicators of health are symptoms comprised in the sick building syndrome (SBS). The questionnaire also contains questions about the apartment, individual behavior, and personal factors. The everyday language describing the building and its function was first obtained by qualitative personal interviews, then by standardized questions. The interview questionnaire was transformed into a postal self-administered questionnaire. The reduction of the questionnaire was based on correlation analysis. It was found that to obtain a good validity, general questions are not sufficient, but specific question on perceptions and observations are needed. Good test-retest agreement was found both on an area level, building level, and individually. For each indicator, a set of questions are constructed and validated. SIEQ has been used in several studies, and the results are presented in graphic problem profiles. Reference data has been calculated for the Stockholm area.     

A Comparative Study Of Discomfort Caused By Indoor Air Pollution,Thermal Load And Noisec

The relative importance of sensory air pollution, thermal load and noise was studied under controlled conditions in two identical environmental chambers. In one chamber subjects were exposed to various levels of either thermal load or poor indoor air quality. For each condition tested in this chamber, the subjects were exposed to a number of noise levels in an adjacent chamber with neutral thermal conditions and good indoor air quality in order to determine a noise level causing the same degree of discomfort. A total of 68 comparisons of the conditions in the two chambers were made by the same group of 16 subjects after one-minute exposure in each chamber. In the operative temperature range of 23–29°C, a 1°C change in operative temperature was found to have the same effect on human comfort as a change in perceived air quality of 2.4 decipol or a change in noise level of 3.9 dB. For levels of perceived air quality up to 10 decipol, a 1 -decipol change in perceived air quality had the same effect on human comfort as a change in noise level of 1.2 dB. A relationship between traffic noise level and percentage dissatisfied was established     

Psychosocial Factors and the “Sick Building-Syndrome”. A case-referent study

Abstract The significance of the psychosocial work environment for the prevalence of symptoms compatible with the “sick building syndrome” (SBS) was studied in a case-referent study including 464 office workers, half of whom had symptoms of SBS. A questionnaire was distributed to all subjects, and representatives of the organisations concerned were interviewed. The aim of the study was to investigate the importance of psychosocial and organisational factors in explaining the prevalence of SBS symptoms among office workers. The results showed that psychosocial work characteristics, such as workload and job satisfaction, as well as worry and reorganisation are factors that have a significant impact on the risk of developing the symptoms of SBS.     

Associations between indoor CO2 concentrations and sick building syndrome symptoms in U.S. office buildings: an analysis of the 1994-1996 BASE study data

Higher indoor concentrations of air pollutants due, in part, to lower ventilation rates are a potential cause of sick building syndrome (SBS) symptoms in office workers. The indoor carbon dioxide (CO2) concentration is an approximate surrogate for indoor concentrations of other occupant-generated pollutants and for ventilation rate per occupant. Using multivariate logistic regression (MLR) analyses, we evaluated the relationship between indoor CO2 concentrations and SBS symptoms in occupants from a probability sample of 41 U.S. office buildings. Two CO2 metrics were constructed: average workday indoor minus average outdoor CO2 (dCO2, range 6-418 ppm), and maximum indoor 1-h moving average CO2 minus outdoor CO2 concentrations (dCO2MAX). MLR analyses quantified dCO2/SBS symptom associations, adjusting for personal and environmental factors. A dose-response relationship (p < 0.05) with odds ratios per 100 ppm dCO2 ranging from 1.2 to 1.5 for sore throat, nose/sinus, tight chest, and wheezing was observed. The dCO2MAX/SBS regression results were similar.