No consistent risk factor pattern for symptoms related to the sick building syndrome: a prospective population based study

  • Charlotte Brauer
  • Henrik Kolstad
  • Palle Ørbæk
  • Sigurd Mikkelsen
Original Article

Abstract

Objectives: To examine associations between perceived indoor environment at work and the non-specific symptoms that are often referred to as the sick building syndrome (SBS), using cross-sectional and prospective analyses for a large cohort from the general population. Methods: The sample comprised 2,164 adults in employment, who completed a postal questionnaire in April 2001. Of these 1,402, who were still working and living in the same place, completed a second questionnaire a year later. The outcome measures were the prevalence of mucous membrane symptoms and general symptoms at baseline and the incidence and persistence of these symptoms at follow-up. Self-reports of the indoor environment from the baseline questionnaire were used as predictors in the analyses. Results: Inconsistent results were found between the cross-sectional and the longitudinal analyses for the associations between perceived indoor environment factors at work and symptoms. Whereas mucous membrane symptoms in the cross-sectional analysis were significantly associated with self-reported high temperature and dry air, the prospective analyses showed that onset of mucous membrane symptoms was associated with the sensation of draught, dry air, and noise. Persistent mucous membrane symptoms were associated only with stuffy air. General symptoms were associated with self-reported stuffy air and dry air in the cross-sectional analysis, while draught was the only predictor of onset of general symptoms. We found no predictors in the indoor environment for the persistence of general symptoms. Conclusions: The symptoms that are often connected with SBS are very common symptoms in the general population among manual workers as well as non-manual workers. Our study gives only limited support to the hypothesis of causal relationships between the indoor environment and these symptoms. We found no evidence of persistent mucous membrane symptoms and general symptoms related to specific factors in the indoor environment.

Keywords

Sick building syndrome Epidemiological study Cohort study Risk factors Indoor air quality 

References

  1. Allison PD (1999) Logistic regression using the SAS® system: theory and application. SAS Institute Inc., Cary, NCGoogle Scholar
  2. Andersen JH, Thomsen JF, Overgaard E, Lassen CF, Brandt LP, Vilstrup I, Kryger AI, Mikkelsen S (2003) Computer use and carpal tunnel syndrome: a 1-year follow-up study. JAMA 289:2963–2969PubMedCrossRefGoogle Scholar
  3. Bachmann MO, Myers JE (1995) Influences on sick building syndrome symptoms in three buildings. Soc Sci Med 40:245–251PubMedCrossRefGoogle Scholar
  4. Bjornsson E, Janson C, Norback D, Boman G (1998) Symptoms related to the sick building syndrome in a general population sample: associations with atopy, bronchial hyper-responsiveness and anxiety. Int J Tuberc Lung Dis 2:1023–1028PubMedGoogle Scholar
  5. Brauer C (2005) The sick building syndrome revisited. Ph.D. Thesis. Copenhagen University Hospital, Glostrup, DenmarkGoogle Scholar
  6. Brauer C, Mikkelsen S (2003) The context of a study influences the reporting of symptoms. Int Arch Occup Environ Health 76:621–624PubMedCrossRefGoogle Scholar
  7. Brauer C, Mikkelsen S, Skov P (2000) Reliability and validity of a new questionnaire for investigation of symptoms related to “The Sick Building Syndrome” and perceived indoor air quality [in Danish]. Department of Occupational Medicine, Copenhagen University Hospital, Glostrup, Denmark, Own printGoogle Scholar
  8. Broder I, Pilger C, Corey P (1990) Building related discomfort is associated with perceived rather than measured levels of indoor environmental variables. Indoor Air ‘90, vol 1. Conference Proceeding, pp 221–226Google Scholar
  9. Chao HJ, Schwartz J, Milton DK, Burge HA (2003) The work environment and workers’ health in four large office buildings. Environ Health Perspect 111:1242–1248PubMedGoogle Scholar
  10. Engelhart S, Burghardt H, Neumann R, Ewers U, Exner M, Kramer MH (1999) Sick building syndrome in an office building formerly used by a pharmaceutical company: a case study. Indoor Air 9:139–143PubMedCrossRefGoogle Scholar
  11. Engvall K, Norrby C, Norback D (2001) Sick building syndrome in relation to building dampness in multi-family residential buildings in Stockholm. Int Arch Occup Environ Health 74:270–278PubMedCrossRefGoogle Scholar
  12. Finnegan MJ, Pickering CA, Burge PS (1984) The sick building syndrome: prevalence studies. Br Med J (Clin Res Ed) 289:1573–1575Google Scholar
  13. Franck C, Bach E, Skov P (1993) Prevalence of objective eye manifestations in people working in office buildings with different prevalences of the sick building syndrome compared with the general population. Int Arch Occup Environ Health 65:65–69PubMedCrossRefGoogle Scholar
  14. Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, Bullinger M, Kaasa S, Leplege A, Prieto L, Sullivan M (1998) Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. J Clin Epidemiol 51:1171–1178PubMedCrossRefGoogle Scholar
  15. Gustafsson J-E (1980) Testing and obtaining fit of data to the Rasch model. Br J Math Stat Psychol 33:205–233Google Scholar
  16. Harrison J, Pickering CA, Faragher EB, Austwick PK, Little SA, Lawton L (1992) An investigation of the relationship between microbial and particulate indoor air pollution and the sick building syndrome. Respir Med 86:225–235PubMedCrossRefGoogle Scholar
  17. Hodgson MJ, Morey P, Leung WY, Morrow L, Miller D, Jarvis BB, Robbins H, Halsey JF, Storey E (1998) Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor. J Occup Environ Med 40:241–249PubMedCrossRefGoogle Scholar
  18. Hosmer DW, Lemeshow S (2000) Applied logistic regression. Wiley, New York, NYGoogle Scholar
  19. Johansson SG, Hourihane JO, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, Kowalski ML, Mygind N, Ring J, van Cauwenberge P, Hage-Hamsten M, Wuthrich B (2001) A revised nomenclature for allergy. An EAACI position statement from the EAACI nomenclature task force. Allergy 56:813–824PubMedCrossRefGoogle Scholar
  20. Karasek R, Theorell T (1990) Healthy work: stress, productivity, and the reconstruction of working life. Basic Books, New York, NYGoogle Scholar
  21. Koskinen OM, Husman TM, Meklin TM, Nevalainen AI (1999) The relationship between moisture or mould observations in houses and the state of health of their occupants. Eur Respir J 14:1363–1367PubMedCrossRefGoogle Scholar
  22. Li CS, Hsu CW, Tai ML (1997) Indoor pollution and sick building syndrome symptoms among workers in day-care centers. Arch Environ Health 52:200–207PubMedGoogle Scholar
  23. McDonald JC, Armstrong B, Benard J, Cherry NM, Farant JP (1993) Sick building syndrome in a Canadian office complex. Arch Environ Health 48:298–304PubMedGoogle Scholar
  24. Muzi G, Abbritti G, Accattoli MP, dell’Omo M (1998) Prevalence of irritative symptoms in a nonproblem air-conditioned office building. Int Arch Occup Environ Health 71:372–378PubMedCrossRefGoogle Scholar
  25. Nelson NA, Kaufman JD, Burt J, Karr C (1995) Health symptoms and the work environment in four nonproblem United States office buildings. Scand J Work Environ Health 21:51–59PubMedGoogle Scholar
  26. Norback D, Edling C (1991) Environmental, occupational, and personal factors related to the prevalence of sick building syndrome in the general population. Br J Ind Med 48:451–462PubMedGoogle Scholar
  27. Norback D, Michel I, Widstrom J (1990a) Indoor air quality and personal factors related to the sick building syndrome. Scand J Work Environ Health 16:121–128Google Scholar
  28. Norback D, Torgen M, Edling C (1990b) Volatile organic compounds, respirable dust, and personal factors related to prevalence and incidence of sick building syndrome in primary schools. Br J Ind Med 47:733–741Google Scholar
  29. Nordstrom K, Norback D, Akselsson R (1994) Effect of air humidification on the sick building syndrome and perceived indoor air quality in hospitals: a four month longitudinal study. Occup Environ Med 51:683–688PubMedCrossRefGoogle Scholar
  30. Nordstrom K, Norback D, Akselsson R (1995) Influence of indoor air quality and personal factors on the sick building syndrome (SBS) in Swedish geriatric hospitals. Occup Environ Med 52:170–176PubMedGoogle Scholar
  31. Ooi PL, Goh KT, Phoon MH, Foo SC, Yap HM (1998) Epidemiology of sick building syndrome and its associated risk factors in Singapore. Occup Environ Med 55:188–193PubMedGoogle Scholar
  32. Reinikainen LM, Jaakkola JJ (2001) Effects of temperature and humidification in the office environment. Arch Environ Health 56:365–368PubMedCrossRefGoogle Scholar
  33. Robertson AS, McInnes M, Glass D, Dalton G, Burge PS (1989) Building sickness, are symptoms related to the office lighting? Ann Occup Hyg 33:47–59PubMedCrossRefGoogle Scholar
  34. Setterlind S, Larsson G (1995) The stress profile: a psychosocial approach to measuring stress. Stress Med 11:85–92CrossRefGoogle Scholar
  35. Siegrist J (1996) Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol 1:27–41PubMedCrossRefGoogle Scholar
  36. Skov P, Valbjorn O (1987) The “sick” building syndrome in the office environment: the Danish Town Hall Study. Environ Int 13:339–349CrossRefGoogle Scholar
  37. Skov P, Valbjorn O, Pedersen BV (1990) Influence of indoor climate on the sick building syndrome in an office environment. The Danish Indoor Climate Study Group. Scand J Work Environ Health 16:363–371Google Scholar
  38. Streiner DL (1994) Figuring out factors: the use and misuse of factor analysis. Can J Psychiatry 39:135–140PubMedGoogle Scholar
  39. Sundell J, Lindvall T, Stenberg B, Wall S (1994) Sick building syndrome (SBS) in office workers and facial skin syndromes among VDT-workers in relation to building and room characteristics: two case-referent studies. Indoor Air 4:83–94CrossRefGoogle Scholar
  40. Tang SK (1997) Performance of noise indices in air-conditioned landscaped office buildings. J Acoust Soc Am 102:1657–1663PubMedCrossRefGoogle Scholar
  41. Toftum J (2004) Air movement—good or bad? Indoor Air 14(Suppl 7):40–45PubMedCrossRefGoogle Scholar
  42. U.S. Environmental Protection Agency (1991) Indoor air quality and work environment study: EPA headquarters building, vol III: relating employee responses to the follow-up questionnaire with environmental measurements of indoor air quality. U.S. Environmental Protection Agency, NC, USAGoogle Scholar
  43. Wan GH, Li CS (1999) Dampness and airway inflammation and systemic symptoms in office building workers. Arch Environ Health 54:58–63PubMedGoogle Scholar
  44. World Health Organization (1983) Indoor air pollutants: exposure and health effects—report on a WHO meeting, vol 78. WHO Regional Office for Europe. EURO Reports and Studies 78, pp1–48Google Scholar
  45. Zweers T, Preller L, Brunekreef B, Boleij JSM (1992) Health and indoor climate complaints of 7043 office workers in 61 buildings in the Netherlands. Indoor Air 2:127–136CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Charlotte Brauer
    • 1
    • 4
  • Henrik Kolstad
    • 2
  • Palle Ørbæk
    • 3
  • Sigurd Mikkelsen
    • 1
  1. 1.Department of Occupational MedicineCopenhagen University HospitalGlostrupDenmark
  2. 2.Department of Occupational MedicineAarhus University HospitalAarhusDenmark
  3. 3.National Institute of Occupational HealthCopenhagenDenmark
  4. 4.Arbejdsmedicinsk KlinikAmtssygehuset i GlostrupGlostrupDenmark

Personalised recommendations