Abstract
It is well known that patients seek help for symptoms attributed to the exposure of different indoor environments. Due to lack of knowledge about these symptoms, patients were often treated as hysterics. In the early 1980s, the sick building syndrome (SBS) concept was defined by the World Health Organization (WHO). SBS symptoms were reported to be in the eyes, nose, throat, and lower airways; skin reactions; non-specific hypersensitivity; mental fatigue; headaches; nausea and dizziness among persons staying in the suspected building. The SBS symptoms in most cases disappeared or diminished after leaving the building. Some patients though stayed sensitive and had the SBS symptoms even after leaving the suspected building. They also with time became sensitive to other exposures such as smells, perfumes, electromagnetic fields and suffered from anxiety symptoms. In such cases it is an environmental illness (EI) of psychogenic nature that can be treated therapeutically. Personality studies show that on a group level the SBS subjects have personality traits within normal range and not on a pathological level, although they have personality traits such as high anxiety, high aggressivity, low sense of coherence, and higher neuroticism which created a vulnerability factor for SBS. Psychosocial studies show that poor psychological work environment is associated to SBS symptoms. Follow-up studies of SBS patients reveal that they were not treated and that their symptoms worsened with time. There are no studies on effective treatment methods for SBS patients, although psychological methods for treatment of similar problems exist, such as anxiety and phobia disorders. One such a method is Cognitive Behavioral Therapy (CBT) with a focus on identifying factors that maintain the expression of anxiety. However, there are unpublished clinical reports that CBT alone is not enough in treating the SBS patients successfully. The therapists reported a struggle with the patient’s own needs to project the cause of illness onto the physical environment and the EI patients complained that the therapists were lacking a broader knowledge in the field of environmental medicine and were not able to alleviate the patients’ worries. In order to handle therapy pitfalls, an Integrative Model for treatment of Environmental Illness of psychogenic nature (IMEI) was developed. The focus of this model is uncovering and treating the environmental sensitivity of a psychogenic nature. When the patient understands the process generating the symptoms, identifies anxiety and hyperventilation as a cause of the symptoms, and acquires skills to prevent the symptoms, then resistance develops to the thoughts and worries about the catastrophic symptoms that previously were disabling. The IMEI can be successfully applied with any environmental sensitivity of psychogenic nature provided that the patients are motivated to discover the role of psychological factors involved in generating the symptoms.
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Abbreviations
- CBT:
-
Cognitive behavioral therapy
- CI:
-
The Cornell index-form N3
- CRI:
-
The stress and crisis inventory
- DCS:
-
The job demands control support model
- EPI:
-
The Eysenck’s personality inventory
- HADS:
-
The hospital anxiety and depression scale
- IMEI:
-
The integrative model for treatment of environmental illness
- KSP:
-
The Karolinska scales of personality
- MCS:
-
The multiple chemical sensitivity
- MFS:
-
The mental fatigue scale
- MMPI:
-
The Minnesota multiphasic personality inventory
- SBS:
-
The sick building syndrome
- SHS:
-
The sick house syndrome
- SL:
-
The stress load
- SOC:
-
The sense of coherence
- TAS:
-
The Toronto alexithymia scale
References
WHO. Indoor air pollutants: exposure and health effects, EURO reports and studies, vol. 78. Copenhagen: World Health Organization; 1983.
Rothman AL, Weintraub MI. The sick building syndrome and mass hysteria. Neurol Clin. 1995;13(2):405–12.
Norbäck D, Edling C. Environmental, occupational, and personal factors related to the prevalence of sick building syndrome in the general population. Br J Ind Med. 1991;48(7):451–62.
Engvall K, Norrby C, Norbäck D. Sick building syndrome in relation to building dampness in multi-family residential buildings in Stockholm. Int Arch Occup Environ Health. 2001;74(4):270–8.
Ishibashi M, Tonori H, Miki T, Miyajima E, Kudo Y, Tsunoda M. Classification of patients complaining of sick house syndrome and/or multiple chemical sensitivity. Tohoku J Exp Med. 2007;211:223–33.
Imai N, Imai Y, Kido Y. Psychosocial factors that aggravate the symptoms of sick house syndrome in Japan. Nurs Health Sci. 2008;10(2):101–9.
Boxer PA. Indoor air quality: a psychosocial perspective. JOM. 1990;32:425–8.
Crawford JO, Bolas C. Sick building syndrome, work factors and occupational stress. Scand J Work Environ Health. 1996;22:243–50.
Runeson R, Norbäck D, Stattin H. Symptoms and sense of coherence (SOC) - A follow-up study of personnel from workplace buildings with indoor air problems. Int Arch Occup Environ Health. 2003;76:29–38.
Runeson R, Norbäck D, Klinteberg B, Edling C. The influence of personality, measured by the Karolinska scales of personality (KSP), on symptoms among subjects in suspected sick building. Indoor Air. 2004;14:394–404.
Staudenmayer H. Clinical consequences of the EI/MCS “diagnosis”: two paths. Regul Toxicol Pharmacol. 1996;24:96–110.
Edvardsson B, Stenberg B, Bergdahl J, Eriksson N, Linden G, Widman L. Medical and social prognoses of non-specific building-related symptoms (sick building syndrome): a follow-up study of patients previously referred to hospital. Int Arch Occup Environ Health. 2008;81:805–12.
Schiele BC, Baker AB, Hathaway SR. The Minnesota multiphasic personality inventory. J Lancet. 1943;63:292–7.
Butcher JN, Dahlstrom WG, Graham JR, Tellegen A, Kaemmer B. The Minnesota multiphasic personality Inventory-2 (MMPI-2): manual for administration and scoring. Minneapolis: University of Minnesota Press; 1989.
Weider A, Brodman K. The Cornell Index; a method for quickly assaying personality and psychosomatic disturbances, to be used as an adjunct to interview. Psychosom Med. 1946;8(6):411–3.
Eysenck HJ, Eysenck SBG. Manual of the Eysenck personality questionnaire. London: Hodder and Stoughton; 1975.
Schalling D, Åsberg M, Edman G, Oreland L. Markers for vulnerability to psychopathology: temperament traits associated with platelet MAO activity. Acta Psychiatr Scand. 1987;76:172–82.
Ortet G, Ibáñez MI, Llerena A, Torrubia R. The underlying traits of the Karolinska scales of personality (KSP). Eur J Psychol Assess. 2002;18(2):139–48.
Antonovsky A. Unravelling the mystery of health. San Francisco: Jossey-Bass; 1987.
Antonovsky A. The structure and properties of the sense of coherence scale. Soc Sci Med. 1993;36:725–33.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.
Bauer RM, Greve KW, Besch EL, Schramke CI, Crouch J, Hicks A, et al. The role of psychological factors in the report of building-related symptoms in sick building syndrome. J Consult Clin Psychol. 1992;60:213–9.
Hedge A, Erickson WA, Rubin G. Individual and occupation- al correlates of the sick building syndrome. Indoor Air. 1995;5:10–21.
Bachmann MO, Myers JE. Influences on sick building syndrome symptoms in three buildings. Soc Sci Med. 1995;40:245–51.
Björnsson E, Janson C, Norbäck D, Boman G. 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. 1998;2(12):1023–8.
Gomzi M, Bobic J, Radosevic-Vidacek B, Macan J, Varnai VM, Milkovic-Kraus S, et al. Sick building syndrome: psychological, somatic, and environmental determinants. Arch Environ Occup Health. 2008;62(3):147–55.
Magnavita N. Work-related symptoms in indoor environments: a puzzling problem for the occupational physician. Int Arch Occup Environ Health. 2015;88(2):185–96.
Karasek RA, Theorell T. Healthy work: stress, productivity, and the reconstruction of working life. New York: Basic Books, Inc; 1990.
Johnson JV. The impact of workplace social support, job demands and work control upon cardiovascular disease in Sweden. PhD diss., John Hopkins University; Report no. 1–86, Distributed by Department of Psychology, University of Stockholm. Stockholm, Sweden. 1986.
Skov P, Valbjorn O, Pedersen BV. Influence of personal characteristics, job-related factors and psychosocial factors on the sick building syndrome. Danish indoor climate study group. Scand J Work Environ Health. 1989;15(4):286–95.
Norback D, Michel I, Widström J. Indoor air quality and personal factors related to the sick building syndrome. Scand J Work Environ Health. 1990;16:121–8.
Ooi PL, Goh KT. Sick building syndrome: an emerging stress-related disorder? Int J Epidemiol. 1997;26(6):1243–9.
Skyberg K, Skulberg KR, Eduard W, Skåret E, Levy F, Kjuus H. Symptoms prevalence among office employees and associations to building characteristics. Indoor Air. 2003;13(3):246–52.
Lahtinen M, Sundman-Digert C, Reijula K. Psychosocial work environment and indoor air problems: a questionnaire as a means of problem diagnosis. Occup Environ Med. 2004;61(2):143–9.
Runeson R, Wahlstedt K, Wieslander G, Norbäck D. Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce. Indoor Air. 2006;16(6):445–53.
Bakke JV, Moen BE, Wieslander G, Norbäck D. Gender and the physical and psychosocial work environments are related to indoor air symptoms. J Occup Environ Med. 2007;49(6):641–50.
Hansen AM, Meyer HW, Gyntelberg F. Building-related symptoms and stress indicators. Indoor Air. 2008;18(6):440–6.
Brauer C, Mikkelsen S. The influence of individual and contextual psychosocial work factors on the perception of the indoor environment at work: a multilevel analysis. Int Arch Occup Environ Health. 2010;83:639–51.
Abdel-Hamid MA, A Hakim S, Elokda EF, Mostafa NS. Prevalence and risk factors of sick building syndrome among office workers. J Egypt Public Health Assoc. 2013;88(2):109–14.
Runeson-Broberg R, Norbäck D. Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish work force. Int Arch Occup Environ Health. 2013;86(8):915–22.
Azuma K, Ikeda K, Kagi N, Yanagi U, Osawa H. Prevalence and risk factors associated with nonspecific building-related symptoms in office employees in Japan: relationships between work environment, indoor air quality, and occupational stress. Indoor Air. 2015;25:499–511.
Lukcso D, Guidotti TL, Franklin DE, Burt A. Indoor environmental and air quality characteristics, building-related health symptoms, and worker productivity in a federal government building complex. Arch Environ Occup Health. 2016;71(2):85–101.
Marmot AF, Eley J, Stafford M, Stansfeld SA, Warwick E, Marmot MG. Building health: an epidemiological study of “sick building syndrome” in the Whitehall II study. Occup Environ Med. 2006;63(4):283–9.
Runeson R, Wahlstedt K, Norbäck D. Projective drawings for assessing stress among subjects with medical symptoms compatible with sick building syndrome, and validation of a modified version of the stress load index from the drawing personality profile: a pilot study. Percept Mot Skills. 2007;104(1):111–2.
Nakazawa H, Ikeda H, Yamashita T, Hara I, Kumai Y, Endo G, et al. A case of sick building syndrome in a Japanese office worker. Ind Health. 2005;43(2):341–5.
Dalton PH, Jaén C. Responses to odors in occupational environments. Curr Opin Allergy Clin Immunol. 2010;10(2):127–32.
Feldman Barrett L. How emotions are made: the secret life of the brain. Boston: Houghton Mifflin; 2017.
Runeson-Broberg R. Manual of the Integrative Model for treatment of Environmental Illness (IMEI©). In: Swedish: Integrerad modell för behandling av miljööverkänslighet. IMEI. (Manuscript in preparation, 2Ls Logic AB. Uppsala). 2019.
Öst L-G. Single –session exposure treatment of injection phobia: a case study with continuous rate measurement. Scand J Behav Ther. 1985;16:175–84.
Zlomke K, Davis TE II. One-session treatment of specific phobias: a detailed description and review of treatment efficacy. Behav Ther. 2008;39:2007–223.
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Runeson-Broberg, R. (2020). Sick Building Syndrome (SBS), Personality, Psychosocial Factors and Treatment. In: Kishi, R., Norbäck, D., Araki, A. (eds) Indoor Environmental Quality and Health Risk toward Healthier Environment for All. Current Topics in Environmental Health and Preventive Medicine. Springer, Singapore. https://doi.org/10.1007/978-981-32-9182-9_15
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