Prevalence of the sick building syndrome symptoms in office workers before and six months and three years after being exposed to a building with an improved ventilation system.

Date:   3/3/2005 6:36:34 AM ( 19 y ago)

Sick Building Syndrome
Bernhard JD. Sick-building syndrome [Letter]. Lancet 1997; 349(9069): 1913.

Bourbeau J, Brisson C, Allaire S. Prevalence of the sick building syndrome symptoms in office workers before and six months and three years after being exposed to a building with an improved ventilation system. Occupational and Environmental Medicine 97; 54(1): 49-53.

Abstract: OBJECTIVE: The prevalence of symptoms associated with the sick building syndrome (SBS) has recently been shown to decrease by 40% to 50% among office workers six months after they were exposed to a building with an improved ventilation system. The objective of the present study was to find whether the decrease in the prevalence of symptoms was maintained three years later. METHODS: Workers from the same organisation occupied five buildings in 1991 and moved during that year to a single building with an improved ventilation system. All buildings had sealed windows with mechanical ventilation, air conditioning, and humidification. Workers completed a self administered questionnaire during normal working hours in February 1991 before moving, in February 1992 six months after moving, and in February 1995, three years after moving. The questionnaire encompassed symptoms of the eyes, nose and throat, respiratory system, skin, fatigue, and headache, as well as difficulty concentrating, personal, psychosocial, and workstation factors. During normal office hours of the same weeks, environmental variables were measured. RESULTS: The study population comprised 1390 workers in 1991, 1371 in 1993, and 1359 in 1995, which represents 80% of the population eligible each year. The prevalence of most symptoms decreased by 40% to 50% in 1992 compared with 1991. This was similar in 1995. These findings were significant and remained generally similar after controlling for personal, psychosocial, and work related factors. CONCLUSION: In this study, the decrease of 40% to 50% in the prevalence of most symptoms investigated six months after workers were exposed to a new building with an improved ventilation system was maintained three years later. The results of the present follow up study provide further support for a real effect of exposure to a new building with an improved ventilation system on the prevalence of symptoms associated with the SBS.

Chester AC, Levine PH. Concurrent sick building syndrome and chronic fatigue syndrome: epidemic neuromyasthenia revisited. Clinical Infectious Diseases 1994; 18(Supp 1): S43-8.

Abstract: Sick building syndrome (SBS) is usually characterized by upper respiratory complaints, headache, and mild fatigue. Chronic fatigue syndrome (CFS) is an illness with defined criteria including extreme fatigue, sore throat, headache, and neurological symptoms. We investigated three apparent outbreaks of SBS and observed another more serious illness (or illnesses), characterized predominantly by severe fatigue, that was noted by 9 (90%) of the 10 teachers who frequently used a single conference room at a high school in Truckee, California; 5 (23%) of the 22 responding teachers in the J wing of a high school in Elk Grove, California; and 9 (10%) of the 93 responding workers from an office building in Washington, D.C. In those individuals with severe fatigue, symptoms of mucous membrane irritation that are characteristic of SBS were noted but also noted were neurological complaints not typical of SBS but quite characteristic of CFS. We conclude that CFS is often associated with SBS.

Chester AC, Levine PH. The natural history of concurrent sick building syndrome and chronic fatigue syndrome. Journal of Psychiatric Research 1997; 31(1): 51-57.

Abstract: An outbreak of chronic fatigue syndrome linked with sick building syndrome was recently described as a new association. Whether chronic fatigue syndrome acquired in this setting tends to remit or, as sporadic cases often do, persist, is unknown. To clarify the natural history of chronic fatigue syndrome in association with sick building syndrome the 23 individuals involved in the outbreak were interviewed four years after the onset. In the previous interview one year after the onset of symptoms, 15 (including 5 with chronic fatigue syndrome and 10 with idiopathic chronic fatigue) of the 23 noted fatigue. Three years later 10 of the 15 were "fatigue free" or "much improved". Five were only "some better", "the same", or "worse". Three of the five people previously diagnosed with chronic fatigue syndrome were "much improved" (two) or "fatigue free" (one). The remaining two were seriously impaired, homebound and unable to work. The 10 individuals with substantially improved fatigue (three of the five with chronic fatigue syndrome and seven of the 10 with idiopathic chronic fatigue) were more likely to have noted improvement in nasal and sinus symptoms, sore throats, headaches, and tender cervical lymph nodes when compared to those with a lingering significant fatigue (p < 0.001). Upper respiratory symptoms and headaches improved in those with reduced fatigue but remained problematic in those with persisting significant fatigue. We conclude that the fatigue related to sick building syndrome, including chronic fatigue syndrome, is significantly more likely to improve than fatigue identified in sporadic cases of chronic fatigue syndrome.

Horvath EP. Building-related illness and sick building syndrome: from the specific to the vague. Cleveland Clinic Journal of Medicine 97; 64(6): 303-309.

Abstract: When a primary-care physician encounters a patient with a possible building-related illness, common sense applies. Does the patient have a potentially serious condition? Does he or she need a referral to a specialist? This paper explores the topics of building-related illness and sick building syndrome.

Malloy CD, Marr JS. Sick-building syndrome [Letter]. Lancet 1997; 349(9069): 1913.

Ohm M, Juto JE, Andersson K, Bodin L. Nasal histamine provocation of tenants in a sick-building residential area. American Journal of Rhinology 1997; 11(2): 167-75.

Abstract: Health problems associated with the indoor climate have aroused an increasing scientific interest, and the term "sick-building syndrome" (SBS), which describes the most frequent symptoms in this context, has been coined. However, it has been difficult to demonstrate objectively any pathophysiological changes in the subjects affected. Thirty-three healthy and nonatopic persons were randomly selected on the basis of answers in a postal questionnaire dealing with discomfort or health symptoms experienced in their home environment. Twenty-three lived in a residential area with indoor climate problems (SBS area) and 10 lived in an area without climate problems (non-SBS area). Twelve persons from the SBS area reported nasal symptoms, which they ascribed to their home environment. The remaining 11 persons from the same area, as well as the 10 subjects from the non-SBS area, had no nasal distress. They were examined with rhinostereometry during histamine provocation. Hyperreactivity, defined as mucosal swelling exceeding 0.4 mm at 5 and 10 minutes after provocation with 0.14 ml of 2 mg/ml histamine chloride, was frequent in the symptomatic SBS group as well as in the asymptomatic SBS group. The analysis of the increment of mucosal swelling for the whole range of histamine chloride concentrations (0.1 mg/ml to 16 mg/ml) showed significantly different growth curves for the three groups in the residential areas and an external reference group, (p < 0.0001). Subjects living in the SBS area were prone to nasal hyperreactivity, whether they reported symptoms from the upper airways or not. The results support the hypothesis that living in an SBS area increases the risk of developing nonspecific nasal hyperreactivity.

Redlich CA, Sparer J, Cullen MR. Sick-building syndrome. Lancet 1997; 349(9057): 1013-1016.

Abstract: Sick-building syndrome (SBS) is an increasingly common problem. Although objective physiological abnormalities are not generally found and permanent sequelae are rare, the symptoms of SBS can be uncomfortable, even disabling, and whole workplaces can be rendered non-functional. In assessment of patients with SBS complaints, specific building-related illnesses suggested by history or physical examination should be ruled out. On-site assessment of buildings is extremely useful. Treatment involves both the patient and the building. Whenever possible, changes such as ventilation improvements and reduction of sources of environmental contamination should be initiated even if specific aetiological agents have not been identified.

Tsacoyianis R. Indoor air pollutants and sick building syndrome: a case study and implications for the community health nurse. Public Health Nursing 1997; 14(1): 58-75.

Abstract: Indoor air pollutants and sick building syndrome are only recently gaining recognition as a public health concern. Unfortunately, however, most nurses feel ill equipped to address such environmental health issues. This article begins with a review of literature on indoor air pollutants and sick building syndrome, followed by a case study of occupant illness in a school since the onset of a school construction and renovation project. Included in the case study is an in-depth analysis of Material Safety Data Sheets (MSDSs) and Product Data Sheets, conducted to examine the potential health effects resulting from product use in the indoor environment. The results of the analysis indicate that a significant number of products used in the project may have induced the reported occupant symptoms. The conclusion of the case study is that building occupants were exposed to multiple products that have numerous acute overexposure health effects and unknown long-term effects, and thereby placed occupants at an ill-defined health risk. The review of literature and case study findings demonstrate the imminent need for community health nurses to assume a proactive role in promoting environmental health. nursing implications are provided to guide the community health nurse's role in cases of sick building syndrome.



 

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