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Indoor Environment in Dwellings and Sick Building Syndrome (SBS): Longitudinal Studies
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

People spend most of their time indoors and mostly in the dwelling. It is therefore important to investigate associations between indoor exposure in dwellings and health. Symptoms that may be related to the indoor environment are sometimes referred to as the "sick building syndrome" (SBS). SBS involves symptoms such as eye, skin and upper airway irritation, headache and fatigue. Three longitudinal studies and one prevalence study on personal and environmental risk factors for SBS in adults were performed. The prevalence study included measurements of indoor exposures in the dwellings. The longitudinal studies, with 8-10 years follow-up time, showed that smoking and indoor paint emissions were risk factors for SBS. Moreover, building dampness and moulds in dwellings were risk factors for onset (incidence) of general symptoms, skin symptoms and mucosal symptoms. In addition subjects living in damp dwellings have a lower remission of general symptoms and skin symptoms. Hay fever was a risk factor for onset of skin symptoms and mucosal symptoms, and asthma was a risk factor for onset of general and mucosal symptoms. Biomarkers of allergy and inflammation (bronchial reactivity, total IgE, ECP and eosinophil count) were predictors of onset of SBS symptoms, in particular mucosal symptoms. In the prevalence study, any SBS-symptom was associated with some individual volatile organic compounds of possible microbial origin (MVOC) e.g. 2-pentanol, 2-hexanon, 2-pentylfuran and 1-octen-3ol. Moreover, there were associations between indoor levels of formaldehyde and the plasticizer Texanol and any SBS. The result from the study indicates that individual MVOC are better indicators of SBS than the total value of MVOC. A final conclusion is that smoking, dampness and moulds and emissions from indoor painting may increase the onset of SBS. The indoor environment in dwellings over time has improved, but there is still a need for further improvements of the indoor environment in dwellings. More longitudinal SBS studies are needed.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. , 63 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 783
Keyword [en]
Indoor environment, sick building syndrome (SBS), dwelling, longitudinal cohort study, building dampness, mould, microbial volatile organic compounds (MVOC), biomarkers, asthma, risk factors
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
URN: urn:nbn:se:uu:diva-172769ISBN: 978-91-554-8393-7 (print)OAI: oai:DiVA.org:uu-172769DiVA: diva2:523987
Public defence
2012-06-13, Frödingsalen, Ulleråkersvägen 40, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-05-23 Created: 2012-04-13 Last updated: 2012-08-01Bibliographically approved
List of papers
1. Indoor environment in dwellings, asthma, allergies, and sick building syndrome in the Swedish population: a longitudinal cohort study from 1989 to 1997
Open this publication in new window or tab >>Indoor environment in dwellings, asthma, allergies, and sick building syndrome in the Swedish population: a longitudinal cohort study from 1989 to 1997
2009 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, no 10, 1211-1218 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate changes of sick building syndrome (SBS) and different types of indoor exposures at home over an 8-year follow-up period (1989-1997), and onset of SBS symptoms in relation to size of residence town and education level. METHODS: A random sample (0.1%) of the population in a 3-county region in Sweden, initially aged 20-65 years (n = 466). In total, 348 (75%) answered the postal follow-up questionnaire. RESULTS: Water leakage during the last year had decreased from 11.2 to 4.8% visible indoor mould had decreased from 4.7 to 1.6%, and any sign of building dampness decreased from 16.1 to 9.5%. The prevalence of current smoking had decreased from 30 to 19%. Smokers at baseline reported more onset of SBS symptoms than non-smokers. Furthermore, remission from mucosal symptoms was less likely in subjects that were tobacco smoker. Subjects with any indoor painting during follow-up period reported more onset of SBS symptoms, and those with intermediate education level had more onset of skin symptoms. CONCLUSION: Smoking and indoor painting could be predictors of new onset of SBS symptoms. Focus on indoor environment in Sweden the last decades may have resulted in environmental improvements in the dwellings, which can be beneficial both for the inhabitants and for the future public health.

Keyword
Asthma, Building dampness, Sick building syndrome, Indoor environment, Cohort study, Risk factors
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-122946 (URN)10.1007/s00420-009-0444-3 (DOI)000271200400005 ()19618200 (PubMedID)
Available from: 2010-04-21 Created: 2010-04-21 Last updated: 2017-12-12Bibliographically approved
2. Sick building syndrome in relation to domestic exposure in Sweden: A cohort study from 1991 to 2001
Open this publication in new window or tab >>Sick building syndrome in relation to domestic exposure in Sweden: A cohort study from 1991 to 2001
2010 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 3, 232-238 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Most studies on sick building syndrome (SBS) are cross-sectional and have dealt with symptoms among office workers. There are very few longitudinal cohort studies and few studies on SBS in relation to domestic exposures. The aim of this study was to investigate changes in SBS symptoms during the follow-up period and also to investigate changes in different types of indoor exposures at home and relate them to SBS symptoms in a population sample of adults from Sweden. We also wanted to investigate if there was any seasonal or regional variation in associations between exposure and SBS. METHODS: A random sample of 1,000 people of the general population in Sweden (1991) was sent a self administered questionnaire. A follow-up questionnaire was sent in 2001. RESULTS: An increased risk for onset of any skin symptoms (risk ratio (RR) 2.32, 1.37-3.93), mucosal symptoms (RR 3.17, 1.69-5.95) or general symptoms (RR 2.18, 1.29-3.70) was found for those who had dampness or moulds in the dwelling during follow-up. In addition people living in damp dwellings had a lower remission of general symptoms and skin symptoms. CONCLUSIONS: Dampness in the dwelling is a risk factor for new onset of SBS symptoms. Focus on indoor environment improvements in dwellings can be beneficial both for the inhabitants and the general population. Reducing dampness in buildings is an important factor for reducing SBS symptoms in the general population.

Keyword
Asthma, building dampness, cohort study moulds, indoor environment, sick building syndrome (SBS) Introduction Sick
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-122947 (URN)10.1177/1403494809350517 (DOI)000277168800002 ()19850651 (PubMedID)
Available from: 2010-04-21 Created: 2010-04-21 Last updated: 2017-12-12Bibliographically approved
3. Onset of mucosal, dermal, and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 2002
Open this publication in new window or tab >>Onset of mucosal, dermal, and general symptoms in relation to biomarkers and exposures in the dwelling: a cohort study from 1992 to 2002
Show others...
2012 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 22, no 4, 331-338 p.Article in journal (Refereed) Published
Abstract [en]

We examined the associations between biomarkers of allergy and inflammation, indoor environment in dwellings, and incidence and remission of symptoms included in the sick building syndrome (SBS) and changes in the home environment of 452 adults who were followed from 1992 to 2002 within the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, and dermal symptoms was 8.5%, 12.7%, and 6.8%, respectively. Dampness or indoor molds at baseline was a predictor of incidence of general (relative risk [RR] = 1.98), mucosal (RR = 2.28), and dermal symptoms (RR = 1.91). Women had higher incidence of general (RR = 1.74) and mucosal symptoms (RR = 1.71). Indoor painting increased the incidence of general symptoms (RR = 1.62). Bronchial responsiveness (BR), eosinophil counts in blood, total IgE and eosinophilic cationic protein (ECP) in serum at baseline were predictors of incidence of SBS. At follow-up, BR, total IgE, and C-reactive protein (CRP ) were associated with increased incidence of SBS. Moreover, subjects with doctor-diagnosed asthma at baseline had a higher incidence of general (RR = 1.65) and mucosal symptoms (RR = 1.97). In conclusion, female gender, dampness or indoor molds, indoor painting, and biomarkers of allergy and inflammation were associated with a higher incidence of SBS symptoms, in particular mucosal symptoms.

Place, publisher, year, edition, pages
John Wiley & Sons, 2012
Keyword
Biomarkers, Indoor environment, Longitudinal cohort study, Asthma, Sick building syndrome (SBS), Dwelling
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-172535 (URN)10.1111/j.1600-0668.2012.00766.x (DOI)000306223500008 ()22257085 (PubMedID)
Available from: 2012-04-11 Created: 2012-04-11 Last updated: 2017-12-07Bibliographically approved
4. Airborne moulds and bacteria, microbial volatile organic compounds (MVOC), plasticizers and formaldehyde in dwellings in three North European cities in relation to sick building syndrome (SBS)
Open this publication in new window or tab >>Airborne moulds and bacteria, microbial volatile organic compounds (MVOC), plasticizers and formaldehyde in dwellings in three North European cities in relation to sick building syndrome (SBS)
Show others...
(English)Manuscript (preprint) (Other academic)
Abstract [en]

There are few studies on associations between airborne microbial exposure, formaldehyde and plasticizers in dwellings and symptoms compatible with the sick building syndrome (SBS). Within the follow-up of the European Community Respiratory Health Survey (ECRHS II), indoor measurements were performed in homes in three north European cities. The aim was to examine if volatile organic compound of possible microbial origin (MVOC), and airborne levels of bacteria, moulds, formaldehyde and two plasticizers in dwellings were associated with the prevalence of SBS, and to study associations between MVOC and reports on dampness and mould.

The study included homes from three centres from ECRHS II. In total, 159 adults (57% females) participated (19% from Reykjavik, 40% from Uppsala and 41% from Tartu). A random sample and additional homes with a history of dampness were included. Exposure measurements were performed in the 159 homes. MVOC was analysed by GCMS with selective ion monitoring (SIM). Symptoms were reported in a standardized questionnaire. Associations were analysed by multiple logistic regression.

 

Totally 30.8% reported any SBS (20% mucosal,10% general and 8% dermal symptoms) and 41% of the homes had a history of dampness and moulds There were positive associations between any SBS and levels of 2-pentanol (p=0.002), 2-hexanon (P=0.0002), 2-pentylfuran (P=0.009), 1-octen-3ol (P=0.002), formaldehyde (P=0.05), and 2,2,4-trimethyl-1,3-pentanediol monoisobutyrate (Texanol) (P=0.05). 1-octen-3ol was associated with mucosal symptoms. In dwelling with dampness and moulds, the levels of total bacteria (P=0.02), total mould (p=0.04), viable mould (p=0, 02), 2-methylfuran (p=0.008) and etyl-iso-butyrate (p=0.02) were higher.

In conclusion, some MVOC such as 1-octen-3-ol, formaldehyde and the plasticizer Texanol may be a risk factor for sick building syndrome. Moreover concentration of airborne moulds, bacteria and some other MVOC were slightly higher in homes with reported dampness and mould.

Keyword
Microbial volatile organic compounds (MVOC), indoor environment, sick building syndrome (SBS), dwelling, dampness, mould.
National Category
Environmental Health and Occupational Health
Research subject
Occupational and Environmental Medicine
Identifiers
urn:nbn:se:uu:diva-172537 (URN)
Available from: 2012-04-11 Created: 2012-04-11 Last updated: 2012-08-01

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