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Putus T, Vilén L, Atosuo J. The Association Between Work-related Stress, Indoor Air Quality and Voice Problems Among Teachers - Is There a Trend? J Voice 2024; 38:541.e21-541.e29. [PMID: 34642072 DOI: 10.1016/j.jvoice.2021.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Hoarseness and other voice problems are common in occupations where the person has to speak, sing or shout in a work environment containing dust, noise, gaseous or particulate irritants. In recent years, stress has often been associated with voice problems. OBJECTIVE The aim of this study was to examine trends over a period of time of the prevalence of voice problems and reported stress in Finnish school buildings. STUDY DESIGN School buildings from different parts of the country were studied for ten years using a similar questionnaire (N = 1721). Five schools participated before and after the remediation of an indoor air problem in the school buildings (n = 315). RESULTS In the pilot study (2007-2008), the reported work-related stress was on a very low level (3%) and the prevalence of hoarseness was 10%. After the economic crisis in 2008, the stress was observed to have increased. During the follow-up (2008-2017), the reported stress had continued to increase and in the latest surveys it was 21% and the prevalence of hoarseness 34%. Indoor air factors correlated significantly with hoarseness even when controlling for age, gender, owning pets and job satisfaction in a logistic regression model. In the school buildings where the remediation of the building was completed, the prevalence of hoarseness decreased but the level of stress increased. In general, the proportion of respondents reporting stress was lower than the proportion of respondents with hoarseness. Additionally, the reported stress also correlated with factors other than health in the education branch, especially economic resources and major changes in the core curriculum. CONCLUSION Hoarseness and work-related stress have, to a large extent, different risk factors. Over time, the proportion of individuals with stress has been at a lower level than the proportion of respondents with voice problems; hence, we conclude that it is quite unlikely that stress would be a causative risk factor for hoarseness. We recommend that irritant dust and gases should be reduced from the work environment of teachers to enable recovery from hoarseness and other voice problems. Coping with work-related stress should be alleviated with other measures.
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Affiliation(s)
- Tuula Putus
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland.
| | - Liisa Vilén
- Department of Clinical Medicine, Environmental Medicine and Occupational Health, University of Turku, Turku, Finland
| | - Janne Atosuo
- Department of Life Technologies, The Laboratory of Immunochemistry, University of Turku, Turku, Finland
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Claeson AS, Edvardsson B, Liljelind I. Stress and Sleep in Relation to Severity of Building Related Symptoms. J Occup Environ Med 2023; 65:541-545. [PMID: 36952319 DOI: 10.1097/jom.0000000000002844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVE This study investigates different aspects of stress and sleep in medically examined individuals with varying severity of building-related symptoms (BRS). METHODS Three questionnaires were used to assess acute and long-term stress and sleep (Perceived Stress Scale; Shirom Melamed Burnout Questionnaire, and Karolinska Sleep Questionnaire). RESULTS Individuals with BRS, regardless of severity, did not differ in level of perceived stress (indicator of short-term stress). The indicators of long-term stress differed between the groups where an increased severity was associated with higher levels of burnout and sleep problems. CONCLUSIONS The study suggests an association between symptom severity and measures of long-term stress and sleep quality. This has implications for the treatment of persons affected by BRS, because not only the environment needs to be treated, but also the concurrent signs of distress, such as burnout or sleep problems.
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Affiliation(s)
- Anna-Sara Claeson
- From the Department of Psychology, Umeå University, Umeå, Sweden (A.C); and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden (B.E., I.L.)
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Azuma K, Kagi N, Yanagi U, Kim H, Osawa H. A longitudinal study on the effects of hygro-thermal conditions and indoor air pollutants on building-related symptoms in office buildings. INDOOR AIR 2022; 32:e13164. [PMID: 36437678 DOI: 10.1111/ina.13164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
We conducted a longitudinal epidemiological study for over 1 year in Tokyo and Osaka, Japan, beginning June 2015, to examine the association between indoor environmental factors and building-related symptoms (BRSs) in office workers. Data were obtained from 483 subjects (225 females and 258 males) in 24 office rooms in 11 office buildings. Environmental monitoring was conducted for hygro-thermal conditions and carbon dioxide and sampling was performed for indoor air pollutants. Questionnaires were concurrently administered to collect information on participants' perceptions of their comfort and health and the conditions of the work environments. Multivariable analyses revealed that upper respiratory symptoms were significantly correlated with a decrease in both relative [odds ratio (OR): 0.77; 95% confidence intervals (CI): 0.62-0.95; p = 0.014] and absolute humidity (OR: 0.89; 95% CI: 0.81-0.97; p = 0.008). Statistically, significant evidence was found that average relative humidity of <38% (OR: 2.68; 95% CI: 1.36-5.27; p = 0.004) showed the most significant association with increased risk of upper respiratory symptoms. Air concentrations of carbon dioxide showed no significant correlation with BRSs at mean concentrations <1000 ppm in most buildings surveyed. Most indoor air pollutant concentrations were relatively low or lower than the values set by indoor air quality guidelines and the values of thresholds for sensory irritation. Air concentrations of indoor air pollutants showed no significant correlation with BRSs. Our data emphasize the importance of appropriate humidity control during low humidity in winter.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, Japan
| | - Naoki Kagi
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, Japan
- Department of Architecture and Building Engineering, School of Environment and Society, Tokyo Institute of Technology, Tokyo, Japan
| | - U Yanagi
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, Japan
- Department of Architecture, School of Architecture, Kogakuin University, Tokyo, Japan
| | - Hoon Kim
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, Japan
| | - Haruki Osawa
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, Japan
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Švajlenka J, Kozlovská M, Pošiváková T. Analysis of the indoor environment of agricultural constructions in the context of sustainability. ENVIRONMENTAL MONITORING AND ASSESSMENT 2019; 191:489. [PMID: 31292760 DOI: 10.1007/s10661-019-7608-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/18/2019] [Indexed: 06/09/2023]
Abstract
This research paper focuses on agricultural constructions, a special type of constructions with an important role in industry and agriculture. Food production is an important social factor that is vital to human survival, so its qualitative aspect is a key determinant of living standards and is also important in terms of sustainability. The need to create a suitable environment (welfare) for animals, as a factor in terms of health and productivity, is drawing increasing attention. The environment continuously and directly affects animals, so it is quickly reflected in their productivity and medical condition. The objective of this research paper is to present an analysis of the interactions between agricultural constructions' outdoor and indoor environment by monitoring an actual operational construction designed for animal rearing, from the point of view of animal welfare and sustainability, taking into account thermal protection and indoor climate.
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Affiliation(s)
- Jozef Švajlenka
- Laboratory of Construction Technology and Management, Department of Construction Technology and Management, Faculty of Civil Engineering, Technical University of Košice, Košice, Slovak Republic.
| | - Mária Kozlovská
- Department of Construction Technology and Management, Faculty of Civil Engineering, Technical University of Košice, Košice, Slovak Republic
| | - Terézia Pošiváková
- Department of the Environment, Veterinary Legislation and Economy, University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovak Republic
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Finell E, Tolvanen A, Pekkanen J, Minkkinen J, Ståhl T, Rimpelä A. Psychosocial Problems, Indoor Air-Related Symptoms, and Perceived Indoor Air Quality among Students in Schools without Indoor Air Problems: A Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071497. [PMID: 30012972 PMCID: PMC6069432 DOI: 10.3390/ijerph15071497] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 02/07/2023]
Abstract
The effect of students' psychosocial problems on their reporting of indoor air quality (subjective IAQ) and indoor air-related (IA-related) symptoms has not been studied in schools in a longitudinal setting. Therefore, we analyzed whether changes in students' psychosocial problems (socioemotional difficulties and perceived teacher⁻student relations) between the beginning of seventh grade (age 12⁻13 years) and the end of ninth grade (15⁻16 years) predicted subjective IAQ and IA-related symptoms at the end of ninth grade. In order to explore the independent effect of psychosocial factors, we focused only on students in schools without observed indoor air problems. The analysis was of longitudinal data (N = 986 students) using latent change modelling. Increased socioemotional difficulties were related to more IA-related symptoms (standardized beta = 0.20) and deteriorated subjective IAQ (standardized beta = 0.20). Increased problems in teacher⁻student relations were related to deteriorated subjective IAQ (standardized beta = 0.21). Although students' psychosocial problems explained only 9⁻13% of the total variances, our findings support the notion that psychosocial factors also need to be taken into account in the evaluation of IAQ and the prevalence of IA-related symptoms in schools.
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Affiliation(s)
- Eerika Finell
- Faculty of Social Sciences (Social Sciences), University of Tampere, 33014 Tampere, Finland.
| | - Asko Tolvanen
- Methodology Centre for Human Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland.
| | - Juha Pekkanen
- Department of Public Health, University of Helsinki, 00014 Helsinki, Finland.
- Department of Health Security, National Institute for Health and Welfare, 70701 Kuopio, Finland.
| | - Jaana Minkkinen
- Faculty of Social Sciences (Psychology), University of Tampere, 33014 Tampere, Finland.
| | - Timo Ståhl
- Department of Welfare, National Institute for Health and Welfare, 33520 Tampere, Finland.
| | - Arja Rimpelä
- Faculty of Social Sciences (Health Sciences), University of Tampere, 33014 Tampere, Finland.
- PERLA (Tampere Centre for Childhood, Youth and Family Research), University of Tampere, 33014 Tampere, Finland.
- Department of Adolescent Psychiatry, Tampere University Hospital, 33380 Nokia, Finland.
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Carrer P, Wolkoff P. Assessment of Indoor Air Quality Problems in Office-Like Environments: Role of Occupational Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040741. [PMID: 29649167 PMCID: PMC5923783 DOI: 10.3390/ijerph15040741] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 03/31/2018] [Accepted: 04/09/2018] [Indexed: 11/30/2022]
Abstract
There is an increasing concern about indoor air quality (IAQ) and its impact on health, comfort, and work-performance in office-like environments and their workers, which account for most of the labor force. The Scientific Committee on Indoor Air Quality and Health of the ICOH (Int. Comm. Occup. Health) has discussed the assessment and management of IAQ problems and proposed a stepwise approach to be conducted by a multidisciplinary team. It is recommended to integrate the building assessment, inspection by walk-through of the office workplace, questionnaire survey, and environmental measurements, in that order. The survey should cover perceived IAQ, symptoms, and psychosocial working aspects. The outcome can be used for mapping the IAQ and to prioritize the order in which problems should be dealt with. Individual health surveillance in relation to IAQ is proposed only when periodical health surveillance is already performed for other risks (e.g., video display units) or when specific clinical examination of workers is required due to the occurrence of diseases that may be linked to IAQ (e.g., Legionnaire’s disease), recurrent inflammation, infections of eyes, respiratory airway effects, and sensorial disturbances. Environmental and personal risk factors should also be compiled and assessed. Workplace health promotion should include programs for smoking cessation and stress and IAQ management.
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Affiliation(s)
- Paolo Carrer
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, 20157 Milan, Italy.
| | - Peder Wolkoff
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark.
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Švajlenka J, Kozlovská M, Pošiváková T. Assessment and biomonitoring indoor environment of buildings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2017; 27:427-439. [PMID: 28868901 DOI: 10.1080/09603123.2017.1373276] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 08/26/2017] [Indexed: 05/23/2023]
Abstract
Ensuring hygiene and health protection is one of the basic construction requirements. Such requirements are examined when commissioning new constructions and examining defects in constructions already in use. One substantial defect is biocorrosion which represents a synergistic process with a complex variety of factors. It is caused by biochemical manifestations of various micro-organisms (micromycetes). Micromycetes producing mycotoxins therefore play an important role regarding the so-called 'Sick Building Syndrome' that has become a global problem nowadays. The case study presented here aims to demonstrate the effectiveness of the diagnostic methods used in assessing the presence of micromycetes in a building's internal atmosphere and on the internal surfaces of a construction built using traditional construction methods. The methodology of comparing methods is based on their effectiveness, taking into account the identification of type and intensity of micromycetes presence in the air and on the material surfaces in the monitored areas.
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Affiliation(s)
- Jozef Švajlenka
- a Department of Construction Technology and Management, Faculty of Civil Engineering , Technical University of Kosice , Košice , Slovak Republic
| | - Mária Kozlovská
- a Department of Construction Technology and Management, Faculty of Civil Engineering , Technical University of Kosice , Košice , Slovak Republic
| | - Terézia Pošiváková
- b Department of Environment, Veterinary Legislative and Economics , University of Veterinary Medicine and Pharmacy in Košice , Košice , Slovak Republic
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Azuma K, Ikeda K, Kagi N, Yanagi U, Osawa H. Evaluating prevalence and risk factors of building-related symptoms among office workers: Seasonal characteristics of symptoms and psychosocial and physical environmental factors. Environ Health Prev Med 2017; 22:38. [PMID: 29165170 PMCID: PMC5664800 DOI: 10.1186/s12199-017-0645-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 02/01/2017] [Indexed: 01/21/2023] Open
Abstract
Background Psychosocial and environmental factors at the workplace play a significant role in building-related symptoms (BRSs). Environmental factors change during summer cooling and winter heating using air-conditioning systems. Thus, significant risk factors in each season need to be clarified. Methods A nationwide cross-sectional study was conducted during summer in Japan and seasonal differences between summer and winter were evaluated. Self-administered questionnaires were distributed to 489 offices. Possible risk factors for BRSs associated with the work environment, indoor air quality, and job stressors were examined by multiple regression analyses. Results Among people having at least one BRS, the prevalence of BRSs in summer (27.8%) was slightly higher than that in winter (24.9%). High prevalence was observed for eye and nasal symptoms related to dryness and general symptoms related to psychological distress in both seasons. Analyses revealed that dryness of air was an important and significant risk factor associated with BRSs, and job stressors were significantly associated with general symptoms in both seasons. Conversely, humidity was a significant risk factor of general symptoms in summer (odds ratio, 1.20; 95% confidence interval, 1.02–1.43). Carpeting, recently painted walls, and unpleasant chemical odors in summer and noise, dust and dirt, and unpleasant odors such as body or food odors in both seasons were significant risk factors for BRSs. Conclusions Improvements in the physical environmental qualities in an office throughout the year are important along with the reduction in psychological distress related to work. Electronic supplementary material The online version of this article (doi:10.1186/s12199-017-0645-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan.
| | - Koichi Ikeda
- Department of Architecture, College of Science and Technology, Nihon University, 8-14 Kanda-Surugadai 1-chome, Chiyoda-ku, Tokyo, 101-8308, Japan
| | - Naoki Kagi
- Department of Mechanical and Environmental Informatics, Graduate School of Information Science and Engineering, Tokyo Institute of Technology, 2-12-1 Ookayama, Meguro-ku, Tokyo, 152-8550, Japan
| | - U Yanagi
- Department of Architecture, School of Architecture, Kogakuin University, 1-24-2 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 163-8677, Japan
| | - Haruki Osawa
- Department of Environmental Health, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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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. [PMID: 25244340 DOI: 10.1111/ina.12158] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 09/11/2014] [Indexed: 06/03/2023]
Abstract
A nationwide cross-sectional study of 3335 employees was conducted in 320 offices in Japan to estimate the prevalence of building-related symptoms (BRSs) and determine the risk factors related to work environment, Indoor Air Quality, and occupational stress. Data were collected through self-administered questionnaires. The prevalences of general symptoms, eye irritation, and upper respiratory symptoms were 14.4%, 12.1%, and 8.9%, respectively. Multiple logistic regression analyses revealed that eye irritation was significantly associated with carpeting [odds ratio (OR), 1.73; 95% confidence interval (CI), 1.24-2.41], coldness perception (OR, 1.28; 95% CI, 1.13-1.45), and air dryness perception (OR, 1.61; 95% CI, 1.42-1.82). General symptoms were significantly associated with unpleasant odors (OR, 1.37; 95% CI, 1.13-1.65), amount of work (OR, 1.24; 95% CI, 1.06-1.45), and interpersonal conflicts (OR, 1.44; 95% CI, 1.23-1.69). Upper respiratory symptoms were significantly associated with crowded workspaces (OR, 1.36; 95% CI, 1.13-1.63), air dryness perception (OR, 2.07; 95% CI, 1.79-2.38), and reported dustiness on the floor (OR, 1.39; 95% CI, 1.16-1.67). Although psychosocial support is important to reduce and control BRSs, maintaining appropriate air-conditioning and a clean and uncrowded workspace is of equal importance.
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Affiliation(s)
- K Azuma
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, Osakasayama, Osaka, Japan
| | - K Ikeda
- Department of Architecture, College of Science and Technology, Nihon University, Chiyoda-ku, Tokyo, Japan
| | - N Kagi
- Department of Mechanical and Environmental Informatics, Graduate School of Information Science and Engineering, Tokyo Institute of Technology, Meguro-ku, Tokyo, Japan
| | - U Yanagi
- Department of Architecture, School of Architecture, Kogakuin University, Shinjuku-ku, Tokyo, Japan
| | - H Osawa
- National Institute of Public Health, Wako, Saitama, Japan
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Jung CC, Liang HH, Lee HL, Hsu NY, Su HJ. Allostatic load model associated with indoor environmental quality and sick building syndrome among office workers. PLoS One 2014; 9:e95791. [PMID: 24759685 PMCID: PMC3997416 DOI: 10.1371/journal.pone.0095791] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 03/31/2014] [Indexed: 11/18/2022] Open
Abstract
This study investigates whether indoor environmental quality (IEQ) influences allostatic load (AL) and whether AL can be a predictor for sick building syndrome (SBS). We also assessed and compared the associations between AL and SBS versus 8-hydroxydeoxyguanosine (8-OHdG) and SBS. A total of 115 office workers from 21 offices completed self-reported SBS questionnaires, and provided 11 biomarkers for their AL. Multiple linear regressions and logistic regression analysis were applied to examine the correlations between IEQ and AL or 8-OHdG and between AL or 8-OHdG and SBS, respectively. Our data revealed that the neuroendocrine system was correlated with CO2, the difference between indoor and outdoor CO2 levels (dCO2), and the indoor-outdoor ratio of CO2 (CO2 I/O). Metabolic system effects were associated with illumination. The relationships between illumination, CO2, dCO2, CO2 I/O and 8-OHdG were consistent with those and AL in specific systems. Furthermore, we found that risks for SBS syndromes were related with neuroendocrine and metabolic system of the AL. 8-OHdG was associated with eye dryness or irritation, eye tiredness and vomiting. We conclude that IEQ significantly influences AL and that AL can be a predictor for reporting SBS with information on system-specific effects.
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Affiliation(s)
- Chien-Cheng Jung
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan city, Taiwan
| | - Hsiu-Hao Liang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan city, Taiwan
| | - Hui-Ling Lee
- Department of Chemistry, College of Science and Engineering, Fu Jen Catholic University, New Taipei city, Taiwan
| | - Nai-Yun Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan city, Taiwan
| | - Huey-Jen Su
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan city, Taiwan
- * E-mail:
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Ervasti J, Kivimäki M, Kawachi I, Subramanian SV, Pentti J, Oksanen T, Puusniekka R, Pohjonen T, Vahtera J, Virtanen M. School environment as predictor of teacher sick leave: data-linked prospective cohort study. BMC Public Health 2012; 12:770. [PMID: 22966903 PMCID: PMC3490775 DOI: 10.1186/1471-2458-12-770] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 09/10/2012] [Indexed: 11/21/2022] Open
Abstract
Background Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers. Methods Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers’ (n = 1678) sick leaves in 2001–02 and in 2004–05. Results Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves. Conclusions Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland.
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Zhang X, Sahlberg B, Wieslander G, Janson C, Gislason T, Norback D. Dampness and moulds in workplace buildings: associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 430:75-81. [PMID: 22634552 DOI: 10.1016/j.scitotenv.2012.04.040] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Revised: 04/16/2012] [Accepted: 04/16/2012] [Indexed: 06/01/2023]
Abstract
There are few longitudinal studies on health effects of dampness and moulds in workplace buildings. We studied associations between dampness and indoor moulds in workplace buildings and selected biomarkers as well as incidence and remission of sick building syndrome (SBS). The study was based on a ten-year prospective study (1992-2002) in a random sample of adults (N=429) from the Uppsala part of the European Community Respiratory Health Survey (ECRHS). The 10-year incidence (onset) of general, mucosal, dermal symptoms and any symptom improved when away from the workplace (work-related symptoms) was 7.2%, 11.6%, 6.4% and 9.4% respectively. The 10-year remission of general, mucosal, dermal symptoms and work-related symptoms was 71.4%, 57.1%, 70.4% and 72.2% respectively. Signs of dampness in the floor construction in any workplace building during follow up (cumulative exposure) was associated with incidence of mucosal symptoms (OR=2.43). Cumulative exposure to moldy odor was associated with incidence of work-related symptoms (OR=2.69). Cumulative exposure to dampness or moulds was associated with decreased remission of work-related symptoms (OR=0.20 for water leakage, OR=0.17 for floor dampness, and OR=0.17 for visible indoor mould growth). Working in a building repaired because of dampness (repaired building) or mould was associated with decreased remission of work-related symptoms (OR=0.32). Any dampness or moulds at baseline in the workplace building was associated with increased bronchial responsiveness (BR) and higher levels of Eosinphilic Cationic Protein (ECP) in serum and Eosinophilic counts in blood at baseline. Cumulative exposure to dampness and moulds, and work in a repaired building, was associated with increased BR at follow-up. In general, dampness and moulds in the workplace building is associated with increased incidence and decreased remission of SBS, as well as increased bronchial responsiveness and eosinophilic inflammation.
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Affiliation(s)
- Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, 030006, Taiyuan, China.
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Zhang X, Zhao Z, Nordquist T, Norback D. The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: a two-year follow-up study. INDOOR AIR 2011; 21:462-471. [PMID: 21615503 DOI: 10.1111/j.1600-0668.2011.00726.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear. PRACTICAL IMPLICATIONS We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.
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Affiliation(s)
- X Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China.
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Zhang X, Zhao Z, Nordquist T, Larsson L, Sebastian A, Norback D. A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:5253-5259. [PMID: 21943723 DOI: 10.1016/j.scitotenv.2011.08.059] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 08/23/2011] [Accepted: 08/25/2011] [Indexed: 05/31/2023]
Abstract
There are few longitudinal studies on sick building syndrome (SBS), which include ocular, nasal, throat, and dermal symptoms, headache, and fatigue. We studied the associations between selected microbial components, fungal DNA, furry pet allergens, and incidence and remission of SBS symptoms in schools in Taiyuan, China. The study was based on a two-year prospective analysis in pupils (N=1143) in a random sample of schools in China. Settled dust in the classrooms was collected by vacuum cleaning and analyzed for lipopolysaccharide (LPS), muramic acid (MuA), and ergosterol (Erg). Airborne dust was collected in Petri dishes and analyzed for cat and dog allergens and fungal DNA. The relationship between the concentration of allergens and microbial compounds and new onset of SBS was analyzed by multi-level logistic regression. The prevalence of mucosal and general symptoms was 33% and 28%, respectively, at baseline, and increased during follow-up. At baseline, 27% reported at least one symptom that improved when away from school (school-related symptoms). New onset of mucosal symptoms was negatively associated with concentration of MuA, total LPS, and shorter lengths of 3-hydroxy fatty acids from LPS, C14, C16, and C18. Onset of general symptoms was negatively associated with C18 LPS. Onset of school-related symptoms was negatively associated with C16 LPS, but positively associated with total fungal DNA. In general, bacterial compounds (LPS and MuA) seem to protect against the development of mucosal and general symptoms, but fungal exposure measured as fungal DNA could increase the incidence of school-related symptoms.
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Affiliation(s)
- Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, 030006 Taiyuan, China.
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