Prevalence and risk factors of pre-sick building syndrome: characteristics of indoor environmental and individual factors

AWMF mold guideline "Medical clinical diagnostics for indoor mold exposure" - Update 2023 AWMF Register No. 161/001

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Is indoor environment a risk factor of building-related symptoms?

The indoor environment, particularly indoor air quality (IAQ), is significantly associated with building-related symptoms (BRSs) in humans. In our previous studies, we demonstrated a significant relationship between BRSs and indoor chemical concentrations. In Japan, the Ministry of Health, Labor, and Welfare (MHLW) guideline recommends an air quality target of 13 volatile organic compounds (VOCs) and a provisional target of 400 μg/m3 for total VOCs (TVOC). The objective of this study was to determine the relationship between TVOC levels and the risk of BRSs using the Japanese provisional target TVOC level of 400 μg/m3. The relationship between odor intensity and BRSs while the TVOC levels were under 400 μg/m3 was also examined. The study was conducted in a laboratory house (LH) on the campus of Chiba University from 2017-2019. The study included 149 participants who spent 60 minutes in the LH. The participants were asked to evaluate the IAQ of the LH. A significant relationship between the risk of BRSs and the provisional target TVOC level was observed (odds ratio: 2.94, 95% confidence interval: 1.18-7.35). Furthermore, a significant relationship between odor intensity and risk of BRSs in spaces with TVOC levels less than 400 μg/m3 was detected (odds ratio: 6.06, 95% confidence interval: 1.21-30.44). In conclusion, the risk of BRSs is significantly lower in spaces with low TVOC levels and low odor intensity. Reducing the concentration of airborne chemicals and odor intensity may improve IAQ and prevent BRSs.

Analysis of the Interior Microclimate in Art Nouveau Heritage Buildings for the Protection of Exhibits and Human Health

Poor air quality inside museums can have a double effect; on the one hand, influencing the integrity of the exhibits and on the other hand, endangering the health of employees and visitors. Both components can be very sensitive to the influence of the internal microclimate, therefore careful monitoring of the physical parameters and pollutants is required in order to maintain them within strict limits and thus to reduce the hazards that can be induced. The current study considers the determination and analysis of 15 indicators of the internal microclimate in an Art Nouveau museum built at the beginning of the 20th century in the Municipality of Oradea, Romania. The monitoring spanned a period of seven months, between September 2021 and March 2022, targeting three rooms of the museum with different characteristics and containing exhibits with a high degree of fragility. The results show that, although there are numerous indicators that have exceeded the thresholds induced by international standards, the possible negative impact on the exhibits and/or on human health remains moderate. This is due to the fact that, most of the time, exceeding the permitted limits are small or only sporadic, the values quickly returning to the permitted limits. Thus, only 22 of the 212 days of monitoring recorded marginal conditions regarding the quality of the indoor air, the rest having acceptable and good conditions. To improve the indoor conditions, a more careful management is needed, especially regarding the values of temperature, humidity, particulate matters, natural and artificial light, volatile organic compounds (VOC) and formaldehyde (HCHO), which during the measurements recorded high values that fluctuated in a wide spectrum. The obtained results can represent the basis for the development and implementation of long-term strategies for stabilizing the microclimatic conditions in the museum in order to preserve the exhibits preventively and to ensure a clean and safe environment for people.

Effects of occupant behaviors on perceived dormitory air quality and sick building syndrome symptoms among female college students

We performed a cross-sectional survey of 2143 female students in a university in Tianjin, China regarding perceived air quality (PAQ) and sick building syndrome (SBS) symptoms in the student dormitory. The prevalence of general, mucosal, and skin symptoms was 22.1%, 21.9%, and 26.3%, respectively. The three most prevalent PAQ complaints were "dry air" (48.9% often), "stuffy odor" (18.2%), and "other unpleasant odors" (5.1%), and they were significant risk factors for 11-12 out of 12 SBS symptoms (adjusted odds ratios [AOR]: 1.6-5.8). Survey data of 1471 undergraduates, whose dorms were of uniform layout and furnishing, were used to further investigate the influences of occupancy level and occupant behaviors on PAQ and SBS symptoms. Frequent use of air freshener/perfume was a significant risk factor for "dry air," less frequent room cleaning and higher occupancy density were significant risk factors for "stuffy odor," and less natural ventilation was a significant risk factor for both "stuffy odor" and "pungent odor." These factors were also significantly associated with some SBS symptoms. In particular, the use of air freshener/perfume exhibited a significant dose-response pattern with "fatigue" (sometimes: AOR 1.3; often: AOR 2.0) and with "irritated, stuffy, or runny nose" (sometimes: AOR 1.6; often: AOR 2.2).

Associations between indoor environment and lifestyles and sick building syndrome symptoms among adults in Taiyuan and Urumqi of China

The complex and uncertain causes of sick building syndrome (SBS) have become one of the most challenging and hot issues worldwide. Studies on the correlation between indoor environment and SBS based on local characteristics are relatively limited in China. We studied typical SBS risk factors related to the indoor environment and lifestyle in two northern Chinese cities. The study population was drawn from parents of pre-school children in randomized daycare centers in Taiyuan, Shanxi, and Urumqi, Xinjiang, China (N = 6838). Data on SBS and indoor environment were obtained from cross-sectional questionnaires. Odds ratios (OR) were estimated by multilevel logistic regression and adjusted using gender, atopy, own smoking, home size, and dampness index. Results showed that location, homeownership, year of construction completion, changes in the indoor environment (new furniture and decorations), and changes in indoor air (smoking, burning mosquito repellent and incense, cooking fuels including electricity, natural gas, coal, and wood) might contribute to different levels of SBS in Chinese adults, including eye, nasal, throat, dermal symptoms, and headache and tiredness. The results of the subgroup analysis suggest city and gender differences in susceptibility. Daily cleaning, window opening, and improved ventilation effectively improved SBS. People should improve their indoor environment and lifestyles based on sensitivity factors, gender, and geographic characteristics to reduce SBS risks.

Exposures, Symptoms and Risk Perception among Office Workers in Relation to Nanoparticles in the Work Environment

Submicroscopic nanoparticles (NPs) in air have received much attention due to their possible effects on health and wellbeing. Adverse health impacts of air pollution may not only be associated with level of exposure, but also mediated by the perception of the pollution and by beliefs of the exposure being hazardous. The aim of this study was to test a model that describes interrelations between NP pollution, perceived air quality, health risk perception, stress, and sick building syndrome. In the NanoOffice study, the level of NPs was measured and a survey on health risk perception was conducted among 260 employees in twelve office buildings in northern Sweden. Path analyses were performed to test the validity of the model. The data refute the model proposing that the NP exposure level significantly influences stress, chronic diseases, or SBS symptoms. Instead, the perceived exposure influences the perceived risk of NP, and the effect of perceived exposure on SBS and chronic disease is mediated by stress. There was little concern about nanoparticles, despite relatively high levels in some facilities. Perceived pollution and health risk perception may explain a large part of the environmentally induced symptoms and diseases, particularly in relatively low levels of pollution. The research results raise important questions on the physiologically or psychologically mediated health effects of air pollution.

Assessment of Personal Relaxation in Indoor-Air Environments: Study in Real Full-Scale Laboratory Houses

The relationship between chemical concentrations in indoor air and the human sense of comfort and relaxation have been reported. We investigated the effect of the sum of volatile organic compounds (ΣVOCs; sum of 79 VOCs) on the level of relaxation in two laboratory houses with almost identical interior and exterior appearances. The electroencephalogram (EEG) was monitored to evaluate the degree of personal relaxation objectively. The experiments were conducted in laboratory houses (LH) A and B with lower and higher levels of ΣVOCs, respectively. A total of 168 healthy volunteers participated, who each performed the task for 20 min, followed by a 10-min break, and EEG was measured during the break. Simultaneously as subjective evaluations, the participants were asked to fill a questionnaire regarding the intensity of odor and preference for the air quality in each LH. The subjective evaluation showed a significant association between ΣVOCs and participants’ relaxation (OR: 2.86, 95%CI: 1.24–6.61), and the objective evaluation indicated that the participants were more relaxed in the LH with lower levels of ΣVOCs than that with higher levels (OR: 3.03, 95%CI: 1.23–7.50). Therefore, the reduction of ΣVOCs and odors in indoor air would have an effect, which is the promotion of relaxation.

Airborne fungi in Universiti Sains Malaysia: knowledge, density and diversity

Airborne fungi are among common contaminants in indoor and outdoor environments, leading to poor indoor air quality (IAQ), and to some extent, implicate health risks to humans worldwide. In Malaysia, fungal contamination in institutional buildings is rarely documented although these places are frequently visited by many. This study was conducted to assess the density and diversity of airborne fungi in Universiti Sains Malaysia (USM) main campus, Penang. A total of 11 sampling sites were assessed. Fungi were collected by using Andersen Single Stage Impact Air Sampler N-6 and MEA plates. Two separate trials, namely Trial 1 and Trial 2, were conducted in 2008 and 2019, respectively. The recovered fungi were identified up to the genus level-based morphological features. A survey involving 400 respondents among USM staff and students in relation to fungal contamination in indoor air environment was also conducted to evaluate the knowledge on indoor fungi among USM community. The densities of indoor air fungi in Trial 1 were higher; ranging from 81 to 1743 CFU/m³, exceeding the recommended level set by the Malaysia Industry Code of Practice (MCPIAQ) in some sampling sites, compared to that of in Trial 2 where the densities ranged from 229 to 699 CFU/m³. A total of 154 isolates and 230 isolates of airborne fungi were recovered in Trial 1 and Trial 2, respectively. In total, 11 fungal genera were identified in both trials, and three genera were predominant: Aspergillus, Penicillium, and Cladosporium. The survey also revealed that knowledge of IAQ among staff and students was limited and that they were unaware of fungal contamination and IAQ. A continuous and wide-spread awareness should be implemented at USM main campus for safer and healthier indoor air environments, particularly university students where productivity and efficiency are of the utmost importance.

Evaluation of the relationship between sick building syndrome complaints among hospital employees and indoor environmental quality

Background:

Sick building syndrome (SBS) is defined as a condition occurring in people who live or work in a modern building and who suffer from complaints such as headache, fatigue, lack of concentration, and irritation of the skin and mucous membranes.

Objectives:

The aim of this study is to examine the complaints associated with SBS in the employees of our hospital and evaluate the relationship between the characteristics of the work environment and the complaints of SBS.

Methods:

890 workers participated in the study. The complaints of the participants were rated and the sum of all complaints was recorded as the Total Complaint Score (TCS). The mean TCS of the participants was compared according to demographic characteristics and work environment characteristics.

Results:

The most common complaints among the employees were fatigue (40%), and general muscle and joint pain (31.4%). There was a statistically significant difference in TCS according to the position (p < 0.001). The mean TCS was significantly higher in females [13 (0–81)] than in males [6 (0–59)] (p < 0.001). The mean TCS increased with the presence of odor, new wall paint, the presence of fungus/mold on walls, and the presence of rotting/mold smell (p < 0.001, for all). TCS positively correlated with stress level, social relationship, noise level, comfort, cleanliness, number of employees in the same room, presence of odor, new wall paint, presence of rotting/mold, and use of chemical materials for cleaning in the room (p < 0.001, for all), and negatively correlated with room size and number of windows (p = 0.006, p < 0.001, respectively).

Discussion:

The present study found that the female gender, a high level of education, a high level of stress, a low level of social relationships and work environment characteristics were associated with the complaints of SBS among the employees. Accordingly, we believe that hospital management should be informed in order for the managers to take precautions and make new regulations.

Association between sum of volatile organic compounds and occurrence of building-related symptoms in humans: A study in real full-scale laboratory houses

It is well known that the indoor environment, particularly indoor air quality (IAQ), has significant effects on building-related symptoms (BRSs) in humans, such as irritation of mucosal membranes, headaches, and allergies, such as asthma and atopic dermatitis. In 2017, Chiba University launched the "Chemiless Town Project Phase 3" to investigate the relationship between IAQ and human health. Two laboratory houses (LHs) were built on a university campus in which the interiors and exteriors were similar, but the levels of indoor air volatile organic compounds (VOCs) were different. A total of 141 participants evaluated IAQ using their sensory perception. There was a significant relationship between differences in VOC levels and BRSs occurrence (OR: 6.89, 95% CI: 1.40-33.98). It was suggested that people with a medical history of allergies (OR: 5.73, 95% CI: 1.12-29.32) and those with a high sensitivity to chemicals (OR: 8.82, 95% CI: 1.16-67.16) tended to experience BRSs. Thus, when buildings are constructed, people with a history of allergies or with a sensitivity to chemicals may be at high risk to BRSs, and it is important to pay attention to IAQ to prevent BRSs.

Characterization of Responsive Plasters for Passive Moisture and Temperature Control

Ambient comfort maintenance accompanied by excessive energy consumption is hugely criticized concerning the limited sustainability of the building sector in the long-term. In this sense, the energy reduction strategies based on the employment of passive air-control techniques are viewed as a prospective solution for improved energy performance. In order to contribute to this significant issue, this paper is aimed at the design and material characterization of novel plaster with an improved thermal and humidity control performance. For this purpose, a form-stable diatomite/dodecanol-based phase change material together with superabsorbent polymer are used as admixtures for the passive moderation of indoor air quality by newly designed modified plasters. The experimental assessment of the functional properties by means of mechanical strength, thermal conductivity, and hygric properties is performed. Considering the goal of the paper, particular attention is paid to the characterization of water vapor storage and moisture buffering according to the Nordtest method. Differential scanning calorimetry is employed for the description of phase change intervals as well as the specific enthalpy of phase change. The obtained results point to significant improvements in the hygroscopic performance and increased thermal energy storage that can be used for passive moderation of the indoor temperature and reduction of the relative humidity swings.

Lifestyle behaviors and home and school environment in association with sick building syndrome among elementary school children: a cross-sectional study

Background

Sick building syndrome (SBS) refers to the combination of symptoms experienced by occupants of specific building characteristics. This study investigated the associations of children’s lifestyle behaviors, allergies, home, and school environment with SBS symptoms.

Methods

A total of 4408 elementary school children living in Sapporo City, Japan participated in this study. SBS was determined on parental answers to MM080 standardized school questionnaires on symptoms that were weekly experienced by these children, and if the symptom is attributed to their home or school environment. The Japanese version of the International Study of Asthma and Allergies in Childhood questionnaire was used to assess wheeze, rhino-conjunctivitis, and eczema. A logistic regression analysis was conducted to evaluate the associations between SBS symptoms and variables by controlling the potential confounders (gender, grade, school, and parental history of allergies). A stepwise backward elimination was conducted to assess independent variables related to SBS.

Results

Participants revealed mucosal (6.9%), skin (2.0%), and general (0.8%) symptoms. The presence of one or more allergy was associated with increased mucosal and skin symptoms. Children who skipped breakfast, displayed faddiness (like/dislike of food), had constipation, have insufficient sleep, did not feel refreshed after sleep, and lacked deep sleep showed significantly high odds ratios with SBS symptoms. The stepwise analysis showed faddiness for mucosal symptoms and not feeling refreshed after sleep for mucosal and skin symptoms, whereas constipation and lacking deep sleep for general symptoms were independent variables in increasing the symptoms. We found no significant relationship between SBS in children and schools. Considering children’s home, old building, no ventilation, wall-to-wall carpet, and heavy nearby traffic were associated with elevated mucosal symptom, while living in a multifamily home increased general symptoms. Home dampness was an independent variable in increasing all SBS symptoms.

Conclusions

Allergies and lifestyle behaviors were associated with increased SBS in children, including skipping breakfast, displaying faddiness, constipation, insufficient sleep, not feeling refreshed after sleep, and the lack of deep sleep. Further, dampness at home was associated with increase in all SBS symptoms. Lifestyle (e.g., eating and sleeping habits) and home (i.e., dampness) improvements might alleviate SBS symptoms in children.

Influence of Superabsorbent Polymers on Moisture Control in Building Interiors

Moisture loads in building interiors are accompanied by a deterioration of the indoor air quality. Such a phenomenon may induce serious health risks for building inhabitants as well as degradation of furnishing. Unfortunately, the employment of additional heat, ventilation and air conditioning (HVAC) devices does not comply with the sustainability principle due to increased energy consumption, thus cannot be viewed as an efficient solution. This study deals with the use of superabsorbent polymers (SAP) in cement-lime plasters, thus extends the current state of knowledge and outlines further possible development of novel moisture responsive plasters since lightweight aggregates do not provide the desired performance. To be specific, this paper contemplates the experimental analysis of novel plasters modified by 0.5, 1 and 1.5 wt. % of SAP to obtain input parameters for computational modeling. Based on the obtained outputs, the incorporation of SAP admixture resulted in a substantial increase in moisture transport properties including the water absorption coefficient and water vapor diffusion properties. The performed computational modeling revealed a considerable reduction of relative humidity fluctuations, thus mitigation of potential health issues associated with undesired moisture content in building interiors. Achieved results indicate that the SAP enhanced plasters have substantial passive moisture buffering performance and thus may contribute to the improvement of indoor air quality.