Rehabilitation of sick-listed LBP patients in occupational health with collaboration of the workplace.

The aim was to evaluate if rehabilitation procedures including occupational health (OH) and workplace participation increase return to work (RTW) rates among patients with subacute and chronic low back pain (LBP). A systematic review of randomized controlled trials was conducted using the PubMed and Cochrane databases. Main outcomes were RTW and days of sick leave. Interventions needed to be multidisciplinary including both OH and active workplace involvement in rehabilitation. Out of 1073 potentially eligible references, 8 met the inclusion criteria. Three studies had OH and 5 case managers involved in rehabilitation. Rehabilitation involving both OH and workplace improved RTW and decreased the number of sick leave days among LBP patients. Having case managers involved had no effect in RTW. In order to improve RTW, workplace visits and work ability meetings (WAMs) between OH and workplace are essential components in the rehabilitation process among patients with chronic LBP. Based on the study results, the authors suggest utilizing these co-operative interventions with workplaces in OH. High quality research investigating only the effect of WAMs in OH setting is needed in future. Int J Occup Med Environ Health. 2024;37(1):3-17.

Collaboration between occupational health professionals in smoking cessation treatment and support.

BACKGROUND: Promoting health is an important part of occupational health (OH) professionals' daily practice. Occupational health services (OHS) support work ability and prevent both work-related diseases and lifestyle-related illnesses. OBJECTIVE: We focused on how interprofessional collaboration (IPC), regardless of whether the OHS provider is public, private or in-house, influences the implementation of smoking cessation treatment and support (SCTS). We studied IPC of OH professionals in SCTS and whether they differ depending on OHS providers. METHODS: We collected data through an online survey of a cross-sectional sample of OH professionals of physicians (n = 182), nurses (n = 296) and physiotherapists (n = 96) at two different time-points, in 2013 and 2017. The questionnaire contained questions on interprofessional SCTS practices, so that we could assess how the professionals' experiences differed from each other. We used explanatory factor analysis to study the collaboration, and the Kruskall-Wallis test to detect the differences between the OH professional groups as a post-hoc data analysis. Background: OH physicians (mean 3.4, SD 1.2) and OH nurses (mean 3.2, SD 1.1) experienced smooth collaboration in SCTS whereas OH physiotherapists (mean 2.5, SD 1.1) felt excluded from IPC. In-house OH centres (mean 3.5, SD 1.0) seemed to offer the best opportunities for implementing IPC in SCTS comparing to public (mean 3.1, SD 0.9) or private (mean 2.9, SD 0.9) OHS. CONCLUSION: The IPC of OH professionals in SCTS interventions need to be rearranged. This requires boundary-crossing SCTS practices involving all professionals. All OH professionals should implement IPC in SCTS and share their specific competence.

Occupational health professionals' attitudes, knowledge, and motivation concerning smoking cessation-Cross-sectional survey.

OBJECTIVES: Occupational health (OH) professionals could play a prominent role in smoking cessation treatment and support (SCTS) and help individuals and workplaces become smoke free. However, their role has not been evaluated. The aim of this study was to assess differences between OH professionals' perceptions of their role in SCTS by measuring three groups of OH professionals' attitudes, knowledge, and motivation concerning SCTS. METHODS: We collected data through an online survey completed by a cross-sectional sample of OH professionals: OH physicians (n = 182), OH nurses (n = 296), and OH physiotherapists (n = 96), collected from national trade union registers. The differences between the OH professional groups were analyzed using ANOVA, the Kruskal-Wallis, and chi-square tests. RESULTS: The OH professionals had a positive attitude toward offering SCTS and were highly motivated to enhance their knowledge of this topic and acquire further training. The OH physicians and OH nurses assessed their current knowledge as sufficient. Conversely, the OH physiotherapists' level of knowledge was seen as insufficient. Traditionally, OH physicians and OH nurses have been responsible for carrying out SCTS, but the majority of the OH physiotherapists thought that SCTS should also be included in their job description. CONCLUSIONS: All the OH professionals were highly motivated to deepen their knowledge of SCTS. The barriers between different professionals need to be recognized in occupational health services (OHS). OHS should organize its SCTS more effectively, strengthen their contributions to smoking cessation programs, and recognize the potential of OH physiotherapists for providing SCTS and enable them to expand their training.

Perceived indoor air quality and psychosocial work environment in office, school and health care environments in Finland.

OBJECTIVES: The study examined the extent and prevalence of perceived indoor environment-related (IE-related) symptoms environmental complaints and psychosocial work environmental factors in Finnish office, school and health care environments. MATERIAL AND METHODS: The data were collected from non-industrial workplaces (N = 455) in 2011-2012 and 2015-2017 using the Finnish Institute of Occupational Health's Indoor Air Questionnaire (IA Questionnaire). Suspicion of IE-related problems was reported in 59% of workplaces. The data consisted of 28 826 employees' responses. RESULTS: The employees reported symptoms and environmental discomfort in office environments less often than in school or health care environments. The most often reported IE-related complaints were stuffy air (39% of respondents), dry air (34%) and insufficient ventilation (33%). The most often reported symptoms were irritation of the nose (27% of respondents), irritation of the eyes (26%), and hoarse or dry throat (24%). The results showed differences between the perceived IE in office, school and health care environments. CONCLUSIONS: Compared to earlier findings, the most often perceived IE-related symptoms and complaints have increased in Finnish health care environments. The office employees' perceptions of psychosocial work environment remained fairly unchanged whereas health care personnel more often assessed their psychosocial environment as positive compared to previous reports. Instead of exact reference values, comparing the results of IA Questionnaires with the distributions and mean values of the results of this study may be more informative for those striving to solve IE-related problems. The presented distribution and mean values of perceived symptoms, environmental complaints and psychosocial work environment might help to relate the results to other workplaces. This, in turn, might increase the understanding that IA Questionnaire results are influenced by many factors. The results presented can be used as new reference material when interpreting the results of IA Questionnaires in office, school and health care environments. Int J Occup Med Environ Health. 2020;33(4):479-95.

Healthy people in healthy premises: the Finnish Indoor Air and Health Programme 2018-2028.

Clean and fresh indoor air supports health and well-being. However, indoor air can contain pollutants that can cause a variety of symptoms and reduce well-being. Individual exposure agents can also increase the risk of certain diseases. Finns have taken major steps to improve the quality of indoor air for several decades. The primary focus of these activities has been the prevention and reduction of exposure to poor indoor air quality through guidance and regulation directing remediation of damaged buildings. Nevertheless, reported symptoms related to poor indoor air quality are common in Finland. In addition to exposure to indoor air pollutants, this may be partly due to the lively public discussion on the health risks caused by poor indoor air quality, conflicting views between experts, and mistrust towards public authorities, building owners and builders. Because of the scale of the indoor air problems in Finland, people's needs for reliable information and support, and the major costs involved, there is a call for new evidence-based methods, perspectives and solutions. Therefore, the Finnish Institute for Health and Welfare initiated the Finnish Indoor Air and Health Programme 2018-2028 together with a number of collaborators and stakeholders. The primary, long-term objective of the programme is to reduce hazards to health and well-being linked to indoor environments in Finland. To fulfill this objective, the programme will focus on the promotion of human health and well-being, the prevention of hazards, improved communication and engage the whole health-care sector to manage better patients´ symptoms and complaints. The 10-year Finnish Indoor Air and Health Programme consists of four areas that aim (1) to increase understanding of the effects of indoor environments on health and well-being; (2) to develop the management of problems linked to indoor environments; (3) to improve the treatment and working and functional capacity of people with symptoms and illnesses; and (4) to strengthen the competence in matters related to indoor environments. The progress of the programme and reaching the predefined, quantitative goals will be monitored throughout the programme.

" Nature step" to prevent noncommunicable inflammatory disease.

The prevention of many diseases has significantly improved by intervening in known risk factors. However, the causes of the increase in allergy and type 1 diabetes are unknown. These diseases are often associated with a low-grade inflammation and immunological imbalance. The lifestyle and environment of urbanized populations have changed causing imbalance in the human normal flora and affecting immune regulation. We discuss everyday factors affecting immune regulation, using allergy as an example. Health may be promoted through the "nature step", by supporting the connection between humans and nature.

Participative Facility Planning for Obstetrical and Neonatal Care Processes: Beginning of Life Process.

Introduction. Old hospitals may promote inefficient patient care processes and safety. A new, functionally planned hospital presents a chance to create an environment that supports streamlined, patient-centered healthcare processes and adapts to users' needs. This study depicts the phases of a facility planning project for pregnant women and newborn care processes (beginning of life process) at Turku University Hospital. Materials and Methods. Project design reports and meeting documents were utilized to assess the beginning of life process as well as the work processes of the Women's and Children's Hospital. Results. The main elements of the facility design (FD) project included rigorous preparation for the FD phase, functional planning throughout the FD process, and setting key values: (1) family-centered care, (2) Lean thinking and Lean tools as the framework for the FD process, (3) safety, and (4) cooperation. Conclusions. A well-prepared FD project with sufficient insight into functional planning, Lean thinking, and user-centricity seemed to facilitate the actual FD process. Although challenges occurred, the key values were not forgone and were successfully incorporated into the new hospital building.

Thermal environment in eight low-energy and twelve conventional Finnish houses.

We assessed the thermal environment of eight recently built low-energy houses and twelve conventional Finnish houses. We monitored living room, bedroom and outdoor air temperatures and room air relative humidity from June 2012 to September 2013. Perceived thermal environment was evaluated using a questionnaire survey during the heating, cooling and interim seasons. We compared the measured and perceived thermal environments of the low-energy and conventional houses. The mean air temperature was 22.8 °C (21.9-23.8 °C) in the low-energy houses, and 23.3 °C (21.4-26.5 °C) in the conventional houses during the summer (1. June 2013-31. August 2013). In the winter (1. December 2012-28. February 2013), the mean air temperature was 21.3 °C (19.8-22.5 °C) in the low-energy houses, and 21.6 °C (18.1-26.4 °C) in the conventional houses. The variation of the air temperature was less in the low-energy houses than that in the conventional houses. In addition, the occupants were on average slightly more satisfied with the indoor environment in the low-energy houses. However, there was no statistically significant difference between the mean air temperature and relative humidity of the low-energy and conventional houses. Our measurements and surveys showed that a good thermal environment can be achieved in both types of houses.

Cancer incidence among waiters: 45 years of follow-up in five Nordic countries.

AIMS: To study cancer risk patterns among waiters in the Nordic countries. METHODS: We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS: The SIR of all cancers in waiters, in the five countries combined, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral cavity (4.91; 95% CI 3.81-6.24) and tongue (4.36; 95% CI 3.13-5.92); and in female waiters, in the larynx (2.17; 95% CI 1.63-2.82), oral cavity (1.96; 95% CI 1.60-2.34) and lung (1.89; 95% CI 1.80-1.99). CONCLUSIONS: The risk of cancer among waiters was higher than in the general population. The elevated incidence in some cancer sites can likely be explained by higher alcohol consumption, the prevalence of smoking and occupational exposure to tobacco smoke. Hopefully, the incidence of cancer among waiters will decrease in the future, due to the banning of tobacco smoking in restaurants and bars in the Nordic countries.

Application of good practices as described by the NEPSI agreement coincides with a strong decline in the exposure to respiratory crystalline silica in Finnish workplaces.

To protect the health of those occupationally exposed to respirable crystalline silica, the main industries in European Union associated with exposure to respirable silica, agreed on appropriate measures for the improvement of working conditions through the application of good practices, as part of 'The Agreement on Workers Health Protection through the Good Handling and Use of Crystalline Silica and Products Containing it' (NEPSI agreement), signed in April 2006. The present paper examines trends in exposure to respirable crystalline silica in Finland prior to and following the implementation of the NEPSI agreement and includes a working example of the NEPSI approach in the concrete industry. Data derived from workplace exposure assessments during the years 1994-2013 are presented, including 2556 air samples collected mostly indoors, from either the breathing zone of workers or from stationary points usually at a height of 1.5 m above the floor, with the aim to estimate average exposure of workers to respiratory crystalline silica during an 8-h working day. The aim was, to find out how effective this unique approach has been in the management of one of the major occupational hazards in the concerned industries. Application of good practices as described by the NEPSI agreement coincides with a strong decline in the exposure to respirable crystalline silica in Finnish workplaces, as represented by the clientele of Finnish Institute of Occupational Health. During the years followed in the present study, we see a >10-fold decrease in the average and median exposures to respirable silica. Prior to the implementation of the NEPSI agreement, >50% of the workplace measurements yielded results above the OEL8 h (0.2mg m(-3)). As of present (2013), circa 10% of the measurements are above of or identical to the OEL8 h (0.05mg m(-3)).

Rehabilitation centers in change: participatory methods for managing redesign and renovation.

OBJECTIVE: The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods in a larger framework of change process model and participatory design. BACKGROUND: Rehabilitation organizations are currently in transition; customer groups, financing, services, and the processes of rehabilitation centers are changing. The pressure for change challenges the centers to develop both their processes and facilities. There is a need for methods that support change management. METHODS: Four participatory methods were developed: future workshop, change survey, multi-method assessment tool, and participatory design generator cards. They were tested and evaluated in three rehabilitation centers at the different phases of their change process. RESULTS: The developed methods were considered useful in creating a mutual understanding of the change goals between different stakeholders, providing a good picture of the work community's attitudes toward the change, forming an integrated overview of the built and perceived environment, inspiring new solutions, and supporting the management in steering the change process. CONCLUSIONS: The change process model described in this article serves as a practical framework that combined the viewpoints of organizational and facility development. However, participatory design continues to face challenges concerning communication between different stakeholders, and further development of the methods and processes is still needed. Intervention studies could provide data on the success factors that enhance the transformations in the rehabilitation sector. KEYWORDS: Design process, methodology, organizational transformation, planning, renovation.

Total prohibition of smoking but not partial restriction effectively reduced exposure to tobacco smoke among restaurant workers in Finland.

OBJECTIVES: To assess work-related exposure to tobacco smoke in Finnish restaurants, a series of nationwide questionnaire surveys were conducted among restaurant workers and the levels of indoor air nicotine concentrations were measured in restaurants. The survey aimed to evaluate the impact of the smoke-free legislation in general and in particular after the total smoking ban launched in 2007. MATERIALS AND METHODS: In 2003-2010, four national questionnaire surveys were conducted among restaurant workers and the concentration of nicotine in indoor air was measured in different types of restaurants, bars and nightclubs. RESULTS: Between 2003 and 2010, the proportion of restaurant workers reporting occupational exposure to tobacco smoke dropped from 59% to 11%. Among pub workers, the decrease was from 97% to 18% and in workers of dining restaurants from 49% to 10%, respectively. The median concentration of nicotine in indoor air of all restaurants decreased from 11.7 µg/m(3) to 0.1 µg/m(3). The most significant decrease was detected in pubs where the decrease was from 16.1 µg/m(3) to 0.1 µg/m(3). Among all restaurant workers, in 2003-2010 the prevalence of daily smokers was reduced from 39% to 31% in men and from 35% to 25% in women. CONCLUSION: Total prohibition of smoking but not partial restriction in restaurants was effective in reducing work-related exposure to tobacco smoke. Strict tobacco legislation may partly be associated with the significant decrease of daily smoking prevalence among restaurant workers.

Different types of door-opening motions as contributing factors to containment failures in hospital isolation rooms.

Hospital isolation rooms are vital for the containment (when under negative pressure) of patients with, or the protection (when under positive pressure) of patients, from airborne infectious agents. Such facilities were essential for the management of highly contagious patients during the 2003 severe acute respiratory syndrome (SARS) outbreaks and the more recent 2009 A/H1N1 influenza pandemic. Many different types of door designs are used in the construction of such isolation rooms, which may be related to the space available and affordability. Using colored food dye as a tracer, the qualitative effects of door-opening motions on the dissemination of potentially contaminated air into and out of a single isolation room were visualized and filmed using Reynolds-number-equivalent, small-scale, water-tank models fitted with programmable door-opening and moving human figure motions. Careful scaling considerations involved in the design and construction of these water-tank models enabled these results to be accurately extrapolated to the full-scale situation. Four simple types of door design were tested: variable speed single and double, sliding and hinged doors, in combination with the moving human figure. The resulting video footage was edited, synchronized and presented in a series of split-screen formats. From these experiments, it is clear that double-hinged doors pose the greatest risk of leakage into or out of the room, followed by (in order of decreasing risk) single-hinged, double-sliding and single-sliding doors. The relative effect of the moving human figure on spreading any potential contamination was greatest with the sliding doors, as the bulk airflows induced were large relative to those resulting from these door-opening motions. However, with the hinged doors, the airflows induced by these door-opening motions were significantly greater. Further experiments involving a simulated ventilated environment are required, but from these findings alone, it appears that sliding-doors are far more effective for hospital isolation room containment.

Indoor air particles in office buildings with suspected indoor air problems in the Helsinki area.

OBJECTIVES: Airborne particle concentrations can be used as quality indicators of indoor environments. The previous lack of reference data has limited the use of particle measurements in office environments. The aim of this study was to describe the concentrations of airborne particles (≥ 0.5 µm and ≥ 5.0 µm) in 122 Finnish office buildings with suspected indoor air problems. MATERIALS AND METHODS: The database consisted of indoor air and supply air particle samples collected in 2001-2006 from the Helsinki area. The particle concentrations (≥ 0.5 µm and ≥ 5.0 µm) were measured in the indoor air (528 samples from 122 office rooms) and in the supply air (384 samples from 105 office rooms) with an optical particle counter. Airborne particle concentrations ≥ 0.5 µm were categorized according to the efficiency of supply air filtration and health survey data. RESULTS: The mean concentrations in the indoor air equaled 1900 particles/l and in the supply air 1300 particles/l. The efficiency of supply air filtration decreased the fine particles counts in both the indoor and supply air. The counts of large particles, ≥ 5.0 µm, were low in the indoor air. Airborne counts of ≥ 0.5 µm particles (geometric mean) were statistically higher in the offices whose occupants had work-related symptoms (eye and/or upper respiratory symptoms or upper respiratory infections) than in the offices whose occupants had no such symptoms. However, the symptoms may also be linked to other indoor air problems or particle characteristics not studied in this work. CONCLUSIONS: This study indicates typical airborne particle levels (≥ 0.5 µm and ≥ 5.0 µm) in Finnish office buildings with suspected indoor air problems. The results can be used to evaluate the quality of indoor environment, possible indoor air problems, and the need for additional investigations.

Exposure to tobacco smoke and prevalence of symptoms decreased among Finnish restaurant workers after the smoke-free law.

INTRODUCTION: The impact of tobacco legislation and exposure to environmental tobacco smoke (ETS) in bars and restaurants were assessed in a national survey. METHODS: Questionnaire surveys among restaurant workers were conducted in 2007 before the smoking ban, and in 2009. RESULTS: The exposure to ETS decreased significantly after the launch of the 2007 smoke-free law. During 2007-2009, the prevalence of those restaurant workers with no exposure increased from 54% to 82% (P-value < 0.0001), and among bartenders from 10% to 70% (P < 0.0001). Employees exposed daily for more than 4 hr decreased from 24% to 4% (P < 0.0001) and from 67% to 9% among bartenders (P < 0.0001). The prevalence of respiratory symptoms decreased from 18% to 4% (P < 0.0001) and of eye symptoms from 23% to 6% (P < 0.0001). CONCLUSION: The reform of tobacco legislation in 2007, which prohibited smoking in restaurants and bars, significantly decreased the exposure to ETS and the prevalence of symptoms among restaurant workers.

Perceived indoor air quality, air-related symptoms and ventilation in Finnish hospitals.

OBJECTIVES: Good ventilation is more important in hospitals than in many other buildings. The objective of this study was to evaluate the effect of the condition, performance and modernity of ventilation systems on the perceived indoor air quality (IAQ) and the indoor air-related symptoms of hospital personnel. MATERIALS AND METHODS: An inspection and evaluation graded on a 1 to 3 scale of the condition, performance, and modernity of the ventilation systems was carried out in ten central hospitals in Finland. The perceived IAQ and the related symptoms were collected by means of an indoor air questionnaire survey among the workers in these hospitals. RESULTS: The condition, performance and modernity of the ventilation systems were good in 40% of the hospitals included in the research and poor in another 40% of them. In hospitals where the majority of the ventilation systems were assessed to be good, the prevalence of the indoor air-related complaints and symptoms was lower than in hospitals where the majority of the ventilation systems were assessed as needing extensive repairs. CONCLUSIONS: The condition and performance of the ventilation systems in hospitals had a significant impact on the perceived IAQ and the symptoms observed among the employees in Finnish hospitals. Therefore, it is important that hospital ventilation systems are maintained properly and regularly. Furthermore, they should be renovated, at the latest when their technical lifespan expires.

Indoor air problems in hospitals: a challenge for occupational health.

Indoor air problems, caused by moisture damage and limited ventilation, have been detected in Finnish hospital buildings. A recent survey found that hospital personnel experience indoor air-related symptoms more often than office workers. The aim of this study was to assess the role, capabilities, and methods of hospital occupational health professionals in handling indoor air problems. Data were generated through semi-structured interviews. Representatives of occupational health, occupational safety, and infection control were interviewed in seven central hospitals. The data were analyzed using qualitative methods. According to interviewed professionals, indoor air problems are difficult to tackle. The evaluation of health risks and risk communication were considered particularly difficult. A uniform action model for resolving indoor air problems should be created. An interprofessional indoor air group to handle indoor air problems should be created in all hospitals.

The impact of Finnish tobacco legislation on restaurant workers' exposure to tobacco smoke at work.

AIMS: To evaluate the impact of Finnish tobacco legislation concerning restaurants, questionnaire surveys were carried out four times between 1999 and 2007. Their purpose was to assess the effects of the legislation on employees' exposure to tobacco smoke in bars and restaurants in Finland before the total prohibition of smoking. METHODS: National questionnaire surveys on reported exposure to tobacco smoke among restaurant workers were conducted in 1999, 2001, 2003, and in the spring of 2007 just before the total smoking ban. RESULTS: The data show that smoking is more common among restaurant workers than in the Finnish population in general. Reported exposure to tobacco smoke in bars and restaurants declined slowly after the launch of the renewed Tobacco Act. Between 1999 and 2007, it decreased from 73% to 43% among waiters who were exposed for over four hours per work shift and from 93% to 67% among bartenders. At the same time, non-exposed waiters increased from 15% to 39% and bartenders from 5% to 10%. The number of daily smoked cigarettes, however, remained the same among restaurant workers during the seven-year follow-up. CONCLUSIONS: We conclude that the reform of the Finnish tobacco legislation in 2000, which did not totally prohibit smoking in restaurants, decreased the exposure to environmental tobacco smoke but was not sufficiently effective in protecting restaurant workers from occupational exposure to tobacco smoke.

A new method to assess perceived well-being among elderly people--a feasibility study.

BACKGROUND: A simple but countable electronic device has been developed to gain reliable information on elderly patients' perceived well-being. The device has been tested and proven to be technically functional and countable. It was now tested in two care homes for the elderly and two private homes to evaluate if it provided solid information about the well-being of elderly persons. This report illustrates the practical usage of the device and shows its efficiency in gathering solid well-being information from the focus group. METHODS: The test arrangement was carried out by assigning a group of volunteers (n = 10) in care homes for the elderly for two weeks. The time period was long enough to collect a sufficient amount of information to evaluate the perceived well-being of the test subjects. Perceived well-being was assessed by using a Con-Dis device and by filling out an attached questionnaire - RAI - at the same time. RAI consisted of questions concerning mood, pain and quality of life. A standardised RAVA questionnaire with 12 questions concerning test subject's health was also answered once during the two-week time period by each test subject. After the test period the data obtained by Con-Dis was compared with the findings collected using questionnaires. RESULTS: A statistically significant correlation was found between perceived well-being (measured by Con-Dis) and questionnaire-based mood (r = 0,66, Pearson Correlation Coefficient) and quality of life (r = 0,68). No statistically significant correlation was found between perceived well-being and pain (r = 0,28). Technical functionality and feasibility of Con-Dis were good during the test period. Some problems arose because the test subjects were elderly and some in poor physical condition. CONCLUSION: On the basis of the collected results, the Con-Dis device presented information on the test subjects' perceived well-being that appeared to correlate with certain aspects of their health status. The test subjects' mood and quality of life but not pain had a statistically significant association with the perceived well-being level measured by Con-Dis.

Man-made vitreous fibers in office buildings in the Helsinki area.

Several sources of man-made vitreous fibers (MMVFs) may exist in an office environment causing irritation symptoms among occupants. In 258 office buildings, the occurrence and density of settled MMVFs on surfaces were measured by two sampling methods. Altogether, 1113 samples of settled dust were collected from surfaces with plastic bags and gelatine tape and were analyzed with a scanning electron microscope and a stereomicroscope, respectively. Tape samples from 68 buildings were collected from frequently cleaned (n = 162) and seldom cleaned (n = 57) room surfaces in 56 and 29 offices, respectively, and from supply air ducts (n = 24) in 10 offices. MMVFs longer than 20 microm were counted with a stereomicroscope. Irritation symptoms were recorded with a questionnaire. More than 60% of the surface dust and almost 90% of the samples collected from supply air ducts contained MMVFs. The density of MMVFs longer than 20 microm ranged from < 0.1 to 5 fiber cm(- 2). The mean density of the MMVFs was about two times higher on the seldom cleaned surfaces than on the frequently cleaned surfaces. The density was usually under 0.2 MMVF cm(- 2) in surface dust of offices without emission sources of MMVFs. The measurements combined with qualitative analysis of settled dust can help to localize relevant sources of fiber emissions. Altogether, in 40% of the buildings, several occupants had repeated irritation symptoms that were verified by occupational health care personnel.