Effects of indoor temperature on office workers' performance: an experimental study based on subjective assessments, neurobehavioral tests, and physiological measurements.

Indoor temperature has a critical impact on the performance of office workers. This study aimed to evaluate the effect of indoor temperature on work performance through subjective assessments, neurobehavioral tests, and physiological measurements. The experiment was conducted in a controlled office environment. Under each temperature condition, participants voted on their perception of thermal sensation, thermal satisfaction, and sick building syndrome (SBS) symptoms. Participants were given neurobehavioral tests based on a ten-item task, and their body temperature, blood pressure, heart rate, and blood oxygen saturation were measured before and after the tests. The study showed that the effect of indoor temperature on the test tasks varied greatly and depended on the task type. The indoor temperature, thermal sensation votes, and body temperature for optimum work performance were 17 °C, -0.57, and 36.4 °C, respectively. Work performance was positively correlated with thermal satisfaction votes and negatively correlated with sleepiness intensity.Practitioner summary: Work performance is closely related to indoor temperature. This study evaluated the effect of indoor temperature on work performance through subjective assessments, neurobehavioral tests, and physiological measurements. The relationships between work performance and indoor temperature, perceived votes, and physiological parameters were established, respectively.

[POST-COVID SYNDROME, SICK BUILDING SYNDROME, SILICONE BREAST SYNDROME, CHRONIC FATIGUE SYNDROME, FIBROMYALGIA; AUTOIMMUNITY TO THE AUTONOMIC NERVOUS SYSTEM].

INTRODUCTION: POST-COVID SYNDROME, SICK BUILDING SYNDROME, SILICONE BREAST SYNDROME, CHRONIC FATIGUE SYNDROME, FIBROMYALGIA; AUTOIMMUNITY TO THE AUTONOMIC NERVOUS SYSTEM.

Moisture damage and fungal contamination in buildings are a massive health threat - a surgeon's perspective.

OBJECTIVES: Indoor air toxicity is of major public health concern due to the increase in humidity-induced indoor mould exposure and associated health changes. The objective is to present evidence for the causality of health threats and indoor mould exposure. METHODS: PubMed search on the following keywords: dampness, mould, indoor air quality, public health, dampness, and mould hypersensitivity syndrome, sick building syndrome, and building-related illness as well as information from the health authorities of Bavaria and North Rhine-Westphalia, the Center of Disease Control (CDC), World Health Organisation (WHO), and guidelines of professional societies. RESULTS: The guidelines of professional societies published in 2017 are decisive for the assessment of the impact of mould pollution caused by moisture damage on human health and for official regulations in Germany. Until 2017, a causal connection between moisture damage and mould exposure could usually only be established for pulmonary diseases. The health risk of fungal components is apparent as documented in the fungal priority pathogens list (FPPL) of the WHO. Since 2017, studies, especially in Scandinavia, have proved causality between moisture and mould exposure not only for pulmonary diseases but also for extrapulmonary diseases and symptoms. This was made possible by new test methods for determining the toxicity of fungal components in indoor air. Environmental medical syndromes, e.g., dampness and mould hypersensitivity syndrome (DMHS), sick building syndrome (SBS), building-related symptoms (BRS), and building-related illness (BRI), and fungal pathogens, e.g., Aspergillus fumigatus, pose a major threat to public health. CONCLUSION: There is evidence for the causality of moisture-induced indoor moulds and severe health threats in these buildings. According to these findings, it is no longer justifiable to ignore or trivialize the mould contamination induced by moisture damage and its effects on pulmonary and extrapulmonary diseases. The health and economic implications of these attitudes are clear.

Assessment of sick building syndrome using visual analog scales.

BACKGROUND: Despite there is no recommendations for assessing symptoms of sick building syndrome, the use of visual analog scales (VAS) seems attractive and appropriate. We aimed to demonstrate the benefits of using VAS for evaluating subjective symptoms of sick building syndrome. METHOD: We compared an exposed group to a control group with a one-year follow-up. To assess chronology of symptoms, employees were asked to complete four VAS at different times: after vacations (time 1), beginning of the week-beginning of the day (time 2), beginning of the week-end of the day (time 3), and end of the week-end of the day (time 4). Measurements were repeated before and after ventilation work for the exposed group and at the same time in the control group without intervention. Confounding factors were assessed. RESULTS: We included 36 employees (21 in the exposed group and 15 in the control group). Both groups were comparable. Prior to ventilation work, the exposed group had more subjective symptoms than the control group with a chronology of symptoms. After ventilation work, symptoms did not differ between groups, and most symptoms decreased within the exposed group. PRACTICAL IMPLICATION: The use of VAS provided reliable data for assessing sick building syndrome and showed a dose-response relationship between occupational exposure and symptoms.

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.

Indoor humidity levels and associations with reported symptoms in office buildings.

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.

Thermal sensation, sick building syndrome symptoms, and physiological responses of occupants in environments with vertical air temperature differences.

Vertical air temperature differences (VTDs) can have important influences on thermal comfort and the evaluation of air distributions. The air distributions might create either positive or negative VTDs. However, no research has clearly revealed the effect of different directions of VTDs on human comfort. To create environments with positive and negative VTDs in this study, the air temperature of half of the body was maintained at an air temperature of 25 °C, whereas the other half of the body (the upper or lower body part, respectively) was exposed to air temperatures of 22 °C, 25 °C, 28 °C, and 31 °C, respectively. That is two series of experiments with the same VTD value but different directions were compared, based on 16 subjects seated in a climatic box in a climate chamber. The thermal sensations, sick building syndrome (SBS) symptoms, and physiological responses of occupants were studied. The results showed that subjects were more sensitive to the VTD at the upper body part in warm environments with respect to thermal sensations, perceived air quality, and sweat intensity. The analysis indicated that there were more discomfort and heat stress for positive VTDs than negative VTDs. Thus, the criterion for acceptable negative VTDs should be different with the positive VTDs incorporated in current standards. Overall, the directions of the VTDs were suggested to be considered for evaluating the thermally stratified air distributions based on both of thermal comfort and energy efficiency in buildings.

A high environmental composite quality factor score was associated with the risk of sick building syndrome among adults in northeast China.

OBJECTIVES: Epidemiological evidence regarding the association between the combination of indoor and outdoor neighborhood pollution and sick building syndrome (SBS) among adults is limited and inconsistent. A cross-sectional study was conducted to investigate the association between the environmental composite quality factor score and SBS among adults. METHODS: This study included 2594 females and 666 males aged 18-77 years enrolled from the Northeast China. The environmental composite quality factor score was computed based on factors potentially associated with SBS risk, including the outdoor neighborhood pollution sources (the housing on the street, the presence of pollutants within 100 m of the house (gutters, garbage stations, noise, chemical pollution, and dust pollution), and the presence of arterial roads, factories, and chimneys) and indoor pollution sources (redecoration, clean fuel used for heating/cooking, cooking oil fume (COF) outside kitchen, using of mosquito coil or repellent, and using of incense). We performed multivariate logistic regression analysis to calculate the odds ratios (ORs) and 95% confidence intervals (95%CIs) between environmental composite quality factor score, indoor pollution composite factor score, outdoor neighborhood pollution composite factor score, and SBS adjustment for covariates. Further, we also did the stratified analysis and constructed a weighted score to verify the results. RESULTS: Compared with the lowest environmental composite quality factor score, the ORs of the highest scores were: 1.58 (95% CI, 1.20-2.27, Ptrend = 0.001) for general symptoms; 1.73 (95% CI, 1.35-2.23, Ptrend < 0.001) for mucosal symptoms and 1.75 (95% CI, 1.34-2.29, Ptrend < 0.001) for dermal symptoms and 1.81 (95% CI, 1.36-2.42, Ptrend < 0.001) for all of the three symptoms. We also observed similar patterns with the using of weighted scores and stratified analysis. CONCLUSION: Higher exposure to indoor pollution sources and outdoor pollution sources near the residence may be associated with a higher risk of SBS in adults in northeast China.

Indoor air quality and sick building syndrome in a university setting: a case study in Greece.

The perceived Indoor Air Quality (IAQ), the prevalence of Sick Building Syndrome (SBS) symptoms and its contributing risk factors were assessed in a university during the period of the economic crisis in Greece. Data was collected from 613 employees via questionnaires. Hierarchical linear regression analysis was performed. The most prevalent perceived IAQ complaints were 'Dust and dirt' (63.2%), 'Room temperature too low' (24.9%) and 'Varying room temperature' (24.4%). The most frequently reported SBS symptom was 'Fatigue' (34.1%). The prevalence of General, Mucosal and Dermal symptoms was 40.8%, 19.8% and 8.1%, respectively. Several contributing risk factors were identified, such as IAQ Discomfort Scale, atopy, sleep problems, female, exposure to biological and chemical agents, PC-use, Psychosocial Work Scale and job satisfaction. Poor perceived IAQ and high prevalence of SBS symptoms were reported from the university staff in a temperate climate country. SBS seemed to be multifactorial.

Prevalence of sick building syndrome in hospital staff and its relationship with indoor environmental quality.

The aim of this study was to determine the prevalence of sick building syndrome (SBS), and its relationship with indoor environmental quality in hospital settings. This cross-sectional study was carried out on 300 hospital staff in Sivas. MM 040 NA Hospital questionnaire was applied. In the hospital indoor environments, air quality (carbon monoxide (CO), carbon dioxide (CO2), oxygen (O2), methane (CH4), hydrogen sulfide (H2S), nitrogen oxides (NOx)), lighting, noise, respirable dust and thermal comfort measurements were made. The prevalence of SBS was determined as 64.7-74.1% in the hospitals. It was found that the risk of SBS was 4.31 times higher for those who complained about variable room temperature and 3.11 times higher for those who complained about noise, and decreased 1.01 times with the increase in lighting level. In order to minimize the risk of SBS, it is thought that all healthcare administrators should be informed about SBS.

Symptoms and oxylipins in plasma before and after exposure to rooms in which individuals have both experienced and not experienced building-related symptoms - an exploratory study.

The aim of this study was to investigate if there are differences in symptom ratings and plasma concentrations of oxylipins as a measure of acute inflammation between individuals with building-related symptoms (BRS) and referents during exposure to rooms where people experienced BRS and rooms where they did not experience BRS. Medically examined individuals with BRS and healthy, age and sex matched referents working in the same building were exposed for 60 min. Ratings of symptoms and collection of blood to measure oxylipins in plasma were performed before and after each exposure. Individuals with BRS reported more symptoms (mostly mucosal) than the referents in the problem rooms and there was a tendency towards a difference between the groups in concentration of metabolites from the cyclooxygenase pathway (COX). The mean reported intensity of symptoms among all participants was also found to be positively correlated with both COX and lipoxygenase (LOX-15) oxylipins in problem rooms.

Associations of indoor carbon dioxide concentrations, air temperature, and humidity with perceived air quality and sick building syndrome symptoms in Chinese homes.

The indoor environment influences occupants' health. From March 1, 2018, to February 28, 2019, we continuously monitored indoor temperature (T), relative humidity (RH), and CO2 concentration in bedrooms via an online system in 165 residences that covered all five climate zones of China. Meanwhile, we asked one specific occupant in each home to complete questionnaires about perceived air quality and sick building syndrome (SBS) symptoms at the end of each month. Higher CO2 concentration was significantly associated with a higher percentage of perceived stuffy odor and skin SBS symptoms. Higher relative humidity was associated with higher percentage of perceived moldy odor and humid air, while lower RH was associated with a higher percentage of perceived dry air. Occupants who lived in residences with high RH were less likely to have mucosal and skin SBS symptoms (adjusted odds ratio (AOR): 0.73-0.78). However, the benefit of high humidity for perceived dry air and skin dryness symptoms is weaker if there is a high CO2 concentration level.

Association of subjective health symptoms with indoor air quality in European office buildings: The OFFICAIR project.

The aim of this study was to explore the association between the building-related occupants' reported health symptoms and the indoor pollutant concentrations in a sample of 148 office rooms, within the framework of the European OFFICAIR research project. A large field campaign was performed in 37 office buildings among eight countries, which included (a) 5-day air sampling of volatile organic compounds (VOCs), aldehydes, ozone, and NO2 (b) collection of information from 1299 participants regarding their personal characteristics and health perception at workplace using online questionnaires. Stepwise and multilevel logistic regressions were applied to investigate associations between health symptoms and pollutant concentrations considering personal characteristics as confounders. Occupants of offices with higher pollutant concentrations were more likely to report health symptoms. Among the studied VOCs, xylenes were associated with general (such as headache and tiredness) and skin symptoms, ethylbenzene with eye irritation and respiratory symptoms, a-pinene with respiratory and heart symptoms, d-limonene with general symptoms, and styrene with skin symptoms. Among aldehydes, formaldehyde was associated with respiratory and general symptoms, acrolein with respiratory symptoms, propionaldehyde with respiratory, general, and heart symptoms, and hexanal with general SBS. Ozone was associated with almost all symptom groups.

Effects of increased humidity on physiological responses, thermal comfort, perceived air quality, and Sick Building Syndrome symptoms at elevated indoor temperatures for subjects in a hot-humid climate.

Recently, studies suggest that the average indoor temperature is typically >30°C and that the maximum temperature can reach 37.5°C in hot-humid areas. However, the effects caused by increasing the humidity at high indoor temperatures are not clear. In this study, twelve female and twelve male subjects were exposed to different operative temperature (26.6, 30.6, and 37.4°C) and relative humidity (50% and 70%) in a climate chamber. Data concerning thermal sensation, perceived air quality, and Sick Building Syndrome (SBS) were collected during 190-min-long exposure to each thermal condition. Heart rate, respiration rate, respiratory ventilation rate, mean skin temperature, and eardrum temperature were measured. It was found that increasing the relative humidity from 50% to 70% at 26 and 30°C had no significant effects on the physiological responses, thermal comfort, perceived air quality, or SBS symptoms of the subjects. However, when the temperature was elevated to 37°C, the heart rate, respiration rate, respiratory ventilation rate, mean skin temperature, and eardrum temperature increased significantly as a result of the increase in the relative humidity from 50% to 70%. The subjects felt hotter and more uncomfortable, and they found indoor air quality was more difficult to accept. The subjects are acclimatized to hot environments and more tolerant to heat. Therefore, the results are applicable to the acclimated people living in hot-humid climate.

Teachers' work-related non-literature-known building-related symptoms are also connected to indoor toxicity: A cross-sectional study.

A previous study showed that classical building-related symptoms (BRS) were related to indoor dust and microbial toxicity via boar sperm motility assay, a sensitive method for measuring mitochondrial toxicity. In this cross-sectional study, we analyzed whether teachers' most common work-related non-literature-known BRS (nBRS) were also associated with dust or microbial toxicity. Teachers from 15 schools in Finland completed a questionnaire evaluating 20 nBRS including general, eye, respiratory, hearing, sleep, and mental symptoms. Boar sperm motility assay was used to measure the toxicity of extracts from wiped dust and microbial fallout samples collected from teachers' classrooms. 231 teachers answered a questionnaire and their classroom toxicity data were recorded. A negative binomial mixed model showed that teachers' work-related nBRS were 2.9-fold (95% CI: 1.2-7.3) higher in classrooms with highly toxic dust samples compared to classrooms with non-toxic dust samples (p = 0.024). The RR of work-related nBRS was 1.8 (95% CI: 1.1-2.9) for toxic microbial samples (p = 0.022). Teachers' BRS appeared to be broader than reported in the literature, and the work-related nBRS were associated with toxic dusts and microbes in classrooms.

The home environment in a nationwide sample of multi-family buildings in Sweden: associations with ocular, nasal, throat and dermal symptoms, headache, and fatigue among adults.

Risk factors at home for ocular, nasal, throat and dermal symptoms, headache, and fatigue were studied in a nationwide questionnaire survey in Sweden, the BETSI study in 2006. Totally, 5775 adults from a stratified random sample of multi-family buildings participated. Associations between home environment factors and weekly symptoms were analyzed by multi-level logistic regression. In total, 8.3% had ocular symptoms; 11.9% nasal symptoms; 7.1% throat symptoms; 11.9% dermal symptoms; 8.5% headache and 23.1% fatigue. Subjects in colder climate zones had more mucosal and throat symptoms but less fatigue and ocular symptoms. Rented apartments had poorer indoor environment than self-owned apartments. Those living in buildings constructed from 1961 to 1985 had most symptoms. Building dampness, mold and mold odor were risk factors, especially headache and ocular symptoms. Lack of mechanical ventilation system was another risk factor, especially for headache. Environmental tobacco smoke (ETS), electric radiators, and crowdedness were other risk factors. Oiled wooden floors, recent indoor painting, and new floor materials were negatively associated with symptoms. In conclusion, building dampness, mold, poor ventilation conditions, crowdedness, ETS, and emissions from electric radiators in apartments in Sweden can increase the risk of ocular, nasal, throat and dermal symptoms, headache, and fatigue.

Skin sensitivity to capsaicin, perceived stress and burn out among patients with building-related symptoms.

OBJECTIVE: The mechanisms behind building-related symptoms have remained unknown despite many years of research. It is known that environmental and psychosocial factors are of importance. Some receptors in the Transient Receptor Potential family elicit the same symptoms when stimulated, as reported by those suffering from building-related symptoms. The aim of this study was to compare capsaicin sensitivity between people with and without skin symptoms. A second aim was to investigate perceived stress among individuals with different levels of capsaicin sensitivity. METHODS: People referred to an occupational health care unit and judged to have building-related symptoms by a physician answered a questionnaire regarding their symptoms. Solutions with different capsaicin concentrations were applied to participants' nasolabial folds. Self-reported stress and burnout were assessed using two questionnaires: the Perceived Stress Scale (PSS) and the Shirom-Melamed Burnout Questionnaire (SMBQ). RESULTS: We found that people who reported facial erythema or itching, stinging, tight or burning facial skin were more sensitive than those without symptoms and similarities with Sensitive Skin are discussed. We also found that participants who reacted to the lowest capsaicin concentrations scored significantly higher on scales for stress and burnout. CONCLUSIONS: We found associations between sensitivity to capsaicin and skin symptoms among people with building-related symptoms, as well as associations between capsaicin sensitivity and perceived stress/burnout.

Sick building syndrome among healthcare workers and healthcare associates at observed general hospital in Slovenia.

OBJECTIVE: The aim of this study was to assess the possible associations between self-perceived sick building syndrome (SBS) symptoms among healthcare workers and healthcare associates and self-perceived parameters of indoor work environment quality. METHODS: The cross-sectional study was conducted from February to April 2019. Validated standardized evaluation tools (MM 040 NA Hospital 2007 and MM 040 NA Office 2007) were used for estimating the prevalence of SBS among observed populations. Chi-square and Mann-Whitney U tests for assessing possible associations in SBS symptoms between healthcare workers and associates were used. RESULTS: The response rate was 69.8%. The results showed a lower prevalence of six or more SBS symptoms in healthcare associates (6.4%) compared to healthcare workers (12.0%). Healthcare workers perceived the most frequent risk factors for SBS to be poor air quality, an inappropriate level of relative humidity, and inappropriate room temperature, while the least frequently self-perceived risk factors were inappropriate lighting and noise levels. CONCLUSIONS: This study represents a platform for further analyses - the identification of health risk factors with environmental monitoring.

The role of bio-pollutants in the indoor air quality of old museum buildings: artworks biodeterioration as preview of human diseases.

Indoor air quality in buildings is strongly affected by chemical, physical, and biological agents. Long exposure to inadequate indoor air quality can be very dangerous for the building occupants and can lead to chronic diseases associated with the sick building syndrome (SBS). In this paper, the large presence of biological pollutants in the indoor rooms of an old building and its strict relationship with the outdoor/indoor air conditions were investigated studying Coronini Cronberg Palace Foundation, a historic house museum of the sixteenth century in Gorizia (Italy), where biological contamination affecting the artworks can soon become potentially harmful also for operators and visitors. Detailed aerobiological and microbiological analyses on organic natural materials, combined with a microclimate monitoring, were conducted to evaluate the influence of temperature and relative humidity levels within the Palace in the conspicuous growth and diffusion of microorganisms. Fungal and bacterial colonies damaging materials, mainly affected by the sudden fluctuations of hygrothermal values, were found to widely exceed Italian and international recommended levels for good air quality for both artworks and human beings. Understand their impact on human health would be strictly necessary to reduce biological risks for museum staff and cultural heritage users, but consequently to improve indoor air quality.