Stress and Sleep in Relation to Severity of Building Related Symptoms.

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.

Development and evaluation of a questionnaire instrument for chemical intolerance, based on the International Classification of Functioning, Disability and Health.

PURPOSE: The purpose was to develop a questionnaire instrument to measure difficulties in activities and participation, and impact of environmental factors in chemical intolerance, based on the International Classification of Functioning, Disability and Health, and to assess its validity and reliability. METHOD: Development in three steps: (1) choosing items of relevance for chemical intolerance with an expert group, (2) conducting interviews with persons with chemical intolerance, using sampling to redundancy, (3) conducting a survey with 112 respondents at a first assessment and 91 at a second assessment for test-retest. RESULTS: The final version of the instrument consists of 57 items divided in three parts, which showed good internal consistency in each part, Cronbach alpha: 0.73-0.87. It had good content validity, readability and face validity. Test-retest showed good to very good (≥0.61) Kappa agreement for 37 items, and moderate (0.41-0.60) for 17 items. Three items had poor or fair (<0.41) Kappa agreement. CONCLUSION: The instrument was found to be valid and reliable. It can be used as a clinical tool to help persons with chemical intolerance to receive the best suited help and support for each individual, identify key points in rehabilitation, measure rehabilitation outcome and establish priority for treatment.IMPLICATIONS FOR REHABILITATIONThe questionnaire instrument based on the International Classification of Functioning, Disability and Health which was developed and evaluated in this study, can be used to measure difficulties in activities and participation, and impact of environmental factors in chemical intolerance.Persons with chemical intolerance report lack of support from healthcare and society. Using this questionnaire instrument can help forming the best suited help and support for each individual based on his/her preconditions.This questionnaire instrument can be used to identify key points in rehabilitation and measure rehabilitation outcome.

Medical and social prognosis for patients with perceived hypersensitivity to electricity and skin symptoms related to the use of visual display terminals.

OBJECTIVES: This study attempted to give a medical and social prognosis for patients with perceived "electrical sensitivity". METHODS: In 1980-1998, 350 patients with electrical sensitivity were registered at the University Hospital of Northern Sweden in Umeå, Sweden. Those with hypersensitivity to electricity had multiple symptoms evoked by exposure to different electric environments. Those with skin symptoms related to the use of visual display terminals (VDT) predominantly had facial skin symptoms evoked by a VDT, television screens, or fluorescent light tubes. A questionnaire on civil status, current health status, care, treatment and other measures taken, consequences of the problem, eliciting factors, and current employment was sent to all the patients. The response rate was 73%. Of the 50 respondents with hypersensitivity to electricity, 38% were men and 62% were women. Of the 200 patients with skin symptoms related to VDT use, 21.5% were men and 78.5% women. RESULTS: More women than men had turned to caregivers, including complementary therapies. A larger proportion of patients with hypersensitivity to electricity (38%) than those with skin symptoms related to VDT use (17%) was no longer gainfully employed. Both groups reported a higher symptom frequency than that reported by the the general population. Over time, the medical prognosis improved in the latter group but not in the former. CONCLUSIONS: Patients with hypersensitivity to electricity, particularly women, have extensive medical problems and a considerable number of them stop working. Many patients with skin symptoms related to VDT use have a favorable prognosis. Both groups need early and consistent management.