Personal and psychosocial factors and symptoms compatible with sick building syndrome in the Swedish workforce.

A random sample of 1000 subjects (20-65 years of age) received a postal questionnaire regarding sick building syndrome (SBS), including the three-dimensional model of demand-control-support (DCS). The response rate was 70% (n = 695), and 532 were occupationally active. Female gender and atopy were the main predictors of symptoms. Eye symptoms were more common at low social support combined with strained work situation [odds ratio (OR) 2.37], and at high social support combined with active work situation (OR 3.00). Throat symptoms were more common at low social support combined with either passive (OR 1.86) or strained situation (OR 2.42). Tiredness was more common at low social support combined with either passive (OR 2.41), strained (OR 2.25), or active situation (OR 1.87), and at high social support combined with active work situation (OR 1.83). Low social support combined with either passive (P = 0.01) or strained job situation (P = 0.01) was associated with a higher symptom score (SC). The lowest SC was found at a relaxed work situation, irrespective of social support. In conclusion, female gender, low age, asthma, atopy and psychosocial work environment are associated with symptoms. The three-dimensional model can predict symptoms compatible with SBS, but in a more complex way than earlier research indicated. Practical Implications A multi-disciplinary approach, including psychosocial stress factors as well as personal factors such as gender, age, atopy and asthma, and indoor exposures, should be applied in studies on symptoms compatible with sick building syndrome (SBS). Males and females perceive psychosocial work conditions differently, and may react differently to job stressors. The psychosocial work environment can be as important as gender and atopy as a predictor of SBS symptoms.

The influence of personality, measured by the Karolinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings.

UNLABELLED: The aim was to study possible relationships between personality traits as measured by the Karolinska Scales of Personality (KSP), a self-report personality inventory based on psychobiological theory, and medical symptoms, in subjects with previous work history in suspected sick buildings. The study comprised 195 participants from 19 consecutive cases of suspected sick buildings, initially collected in 1988-92. In 1998-89, the KSP inventory and a symptoms questionnaire were administered in a postal follow-up study. There were 16 questions on symptoms, including symptoms from the eyes, nose, throat, skin, and headache, tiredness, and a symptom score (SC), ranging from 0 to 16, was calculated. The questionnaire also requested information on personal factors, including age, gender, smoking habits, allergy and diagnosed asthma. The KSP ratings in the study group did not differ from the mean personality scale norm scores, calculated from an external reference group. Females had higher scores for somatic anxiety (P < 0.01), muscular tension (P < 0.001), psychic anxiety (P < 0.01), psychasthenia (P < 0.05), indirect aggression (P < 0.05), and guilt (P < 0.05), while males scored higher on detachment (P < 0.001). Subjects with higher SC were found to display higher degree of somatic anxiety (P < 0.001), muscular tension (P < 0.001), psychic anxiety (P < 0.001), psychasthenia (P < 0.001), inhibition of aggression (P < 0.05), detachment (P < 0.05), suspicion (P < 0.01), indirect aggression (P < 0.01), and verbal aggression (P < 0.05). In addition, ocular, respiratory, dermal, and systemic symptoms (headache and tiredness) were significantly related to anxiety- and aggressivity-related scales. There were associations between personality scales and change of symptom score (SC) during the 9-year period. The associations between KSP personality traits and symptoms were more pronounced in females. In conclusion, there are gender differences in personality and SBS symptoms. Personality may play a role in the occurrence of symptoms studied in indoor environmental epidemiology. Our results support a view that measurement of personality could be of value in future studies and vulnerability to environmental stress. PRACTICAL IMPLICATIONS: Personality and personal vulnerability should be considered in both indoor environmental epidemiology and practical handling of building with suspected indoor problem, especially when the technical investigations fail to identify any obvious technical malfunction. Moreover, personality aspects should be considered among subjects with possible vulnerable personality exposed to environmental stress, and personality diagnosis can be a complementary tool useful when assessing 'sick building patients' in the medical services. We found no evidence of severe personality pathology in among those working in workplaces with environmental problems so called 'sick buildings'.

Symptoms and sense of coherence--a follow-up study of personnel from workplace buildings with indoor air problems.

OBJECTIVES: The aim was to study prevalence and change of symptoms in buildings with suspected indoor air problems in relation to sense of coherence (SOC), a psychological measure of a life attitude. METHODS: A cohort of 194 subjects initially working in 19 Swedish buildings with indoor environmental problems was followed from 1988 to 1998. Information on 16 symptoms compatible with sick building syndrome (SBS) was gathered by an initial questionnaire mailed between 1988 and 1992. The same symptom questionnaire, as well as Antonovsky's SOC, was administered in a postal follow-up study in 1998. The prevalence of symptoms and the change (incidence) plus reminiscence of symptoms were calculated for individual symptoms and a total symptom score (SC). Bivariate analyses, as well as multiple linear and logistic regression analyses, were applied and adjusted for age, gender, history of atopy and tobacco smoking. RESULTS: SBS was more common in women, younger subjects and those with a history of atopy. A low SOC was related to a higher prevalence of ocular, nasal, and throat symptoms, tiredness, and headache. In addition, subjects with a low SOC developed more symptoms during the follow-up period. Women had a lower SOC value, but there was no relation between SOC and age, smoking, doctor's diagnosed asthma or a history of atopy. Subjects leaving the problem buildings during the follow-up period had a decrease in symptoms and were more often non-smokers, but had the same mean SOC score as those remaining in the same workplace. CONCLUSIONS: The study indicates that SOC can detect personal vulnerability in relation to suspected environmental stress. Symptoms reported in the buildings with suspected indoor air problems are partly reversible, as indicated by the reduction of symptoms among those leaving these buildings. A multi-disciplinary approach including personality aspects, allergic disorders and indoor exposures should be applied in investigations of buildings with suspected indoor air problems.