Adaptation of office workers to a new building - impaired well-being as part of the sick-building-syndrome.

AIM: The focus of our study was the assessment of the effects of spatial relocation on office staff. Our aim was to investigate whether psychosocial or personal factors are better predictors of the occurrence of impaired well-being. METHODS: Before relocation the administration of the university hospital of Ulm (Germany) was located in ten different buildings. Chemical and physical parameters of the indoor air were measured. The employees were surveyed with a questionnaire for their health status and psychosocial determinants. After moving to a new wide-spaced building, the same procedure was reapplied shortly afterwards and half a year later. Only respondents who had taken part in all three surveys are taken into account (n=84). The definition of impaired well-being as defined by the ProKlimA-study group was used as the criterion variable. RESULTS: The overall prevalence of impaired well-being rose from 24% to 36% after relocation. Contrarily, persons who were formerly accommodated in a wide spaced-building showed a reduced risk (OR(post1)=0.3). Affected persons had at all times a more negative response pattern. Chemical and physical parameters did not have any influence in this context. CONCLUSIONS: The adaptation to a new environment is influenced by the old "socialization" of the former buildings. Impaired well-being is not limited to bodily complaints, it rather has a systemic character in the form of a distinctive overall response pattern. For an adequate analysis of impaired well-being - and the sick-building-syndrome in consequence - the elucidation of individual and other potentially intervening factors is essential. Taking this into consideration, the search for norm values or a framework seems to be of limited value.

Short-term goal attainment of in-patient rehabilitation in Germany and long-term risk of early retirement in patients with musculoskeletal diseases: results from a prospective 5-year follow-up study.

PURPOSE: Occupational consequences of musculoskeletal disorders (MSDs) are consistently found in epidemiological studies. The aim of this study was to evaluate the prognostic value of various short-term rehabilitation outcome parameters on early retirement in Germany. METHOD: In a prospective multi-centre cohort study of self-rated patient status, physician chosen therapy goals and attainment were measured by means of standardized questionnaires at the beginning and end of medical rehabilitation. Information with regard to disability was collected by self-report over a 5-year follow-up period. RESULTS: We included 1268 MSD patients aged 45-57 who underwent a 3-week, multidisciplinary, in-patient rehabilitation programme in 10 rehabilitation centres in Southern Germany between January and December 2001. During follow-up (mean duration: 3.9 years) 117 (9%) patients received a disability pension. After adjustment for sex, age and patient outcomes, risk for early retirement was significantly increased for patients with only partial success with respect for the therapy goals pain reduction (HR 1.95), improvement in spine motility (HR 1.6) and improvement of muscle strength (HR 2.3). Patients who did not have the therapy goal were at the same risk as patients with full goal achievement. CONCLUSIONS: Clinicians' rating of short-term therapy outcome might be of prognostic relevance of MSD patients' long-term employment status.