nitrogen-dioxide and Sick-Building-Syndrome

Building related illnesses are a common problem in developed countries and are expected to increase rapidly in urban India. Although objective physical abnormalities are not generally found except in a few specific diseases like Legionnaires' disease, the symptoms can be uncomfortable and even disabling. In this review we initially introduce the concept of indoor air pollution and building related illnesses. Subsequently we review the sources of and exposure to the pollutants along with their health effects and the approach to a patient of suspected building related illness. We conclude by discussing the measures for the control of indoor air pollution.

Topics: Air Pollution, Indoor; Carbon Monoxide; Humans; Nitrogen Dioxide; Sick Building Syndrome; Smoking

Indoor environment is associated with the sick building syndrome (SBS), but little is known about the contribution of outdoor air pollution and meteorological conditions to SBS. We studied associations between outdoor air pollution, meteorological parameters and selected indoor exposure and building characteristics at home and weekly SBS symptoms in a standardized questionnaire study among 3485 randomly selected adults in China. Outdoor factors included particulate matters with diameter <10μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), outdoor temperature (T), relative air humidity (RH), and wind speed (WS) during last three months. Multiple logistic regression was applied calculating odds ratios (OR) with 95% confidence interval (95% CI). Asthma or allergic rhinitis (atopy) was associated with all types of SBS symptoms except fatigue. Indoor factors played a major role in SBS symptoms. Mold/dampness on the floor/ceiling was associated with fatigue OR=1.60 (1.11-2.30) and headache OR=1.80 (1.07-3.04). Moldy odor was associated with fatigue OR=1.59 (1.07-2.37) and dermal symptoms OR=1.91 (1.21-3.02). Window pane condensation in winter was associated with fatigue OR=1.73 (1.30-2.31) and throat symptoms OR=1.53 (1.01-2.31). Damp bed clothing was related with throat symptom OR=1.62 (1.09-2.40). Home redecoration was associated with fatigue OR=1.49 (1.07-2.06). Frequent window opening was associated with less nose symptoms OR=0.54 (0.36-0.82) and mechanical ventilation in the bathroom reduced dermal symptoms OR=0.66 (0.44-0.99). Females were more susceptible to redecoration and window pane condensation than men. No associations with SBS were observed for outdoor air pollutants or meteorological parameters in the final models combining indoor and outdoor factors, although SO2, T, and RH were associated with some SBS symptoms (fatigue, eyes and nose symptoms) in the separate outdoor models. In conclusion, indoor mold/dampness, air pollution from redecoration and poorer ventilation conditions in dwellings can be risk factors for SBS symptoms in an adult Chinese population, especially among females.

Topics: Adult; Air Pollutants; Air Pollution; Air Pollution, Indoor; Asthma; China; Environmental Exposure; Female; Humans; Humidity; Male; Meteorology; Middle Aged; Nitrogen Dioxide; Odorants; Random Allocation; Seasons; Sick Building Syndrome; Sulfur Dioxide; Ventilation

To compare exposure to formaldehyde, nitrogen dioxide, ozone and terpenes among office workers with and without sick building syndrome and the odds ratio for exposure. Are there significant differences?. In this cross-sectional study of office workers, we investigated the associations between exposure to formaldehyde, nitrogen dioxide, ozone, α-pinene, and D-limonene using a case-control analysis. Data on perceived general, mucosal, and skin symptoms were obtained by questionnaires. Personal exposure measurements of the compounds were performed among cases and controls, and the odds ratios for exposures to the substances, both singly and in combination, were investigated.. Exposures varied for formaldehyde between 0.23 and 45 µg/m(3), nitrogen dioxide between 0.26 and 110 µg/m(3), ozone between <16 and 165 µg/m(3), α-pinene between 0.2 and 170 µg/m(3), and D-limonene between 0.8 and 1,400 µg/m(3). No consistent differences in exposure odds ratios were found between cases and controls or for individual symptoms.

Topics: Adult; Aged; Air Pollutants, Occupational; Air Pollution, Indoor; Case-Control Studies; Cross-Sectional Studies; Female; Formaldehyde; Humans; Male; Middle Aged; Nitrogen Dioxide; Occupational Diseases; Occupational Exposure; Odds Ratio; Ozone; Sick Building Syndrome; Surveys and Questionnaires; Sweden; Terpenes; Young Adult

There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO2), nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), particulate matter (PM10), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010-2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO2 were found positively associated with prevalence of school-related symptoms. Indoor O3 was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM10 was found to be positively associated with new onset of skin, mucosal and general symptoms. CO2 and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO2 was positively associated with new onset of skin symptoms, while outdoor NO2 was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM10 was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM10, SO2 and NO2, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.

Topics: Adolescent; Air Pollutants; Asthma; Child; China; Cohort Studies; Environmental Monitoring; Female; Follow-Up Studies; Humans; Humidity; Hypersensitivity; Longitudinal Studies; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Prevalence; Prospective Studies; Risk Factors; Sick Building Syndrome; Sulfur Dioxide; Surveys and Questionnaires; Temperature

There are few incidence studies on sick building syndrome (SBS). We studied two-year change of SBS in Chinese pupils in relation to parental asthma/allergy (heredity), own atopy, classroom temperature, relative humidity (RH), absolute humidity (AH), crowdedness, CO₂, NO₂, and SO₂. A total of 1993 participated at baseline, and 1143 stayed in the same classrooms after two years. The prevalence of mucosal and general symptoms was 33% and 28% at baseline and increased during follow-up (P < 0.001). Twenty-seven percent reported at least one symptom improved when away from school. Heredity and own atopy were predictors of SBS at baseline and incidence of SBS. At baseline, SO₂ was associated with general symptoms (OR=1.10 per 100 μg/m³), mucosal symptoms (OR=1.12 per 100 μg/m³), and skin symptoms (OR=1.16 per 100 μg/m³). NO₂ was associated with mucosal symptoms (OR=1.13 per 10 μg/m³), and symptoms improved when away from school (OR=1.13 per 10 μg/m³). Temperature, RH, AH, and CO₂ were negatively associated with prevalence of SBS. Incidence or remission of SBS was not related to any exposure, except a negative association between SO₂ and new skin symptoms. In conclusion, heredity and atopy are related to incidence and prevalence of SBS, but the role of the measured exposures for SBS is more unclear.. We found high levels of CO₂ indicating inadequate ventilation and high levels of SO₂ and NO₂, both indoors and outdoors. All schools had natural ventilation, only. Relying on window opening as a tool for ventilation in China is difficult because increased ventilation will decrease the level of CO₂ but increase the level of NO₂ and SO₂ indoors. Prevalence studies of sick building syndrome (SBS) might not be conclusive for causal relationships, and more longitudinal studies on SBS are needed both in China and other parts of the world. The concept of mechanical ventilation and air filtration should be introduced in the schools, and when planning new schools, locations close to heavily trafficked roads should be avoided.

Topics: Air Pollution, Indoor; Animals; Carbon Dioxide; China; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Humidity; Male; Nitrogen Dioxide; Pets; Schools; Sick Building Syndrome; Students; Sulfur Dioxide; Temperature; Time Factors; Ventilation

Poor indoor air quality has been implicated in the increase in allergic and respiratory diseases seen in industrialized countries in recent decades. Although air pollution in the workplace is well studied, much less is known about the consequences of poor air quality in homes. In an attempt to halt or slow down the increase in allergic and respiratory diseases, the European Federation of Allergy and Airways Diseases Patients Associations (EFA) carried out the EU-funded project entitled 'Towards Healthy Air in Dwellings in Europe' (THADE). The aims were to: compile an overview of evidence-based data about exposure to indoor air pollution and its health effects, particularly in relation to allergies, asthma and other respiratory diseases such as chronic obstructive pulmonary disease; review cost-effective measures and technology to improve indoor air quality; review legislation and guidelines on indoor air pollution; produce maps of pollutants in dwellings; and recommend an integrated strategy that defines appropriate indoor air quality policies for implementation in Europe. This paper summarizes the information about air quality in dwellings and indoor environment-related diseases collected by expert consultants within the framework of THADE and terminates with recommendations for actions aimed at improving air quality in homes. The results of this project confirmed that air pollution in dwellings is a relevant health problem. It is a complex problem that must be addressed at European and international levels, and it involves the medical profession, scientific societies, patients' organizations, lawmakers, architects and the building industry. The complete THADE report is available at http://www.efanet.org/activities/documents/THADEReport.pdf.

Topics: Air Pollutants; Air Pollution, Indoor; Allergens; Animals; Carbon Dioxide; Carbon Monoxide; Dust; Europe; Formaldehyde; Fungi; Housing; Humans; Humidity; Legionnaires' Disease; Mineral Fibers; Multiple Chemical Sensitivity; Nitrogen Dioxide; Pyroglyphidae; Radon; Respiratory Hypersensitivity; Sick Building Syndrome; Tobacco Smoke Pollution

This study was conducted to examine the impact of building characteristics and indoor air quality on recurrent wheezing in infants. We followed a birth cohort (BAMSE) comprising 4089 children, born in predefined areas of Stockholm, during their first 2 years of life. Information on exposures was obtained from parental questionnaires when the children were 2 months and on symptoms and diseases when the children were 1 and 2 years old. Children with recurrent wheezing, and two age-matched controls per case, were identified and enrolled in a nested case-control study. The homes were investigated and ventilation rate, humidity, temperature and NO2 measured. We found that living in an apartment erected after 1939, or in a private home with crawl space/concrete slab foundation were associated with an increased risk of recurrent wheezing, odds ratio (OR) 2.5 (1.3-4.8) and 2.5 (1.1-5.4), respectively. The same was true for living in homes with absolute indoor humidity >5.8 g/kg, OR 1.7 (1.0-2.9) and in homes where windowpane condensation was consistently reported over several years, OR 2.2 (1.1-4.5). However, air change rate and type of ventilation system did not seem to affect the risk. In conclusion, relatively new apartment buildings, single-family homes with crawl space/concrete slab foundation, elevated indoor humidity, and reported wintertime windowpane condensation were associated with recurrent wheezing in infants. Thus, improvements of the building quality may have potential to prevent infant wheezing.

Topics: Air Pollutants; Air Pollution, Indoor; Asthma; Case-Control Studies; Child, Preschool; Environmental Monitoring; Epidemiological Monitoring; Female; Humans; Humidity; Infant; Infant, Newborn; Male; Nitrogen Dioxide; Respiratory Sounds; Sick Building Syndrome; Surveys and Questionnaires; Sweden; Temperature; Ventilation

This study focuses on the variability in chemical exposures for individuals working in office buildings. The study involved eight office buildings with 79 participants, and exposures were measured using personal samplers for volatile organic compounds, aldehydes, amines, nitrogen dioxide, ozone, and particles. Ventilation was assessed in each individual office. "Variability among buildings" and "variability among individuals" were evaluated for any component (of the 123) measured in samples from at least 20 persons, using variance component analysis and principal component analysis. Interpersonal differences explained the major part of the variance for 78% of the compounds versus between-buildings differences for 14% of the compounds. For 8% of compounds, the variation was explained in equal amounts by the differences among individuals and among buildings. This study illustrates the necessity for individualised measurements (versus stationary measurements in building) to estimate personal exposures. These results also support the conclusion that in case-referent studies of "sick building syndrome" (SBS), referents to SBS cases can be randomised for building location.

Topics: Air Pollution, Indoor; Aldehydes; Amines; Environmental Exposure; Environmental Monitoring; Epidemiologic Studies; Facility Design and Construction; Humans; Nitrogen Dioxide; Organic Chemicals; Ozone; Particle Size; Reproducibility of Results; Sick Building Syndrome; Sweden; Workplace