Indoor Environment in Dwellings and Sick Building Syndrome (SBS) : Longitudinal Studies

Abstract: People spend most of their time indoors and mostly in the dwelling. It is therefore important to investigate associations between indoor exposure in dwellings and health. Symptoms that may be related to the indoor environment are sometimes referred to as the "sick building syndrome" (SBS). SBS involves symptoms such as eye, skin and upper airway irritation, headache and fatigue. Three longitudinal studies and one prevalence study on personal and environmental risk factors for SBS in adults were performed. The prevalence study included measurements of indoor exposures in the dwellings. The longitudinal studies, with 8-10 years follow-up time, showed that smoking and indoor paint emissions were risk factors for SBS. Moreover, building dampness and moulds in dwellings were risk factors for onset (incidence) of general symptoms, skin symptoms and mucosal symptoms. In addition subjects living in damp dwellings have a lower remission of general symptoms and skin symptoms. Hay fever was a risk factor for onset of skin symptoms and mucosal symptoms, and asthma was a risk factor for onset of general and mucosal symptoms. Biomarkers of allergy and inflammation (bronchial reactivity, total IgE, ECP and eosinophil count) were predictors of onset of SBS symptoms, in particular mucosal symptoms. In the prevalence study, any SBS-symptom was associated with some individual volatile organic compounds of possible microbial origin (MVOC) e.g. 2-pentanol, 2-hexanon, 2-pentylfuran and 1-octen-3ol. Moreover, there were associations between indoor levels of formaldehyde and the plasticizer Texanol and any SBS. The result from the study indicates that individual MVOC are better indicators of SBS than the total value of MVOC. A final conclusion is that smoking, dampness and moulds and emissions from indoor painting may increase the onset of SBS. The indoor environment in dwellings over time has improved, but there is still a need for further improvements of the indoor environment in dwellings. More longitudinal SBS studies are needed.