Possible relations between incidence and prevalence of sick building syndrome (SBS), indoor exposures, and personal factors were studied in a four year longitudinal study among personnel (n = 129) in six primary schools. The The sick building syndrome (SBS) has various nonspecific symptoms such as eye, skin, and upper airway irritation, headache, and fatigue.' Such symptoms are not uncommon in the general population but several studies have shown that these symptoms are more common among people working in so called sick buildings.2'2 Most of these studies only dealt with symptoms among office workers.2"79 A survey performed in a tricounty region in Sweden, however, showed that not only offices but also schools and day care centres were common among the sick buildings known by the occupational health care centres.'0In two recent studies, we found a relation between the prevalence of symptoms in sick buildings and the concentration of volatile organic hydrocarbons (VOC)" and the presence of wall to wall carpets.'2 Other studies have shown that the amount of fleecy material in the building,4 age of buildings,5 room temperature,9 the type of ventilation system,23 and passive smoking9 influence the prevalence of symptoms. Personal factors may also have an influence.4" Although several cross sectional studies on the sick building syndrome have been published,2"8 longitudinal studies aimed to identify factors related to changes of symptoms are sparse.7 12One aim of this study was to identify indoor exposures and personal factors related to the prevalence of chronic SBS symptoms and the incidence of new symptoms. Another was to study the effect of changes over time in personal and building related factors on the prevalence of SBS.

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The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.

Objectives-To investigate associations between diVerent potential risk factors, related and not related to work, and disorders of the neck and upper extremities occurring up to 24 years later. Methods-The study comprised 252 women and 232 men, Swedish citizens, 42-59 years of age and in a broad range of occupations. Information about potential risk factors was available from a former study conducted in 1969. Data on disorders of the neck, shoulder, and hand-wrist disorders were obtained retrospectively for the period 1970-93. Results-Risk factors were found to diVer between the sexes. Among women overtime work, high mental workload, and unsatisfactory leisure time were associated with disorders in the neck-shoulder region. Interaction was found between high mental workload and unsatisfactory leisure time. Neck symptoms earlier in life were associated with recurrent disorders. Hand and wrist disorders were associated mainly with physical demands at work. Among men blue collar work and a simultaneous presence of high mental workload and additional domestic workload predicted disorders in the neck-shoulder region. Conclusions-Factors related and not related to work were associated with disorders of the neck, shoulders, and hands and wrists up to 24 years later in life. These included factors related to working hours which previously have not been noted in this context. Interactions between risk factors both related and not related to work were commonly found. (Occup Environ Med 1999;56:59-66)

Both psychosocial factors and physical factors related to work have been found to be associated with low back pain (LBP) in many cross sectional and some longitudinal studies. [1][2][3][4] In analyses of potential risk factors for LBP related to work, often physical factors only, or psychosocial factors only, have been considered. Less often both types of factors have been studied and analysed simultaneously. 5 Even less often have conditions outside work been studied in parallel with work related conditions.6 Such a parallel approach is necessary for an understanding of the relative significance of diVerent risk factors. One argument for this approach is that, especially among women, a large part of the total daily physical and psychosocial load derives from tasks outside work, 7 as pointed out in a review by Frankenhauser. 8A second argument is that there mightbesides the interaction between work related psychosocial factors which has been demonstrated by Lindström 9 -be an interaction between factors related to work and conditions outside work, especially factors of a psychosocial nature. Such factors might influence each other, as mentioned by both Frankenhauser 8 and Friedman.10 Such reciprocal influence complicates analyses of associations between work related psychosocial risk factors and health outcomes, but increases the need for such analyses.In longitudinal studies psychosocial factors such as job satisfaction, work content, control in the work situation, social relations, and mental overstrain have been found to be associated with LBP. [11][12][13][14][15][16] Physical factors in these studies considered to contribute to LBP are physically heavy work and previous back problems.The aim of the present study was to investigate the relation between psychosocial and physical factors at work, as well as conditions during leisure time, and LBP over 24 years.