Clinical Characteristics of Disability in Patients with Indoor Air–Related Environmental Intolerance

Abstract

Background Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.

Multiple Chemical Sensitivity

“…Thus, a re-experience of the odorant provokes the onset of symptoms. Other authors also suggest, in light of their clinical similarities, that a similar underlying mechanism can be the unifying factor of MCS, CFS, SBS, Burnout syndrome (BS) and Candida Syndrome (CS) within the field of somatoform disorders [ 25 , 87 ]; see also [ 149 ] for findings supporting a functional somatic syndrome in patients with indoor air related intolerance). Park and Knudson [ 115 ] provide an interesting report on the similarities of the medically unexplained physical symptoms MCS, CFS and FM.…”

Odor perception and symptoms during acrolein exposure in individuals with and without building-related symptoms

“…Common symptoms in BRS are irritation of the mucous membranes and the upper respiratory tract, skin-related symptoms, headache, concentration difficulties, and lethargy 1 . Severe BRS leads to substantial suffering, functional impairment, and reduced quality of life 2 – 4 . Environmental factors in the buildings that have been associated with BRS are air contamination, poor ventilation, water damage/dampness, high temperature, and humidity.…”

The Study Of Carbonyls Emissions And Ozone Removal On Green Recycled Building Materials

“…One of the frequently explored indoor air pollutants are VOCs, particularly formaldehyde which can give rise to serious health concerns (IARC 2004;Gall et al 2013;Salthammer 2015). Sick building syndromes are often induced due to short-term exposure to indoor VOCs and formaldehyde (Wolkoff 2018;Vuokko et al 2019). Furthermore, the reactions between indoor VOCs and ambient ozone, especially those VOCs with unsaturated carbon bonds, from various building materials may generate or increase indoor carbonyls which are harmful to our health (Aschmann and Atkinson 1994;Morrison and Nazaroff 2002; Lin and Chen 2014; Cheng et al 2015).…”