Classification of patients complaining of sick house syndrome and/or multiple chemical sensitivity

Tohoku J Exp Med. 2007 Mar;211(3):223-33.

Classification of patients complaining of sick house syndrome and/or multiple chemical sensitivity.

Ishibashi M, Tonori H, Miki T, Miyajima E, Kudo Y, Tsunoda M, Sakabe K, Aizawa Y.

Department of Preventive Medicine and Public Health, Kitasato University School of Medicine, Kanagawa, and Environmental Medical Center, Kitasato Institute Hospital, Tokyo, Japan. dm03005c@st.kitasato-u.ac.jp

Sick house syndrome (SHS) is a Japanese concept derived from sick building syndrome (SBS), however SHS includes a broader scope of sickness than does SBS. Symptoms of SHS/SBS disappear after leaving the sick house/building, while symptoms of multiple chemical sensitivity (MCS) are elicited by the chance of chemical exposure after leaving the sick house/building. To establish the concept of SHS, we propose to introduce a new classification for SHS. A total of 214 patients complaining of SHS and/or MCS were independently classified using a new classification by clinical ecologists who are experienced physicians with expert knowledge of clinical ecology and general physicians according to disease pathogenesis from clinical records. The classification is as follows: type 1 (symptoms of chemical intoxication), type 2 (symptoms developed possibly due to chemical exposure), type 3 (symptoms developed not because of chemical exposure but rather because of psychological or mental factors), and type 4 (symptoms developed due to allergies or other diseases). The agreements on the classification made by clinical ecologists and general physicians reached 77.1% (Cohen's kappa=0.631), suggesting that this new classification was both apt and accurate. Relations between SHS and allergy/MCS were also studied. The cases classified as SHS type 4 more frequently had allergic past histories than did other types. The proportion of possible MCS cases was higher in the chemical induced SHS group (types 1 and 2) than in other types among male patients. For the universal use in clinical practice, it is necessary to prepare helpful diagnostic criteria of this SHS classification based on pathogenesis and carry our study forward all over the country.

PMID: 17347547 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17347547&itool=iconfft&itool=pubmed_DocSum

Symptom definitions for SBS (sick building syndrome) in residential dwellings

Int J Hyg Environ Health. 2007 Jun 14; [Epub ahead of print]

Symptom definitions for SBS (sick building syndrome) in residential dwellings.

Wang BL, Takigawa T, Yamasaki Y, Sakano N, Wang DH, Ogino K.

Department of Public Health, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.

The potential risk factors for sick building syndrome (SBS) in newly built dwellings were investigated. Two different definitions for SBS were used, a narrow definition (symptoms related to home environment and continuously occurring in the last 3 months were regarded as positive) and another relatively broad definition (symptoms related to home environment and either continuously or sporadically occurring in the last 3 months were regarded as positive). With both definitions indoor air chemicals, especially TVOC, and high stress during work were found to be significantly associated with SBS symptoms. Allergic history was more associated with narrow-sense symptoms and odor perception with broad-sense symptoms. The results indicate that the broad definition be preferred to find more potential risk factors.

PMID: 17574916 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17574916&itool=iconabstr&itool=pubmed_DocSum

Office work exposures and adult-onset asthma

Office work exposures and adult-onset asthma

Jaakkola MS, Jaakkola JJ.

Institute of Occupational and Environmental Medicine, University of
Birmingham, Birmingham, United Kingdom.

Environ Health Perspect. 2007 Jul;115(7):1007-11.

BACKGROUND: Office exposures have been linked to symptoms of sick building syndrome, but their relation to the development of asthma has not been studied previously. These exposures have increasing importance because an increasing proportion of the workforce is working in office environments.

OBJECTIVES: The aim of this study was to assess the relations of exposure to carbonless copy paper (CCP), paper dust, and fumes from photocopiers and printers to adult-onset asthma.

METHODS: We conducted a population-based incident case-control study of adults 21-63 years of age living in the Pirkanmaa District in South Finland. All new clinically diagnosed cases (n = 521) of asthma were recruited during a 3-year study period. A random sample of the source population formed the controls (n = 1,016). This part focused on 133 cases and 316 controls who were office workers according to their current occupation classified by the 1988 International
Standard Classification of Occupations. All participants answered a questionnaire on health, smoking, occupation, and exposures at work and home. Subjects with previous asthma were excluded.

RESULTS: Exposures to paper dust [adjusted odds ratio (OR) = 1.97; 95% confidence interval (CI), 1.25-3.10] and CCP (OR = 1.66; 95% CI, 1.03-2.66) were related to significantly increased risk of adult-onset asthma. An exposure-response relation was observed between exposure to paper dust and risk of asthma.

CONCLUSIONS: This study provides new evidence that exposures to paper dust and CCP in office work are related to increased risk of adult-onset asthma. Reduction of these exposures could prevent asthma in office workers. Clinicians seeing asthma patients should be aware of this link to office exposures.

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17637914&itool=pubmed_DocSum

PMID: 17637914 [PubMed - in process]