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Building-related health effects: what do we know?. Ted Schettler MD, MPH Science and Environmental Health Network Institute of Medicine Jan. 10, 2006. Outline. The indoor environment Building-related health/illness Building-determinants of indoor environmental quality, comfort, health
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Building-related health effects: what do we know? Ted Schettler MD, MPH Science and Environmental Health Network Institute of Medicine Jan. 10, 2006
Outline • The indoor environment • Building-related health/illness • Building-determinants of indoor environmental quality, comfort, health • Health impacts beyond the building
The indoor environment • Determinants of comfort and health: • Temperature, temperature gradients • Humidity • Light • Noise • Chemical pollutants, odors • Personal health • Job/activity requirements • Psychosocial factors
The indoor environment • Heterogeneous; many microenvironments • Gradients—chemical pollutants, temperature, humidity • Vary over space and time
Building-related health effects • Building related illness—e.g., Legionnaire’s disease • Building-related symptoms • Sick-building syndrome • Perceptions of unacceptable indoor environment • Sensitive occupants—e.g., multiple chemical sensitivity (heightened sensitivity to often poorly defined but “ordinary” contaminant levels)
Sick-building syndrome • Building occupants experience acute health and comfort symptoms that appear to be linked to time spent in the building, but often no specific cause can be identified. • Complaints may be localized, in a zone, or widespread
Common symptoms of SBS • Headache and nausea • Nasal and chest congestion; wheezing • Eye problems (dry, itching, tearing, or sore eyes, blurry vision, burning eyes, problems with contact lenses) • Sore throat, hoarseness, dry throat • Fatigue • Chills and fever • Muscle pain • Neurological symptoms (difficulty remembering or concentrating, depression, tension, or nervousness) • Dizziness • Dry skin
A summary of the context • Heterogeneity of environment; micro- environments • Heterogeneity of building occupants • Variability of symptoms, illnesses • Result: Difficult to study and understand • Interactions among multiple factors • Bias in cross-sectional surveys • Need for new statistical techniques; e.g., principal component analysis
Determinants of indoor environmental quality • Primary building material emissions • VOCs: • Aliphatic hydrocarbons, aromatic hydrocarbons, halogenated hydrocarbons, alcohols, ketones, aldehydes, esters, ethers, terpenes • Generally highest after manufacture and construction
Indoor sources of VOCs • Consumer and commercial products—cleaning agents, pesticides, office supplies, etc. • Paints and associated supplies • Adhesives • Building materials • Furnishings and clothing • Combustion appliances • Outdoor air pollutants
Determinants of indoor environmental quality • Secondary material emissions • e.g., due to moisture • alkali (in concrete) degradation of PVC/DEHP (correlation with asthma symptoms) • ozone from copiers or laser printers, outdoors and nitrogen oxides can react with VOCs • cleaning materials can react with surfaces • Secondary emissions may be a chronic problem
Determinants of indoor environmental quality • Surface materials: • PVC flooring, synthetic carpet, particleboard, wall coverings, furniture • PVC flooring, wall coverings, phthalate levels and asthma, wheezing, allergic symptoms (Jaakkola, 2004; Oie, 1999; Bornehag, 2004; Tuomainen, 2004) • Choice of surface material determines cleaning requirements
Determinants of indoor environmental quality • Temperature; temperature gradients • Ventilation: important but limited effectiveness to solve complex problems • Dampness and humidity: influence mold growth, material emissions • Particulate air pollution: outdoor sources, high speed floor polishing • Landscaping; indoor/outdoor pesticide use
Conclusions • Low emitting materials • Avoid materials that might support mold growth • Avoid potential for moisture accumulation • Consider cleaning requirements • Low emission materials, ventilation, humidity control, surface temperatures all work together to influence environmental quality • Life cycle impacts of materials
Health impacts beyond the building • Public, occupational, environmental health impacts: • Water and energy use • Materials extraction, manufacturing, transport, disposal • Health care activities provided in buildings