Research Article
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EVALUATION OF THE RELATIONSHIP BETWEEN SICK BUILDING SYNDROME PREVALENCE AND INDOOR AIR QUALITY IN SCHOOLS

Year 2023, Volume: 8 Issue: 1, 42 - 53, 17.01.2023
https://doi.org/10.35232/estudamhsd.1222791

Abstract

In this study, it was aimed to evaluate the relationship between Sick Building Syndrome (SBS) prevalence and indoor
air quality in primary and middle schools in rural and urban areas in the west of Turkey. This cross-sectional study was
carried out between September and November 2018 in three randomly selected schools in rural and urban areas. The
questionnaire designed to reveal perceived indoor air quality and SBS was completed by the parents of the students.
On determined days, particulate matter (PM) and carbon dioxide (CO2) levels were measured in the classrooms.
Multiple logistic regression model was developed to investigate the relationship between SBS and some variables. The
study was conducted on 966 students. The prevalence of SBS was found to be 10.2%. The most common SBS
symptoms were listed as fatigue, nasal congestion-discharge, cough, and headache, respectively. The measured PM2.5,
PM10, and CO2 values were higher in the urban area than in the rural area. The risk of SBS was found to be higher in
primary school students, in students who have poor perceived classroom air, lighting, and noise quality, and in students
studying in classrooms with higher PM2.5, PM10, and CO2 values. One in ten students had SBS. There was a relationship
between SBS and poor perceived indoor air quality and increased CO2 and PM values. Raising awareness about SBS
and conducting studies aimed at improving related factors in schools are thought to be important.

References

  • 1. Hu J, Li N, Lv Y, Liu J, Xie J, Zhang H. Investigation on indoor air pollution and childhood allergies in households in six Chinese cities by subjective survey and field measurements. Int J Environ Res Public Health. 2017;14(9):979. DOI:10.3390/ijerph14090979.
  • 2. Morawska L, Ayoko GA, Bae GN, Buonanno G, Chao CYH, Clifford S, et al. Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure. Vol. 108, Environment International. 2017. p. 75–83. DOI:10.1016/j.envint. 2017.07.025.
  • 3. Hou Y, Liu J, Li J. Investigation of Indoor Air Quality in Primary School Classrooms. Procedia Eng. 2015; 121:830–7. DOI:10.1016/j.proeng. 2015.09.037.
  • 4. World Health Organization. Indoor air pollutants: exposure and health effects. (EURO Reports and Studies No 78). Copenhagen: WHO Regional Office for Europe. In 1983.
  • 5. Lu C-Y, Tsai M-C, Muo C-H, Kuo Y-H, Sung F-C, Wu C-C. Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan. Int J Environ Res Public Health. 2017;15(1):7. DOI:10.3390/ijerph15010007.
  • 6. Who Regional Office for Europe. Health and environment in Europe: progress assessment. WHO Regional Office Europe. 2010.
  • 7. Steinle S, Reis S, Sabel CE, Semple S, Twigg MM, Braban CF, et al. Personal exposure monitoring of PM2.5 in indoor and outdoor microenvironments. Sci Total Environ. 2015;508:383–94. DOI: 10.1016/j.scitotenv.2014.12.003.
  • 8. Andersson K. The MM Questionnaire [Internet]. [cited 2022 Jan 8]. Available from: http://www.mmquestionnaire. se/mmq/mmq.html
  • 9. Chirico F, Ferrari G, Taino G, Oddone E, Giorgi I, Imbriani M. Prevalence and risk factors for Sick Building Syndrome among Italian correctional officers: A pilot study. J Heal Soc Sci. 2017;2(1):31–46.
  • 10. Norbäck D, Hashim JH, Markowicz P, Cai GH, Hashim Z, Ali F, et al. Endotoxin, ergosterol, muramic acid and fungal DNA in dust from schools in Johor Bahru, Malaysia - Associations with rhinitis and sick building syndrome (SBS) in junior high school students. Sci Total Environ. 2016;545:95–103. DOI:10.1016/j. scitotenv.2015.12.072.
  • 11. Saijo Y, Nakagi Y, Ito T, Sugioka Y, Endo H, Yoshida T. Dampness, food habits, and sick building syndrome symptoms in elementary school pupils. Environ Health Prev Med. 2010;15(5):276. DOI:10.1007/ s12199-010-0139-0.
  • 12. Azuma K, Ikeda K, Kagi N, Yanagi U, Osawa H. Evaluating prevalence and risk factors of building-related symptoms among office workers: Seasonal characteristics of symptoms and psychosocial and physical environmental factors. Environ Health Prev Med. 2017;22(1):38. DOI:10.1186/s12199- 017-0645-4.
  • 13. Branco PTBS, Alvim-Ferraz MCM, Martins FG, Sousa SIV. Quantifying indoor air quality determinants in urban and rural nursery and primary schools. Environ Res. 2019;176:108534. DOI:10.1016/j.envres.2019.108534.
  • 14. Hulin M, Annesi-Maesano I, Caillaud D. Indoor air quality at school and allergy and asthma among schoolchildren. Differences between rural and urban areas. Rev Fr Allergol. 2011;51(4): 419–24. DOI:10.1016/j.reval.2011. 01.002.
  • 15. Yoon C, Lee K, Park D. Indoor air quality differences between urban and rural preschools in Korea. Environ Sci Pollut Res. 2011;18(3):333–45. DOI:10. 1007/s11356-010-0377-0.
  • 16. Zhang X, Li F, Zhang L, Zhao Z, Norback D. A longitudinal study of sick building syndrome (SBS) among Pupils in Relation to SO2, NO2, O3 and PM10 in schools in China. PLoS One 2014;9(11):e112933. DOI:10.1371 /journal.pone.0112933.
  • 17. Zhang X, Zhao Z, Nordquist T, Larsson L, Sebastian A, Norback D. A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China. Sci Total Environ. 2011;409(24):5253–9. DOI:10.1016/j.scitotenv.2011.08.059.
  • 18. Zhang X, Zhao Z, Nordquist T, Norback D. The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: A two-year follow-up study. Indoor Air. 2011;21(6):462–71. DOI:10.1111/ j.1600-0668.2011.00726.
  • 19. Magnavita N. Work-related symptoms in indoor environments: a puzzling problem for the occupational physician. Int Arch Occup Environ Health. 2014;88 (2):185–96. DOI:10.1007/s00420-014- 0952-7.
  • 20. Khosravinejad A, Sayehmiri K, Kazemy M, Shirmohamadi N, Abyaz M, Kurd N. Evaluation of Sick Building Syndrome prevalence among Mustafa Khomeini hospital staff in Ilam, 2015. J ilam Univ Med Sci. 2018;25(5):1–9. DOI:10.29252/ sjimu.25.5.1.
  • 21. Amouei A, Aghalari Z, Zarei A, Afsharnia M, Geraili Z, Qasemi M. Evaluating the relationships between air pollution and environmental parameters with sick building syndrome in schools of Northern Iran. Indoor Built Environ. 2019;28(10):1422–30. DOI:10.1177/ 1420326X19842302.
  • 22. Norbäck D, Lu C, Zhang Y, Li B, Zhao Z, Huang C, et al. Sources of indoor particulate matter (PM) and outdoor air pollution in China in relation to asthma, wheeze, rhinitis and eczema among preschool children: Synergistic effects between antibiotics use and PM10 and second-hand smoke. Environ Int. 2019;125:252–60. DOI:10.1016/ j.envint.2019.01.036.
  • 23. WHO. Air Quality Guidelines for Particulate Matter, Ozone, Nitrogen Dioxide and Sulfur Dioxide; World Health Organization: Geneva, Switzerland, 2006.
  • 24. Peng Z, Deng W, Tenorio R. Investigation of indoor air quality and the identification of influential factors at primary schools in the North of China. Sustainability. 2017;9(7):1180. DOI:10.3390/ su9071180.
  • 25. Madureira J, Paciência I, Pereira C, Teixeira JP, Fernandes E de O. Indoor air quality in Portuguese schools: levels and sources of pollutants. Indoor Air. 2016;26(4):526–37. DOI:10.1111/ina. 12237.
  • 26. Kim KH, Kabir E, Kabir S. A review on the human health impact of airborne particulate matter. Vol. 74, Environment International. 2015. p. 136–43. DOI:10.1016/j.envint.2014.10.005.
  • 27. Zhang X, Wargocki P, Lian Z. Human responses to carbon dioxide, a follow-up study at recommended exposure limits in non-industrial environments. Build Environ. 2016;100:162–71. DOI:10. 1016/ j.buildenv.2016.02.014 .
  • 28. Ahmed Abdul–Wahab SA, En SCF, Elkamel A, Ahmadi L, Yetilmezsoy K. A review of standards and guidelines set by international bodies for the parameters of indoor air quality. Atmos Pollut Res. 2015;6(5):751–67. DOI:10.5094/APR.2015.084.
  • 29. Mendell MJ, Eliseeva EA, Davies MM, Lobscheid A. Do classroom ventilation rates in California elementary schools influence standardized test scores? Results from a prospective study. Indoor Air. 2016;26(4):546–57. DOI:10.1111/ ina.12241.
  • 30. Muscatiello N, Mccarthy A, Kielb C, Hsu WH, Hwang SA, Lin S. Classroom conditions and CO2 concentrations and teacher health symptom reporting in 10 New York State Schools. Indoor Air. 2015;25(2):157–67. DOI:10.1111/ina. 12136.
  • 31. Dorizas PV, Assimakopoulos MN, Helmis C, Santamouris M. An integrated evaluation study of the ventilation rate, the exposure and the indoor air quality in naturally ventilated classrooms in the Mediterranean region during spring. Sci Total Environ. 2015;502:557–70. DOI:10.1016/j.scitotenv.2014.09.060.
  • 32. Shan X, Zhou J, Chang VWC, Yang EH. Comparing mixing and displacement ventilation in tutorial rooms: Students’ thermal comfort, sick building syndromes, and short-term performance. Build Environ. 2016;102:128–37. DOI:10.1016/j.buildenv.2016.03.025.
  • 33. Finell E, Haverinen-Shaughnessy U, Tolvanen A, Laaksonen S, Karvonen S, Sund R, et al. The associations of indoor environment and psychosocial factors on the subjective evaluation of Indoor Air Quality among lower secondary school students: a multilevel analysis. Indoor Air. 2017;27(2):329–37. DOI:10.1111/ ina.12303.
  • 34. Simoni M, Baldacci S, Canciani M, Pini C, Brunetti LM, Indinnimeo L, et al. How do children perceive indoor air quality (IAQ) at school? In: 61 Epidemiology. European Respiratory Society; 2016. p. PA4923. DOI:10.1183/13993003. congress-2016.pa4923.

OKULLARDA HASTA BİNA SENDROMU YAYGINLIĞI İLE İÇ ORTAM HAVA KALİTESİ ARASINDAKİ İLİŞKİNİN DEĞERLENDİRİLMESİ

Year 2023, Volume: 8 Issue: 1, 42 - 53, 17.01.2023
https://doi.org/10.35232/estudamhsd.1222791

Abstract

Bu çalışmanın amacı, Türkiye’nin batısında yer alan kırsal ve kentsel bölgelerdeki ilköğretim okullarında Hasta Bina
Sendromu (HBS) yaygınlığı ile iç ortam hava kalitesi arasındaki ilişkiyi değerlendirmektir. Bu kesitsel çalışma, kırsal ve
kentsel alanlardan rastgele seçilen üç okulda Eylül-Kasım 2018 tarihleri arasında gerçekleştirildi. Öğrenci velileri
tarafından, iç ortam hava kalitesi algısı ve HBS’yi tanımlamaya yönelik hazırlanan anket formu dolduruldu. Belirlenen
günlerde sınıflarda partikül madde (PM) ve karbondioksit (CO2) seviyeleri ölçüldü. HBS ile bazı değişkenler arasındaki
ilişkiyi incelemek için çoklu lojistik regresyon modeli oluşturuldu. Araştırma 966 öğrencide gerçekleştirildi. HBS
prevalansı %10,2 olarak bulundu. En sık görülen HBS semptomları yorgunluk, burun tıkanıklığı-akıntısı, öksürük ve baş
ağrısı olarak sıralandı. Ölçülen ortalama PM2.5, PM10 ve CO2 değerleri kentsel bölgede kırsal bölgeye göre daha
yüksekti. HBS olma riski; ilkokul öğrencilerinde, sınıf hava kalite algısı, sınıf aydınlatma algısı ve sınıf gürültü algısı kötü
olanlarda, PM2.5 ve PM10 değerlerinin daha yüksek ölçüldüğü sınıflardaki öğrencilerde daha yüksek bulundu. Her on
öğrenciden birinde HBS vardı. HBS ile iç ortam hava kalitesinden rahatsız olma durumu ve artan CO2 ve PM değerleri
arasında bir ilişki vardı. Okullarda HBS konusunda farkındalığın artırılması ve ilgili unsurların iyileştirilmesine yönelik
çalışmaların yapılmasının önemli olduğu düşünülmektedir.

References

  • 1. Hu J, Li N, Lv Y, Liu J, Xie J, Zhang H. Investigation on indoor air pollution and childhood allergies in households in six Chinese cities by subjective survey and field measurements. Int J Environ Res Public Health. 2017;14(9):979. DOI:10.3390/ijerph14090979.
  • 2. Morawska L, Ayoko GA, Bae GN, Buonanno G, Chao CYH, Clifford S, et al. Airborne particles in indoor environment of homes, schools, offices and aged care facilities: The main routes of exposure. Vol. 108, Environment International. 2017. p. 75–83. DOI:10.1016/j.envint. 2017.07.025.
  • 3. Hou Y, Liu J, Li J. Investigation of Indoor Air Quality in Primary School Classrooms. Procedia Eng. 2015; 121:830–7. DOI:10.1016/j.proeng. 2015.09.037.
  • 4. World Health Organization. Indoor air pollutants: exposure and health effects. (EURO Reports and Studies No 78). Copenhagen: WHO Regional Office for Europe. In 1983.
  • 5. Lu C-Y, Tsai M-C, Muo C-H, Kuo Y-H, Sung F-C, Wu C-C. Personal, Psychosocial and Environmental Factors Related to Sick Building Syndrome in Official Employees of Taiwan. Int J Environ Res Public Health. 2017;15(1):7. DOI:10.3390/ijerph15010007.
  • 6. Who Regional Office for Europe. Health and environment in Europe: progress assessment. WHO Regional Office Europe. 2010.
  • 7. Steinle S, Reis S, Sabel CE, Semple S, Twigg MM, Braban CF, et al. Personal exposure monitoring of PM2.5 in indoor and outdoor microenvironments. Sci Total Environ. 2015;508:383–94. DOI: 10.1016/j.scitotenv.2014.12.003.
  • 8. Andersson K. The MM Questionnaire [Internet]. [cited 2022 Jan 8]. Available from: http://www.mmquestionnaire. se/mmq/mmq.html
  • 9. Chirico F, Ferrari G, Taino G, Oddone E, Giorgi I, Imbriani M. Prevalence and risk factors for Sick Building Syndrome among Italian correctional officers: A pilot study. J Heal Soc Sci. 2017;2(1):31–46.
  • 10. Norbäck D, Hashim JH, Markowicz P, Cai GH, Hashim Z, Ali F, et al. Endotoxin, ergosterol, muramic acid and fungal DNA in dust from schools in Johor Bahru, Malaysia - Associations with rhinitis and sick building syndrome (SBS) in junior high school students. Sci Total Environ. 2016;545:95–103. DOI:10.1016/j. scitotenv.2015.12.072.
  • 11. Saijo Y, Nakagi Y, Ito T, Sugioka Y, Endo H, Yoshida T. Dampness, food habits, and sick building syndrome symptoms in elementary school pupils. Environ Health Prev Med. 2010;15(5):276. DOI:10.1007/ s12199-010-0139-0.
  • 12. Azuma K, Ikeda K, Kagi N, Yanagi U, Osawa H. Evaluating prevalence and risk factors of building-related symptoms among office workers: Seasonal characteristics of symptoms and psychosocial and physical environmental factors. Environ Health Prev Med. 2017;22(1):38. DOI:10.1186/s12199- 017-0645-4.
  • 13. Branco PTBS, Alvim-Ferraz MCM, Martins FG, Sousa SIV. Quantifying indoor air quality determinants in urban and rural nursery and primary schools. Environ Res. 2019;176:108534. DOI:10.1016/j.envres.2019.108534.
  • 14. Hulin M, Annesi-Maesano I, Caillaud D. Indoor air quality at school and allergy and asthma among schoolchildren. Differences between rural and urban areas. Rev Fr Allergol. 2011;51(4): 419–24. DOI:10.1016/j.reval.2011. 01.002.
  • 15. Yoon C, Lee K, Park D. Indoor air quality differences between urban and rural preschools in Korea. Environ Sci Pollut Res. 2011;18(3):333–45. DOI:10. 1007/s11356-010-0377-0.
  • 16. Zhang X, Li F, Zhang L, Zhao Z, Norback D. A longitudinal study of sick building syndrome (SBS) among Pupils in Relation to SO2, NO2, O3 and PM10 in schools in China. PLoS One 2014;9(11):e112933. DOI:10.1371 /journal.pone.0112933.
  • 17. Zhang X, Zhao Z, Nordquist T, Larsson L, Sebastian A, Norback D. A longitudinal study of sick building syndrome among pupils in relation to microbial components in dust in schools in China. Sci Total Environ. 2011;409(24):5253–9. DOI:10.1016/j.scitotenv.2011.08.059.
  • 18. Zhang X, Zhao Z, Nordquist T, Norback D. The prevalence and incidence of sick building syndrome in Chinese pupils in relation to the school environment: A two-year follow-up study. Indoor Air. 2011;21(6):462–71. DOI:10.1111/ j.1600-0668.2011.00726.
  • 19. Magnavita N. Work-related symptoms in indoor environments: a puzzling problem for the occupational physician. Int Arch Occup Environ Health. 2014;88 (2):185–96. DOI:10.1007/s00420-014- 0952-7.
  • 20. Khosravinejad A, Sayehmiri K, Kazemy M, Shirmohamadi N, Abyaz M, Kurd N. Evaluation of Sick Building Syndrome prevalence among Mustafa Khomeini hospital staff in Ilam, 2015. J ilam Univ Med Sci. 2018;25(5):1–9. DOI:10.29252/ sjimu.25.5.1.
  • 21. Amouei A, Aghalari Z, Zarei A, Afsharnia M, Geraili Z, Qasemi M. Evaluating the relationships between air pollution and environmental parameters with sick building syndrome in schools of Northern Iran. Indoor Built Environ. 2019;28(10):1422–30. DOI:10.1177/ 1420326X19842302.
  • 22. Norbäck D, Lu C, Zhang Y, Li B, Zhao Z, Huang C, et al. Sources of indoor particulate matter (PM) and outdoor air pollution in China in relation to asthma, wheeze, rhinitis and eczema among preschool children: Synergistic effects between antibiotics use and PM10 and second-hand smoke. Environ Int. 2019;125:252–60. DOI:10.1016/ j.envint.2019.01.036.
  • 23. WHO. Air Quality Guidelines for Particulate Matter, Ozone, Nitrogen Dioxide and Sulfur Dioxide; World Health Organization: Geneva, Switzerland, 2006.
  • 24. Peng Z, Deng W, Tenorio R. Investigation of indoor air quality and the identification of influential factors at primary schools in the North of China. Sustainability. 2017;9(7):1180. DOI:10.3390/ su9071180.
  • 25. Madureira J, Paciência I, Pereira C, Teixeira JP, Fernandes E de O. Indoor air quality in Portuguese schools: levels and sources of pollutants. Indoor Air. 2016;26(4):526–37. DOI:10.1111/ina. 12237.
  • 26. Kim KH, Kabir E, Kabir S. A review on the human health impact of airborne particulate matter. Vol. 74, Environment International. 2015. p. 136–43. DOI:10.1016/j.envint.2014.10.005.
  • 27. Zhang X, Wargocki P, Lian Z. Human responses to carbon dioxide, a follow-up study at recommended exposure limits in non-industrial environments. Build Environ. 2016;100:162–71. DOI:10. 1016/ j.buildenv.2016.02.014 .
  • 28. Ahmed Abdul–Wahab SA, En SCF, Elkamel A, Ahmadi L, Yetilmezsoy K. A review of standards and guidelines set by international bodies for the parameters of indoor air quality. Atmos Pollut Res. 2015;6(5):751–67. DOI:10.5094/APR.2015.084.
  • 29. Mendell MJ, Eliseeva EA, Davies MM, Lobscheid A. Do classroom ventilation rates in California elementary schools influence standardized test scores? Results from a prospective study. Indoor Air. 2016;26(4):546–57. DOI:10.1111/ ina.12241.
  • 30. Muscatiello N, Mccarthy A, Kielb C, Hsu WH, Hwang SA, Lin S. Classroom conditions and CO2 concentrations and teacher health symptom reporting in 10 New York State Schools. Indoor Air. 2015;25(2):157–67. DOI:10.1111/ina. 12136.
  • 31. Dorizas PV, Assimakopoulos MN, Helmis C, Santamouris M. An integrated evaluation study of the ventilation rate, the exposure and the indoor air quality in naturally ventilated classrooms in the Mediterranean region during spring. Sci Total Environ. 2015;502:557–70. DOI:10.1016/j.scitotenv.2014.09.060.
  • 32. Shan X, Zhou J, Chang VWC, Yang EH. Comparing mixing and displacement ventilation in tutorial rooms: Students’ thermal comfort, sick building syndromes, and short-term performance. Build Environ. 2016;102:128–37. DOI:10.1016/j.buildenv.2016.03.025.
  • 33. Finell E, Haverinen-Shaughnessy U, Tolvanen A, Laaksonen S, Karvonen S, Sund R, et al. The associations of indoor environment and psychosocial factors on the subjective evaluation of Indoor Air Quality among lower secondary school students: a multilevel analysis. Indoor Air. 2017;27(2):329–37. DOI:10.1111/ ina.12303.
  • 34. Simoni M, Baldacci S, Canciani M, Pini C, Brunetti LM, Indinnimeo L, et al. How do children perceive indoor air quality (IAQ) at school? In: 61 Epidemiology. European Respiratory Society; 2016. p. PA4923. DOI:10.1183/13993003. congress-2016.pa4923.
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Details

Primary Language English
Subjects Public Health, Environmental Health
Journal Section Research Article
Authors

Ömer Faruk Tekin 0000-0002-7150-5933

İnci Arıkan 0000-0001-5060-7722

Publication Date January 17, 2023
Submission Date December 22, 2022
Published in Issue Year 2023 Volume: 8 Issue: 1

Cite

Vancouver Tekin ÖF, Arıkan İ. EVALUATION OF THE RELATIONSHIP BETWEEN SICK BUILDING SYNDROME PREVALENCE AND INDOOR AIR QUALITY IN SCHOOLS. ESTUDAM Public Health Journal. 2023;8(1):42-53.

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