sick building syndrome in relation to environmental tobacco smoke and overtime tetsuya mizoue, md,...
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Sick Building Syndromein Relation to Environmental
Tobacco Smoke and Overtime
Tetsuya MIZOUE, MD, PhDDept. of Preventive Medicine,Kyushu University (JAPAN)
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Learning objective
• To understand the concept and risk factors of sick building syndrome (SBS)
• To understand the importance of environmental tobacco smoke and overtime as risks of SBS
• To understand how overtime affects SBS
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Performance objective• Measure prevalence of SBS
symptoms using questionnaire • Explain the factors that determine
the level of ETS exposure in the working population
• Explain the potential roles of overtime work in the development of SBS
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Introduction I am an epidemiologist in the field of
occupational and environmental health. I first developed an interest in indoor air issues during a stay in Finland. Upon my return to Japan, I noticed that both exposure to environmental tobacco smoke and overwork are potentially significant risk factors for sick building syndrome among Japanese office workers.
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Sick Building SyndromeTypical symptoms
1. General malaises: fatigue, headache, nausea,
difficulty in concentration
2. Irritation/dryness of the eyes, nose, throat, and skin
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Risk factors of SBS
• Building characteristics
• Indoor environments
• Working condition
• Human factors
• Psychological factors
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Smoking prevalence in Japan
0
20
40
60
80
100
(%)Male
Female
Source: Japan Tobacco (JT) Inc.
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Determinants of levels of workplace ETS exposure
• Smoking prevalence• Workplace smoking restriction• Tightness of office buildings• Room sharing with colleague• Working hours
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Trends of average working hours in Japan
0
1000
2000
3000Hours worked/year
Source: Ministry of Health, Labor and Welfare
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Epidemiological study
Design cross-sectional study, using questionnaire
Setting city office buildings in Kitakyushu, Japan
Subjects 1281 indoor workers (response rate, 89%)
Am J Epidemiol 2001;154:803-8
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MM040EAÖrebro questionnaire
• Designed for epidemiological assessment of indoor air problems
• Symptoms asked (No. of items) general symptoms (5): fatigue,
headache, etc.; symptoms of the eyes (1), nose (1), throat (2), and skin (3)
• Response optionsoften(weekly), sometimes, no
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Workplace ETS exposure and SBS symptoms
smoker
SBSGeneralNose
0
1
2
3
<1 1-<4 >4 Current
Odds ratio
Daily hours of ETS exposure in nonsmoker
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How does overtime work increase the risk of SBS?
Overtimework
SBS
StressLifestyle
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Work characteristics and health behaviors according to overtime
Hours of overtime worked in the past month
<10 10-<30 30+
Use of a VDT (4 hours +/day)
12.7 18.4 32.4
Work overload (often)
6.6 19.2 50.7
Sports activity (3 times +/week)
17.0 15.8 8.1
Sleep (<6 hours) 5.3 6.4 22.8
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Risk of SBS associated with 30 hours or more overtime work
0
1
2
3
4 Crude model *Adjusted +Adjusted ++
Odds ratio
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Conclusions• ETS exposure at work is a risk
factor for SBS, particularly for symptoms involving the mucous membrane.
• Strict restrictions on smoking may prevent SBS symptoms.
• Long work hours increase the risk of SBS, in part through factors concomitant with overtime.