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)
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
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
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.
Sick Building SyndromeTypical symptoms
1. General malaises: fatigue, headache, nausea,
difficulty in concentration
2. Irritation/dryness of the eyes, nose, throat, and skin
Risk factors of SBS
• Building characteristics
• Indoor environments
• Working condition
• Human factors
• Psychological factors
Smoking prevalence in Japan
0
20
40
60
80
100
(%)Male
Female
Source: Japan Tobacco (JT) Inc.
Determinants of levels of workplace ETS exposure
• Smoking prevalence• Workplace smoking restriction• Tightness of office buildings• Room sharing with colleague• Working hours
Trends of average working hours in Japan
0
1000
2000
3000Hours worked/year
Source: Ministry of Health, Labor and Welfare
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
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
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
How does overtime work increase the risk of SBS?
Overtimework
SBS
StressLifestyle
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
Risk of SBS associated with 30 hours or more overtime work
0
1
2
3
4 Crude model *Adjusted +Adjusted ++
Odds ratio
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.