A Longitudinal Study of Sick Building Syndrome (SBS) Among Pupils in Relation to SO2, NO2, O3 and PM10 in Schools in China

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 Nov 15

PMID 25398002

Citations 9

Authors

Xin Zhang

Fan Li

Li Zhang

Zhuohui Zhao

Dan Norback

Affiliations

Soon will be listed here.

Abstract

There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO2), nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), particulate matter (PM10), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010-2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO2 were found positively associated with prevalence of school-related symptoms. Indoor O3 was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM10 was found to be positively associated with new onset of skin, mucosal and general symptoms. CO2 and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO2 was positively associated with new onset of skin symptoms, while outdoor NO2 was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM10 was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM10, SO2 and NO2, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.

Citing Articles

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References

Saijo Y, Nakagi Y, Ito T, Sugioka Y, Endo H, Yoshida T . Relation of dampness to sick building syndrome in Japanese public apartment houses. Environ Health Prev Med. 2009; 14(1):26-35. PMC: 2684768. DOI: 10.1007/s12199-008-0052-y. View

Satish U, Mendell M, Shekhar K, Hotchi T, Sullivan D, Streufert S . Is CO2 an indoor pollutant? Direct effects of low-to-moderate CO2 concentrations on human decision-making performance. Environ Health Perspect. 2012; 120(12):1671-7. PMC: 3548274. DOI: 10.1289/ehp.1104789. View

Mengersen K, Morawska L, Wang H, Murphy N, Tayphasavanh F, Darasavong K . Association between indoor air pollution measurements and respiratory health in women and children in Lao PDR. Indoor Air. 2010; 21(1):25-35. DOI: 10.1111/j.1600-0668.2010.00679.x. View

Cai G, Hashim J, Hashim Z, Ali F, Bloom E, Larsson L . Fungal DNA, allergens, mycotoxins and associations with asthmatic symptoms among pupils in schools from Johor Bahru, Malaysia. Pediatr Allergy Immunol. 2011; 22(3):290-7. DOI: 10.1111/j.1399-3038.2010.01127.x. View

Apter A, Bracker A, Hodgson M, Sidman J, Leung W . Epidemiology of the sick building syndrome. J Allergy Clin Immunol. 1994; 94(2 Pt 2):277-88. View

Mendell M, Heath G . Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature. Indoor Air. 2005; 15(1):27-52. DOI: 10.1111/j.1600-0668.2004.00320.x. View

Wang J, Li B, Yang Q, Yu W, Wang H, Norback D . Odors and sensations of humidity and dryness in relation to sick building syndrome and home environment in Chongqing, China. PLoS One. 2013; 8(8):e72385. PMC: 3753273. DOI: 10.1371/journal.pone.0072385. View

Richter A, Burrows J, Nuss H, Granier C, Niemeier U . Increase in tropospheric nitrogen dioxide over China observed from space. Nature. 2005; 437(7055):129-32. DOI: 10.1038/nature04092. View

Fox A, Harley W, Feigley C, Salzberg D, Toole C, Sebastian A . Large particles are responsible for elevated bacterial marker levels in school air upon occupation. J Environ Monit. 2005; 7(5):450-6. DOI: 10.1039/b418038k. View

10.

Simoni M, Annesi-Maesano I, Sigsgaard T, Norback D, Wieslander G, Nystad W . School air quality related to dry cough, rhinitis and nasal patency in children. Eur Respir J. 2010; 35(4):742-9. DOI: 10.1183/09031936.00016309. View

11.

Penard-Morand C, Charpin D, Raherison C, Kopferschmitt C, Caillaud D, Lavaud F . Long-term exposure to background air pollution related to respiratory and allergic health in schoolchildren. Clin Exp Allergy. 2005; 35(10):1279-87. DOI: 10.1111/j.1365-2222.2005.02336.x. View

12.

Norback D, Edling C . Environmental, occupational, and personal factors related to the prevalence of sick building syndrome in the general population. Br J Ind Med. 1991; 48(7):451-62. PMC: 1035398. DOI: 10.1136/oem.48.7.451. View

13.

Norback D . An update on sick building syndrome. Curr Opin Allergy Clin Immunol. 2009; 9(1):55-9. DOI: 10.1097/ACI.0b013e32831f8f08. View

14.

Oeder S, Dietrich S, Weichenmeier I, Schober W, Pusch G, Jorres R . Toxicity and elemental composition of particulate matter from outdoor and indoor air of elementary schools in Munich, Germany. Indoor Air. 2011; 22(2):148-58. DOI: 10.1111/j.1600-0668.2011.00743.x. View

15.

Zhang J, Hu W, Wei F, Wu G, Korn L, Chapman R . Children's respiratory morbidity prevalence in relation to air pollution in four Chinese cities. Environ Health Perspect. 2002; 110(9):961-7. PMC: 1240998. DOI: 10.1289/ehp.02110961. View

16.

Hwang B, Jaakkola J, Lee Y, Lin Y, Guo Y . Relation between air pollution and allergic rhinitis in Taiwanese schoolchildren. Respir Res. 2006; 7:23. PMC: 1420289. DOI: 10.1186/1465-9921-7-23. View

17.

Redlich C, Sparer J, Cullen M . Sick-building syndrome. Lancet. 1997; 349(9057):1013-6. DOI: 10.1016/S0140-6736(96)07220-0. View

18.

Norback D, Nordstrom K . An experimental study on effects of increased ventilation flow on students' perception of indoor environment in computer classrooms. Indoor Air. 2008; 18(4):293-300. DOI: 10.1111/j.1600-0668.2008.00530.x. View

19.

Lee S, Chang M . Indoor and outdoor air quality investigation at schools in Hong Kong. Chemosphere. 2000; 41(1-2):109-13. DOI: 10.1016/s0045-6535(99)00396-3. View

20.

Zhang X, Sahlberg B, Wieslander G, Janson C, Gislason T, Norback D . Dampness and moulds in workplace buildings: associations with incidence and remission of sick building syndrome (SBS) and biomarkers of inflammation in a 10 year follow-up study. Sci Total Environ. 2012; 430:75-81. DOI: 10.1016/j.scitotenv.2012.04.040. View