In this study we aimed to research the frequency of and possible risk factors for sick building syndrome (SBS) in indoor workplaces in Istanbul. The investigation was carried out in 50 non-governmental bank offices: 25 had a central ventilation system (the study group) and 25 a local ventilation system (the control group). Clinical outcomes were estimated by a standardised questionnaire completed by employees. In addition, the level of indoor gaseous pollutants and bio-aerosols (micro-fungi and bacteria) were measured. The most prevalent bio-aerosols found in the study offices were high densities of Penicillium and Aspergillus spores in contrast to the control offices where the predominant species were Cladasporium and Alternia spores. Findings of SBS were relatively increased in those working in buildings with a central air conditioning system (OR=1.68; 95% CI: 1.04-2.70); in those working for less than 3 years in the building (OR=1.91; 95% CI: 1.18-3.09); in those operating a photocopier frequently (OR=1.70; 95% CI: 1.15-2.53); in women (OR=1.78; 95% CI: 1.21-2.63) and in those with workplace dissatisfaction (OR=2.06; 95% CI: 1.40-3.05).
EPA (Environmental Protection Agency): Indoor air facts (revised): Sick building syndrome (SBS), www.epa.gov/iaq, 2006.
2.
Burge PS : Sick building syndrome : Occup Environ Med2004;61: 185-190 .
3.
Samet JM , Spengler JD : Indoor air pollution. In Rom WN (ed.) Environmental Occupational Medicine, 2nd edn., Little Brown and Company, Boston, USA , 1992, pp. 1243-1254.
4.
World Health Organization (WHO) : Health Aspects of Indoor Air Quality, European Reports and Studies. WHO Regional Publications, European Series No. 21, WHO, Regional Office for Europe, Copenhagen , 1992.
5.
Redlich CA , Sparer J , Cullen MR : Sick building syndrome : Lancet1997;349: 1013-1016 .
6.
Apter A , Bracker A , Hodgson M , Sidman J , Leung W-Y : Epidemiology of the sick building syndrome : J Allergy Clin Immunol1994;94(Suppl 2, pt 2): 277-288 .
7.
Vitel C : The quality of the air in our buildings : Indoor Built Environ2001;10: 266-270 .
8.
Harrison P , Aylward C , Holmes P , Harris : Indoor environment research in Europe: beware the gaps : Indoor Built Environ2005;14(5): 341-343 .
9.
Nesa D , Lortholary J , Bouakline A , Bordes M , Chandenier J , Derouin F , Gagneux JP : Comparative performance of impactor air samplers for quantification of fungal contamination : J Hosp Infect2001;47: 149-155 .
10.
Meier R , Zingre H : Qualification of air sampler systems: The MAS-100 : Swiss Pharma2000;22: 15-21 .
11.
Larone DH : Medically Important Fungi. A Guide to Identification, 2nd edn.Washington, DC, American Society for Microbiology , 1993.
12.
Samson RA , Hoeskstra ES , Frisvad JC , Filtenborg O : Introduction to Food and Airborne Fungi, 6th edn. Central bureau Voor Schimmelcultures Utrecht. An Institute of the Royal Netherlands Academy of Arts and Sciences. Wagemimgen, The Netherlands, Ponsen & Looyen , 2000.
13.
Flannigan B : Air sampling for fungi in indoor environments : J Aerosol Sci1997;28: 381-392 .
14.
De Hoog GS , Guarro J , Gene J , Figuerras MJ : Atlas of Clinical Fungi, 2nd edn.Central bureau voor Schimmelcultures/Universitat Rovira I Virgili Reus, Spain , 2000.
15.
Kubo T , Mizoue T , Ide R , Tokui N , Fujino Y , Minh PT , Shirane K , Matsumoto T , Yoshimura T : Visual display terminal work and sick building syndrome - the role of psychosocial distress in the relationship : J Occup Health2006;48: 107-112 .
16.
Anderson K , Stridh G : The use of standardized questionnaires in building related illness (BRI) and sick building syndrome (SBS) surveys. In: Levy F , Maroni M (eds) NATO/CCMS Pilot Study on Indoor Air Quality 1992, Oslo, National Institute of Occupational Health , 1992, pp 47-64.
17.
NIOSH: Indoor Air Quality, Selected References, National Institute for Occupational Safety and Health, September 1989, Cincinnati, OH, USA.
18.
NIOSH: Building Air Quality: A Guide for Building Owners and Facility Managers, Cincinnati, OH, US Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH), Publication No. 91-114, 1991.
19.
Engvall K , Norrby C , Sandstedt E : The Stockholm Indoor Environment Questionnaire: a sociologically based tool for the assessment of indoor environment and health in dwellings : Indoor Air2004;14: 24-33 .
20.
NIOSH : Indoor Air Quality and Work Environment Symptoms Survey, NIOSH Indoor Environmental Quality Survey . http://www.cdc.gov/n1osh/ieqwww.txt.
21.
Guo H , Lee SC , Chan LY : Indoor air quality investigation at air conditioned and non-air conditioned markets in Hong Kong : Sci Total Environ2004;323: 87-98 .
22.
Skov P , Valbjørn O : The sick building syndrome in the office environment. The Danish Town Hall Study : Environ Intl1987;13: 339-349 .
23.
Bengtsson M : The Users’ Perception of the Indoor Environment: A Field Survey in a Modern Office Building (in Swedish), Chalmers University of Technology, Gothenburg, Sweden , 2003.
24.
Stoops JL : The Thermal Environment and Occupant Perceptions in European Office Buildings, Chalmers University of Technology, Gothenburg , 2000.
25.
Stoops JL : The Physical Environment and Occupant Thermal Perceptions in Office Building - An Evaluation of Sampled Data from Five European Countries, Chalmers University of Technology, Gothenburg, Sweden , 2001.
26.
Christoffersen J , Petersen E , Johnsen K , Valbjørn O : Windows and Daylight - A Field Study in Office Buildings, Statens Byggeforskningsinstitut, Hørsholm, Denmark , 1999, p. 73-73.
27.
Thörn A : Emergence and preservation of a chronically sick building : J Epidemiol Commun Health2000;54: 552-556 .
28.
ASHRAE (American Society for Heating, Refrigerating and Air-conditioning Engineers) : ASHRAE Standard Ventilation for Acceptable Indoor Air Quality, ANSI/ASHRAE 62-1999.
29.
TSE (Institute of Turkish Standards) : Environmental Health Measures for Indoor Air, TSE 12281, April 1997, Ankara, Turkey .
30.
European Collaborative Action (ECA) : Indoor air quality and its impact on man. COST Project 613. Biological particles in indoor environments. Report No. 12, EUR 14988 EN. Office for official Publications of the European Communities, Luxembourg . 1993.
31.
McGrath JJ , Wong WC , Cooley D , Straus DC : Continually measured fungal profiles in sick building syndrome , Curr Microbiol1999;38: 33-36 .
32.
McGrath JJ , Wong WC , Cooley JD , Straus DC : Continually measured fungal profiles in sick building syndrome , Curr Microbiol1999;38: 33-36 .
33.
Bush RK , Portnoy JM : The role and abatement of fungal allergens in allergic disease : J Allergy Clin Immun2001;107(Suppl 3, part 2): 430-440 .
34.
Rao CY , Burge HA , Chang JCS : Review of quantitative standards and guidelines for fungi in indoor air : J Air Waste Manag Assoc1996;46: 899-908 .
35.
Pastuszka JS , Kyaw Tha Paw U , Lis Do , Wlazlo A , Ulfig : Bacteria and fungal aerosol in indoor environment : Atmos Environ2000;34: 3833-3842 .
36.
Shelton BG , Kirkland KH , Flanders WD , Morris GK : Profiles of airborne fungi in buildings and outdoor environments in the United States : Appl Environ Microb2002;68: 1743-1753 .
37.
Gelincik AA , Büyüköztürk S , Gül H , Güngör G , Issever H , Çagatay A : The effect of indoor fungi on the symptoms of patients with allergic rhinitis in Istanbul : Indoor Built Environ2005;14: 427-432 .
38.
Lee SC , Guo H , Li WM , Chan LY : Inter-comparison of air pollutant concentrations in different indoor environment in Hong Kong : Atmos Environ2002;36: 1929-1940 .
39.
Martinez KF , Malkin R : Health Hazard Evaluation Report, HETA 92-0102-2537, 1995, Sacramento Army Depot, Sacramento, CA .
40.
Jankowska E , Kondej D , Posniak M : Subjective evaluation of the work environment quality in offices : Med Pr2003;54(5): 437-444 .
41.
Gilbert AN , Knasko SC , Sabini J : Sex differences in task performance associated with attention to ambient odor : Arc Environ Health1997;52: 195-199 .
42.
Saijo Y , Kishi R , Sata F , Katakura Y , Urashima Y , Hatakeyama A , Kobayashi S , Jin K , Kurahashi N , Kondo T , Gong YY , Umemura T : Symptoms in relation to chemicals and dampness in newly built dwellings : Int Arc Occup Environ Hlth2004;77: 461-470 .
43.
Runeson R , Norback D , Klinteberg B , Edling C : The influence of personality, measured by the Karollinska Scales of Personality (KSP), on symptoms among subjects in suspected sick buildings : Indoor Air2004;14(6): 394-404 .
44.
Runeson R , Norback D , Stattin H : Symptoms and sense of coherence - a follow-up study of personnel from workplace buildings with indoor air problems : Int Arch Occup Environ Hlth2003;76(1): 29-38 .
45.
Brasche S , Bullinger M , Morfeld M , Gebhardt HJ , Bischof W : Why do women suffer from sick building syndrome more often than men? Subjective higher sensitivity versus objective causes : Indoor Air. 2001;11(4): 217-222 .
46.
Marmot AF , Eley J , Stafford M , Stansfeld SA , Warwick E , Marmot MG : Building health: an epidemiological study of “sick building syndrome” in the Whitehall II Study : Occup Environ Med2006;63: 283-289 .
