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http://dx.doi.org/10.1016/j.shaw.2019.06.003

Clinical Characteristics of Disability in Patients with Indoor Aire-Related Environmental Intolerance  

Vuokko, Aki (Finnish Institute of Occupational Health)
Karvala, Kirsi (Finnish Institute of Occupational Health)
Suojalehto, Hille (Finnish Institute of Occupational Health)
Lindholm, Harri (Nokia Bell Labs, Nokia Group)
Selinheimo, Sanna (Finnish Institute of Occupational Health)
Heinonen-Guzejev, Marja (University of Helsinki, Department of Public Health, Faculty of Medicine)
Leppamaki, Sami (Department of Psychiatry, Helsinki University Hospital)
Cederstrom, Sebastian (Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital)
Hublin, Christer (Finnish Institute of Occupational Health)
Tuisku, Katinka (Outpatient Clinic for Assessment of Ability to Work, Department of Psychiatry, Helsinki University Central Hospital)
Sainio, Markku (Finnish Institute of Occupational Health)
Publication Information
Safety and Health at Work / v.10, no.3, 2019 , pp. 362-369 More about this Journal
Abstract
Background: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods: We investigated 12 patients with indoor aire-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
Keywords
Building-related intolerance; Disability evaluation; Environmental intolerance; Functional somatic syndromes; Indoor air;
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