上海市冬季不良建筑物综合征的流行病学调查

[目的]探讨上海市冬季生物因素和飘尘对工作于封闭式建筑物办公室人员发生不良建筑物综合征（SBS）的影响。[方法]1997、1998年冬季，选择竣工10年以内的27幢办公楼进行包括空气细菌总数、霉菌总数、飘尘总量和人均面积的测试，并据此将建筑物分成3组，办公楼的841名办公室工作人员相应形成3组，分别进行症状调查中症状报告率、个人症状指数（PSI）及个人5项症状指数（5－PSI）平均值和眼科、耳鼻喉科和皮肤科检查中体征阳性率的趋势分析。[结果] 眼和鼻咽喉部刺激体征的阳性率随着空气细菌总数、霉菌总数和飘尘总量的增加而逐渐上升，还随着人均面积的减少而逐渐上升。除了人均面积与飘尘总量相关外，4个因素对SBS来说都是独立起作用的因素。[ 结论]眼和鼻咽喉黏膜的刺激体征与上述因素有关。     

上海市冬季不良建筑物综合征的流行病学调查

[目的]探讨上海市冬季生物因素和飘尘对工作于封闭式建筑物办公室工作人员发生不良建筑物综合征(SBS)的影响.[方法]1997、1998年冬季,选择竣工10年以内的27幢办公楼进行包括空气细菌总数、霉菌总数、飘尘总量和人均面积的测试,并据此将建筑物分成3组,办公楼内的841名办公室工作人员相应形成3组,分别进行症状调查中症状报告率、个人症状指数(PSI)及个人5项症状指数(5-PSI)平均值和眼科、耳鼻喉科和皮肤科检查中体征阳性率的趋势分析.[结果]眼和鼻咽喉部刺激体征的阳性率随着空气细菌总数、霉菌总数和飘尘总量的增加而逐渐上升,还随着人均面积的减少而逐渐上升.除了人均面积与飘尘总量相关外,4个因素对SBS来说都是独立起作用的因素.[结论]眼和鼻咽喉黏膜的刺激体征与上述因素有关.     

上海市冬季微小气候和照度对办公室人员健康的影响

目的探讨上海市冬季室内微小气候和照度对封闭式空调办公室人员中不良建筑物综合征(SBS)或办公室综合征发生影响的情况和程度。方法1997年和1998年冬季,在峻工10年以内的27幢办公楼中进行室温、相对湿度和照度的测定,并据此分层而成3组。这些楼内的841名办公室人员亦相应分成3组,分别进行症状出现率、个人症状指数(PSI)和个人5项症状指数(5-PSI)的均值以及眼科、耳鼻喉科和皮肤科检查中体征阳性率的趋势分析,研究这些因素的作用。结果各测定因素与眼和鼻咽喉部刺激体征的阳性率呈显著负相关趋势;室温和照度与症状出现率及症状报告指数均呈显著正相关趋势,而相对湿度则与之呈显著负相关趋势。结果还表明,相对湿度与室温以及相对湿度与照度是两对互为负相关的因素。结论在人体冬季适宜范围内的室温(13～20℃)、相对湿度(33％～82％)和照度(95～1800lx)条件下,测定数值越低,眼和鼻咽部刺激体征的标化阳性率越高。相对湿度与另两个测定因素表现的互为负相关。研究提示,在流行病学研究中进行症状调查的同时,应建立医学检查、功能测试或职业心理因素调查等指标。     

大楼内环境与黏膜刺激症

室内空气质量对人体健康的影响,从70年代起就受到人们的关注。世界卫生组织曾综合了世界各国的研究资料,明确指出在封闭式不良建筑物内人们会出现黏膜、呼吸、皮肤和神经等四个系统的一系列症状,形成一个症候群,称建筑物综合征。近二十年来,随着经济的快速发展,都市的高层建筑越来越多,随之而来的健康问题也受到社会各界的重视。其中封闭式建筑物内空气的质量对人群健康的影响最为重要。最近上海市疾病预防控制中心对上海市27幢办公大楼进行了调查,发现空气中总颗粒物与眼结膜刺激症密切相关,而空气中相对湿度增高反而使眼结膜症减少。值得…     

宁波市新开业宾馆室内空气的卫生学状况

目的 了解宾馆开业时室内空气质量及对从业人员健康的影响。方法 选择4家2～4星级新建并已装修的宾馆于开业后1～4周进行室内空气质量卫生学调查,同时进行从业人员健康影响调查。结果 宾馆内温度、相对湿度、CO、CO2和空气细菌总数与室外对照差异无显著性。甲醛和可吸入颗粒物与室外对照差异有显著性（P<0.05）,其中客房内分别高达（0.42±0.23）mg/m3和（0.13± 0.08）mg/m3。从业人员眼、鼻和咽刺激症状、失眠、头晕和头痛症状阳性率均高于开业5年以上宾馆内从业人员,其中咽、眼刺激症状阳性率高达70.0％和50.0％。结论 新开业宾馆甲醛污染主要来自装饰材料及室内通风换气不足。     

高铁客运站候车环境卫生调查

目的掌握和评估客运专线大型客站候车环境卫生控制现状,为建立高铁车站候车环境卫生规范及加强高铁车站候车环境卫生管理工作提供依据。方法选择京沪高铁南京南站作为监测对象,于2013年春运和暑运期间对车站候车空间热环境、空气品质与物理因素进行现场测试,并对监测数据进行统计学分析。结果高铁客运站候车空间噪声以及夏季相对湿度、冬季照度超标率分别为50%、30%和33%,其余监测指标均达标;总挥发性有机物、甲醛、细菌总数、一氧化碳、负离子夏季均高于冬季,可吸入颗粒冬季高于夏季,夏季与冬季空气品质比较上述指标差异有显著统计学意义(P0.01)。结论南京南站候车大厅环境质量状况总体良好,但需加强降噪、夏季通风除湿以及冬季照明措施。     

钒职业接触对皮肤黏膜的影响及影响因素分析

我们通过横断面研究方法,分析钒对职业接触作业工人皮肤黏膜主要症状和体征的影响,并经logistic回归模型拟合,探索其相关的影响因素。结果表明,钒化合物可引起接钒工人出现明显的皮肤黏膜刺激症状,且皮肤黏膜的异常体征检出率明显高于对照组;高温、酸碱等职业有害因素可增加钒对皮肤黏膜刺激症状的发生率。     

PM10和PM2.5与人类健康效应关系的研究进展

悬浮在空气中的颗粒物,按其空气动力学直径的大小,可分为PM10和PM2.5。2006年,WHO推荐用PM2.5代替PM10作为空气颗粒物浓度的指标。大气颗粒物（PM2.5）中主要包含有机碳、元素碳及碳酸盐碳。建筑扬尘、土壤尘、民用污染（燃煤）和交通污染（机动车尾气排放）为主要来源。北京、上海、西安日PM2.5和PM10日超标浓度皆较高。风速与春季和冬季的PM2.5质量浓度之间呈负相关,PM2.5质量浓度随空气相对湿度增加而增大,相对湿度与PM2.5质量浓度之间有正相关;温度与PM2.5质量浓度之间则无明显相关性。大气PM2.5浓度的升高会引起全死因疾病死亡率、心血管疾病死亡率的增加。大气PM2.5浓度的升高与心血管疾病有关。建议采取加大环境污染企业的治理力度,此外应该降低大城市汽车数量。     

广九直通车客车微小气候和空气质量监测结果分析

目的了解广九直通车客车的微小气候和空气质量现状，为提高和改善其卫生状况提供依据。方法对2007—2011年，温度、相对湿度、风速、二氧化碳、一氧化碳、空气细菌总数和可吸入颗粒（PM10）等指标的监测数据进行统计分析。结果共检测99份样品，夏季温度达标率93％，冬季温度达标率22％，相对湿度达标率54％；其它指标达标率均为100％。结论广九直通车客车空气质量评价指标符合国家卫生标准，主要卫生问题是相对湿度和冬季温度偏高，其卫生调控措施应以降低车内湿度为主。冬季宜采取“降温除湿”的方法调整车内温度和相对湿度。     

桑蚕丝尘对工人健康危害的调查

对 5 61名桑蚕丝接尘工人和 160名对照人群进行劳动卫生学调查及健康检查。结果表明 :车间粉尘浓度 ( 9 81±3 72 )mg/m3,超标率 45 %。与对照组比较 ,接尘组的易感冒、鼻咽喉干燥、眼痒眼干、头昏头痛、丘疹、腰酸腿痛、咳嗽、咯痰、气短等症状及体征阳性率显著增高 (P <0 0 1) ;血液白细胞、嗜酸细胞、免疫球蛋白IgM、IgG增高 ,Hb、IgA降低 ,与对照组比较差异有显著性 ;肺功能大、小气道各项指标接尘组显著低于对照组 (P <0 0 0 1)。提示蚕丝尘对人体健康危害是多方面的 ,应改善劳动条件 ,加强健康监护     

上海市卢湾区办公楼宇职业办公人群不良建筑综合征调查

[目的]研究办公楼宇职业办公人群不良建筑综合征（sick building syndrome,SBS）与办公环境之间的关系及其主要影响因素。[方法]以是否使用集中式空调为标准将办公楼分组,对办公楼环境进行检测并调查其中办公人群,用个人5项症状（即眼干燥或疼痛,鼻塞、喉干燥或疼痛、头痛和疲倦感5项症状都出现的出现数并结合离开办公室症状消除作为判断依据）进行判别并分析其与环境指标之间的关系。[结果]使用集中式空调办公楼的主要环境影响因素是氨、噪声、湿度和新风量,不使用集中式空调办公楼的主要环境影响因素是甲醛、氨、噪声、温度、照度;使用集中武空调办公楼与不使用集中式空调办公楼办公人群的SBS症状检出率分别为13．2％与10．2％,疲倦、眼干燥或疼痛、皮肤干燥、头痛、喉干分别位居各类症状的前5位。[结论]办公环境温度、环境湿度、新风量3项指标与办公楼宇SBS人群存在相关关系,是办公环境SBS的主要影响因素。     

上海冬季大楼综合征的流行病学研究

目的：探讨上海冬季封闭性建筑物的办公室人员中是否存在大楼综合征（ＳＢＳ）,以及基本的总体表现。方法：１９９７和１９９８年冬季,在峻工１０年以内的２７幢办公楼及其内的８４１中办公室工作人员中进行内容包括办公室一般情况、环境检测、个人一般情况、个人症状问询,以及个人医学检查的现况调查。结果：１４项问询症状中有８个症状的报告率超过了１５％,其中４个超过了３０％;个人症状指数（ＰＳＩ）及个人５项症状指数（     

Exposure of humans to a volatile organic mixture. III. Inflammatory response.

A set of symptoms has been described during the past two decades that has been called the "sick building syndrome." These symptoms include eye, nose, and throat irritation; headache; mental fatigue; and respiratory distress. It is likely that the volatile organic compounds (VOCs) present in synthetic materials used in homes and office buildings contribute to these symptoms. However, there have been very few studies in which humans have been exposed to known amounts of VOCs under carefully controlled conditions. In this study, 14 subjects were exposed to a mixture of VOCs (25 mg/m3 total hydrocarbon) that is representative of what is found in new homes and office buildings. Because irritations of the nose and throat are symptoms often associated with the upper respiratory tract and may result from an inflammatory response in the upper airways, we used nasal lavage to monitor neutrophil (PMN) influx into the nasal passages following exposure to VOCs. There were statistically significant increases in PMNs, both immediately after a 4-h exposure to VOCs and 18 h later.     

Office workers' sick building syndrome and indoor carbon dioxide concentrations

This study attempted to determine whether any association exists between sick building syndrome (SBS) and indoor carbon dioxide (CO(2)) concentrations. We evaluated SBS among 111 office workers in August and November 2003. The environmental conditions in the office, including CO(2) concentrations, temperature, relative humidity, and fine particulate matter (PM(2.5)), were continuously monitored. The most prevalent symptoms of the five SBS groups were eye irritation and nonspecific and upper respiratory symptoms. The generalized estimating equation (GEE) models show that workers exposed to indoor CO(2) levels greater than 800 ppm were likely to report more eye irritation or upper respiratory symptoms.     

Reactions of healthy persons and persons suffering from allergic rhinitis when exposed to office dust

OBJECTIVES: Reactions to airborne office dust among healthy subjects and subjects suffering from allergic rhinitis were investigated. METHODS: Twelve healthy and 11 subjects suffering from allergic rhinitis were exposed to clean air [17 (SD 2) microg/m3] and office dust [439 (SD 68) microg/m3] for 245 minutes. The effect measurements included subjective sensations (questionnaire and potentiometer ratings), mood scale, peak flow, bronchial provocation with histamine using forced expiratory volume in 1 second as the effect measure, nasal mucosal swelling, tear film stability, epithelial damage, foam formation in the eye canthus, threshold for eye irritation with carbon dioxide, eye redness, cellular content of conjunctival fluid, and an addition test for distraction. As many investigations were made and as many statistical analyses (including subgroup analyses) were carried out, the risk of mass significance appeared. This problem was dealt with using the Bonferroni correction for multiple significance tests. RESULTS: The mean ratings of the potentiometer were higher (the subjects showed more irritation) during the dust exposure. The objective investigations showed only indications of effects of dust exposure, and some of the indications were in biologically unexplainable directions. No difference in the reactions to dust was observed between the healthy subjects and the subjects suffering from allergic rhinitis. CONCLUSIONS: Dust does not seem to have objective or subjective effects on humans, as only indications of dust effects were found. Subjects suffering from allergic rhinitis do not appear to be a risk group in relation to dust exposure.     

Dampness and airway inflammation and systemic symptoms in office building workers

To evaluate dose-response relationships between airway inflammation/systemic symptoms and dampness exposure, we conducted a self-reported questionnaire study on risk factors among 1237 employees in 19 air-conditioned office buildings in the Taipei area. The odds ratio for eye irritation was 1.34 when either stuffy odor or mold was present in the buildings. The odds ratio increased to 1.72 when both stuffy odor and mold were present, to 3.14 when water damage was also present, and to 5.03 when four dampness exposure factors were present. Dampness in the building had a dose-response effect on eye irritation, cough, and lethargy/fatigue.     

Health effects of low-level exposure to formaldehyde

Twenty-one subjects exposed to formaldehyde (at levels between 0.12 and 1.6 parts per million [ppm]) in two mobile trailers and the remaining 18 unexposed workers of the same workforce were examined by questionnaire and spirometry. Symptoms of eye and throat irritation and increased headache and fatigue were significantly more common among the exposed group than the comparison group. Irritation of the nose, chest tightness, and shortness of breath were also more common among the exposed. Spirometry revealed no decrease in ventilatory function among the exposed workers. The significant increase in frequency of individuals with symptoms indicated an adverse health effect from exposure to formaldehyde at levels between 0.12 and 1.6 ppm. This may have implications regarding the adequacy of the US permissible exposure limit value and suggests the need for further examination of the health effects of formaldehyde in the nonoccupational environment.     

Nose picking and nasal carriage of Staphylococcus aureus.

OBJECTIVE: Nasal carriage of Staphylococcus aureus is an important risk factor for S. aureus infection and a reservoir for methicillin-resistant S. aureus. We investigated whether nose picking was among the determinants of S. aureus nasal carriage. SETTING AND PARTICIPANTS: The study cohort comprised 238 patients who visited the ear, nose, and throat (ENT) disease outpatient clinic of a tertiary care hospital and did not have a nose-specific complaint (defined as ENT patients) and 86 healthy hospital employees (including medical students and laboratory personnel). MEASUREMENTS: All participants completed a questionnaire on behavior regarding the nose and were screened for S. aureus nasal carriage; only ENT patients underwent nasal examination by an ear, nose, and throat physician for clinical signs of nose picking. RESULTS: Among ENT patients, nose pickers were significantly more likely than non-nose pickers to carry S. aureus (37 [53.6%] of 69 vs 60 [35.5%] of 169 patients; relative risk, 1.51 [95% confidence interval, 1.03-2.19]). Among healthy volunteers, there was a statistically significant positive correlation between the self-perceived frequency of nose picking and both the frequency of positive culture results (R=0.31; P=.004) and the load of S. aureus present in the nose (R=0.32; P=.003). CONCLUSION: Nose picking is associated with S. aureus nasal carriage. The role of nose picking in nasal carriage may well be causal in certain cases. Overcoming the habit of nose picking may aid S. aureus decolonization strategies.     

Influence of indoor air quality and personal factors on the sick building syndrome (SBS) in Swedish geriatric hospitals.

OBJECTIVES--Sick building syndrome (SBS) involves symptoms such as irritation to the eyes, skin, and upper airways, headache, and fatigue. The relations between such symptoms and both personal and environmental factors were studied in 225 female hospital workers, working in eight hospital units in the south of Sweden. METHODS--Symptoms of SBS and personal factors were measured by means of a standardised self administered questionnaire. The technical investigation comprised a building survey and measurements of room temperature, supply air temperature, air humidity, and exhaust air flow. RESULTS--The prevalence of symptoms differed from one unit to another. The mean value of weekly complaints of fatigue was 30%, of eye irritation 23%, and of dry facial skin 34%. Eye irritation was related to work stress, self reported exposure to static electricity, and was also more common in buildings with a high ventilation flow and a high noise level (55 dB(A)) from the ventilation system. Nasal symptoms were related to asthma and hay fever only. Throat symptoms were more common in smokers, subjects with asthma or hay fever, new buildings, and in buildings with a high ventilation flow. Facial skin irritation was related to a lack of control of the work conditions, and was more common in new buildings, and buildings with a high ventilation flow and ventilation noise. General symptoms, such as headache and fatigue, were related to current smoking, asthma or hay fever, work dissatisfaction, and static electricity. CONCLUSION--As the prevalence of symptoms was high, there is a need to improve the indoor environment as well as the psychosocial environment in hospitals. These improvements could include a reduction of ventilation noise, minimised smoking, and improvements in the psychosocial climate. Further research is needed to identify indoor climatic factors that cause the increased prevalence of symptoms of SBS in new buildings.