Online & Oslo, Norway
21-23 June 2021
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Session 11: Indoor environment and symptoms
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Can we trust what humans report? – Myths and realities
University Hospital of North Norway, Norway; University of Tromsø, Norway
Human information is crucial for efforts in the field of buildings, health and experiences. Despite this, there is strikingly little focus on how it is created and may be understood. Division between e.g. “subjective”/ “feelings” vs. “objective”/ “facts” and thinking that e.g. questionnaires produce “facts” are examples of popular ideas more based on cultural myths than science. Traditionally, the brain is thought to register what happens in- and outside the body. Emerging knowledge indicates that the brain instead should be seen as creating all conscious experiences. In principle, the creation is an “integration” of (a) our previous experiences (i.e. acting as a model to generate predictions on future events) and (b) what actually happens (i.e. the inputs the brain gets, e.g. from our senses); (a) and (b) themselves not being consciously experienced. In this “integration”, factors (a) vs. (b) may have any distribution. If (b) dominates, the traditional model may fit, i.e. experience is rather equivalent to what actually happens. If (a) dominates, the traditional model fails, experience has limited relevance to what actually happens and may be understood as a “copy” based on previous experiences; e.g. still getting symptoms in a building long time after proper renovation of a water-damage. The new knowledge has several important implications, like: (1) Talking, questionnaires etc. “only” give the experience of each person, in principle no “objective” data on causal mechanisms, buildings etc.; (2) As all experiences are “subjective”, no persons report “wrong” data; (3) Cultural misconstructions like “psyche”/“feelings” vs. “soma”/“real” are invalid, misleading and may be destructive. Taking the emerging knowledge into account may be of substantial help for all professions working in the field of buildings, health and experiences.
Characteristics of non-specific building-related symptoms
Umeå University, Sweden
Non-specific building-related symptoms (NBRS) are common in the general population, calling for better understanding regarding characteristics for preven-tion and treatment. The present objective was to review the characteristics of NBRS with respect to basic aspects, symptoms and quality of life, and comorbidity. Among the findings, the review suggests that unmarried women with low education constitute a particular risk group for NBRS, and that it is common to have had NBRS for a long period. Symptoms considered to be typical for NBRS (general, mucosal and skin) are reported by 3-4% of the general population, and the impact on quality of life includes daily activities, harassing attitudes and consequences for working life. Comorbidity with NBRS includes other environmental intolerances, inflammatory diseases, functional somatic syndromes and psychiatric condi-tions. These characteristics imply that assessment for prevention and treatment should include the indi-vidual’s life situation and comorbid conditions in a broad sense.
Understanding “Symptoms Associated with Environmental Factors” (SAEF) in buildings; e.g. “sick building syndrome”, “electromagnetic hypersensitivity” and “multiple chemical sensitivity”
University Hospital of North Norway, Norway; University of Tromsø, Norway
The field of buildings, health and human experiences may be divided between conditions (a) with scientific support for causal relations between exposure and health effects, e.g. dampness in buildings and asthma exacerbation; (b) lacking such scientific support, e.g. “sick building syndrome” (SBS). b) conditions are often disregarded as imaginations, psychogenic etc. Traditional ideas are (1) the brain registers what happens in- and outside the body, thus reports of symptoms and experiences “objectively” reflect the underlying biological processes; (2) all symptoms and experiences result from biological processes in the body, often due to external causes. Emerging knowledge indicates that the brain instead creates all consciously experiences. In principle, experiences are “integrations” of (I) previous experiences (i.e. acting as models to generate predictions on future events) and (II) what actually happens (i.e. inputs to the brain, e.g. from senses); (I) and (II) themselves not being consciously experienced. In this “integration”, factors (I) vs. (II) may have any distribution. If (II) dominates, the traditional model may fit, i.e. experience is rather equivalent to what actually happens. If (I) dominates, the traditional model fails, experience has limited relevance to what actually happens and may be understood as a “copy” based on previous experiences; e.g. still getting asthma(like) symptoms in a building long time after proper renovation of water-damages. This new knowledge offers plausible explanations for learned phenomena like SBS, “multiple chemical sensitivities”, “electromagnetic hypersensitivity” and other conditions with limited scientific documentation for causality between associated environmental factors, e.g. “building”, “electromagnetic” and “chemical”, and experiences like symptoms. Important implications are (A) the symptoms and experiences in e.g. “SBS” are just as real as in any other medical condition; (B) as the symptoms and experiences in such conditions are not caused by the associated factor (e.g. “building”), nor through mechanisms like “syndrome”, “(hyper)sensitivity” etc.; such misleading terms should be abandoned. The new concept and phenomenon description “Symptoms Associated with Environmental Factors” (SAEF) offers a paradigm shift. SAEF opens for a better understanding of such phenomena, including prevention, treatment and the need for interdisciplinary approaches.
Possible mechanisms underlying non-specific building-related symptoms
Umeå University, Sweden
Non-specific building-related symptoms (NBRS) can be referred to health symptoms from the indoor air that are not caused by toxins, showing no organ pathology. The consequences of NBRS for the afflicted individual and society calls for preventive and thera-peutic measures, which should be based on mech-anisms underlying NBRS. The objective of this paper is to provide a brief overview of theoretical and empirical support for protective psychobiological mechanisms that may underlie NBRS. These mechanisms are neural sensitization, neurogenic inflammation, classical con-ditioning, symptom misattribution and somatosensory amplification, and nocebo.
Technical Specification of Human Nose: Bi-directional, cyclically operating combi-device for air-conditioning, heat and moisture recovery, filtration and odor detection but limited capacity
Condair Group AG, Switzerland
We will explain the physiological limitations of our nose for heat and water exchange and explain the potential stress burden by indoor and outdoor temperate climate in winter. Our nose – a small organ (8-10 cm long, surface area 150-200 cm2) bears the burden for heating and moistening roughly 15’000 liters of breathing air per day to 100% humidity and 37°C, Fig. 1, 2. Simultaneously the nose serves as self-cleaning and efficient particle filter. The first task is vital for gas exchange, the second prevents infections and disease by infectious aerosols and air pollution.
The switch from inhalation to exhalation in tidal breathing requires a cycle time of roughly two seconds and a bi-directional workflow process. In intervals of two seconds the nose switches from heat and moisture supply to heat and moisture recovery and is capable to regain roughly 60% of the transferred water and heat. This impressive performance over time is enabled by alternating flow reduction in left and right nose compartment by mucosal swelling, triggered by adjusted blood supply. This allows intermittent work-recovery periods by changing priority from conditioning to filtration and clearance, the key reason for the “nasal cycle”, Fig. 4.
Our nose has a high short-term capacity and may manage increased respiratory minute volumes by physical work or sports activities. But heavy workload by very dry or cold ambient air that persists for several days or weeks, overburdens all noses with a suboptimal performance. This is the case for all elderly people, smokers and all persons with reduce nose breathing capacity for geometric, allergic, vasomotor or infectious reasons, hence more than half of the population. Overburdened noses desiccate and epithelial cell death may result (Fig. 3). The isothermal saturation boundary, normally just above the tracheal bifurcation, moves distally. This exposes a larger portion of conductive airway mucosa to not fully conditioned inhaled air. Conductive airways below the trachea, which are not prepared to resist stress by dry and cold air, become damaged, Fig. 3. Prolonged exposure to dry air (<40% RH) leads to mucosa desiccation, decreased clearance and increased vulnerability for infections and exposure to air pollution.
A field study of indoor air quality and overheating in newly built primary classrooms in low-carbon UK schools
The University of Nottingham, United Kingdom
School buildings confront complex design and layout problems due to needing to respond to a wide range of environmental factors while accommodating intermittent high-density occupancy. Despite current policy-driven emphases on improving building energy efficiency, focusing exclusively on energy issues fails to capture the full effect buildings have on their occupants and the environment. This paper investigates recently constructed low-carbon schools in the UK, examining the indoor environmental quality and assessing overheating assessment against established standards. The findings reveal that carbon dioxide concentrations exceeded the maximum threshold (1,000 ppm) for more than 60% of school hours during both heating and non-heating seasons and that particulate matter levels exceeded 20 g/m3 during the heating season and 10 g/m3 during the non-heating season, indicating annual individual exposure above recommended health guidelines. Furthermore, the classrooms monitored experienced overheating for more than 40% of the school day.
Performance, psychological and physiological effects of office noise
Turku University of Applied Sciences, Finland
BACKGROUND: Background speech is a common disturbance in open-plan offices. Irrelevant speech influences performance and subjective estimations. However, not many studies have examined simultaneously physiological, performance and psychological consequences background speech has on humans.
AIM: To examine the influence of background speech on subjective experience, performance, and physiological measures.
METHODS: The influence of background speech compared to silence was examined in a between-group laboratory experiment. Forty subjects participated (22 females, 18 males, mean age 25 years). Twenty-one subjects participated in the speech group and 19 subjects in the silence group (sound level of ventilation 35 dB LAeq). Background speech was a radio dialogue played at 65 dBA level, which people were supposed to ignore while making cognitive tasks and answering questionnaires. Background speech condition lasted for 50 minutes. Participants’ performance, subjective experience and various physiological stress reactions (e.g. stress hormone level, heart rate variability) were measured.
RESULTS: Compared to the silence group, the speech group had lower performance and higher physiological stress level. Speech was subjectively estimated more annoying and loading, but less tiring than silence.
PRACTICAL IMPLICATIONS: This study shows that background speech influences experience, performance, and physiological stress level while performing cognitively demanding tasks. Therefore, its influence should be minimized in offices, where work requiring concentration is needed.
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