title: Air recirculation and sick building syndrome: a blinded crossover trial.
abstract: OBJECTIVE
  This study tested the hypothesis that recirculated air in mechanically ventilated buildings causes symptoms commonly referred to as the sick building syndrome and perceptions of poor indoor air quality.
  
  
  METHODS
  A blinded, four-period crossover trial was carried out in two identical buildings, contrasting 70% return air (index phase) with 0% of return air (reference phase). Each period lasted 1 work-week. The study population comprised 75 workers who had reported symptoms related to the work environment or perceptions of poor indoor air quality. Participants reported their ratings of symptoms, their perceptions, and related information in a daily diary. The outcome criteria included aggregative symptom scores for mucosal irritation, skin reaction, allergic reaction, and general symptoms formed of ratings of component symptoms. Perceptions of unpleasant odor, stuffiness, or dustiness were additional outcome criteria.
  
  
  RESULTS
  All 75 participants returned their diaries. For no symptoms did the scores differ between the two phases more than could be expected by chance. Mean rating of unpleasant odor was significantly smaller during the index phase, but mean ratings of dustiness and stuffiness did not differ materially between the two phases.
  
  
  CONCLUSIONS
  Our results suggest that 70% recirculated air, when accompanied by an adequate intake of outdoor air, can be used without causing adverse effects.
authors.affiliation: Department of Public Health, University of Helsinki, Finland.
authors.forename: J J
authors.initials: JJ
authors.lastname: Jaakkola
authors.forename: P
authors.initials: P
authors.lastname: Tuomaala
authors.forename: O
authors.initials: O
authors.lastname: Seppänen
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D016037:Single-Blind Method; D014691:Ventilation / Q000379:methods*
chemical_list: D000395:Air Pollutants, Occupational