title: Prevalence of building-related symptoms as an indicator of health and productivity.
abstract: BACKGROUND
  The prevalence of building-related symptoms (BRS) is commonly used to characterize the indoor air quality in office buildings. To analyze the costs of building renovation and the improvement of the indoor environment, it is useful to quantitatively relate the prevalence or intensity of BRS to productivity. The intent of this study is to summarize the links between the BRS and productivity, and demonstrate this linkage in two case buildings.
  
  
  METHODS
  A literature was surveyed for studies that measured simultaneously the prevalence or intensity of BRS and subjectively reported or objectively measured productivity. Case studies in two office environments were performed. An association between the prevalence of BRS and productivity of workers in a call center and in an insurance office were investigated. In the first case study, the productivity was expressed using the direct productivity metrics, namely the number of telephone contacts during active working hours while in the second case, the productivity was assessed by using the data concerning sick leave rates.
  
  
  RESULTS
  Employees who report more BRS also have more often absences which relate to indoor environment quality (IEQ). Their productivity is lower than those who have better IEQ in their offices. Despite uncertainties related to the data concerning recorded sick leave and self-reported productivity, the number of studies showing an association between BRS and productivity or sick leave suggests that such a relationship exists. The present case studies also demonstrated an association between the BRS and the direct productivity. Based on the data from the call center, a reduction of 10%-units in the prevalence of general symptoms (such as fatigue, headache, nausea, etc.) corresponded with a gain of 1.5% in performance. Based on the findings in the insurance company, a reduction of 10%-units in the prevalence of irritation symptoms corresponded with a decrease of 0.7% in the short-term absenteeism.
  
  
  CONCLUSIONS
  A review of 23 studies suggests that a linkage exists between typical BRS and productivity indicators such as task or work performance or absence from work. Quantitative associations between BRS and productivity were demonstrated in two office environments. Quantitative associations between BRS and economic metrics enable cost-benefits analysis.
authors.affiliation: Good Indoor Environment Quality Theme, Finnish Institute of Occupational Health, Helsinki, Finland. raimo.niemela@occuphealth.fi
authors.forename: Raimo
authors.initials: R
authors.lastname: Niemelä
authors.forename: Olli
authors.initials: O
authors.lastname: Seppänen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Korhonen
authors.forename: Kari
authors.initials: K
authors.lastname: Reijula
mesh_terms: D000041:Absenteeism; D016902:Air Pollution, Indoor; D017598:Efficiency, Organizational; D005260:Female; D006304:Health Status; D006801:Humans; D007341:Insurance; D008297:Male; D016272:Occupational Health; D018877:Sick Building Syndrome / Q000145:classification* / Q000503:physiopathology; D018582:Sick Leave; D013689:Telephone; D016526:Workload; D017132:Workplace