title: Work-related symptoms in indoor environments: a puzzling problem for the occupational physician.
abstract: OBJECTIVE
  People who work indoors often manifest symptoms related to the work environment. Sick building syndrome (SBS) is a condition closely associated with sealed, air-conditioned workplaces and is especially frequent in countries with a cold climate. However, it is also present in Mediterranean countries where artificial ventilation accompanies the natural one. The significance of personal factors, air quality perception, and psychosocial work conditions in relation to SBS and other work-related symptoms needs to be clarified.
  
  
  METHODS
  Workers from 28 companies in the Latium region of Italy were invited to answer a questionnaire during their routine medical examination at the workplace. A total of 4,029 out of 4,129 took part in the survey, giving a response rate of 97.6 %.
  
  
  RESULTS
  A high percentage of workers (31.9 %) reported symptoms related to work, and two-thirds of the employees (65.4 %) complained of environmental problems. In logistic regression models, personal factors (gender, smoking habit, age, and atopy), anxiety and depression, environmental discomfort and job strain were associated both with symptoms of SBS and other work-related symptoms. There was a significant association between the perception of stuffy air, dry air, and electricity and cases of SBS. Some associations between symptoms and the work environment lacked biological plausibility.
  
  
  CONCLUSIONS
  The occupational physician's task is to systematically monitor workers' symptoms and their perception of the work environment in order to analyze this relationship and indicates the best mode of preventing illness/discomfort. This paper provides a method and reference values.
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Largo Gemelli 8, 00168, Rome, Italy, nicolamagnavita@gmail.com.
authors.forename: Nicola
authors.initials: N
authors.lastname: Magnavita
mesh_terms: D000328:Adult; D000389:Air Conditioning; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009787:Occupational Medicine; D010820:Physicians; D012307:Risk Factors; D017678:Sex Distribution; D018877:Sick Building Syndrome / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational