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  • 1.
    Edvardsson, Berit
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    "Det är inte mig det är fel på, det är huset": en studie av prognosfaktorer och bemötande med fokus på sjuka hus-syndromet2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Sick Building Syndrome (SBS) is still in 2015 a controversial condition. The set of non-specific symptoms occurring in a particular building and not caused by specific illness such as allergy or infection are questioned. The variousSBS symptoms can be grouped as dermal, mucosal and general and there is no universally accepted clinical definition of SBS. Symptoms normally improve or disappear when people are not exposed in a particular building. SBS is a multifactorial disease and described as a syndrome caused or aggravated by many factors related to indoor environment such as dampness and mould, insufficiency of fresh air, but also psychosocial and individual factors like female gender and personality.

    Objectives: The hypothesis is that personal factors such as previous health, actions taken, time, treatment, personality and coping resources are factors important in influencing the prognosis for SBS patients. The main purpose of this thesis is to explore more about how the symptoms affect work-capability and if SBS patients recover from their symptoms. Another important aim is to explore the experience of the emergence of symptoms and encounters in a group of people with SBS. To find out more about personality and coping resources and their importance for the progress of SBS symptoms comparisons were made with a selection from the general population, a group of patients having hand eczema and a group of patients with perceived sensitivity to electricity.

    Methods: A follow-up questionnaire focusing on current medical and social status, care, treatment, other measures taken, coping and personality traits was sent to 239 patients with non-specific building-related symptoms, assessed during the period between 1986-1998 at the University Hospital in Umeå, Sweden, response rate 79,1%. Prognosis and risk factors for prognosis were calculated for the SBS patients.  Measurement of personality traits like self-image was done using Structural analysis of Social Behaviour, SASB, and coping ability was measured with Coping Resources Inventory, CRI. Similar follow-up questionnaires for patient groups with hand eczema and perceived electrical sensitivity were used and response rates were 68% respectively 73%. Risk factors for prognosis with focus on self-image and coping were calculated for the SBS patients and the group of patients having hand eczema. Comparisons were made between self-image and coping among SBS patients, patients with electrical hypersensitivity, patients with hand eczema and a selection from the general population. To explore the experience of SBS symptoms and encounters a semi-structured interview was performed with 10 informants with symptoms of SBS. Five of them were previously diagnosed and had participated in the earlier follow-up study. The remaining five had had SBS symptoms for a shorter period. The interviews were analysed using qualitative content analysis.   

    Results: The degree and severity of SBS symptoms decreased over time, although nearly half of the SBS patients claimed that symptoms were more or less unchanged after 7 years or more. The risk of having no work capabilities was significantly increased at follow-up if the time from debut to first visit at the hospital clinic was more than one year and this risk was also significantly higher if the patient at the first visit had 5 or more symptoms. Common daily activities, like going by bus, also aggravated the SBS symptoms according to answers in the questionnaires.

    The informants’ experiences of the emerging SBS symptoms are that when they first appear they are often similar to those of flu like runny nose and eyes, hoarseness, cough, and headache. Many of the informants act to change the way they manage the situation as a result of increased symptoms. During this whole process the informants/patients perceived a lack of confirmation and support from e.g. employers, primary health care and occupational health care centres.

    Regarding self-image, all three patient groups scored higher on spontaneous and positive self-image than a comparison group. They were all less controlled. The patients with hand-eczema together with the patients with perceived electrical sensitivity also had a high score on negative self-image. CRI- domains did not differ between patients and comparison group except on CRI cognitive, were the hand eczema patients had a lower score than the comparison group contrary to SBS patients who had a higher score than the comparison group. The patients with perceived electrical sensitivity had a higher score on CRI spiritual. Self-image or coping ability was not associated with SBS symptoms or persistent hand eczema symptoms at follow-up and their personality did not affect their work capability. Previous atopic dermatitis was the only consistent predictor of hand eczema at follow-up.

    Conclusion: Within this group of SBS patients there are long lasting symptoms aggravated by environmental factors. The results support that early and comprehensive measures for rehabilitation are essential for these patients. In the beginning the symptoms of SBS are diffuse and difficult to recognise for all involved. Patients with SBS symptoms experience a lack of confirmation and support. It is important that healthcare personnel confirm the patient and are aware of the possible connection between symptoms and the indoor environment. For employers and facility managers knowledge of their obligations in terms of working environment is important. Differences in personality traits were seen in a well-established condition and not only in patients with medically unexplained symptoms. This can imply that patients with general chronic symptoms can deviate from the general population with respect to self-image and coping ability. Certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations.  

     

  • 2.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology. Institute of Clinical Dentistry, University of Tromsø, Tromsø, Norway.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Coping and Self-image in Patients With Symptoms Attributed to Indoor Environment2013In: Archives of Environmental & Occupational Health, ISSN 1933-8244, E-ISSN 2154-4700, Vol. 68, no 3, p. 145-152Article in journal (Refereed)
    Abstract [en]

    This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure.

  • 3.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Eriksson, N
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindén, G
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Widman, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Medical and social prognoses of non-specific building-related symptoms (Sick Building Syndrome): a follow-up study of patients previously referred to hospital2008In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 81, no 7, p. 805-812Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to describe and analysethe medical and social prognoses of patients with nonspeciWcbuilding-related symptoms.Methods A follow-up questionnaire focusing on current medical and social status, care, treatment, other actions taken and personality traits was sent to 239 patients with non-speciWc building-related symptoms assessed during theperiod between1986 and 1998 at University Hospital in Umeå, Sweden. The response rate was 79%.Results Fatigue, irritation of the eyes, and facial erythemawere the most common weekly symptoms reported atfollow-up. As females constituted 92% of the respondents,statistical analyses were restricted to women. The level andseverity of symptoms decreased over time, although nearlyhalf of the patients claimed that symptoms were more or lessunchanged after 7 years or more, despite actions taken.Twenty-Wve percent of the patients were on the sick-list, and20% drew disability pension due to persistent symptoms atfollow-up. The risk of having no work capabilities at followupwas signiWcantly increased if the time from onset to Wrstvisit at the hospital clinic was more than 1 year. This riskwas also signiWcantly higher if the patient at the Wrst visithad Wve or more symptoms. All risk assessments wereadjusted for length of follow-up. Symptoms were oftenaggravated by diVerent situations in everyday life.Conclusions Long-lasting symptoms aggravated by environmentalfactors exist within this group of patients. Theresults support that early and comprehensive measures forrehabilitation are essential for the patients.

  • 4.
    Edvardsson, Berit
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenberg, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Dermatology and Venerology.
    Bergdahl, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Eriksson, Nils
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Linden, G
    Widman, L
    The medical and social prognosis of Sick Building Syndrome: a follow-up study focusing on female patients2005In: Indoor air 2005: proceedings of the 10th international conference on indoor air quality and climate, vols 1-5 / [ed] Yang, X; Zhao, B; Zhao, R, Beijing: Tsinghua university press , 2005, p. 3706-3710Conference paper (Refereed)
    Abstract [en]

    A follow-up questionnaire focusing medical and social status, actions taken and personality traits was sent to 239 patients with Sick Building Syndrome (SBS) registered at the University Hospital in Umea, Sweden. The response rate was 79 percent. As females constituted 92 percent of the respondents all statistical analyses were restricted to women. Almost half of the respondents had been exposed to environments with visible water damages. Fatigue, irritated eyes and facial erythema were the most common symptoms. Nearly half of the patients claimed that the symptoms were more or less unchanged after 7 years or more. Twenty-five percent of the patients were on the sick-list and twenty percent drew disability pension due to SBS-symptoms at follow-up. Symptoms were often aggravated in different situations in everyday life. No important deviations concerning personality factors were found. The results support that early and comprehensive measures for rehabilitation are essential for these patients.

  • 5. Feder, Gene
    et al.
    Rohde, Jon E
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Jimba, Masamine
    Materia, Enrico
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Goldin, Stephen
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Stafford, Tom
    Edvardsson, Berit
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Hilt, Bjorn
    Parkinson, Stuart
    Birch, Marion
    Jones, Anna
    Archibald, Kathy
    Pastore, John O
    Reed Elsevier and the international arms trade.2005In: Lancet, ISSN 1474-547X, Vol. 366, no 9489, p. 889; discussion 889-90Article in journal (Refereed)
  • 6.
    Stenberg, Berndt
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Bergdahl, Jan
    Edvardsson, Berit
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Eriksson, Nils
    Lindén, Gerd
    Widman, Lars
    Medical and social prognosis for patients with perceived hypersensitivity to electricity and skin symptoms related to the use of visual display terminals.2002In: Scand J Work Environ Health, ISSN 0355-3140, Vol. 28, no 5, p. 349-57Article in journal (Refereed)
  • 7.
    Stenberg, Berndt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Edvardsson, Berit
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Sjuka hus-syndromet och kroniska hälsoproblem: en studie i varför vissa blir långvarigt sjuka och arbetsoförmögna av dålig inomhusluft2012In: Byggnadsrelaterad ohälsa i Kvarkenregionen: nio delprojekt om miljökänslighet, luftkvalitet och sjuka hus ur ett tvärvetenskapligt perspektiv : slutrapport för projektet Kompetenscentrum Byggnad - Luftkvalitet - Hälsa 2 (KLUCK 2) / [ed] Martina Österberg, Vasa: Yrkeshögskolan Novia , 2012, p. 45-51Chapter in book (Other academic)
    Abstract [sv]

    I västvärlden vistas människor inomhus eller inne i olika transportfordon under större delen av dygnet, vilket innebär att inomhusmiljön kan ha en betydande inverkan på människors hälsa, välbefinnande och arbetsförmåga. Ett hälsoproblem som kan uppkomma i miljöer med dålig luftkvalitet brukar benämnas sjuka hus-syndromet eller SBS efter det engelska uttrycket Sick Building Syndrome. Vår undersökning inom KLUCK 2 fokuserade på patienter som remitterats till Norrlands Universitetssjukhus på grund av symptom som har samband med sjuka hus. Vi ville veta hur det går för patienterna i ett längre perspektiv och förstå varför vissa patienter utvecklar kroniska besvär.

1 - 7 of 7
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