Background
Methods
Study design and population
Questionnaires
BRS groups
Statistical analyses
Results
Participants
Characteristic | Mean ± SD or n/N (%)
a
|
---|---|
Gender | |
Male | 1859/2998 (62.0) |
Female | 1139/2998 (38.0) |
Age group | |
10–19 | 6/2990 (0.2) |
20–29 | 352/2990 (11.8) |
30–39 | 807/2990 (27.0) |
40–49 | 794/2990 (26.6) |
50–59 | 645/2990 (21.6) |
≥ 60 | 386/2990 (12.9) |
Job categories | |
Managerial | 656/2947 (22.3) |
Professional | 139/2947 (4.7) |
Technical | 415/2947 (14.1) |
Sales | 363/2947 (12.3) |
Planning/administrative | 1223/2947 (41.5) |
Secretarial/clerical | 6/2947 (0.2) |
Other | 145/2947 (4.9) |
Smoking status | |
Never | 1286/3006 (42.8) |
Former | 714/3006 (23.8) |
Current/sometime | 99/3006 (3.3) |
Current/everyday | 907/3006 (30.2) |
Mean year working in the building (n = 2997) | 7.6 ± 7.1 |
Prevalence of BRSs
Symptoms | Weekly
a
n/N (%)
b
| Monthly
c
n/N (%)
b
|
---|---|---|
Tension, irritability, or nervousness | 327/2825 (11.6) | 245/2825 (8.7) |
Tired or strained eyes | 286/2800 (10.2) | 171/2800 (6.1) |
Dry, itching, or irritated eyes | 222/2952 (7.5) | 121/2952 (4.1) |
Feeling depressed | 195/2857 (6.8) | 179/2857 (6.3) |
Unusual tiredness, fatigue, or drowsiness | 186/2911 (6.4) | 143/2911 (4.9) |
Sore or dry throat | 108/2919 (3.7) | 108/2919 (3.7) |
Headache | 78/2938 (2.7) | 168/2938 (5.7) |
Difficulty remembering things or concentration | 62/2837 (2.2) | 104/2837 (3.7) |
Sneezing | 52/2828 (1.8) | 102/2828 (3.6) |
Cough | 36/2902 (1.2) | 84/2902 (2.9) |
Dry or flushed facial skin | 36/2974 (1.2) | 37/2974 (1.2) |
Stuffy or runny nose, or sinus congestion | 34/2893 (1.2) | 63/2893 (2.2) |
Hands dry, Itching, red skin | 33/2963 (1.1) | 26/2963 (0.9) |
Dizziness or lightheadedness | 32/2928 (1.1) | 65/2928 (2.2) |
Nausea or upset stomach | 32/2941 (1.1) | 65/2941 (2.2) |
Scaling/itching scalp or ears | 23/2961 (0.8) | 26/2961 (0.9) |
Shortness of breath | 15/2978 (0.5) | 32/2978 (1.1) |
Chest tightness | 15/2995 (0.5) | 49/2995 (1.6) |
Wheezing | 7/3003 (0.2) | 17/3003 (0.6) |
Total
d
| 721/2597 (27.8) | 1330/2666 (42.4) |
Risk factors associated with BRSs
Variable factors | Eye irritation OR (95% CI) | General symptoms OR (95% CI) | Upper respiratory OR (95% CI) | Skin symptoms OR (95% CI) |
---|---|---|---|---|
N = 2590 |
N = 2505 |
N = 2486 |
N = 2687 | |
Personal | ||||
Gender (female) | 2.17 (1.53–3.09)**
| 2.19 (1.57–3.05)**
| 2.33 (1.42–3.83)**
| 5.05 (2.10–12.14)**
|
Age | ||||
10–19 | 1.45 (0.15–14.02) | 1.14 (0.12–10.68) | 2.98 (0.29–30.11) | – |
20–29 | 2.06 (1.15–3.67)*
| 2.34 (1.37–3.99)**
| 1.69 (0.77–3.69) | 0.74 (0.25–2.16) |
30–39 | 1.65 (0.96–2.84) | 1.74 (1.07–2.85)*
| 1.40 (0.67–2.92) | 0.68 (0.27–1.75) |
40–49 | 1.26 (0.73–2.17) | 1.12 (0.68–1.84) | 0.87 (0.41–1.86) | 0.46 (0.17–1.24) |
50–59 | 1.76 (1.02–3.03) *
| 1.18 (0.71–1.96) | 1.13 (0.53–2.42) | 0.37 (0.13–1.06) |
≥ 60 | Ref. | Ref. | Ref. | Ref. |
p for trend | 0.048 | <0.001 | 0.149 | 0.425 |
Job categories | ||||
Managerial | Ref. | Ref. | Ref. | Ref. |
Professional | 0.61 (0.27–1.36) | 0.77 (0.39–1.52) | 0.83 (0.23–3.04) | 0.60 (0.07–5.37) |
Technical | 0.49 (0.28–0.86)*
| 0.76 (0.48–1.19) | 1.35 (0.61–2.97) | 0.56 (0.11–2.96) |
Sales | 0.67 (0.41–1.10) | 0.90 (0.58–1.39) | 1.06 (0.46–2.46) | 1.06 (0.25–4.54) |
Planning/administrative | 1.17 (0.78–1.75) | 1.25 (0.84–1.85) | 2.39 (1.20–4.76)*
| 1.72 (0.56–5.29) |
Secretarial/clerical | 2.16 (0.33–14.34) | 0.78 (0.08–7.65) | 8.85 (1.29–60.90) *
| – |
Other | 0.50 (0.20–1.24) | 1.02 (0.51–2.03) | 1.96 (0.70–5.46) | 2.19 (0.55–8.64) |
Smoking | ||||
Never | Ref. | Ref. | Ref. | Ref. |
Former | 0.91 (0.65–1.27) | 0.99 (0.72–1.35) | 1.22 (0.77–1.93) | 1.77 (0.87–3.63) |
Current/sometime | 0.99 (0.48–2.06) | 0.75 (0.35–1.58) | 1.08 (0.40–2.95) | 1.09 (0.14–8.43) |
Current/everyday | 0.93 (0.68–1.27) | 0.89 (0.66–1.20) | 0.95 (0.60–1.50) | 1.54 (0.74–3.18) |
Contact lens use | 1.49 (1.14–1.95)**
| 1.20 (0.92–1.57) | 1.46 (1.00–2.12)*
| 1.18 (0.63–2.19)*
|
Pet ownership (Cat) | 1.79 (1.07–2.99)*
| 3.16 (1.59–6.28)**
| ||
Job stressors | ||||
Amount of work
a
| 1.24 (1.08–1.42)**
| 1.27 (1.11–1.44)**
| 1.28 (1.09–1.49)**
| |
Mental workload
a
| 1.19 (1.01–1.39)*
| 1.19 (1.03–1.39)*
| ||
Physical overload
b
| 0.77 (0.65–0.91)**
| 0.93 (0.79–1.08) | 1.06 (0.84–1.33) | |
Interpersonal conflict
a
| 1.16 (1.01–1.33)*
| 1.69 (1.47–1.94)**
| 1.25 (1.04–1.51)*
| 1.72 (1.27–2.32)**
|
Job control
a
| 0.91 (0.80–1.04) | 0.77 (0.68–0.87)**
| 0.94 (0.78–1.12) | 0.91 (0.68–1.21) |
Skill utilization
c
| 0.84 (0.71–0.98)*
| 0.95 (0.81–1.11) | 0.87 (0.70–1.07) | 1.06 (0.74–1.51) |
Job suitability
d
| 0.96 (0.82–1.12) | 1.12 (0.96–1.30) | 1.02 (0.82–1.26) | |
Work satisfaction
d
| 0.97 (0.83–1.14) | 0.68 (0.58–0.79)**
| 0.84 (0.67–1.05) | 1.02 (0.77–1.36) |
Variable factors | Eye irritation OR (95% CI) | General symptoms OR (95% CI) | Upper respiratory OR (95% CI) | Skin symptoms OR (95% CI) |
---|---|---|---|---|
N = 2332 |
N = 2275 |
N = 2262 |
N = 2438 | |
No. of people in office
a
| 1.16 (1.00–1.36) | 1.13 (0.97–1.31) | 1.11 (0.89–1.38) | 1.15 (0.81–1.64) |
Work station | ||||
Floor carpet (with) | 1.53 (1.13–2.06)**
| 1.56 (1.17–2.08) **
| 1.77 (1.13–2.78) *
| 3.07 (1.30–7.27) *
|
Lighting
b
| 0.77 (0.58–1.01) | 0.89 (0.68–1.17) | 0.64 (0.45–0.93)*
| 0.62 (0.35–1.09) |
Reflection or glare in vision
c
| 1.42 (1.23–1.66)**
| 1.48 (1.27–1.72)**
| 1.49 (1.22–1.82) **
| 1.61 (1.21–2.16) **
|
Table comfort
d
| 1.03 (0.82–1.31) | 1.07 (0.85–1.35) | 0.88 (0.63–1.22) | 1.31 (0.78–2.18) |
Chair comfort
d
| 1.48 (1.19–1.86)**
| 1.58 (1.27–1.96)**
| 2.06 (1.53–2.79)**
| 1.18 (0.72–1.95) |
Work with computer | 3.53 (1.03–12.18) *
| 1.41 (0.66–3.03) | ||
Use of odorous chemicals
e
| 1.14 (1.05–1.23)**
| 1.10 (1.02–1.19)*
| 1.06 (0.94–1.19) | 0.98 (0.81–1.19) |
Change in workplace
f
| ||||
New carpeting | 0.99 (0.36–2.75) | 0.52 (0.11–2.40) | ||
Painted wall | 5.96 (1.16–30.64)*
| |||
New furniture | 0.88 (0.48–1.63) | 1.06 (0.44–2.56) | ||
New wall covering | 1.19 (0.43–3.28) | 1.19 (0.22–6.47) | ||
Water damage | 1.32 (0.40–4.35) | |||
Equipment/installation | ||||
Laser printer
g
| 1.11 (0.83–1.50) | 0.96 (0.72–1.29) | ||
Bubble jet printer
g
| 1.05 (0.79–1.40) | 1.02 (0.77–1.36) | 1.71 (0.92–3.18) | |
Copier
g
| 1.25 (0.92–1.70) | 1.33 (0.99–1.78) | 1.20 (0.81–1.77) | 1.64 (0.88–3.07) |
Exterior window
g
| 0.79 (0.54–1.16) | |||
Door
g
| 0.71 (0.52–0.97) | |||
Fragrance
h
| 1.59 (0.59–4.26) | |||
Air freshener
h
| 1.04 (0.71–1.44) | 1.15 (0.67–1.98) | ||
Repellent
h
| 1.15 (0.66–2.03) | 0.63 (0.23–1.72) |
Variable factors
a
| Eye irritation OR (95% CI) | General symptoms OR (95% CI) | Upper respiratory OR (95% CI) | Skin symptoms OR (95% CI) |
---|---|---|---|---|
N = 2587 |
N = 2502 |
N = 2483 |
N = 2684 | |
Too much air movement | 0.78 (0.55–1.09) | 0.95 (0.69–1.32) | 1.00 (0.66–1.53) | 0.61 (0.31–1.23) |
Too little air movement | 1.00 (0.87–1.15) | 1.31 (1.14–1.50)**
| 1.23 (1.03–1.49)*
| 1.13 (0.84–1.54) |
Too hot | 1.09 (0.94–1.26) | 1.15 (1.00–1.33) | 1.26 (1.03–1.54)*
| 1.13 (0.80–1.60) |
Varying room temperature | 1.16 (0.98–1.36) | 1.00 (0.85–1.18) | 1.03 (0.82–1.29) | 1.11 (0.77–1.60) |
Too cold | 0.97 (0.80–1.18) | 1.38 (1.13–1.68)**
| 1.12 (0.87–1.44) | 0.91 (0.61–1.35) |
Air too humid | 1.21 (1.02–1.45) *
| 1.12 (0.94–1.34) | 0.89 (0.69–1.13) | 0.98 (0.67–1.43) |
Air too dry | 1.49 (1.25–1.77)**
| 1.23 (1.02–1.47)*
| 1.78 (1.44–2.19)**
| 2.56 (1.83–3.57)**
|
Static electricity | 1.38 (1.01–1.90)*
| 1.08 (0.76–1.53) | 0.68 (0.43–1.05) | 1.10 (0.63–1.90) |
Noise | 1.23 (0.99–1.52) | 1.50 (1.22–1.84)**
| 1.34 (1.03–1.76) *
| 1.22 (0.81–1.86) |
Airflow from air conditioner | 1.11 (0.96–1.28) | 1.11 (0.96–1.28) | 1.13 (0.93–1.36) | 0.89 (0.64–1.25) |
Odors from air conditioner | 1.07 (0.83–1.39) | 1.01 (0.77–1.32) | 0.94 (0.67–1.31) | 1.25 (0.75–2.09) |
Mold odor | 0.90 (0.66–1.24) | 0.84 (0.61–1.16) | 1.09 (0.75–1.58) | 0.64 (0.35–1.17) |
Dust and dirt | 1.08 (0.88–1.32) | 1.10 (0.90–1.34) | 1.22 (0.96–1.55) | 0.82 (0.55–1.22) |
Tobacco smoke odor | 1.22 (1.03–1.43)*
| 1.23 (1.04–1.45) *
| 1.19 (0.97–1.46) | 1.23 (0.88–1.70) |
Unpleasant chemical odor | 1.03 (0.69–1.56) | 0.87 (0.57–1.32) | 1.56 (1.01–2.42) *
| 2.52 (1.44–4.42)**
|
Unpleasant other odor
b
| 1.19 (1.00–1.42) | 1.37 (1.15–1.64)**
| 1.20 (0.96–1.50) | 1.55 (1.10–2.19)*
|
Variable factors | Eye irritation OR (95% CI) | General symptoms
l
OR (95% CI) | Upper respiratory OR (95% CI) | Skin symptoms
l
OR (95% CI) |
---|---|---|---|---|
N = 2330 |
N = 2275 |
N = 2260 |
N = 2436 | |
Personal | ||||
Gender (female) | 1.67 (1.23–2.28)**
| 1.80 (1.36–2.38)**
| 2.27 (1.48–3.48)**
| 3.12 (1.48–6.59)**
|
Age | ||||
10–19 | – | 1.96 (0.19–19.71) | – | – |
20–29 | – | 3.24 (1.68–6.23)**
| – | – |
30–39 | – | 2.16 (1.16–4.00)*
| – | – |
40–49 | – | 1.66 (0.89–3.11) | – | – |
50–59 | – | 1.35 (0.71–2.58) | – | – |
≥ 60 | – | Ref. | – | – |
p for trend | – | <0.001 | – | – |
Contact lens use | 1.59 (1.20–2.10)**
| – | 1.73 (1.16–2.57)**
| – |
Pet ownership (Cat) | – | 2.86 (1.28–6.43)*
| ||
Work environment | ||||
No. of people in office
a
| 1.19 (1.03–1.39)*
| – | – | – |
Work station | ||||
Floor carpet (with) | 1.44 (1.07–1.95)*
| 1.53 (1.15–2.05)**
| 1.74 (1.10–2.75)*
| – |
Reflection or glare in vision
b
| 1.25 (1.07–1.45)**
| 1.32 (1.13–1.55)**
| – | – |
Chair comfort
c
| 1.37 (1.13–1.67)**
| 1.35 (1.11–1.63)**
| 1.74 (1.34–2.27)**
| – |
Work with computer | 5.51 (1.62–18.73)**
| – | ||
Use of odorous chemicals
d
| 1.11 (1.02–1.21)*
| – | – | – |
Change in workplace
e
| ||||
Painted wall | 4.72 (1.57–14.22)**
| |||
Workplace conditions in last 4 weeks
f
| ||||
Too little air movement | – | 1.37 (1.21–1.56)**
| 1.26 (1.05–1.50)*
| – |
Varying room temperature | 1.23 (1.07–1.42)**
| – | – | – |
Too cold | – | 1.45 (1.21–1.73)**
| – | – |
Air too humid | – | 1.20 (1.02–1.43)*
| – | – |
Air too dry | 1.46 (1.24–1.72)**
| – | 1.76 (1.44–2.14)**
| 2.71 (2.10–3.51)**
|
Static electricity | – | – | – | – |
Noise | 1.29 (1.05–1.59)*
| 1.54 (1.25–1.88)**
| 1.41 (1.09–1.82)**
| – |
Dust and dirt | – | – | 1.26 (1.00–1.58)*
| – |
Tobacco smoke odor | 1.21 (1.02–1.43)*
| – | – | – |
Unpleasant chemical odor | – | – | 1.96 (1.24–3.08)**
| 2.60 (1.63–4.15)**
|
Unpleasant other odor
g
| 1.22 (1.02–1.45)*
| 1.35 (1.14–1.61)**
| – | |
Job stressors | ||||
Amount of work
h
| 1.34 (1.19–1.51)**
| 1.38 (1.23–1.55)**
| 1.25 (1.06–1.46)**
| |
Mental workload
h
| – | – | ||
Physical overload
i
| 0.70 (0.59–0.83)**
| – | – | |
Interpersonal conflict
h
| – | 1.42 (1.21–1.65)**
| – | – |
Job control
h
| – | 0.80 (0.70–0.92)**
| – | – |
Skill utilization
j
| – | – | – | – |
Job suitability
k
| – | – | ||
Work satisfaction
k
| – | 0.76 (0.66–0.88)**
| – | – |
Personal factors
Job stressors
Work environment
Workplace conditions
Seasonal comparisons of prevalence and risk factors of BRSs
Symptoms | Prevalence
a
(%) | Summer (vs. winter) | ||
---|---|---|---|---|
Winter | Summer | Crude OR (95% CI) | Adjusted ORb (95% CI) | |
Tension, irritability, or nervousness | 8.77 | 11.58 | 1.36 (1.15–1.61)**
| 1.30 (1.09–1.55)**
|
Tired or strained eyes | 7.99 | 10.21 | 1.31 (1.10–1.57)**
| 1.27 (1.05–1.53)*
|
Dry, itching, or irritated eyes | 7.15 | 7.52 | 1.06 (0.87–1.28) | 1.01 (0.82–1.23) |
Feeling depressed | 5.12 | 6.83 | 1.36 (1.10–1.68)**
| 1.31 (1.05–1.63)*
|
Unusual tiredness, fatigue, or drowsiness | 4.71 | 6.39 | 1.38 (1.11–1.72)**
| 1.36 (1.08–1.70)**
|
Sore or dry throat | 5.69 | 3.70 | 0.64 (0.50–0.81)**
| 0.56 (0.43–0.72)**
|
Headache | 2.35 | 2.65 | 1.13 (0.82–1.56) | 1.06 (0.76–1.47) |
Difficulty remembering things or concentration | 1.45 | 2.19 | 1.52 (1.03–2.23)*
| 1.46 (0.98–2.17) |
Sneezing | 1.82 | 1.84 | 1.01 (0.69–1.47) | 0.97 (0.65–1.43) |
Cough | 1.55 | 1.24 | 0.80 (0.52–1.23) | 0.73 (0.47–1.14) |
Dry or flushed facial skin | 3.18 | 1.21 | 0.37 (0.25–0.55)**
| 0.33 (0.22–0.49)**
|
Stuffy or runny nose, or sinus congestion | 1.71 | 1.18 | 0.68 (0.44–1.05) | 0.67 (0.43–1.04) |
Hands dry, Itching, red skin | 1.43 | 1.11 | 0.78 (0.49–1.22) | 0.68 (0.42–1.08) |
Dizziness or lightheadedness | 0.74 | 1.09 | 1.48 (0.87–2.53) | 1.38 (0.80–2.36) |
Nausea or upset stomach | 0.86 | 1.09 | 1.27 (0.76–2.11) | 1.10 (0.65–1.84) |
Scaling/itching scalp or ears | 1.01 | 0.78 | 0.77 (0.45–1.31) | 0.68 (0.39–1.16) |
Shortness of breath | 0.27 | 0.50 | 1.84 (0.80–4.20) | 1.58 (0.69–3.64) |
Chest tightness | 0.52 | 0.50 | 0.97 (0.48–1.95) | 0.84 (0.40–1.75) |
Wheezing | 0.21 | 0.23 | 1.10 (0.39–3.14) | 1.14 (0.38–3.40) |
Symptoms and seasons | Significant risk factors | ||
---|---|---|---|
Job stressor | Work environment | Indoor air quality | |
Eye irritation | |||
Winter | • Excessive work • Adequate skill utilization | • Carpeting • Poor lighting • Uncomfortable seating • Often use of odorous chemicalsa
| • Too cold • Too dry • Strong static electricity • Airflow from air conditioner • Dust and dirt |
Summer | • Excessive work • Low physical overload | • Crowded workplace • Carpeting • Often reflection or glare in vision • Uncomfortable seating • Computer work • Often use of odorous chemicalsa
| • Varying room temperature • Too dry • Noise • Tobacco smoke odor • Unpleasant other odorb
|
General symptoms | |||
Winter | • Excessive work • High mental workload • Strong interpersonal conflict • Low job suitability • Low work satisfaction | • Crowded workplace | • Too little air movement • Varying room temperature • Too cold • Too dry • Noise • Dust and dirt • Unpleasant other odorb
|
Summer | • Excessive work • Strong interpersonal conflict • Low job control • Low work satisfaction | • Carpeting • Reflection or glare in vision • Uncomfortable seating | • Too little air movement • Too cold • Too humid • Noise • Unpleasant other odorb
|
Upper respiratory | |||
Winter | • Strong interpersonal conflict | • Crowded workplace • Installation of bubble jet printer | • Too dry • Dust and dirt • Unpleasant other odorb
|
Summer | • Excessive work | • Carpeting • Uncomfortable seating • Recent painted wall | • Too little air movement • Too dry • Noise • Dust and dirt • Unpleasant chemical odor |
Skin symptoms | |||
Winter | • Low work satisfaction | • Varying room temperature • Too dry • Noise • Airflow from air conditioner • Dust and dirt | |
Summer | • Too dry • Unpleasant chemical odor |