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Cited by 27Occupational exposure and asthmaIndoor Air Quality and Microbial ExposureWorkplace Health and Well-being

Decreased work ability associated to indoor air problems – An intervention (RCT) to promote health behavior

Vuokko, Aki, Selinheimo, Sanna, Sainio, Markku, Suojalehto, Hille, Järnefelt, Heli, Virtanen, Marianna, Kallio, Eila, Hublin, Christer +1 more·2015·NeuroToxicology
DOI 10.1016/j.neuro.2015.04.010
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Abstract

Introduction Indoor air problems may induce respiratory irritation and inflammation. In occupational settings, long-lasting non-specific building-related symptomatology, not fully medically explained, is encountered. The symptomatology may lead to illness, avoidance behavior and decreased work ability. In Finland, investigations of workers suspected of occupational asthma have revealed excess disability. There are no well-established clinical practices for the condition.Objective The aim was to develop a clinical intervention for patients with non-specific indoor air-related symptoms and decreased work ability.Methods A randomized controlled trial including psychoeducation and promotion of health behavior was carried out in 55 patients investigated for causal relationship between work-related respiratory symptoms and moisture damaged workplaces. Inclusion criteria for disability was the work ability score (WAS)≤7 (scale 0-10) and indoor air-related sick leave ≥14 days the preceding year. After medical evaluation and the 3-session counseling intervention, follow-up at 6-months was assessed using self-evaluated work-ability, sick leave days, quality of life, and illness worries as outcome measures.Results The mean symptom history was 55.5 months. 82% (45 out of 55) had asthma with normal lung function tests in most cases, although reporting abundant asthma symptoms. 81% of patients (39/48) had symptomatology from multiple organ systems without biomedical explanation, despite environmental improvements at work place. At the psychological counseling sessions, 15 (60%) patients of the intervention (INT, n=25) group showed concerns of a serious disease and in 5 (20%), concerns and fears had led to avoidance and restricted personal life. In the 6-month follow-up, the outcomes in the INT group did not differ from the treatment as usual group.Conclusion No intervention effects were found. Patients shared features with medically unexplained symptoms and sick building syndrome or idiopathic environmental intolerance. Long environment-attributed non-specific symptom history and disability may require more intensive interventions. There is a need for improved recognition and early measures to prevent indoor-associated disability.Trial registration number Single-center randomized controlled trial (ISRCTN33165676).

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Authors
Vuokko, A., Selinheimo, S., Sainio, M., Suojalehto, H., Järnefelt, H., Virtanen, M., Kallio, E., Hublin, C., & Karvala, K.
Affiliations
Finnish Institute of Occupational Health (FI)
Corresponding author
Vuokko, Aki
ORCID
Venue
NeuroToxicology
Publisher
Elsevier BV
Published
2015-07
Volume
49
Pages
59-67
ISSN
0161-813X (ISSN-L)
DOI
10.1016/j.neuro.2015.04.010
OpenAlex
W796800819
Cited by
27
References
60
Citations by year
2026: 2 · 2025: 1 · 2024: 5 · 2023: 2 · 2020: 2 · 2019: 4 · 2017: 5 · 2016: 3 · 2015: 3
FWCI
3.93
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • NeuroToxicology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Finnish Ministry of Social Affairs and Health
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Keywords
indoor air quality, sick building syndrome, multiple chemical sensitivity, non-specific symptoms, work ability, work-related respiratory symptoms, psychoeducation, health behavior promotion, psychological counseling, sick leave, quality of life, occupational asthma
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychometrics, Psychotherapy, Respiration Disorders, Health Behavior, Treatment Outcome, Air Pollution, Indoor, Sick Building Syndrome, Young Adult, Self Report, Return to Work

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