Clinical Characteristics of Disability in Patients with Indoor Air–Related Environmental Intolerance
Open accessAbstract
BACKGROUND: Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. METHODS: We investigated 12 patients with indoor air-related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. RESULTS: The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. CONCLUSION: No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.
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Disabling PPS, manifesting as building-related environmental intolerance, has a biopsychosocial nature, emphasizing symptom perception, awareness, and interpretation rather than organic or toxicological causes.
“Research has revealed that disabling PPS, manifesting as building-related environmental intolerance, has a biopsychosocial nature, emphasizing symptom perception, awareness, and interpretation rather than organic or toxicological causes [12, 13, 15].”
From Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial. (2026) · cites this paper as [13]
The Introduction (page unavailable) describes environmental intolerance in terms of increased responsiveness and negative expectancy rather than harmful exposure. The Discussion (page unavailable) reports no evidence of harmful indoor exposure or medical cause for disability in the study’s 12 patients, and notes possible psychosocial contributions. It does not establish that symptom perception, awareness, and interpretation are the primary mechanisms of disabling building-related symptoms generally. (LLM, conf=0.84)
Experimental — accuracy not yet measuredReactions to everyday environmental factors can range from mild discomfort to general, nonspecific symptoms across various organ systems, and disabling fear-avoidance, impacting daily life, work attendance, and productivity.
“Reactions to everyday environmental factors can range from mild discomfort to general, nonspecific symptoms across various organ systems, such as headaches, fatigue, or respiratory issues, and disabling fear-avoidance, impacting daily life, work attendance, and productivity [2, 11, 13, 14].”
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Self-citation
- Authors
- Vuokko, A., Karvala, K., Suojalehto, H., Lindholm, H., Selinheimo, S., Heinonen-Guzejev, M., Leppämäki, S., Cederström, S., Hublin, C., Tuisku, K., & Sainio, M.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- Nokia (Finland) (FI)
- University of Helsinki (FI)
- Helsinki University Hospital (FI)
- Corresponding author
- Vuokko, Aki
- ORCID
- Venue
- Safety and Health at Work
- Publisher
- Elsevier BV
- Published
- 2019-09
- Volume
- 10
- Issue
- 3
- Pages
- 362-369
- ISSN
- 2093-7911 (ISSN-L)
- PMC
- PMC6717934
- OpenAlex
- W2952514004
- Cited by
- 21
- References
- 67
- Citations by year
- 2026: 3 · 2024: 8 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Safety and Health at Work (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Työväentutkimus Vuosikirja (submittedVersion)
- Funders
- Finnish Ministry of Social Affairs and Health (STM/3508/2014)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- multiple chemical sensitivity, functional somatic syndromes, burnout, anxiety, depression, insomnia, sympathetic nervous system reactivity, rehabilitation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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