Vuokko Aki, Karvala Kirsi, Suojalehto Hille, Lindholm Harri, Selinheimo Sanna, Heinonen-Guzejev Marja, Leppämäki Sami, Cederström Sebastian, Hublin Christer, Tuisku Katinka, Sainio Markku
Finnish Institute of Occupational Health, Helsinki, Finland.
Nokia Bell Labs, Nokia Group, Espoo, Finland.
Saf Health Work. 2019 Sep;10(3):362-369. doi: 10.1016/j.shaw.2019.06.003. Epub 2019 Jun 14.
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.
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.
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.
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.
归因于室内非工业工作环境的慢性非特异性症状很常见，可能导致残疾，但这种残疾的医学本质尚不清楚。目的是从医学角度描述由工作场所低水平室内污染物导致的慢性、复发性症状及工作参与受限所表现出的残疾情况，以及该病症是否具有特发性环境不耐受的特征。
我们调查了12名患有与室内空气相关工作残疾的患者。检查包括躯体、心理和精神评估，以及自主神经系统检查、皮质醇测量、肺功能和过敏测试。我们通过问卷调查评估幸福感、健康状况、残疾情况、失眠、疼痛、焦虑、抑郁和倦怠。
平均症状史为10.5年；致残症状的平均症状史为2.7年。11名患者报告反应主要由室内霉菌引发，1名仅由香料引发。10名报告对有气味的化学物质敏感，3名对电子设备敏感。几乎所有人都有同时存在的躯体和精神诊断以及疼痛、失眠、倦怠和/或交感神经反应增强的迹象。避免某些环境导致了几个生活领域的限制。在自我评估量表上，残疾的严重程度高于医生评估，而焦虑的严重程度低于医生评估。
未发现医学原因可解释这种残疾。研究结果支持该病症是特发性环境不耐受的一种形式，属于功能性躯体综合征。适用于功能性躯体综合征的康复方法，而非无休止的回避。
