2. Sick Building Syndrome in Mauritius: Is there need for concern? Professor A H Subratty Dr R.Bholah Dr R.Bholah Assoc Prof V Jowaheer Dr M. F. Lan Cheong Wah Dr M. F. Lan Cheong Wah

3. Sick Building Syndrome SBS refers to non-specific symptoms such as eye, nose,throat irritation, mental fatigue, headaches, nausea and skin irritation (WHO, 1983). Other terms –Tight Building Syndrome –Sick office Syndrome –Office Eye Syndrome but SBS is now the accepted terminology

4. Indoor Air Pollution People spend an average of 90 percent of their time indoors while some at-risk subgroups such as the elderly, very young, and chronically ill may spend nearly all their time indoors.

5. Indoor Air Pollution When a number of occupants of a building display acute symptoms without a particular pattern and the varied symptoms cannot be associated with a particular source, the phenomenon is often referred as Sick Building Syndrome (SBS).

6. Sick Building Syndrome SBS refers to non-specific symptoms such as eye, nose,throat irritation, mental fatigue, headaches, nausea and skin irritation (WHO, 1983). Other terms –Tight Building Syndrome –Sick office Syndrome –Office Eye Syndrome but SBS is now the accepted terminology

7. Indoor Air Pollutants Asbestos Radon Formaldehyde Volatile Organic Compounds Pesticides Carbon Monoxide Environmental Tobacco Smoke Combustion Products Biological Agents –mould / mildew / fungi –pollen –dander –dustmites

8. Acute Health Effects of Sick Building Syndrome Sensory Irritation –mucous membrane irritants –allergic reactions (watery eyes, runny nose) General Symptoms –shortness of breath / respiratory tract irritation –dizziness –nausea –headache

9. Bronchial Asthma

10. Chronic Health Effects of Sick Building Syndrome Cancer Birth Defects Immunologic Disorders Neurologic Disease Reproductive Disease

11. Causes of Indoor Air Quality Problems Inadequate Ventilation (52%) Inside Air Contaminants (17%) Outside Air Contaminants (11%) Biological Agents (10%) Building Materials (3%) Unknown (12%)

14. Clinical manifestation of SBS  Nasal Manifestations  Ocular Manifestations  Oro-pharyngeal Manifestations  Cutaneous Manifestations  General Manifestations Non-specific symptoms linked with indoor climate problem (WHO, 1983)

16. Acute Health Effects of Sick Building Syndrome Sensory Irritation –mucous membrane irritants –allergic reactions (watery eyes, runny nose) General Symptoms –shortness of breath / respiratory tract irritation –dizziness –nausea –headache

17. Sick Building Syndrome Contributing factors: Physical Chemical Biological

18. Mauritius : Is a small island Has a subtropical climate Is a densely built environment Needs energy conservation requirements All the above pose special constraints to the building industry.

19. Objectives of the study  Establish the prevalence of building related symptoms among office workers  Obtain baseline information on IAQ of office premises  Identify possible relationships of these symptoms (if any) to personal, demographic, occupational, psychosocial and indoor environmental factors (variables)?

20. Identification of sites 21 office buildings, occupied by public and private companies were investigated. Buildings surveyed were selected according to type of organisation, type of ventilation, and office layout. All buildings selected were situated at different sites around the island (Fig.1- Map of Mauritius).

21. METHODOLOGY  Identification of sites  Questionnaire survey  Personal characteristics  Work environment  Demographic variables  P erceived environment conditions  S ick building syndrome symptoms, general health  Psychosocial and physical conditions  Walk-through investigations  History of building  Interviews with managers, engineers and maintenace officers  Work equipment, office furniture  Ventilation systems  Room characteristics  Work environment (physical, chemical and biological)  Occupational factors ( job stress, job uncertainty)  M usculoskeletal symptoms, postural discomfort, injury  Measurements of Physico-chemical and biological parameters  Statistical modeling

22. Questionnaire survey

23. Questions on personal characteristics, work environment and demographic factors formed part of the questionnaire. Other factors of relevance included indoor climate at work, perception of symptoms, psychosocial and physical conditions.

24. Walk-through inspection in offices A detailed walk-through inspection was also conducted to obtain information on the history of the building use and factors, which could influence indoor air quality. During this exercise, observations were made on the building and room characteristics

25. Indoor air quality measurements Indoor environmental measurements were monitored for relative humidity (Griffin sling psychrometer, B.S 2842), air temperature (digital temperature meter SEI 26 Solex, temperature accuracy  0.8  C, range 0-60  C), air velocity (Lutron anenometer, AM/4201, speed range 0.4- 30 m/s), noise (Griffin sound level Meter, detection limit, 0.1 dB(A) and range 40-110 dB(A) ), light (Philips Harris luxmeter Log range 0 to 1000 lux). Carbon dioxide, carbon monoxide and nitrogen dioxide (Detectawl Toxic Gaztell Portable gas detectors, DGT model and range 0- 1000 ppm) were also measured.

26. RESULTS

31. Indoor climate

34. Monitoring Indoor Air Quality Carbon monoxide Carbon dioxide Ozone Total hydrocarbons Biological agents Temperature Humidity Formaldehyde Nitrogen oxides Particulates

35. With rapid urbanization the prevention of ill health in office and domestic interiors present a growing challenge to medical practitioners and building managers in Mauritius.