Volatile organic compounds from microorganisms : identification and health effects

Damp building materials are subjected to degradation processes due to moisture and also microbial growth, with both of these giving rise to emissions of volatile organic compounds (VOCs) that may contribute to indoor air health problems. The overall aim of this thesis was to investigate emissions of reactive and non-reactive VOCs from damp building materials and from the microorganisms growing on them, and also to investigate the possible health impact of these compounds. Three studies were carried out in order to study emissions of VOCs. The first investigated emissions from a mixture of five fungi (Aspergillus versicolor, Fusarium culmorum, Penicillium chrysogenum, Ulocladium botrytis and Wallemia sebi) and the second emissions from the bacterium Streptomyces albidoflavus. In both studies the microorganisms were cultivated on three different building materials (pine wood, particle board and gypsum board) and one synthetic media, MEA and TGEA respectively. The bacterium was also cultivated on sand. Air samples from the cultures were collected on six different adsorbents and chemosorbents to sample a wide range of compounds such as VOCs, aldehydes, amines and light-weight organic acids. The samples were analyzed with gas chromatography, high-pressure liquid chromatography and ion chromatography. Mass spectrometry was used for identification of the compounds. Alcohols and ketones were the predominant compound groups identified. The bacterial culture growing on TGEA emitted ammonia, methylamine, diethylamine and ethylamine. The third study dealt with secondary emissions collected from buildings with moisture and mould problems. Samples were taken when the materials were dry and also after they had been wet for a week. Most alcohols and ketones could be identified from the wet materials. Trimethylamine and triethylamine, were identified from sand contaminated by Bacillus. One study looked at the development of a method for analysis of primary and secondary amines with LC-MS/MS. A three-step process was developed, with the first step screening the samples for NIT derivatives with selected reaction monitoring, SRM. In the second step a precursor ion scan gave the [M+H]+ ion, and the last step involved fragmentation with a product ion scan. It was possible to separate and identify all the investigated amines, which showed that the method was both specific and selective and therefore well suited for the analysis of amines in complex environments. The last study comprised two exposure studies. In study 1 each participant took part in two exposure conditions, one with air from mouldy building materials and one with blank air for a 60 minute period. In study 2 each participant was exposed four times (for a period of 10 min) at random to air from mouldy building materials and blank air, with and without nose-clip. The participants rated air quality and symptoms before, during and after each exposure. Exposure to moderate VOC levels resulted in reports of perceived poor air quality, but no such results were received when exposing the participants to low VOC levels

Skin sensitivity to capsaicin, perceived stress and burn out among patients with building-related symptoms

Objective: The mechanisms behind building-related symptoms have remained unknown despite many years of research. It is known that environmental and psychosocial factors are of importance. Some receptors in the Transient Receptor Potential family elicit the same symptoms when stimulated, as reported by those suffering from building-related symptoms. The aim of this study was to compare capsaicin sensitivity between people with and without skin symptoms. A second aim was to investigate perceived stress among individuals with different levels of capsaicin sensitivity. Methods: People referred to an occupational health care unit and judged to have building-related symptoms by a physician answered a questionnaire regarding their symptoms. Solutions with different capsaicin concentrations were applied to participants' nasolabial folds. Self-reported stress and burnout were assessed using two questionnaires: the Perceived Stress Scale (PSS) and the Shirom-Melamed Burnout Questionnaire (SMBQ). Results: We found that people who reported facial erythema or itching, stinging, tight or burning facial skin were more sensitive than those without symptoms and similarities with Sensitive Skin are discussed. We also found that participants who reacted to the lowest capsaicin concentrations scored significantly higher on scales for stress and burnout. Conclusions: We found associations between sensitivity to capsaicin and skin symptoms among people with building-related symptoms, as well as associations between capsaicin sensitivity and perceived stress/burnout

Odor perception and symptoms during acrolein exposure in individuals with and without building-related symptoms

Building-related symptoms (BRS) is a significant work-related and public health problem, characterized by non-specific symptoms occurring in a particular building. The cause of BRS is unknown, but certain reactive compounds are suggested risk factors. The aim of this controlled exposure study was to investigate whether BRS cases report more odor annoyance and symptoms and show altered autonomous nervous system (ANS) response during exposure to the reactive aldehyde, acrolein in comparison with referents. Individuals with BRS (n = 18) and referents (n = 14) took part in two exposure sessions (80 min). One session contained heptane alone, and the other heptane and acrolein. Perceived odor annoyance; eye, nose, and throat symptoms; and ANS response were measured continuously. BRS cases did not experience more odor annoyance; eye, nose, and throat symptoms; or altered ANS response in comparison with referents during the exposures. Supplementary analyses revealed that BRS cases that also reported chemical intolerance perceived more symptoms than referents during acrolein exposure. Acrolein exposure at a concentration below previously reported sensory irritation detection thresholds is perceived as more irritating by a subgroup of BRS individuals compared with referents. The results of this study indicate that a subset of individuals with building related symptoms (BRS) has a lowered sensory irritation threshold towards acrolein exposure. Future guidelines on chemical exposures to acrolein should take time and individual sensitivity into account

The Impact of Indoor Malodor : Historical Perspective, Modern Challenges, Negative Effects, and Approaches for Mitigation

Malodors, odors perceived to be unpleasant or offensive, may elicit negative symptoms via the olfactory system’s connections to cognitive and behavioral systems at levels below the known thresholds for direct adverse events. Publications on harm caused by indoor malodor are fragmented across disciplines and have not been comprehensively summarized to date. This review examines the potential negative effects of indoor malodor on human behavior, performance and health, including individual factors that may govern such responses and identifies gaps in existing research. Reported findings show that indoor malodor may have negative psychological, physical, social, and economic effects. However, further research is needed to understand whether the adverse effects are elicited via an individual’s experience or expectations or through a direct effect on human physiology and well-being. Conversely, mitigating indoor malodor has been reported to have benefits on performance and subjective responses in workers. Eliminating the source of malodor is often not achievable, particularly in low-income communities. Therefore, affordable approaches to mitigate indoor malodor such as air fresheners may hold promise. However, further investigations are needed into the effectiveness of such measures on improving health outcomes such as cognition, mood, and stress levels and their overall impact on indoor air quality

Associations between symptoms, modern health worries, and somatosensory amplification in patients with building-related symptoms

Objective: The objective of the present study was to investigate the associations between somatosensory amplification, modern health worries (MHWs), and symptoms among patients with building-related symptoms (BRS). Methods: Patients with self-reported and medically confirmed BRS (n = 83) were included in this cross-sectional study. The Somatosensory Amplification Scale (SSAS) was used to quantify the tendency to amplify somatic sensations and perceive them as unpleasant and dangerous. Concerns about harmful effects of modern technologies were assessed with the Modern Health Worries Scale (MHWS). Symptoms commonly found in different forms of environmental intolerance were assessed with the Environmental Hypersensitivity Symptom Inventory (EHSI). Results: Patients with BRS were characterized by more frequent and more severe environmental hypersensitivity symptoms compared to a reference population. Females and those with co-morbid self-reported chemical intolerance reported even more symptoms. MHWS and SSAS scores showed weak to moderate associations with symptoms, even after adjusting for socio-economic variables. However, neither the mean MHWS score or the SSAS score of our sample differed from normative scores. Conclusion: Patients with BRS are not characterized by elevated levels of MHWs and somatosensory amplification, thus other, psychosocial and/or environmental, factors may have contributed to the development of the condition. However, the associations between severity of symptoms and MHWs and somatosensory amplification suggest that psychosocial characteristics may substantially influence symptom experience in this group

Prototype stories of life with Chemical Intolerance : when the environment becomes a threat to health and well-being

We aimed to explore how individuals living with Chemical Intolerance (CI) describe the onset and progression of CI, and how they live and cope with CI. The participants were recruited via Swedish websites hosted by CI support groups. A postal survey, including a Life history calender, was sent to potential participants. Eleven respondents fitted the consensus-based criteria for CI while not reporting comorbidity. A narrative analysis of their written replies resulted in five prototypical stories based on similarities in the onset and course of CI. All five stories contain descriptions of alienation from society and insufficient social support. Differences in participants’ perceptions of the symptom onset – with regard to suddenness, the point in life and the perceived cause of symptoms – partly corresponded to etiological theories of CI related to stress or inflammation. Further differences between the prototype stories mainly concern the possible effects on health and well-being related to social support and coping. Given these differences, we recommend that medical professionals and others apply a holistic, context-sensitive approach before discouraging or promoting a specific coping strategy in relation to CI

Symptoms and oxylipins in plasma before and after exposure to rooms in which individuals have both experienced and not experienced building- related symptoms – an exploratory study

The aim of this study was to investigate if there are differences in symptom ratings and plasma concentrations of oxylipins as a measure of acute inflammation between individuals with building-related symptoms (BRS) and referents during exposure to rooms where people experienced BRS and rooms where they did not experience BRS. Medically examined individuals with BRS and healthy, age and sex matched referents working in the same building were exposed for 60 min. Ratings of symptoms and collection of blood to measure oxylipins in plasma were performed before and after each exposure. Individuals with BRS reported more symptoms (mostly mucosal) than the referents in the problem rooms and there was a tendency towards a difference between the groups in concentration of metabolites from the cyclooxygenase pathway (COX). The mean reported intensity of symptoms among all participants was also found to be positively correlated with both COX and lipoxygenase (LOX-15) oxylipins in problem rooms

Comparable responses to a wide range of olfactory stimulation in women and men

The evidence for differences between women and men in terms of olfactory abilities is contradictory. We analyzed women and men's performance and reactions to a wider range of odour exposure outcomes than usually studied, to assess possible differences and similarities between sexes. Measures of sensitivity and sensory decision rule were established in 37 women and 39 men. Perceptual, cognitive, symptom-related and autonomic nervous system (skin conductance level and heart-rate variability) reactions were also assessed during extended ambient odour exposure, as well as participants' self-rated chemical intolerance. Bayesian analyses consistently revealed greater support for sex-related similarities than differences, suggesting that women and men perform and react comparably not only in terms of basic olfactory measures, but also to environmental odour exposure mimicking everyday situations

The environmental hypersensitivity symptom inventory : metric properties and normative data from a population-based study

BACKGROUND: High concomitant intolerance attributed to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMF), and everyday sounds calls for a questionnaire instrument that can assess symptom prevalence in various environmental intolerances. The Environmental Hypersensitivity Symptom Inventory (EHSI) was therefore developed and metrically evaluated, and normative data were established. The EHSI consists of 34 symptom items, requires limited time to respond to, and provides a detailed and broad description of the individual's symptomology. METHODS: Data from 3406 individuals who took part in the Vasterbotten Environmental Health Study were used. The participants constitute a random sample of inhabitants in the county of Vasterbotten in Sweden, aged 18 to 79 years, stratified for age and gender. RESULTS: Exploratory factor analysis identified five significant factors: airway symptoms (9 items; Kuder-Richardson Formula 20 coefficient, KR-20, of internal consistency = 0.74), skin and eye symptoms (6 items; KR-20 = 0.60), cardiac, dizziness and nausea symptoms (4 items; KR-20 = 0.55), head-related and gastrointestinal symptoms (5 items; KR-20 = 0.55), and cognitive and affective symptoms (10 items; KR-20 = 0.80). The KR-20 was 0.85 for the entire 34-item EHSI. Symptom prevalence rates in percentage for having the specific symptoms every week over the preceding three months constitute normative data. CONCLUSIONS: The EHSI can be recommended for assessment of symptom prevalence in various types of environmental hypersensitivity, and with the advantage of comparing prevalence rates with normality