Indoor environmental quality in offices and risk of health and productivity complaints at work: A literature review

Many service jobs are carried out in modern offices, with individual offices being increasingly replaced by open-plan settings. The high number of adult people working in office buildings, in most situations sharing the work-place with many others during a considerable part of their daily time, highlights the importance of providing adequate guidance to ensure the quality of office environments. This paper aims to summarize existing data on modern offices' indoor environmental quality (IEQ) conditions in terms of air pollution (volatile organic compounds (VOC), particulate matter and inorganic pollutants), thermal comfort, lighting and acoustics and the respective associations with health and productivity-related outcomes in workers. Evidence shows that al-though many offices present acceptable IEQ, some office settings can have levels of air pollutants, hygrothermal conditions/thermal comfort and illuminance that do not comply with the existing international standards and recommendations. In addition, findings suggest the existence of significant associations between the assessed IEQ indicators and the risk of detrimental effects on health and productivity of office workers. In particular, airborne particles, CO2, O 3 and thermal comfort were linked with the prevalence of sick building syndrome symptoms. Poor lighting and acoustical quality have also been associated with malaise and physiological stress among office workers. Similarly, better productivity levels have been registered for good indoor air quality conditions, in terms of VOC, airborne particles and CO2. Overall, the evidence revised in this work suggests that for promoting health and productivity recommendations for office building managers include actions to ensure that: i) all relevant IEQ indicators are periodically controlled to ensure that levels comply with recommended limit values; ii) declared in-door pollution sources are avoided; iii) adequate ventilation and acclimatization strategies are implemented; and iv) there is the possibility of conduct personalized adjustments to environmental conditions (following workers' preferences).The authors gratefully acknowledge Fundacao para a Ciencia e nologia (FCT) for the financial support of FF through the PhD BD/6521/2020

A study protocol for a randomized controlled trial of an anti-inflammatory nutritional intervention in patients with fibromyalgia

BackgroundThis study aims to analyze the effects of a potentially anti-inflammatory nutritional intervention in disease assessment parameters, inflammatory markers, and quality of life of fibromyalgia (FM) patients.MethodsA sample of 100 female patients diagnosed with FM, followed up at Portuguese Institute of Rheumatology (IPR) in Lisbon, is being randomly allocated in two groups. Patients in the intervention group are adopting an anti-inflammatory diet, characterized by the exemption of the intake of foods containing gluten, dairy, sugar, and ultra-processed foods, during 3months. During the first month, a low fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) diet is implemented, along with the anti-inflammatory diet, followed by the reintroduction of all fruits and vegetables over a consecutive period of 2months. Patients in the control group are adopting a diet based on general recommendations for healthy eating. The outcomes are pain, fatigue, quality of sleep, quality of life, gastrointestinal symptoms, and inflammation. Before and after the 3months intervention, and also 1month after beginning the intervention, the following questionnaires are applied: Revised Fibromyalgia Impact Questionnaire, visual analog pain scale, Brief Pain Inventory,visual analog scale from a list of common gastrointestinal and extraintestinal symptoms in FM, Short Form 36, Fatigue Severity Survey, and Pittsburg Sleep Quality Index. Ultra-sensitive serum C-reactive protein, eritrocyte sedimentation rate, and interleukin-8 are determined. Age, physical activity, anthropometric parameters, and body composition are being collected. Student's t test will assess the association between the disease evaluation parameters, the inflammatory markers, and the dietary interventions.DiscussionThe results of this study are expected to determine whether a change in patient nutrition helps to alleviate symptoms, which would optimize medical intervention.Trial registrationwww.ClinicalTrials.gov NCT04007705. Registered on July 5, 2019

An anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols diet improved patient reported outcomes in fibromyalgia: A randomized controlled trial

Background: Fibromyalgia (FM) has been associated with dysbiosis and low-grade inflammation. Studies have reported that diet influences clinical features in FM. Objective: To evaluate the effect of an anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols (FODMAP) diet on clinical outcomes of patients with FM. Methods: This two arms Randomized Controlled Trial (NCT04007705) included 46 female patients with FM. The intervention group (n = 22) adopted an anti-inflammatory diet for 3 months, excluding gluten, dairy, added sugar, and ultra-processed foods, along with a low FODMAPs diet in the first month. The control group (n = 24) followed general healthy eating recommendations. Both diets were applied by a certified dietitian. Before and after the intervention, participants were assessed regarding pain, fatigue, gastrointestinal symptoms, quality of sleep, and quality of life, through the Revised Fibromyalgia Impact Questionnaire (FIQR), Visual Analogue Pain Scale (VAS), Visual Analog Scale from gastrointestinal symptoms (VAS GI), Brief Pain Inventory (BPI), Pittsburg Sleep Quality Index (PSQI), Fatigue Severity Survey (FSS), and The Short Form Health Survey (SF-36). A blood sample was collected and high-sensitive C-Reactive Protein and Erythrocyte Sedimentation Rate were quantified. Paired Samples t-test/Wilcoxon and independent samples t-test/Mann-Whitney were used to compare variables between groups. Results: After intervention, there was an improvement in intervention group scores of FIQR (p = 0.001), VAS (p = 0.002), BPI (p = 0.011), FSS (p = 0.042), VAS_GI (p = 0.002), PSQI (p = 0.048), and SF36 (p = 0.045) compared to control group. Inflammatory biomarkers (hs-CRP, ESR) did not change in both groups. The intervention was beneficial in the intervention group, regardless of age, disease duration, body mass index variation, and body fat change between baseline and post-intervention. Conclusion: An anti-inflammatory and low-FODMAP diet improved clinical features in patients with FM and may be useful as a complement to pharmacological therapy

Prognostic Power of Anaerobic Threshold Parameters in Patients with Transposition of the Great Arteries and Systemic Right Ventricle

INTRODUCTION: Both transposition of the great arteries (TGA) previously submitted to a Senning/Mustard procedure and congenitally corrected TGA (cc-TGA) have the systemic circulation supported by the morphological right ventricle, thereby rendering these patients to heart failure events risk. The aim of this study was to evaluate cardiopulmonary exercise test parameters for stratifying the risk of heart failure events in TGA patients. METHODS: Retrospective evaluation of adult TGA patients with systemic circulation supported by the morphological right ventricle submitted to cardiopulmonary exercise test in a tertiary centre. Patients were followed up for at least 1 year for the primary endpoint of cardiac death or heart failure hospitalisation. Several cardiopulmonary exercise test parameters were analysed as potential predictors of the combined endpoint and their predictive power were compared (area under the curve). RESULTS: Cardiopulmonary exercise test was performed in 44 TGA patients (8 cc-TGA), with a mean age of 35.1 ± 8.4 years. The primary endpoint was reached by 10 (22.7%) patients, with a mean follow-up of 36.7 ± 26.8 months. Heart rate at anaerobic threshold had the highest area under the curve value (0.864), followed by peak oxygen consumption (pVO2) (0.838). Heart rate at anaerobic threshold ≤95 bpm and pVO2 ≤20 ml/kg/min had a sensitivity of 87.5 and 80.0% and a specificity of 82.4 and 76.5%, respectively, for the primary outcome. CONCLUSION: Heart rate at anaerobic threshold ≤95 bpm had the highest predictive power of all cardiopulmonary exercise test parameters analysed for heart failure events in TGA patients with systemic circulation supported by the morphological right ventricle.info:eu-repo/semantics/publishedVersio