Use of ultraclean indoor areas can increase symptom sensitivity – persons with symptoms need wide-ranging and knowledge-based support
When an employee or school pupil shows prolonged and diverse symptoms in buildings, in which indoor air has not been shown to have factors that cause symptoms, ultraclean indoor areas are increasingly offered as a solution both in schools and at workplaces.
There is no medical foundation for the use of ultraclean spaces, and they should not be used before their long-term effects on health and well-being have been clarified. Instead of using specially ultracleaned spaces, persons with prolonged symptoms should be given wide-ranging and knowledge-based support.
This is explained in a position paper by the health care specialist group of the Finnish Indoor Air and Health Programme. The position paper focused on ultraclean spaces and did not address the situation, when all users of the building, irrespective of their symptoms, are moved temporarily to other buildings, e.g. due to repairs.
There are risks connected with the use of ultraclean indoor spaces
In a situation in which no factors causing symptoms have been detected in the indoor air of a building, a move to ultraclean indoor areas can make the situation of a symptomatic person worse. The move reinforces the impression that the symptoms would be caused by unknown factors connected with the indoor air, which could lead to greater avoidance behaviours and a decline in the ability to function.
When special conditions are used as a solution, it often limits the physical and social living conditions of symptomatic persons or their families. This can have far-reaching negative consequences, especially for children.
Moving to ultraclean areas can also worsen concerns, negative experiences, and notions of harm linked with indoor air for other users of the building or family members. Emphasising risks can reinforce or maintain functional symptoms and increase the risk of environmental sensitivity.
“In the prevention and treatment of environment sensitivity it is important to focus especially on perceptions of harm and danger connected with indoor air. This requires responsibly from all actor, such as officials, health care professionals, decision-makers, the media, and other organisations in their actions and recommendations”, says Risto Vataja, Chief Physician at the Helsinki University Hospital HUS.
Prolonged symptoms reducing functional ability must be investigated in the health care
Prolonged symptoms that harm the ability to function should be investigated with the help of a health care professional and patients need to be provided with the treatment and rehabilitation plan they need.
“Symptoms that cause problems need to be thoroughly cleared up in health care. Typically, symptoms have a variety of causes, so treatment and rehabilitation should be tailored individually. In exceptional situations it is possible to avoid certain indoor locations, but only temporarily and as a part of other treatment and rehabilitation. Constant avoidance over the long term can reinforce reactions to ordinary environments and lead to environmental sensitivity that makes normal life difficult”, Maritta Kilpeläinen Chief Physician at the Turku University Hospital.
Persons with symptoms can be helped and supported in many ways
Instead of using ultraclean indoor areas, persons with symptoms in an indoor environment need preventative and wide-ranging support. There are many ways to support the function and well-being of all users of the building.
These include:
- improving the quality and comfort of the indoor environment (for example, temperature, noise, dry air, impurities, odours, and many factors affecting concentration and comfort)
- careful investigation of the symptoms in health care, their treatment, rehabilitation, measures, and follow-up. Common understanding of the factors affecting the symptoms and at reduction of possible unnecessary concerns
- flexible utilisation of different ways to ease symptoms and to recover from them (e.g., symptom-based treatment, reducing stress, and increasing resources, psycho-social support and rehabilitation)
- modification of work temporarily as a part of other support to improve capacity to work (e.g., rearranging work tasks or the workspace, remote work, and working hours)
- increased interactive communication on indoor air quality of the buildings and sharing information on the health effects of indoor air and factors that affect symptoms
The specialist group is part of the Finnish Indoor Air and Health Programme. A key objective of the programme is to improve the treatment and capacity to function of people experiencing symptoms in indoor environments.
More information
The programme's specialist group (in Finnish)
Risto Vataja
Chief Physician
HUS, Psychiatry
tel. +358 (0)50 4277 331
[email protected]
Maritta Kilpeläinen
Chief Physician
Turku University Hospital, Pulmonary Diseases
tel. +358 50 566 3340
[email protected]
Juha Pekkanen
Professor
Finnish Institute for Health and Welfare and University of Helsinki
tel. +358 40 508 1077
[email protected]
