A longitudinal study of sick building syndrome (SBS) among pupils in relation to SO2, NO2, O3 and PM10 in schools in China

PLoS One. 2014 Nov 14;9(11):e112933. doi: 10.1371/journal.pone.0112933. eCollection 2014.

Abstract

There are fewer longitudinal studies from China on symptoms as described for the sick building syndrome (SBS). Here, we performed a two-year prospective study and investigated associations between environmental parameters such as room temperature, relative air humidity (RH), carbon dioxide (CO2), nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), particulate matter (PM10), and health outcomes including prevalence, incidence and remission of SBS symptoms in junior high schools in Taiyuan, China. Totally 2134 pupils participated at baseline, and 1325 stayed in the same classrooms during the study period (2010-2012). The prevalence of mucosal symptoms, general symptoms and symptoms improved when away from school (school-related symptoms) was 22.7%, 20.4% and 39.2%, respectively, at baseline, and the prevalence increased during follow-up (P<0.001). At baseline, both indoor and outdoor SO2 were found positively associated with prevalence of school-related symptoms. Indoor O3 was shown to be positively associated with prevalence of skin symptoms. At follow-up, indoor PM10 was found to be positively associated with new onset of skin, mucosal and general symptoms. CO2 and RH were positively associated with new onset of mucosal, general and school-related symptoms. Outdoor SO2 was positively associated with new onset of skin symptoms, while outdoor NO2 was positively associated with new onset of skin, general and mucosal symptoms. Outdoor PM10 was found to be positively associated with new onset of skin, general and mucosal symptoms as well as school-related symptoms. In conclusion, symptoms as described for SBS were commonly found in school children in Taiyuan City, China, and increased during the two-year follow-up period. Environmental pollution, including PM10, SO2 and NO2, could increase the prevalence and incidence of SBS and decrease the remission rate. Moreover, parental asthma and allergy (heredity) and pollen or pet allergy (atopy) can be risk factors for SBS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Air Pollutants / analysis
  • Asthma / complications
  • Asthma / epidemiology
  • Child
  • China / epidemiology
  • Cohort Studies
  • Environmental Monitoring*
  • Female
  • Follow-Up Studies
  • Humans
  • Humidity
  • Hypersensitivity / complications
  • Hypersensitivity / epidemiology
  • Longitudinal Studies
  • Male
  • Nitrogen Dioxide / analysis*
  • Ozone / analysis*
  • Particulate Matter / analysis*
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Sick Building Syndrome / complications
  • Sick Building Syndrome / epidemiology*
  • Sick Building Syndrome / pathology
  • Sulfur Dioxide / analysis*
  • Surveys and Questionnaires
  • Temperature

Substances

  • Air Pollutants
  • Particulate Matter
  • Sulfur Dioxide
  • Ozone
  • Nitrogen Dioxide

Grants and funding

This study was supported by grants from the Swedish Research Council (348-2011-7402), the National Natural Science Foundation of China (21207083), Natural Science Foundation of Shanxi Province of China (2013021033-1), a research project supported by Shanxi Scholarship Council of China (2012-005), and Taiyuan Environmental Protection Agency for Environmental Sciences and Technology (201218). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.