Bad building syndrome

Introduction Sick building syndrome (SBS), also known as sick building syndrome, is the result of air pollution and low air exchange rate in some buildings proposed by foreign experts in recent years. The active population produced a series of symptoms, and after leaving the building, the symptoms resolved. This type of building is called a "bad (or ill-conditioned) building" and the resulting series of symptoms are called "bad building syndrome." Most patients will quickly improve their symptoms after leaving the corresponding indoor environment. Only a few patients still have symptoms after the corresponding environmental quality is improved or other environments, and generally there is no need for treatment and no known sequelae. Therefore, try to Reduce the psychological burden of the patient.

Cause

More famous are the WSain theory and the GDNielsen doctrine. Here, only the theory of GDNielsen et al. is as follows: Unmyelinated A fibers with a large number of trigeminal nerves distributed in the mucosa of the eyes, nose, pharynx and upper respiratory tract. A protein complex of sensory stimulating receptor (SIR) and cation/calcium channel (Cation/Ca2+ Channel) is embedded in the unmyelinated C fiber and the thin myelin A fiber membrane. VOC, formaldehyde, etc. can activate SIR by physical adsorption and/or chemical reaction, thereby opening the cation/calcium channel and then causing calcium influx. The accumulation of intracellular calcium can in turn lead to degranulation of the substance P (Substance P, SP) and Calcitonin Gene-related Peptide (CGRP) particles in the local and central fiber terminals. When SP and CGRP degranulation occurs in the central nervous system, irritation and systemic symptoms can be produced. When it occurs in the mucous membranes of the eyes, nose, throat and upper respiratory tract, local inflammation and other reactions occur.

Factors involved in this process are: metabolism of VOC and formaldehyde in the upper respiratory tract (-); modulation of proton donors (+); metabolism of SP and CGRP in the upper respiratory tract (-); inhibition of SP and CGRP metabolism ( +); SP receptor antagonist (-) and activator (+) and so on.

an examination

Related inspection

Urine routine

Attention must be paid to the patient's symptoms, occupational history and environmental conditions including working hours and the family environment. Mainly: basic situation of the individual; symptom manifestation; description of the working process and indoor environment, ventilation, exposure source, dust, humidity, temperature and light; whether there are any environmental changes such as new decoration, new equipment, or other related Changes; colleagues with the same symptoms and improved symptoms after leaving the building are important for the diagnosis of SBS; other factors such as job satisfaction, work stress, etc. should also be included.

The diagnosis of SBS is based on the clinical manifestations of the patient, the incidence of the disease in the co-workers, the improvement in symptoms after leaving the building, the absence of pathophysiological abnormalities, and a similar diagnosis without any cause. SBS is not a specific diagnosis, it does not have to exclude all other possibilities before taking a solution.

Differential diagnosis

The symptoms of this disease need to be differentiated from air conditioning syndrome:

Air conditioning syndrome:

With the rapid development of the economy, people are increasingly demanding the comfort of temperature and humidity in residential and office environments. Almost all of the newly built star-rated hotels, commercial buildings, office buildings, apartments and residential buildings are equipped with air-conditioning systems or air-conditioning equipment. However, people who have been in an air-conditioned environment for a long time may have the following symptoms: dizziness, headache, facial nerve pain, chest tightness, weakness of the lower back pain, body chills, and a series of illnesses caused by pathogenic microbial infections. Environmental health workers refer to the aforementioned syndrome as "air conditioning disease", also known as "air conditioning syndrome."

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