Functional Impairment Due to Indoor Air Symptoms Is Common, Survey Finds

Nearly 20% of people report functional impairment due to indoor air-related symptoms, with about 7% experiencing moderate to severe impairment, according to Finnish survey study in the September Journal of Occupational and Environmental Medicine.

People with severe impairment due to indoor air symptoms have elevated rates of other physical and mental health concerns—which may have important implications for treatment and support, according to the new research by Juha Pekkanen, MD, PhD, of University of Helsinki and colleagues.

In the National Survey on Indoor Air, a random sample of Finnish adults were asked about symptoms related to indoor air at home or work. Those reporting symptoms were asked to rate the severity of their symptoms and any related functional impairment: at home, at work, or in social settings. 

On analysis of 1,770 responses, 23.1% of participants reported indoor air-related symptoms and 18.2% reported at least mild functional impairment. Moderate impairment due to indoor air symptoms was reported by 5.3% of respondents and severe impairment by 1.8%.

Severe functional impairment was strongly associated with comorbid diseases, such as asthma and irritable bowel syndrome. Participants with severe impairment were more likely to have perceived sensitivities to environmental factors such as chemicals, symptoms involving multiple organ systems, and possibly a poorer financial situation.

Analysis of the severity of indoor air symptoms showed similar associations. Indoor air- or building-related symptoms are common in home and non-industrial work environments. The new study is the first to explore levels of functional impairment and symptom severity due to indoor air-related symptoms in a population-based sample.

The results show that indoor air-related symptoms are common and associated with moderate to severe functional impairment in a small but substantial proportion of the population. Symptom severity and functional impairment appear highly variable. 

"When trying to understand this heterogeneity, other biological, psychological, and social factors need to be considered in addition to indoor air quality," Dr. Pekkanen and colleagues write. They add: "[T]he determinants and aetiologies of symptoms and functional impairments of differing severity likely differ and thus there is also a need for different types of treatments and support."

​About the Authors
From the Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland (E.E., S.S., J.P.); Finnish Institute of Occupational Health, Helsinki, Finland (S.S.); and Department of Health Security, Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland (J.L., A.S., J.P.).

ACOEM (, an international society of 4,000 occupational physicians and other health care professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.
About the Journal of Occupational and Environmental Medicine
The Journal of Occupational and Environmental Medicine ( is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.
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Eidstø, Einar BM; Selinheimo, Sanna PhD; Lampi, Jussi MD, PhD; Salmela, Anniina PhD; Pekkanen, Juha MD, PhD. The Continuum of Severity of Functional Impairment Due to Indoor Air Symptoms: Prevalence and Determinants. Journal of Occupational and Environmental Medicine 65(9):p 717-724, September 2023. | DOI: 10.1097/JOM.0000000000002884