Chemical Sensitivity and Sick-Building Syndrome: 1st Edition (Hardback) book cover

Chemical Sensitivity and Sick-Building Syndrome

1st Edition

By Yukio Yanagisawa, Hiroshi Yoshino, Satoshi Ishikawa, Mikio Miyata

CRC Press

194 pages | 88 B/W Illus.

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Description

Written by multidisciplinary experts in medicine, chemistry, and architecture, this book examines chemical sensitivity (CS). In 15 chapters fitted to 15 lectures, it discusses not only the medical explanation, but also the environmental factors of this hypersensitive reaction, such as chemistry and architectural aspects. The book overviews pollution-induced diseases such as Minamata Disease. It also points out the similarity of modern hypersensitivity syndromes to historical pollution diseases from the viewpoints of not only natural scientific aspects, but also social understanding of the disease.

Table of Contents

Preface……………………………………………………………………………………………………….xv

Acknowledgments………………………………………………………………………………………xvii

Authors………………………………………………………………………………………………………xix

Introduction………………………………………………………………………………………………..xxi

Chapter 1 Present Status of Chemical Sensitivity………………………………………….1

Satoshi Ishikawa

1.1 Background………………………………………………………………………1

1.1.1 Disease Registration of CS……………………………………..2

1.1.2 CS Studies in Europe…………………………………………….3

1.1.3 CS Studies in Japan……………………………………………….3

1.1.4 Sick-Building/House Syndrome………………………………3

1.2 Clinical Symptoms……………………………………………………………3

1.3 Psychiatric and Social Aspects……………………………………………4

1.4 Chemical Agents Implicated in CS……………………………………..5

1.5 Why the Diagnosis of CS Is Difficult…………………………………..8

1.5.1 Reasons for the Lack of Understanding of CS…………..8

Endnotes……………………………………………………………………………………8

Chapter 2 Effects of Chemical Sensitivity on Patients’ Daily Lives………………. 11

Satoshi Ishikawa

2.1 Effects of Chemical Sensitivity………………………………………… 11

2.2 Countermeasures……………………………………………………………. 12

2.2.1 Making Your Home, Workplace, and School

Environment Safe……………………………………………….. 12

2.2.2 Food and Digestive Issues……………………………………. 12

2.2.3 Caution in Use of Daily Products………………………….. 12

2.2.4 Avoidance of Environmental Chemicals………………… 13

2.2.5 Effects of Electromagnetic Waves………………………… 13

2.2.5.1 ES and International Classification

of Disease 10 (ICD)………………………………. 14

Endnotes…………………………………………………………………………………. 14

Chapter 3 Promoting Understanding of Chemical Sensitivity………………………. 17

Satoshi Ishikawa

3.1 Medical Insurance in Japan……………………………………………… 17

3.2 Understanding of CS at the Judicial Level…………………………. 17

3.3 Education………………………………………………………………………. 18

3.3.1 Specific Education of Medical Doctors………………….. 18

3.3.2 Specific Education for Dentists…………………………….. 18

vi Contents

3.3.3 Specific Education for the Healthcare Team…………… 19

3.3.4 Patient Education for a Comfortable Daily Life……… 19

3.3.5 Education of Laypersons……………………………………… 19

Endnotes………………………………………………………………………………….20

Chapter 4 Medical Facts………………………………………………………………………….. 21

Mikio Miyata, Kou Sakabe, and Satoshi Ishikawa

4.1 Acute Toxicology, Intermediate Syndrome………………………… 21

4.2 Chronic Toxicology………………………………………………………… 21

4.3 Animal Experiments Using Extremely Low Dosages…………. 21

4.4 Research on the Mechanism of CS……………………………………23

4.4.1 Detoxification……………………………………………………..23

4.4.2 Nervous Sensitivity Acquisition…………………………….25

Endnotes………………………………………………………………………………….26

Chapter 5 Diagnosis…………………………………………………………………………………29

Satoshi Ishikawa and Mikio Miyata

5.1 Detailed and Careful Interview…………………………………………29

5.2 Neuro-Ophthalmological and Neurological Examinations

in Conjunction with Ordinary Clinical Examinations

in Japan………………………………………………………………………….29

5.2.1 Tracking Eye Movement Examination……………………30

5.2.2 Pupillary Function………………………………………………. 31

5.2.3 Standing Ability…………………………………………………. 32

5.2.4 Contrast Sensitivity Examination of Higher

Visual Centers……………………………………………………. 33

5.2.5 Accommodation Examination of Eyes…………………… 33

5.2.6 Cerebral Function Examination……………………………. 33

5.2.7 Immune Examination…………………………………………..34

5.2.8 Respiratory Function……………………………………………34

5.2.9 Peripheral Venous Blood Oxygen Concentration……..34

5.3 Chemical Load Tests……………………………………………………….34

5.3.1 Use of a Clean Room……………………………………………34

5.3.2 Determination of Causative Chemicals

(Challenge Test)…………………………………………………..34

Endnotes………………………………………………………………………………….36

Chapter 6 Treatment of Patients with Chemical Sensitivity………………………….. 37

Mikio Miyata and Satoshi Ishikawa

6.1 Avoidance of Chemical Substances…………………………………… 37

6.1.1 Food…………………………………………………………………..37

6.1.2 Water………………………………………………………………… 37

6.1.3 Air…………………………………………………………………….38

6.1.3.1 Use of an Air Purifier…………………………….38

Contents vii

6.1.4 Clothes………………………………………………………………. 39

6.1.5 Medicine……………………………………………………………. 39

6.2 Detoxification………………………………………………………………… 39

6.2.1 Spa, Hot Spring, Bath, Low-Temperature Sauna……..40

6.2.2 Drug Treatment…………………………………………………..40

6.2.2.1 Conjugation…………………………………………..40

6.2.2.2 Vitamins………………………………………………40

6.2.2.3 Symptomatic Therapy……………………………. 41

6.2.2.4 Minerals………………………………………………. 41

6.2.2.5 EDTA, Penicillamine, PAM, and Others…. 42

6.3 Alternative Therapy………………………………………………………… 42

6.3.1 Prayer and Meditation in Zen Buddhism……………….. 42

6.3.2 Eastern Medicine and Alternative Medicine………….. 43

6.4 Nutritional Instruction…………………………………………………….. 43

Endnotes………………………………………………………………………………….44

Chapter 7 Chemical Sensitivity in Children……………………………………………….. 45

Kazuhiko Kakuta

7.1 General Symptoms…………………………………………………………. 45

7.1.1 Formaldehyde Concentration and Symptoms…………. 45

7.1.2 TVOC Concentration and Symptoms…………………….46

7.1.3 Red Cell Cholinesterase……………………………………….46

7.2 Effects of Indoor Chemicals on the Intelligence

and Cognitive Function of Children………………………………….. 47

7.2.1 Evaluation of Intelligence…………………………………….. 47

7.2.2 WISC-III Test Results and Concentration

of Indoor Chemicals……………………………………………. 47

7.2.3 Development of Sick-House Syndrome…………………..49

7.3 Case Report of CS in a Young Boy Who Had Been Treated

with Sumatriptan Succinate and Selective Serotonin

Reuptake Inhibitors…………………………………………………………50

Endnotes…………………………………………………………………………………. 51

Chapter 8 Multiple Chemical Sensitivity—Medical Aspects from Germany….. 53

Klaus-Dietrich Runow

8.1 Chemical Sensitivity………………………………………………………..54

8.2 Biochemical Individuality………………………………………………..54

8.3 Randolph’s Specific Adaptation Syndrome in Response

to Environmental Stressors………………………………………………. 57

8.4 Causes: Fire in the Body and the Brain……………………………… 59

8.5 Diagnostic Program Recommended for CS Patients……………. 59

8.5.1 Metabolic and Nutritional Status (Organic Acid

Profiles), Toxins………………………………………………….. 59

8.5.2 Toxic Metals……………………………………………………….60

viii Contents

8.5.3 Phthalates and Parabens Profile……………………………. 61

8.5.3.1 Why Assess Phthalate and Paraben

Levels?………………………………………………… 61

8.5.3.2 Where Are Phthalates and Parabens

Found?………………………………………………… 61

8.5.4 Bisphenol A……………………………………………………….. 62

8.5.5 Hidden Food Allergies………………………………………… 62

8.5.5.1 Gluten Sensitivity Can Cause

Neurological and Autoimmune Disease……64

8.5.6 Stool and Digestive Analysis…………………………………64

8.5.6.1 Why Use Stool Analysis?……………………….65

8.6 Therapy: The DNA Concept……………………………………………..65

8.7 HEPAR-TOX Detoxification…………………………………………….65

8.8 Ecological Architecture and Environmental Medicine…………66

8.8.1 New Projects in Wolfhagen—The Historic City

in the Land of the Brothers Grimm……………………….66

Endnotes…………………………………………………………………………………. 67

Chapter 9 Emission Rate of Chemical Compounds in Building Products

and Materials……………………………………………………………………………69

Shin-ichi Tanabe

9.1 Introduction……………………………………………………………………69

9.2 Categories of Chemical Substances…………………………………..69

9.3 Building Products and Materials………………………………………. 70

9.4 Emission Tests Using a Chamber……………………………………… 70

9.4.1 Small-Chamber Method………………………………………. 70

9.4.2 Large-Chamber Method………………………………………. 71

9.4.3 Desiccator Method……………………………………………… 72

9.4.4 Passive Method…………………………………………………… 72

9.4.5 Microchamber Method for SVOCs……………………….. 73

9.5 Labeling………………………………………………………………………… 75

9.5.1 Formaldehyde…………………………………………………….. 75

9.5.2 VOCs………………………………………………………………… 76

9.5.2.1 For VOC Standard………………………………… 76

Endnotes………………………………………………………………………………….77

Chapter 10 Ventilation Strategies for Each Kind of Building and Statutory

Regulations……………………………………………………………………………… 79

Haruki Osawa and Masaki Tajima

10.1 History and Background of Indoor Air Pollution

Measures in Japan…………………………………………………………..80

10.1.1 Before the Dawn of Measures against Sick Houses….80

10.1.2 Design Assumption and Strategy of Measures

against the Indoor Air Pollution Problem………………. 81

Contents ix

10.2 Statutory Regulations for Indoor Air Quality……………………..83

10.2.1 Technical Standards in the Amended Building

Standard Law……………………………………………………..83

10.2.2 Regulation Regarding the Use of Building

Materials Containing Formaldehyde

and Installation of Ventilation……………………………….83

10.2.2.1 Restrictions on Interior Finishing…………….83

10.2.2.2 Mandatory Installation of Ventilation………83

10.2.2.3 Restrictions Concerning Attic

and Adjacent Concealed Spaces………………84

10.2.3 Technical Standards in the Housing Quality

Assurance Act…………………………………………………….84

10.2.4 Technical Standards of the Act on Maintenance

of Sanitation in Buildings……………………………………..85

10.2.5 Indoor Air Pollution Following the Amendment

of the Building Standard Law in 2003……………………87

10.3 Types and Features of Ventilation Systems…………………………88

10.3.1 Types of Ventilation…………………………………………….88

10.3.2 Methods of Selecting a Mechanical Ventilation

System……………………………………………………………….89

10.4 Trends in Technology Development and Energy-Saving

Performance…………………………………………………………………..90

10.4.1 Mechanical Ventilation System Utilizing

Low- Power Input Motors……………………………………..90

10.4.2 Demand-Controlled Ventilation…………………………….90

10.4.3 Mechanical Ventilation Systems with a Heat

Exchanger…………………………………………………………..90

10.4.4 Hybrid Ventilation System…………………………………… 91

10.5 Important Points for Planning and Operation

of Ventilation Systems…………………………………………………….. 91

10.5.1 Planning of the Ventilation Path…………………………… 91

10.5.2 Notes for Calculating Pressure Drops…………………….92

10.5.3 Notes on Construction………………………………………….92

10.5.4 Notes Concerning Regular Maintenance………………..92

10.5.5 Steps for Ventilation Planning……………………………….93

10.6 Ventilation Equipment in Large Buildings………………………….93

10.6.1 Ventilation in Designated Buildings………………………93

10.6.2 Ventilation Systems Except Those Employed

in Centrally Controlled HVAC Systems………………….94

Endnotes………………………………………………………………………………….95

Chapter 11 Ventilation, Air-Tightness, and Air Pollution……………………………….97

Hiroshi Yoshino and Rie Takaki

11.1 Outline of the Measurement Survey…………………………………..97

11.1.1 Survey Period and Investigated Houses………………….97

x Contents

11.1.2 Survey Points and Measurement Method………………..97

11.2 Measurement Results…………………………………………………….. 100

11.2.1 Air-Tightness of Houses…………………………………….. 100

11.2.2 Ventilation Rate of the Ventilation System…………… 102

11.3 Comparison of Air-Tightness, Ventilation System,

and Chemical Substance Concentrations…………………………. 103

11.3.1 Comparison of Air-Tightness and Chemical

Substance Concentrations………………………………….. 103

11.3.2 Comparison of Air Change Rate and Chemical

Substance Concentrations………………………………….. 104

11.4 Conclusions………………………………………………………………….. 105

Endnotes……………………………………………………………………………….. 105

Chapter 12 Chemical Features of Indoor Pollutants and Current Regulations….. 107

Naohide Shinohara

12.1 Usage and Sources of Chemical Species Detected

in Indoor Environments…………………………………………………. 107

12.1.1 Artificial Wooden Boards and Adhesives…………….. 107

12.1.2 Paint………………………………………………………………… 110

12.1.3 Fungicides, Repellents, Mothballs, Air

Fresheners, and Disinfectants…………………………….. 110

12.1.4 Plasticizers and Flame Retardants………………………. 111

12.1.5 Smoking and Burning Appliances………………………. 112

12.1.6 Secondary Generated Compounds………………………. 112

12.1.7 Contaminants in Outdoor Air…………………………….. 112

12.1.8 Unknown Pollutants………………………………………….. 113

12.2 Determination of Pollutants from the View of Health

Effects…………………………………………………………………………. 113

12.2.1 Target Health Effects…………………………………………. 113

12.2.1.1 Sick-House Syndrome………………………….. 113

12.2.1.2 Asthma………………………………………………. 114

12.2.1.3 Endocrine Disruption………………………….. 114

12.2.1.4 Cancer……………………………………………….. 114

12.2.2 Field Survey of Indoor Pollution…………………………. 114

12.3 Risk Assessment…………………………………………………………… 118

12.3.1 What Is Risk Assessment?…………………………………. 118

12.3.2 Hazard Assessment…………………………………………… 118

12.3.3 Exposure Assessment………………………………………… 120

12.3.4 Risk Assessment……………………………………………….. 121

12.4 Enforcement and Effect of Regulations…………………………… 123

12.4.1 Time Course of Regulations……………………………….. 123

12.4.2 Impact of Regulations………………………………………..124

Endnotes………………………………………………………………………………..124

Contents xi

Chapter 13 Methods for Measurement of Indoor Pollution…………………………… 127

Atsushi Mizukoshi

13.1 Methods for Measurement of Indoor Concentration………….. 127

13.1.1 Integration Measurement…………………………………… 127

13.1.1.1 Active Method……………………………………. 128

13.1.1.2 Passive Method…………………………………… 128

13.1.1.3 Subject Compounds, Carbonyl

Compounds, VOCs, TVOCs, SVOCs…….. 128

13.1.2 Instant Measurement…………………………………………. 130

13.1.2.1 Subject Compounds, TVOCs,

Formaldehyde…………………………………….. 130

13.1.2.2 On-Site Method of Measuring Source

Intensity and Ventilation Rate………………. 130

13.1.3 Combined Application of Integration

Measurement and Instant Measurement………………. 130

13.1.3.1 Peak Capture Method………………………….. 131

13.2 Methods of Measuring the Emission Rate of Building

Materials……………………………………………………………………… 131

13.2.1 Desiccator Method……………………………………………. 131

13.2.2 Chamber Method………………………………………………. 132

13.2.3 On-Site Measurement Method……………………………. 133

13.2.3.1 Field and Laboratory Emission Cell………. 133

13.2.3.2 Passive Emission Colorimetric Sensor…… 133

13.2.3.3 Passive Flux Sampler…………………………… 134

13.2.3.4 Advanced Diffusive Sampling

Emission Cell……………………………………… 135

13.3 Methods of Measuring Personal Exposure Amount………….. 135

13.3.1 Active Sampling–Passive Sampling Method………… 135

13.3.1.1 Search for Causative Compound

of Chemical Sensitivity………………………… 135

13.3.2 Instant Measurement Method……………………………… 136

13.3.2.1 TVOCs and HRV………………………………… 136

Endnotes……………………………………………………………………………….. 136

Chapter 14 The Current Situation and Shift in Approaches to Indoor Air

Pollution……………………………………………………………………………….. 139

Miyuki Noguchi

14.1 Framework of Laws and Regulations………………………………. 139

14.1.1 Housing Quality Assurance Act………………………….. 139

14.1.2 School Health and Safety Act…………………………….. 139

14.1.3 Act on Maintenance of Sanitation in Buildings…….. 140

14.1.4 Revised Building Standards Act…………………………. 140

14.1.5 Indoor Density Guideline Value………………………….. 141

xii Contents

14.2 Trends after Determination of Guideline Values………………. 142

14.2.1 Advantageous Effect of Formaldehyde Labeling…… 142

14.2.1.1 Formaldehyde Concentration in New

Residential Housing…………………………….. 142

14.2.2 Composition of VOCs……………………………………….. 143

14.2.2.1 Significant Reduction

of Concentrations of Guideline

Substances…………………………………………. 143

14.2.2.2 High Concentration Substances

(TVOCs, Acetaldehyde, Aliphatic

Compounds, etc.)………………………………… 143

14.2.3 Widespread Use of Alternative Substances…………… 143

14.2.3.1 Low Formaldehyde Emission Adhesives…. 145

14.2.3.2 Water-Based Paint and Ink…………………… 145

14.2.3.3 Increased Use of Aliphatic Compounds…. 145

14.2.4 Temporal Change of Indoor TVOC Concentration…. 146

14.2.5 Trends of Social Recognitions for Indoor Air

Pollution: New and Remodeled Houses……………….. 146

14.2.5.1 Completion Checks by the Housing

Quality Assurance Act…………………………. 146

14.2.5.2 Widespread Indoor Air Pollution

with Nonregulated Substances……………… 146

14.2.5.3 Recognition That SHS Was Resolved…….. 147

14.2.6 Change in Social Recognition of Indoor Air

Pollution: Routine Countermeasures……………………. 147

14.2.6.1 Air Cleaners……………………………………….. 148

14.2.6.2 Oxidative Decomposition…………………….. 148

14.2.6.3 Secondary Pollutants…………………………… 148

14.3 Required or Recommended Countermeasures………………….. 148

14.3.1 Regulation of TVOC Concentration…………………….. 148

14.3.1.1 Enforcement of the Elimination Period….. 149

14.3.1.2 Information Sharing Among

the Relevant Parties…………………………….. 149

14.3.2 Collecting Information from Medical Doctors……… 149

14.3.2.1 Selection Method for New Guideline

Substances…………………………………………. 149

14.4 Formulation of Counseling or Inquiry Systems

for Patients and New Occupants……………………………………… 150

Chapter 15 Investigation of Indoor Environments and Occupants’ Health

in Sick Houses……………………………………………………………………….. 151

Hiroshi Yoshino, Sachiko Hojo, and Rie Takaki

15.1 Field Survey on Indoor Air Quality, Building

Performance, and Occupants’ Health of 62 Sick Houses……. 151

15.1.1 Description of the Investigation………………………….. 151

Contents xiii

15.1.1.1 Investigated Houses…………………………….. 151

15.1.1.2 Investigation of Building Performance

and the Indoor Environment…………………. 152

15.1.1.3 Survey Questionnaire about Health

Conditions………………………………………….. 153

15.1.2 Results…………………………………………………………….. 153

15.1.2.1 Results of Chemical Substance

Concentration Measurements……………….. 153

15.1.2.2 Relationship between Formaldehyde

Concentration and Air-Tightness

Measurement………………………………………. 153

15.1.2.3 Relationship between Formaldehyde

Concentration and Air Change Rate………. 155

15.1.2.4 Sick-House Syndrome Based

on the QEESI® Questionnaire……………….. 156

15.1.3 Chemical Substance Concentration

and Occupants’ Symptoms…………………………………. 156

15.1.3.1 Relationship between Chemical

Substance Concentration and SHS………… 156

15.1.3.2 Relationship between Chemical

Substance Concentration and Severity

of Symptoms………………………………………. 157

15.1.4 Conclusion……………………………………………………….. 157

15.2 Long-Term Observations Mainly for 30 Houses……………….. 157

15.2.1 Investigated Houses…………………………………………… 159

15.2.2 Results of the Investigation………………………………… 159

15.2.2.1 Relationship between Chemical

Substance Concentration and Building

Age……………………………………………………. 159

15.2.2.2 Yearly Changes of Occupants’ Symptoms…. 160

15.2.3 Change of Symptoms and Chemical Substance

Concentrations………………………………………………….. 161

15.2.3.1 Change of Symptoms in Response

to Countermeasures against Mitigation

of SHS……………………………………………….. 161

15.2.3.2 Decrease of Chemical Substance

Concentration in Response

to Countermeasures against Sick Houses….. 162

15.2.4 Conclusions……………………………………………………… 163

Endnotes……………………………………………………………………………….. 164

Chapter 16 Round Table Discussion………………………………………………………….. 165

Yukio Yanagisawa

16.1 The Current Situation of Indoor Air Pollution………………….. 165

16.2 Medical Correlations in Japan………………………………………… 167

xiv Contents

16.3 Government Actions……………………………………………………… 168

16.4 Patients’ Compensation…………………………………………………. 169

16.5 Damp Buildings……………………………………………………………. 172

16.6 Trade-Offs…………………………………………………………………… 173

Epilogue………………………………………………………………………………………………….. 175

Index……………………………………………………………………………………………………….. 177

About the Authors

Yukio Yanagisawa is Professor Emeritus in Environmental Systems at University of Tokyo, Japan.

Satoshi Ishikawa is Professor Emeritus in Environmental Medicine at Kitasato University, Japan.

Hiroshi Yoshino is Professor Emeritus in Architecture at Tohoku University, Japan.

Mikio Miyata is Professor Emeritus in Environmental Medicine at Kitasato University, Japan.

Subject Categories

BISAC Subject Codes/Headings:
NAT011000
NATURE / Environmental Conservation & Protection
TEC005050
TECHNOLOGY & ENGINEERING / Construction / Heating, Ventilation & Air Conditioning
TEC017000
TECHNOLOGY & ENGINEERING / Industrial Health & Safety