Psychological Factors: How Workplace Conditions Can Lead to Psychogenic Reactions

Introduction
Factors that may play a role in the reporting of indoor air problems
Workplace conditions that could contribute to psychogenic reactions

Introduction

The resolution of indoor air quality health complaints is complicated by the difficulty in detecting and measuring very low levels of pollutants and the lack of scientific medical information of the effects of low-level exposure to mixtures of pollutants, both short-term and long-term. In indoor environments, one is typically exposed not just to one pollutant, but to many, such as volatile organic compounds (VOCs). Most indoor environments will contain hundreds of different VOCs as well as particles, molds, allergens, pesticides, and combustion gases. Further complicating this exposure are other factors such as stress, job requirements, odor, building temperature, building humidity, air movement, and personnel relationships?all things that can affect one's perception of their environment and their overall well-being. As a result, indoor air quality issues are considered "multi-factorial," meaning that their cause is the result of many factors. Psychological and social factors are some of many that may contribute to the reporting of indoor air quality complaints. It has been found that some work characteristics such as workload, job satisfaction, and reorganizations/downsizing are factors that have a significant impact on the risk of developing the symptoms of building-related symptoms (BRS), previously referred to as sick building syndrome.

Occasionally, psychogenic illness can begin when people in a group believe they have been exposed to something very toxic. They begin to experience non-specific symptoms such as headaches, weakness, dizziness and fainting, and other people can begin to feel ill at the same time. The symptoms are real, but medical evaluations and tests generally do not find anything abnormal. Often, a certain trigger will set off a mass reaction such as a noxious odor or the rumor that a toxic substance is in the space. In turn, this may result in a threat that some type of disease may appear, followed by symptoms such as dizziness, anxiety, or fainting, among many workers.¹ These widespread symptoms found in the absence of cause are often referred to as "mass psychogenic illness (MPI), mass hysteria, or epidemic hysteria." It generally occurs in schools and office buildings.

People, in general, are very sensitized to indoor air quality (IAQ) issues, and this sometimes can encourage anxiety. Often uninformed healthcare professionals or building managers can increase anxiety by ignoring situations or not providing sufficient information to ease fears. For example, if an odor is in a building or a building is perceived to have an IAQ issue, the proper studies need to be done to show that the building is "normal and typical," or the offending agents(s) are identified and resolved. Appropriate information should be supplied to show building occupants that there is not a significant health hazard. The "fear of the unknown" should be eliminated.

Factors That May Play a Role in the Reporting of Indoor Air Problems¹

• The extensive coverage of indoor air quality issues, especially building-related illness outbreaks, by the news media.
  
• The increasing emphasis on chemical hazards in the environment at large and on sources of indoor air pollution, such as cigarette smoking, which have become important public health concerns.
  
• A large increase in the number of persons working in office or nonindustrial type environments because the economy has shifted from traditional industrial type work to indoor service sector types of employment.
  
• The multiple technologic changes in office work involving the use of printers, computers, display screens, and copying machines, all of which have increased the number of routine, repetitive, detailed tasks to be performed by workers and have possibly resulted in increased stress.

Workplace Conditions That Could Contribute to Psychogenic Reactions²

• Poor physical environment conditions (poor ventilation, poor lighting, excessive noise)

• Stressful work conditions (tedious work, poor organizational climate, poor labor-management relations)

• Personality differences among individuals (gender differences, differences in anxiety levels).

• Some triggering event (bad odor or installation or use of new building or construction materials) followed by an inappropriate management response to the perceived threat.

References

1. Salvaggio JE. Psychological aspects of "environmental illness," "multiple chemical sensitivity," and building-related illness. J Allergy Clin Immunol. 1994;2(2):366-370.

2. Addressing the psychological aspects of indoor air quality by Professor Alan Hedge, Dept. Design and Environmental Analysis, Cornell Univ. Paper presented at the 1st Asian Indoor Air Quality Seminar in Urumqi, China, Sept. 22-23, 1996.