Lifestyle behaviors and home and school environment in association with sick building syndrome among elementary school children : a cross-sectional study

Background:Sick building syndrome (SBS) refers to the combination of symptoms experienced by occupants ofspecific building characteristics. This study investigated the associations of children’s lifestyle behaviors, allergies,home, and school environment with SBS symptoms.Methods:A total of 4408 elementary school children living in Sapporo City, Japan participated in this study. SBSwas determined on parental answers to MM080 standardized school questionnaires on symptoms that were weeklyexperienced by these children, and if the symptom is attributed to their home or school environment. TheJapanese version of the International Study of Asthma and Allergies in Childhood questionnaire was used to assesswheeze, rhino-conjunctivitis, and eczema. A logistic regression analysis was conducted to evaluate the associationsbetween SBS symptoms and variables by controlling the potential confounders (gender, grade, school, and parentalhistory of allergies). A stepwise backward elimination was conducted to assess independent variables related to SBS.Results:Participants revealed mucosal (6.9%), skin (2.0%), and general (0.8%) symptoms. The presence of one or moreallergy was associated with increased mucosal and skin symptoms. Children who skipped breakfast, displayed faddiness(like/dislike of food), had constipation, have insufficient sleep, did not feel refreshed after sleep, and lacked deep sleepshowed significantly high odds ratios with SBS symptoms. The stepwise analysis showed faddiness for mucosalsymptoms and not feeling refreshed after sleep for mucosal and skin symptoms, whereas constipation and lackingdeep sleep for general symptoms were independent variables in increasing the symptoms. We found no significantrelationship between SBS in children and schools. Considering children’s home, old building, no ventilation, wall-to-wall carpet, and heavy nearby traffic were associated with elevated mucosal symptom, while living in a multifamilyhome increased general symptoms. Home dampness was an independent variable in increasing all SBS symptoms.Conclusions:Allergies and lifestyle behaviors were associated with increased SBS in children, including skippingbreakfast, displaying faddiness, constipation, insufficient sleep, not feeling refreshed after sleep, and the lack of deepsleep. Further, dampness at home was associated with increase in all SBS symptoms. Lifestyle (e.g., eating and sleepinghabits) and home (i.e., dampness) improvements might alleviate SBS symptoms in children