The Analysis of Sick Building Syndrome Symptoms with Environmental Stress Model for New Apartment in Dubai
Chuloh Jung1*, Nahla Al Qassimi1
1 Department of Architecture, College of Architecture, Art and Design, Ajman University, United Arab Emirates
*Corresponding Author: [email protected] Accepted: 15 December 2021 | Published: 31 December 2021
DOI:https://doi.org/10.55057/ajbs.2021.3.4.5
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Abstract: Recently many residents in Dubai, UAE (United Arab Emirates) have complained of various SBS (Sick Building Syndrome) symptoms. However, regarding SBS research, most of them are about the actual condition of indoor air pollutants and the symptoms and reactions perceived by residents are not addressed. The objective of this paper was to explore the subjective symptoms, environmental characteristics, and health damage awareness and countermeasures were identified according to the environmental stress model, and individual lifestyles and habits were investigated. As a methodology, a web survey for Dubai and a field survey at Business Bay and Dubai Marina were conducted at the same time. The result had shown that SBS symptoms were very diverse even within one household, and the circumstances of the suffering were also varied. The subjective symptoms before and after moving to new apartment, the most common symptom before moving in was ‘dry skin’ and the residents’
biggest complaint was ‘increased irritability in daily life’. To prevent SBS symptoms, the most common residents’ countermeasure was ‘More frequent ventilation’. It was statistically proven that SBS directly affects the quality of life of residents, this effect was found to be very serious.
The presence of SBS symptoms despite positive coping behaviors is evidence of how harmful indoor air pollutants from new apartment.
Keywords: SBS (Sick Building Syndrome), IAQ (Indoor Air Quality), Environmental Stress Model, Dubai, United Arab Emirates
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1. Introduction
Recently many residents in Dubai, UAE (United Arab Emirates) have complained of various symptoms such as itchiness, dizziness, headache, and skin problems after moving to a new apartment (Jung & Awad, 2021; Ghaffarianhoseini et al, 2018; Jafari et al, 2015). This symptom varies from person to person and is known to be SBS (Sick Building Syndrome), which is caused by the presence of a large amount of indoor air pollutants of new buildings (Awad & Jung, 2021; Norhidayah et al, 2013). However, due to indoor air quality stipulation and over-the-air broadcasting, concerns about SBS (Sick Building Syndrome), which has become a social topic, and interest in health are increasing (Amin et al, 2015; Maddalena et al, 2015). On the other hand, the fact that there have been few studies on irritant symptoms related to this suggests that the academic community is passively coping with changes in social phenomena and interests (Sun et al, 2019; Lu et al, 2018; Takigawa et al, 2010). However, regarding SBS (Sick Building Syndrome) research, most of them are about the actual condition of chemical factors, such as the evaluation of health risk factors caused by indoor air pollution
(Takaoka et al, 2016; Sahlberg et al, 2010). The contents of symptoms and reactions perceived by residents from the perspective of residents are not addressed (Jung & Awad, 2021; Tham et al, 2015; Guo et al, 2013). Against this background, this study investigated the residents’ health awareness symptoms and responses to sick house syndrome, which will continue to be discussed as an important issue in the rapidly spreading apartment environment (Zhang et al, 2011; Crook & Burton, 2010). While previous research focused on the study of hazardous chemicals in new apartments, this study focused on the symptoms or reactions that residents felt consciously and ultimately provided data on the subjective effects of multiple specific data on sick house syndrome (Jafari et al, 2015; Saijo et al, 2010). It is expected that the social impact will be very large in terms of improving the quality of life of people (Hosseini et al, 2020).
2. Literature Review
In order to achieve the purpose of the study, this study introduced and applied an environmental stress model (Hart & Marshall, 2013; He et al, 2013; Scrosati et al, 2011). Understanding stress and its response is a common subject of inquiry in medicine, biology, and behavioral science, and is an appealing concept for understanding individual health and finding its causes in health education, health promotion, and disease prevention (Swearer & Hymel, 2015; Nevo, 2011).
Stress contributes as a disease-causing factor either through direct physiological phenomena or indirectly through maladaptive health behaviors, inhibiting health behavior practices and making it difficult for individuals to motivate themselves to develop practical health habits (Mancini et al, 2016; Hendricks & Testa, 2012). Stress can be said to be a psychological and physiological link that explains disease or deviant behavior caused by the interaction process between the environment and the human organism (Dixon et al, 2020). The way people respond to stress differs in their responses to stress because of the subjective differences that each individual has (Creel et al, 2013; Fox & Reed, 2011).
Figure 1: Environmental Stress Model
Regarding environmental stress model, as the relationship or interaction between stimuli and the environment, stress was explained not to be in an event but as a result of the interaction between a person and the environment surrounding him (Cohen et al, 2013; Chan et al, 2012;
Holmgren & Scheffer, 2010). The stress phenomenon is defined as the human-environmental relationship that determines the condition of the disease while constantly changing, and the importance of cognitive evaluation and response is suggested by emphasizing the dynamic
aspect of the individual interacting with the environment (Colodro-Conde et al, 2018; White et al, 2015). To properly cope with stress, understand and utilize the role of mediating and buffering or moderating factors such as cognitive evaluation and response and social support (Lena Bercht & Wehrhahn, 2010).
The environmental stress model, which can be said to be the conceptual framework of this study, is a series of theories about how a stressor, which is considered a stimulus that threatens human well-being, feels stressful to people and how to take countermeasures for it (Knöll et al, 2018; Rishi & Khuntia, 2012). This is a model designed appropriately to explain the stress caused by the environment, especially among various stressors (Yang et al, 2018; François et al, 2017). There are various stressors such as job pressure, marital discord, natural disasters, stress from moving to an unfamiliar area, and city congestion and noise (Bilotta et al, 2018;
Beil & Hanes, 2013). A new apartment is a stress group where various stresses are gathered.
This includes various environmental stimuli such as building materials, interior materials changes, and furniture changes (Erell et al, 2014; Coyle et al, 2013).
The new apartment, which is a changed environmental characteristic, acts as a new stimulus (Albott et al, 2018). Other variables in this process include changes in interior materials, changes in furniture characteristics, and changes in lifestyle and habits among environmental characteristics (Park et al, 2013). The process of interpreting the changed stimulus is to recognize and feel the subjective symptoms of health (Chen, 2017). The response to this is physical, mental, and social damage to health as a result of symptoms. In the resistance stage, coping measures for symptom relief of residents include both internal coping measures to cope with environmental changes and external coping measures that depend on external sources such as hospitals and pharmacies (Choi et al, 2021; Park et al, 2016). The burnout and adaptation stage refers to the stage in which the resident adapts when the coping is effective and reaches a state of exhaustion when it is not effective (Larcombe et al, 2019).
3. Methodology
From the time when SBS began to appear conspicuously, subjective symptoms and environmental characteristics were included to examine the patterns of change before and after moving (Jung et al, 2021; Hoang Quoc et al, 2020). In addition, in order to understand the awareness of health damage and countermeasures caused by this, and to control individual's lifestyle and habits, these aspects were also included in the questionnaire (Table 1).
Table 1: Categorization of Survey Questionnaires
Category Questions Numbers
Environmental characteristics
The degree of eco-friendliness felt by residents 4
Objective environmental characteristics 6
lifestyle and habits Cleaning habits, eating habits, etc. 1
Subjective symptoms Self-awareness symptoms for eyes, nose, skin, respiratory system 4
Health problem Physical, mental and social health 1
Countermeasures Internal countermeasures & external countermeasures 2
Improvement Satisfaction with coping plan 2
Residents’ Information Demographic Questions 12
The new apartment was called the stress group, but it can be said to be a group consisting of the house itself, new interior materials, and new furniture (Jung et al, 2021; Lu et al, 2015).
This study started with the assumption that the new apartment contains many chemical properties that are harmful to the human body (Guo et al, 2013). Recently, as the use of
synthetic materials has rapidly increased, Dubai apartments are starting to be widely used as industrial materials (Fahad Alomirah & Moda, 2020). This has had a negative impact on many apartment dwellers. This may be different for each apartment company, but about 2020, the new business system was used a lot, and after that, the symptoms of sick house syndrome were dealt with in articles, and it became a hot topic of the times, and 2020 was set as the time. This study investigated the subjective responses of residents through questionnaires. The questionnaire mainly consists of questions about indoor environment characteristics, changed lifestyles and habits, health awareness symptoms of sick house syndrome, health damage in daily life, countermeasures, satisfaction with the degree of improvement, and general characteristics of the survey subjects (Licina & Yildirim, 2021; Sahlberg et al, 2012). This study conducted a web survey for Dubai and a field survey at Business Bay and Dubai Marina at the same time. The subjects of the survey were housewives living in apartments built after 2018, and a total of 170 questionnaires were collected and analyzed. The survey period was conducted from March 9, 2020 to April 8, 2020. The results were analyzed using the SPSS 26.0 statistical package.
4. Analysis
The general characteristics of the survey subjects are as follows. As a result of the total age of this survey, those in their 30s and 40s accounted for 79.2 % of the total, and those with a high school or college degree accounted for 88.7 % of their educational background. As for the number of families living together, three or four people accounted for 68.4 %, and housewives accounted for 62.8 % of occupations, and general office workers also accounted for 21.1 %.
The husband's occupation was very diverse, and the proportion of households with children was 89.2 %. The average monthly income was 12,000 AED to 15,000 AED, accounting for 56.2 %, and the type of house where they lived before moving in was the apartment with 82.9
%. Business Bay and Dubai Marina accounted for 71.2% of the distribution of the area where the survey subjects lived. As a result of examining the current house size and number of rooms for all respondents, the average size of the house was 1,380 ft2 and the average number of room was 2.85. As a result of examining the period of residence before and after moving for all respondents, the average period of residence in the house where they lived before moving was 5.3 years, and the period of residence in the apartment where they lived after moving on average was 1.6 years (Table 2).
Table 2: General Characteristics of the Surveyor’s Home
Questions Min. Max. Mean Standard
Deviation
The size of the apartment (sqft) 980 1380 1180 282.8
The number of rooms 1.00 5.00 2.85 0.59
Period of residence before moving (years) 1.00 20.00 5.20 4.81
Period of residence after moving (years) 0.45 3.50 1.64 0.82
4.1. Analysis of Resident's Health Awareness Symptoms
As a result of examining the average of the subjective symptoms before and after moving to a new apartment, the most common symptom before moving in was 'dry skin'. The subjective symptom that residents felt the most after moving was also 'dry skin'. When comparing before and after moving, the symptom with the biggest difference was 'stinging or itchy eyes', and the subjective symptom values were generally high after moving. However, the average of the values after moving does not deviate significantly from the 3 points where the average is 'normal', and there is no noticeable difference in the average (Figure 2).
Therefore, in order to find out the exact change strictly, the respondents who answered 'yes' with 4 points and the respondents who answered 'very much' with 5 points were examined. As a result of the analysis, it can be seen that the number of respondents who answered 'my eyes are itchy or itchy' and those who answered 'I have a headache' increased at a high rate .
Figure 2: Self-Conscious SBS (Sick Building Syndrome) Symptoms Before and After Moving
Also, as a result of examining the symptoms that residents thought they had newly appeared after moving to a new house, those related to dry skin and headache accounted for 54.1% and 43.5%, respectively, of high rates. Based on this, it can be safely said that SBS (Sick Building Syndrome) appears after moving into a new apartment (Figure 3).
Figure 3: New SBS (Sick Building Syndrome) Symptoms After Moving
After moving to a new apartment, the results of the symptoms that the resident considers to have appeared new are the results of multiple responses, and the results of examining the corresponding patterns are as follows. Except for 5.88 %, who did not show any symptoms, almost all of the respondents felt the symptoms of SBS (Sick Building Syndrome). As a result of investigating whether such subjective symptoms appeared in other family members even within a household with the same living environment, child 1 had the most at 46.5 %, followed by husband at 34.7 % (Figure 4). “Other” refers to the family living together except for the wife, husband, and children. As a result of examining the pattern of family members
0 0.5 1 1.5 2 2.5 3 3.5
Eyes Nose Dry Skin Skin Spots Cough Short Breath Headache Throat
Frequency
SBS Symptoms
Before Moving After Moving Differences
54.8 42.4
38.6 35.7 26.8
25.6 22.7 18.1
0 10 20 30 40 50 60
Dry Skin Heaaches Itchy Eyes Stuffy Nose Frequent Cough Dry Mouth Itchy Skin/Spot Short Breath
Percentage
experiencing SBS (Sick Building Syndrome) symptoms, 35.9% of the cases where the wife and children felt sick house syndrome symptoms were the most common, and only the wife felt it at 23.5%. Given that the ratio of wives, children, and wives is high, it was found that the longer they spend at home, the more they suffer from sick house syndrome.
Figure 4: Family Members who suffered Sick Building Syndromes
4.2. Analysis of Daily Health Complaints
After moving, if subjective symptoms appeared or worsened compared to before moving, the changes in life in one year were analyzed on a 5 point scale. Respondents who answered 'yes' with a score of 4 and 'very much' with a score of 5 were examined (Figure 5). It can be seen that the items 'increased irritability in daily life' and 'work efficiency deteriorated' appeared at a relatively high ratio.
Figure 5: Daily Life Changes due to SBS (Sick Building Syndrome)
4.3. Analysis of Countermeasures
The results of the measures taken to improve symptoms after moving are as follows when subjective symptoms appear or worsen in the person or family members than before moving (Figure 6). Countermeasures refer to efforts to cope with environmental changes on their own,
46.8
34.2
22.4
3.2 1.7
0 5 10 15 20 25 30 35 40 45 50
Child 01 Husband Child 02 Other Child 03
Percentage
Family Members SBS Percentage
22.1 20.8 15.8 11.8 6.5 4.3 3.8
1.4 1.2 2.4
1.3 1.8
0 0
0 5 10 15 20 25
Increased Irritability in Daily Life Decrease in Work Efficiency Feel Depressed Hate to be at Home Avoid Exposing Skin Difficult to Maintain Happy Family Avoid Interpersonal Relationships
Yes No
and external countermeasures refer to relying on external sources such as hospitals and pharmacies. 'More frequent ventilation' accounted for 90.1 % of the response measures. Next, air purifying plants accounted for 42.9 %, charcoal with 35.4 %, and air purifiers with 28.7 %.
In terms of external countermeasures, hospitals accounted for the highest rate at 32.7%.
Judging from these results, it can be seen that although it is difficult to change life itself, it is relatively easy to place additional items or open and close doors or windows, which residents prefer as a coping solution. As a result of examining the pattern of coping strategies for SBS (Sick Building Syndrome), ventilation alone was the most frequent at 28.1%, and ventilation and charcoal, air purifying plants and ventilation, and air purifying plants and ventilation and charcoal each accounted for 3.1%. As a countermeasure, ventilation is included as a standard, and it can be seen that other types of countermeasures are also used.
Figure 6: Countermeasures to Sick Building Syndromes
As a result of residents' satisfaction with the effectiveness of the coping plan, 75% of the respondents answered that it was effective or very effective, and 24.4% of the respondents answered that there was no change. Although 75% of the respondents said they were satisfied with their coping plan, it is not fundamentally that the cause of sick house syndrome has been completely removed, so verification measures that can solve this problem must be continuously raised.
4.4. Analysis of Interior Finishing Material
In order to analyze the objective environmental characteristics, the results regarding the interior material conditions of the apartment at the time of moving are as follows (Table 3). This shows the state of interior materials of a new apartment, and in the case of moving after remodeling, it shows the state of remodeling. Looking at the results, in the case of the floor, the proportion of respondents who answered that they did not know what material was used was high.
Compared to the living room made of wood, the master bedroom and children's room had a lot of plastic sheets, and the rate of not knowing about the adhesive was very high, but most of the rest were chemical adhesives. Although the percentage of respondents who answered that they did not know about wallpaper was relatively low, it can be seen from the above results that consumers' information about the material is insufficient.
90.1 42.9
35.4 28.7 12.9
10.4 4.3 3.2 3.1 1.8 1.7
32.7 11.8
4.4
0 10 20 30 40 50 60 70 80 90 100
Do More Frequent Ventilation Place Air Purifying Plants
Place Chacoals Purchse Air Purifier Change Eating Habit Purchse New Bed Sheets Change to Organic Clothings Decide not to Keep Pets Change to Eco-Friendly Floor Change to Eco-Friendly Wall Indoor Photocatalyst Work Go to Hospital Go to Pharmacy Miscellaneous
Percentage
Table 3: Interior Finishing Material for New Apartment Living Room Frequency Perent Master
Bedroom
Frequency Perent
Floor Wood 114 68.4 Wood 23 13.5
Tile 5 1.6 Tile 81 47.6
Marble 6 3.5 Marble 0 0
Vinyl Sheet 22 14.2 Vinyl Sheet 0 0
No Idea 23 12.3 No Idea 66 38.8
Total 170 100 Total 170 100
Floor Adhesive Chemical 104 62.1 Chemical 87 51.9
Natural 10 5.0 Natural 14 7.5
Etc 2 1.2 Etc 5 2.9
No Idea 54 31.8 No Idea 64 37.6
Total 170 100 Total 100 100
Wallpaper Silk 95 56.8 Silk 79 47.2
Paper 39 22.7 Paper 55 31.6
Fabric 10 5.9 Fabric 10 5.9
Etc 5 2.9 Etc 4 2.4
No Idea 20 11.8 No Idea 22 12.9
Total 170 100 Total 100 100
Wallpaper Adhesive Chemical 92 55.3 Chemical 89 54.1
Natural 11 5.3 Natural 12 5.3
Etc 2 1.2 Etc 2 1.2
No Idea 65 38.2 No Idea 67 39.4
Total 170 100 Total 170 100
4.5. Analysis of the Environmental Characteristics of a New Apartment
In order to understand the degree of eco-friendliness felt by the residents themselves, it was investigated how they think the apartment they currently live in from an eco-friendly point of view. The reason for this investigation was that objective information alone was judged to be insufficient to grasp the environmental characteristics. Figure 7 is the result of analyzing the current condition of the house on a 7-point scale ranging from ‘very bad’ to ‘very good’. The reason why the survey was conducted on a 7-point scale was that the results had to be viewed by dividing the results into 'not good' and 'good' based on the median value of 4. It was found that the flat conditions were good, and the contents of the rest of the equipment and materials were not good.
Figure 7: Evaluation of Current Apartment by Surveyor
5.67 5.58 4.57
3.79 3.62 3.22 3.01 2.97 2.91 2.89 2.78 2.39 2.32
0 1 2 3 4 5 6
Area of windows for ventilation Plan for cross ventilation Outside air environment Special ventilation structures
Ventilation Fan Household appliances Air cleaning equipment New furniture Built-in furniture Flloring Wallpaper Wallpaper adhesive Flloring adhesive
Points
4.6. Analysis of Changed Lifestyle and Habits
Lifestyle is a phenomenon that is occurring simultaneously with the changed environment as an item investigated to control environmental characteristics. The results of the lifestyle and habits changed after moving are as follows (Figure 8). The difference between the values on the 5-point scale before and after moving and the values on the 5-point scale before and after moving was calculated. Among them, 'degree of ventilation', 'degree of cleaning', 'degree of care about food eaten', 'degree of care about clothing material', and 'degree of care about cosmetics' were moved to positive items. After that, the value often increased. 'The degree of contact with pets', 'the degree of smoking', and 'the degree of drinking' were negative items, and the values tended to decrease after moving. The item with little change in lifestyle and habits was 'the degree of contact with pets'. Even though the degree of ventilation has improved little by little, still feeling SBS (Sick Building Syndrome) clearly indicates that the effect of sick house syndrome is negative.
Figure 8: Changes of Lifestyle and Habits due to SBS (Sick Building Syndrome)
5. Conclusion and Discussion
In this study, from the resident's point of view, subjective symptoms, environmental characteristics, and health damage awareness and countermeasures were identified according to the environmental stress model, and individual lifestyles and habits were investigated. As for the environmental characteristics, both the objective environment and the environmental characteristics that the occupants consider themselves were examined. Symptoms of SBS (Sick Building Syndrome) did not only appear in one person, but in several people. Also, the symptoms were very diverse even within one household, and the circumstances of the suffering were also varied. Since SBS (Sick Building Syndrome) directly affects the quality of life of residents, this effect was found to be very serious. The presence of SBS (Sick Building Syndrome) despite positive coping behaviors is evidence of the harmfulness of a new apartment. It is too early to be reassured that the results of residents' coping behavior are generally satisfactory, and a new method to provide a clean environment should be prepared.
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