Ultraclean indoor spaces may reduce symptom severity

When an employee or school student shows prolonged and diverse symptoms in buildings, in which indoor air has not been shown to have factors that cause symptoms, ultraclean indoor areas are increasingly offered as a solution both in schools and at workplaces, according to a paper by a healthcare group.

There is no medical foundation for the use of ultraclean spaces, and they should not be used before their long-term effects on health and well-being have been clarified, said the National Institute for Health and Welfare (THL), quoting the paper by the healthcare specialist group of the Finnish Indoor Air and Health Programme on Tuesday.

Instead of using especially ultraclean spaces, persons with prolonged symptoms should be given wide-ranging and knowledge-based support.

The position paper focused on ultraclean spaces and did not address the situation, when all users of the building, irrespective of their symptoms, are moved temporarily to other buildings, e.g., due to repairs.

In a situation in which no factors causing symptoms have been detected in the indoor air of a building, a move to ultraclean indoor areas can make the situation of a symptomatic person worse. The move reinforces the impression that the symptoms would be caused by unknown factors connected with the indoor air, which could lead to greater avoidance behaviours and a decline in the ability to function.

When special conditions are used as a solution, it often limits the physical and social living conditions of symptomatic persons or their families. This can have far-reaching negative consequences, especially for children.

Moving to ultraclean areas can also worsen concerns, negative experiences, and notions of harm linked with indoor air for other users of the building or family members. Emphasising risks can reinforce or maintain functional symptoms and increase the risk of environmental sensitivity.

“In the prevention and treatment of environment sensitivity it is important to focus especially on perceptions of harm and danger connected with indoor air. This requires responsibly from all actors, such as officials, healthcare professionals, decision-makers, the media, and other organisations in their actions and recommendations,” said Helsinki University Hospital (HUS) Chief Physician Risto Vataja.

Prolonged symptoms that harm the ability to function should be investigated with the help of a healthcare professional and patients need to be provided with the treatment and rehabilitation plan they need.

“Symptoms that cause problems need to be thoroughly cleared up in healthcare. Typically, symptoms have a variety of causes, so treatment and rehabilitation should be tailored individually. In exceptional situations it is possible to avoid certain indoor locations, but only temporarily and as a part of other treatment and rehabilitation. Constant avoidance over the long term can reinforce reactions to ordinary environments and lead to environmental sensitivity that makes normal life difficult,” said Turku University Hospital Chief Physician Maritta Kilpeläinen.