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Mechanisms underlying nontoxic indoor air health problems: A review.
International Journal of Hygiene and Environmental Health ( IF 6 ) Pub Date : 2020-03-09 , DOI: 10.1016/j.ijheh.2020.113489
Steven Nordin 1
Affiliation  

Indoor air health problems of the type non-specific building-related symptoms (NBRS; formally called “sick-building syndrome”) and chemical intolerance (CI; e.g. multiple chemical sensitivity) can in severe cases lead to significant disability and poor quality of life. Apart from suffering of the afflicted individuals, the productivity loss ascribed to environmental intolerances of this kind is very costly for society. Preventive measures and appropriate treatment call for understanding of the mechanism underlying NBRS and CI. Considerable similarities between NBRS and CI suggest that the two conditions at large share mechanisms. Since typical cases of these conditions cannot be explained by toxic exposure, the present objective is to describe underlying mechanisms of psychobiological nature for which there is well-developed theoretical ground and empirical support. Focus lies on the mechanisms neurogenic inflammation and neural sensitization. Apart from describing its basic mechanisms, neurogenic inflammation is reviewed in relation to NBRS and CI regarding neurogenic switching, activation of the autonomic nervous system and axon reflex as well as interaction effects between chemical irritants, allergens, and psychosocial stressors. In addition to describing various types of sensitization, empirical support for their role in NBRS and CI is reviewed. The mechanism classical conditioning, symptom misattribution and somatosensory amplification, and nocebo are also addressed. The review rounds off with a discussion on why only a subset of individuals exposed to these indoor environments develop NBRS and CI, and a discussion on integration of the presented mechanisms, accompanied by proposed hypotheses for future research.



中文翻译:

无毒室内空气健康问题的潜在机制:综述。

非特异性建筑相关症状(NBRS;正式称为“病态建筑综合症”)和化学耐受不良(CI;例如多种化学敏感性)类型的室内空气健康问题在严重情况下会导致严重的残疾和不良的生活质量。除了遭受折磨的人的痛苦之外,归因于这种环境不宽容的生产力损失对社会来说是非常昂贵的。预防措施和适当治疗要求了解NBRS和CI的潜在机制。NBRS和CI之间的相当相似之处表明,大型共享机制存在两种情况。由于这些情况的典型情况无法通过有毒的暴露来解释,目前的目的是描述心理生物学性质的潜在机制,为此,它们具有完善的理论基础和经验支持。重点在于神经性炎症和神经敏化的机制。除了描述其基本机制外,还针对NBRS和CI审查了神经源性炎症,涉及神经源性转换,自主神经系统的激活和轴突反射以及化学刺激物,过敏原和社会心理压力源之间的相互作用。除了描述各种类型的敏化以外,还回顾了它们在NBRS和CI中的作用的经验支持。还讨论了经典条件,症状错位和体感放大以及nocebo的机制。

更新日期:2020-03-09
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