A simple but dependable electronic device, Con-Dis, has been developed to gain reliable information on elderly persons’ perceptions of their well-being. The device has been tested and proven to be technically functional and dependable. It... more
A simple but dependable electronic device, Con-Dis, has been developed to gain reliable information on elderly persons’ perceptions of their well-being. The device has been tested and proven to be technically functional and dependable. It was tested in two care homes for the elderly and two private homes to evaluate whether it provided reliable information about the service quality. This report illustrates the practical usage of the device and shows its efficiency in gathering reliable service quality information from the focus group. The results suggest that Con-Dis is suitable for measuring the perceived service quality and seems to reduce the risk of too-positive evaluations.
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The prevention of many diseases has significantly improved by intervening in known risk factors. However, the causes of the increase in allergy and type 1 diabetes are unknown. These diseases are often associated with a low-grade... more
The prevention of many diseases has significantly improved by intervening in known risk factors. However, the causes of the increase in allergy and type 1 diabetes are unknown. These diseases are often associated with a low-grade inflammation and immunological imbalance. The lifestyle and environment of urbanized populations have changed causing imbalance in the human normal flora and affecting immune regulation. We discuss everyday factors affecting immune regulation, using allergy as an example. Health may be promoted through the "nature step", by supporting the connection between humans and nature.
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ABSTRACT Facility design related to rapidly changing healthcare (HC) processes is in dire need of new innovations. Due to an ongoing nationwide HC reform in Finland, five University Hospitals among other central hospitals are forced to... more
ABSTRACT Facility design related to rapidly changing healthcare (HC) processes is in dire need of new innovations. Due to an ongoing nationwide HC reform in Finland, five University Hospitals among other central hospitals are forced to find ways to carry out competitive HC design practices in order to maintain efficient work environments and processes. This article illustrates a brief overview of Kuopio University Hospital's (KUH's) design development concept. The researchers reviewed and evaluated all the major facility design projects being carried out at KUH during the past five years. KUH aspires to continuously learn in order to stay effective and improve as a major player in Finnish HC. Creative thinking and openness to new, state-of-the-art solutions have enabled gradual development in the facility design process. Emphasis on participatory design approach, change management and evidence-based design has proven to be beneficial as well. Furthermore, integrating operational design as a main part of the facility design process should pay dividends in the near future. This article brings forth a HC design concept from one of the leading hospitals among Finnish HC. The article sheds light on the methods crucial to KUH for continuous improvement.
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OBJECTIVES: The purpose of the study was to determine whether the Indoor Air Questionnaire of the Finnish Institute of Occupational Health works in a hospital environment and whether the questionnaire can be used to determine moisture and... more
OBJECTIVES: The purpose of the study was to determine whether the Indoor Air Questionnaire of the Finnish Institute of Occupational Health works in a hospital environment and whether the questionnaire can be used to determine moisture and mold damage. METHODS: The Indoor Air Questionnaire of the Finnish Institute of Occupational Health, as modified for hospital enviroments, was sent to the employees of 10 selected hospitals. At the same time, but separately, a team of experts on building and ventilation technology assessed the condition of the hospital facilities. RESULTS: On the whole, hospital staff reported more complaints and symptoms related to indoor air than office workers in a recent control study. More complaints and symptoms related to indoor air were reported in facilities requiring further studies than in facilities that did not require any repairs. The most complaints and symptoms related to indoor air were reported in facilities requiring immediate repairs. In these fa...
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To assess the extent of indoor air problems in office environments in Finland. Complaints and symptoms related to the indoor environment experienced by office workers were collected from 122 workplaces in 1996-99 by using the modified... more
To assess the extent of indoor air problems in office environments in Finland. Complaints and symptoms related to the indoor environment experienced by office workers were collected from 122 workplaces in 1996-99 by using the modified Indoor Air Questionnaire established by the Finnish Institute of Occupational Health. Altogether 11 154 employees took part in the survey. The most common problems were dry air (35% of the respondents), stuffy air (34%), dust or dirt in the indoor environment (25%), and draught (22%). The most common work related symptoms were irritated, stuffy, or runny nose (20%), itching, burning, or irritation of the eyes (17%), and fatigue (16%). Women reported indoor air problems and work related symptoms more often than men. Allergic persons and smokers reported indoor air problems more often, and experienced work related symptoms more often than non-allergic persons and non-smokers. The complaints and work related symptoms associated with indoor air problems we...
Research Interests: Occupational Health, Indoor Air Quality, Environmental Health, Environmental Monitoring, Adolescent, and 15 moreMedicine, Finland, Humans, Female, Male, Clinical Sciences, Middle Aged, Adult, Occupational Exposure, Age Factors, Health surveys, Indoor Environment, Occupational Diseases, Indoor air, and Epidemiological monitoring
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Research Interests: Construction Materials, Asthma, Medicine, Humans, Wood, and 6 moreThorax, Male, Clinical Sciences, Adult, Dust, and Occupational Diseases
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... Exploring the relationship between indoor air and productivity by Riikka Antikainen, MSc(Econ),1 Sanna Lappalainen, PhD,2 Antti Lönnqvist, DSc(Tech),1 Kati Maksi-mainen, MSc,2 Kari Reijula, DMedSci,2 Erkki Uusi-Rauva, DSc(Tech)1 ...... more
... Exploring the relationship between indoor air and productivity by Riikka Antikainen, MSc(Econ),1 Sanna Lappalainen, PhD,2 Antti Lönnqvist, DSc(Tech),1 Kati Maksi-mainen, MSc,2 Kari Reijula, DMedSci,2 Erkki Uusi-Rauva, DSc(Tech)1 ... 7. Seppänen O, Fisk WJ, Lei QH. ...
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Research Interests: Health Behavior, Occupational Health, Occupational Medicine, Fatigue, Medicine, and 15 moreFinland, Pregnancy, Humans, Female, Male, Occupational Safety and Health, Health Status, Aged, Middle Aged, Questionnaires, Adult, Public health systems and services research, Age Factors, Occupational therapy services in mental health services, and Occupational Diseases
Hypersensitivity to natural rubber latex (NRL) in health care personnel exposed to powdered latex gloves appears as conjunctivitis, rhinitis, nasal congestion, cough, dyspnea, or bronchial asthma in approximately 30% of all cases with... more
Hypersensitivity to natural rubber latex (NRL) in health care personnel exposed to powdered latex gloves appears as conjunctivitis, rhinitis, nasal congestion, cough, dyspnea, or bronchial asthma in approximately 30% of all cases with latex allergy while most of the patients have contact urticaria. The purpose of the present study was to determine the prevalence of latex-induced allergic rhinitis in health care workers using NRL gloves on a daily basis. Clinical examination accompanied by skin prick test (SPT) with latex glove extracts and common aeroallergens, measurements of specific IgE to NRL, and lung function tests were performed in 25 symptomatic workers and 11 latex-exposed asymptomatic controls. Sensitization to NRL was detected using SPT in one (4%) of 25 symptomatic workers but not in any of the asymptomatic controls. Positive SPT to aeroallergens was demonstrated in 8/25 symptomatic workers and 6/11 controls. Measurements of forced vital capacity, forced expiratory volume in I sec, and bronchial methacholine challenge did not show any significant differences between the study groups. In conclusion, NRL-aeroallergen-induced occupational rhinitis may occur among physicians and nurses who have a frequent use of latex gloves on a daily basis at hospital work. However, a relatively low prevalence of NRL-induced occupational rhinitis is associated with profuse consumption of no-powder sterile gloves.
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Because the diagnosis of extrinsic allergic bronchiolo-alveolitis is usually on a clinical and serologic basis, recent histopathologic descriptions of the syndrome are rare. As the etiology may vary in different countries, so perhaps may... more
Because the diagnosis of extrinsic allergic bronchiolo-alveolitis is usually on a clinical and serologic basis, recent histopathologic descriptions of the syndrome are rare. As the etiology may vary in different countries, so perhaps may the histopathology? Clinical and serological examination was combined with histopathology of open lung biopsy from 14 northern Finnish patients. All of them, after exposure to mouldy dust, had a typical clinical syndrome with cough and/or dyspnoea, some radiographic changes, and a reduced VC and/or DCO. Precipitating antibodies were demonstrated in 11 patients. Histopathologically, oedema, macrophages and granulomas were found in all patients, as were lymphocytic and plasmocytic infiltrates. Inflammatory changes were alveolar, interstitial and bronchiolar, including bronchiolar granulomas in all but one case. None of the patients had severe fibrosis or emphysema. There were no examples of clear-cut acute or chronic stages as described in previous st...
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ABSTRACT Abstract The number of moisture-problem buildings in Finland is unexpectedly high according to recent investigations. In approximately 55% of Finnish buildings, moisture damage is in need of repair. With more than 1.15 million... more
ABSTRACT Abstract The number of moisture-problem buildings in Finland is unexpectedly high according to recent investigations. In approximately 55% of Finnish buildings, moisture damage is in need of repair. With more than 1.15 million buildings in this country, almost 600 000 buildings suffer moisture problems and in over 100 000 there is growth of molds, either in building materials or on infested surfaces of the building. This means that over 400 000 Finns have been exposed to molds in damp houses. Exposure to molds is a significant health risk and should be prevented. Irritation of eyes, respiratory tract and skin may occur following exposure to microbes, and numbers of exposed persons develop a hypersensitivity reaction to fungal allergens. Asthma, hypersensitivity pneumonitis (extrinsic allergic alveolitis) and organic dust toxic syndrome (ODTS) may also develop after exposure. Secondary infections are more common in persons living in damp houses. In the present article, clinical manifestations associated with mold exposure in moisture-problem buildings will be described.
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ABSTRACT OBJECTIVES: The aim of this study was to assess the perceived indoor air quality and work-related symptoms among hospital employees in a national survey. METHODS: Indoor-air-related symptoms were studied among hospital workers in... more
ABSTRACT OBJECTIVES: The aim of this study was to assess the perceived indoor air quality and work-related symptoms among hospital employees in a national survey. METHODS: Indoor-air-related symptoms were studied among hospital workers in a questionnaire survey in which employees (N=5598) from 10 central hospitals participated. The survey was based on the Indoor Air Questionnaire (MM-40) by the Finnish Institute of Occupational Health. RESULTS: A total of 3811 employees returned the questionnaire (response rate 68%). The environmental problems most frequently reported were dry air (reported by 46% of the respondents), stuffy air (40%), noise (30%), draft (27%), and unpleasant odor (26%). The most common symptoms were nasal irritation (reported by 25% of the participants), hand irritation (24%), eye irritation (23%), and fatigue (21%). CONCLUSIONS: Complaints associated with dry and stuffy air, noise, draft, and unpleasant odors were more common in hospitals than in office environments. Irritation of the nose, hands, and eyes, as well as fatigue, were also experienced more often in hospitals than in office environments.
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ABSTRACT Agreements concerning energy conservation and overgrown property expenses drive organizations to search for cost savings through efficient utilization of space. New multi-space office solutions have been developed to achieve... more
ABSTRACT Agreements concerning energy conservation and overgrown property expenses drive organizations to search for cost savings through efficient utilization of space. New multi-space office solutions have been developed to achieve these goals. Organizations expect relocation from traditional cell-offices to a multi-space office to promote a new positive working culture. However, relocation is often perceived as threatening by personnel, and resistance to change may be strong. The aim of the present case study was to describe and analyze a typical workplace design process, focusing on the success factors of change management in the context of a relocation from a traditional cell-office to a multi-space office. The results showed that the personnel was critical of both the workplace development project and the participative process. The case highlighted the importance of clear, common change goals, and open communication that allows constructive criticism. Moreover, it seems that management should be more active in their leadership, the roles of various stakeholders should be clarified, and the objectives and possible limitations of user participation should be openly discussed. In addition, new kinds of participative methods that would help analyze the demands of work and enhance communication between the design team and users should be developed.
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The effects of highly toxic and nontoxic spores ofStachybotrys atrawere investigated in mice after six intranasal administrations of 1 × 105and 1 × 103spores in phosphate-buffered saline during a 3-week period. Toxic spores contained the... more
The effects of highly toxic and nontoxic spores ofStachybotrys atrawere investigated in mice after six intranasal administrations of 1 × 105and 1 × 103spores in phosphate-buffered saline during a 3-week period. Toxic spores contained the trichothecene mycotoxins, satratoxins G and H, as well as the immunosuppressant stachybotrylactones and -lactams. No trichothecenes were detected in the nontoxic spores, and they contained only minor amounts of stachybotrylactones and -lactams. In mice injected with toxic and nontoxic spores, the platelet count was decreased and leucocyte and erythrocyte counts, hemoglobin concentration, and hematocrit were increased. No IgG antibodies toS. atrawere detected in sera of mice exposed intranasally to spores. No histological changes were detected in spleen, thymus, or intestines of mice. The mice receiving 1 × 105toxic spores intranasally developed severe inflammatory changes within both bronchioles and alveoli. Hemorrhage was detected in alveoli. The mice receiving 1 × 105nontoxic spores also developed inflammatory changes in the lungs, but these changes were significantly milder than those in mice receiving toxic spores. The mice receiving 1 × 103toxic spores developed inflammatory changes in the lungs that were less severe than those in the mice receiving 1 × 105toxic spores. No inflammatory changes were detected in the mice receiving 1 × 103of nontoxic spores. The present findings indicate that exposure toS. atraspores containing toxins (satratoxins) can be a significant health risk.
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Stachybotrys chartarum is a damp building mould and a potent toxin producer that has been related to serious cases of respiratory health problems. However, the direct link between exposure and health symptoms has not been established. To... more
Stachybotrys chartarum is a damp building mould and a potent toxin producer that has been related to serious cases of respiratory health problems. However, the direct link between exposure and health symptoms has not been established. To examine the mechanism by which exposure to spores of satratoxin producing and non-producing S. chartarum strains induce inflammatory responses in murine lungs. BALB/c mice were intranasally exposed for 3 weeks to spores of a satratoxin-producing and a non-producing S. chartarum strain. Inflammatory cell infiltration was characterized from bronchoalveolar lavage (BAL) fluid. Cytokine and chemokine mRNA expression in lung tissue was measured with real-time PCR. Bronchial responsiveness to methacholine (MCh) was determined by whole-body plethysmography and serum antibody levels by ELISA. A dose-dependent increase in monocytes, neutrophils and lymphocytes was observed in BAL fluid after intranasal (i.n.) instillation of S. chartarum spores. There was no difference in the BAL between exposure to the satratoxin-producing and the non-producing strains. Infiltration of inflammatory cells was associated with an induction of pro-inflammatory cytokine (IL-1beta, IL-6 and TNF-alpha) and chemokine (CCL3/MIP-1alpha, CCL4/MIP-1beta and CCL2/MCP-1) mRNA levels in the lungs. Interestingly, CXCL5/LIX was the only chemokine that showed significantly higher mRNA levels after exposure to the satratoxin-producing strain compared with the non-producing strain. MCh-induced bronchial responsiveness was not altered significantly after mould instillation. Moreover, no significant increase in total or specific IgE, IgG2a and IgG1 antibody levels were found after S. chartarum exposure. These results indicate that lung inflammation induced by i.n. instillations of S. chartarum spores is regulated by the induction of pro-inflammatory cytokines and leucocyte-attracting chemokines. The data also imply that S. chartarum-derived components, other than satratoxins, are mediating the development of this inflammatory response.
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Research Interests: Psychology, Epidemiology, Construction, Public Health, Risk assessment, and 15 moreConstruction Industry, Finland, Humans, Toxicity, Asbestos, Female, Male, Incidence, Middle Aged, Questionnaires, Public health systems and services research, Neoplasms, Risk Assessment, Occupational Diseases, and Shipyard
The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods... more
The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods in a larger framework of change process model and participatory design. Rehabilitation organizations are currently in transition; customer groups, financing, services, and the processes of rehabilitation centers are changing. The pressure for change challenges the centers to develop both their processes and facilities. There is a need for methods that support change management. Four participatory methods were developed: future workshop, change survey, multi-method assessment tool, and participatory design generator cards. They were tested and evaluated in three rehabilitation centers at the different phases of their change process. The developed methods were considered useful in creating a mutual understanding of the change goals between different stakeholders, providing a good picture of the work community's attitudes toward the change, forming an integrated overview of the built and perceived environment, inspiring new solutions, and supporting the management in steering the change process. The change process model described in this article serves as a practical framework that combined the viewpoints of organizational and facility development. However, participatory design continues to face challenges concerning communication between different stakeholders, and further development of the methods and processes is still needed. Intervention studies could provide data on the success factors that enhance the transformations in the rehabilitation sector. Design process, methodology, organizational transformation, planning, renovation.
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The fine structure of Thermoactinomyces vulgaris and Saccharopolyspora rectivirgula is described by transmission electron microscopy. These two bacteria are the most common microbes causing farmer's lung. The fine structure of hyphae,... more
The fine structure of Thermoactinomyces vulgaris and Saccharopolyspora rectivirgula is described by transmission electron microscopy. These two bacteria are the most common microbes causing farmer's lung. The fine structure of hyphae, germination of endospores and the details of conidial wall layers of T. vulgaris, as well as the fine structure of septate hypha and globose, polygonal conidia of S. rectivirgula are described. The conidial wall of T. vulgaris consisted of an inner multilayered spore coat, intermediate spore coat and outer spore coat. The findings are important for the investigations to find fragments of these bacteria in the lungs of exposed patients and experimental animals.
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Screening for asbestos-induced diseases in Finland was carried out in 1990-1992 as a part of the Asbestos Program of the Finnish Institute of Occupational Health. The aim of the present study was to find the workers who had developed an... more
Screening for asbestos-induced diseases in Finland was carried out in 1990-1992 as a part of the Asbestos Program of the Finnish Institute of Occupational Health. The aim of the present study was to find the workers who had developed an asbestos-induced disease in certain occupations. Examination of active or retired workers included a personal interview on work history and asbestos exposure, and a chest X-ray. The target group for the screening comprised workers under 70 years of age who had worked at least for 10 years in construction, 1 year in a shipyard or in the manufacture of asbestos products. A preliminary questionnaire was sent to 54,409 workers, 18,943 of whom finally participated in the screening examination. The mean age of the workers was 53 years; 95% were employed in construction, 2% in shipyards, and 3% in the asbestos industry. The criteria for a positive screening result were (1) a radiographic finding clearly indicating lung fibrosis (at least ILO category 1/1), (2) a radiographic finding indicating mild lung fibrosis (ILO category 1/0) with unilateral or bilateral pleural plaques, (3) marked abnormalities of the visceral pleura (marked adhesions with or without pleural thickening), or (4) bilateral pleural plaques. The positive cases totalled 4,133 (22%) and were sent for further investigation. In addition to the screening, information on the presence of asbestos in the work environment, prevention of asbestos exposure, as well as on the health effects of asbestos exposure and smoking were given to the participating workers. The screening acted as a preliminary survey to prompt further national follow-up of asbestos-induced diseases among the workers who have been exposed to asbestos. This article presents the material, methods, and overall results of the screening.
Research Interests: Epidemiology, Construction, Public Health, Prevention, Construction Industry, and 16 moreFinland, Asbestosis, Humans, Asbestos, Female, Male, Lung Diseases, Follow-up studies, Aged, Middle Aged, Adult, Occupational Exposure, Public health systems and services research, Time Factors, Occupational Diseases, and Shipyard
To analyze occupation, expert-evaluated cumulative exposure, and radiographic abnormalities as indicators of asbestos-related cancer risk we followed 16,696 male construction workers for cancer in 1990-2000. We calculated standardized... more
To analyze occupation, expert-evaluated cumulative exposure, and radiographic abnormalities as indicators of asbestos-related cancer risk we followed 16,696 male construction workers for cancer in 1990-2000. We calculated standardized incidence ratios (SIR) in comparison to the Finnish population and relative risks (RR) in a multivariate analysis in comparison to the internal low-exposure category of each indicator. Overall, the risk was increased for mesothelioma (SIR 2.0, 95% CI = 1.0-3.3), but not for lung cancer (SIR 1.1, 95% CI = 0.9-1.2). Radiographic lung fibrosis indicated a 2-fold and a high value of the exposure index a 3-fold RR of lung cancer, while there was no risk among those with pleural plaques. The risk of lung cancer was the highest in insulators (RR 3.7, 95% CI = 1.4-9.9). Occupation, expert-evaluated cumulative exposure, and lung fibrosis are useful indicators of lung cancer risk among construction workers.