Description
Written by multidisciplinary experts in medicine, chemistry, and architecture, this book examines chemical sensitivity (CS). In 15 chapters fitted to 15 lectures, it discusses not only the medical explanation, but also the environmental factors of this hypersensitive reaction, such as chemistry and architectural aspects. The book overviews pollution-induced diseases such as Minamata Disease. It also points out the similarity of modern hypersensitivity syndromes to historical pollution diseases from the viewpoints of not only natural scientific aspects, but also social understanding of the disease.
Table of Contents
Introduction Chapter 1 Present Status of Chemical Sensitivity
1.1 Background
1.1.1 Disease Registration of CS
1.1.2 CS Studies in Europe
1.1.3 CS Studies in Japan
1.1.4 Sick-Building/House Syndrome
1.2 Clinical Symptoms
1.3 Psychiatric and Social Aspects
1.4 Chemical Agents Implicated in CS
1.5 Why the Diagnosis of CS Is Difficult
1.5.1 Reasons for the Lack of Understanding of CS
Chapter 2 Effects of Chemical Sensitivity on Patients’ Daily Lives
2.1 Effects of Chemical Sensitivity
2.2 Countermeasures
2.2.1 Making Your Home, Workplace, and School Environment Safe
2.2.2 Food and Digestive Issues
2.2.3 Caution in Use of Daily Products
2.2.4 Avoidance of Environmental Chemicals
2.2.5 Effects of Electromagnetic Waves
2.2.5.1 ES and International Classification of Disease 10 (ICD
Chapter 3 Promoting Understanding of Chemical Sensitivity
3.1 Medical Insurance in Japan
3.2 Understanding of CS at the Judicial Level
3.3 Education
3.3.1 Specific Education of Medical Doctors
3.3.2 Specific Education for Dentists
3.3.3 Specific Education for the Healthcare Team
3.3.4 Patient Education for a Comfortable Daily Life
3.3.5 Education of Laypersons
Chapter 4 Medical Facts
4.1 Acute Toxicology, Intermediate Syndrome
4.2 Chronic Toxicology
4.3 Animal Experiments Using Extremely Low Dosages...
4.4 Research on the Mechanism of CS
4.4.1 Detoxification 4.4.2 Nervous Sensitivity Acquisition Chapter 5 Diagnosis 5.1 Detailed and Careful Interview 5.2 Neuro-Ophthalmological and Neurological Examinations in Conjunction with Ordinary Clinical Examinations in Japan 5.2.1 Tracking Eye Movement Examination 5.2.2 Pupillary Function 5.2.3 Standing Ability 5.2.4 Contrast Sensitivity Examination of Higher Visual Centers 5.2.5 Accommodation Examination of Eyes
5.2.6 Cerebral Function Examination
5.2.7 Immune Examination
5.2.8 Respiratory Function
5.2.9 Peripheral Venous Blood Oxygen Concentration
5.3 Chemical Load Tests
5.3.1 Use of a Clean Room
5.3.2 Determination of Causative Chemicals (Challenge Test)
Chapter 6 Treatment of Patients with Chemical Sensitivity
6.1 Avoidance of Chemical Substances
6.1.1 Food
6.1.3 Air
6.1.3.1 Use of an Air Purifier
6.1.4 Clothes. 6.1.5 Medicine
6.2 Detoxification
6.2.1 Spa, Hot Spring, Bath, Low-Temperature Sauna
6.2.2 Drug Treatment
6.2.2.1 Conjugation
6.2.2.2 Vitamins
6.2.2.3 Symptomatic Therapy
6.2.2.4 Minerals
6.2.2.5 EDTA, Penicillamine, PAM, and Others
6.3 Alternative Therapy
6.3.1 Prayer and Meditation in Zen Buddhism
6.3.2 Eastern Medicine and Alternative Medicine
6.4 Nutritional Instruction
Chapter 7 Chemical Sensitivity in Children
7.1 General Symptoms
7.1.1 Formaldehyde Concentration and Symptoms
7.1.2 TVOC Concentration and Symptoms
7.1.3 Red Cell Cholinesterase
7.2 Effects of Indoor Chemicals on the Intelligence and Cognitive Function of Children
7.2.1 Evaluation of Intelligence
7.2.2 WISC-III Test Results and Concentration of Indoor Chemicals
7.2.3 Development of Sick-House Syndrome
7.3 Case Report of CS in a Young Boy Who Had Been Treated with Sumatriptan Succinate and Selective Serotonin Reuptake Inhibitors
Chapter 8 Multiple Chemical Sensitivity—Medical Aspects from Germany 8.1 Chemical Sensitivity
8.2 Biochemical Individuality
8.3 Randolph’s Specific Adaptation Syndrome in Response to Environmental Stressors
8.4 Causes: Fire in the Body and the Brain
8.5 Diagnostic Program Recommended for CS Patients
8.5.1 Metabolic and Nutritional Status (Organic Acid Profiles), Toxins
8.5.2 Toxic Metals
8.5.3 Phthalates and Parabens Profile
8.5.3.1 Why Assess Phthalate and Paraben Levels?
8.5.3.2 Where Are Phthalates and Parabens Found?
8.5.4 Bisphenol A
8.5.5 Hidden Food Allergies
8.5.5.1 Gluten Sensitivity Can Cause
Neurological and Autoimmune Disease......64
8.5.6 Stool and Digestive Analysis.........................
8.5.6.1 Why Use Stool Analysis
8.6 Therapy: The DNA Concept
8.7 HEPAR-TOX Detoxification
8.8 Ecological Architecture and Environmental Medicine
8.8.1 New Projects in Wolfhagen—The Historic City in the Land of the Brothers Grimm
Chapter 9 Emission Rate of Chemical Compounds in Building Products and Materials
9.1 Introduction
9.2 Categories of Chemical Substances
9.3 Building Products and Materials
9.4 Emission Tests Using a Chamber
9.4.1 Small-Chamber Method
9.4.2 Large-Chamber Method
9.4.3 Desiccator Method
9.4.4 Passive Method
9.4.5 Microchamber Method for SVOCs
9.5 Labeling
9.5.1 Formaldehyde
9.5.2 VOCs.
9.5.2.1 For VOC Standard. Chapter 10 Ventilation Strategies for Each Kind of Building and Statutory Regulations
10.1 History and Background of Indoor Air Pollution Measures in Japan
10.1.1 Before the Dawn of Measures against Sick Houses
10.1.2 Design Assumption and Strategy of Measures
against the Indoor Air Pollution Problem
10.2 Statutory Regulations for Indoor Air Quality
10.2.1 Technical Standards in the Amended Building Standard Law
10.2.2 Regulation Regarding the Use of Building Materials Containing Formaldehyde and Installation of Ventilation 10.2.2.1 Restrictions on Interior Finishing 10.2.2.2 Mandatory Installation of Ventilation 10.2.2.3 Restrictions Concerning Attic and Adjacent Concealed Spaces 10.2.3 Technical Standards in the Housing Quality Assurance Act 10.2.4 Maintenance of Sanitation in Buildings 10.2.5 Indoor Air Pollution Following the Amendment of the Building Standard Law in 2003 10.3 Types and Features of Ventilation Systems
10.3.1 Types of Ventilation
10.3.2 Methods of Selecting a Mechanical Ventilation System
10.4 Trends in Technology Development and Energy-Saving Performance
10.4.1 Mechanical Ventilation System Utilizing Low- Power Input Motors
10.4.2 Demand-Controlled Ventilation
10.4.3 Mechanical Ventilation Systems with a Heat Exchanger
10.4.4 Hybrid Ventilation System
10.5 Important Points for Planning and Operation of Ventilation Systems
10.5.1 Planning of the Ventilation Path
10.5.2 Notes for Calculating Pressure Drops
10.5.3 Notes on Construction
10.5.4 Notes Concerning Regular Maintenance
10.5.5 Steps for Ventilation Planning
10.6 Ventilation Equipment in Large Buildings
10.6.1 Ventilation in Designated Buildings
10.6.2 Ventilation Systems Except Those Employed in Centrally Controlled HVAC Systems
Chapter 11 Ventilation, Air-Tightness, and Air Pollution
11.1 Outline of the Measurement Survey
11.1.1 Survey Period and Investigated Houses
11.1.2 Survey Points and Measurement Method 11.2 Measurement Results 11.2.1 Air-Tightness of Houses 11.2.2 Ventilation Rate of the Ventilation System 11.3 Comparison of Air-Tightness, Ventilation System, and Chemical Substance Concentrations 11.3.1 Comparison of Air-Tightness and Chemical Substance Concentrations 11.3.2 Comparison of Air Change Rate and Chemical Substance Concentrations 11.4 Conclusions
Chapter 12 Chemical Features of Indoor Pollutants and Current Regulations
12.1 Usage and Sources of Chemical Species Detected in Indoor Environments
12.1.1 Artificial Wooden Boards and Adhesives
12.1.2 Paint
12.1.3 Fungicides, Repellents, Mothballs, Air Fresheners, and Disinfectants
12.1.4 Plasticizers and Flame Retardants
12.1.5 Smoking and Burning Appliances
12.1.6 Secondary Generated Compounds
12.1.7 Contaminants in Outdoor Air
12.1.8 Unknown Pollutants
12.2 Determination of Pollutants from the View of Health Effects
12.2.1 Target Health Effects
12.2.1.1 Sick-House Syndrom
12.2.1.2 Asthma
12.2.1.3 Endocrine Disruption
12.2.1.4 Cancer
12.2.2 Field Survey of Indoor Pollution
12.3 Risk Assessment
12.3.1 What Is Risk Assessment
12.3.2 Hazard Assessment
12.3.3 Exposure Assessment
12.3.4 Risk Assessment
12.4 Enforcement and Effect of Regulations
12.4.1 Time Course of Regulations
12.4.2 Impact of Regulations
Chapter 13 Methods for Measurement of Indoor Pollution
13.1 Methods for Measurement of Indoor Concentration
13.1.1 Integration Measurement
13.1.1.1 Active Method
13.1.1.2 Passive Method
13.1.1.3 Subject Compounds, Carbonyl
Compounds, VOCs, TVOCs, SVOCs
13.1.2 Instant Measurement
13.1.2.1 Subject Compounds, TVOCs,
Formaldehyde
13.1.2.2 On-Site Method of Measuring Source
Intensity and Ventilation Rate
13.1.3 Combined Application of Integration
Measurement and Instant Measurement................... 130
13.1.3.1 Peak Capture Method................................ 131
13.2 Methods of Measuring the Emission Rate of Building
Materials................................................................................. 131
13.2.1 Desiccator Method.................................................... 131
13.2.2 Chamber Method....................................................... 132
13.2.3 On-Site Measurement Method.................................. 133
13.2.3.1 Field and Laboratory Emission Cell.......... 133
13.2.3.2 Passive Emission Colorimetric Sensor...... 133
13.2.3.3 Passive Flux Sampler................................. 134
13.2.3.4 Advanced Diffusive Sampling
Emission Cell............................................. 135
13.3 Methods of Measuring Personal Exposure Amount.............. 135
13.3.1 Active Sampling–Passive Sampling Method............ 135
13.3.1.1 Search for Causative Compound
of Chemical Sensitivity.............................. 135
13.3.2 Instant Measurement Method.................................... 136
13.3.2.1 TVOCs and HRV....................................... 136
Endnotes............................................................................................ 136
Chapter 14 The Current Situation and Shift in Approaches to Indoor Air
Pollution............................................................................................ 139
Miyuki Noguchi
14.1 Framework of Laws and Regulations..................................... 139
14.1.1 Housing Quality Assurance Act................................ 139
14.1.2 School Health and Safety Act................................... 139
14.1.3 Act on Maintenance of Sanitation in Buildings........ 140
14.1.4 Revised Building Standards Act............................... 140
14.1.5 Indoor Density Guideline Value................................ 141
xii Contents
14.2 Trends after Determination of Guideline Values................... 142
14.2.1 Advantageous Effect of Formaldehyde Labeling...... 142
14.2.1.1 Formaldehyde Concentration in New
Residential Housing................................... 142
14.2.2 Composition of VOCs............................................... 143
14.2.2.1 Significant Reduction
of Concentrations of Guideline
Substances................................................. 143
14.2.2.2 High Concentration Substances
(TVOCs, Acetaldehyde, Aliphatic
Compounds, etc.)....................................... 143
14.2.3 Widespread Use of Alternative Substances............... 143
14.2.3.1 Low Formaldehyde Emission Adhesives.... 145
14.2.3.2 Water-Based Paint and Ink........................ 145
14.2.3.3 Increased Use of Aliphatic Compounds.... 145
14.2.4 Temporal Change of Indoor TVOC Concentration.... 146
14.2.5 Trends of Social Recognitions for Indoor Air
Pollution: New and Remodeled Houses.................... 146
14.2.5.1 Completion Checks by the Housing
Quality Assurance Act............................... 146
14.2.5.2 Widespread Indoor Air Pollution
with Nonregulated Substances.................. 146
14.2.5.3 Recognition That SHS Was Resolved........ 147
14.2.6 Change in Social Recognition of Indoor Air
Pollution: Routine Countermeasures......................... 147
14.2.6.1 Air Cleaners............................................... 148
14.2.6.2 Oxidative Decomposition.......................... 148
14.2.6.3 Secondary Pollutants................................. 148
14.3 Required or Recommended Countermeasures....................... 148
14.3.1 Regulation of TVOC Concentration.......................... 148
14.3.1.1 Enforcement of the Elimination Period..... 149
14.3.1.2 Information Sharing Among
the Relevant Parties................................... 149
14.3.2 Collecting Information from Medical Doctors......... 149
14.3.2.1 Selection Method for New Guideline
Substances................................................. 149
14.4 Formulation of Counseling or Inquiry Systems
for Patients and New Occupants............................................. 150
Chapter 15 Investigation of Indoor Environments and Occupants’ Health
in Sick Houses................................................................................... 151
Hiroshi Yoshino, Sachiko Hojo, and Rie Takaki
15.1 Field Survey on Indoor Air Quality, Building
Performance, and Occupants’ Health of 62 Sick Houses....... 151
15.1.1 Description of the Investigation................................ 151
Contents xiii
15.1.1.1 Investigated Houses................................... 151
15.1.1.2 Investigation of Building Performance
and the Indoor Environment...................... 152
15.1.1.3 Survey Questionnaire about Health
Conditions.................................................. 153
15.1.2 Results....................................................................... 153
15.1.2.1 Results of Chemical Substance
Concentration Measurements.................... 153
15.1.2.2 Relationship between Formaldehyde
Concentration and Air-Tightness
Measurement.............................................. 153
15.1.2.3 Relationship between Formaldehyde
Concentration and Air Change Rate.......... 155
15.1.2.4 Sick-House Syndrome Based
on the QEESI® Questionnaire
15.1.3 Chemical Substance Concentration and Occupants’ Symptoms
15.1.3.1 Relationship between Chemical Substance Concentration and SHS
15.1.3.2 Relationship between Chemical Substance Concentration and Severity of Symptoms
15.1.4 Conclusion
15.2 Long-Term Observations Mainly for 30 Houses
15.2.1 Investigated Houses
15.2.2 Results of the Investigation
15.2.2.1 Relationship between Chemical Substance Concentration and Building Age 15.2.2.2 Yearly Changes of Occupants’ Symptoms 15.2.3 Change of Symptoms and Chemical Substance Concentrations 15.2.3.1 Change of Symptoms in Response to Countermeasures against Mitigation of SHS 15.2.3.2 Decrease of Chemical Substance Concentration in Response to Countermeasures against Sick Houses 15.2.4 Conclusions Chapter 16 Round Table Discussion 16.1 The Current Situation of Indoor Air Pollution 16.2 Medical Correlations in Japan 16.3 Government Actions 16.4 Patients’ Compensation 16.5 Damp Buildings 16.6 Trade-Offs
