WHY DO WOMEN REPORT SICK BUILDING SYMPTOMS MORE OFTEN THAN MEN

The prevalence of general, mucosal and skin symptoms compatible with t he 'Sick Building Syndrome' (SBS) was studied in Swedish office worker s. The marked excess in symptom prevalence among females, 12% SBS case s as compared to 4% among males, was analysed with respect to differen ces in biological or acquired risks and different illness and reportin g (interview) behaviour among males and females. The distribution of r isk indicators for symptoms was recorded in a questionnaire to 4943 em ployees. The skin symptom questions were validated in a clinical exami nation. Most risk indicators, such as paper work and psychosocial work load, had an unfavourable distribution for females. In the multivaria te analysis however, female sex remained the most prominent risk indic ator almost unaffected by the addition of other factors. Neither did e ffect modification contribute to the excess prevalence among females. The results from the clinical examination indicate that the excess sym ptoms prevalence among females is real and not a reporting artefact. A s the factors studied did not explain the excess symptom prevalence am ong females, the sex differential observed can be a reflection of a ge neral excess of psychosomatic symptoms among women. Although inequalit ies in social conditions did not substantially explain the sex differe ntial in symptom reporting, the importance of life situation and socia l roles should be further explored. As the studied variables are surro gates for actual measurements, another important issue is whether sex differences in working conditions, entailing different hierarchical po sitions in the office, have consequences for indoor air quality factor s that are important for the symptoms. The study strongly underlines t he importance of taking the sex distribution into account when surveyi ng risk indicators for SBS symptoms.