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It has been clear for years, on the basis of much published research, that symptoms in office workers are associated with several environmental factors in office buildings and also, independently, with psychosocial stressors at work. So, we were surprised to see a recent article by Marmot et al1 reporting that, in offices in the Whitehall II Study, “raised symptom levels appear to be largely due to a working environment characterized by poor psychosocial conditions”. The article concluded that the physical environment in the offices had a small and unimportant influence on these symptoms. The analyses, however, had substantial limitations that were not mentioned. Further, the conclusions were inconsistent with much of the current scientific literature, but the discussion cited only other studies that agreed with the findings and none of the substantial literature that disagreed. We expand on these points.
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Key environmental measurements and interpretations used by Marmot et al1 in the 1991–3 data collection are no longer considered relevant by most indoor environmental scientists. Single metrics of total volatile organic compounds that lump all compounds together have long been considered inappropriate for predicting human response, because irritancy and odour vary by orders of magnitude among specific volatile organic compounds.2 Metrics based on counts of culturable airborne fungi and bacteria do not detect most indoor microbial matter and “provide little information about the microbial status of an indoor environment”.3 Also, many of the thresholds for acceptability used by Marmot et al are not considered relevant for studying building-related symptoms—for example, dry bulb temperature between 19 and 24°C, carbon dioxide (CO2)⩽500 parts per million, or any particular number for total airborne fungi, bacteria or volatile organic compounds. In addition, the lumping together of extreme high and low levels for many of the parameters (eg, combining very …