Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Queenie A. Abad

Second Advisor

Carrie A. Redlich

Abstract

Background: Indoor environmental quality in workplace settings influences worker well-being, yet the relationship between perceived workplace environment and reported symptoms remains less well characterized in heterogeneous healthcare settings. This study describes perceived workplace environmental quality and self-reported symptoms among employees at the West Haven Veterans Affairs (VA) Medical Center.

Methods: An observational, cross-sectional study was conducted of VA employees across clinical and non-clinical roles to assess perceived work environment, symptoms and indoor exposures using an electronic survey and personal and area air monitoring of indoor volatile organic compounds (VOCs) and viruses. Perceived workplace environmental quality was assessed using the MM-40 Indoor Climate Questionnaire, upper respiratory symptoms using the Wisconsin Upper Respiratory Symptom Survey-11 (WURSS-11), and asthma control using the Asthma Control Questionnaire (ACQ). Descriptive statistics summarized participant characteristics, environmental complaints, symptoms, and patterns across service lines and work locations. Survey data from the first 34 participants were used for this analysis. Personal and area air monitoring data collected as part of the broader study were not included in this analysis. This study was approved by the VA Connecticut Healthcare System Human Studies Subcommittee (HSS), and all participants provided informed consent.

Results: Among the initial 34 participants, environmental complaints were nearly universal, with 33 of 34 (97.1%) reporting at least one perceived environmental problem in the prior three months. The most common complaints were thermal in nature, including room temperature too high (91.2%), varying room temperature (88.2%), and room temperature too low (82.4%), followed by unpleasant odor (82.4%), dust and dirt (79.4%), and stuffy air (76.5%). Symptom burden was also high: 29 of 34 participants (85.3%) reported at least one symptom, most commonly fatigue (73.5%), headache (67.6%), and nasal irritation (67.6%). Twelve out of 29 participants (41.4%) that endorsed any symptoms attributed at least one symptom to their work environment. Exploratory comparisons suggested higher rates of work-attributed symptoms in participants within the service lines of Mental Health (66.7%) and Primary Care / Internal Medicine (75.0%), and who primarily work in Building 2 (50.0%) relative to other groups.

Conclusion: Perceived indoor environmental quality concerns and related symptoms were common in this healthcare workforce sample, and 41.4% of symptomatic participants attributed their symptoms to the work environment. Although the small sample limits subgroup inference, the descriptive patterns observed across service lines and buildings support further investigation at a facility level. This analysis represents an initial subset of an ongoing study with a larger planned sample with personal and area air monitoring data, which will allow future integration of worker-reported perceptions with objective exposure measurements.

Comments

This is an Open Access Thesis.

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