Household Hazards

How everyday products make us sick.

The High Life

Advantages and Hazards on the Upper Stories

Somewhere between the extremes of a mythicly elegant allure of high-rise living and the angst of multistory residence in the face of conflagration, may lay a middle-ground of more mundane pluses and minuses. I began to ponder this topic after stumbling across a medical study that seemed to have filled- in a score card of just such wins and losses. The study, an epidemiological analysis out of Switzerland, took advantage of a very large collection of population data. In total, the researchers studied 11.4 million person years of observation. Person-years is a favorite construct among epidemiologists – if you follow 100 people for 10 years you have one thousand person-years under your belt.  For an epidemiologist, studying patterns of disease in populations, the more person-years the merrier. In this case they also had accumulated more than 140,000 deaths as well, categorized by cause, age, sex, profession, and a number of other variables (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696174/). One of those was floor of residence. They asked – once you are living in a multistory building does how high up matter? Only looking at people over age thirty at the start of the study who lived in buildings of four or more floors (no low rises), yes, it did matter, a lot. Eighth floor and above and you had a 40% likelihood to live longer in terms of respiratory disease and 35% for cardiovascular deaths, typically the two of the most common causes of adult mortality. Two for the plus column. On the downside, you had more than twice the risk of suicide by jumping from a height.

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The obvious explanation for better health is the higher socioeconomic status that tracks with living on a higher floor, which the authors of the study acknowledged. But they also raise the question of differences in physical activity and unspecified environmental factors.  Actually, I think it is fairly unlikely that many of these folks were walking up the 8th floor and beyond absent a major power blackout. It must be acknowledge however that the sports niche of “skyscraper running” has not gone unfilled and has even been the subject of scientific analysis. Turn to the pages of the Scandinavian Journal of Medicine & Science in Sports for that one (http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0838.2009.01043.x/abstract;jsessionid=DFFE20468707DFB1B6DCA45165B4C956.f04t04).

The environmental question is a bit more intriguing. This has been an area of some interest where high-rise density and high-density disease coincide. Think Hong Kong. It has been suspected and studies there support the hypothesis that the higher up you are in a high-rise building the lower your risk of tuberculosis but it isn’t just income. Apparently being able to look out the window and see open sky is good for your health (http://www.ncbi.nlm.nih.gov/pubmed/?term=lai+PC+tuberculosis+high-rise). Closer to home, it was also shown that inner city kids in Northern Manhattan and the Bronx breathed outdoor air less contaminated with pollutants on higher floors. Go figure.    

The news out of London that got a lot of play this past year was of a skyscraper whose sloped reflective glass was acting as a heat ray (http://www.bbc.com/news/uk-england-london-23948811).  Mostly bad for cars on the street, apparently: much was made of a damaged jaguar. I suppose this further highlights the complex relationship between socioeconomic status and the adverse effects of tall buildings.  

Paul D. Blanc, M.D., M.S.P.H., is Professor of Medicine and Endowed Chair in Occupational and Environmental Medicine at the University of California San Francisco.

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