The MM Questionnaires

The development of the MM Questionnaires was initiated at the Department of Occupational and Environmental Medicine, Örebro University Hospital, in 1985 [F]. The first standardized questionnaire (MM 040 NA for workplaces) was released in 1989 after more than three years of intense testing regarding validity, reliability and, primarily, its practical application. Reference data for workplaces was presented in 1990 [B]. Since then, different versions have been developed directed at specific environments such as schools, day care centers, offices, hospitals and residential dwellings. The different versions of the questionnaire are based on the same core questions. This allows the possibilities of making comparisons between, for instance, school personnel and students, or tenants and workers. Each version also contains additional questions of a more specific nature, based on feedback from many case studies.

The MM Questionnaires have been used in many studies in “problem buildings” and in large nation-wide surveys. The basic MM Questionnaire (MM 040 NA) has been translated into many foreign languages and is used as a routine instrument in Finland [L,M]. Studies using the MM Questionnaires are presented in the publication list under Publications. The basic questionnaire, the basic manual, the school questionnaires, the school manual, the office questionnaire, the office manual and the health care questionnaire are available as pdf-files. A complete set of questionnaires is available in Swedish in www.inomhusklimatproblem.se.

How to conduct an investigation using the MM Questionnaires
The questionnaire survey should be seen as part of an overall diagnostic strategy. The survey, in itself, cannot be the sole instrument of diagnosis. It is important to carry out the investi­gation correctly, and note that the way in which the investigation is administered, can affect the results [K]. It is especially important to conduct the questionnaire survey with full openness and integrity.

Checklist
* Conduct the investigation amongst all those involved.
* Inform everyone of the goal of the investigation.
* Try to minimize the drop-out frequency and take it into account.
* present the results to all those participating in the investigation.

A graphic technique is presented in the manuals.

As part of an evaluation of remedial actions, it is important to check if the environment has been improved in the way that was intended. Any follow-up questionnaire survey should preferably be made at the same time of the year to avoid the effects of the outdoor climate, especially in countries with temperate climate systems.

Further information and tips, including the presentation of basic reference data, can be found in the Manual work environment, Manual office environment  or Manual school environment.

Basic articles about the Örebro Model and the MM Questionnaires
A. Andersson K, Fagerlund I, Bodin L, and Ydreborg B. Questionnaire as an instrument when evaluating indoor climate. Healthy Buildings´88 Stockholm 1988;vol 1:139-46. Reference 1
B. Andersson K, Fagerlund I, Larsson B. Reference data to the questionnaire MM 040 NA – Indoor Climate (work environment). Report M5/90. Department of Occupational and Environmental Medicine. Örebro University Hospital. Reference 2
C. Andersson K, Stridh G. The use of standardized questionnaires in BRI/SBS surveys. Levy F, Maroni M (eds). Pilot study on Indoor Air Quality. NATO/CCMS, Oslo, Aug 1991.  Reference 3
D. Andersson K, Stridh G, Fagerlund I, Larsson B. The MM-questionnaires – A tool when solving indoor climate problems. Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden. 1993, (17 pages). Reference 4
E. Andersson K. Management of the sick building – investigation strategies. Proceedings of the International Symposium on New Epidemics in Occupational Health, Helsinki, 1994:117-120. Reference 5
F. Andersson K. Epidemiological Approach to Indoor Air Problems. Indoor Air 1998;Suppl.4:32-39. [The basic paper]
G. Andersson K, Fagerlund I, Norlén U, Nygren M. The association between SBS symptoms and the physical and psychosocial environment of school personnel. Proceedings Indoor Air 99, London, 1999;Vol 5:360-365. Reference 7
H. Andersson K, Bodin L, Fagerlund I, Aslaksen W. The perceived physical and psychosocial climate in Swedish schools from 19889 to 2000 - a database analysis. Proceedings Indoor Air 2002, Monterey USA, 2002;Vol 2:296-300. Reference 10
I. Andersson K, Stridh G, Fagerlund I, Aslaksen W. The perception of dust and dirt in Swedish school environments. Proceedings Indoor Air 2002, Monterey USA, 2002;Vol 2:489-493. Reference 11
J. Andersson K, Stridh G, Fagerlund I, Aslaksen W, Rudblad S. Comparison of the perceived indoor climate and symptoms reported by students and personnel in 16 senior high schools in Sweden. Proceedings Indoor Air 2002, Monterey USA, 2002;Vol 3:399-403. Reference 12
K. Andersson K, Karlehagen S, Jonsson B. The importance of variations in questionnaire administration. Appl Ergon 1987;18:229-232.
L. Lahtinen M, Sundman-Digert C, Reijula K. Psychosocial work environment and indoor air problems: a questionnaire as a means of problem diagnosis. Occup Environ Med 2004;61:143-149.
M. Reijula K, Sundman-Digert C. Assessment of indoor air problems at work with a questionnaire. Occup Environ Med 2004;61:33-38

Environmental Medicine Kjell Andersson Örebro