The Effect of Interior Planting on

Health and Discomfort among

Workers and School Children
Tove Fjeld

ADDITIONAL INDEX WORDS. benefits of plants, foliage plants, fluorescent lighting, full-spectrum
lighting, human–horticulture relationships, human issues in horticulture, human well-being,
mucus membrane symptoms, neuropsychological symptoms, people–plant interactions

SUMMARY. Plants are widely used in building environments; however, studies reporting the
health and discomfort symptoms of people in response to indoor foliage plants are few. The
objective of the presented studies was to assess the effect of foliage plants or a combination of
foliage plants and full-spectrum fluorescent lamps on self-reported health and discomfort
complaints in three different work environments: an office building, an X-ray department in a
Norwegian hospital, and a junior high school. Health and discomfort symptoms were found to
be 21% to 25% lower during the period when subjects had plants or plants and full-spectrum
lighting present compared to a period without plants. Neuropsychological symptoms, such as
fatigue and headache, and mucous membrane symptoms, such as dry and hoarse throat,
seemed to be more affected by the treatments than skin symptoms, such as itching skin.

P
lants are widely used in building environments; however, studies
reporting the way people respond to indoor foliage plants regard-
ing human health and discomfort symptoms are few. During the
1980s, laboratory studies reported that plants may reduce the level of air
contaminants, including formaldehyde, benzene, trichloroethylene, car-
bon monoxide and nitrogen dioxide (Wolverton et al., 1989). Other
studies have shown that the well-being of people, as well as their psycho-
logical and physiological stress levels, may be appreciably influenced by
the surroundings; it appears that vistas dominated by vegetation may give
relief from stress (Ulrich, 1979; Ulrich et al., 1993; Ulrich and Parsons,
1992). On the other hand, it seems that health and discomfort problems
are increasing among people that work in modern buildings, possibly due
to new building materials and increased emphasis on energy saving (Skov
et al., 1990). It is therefore relevant to investigate to what extent indoor
plantings affect the well-being of persons who are working in modern
buildings. The objective of this work was to assess whether indoor foliage
plants used for decoration (Study 1) or a combination of plants and full-
spectrum daylight fluorescent light (Study 2 and Study 3) affect self-
reported human health and discomfort symptoms.

Former professor, Department of Horticulture and Crop Sciences, Agricultural University of Norway. Current address: Nordbyvn. 38,
1406 Ski, Norway.
The author appreciates the financial support given by Flower Council of Holland, Statoil AS, Norwegian Growers Association,
Gartnerhallen AS, and Blomsterringen Engros AS. The cost of publishing this paper was defrayed in part by the payment of page charges.
Under postal regulations, this paper therefore must be hereby marked advertisement solely to indicate this fact.

46 ●
January–March 2000 10(1)
 problems). Demographic data were
collected.
STUDY 2: EFFECTS OF INDOOR FOLI-
AGE PLANTS AND FULL-SPECTRUM FLUO-
RESCENT LIGHT ON HEALTH AND DISCOM-
FORT SYMPTOMS AMONG WORKERS IN A
HOSPITAL RADIOLOGY DEPARTMENT. The
location for this study was a room of
about 80 m2 (860 ft2) with no win-
dows or natural light. The room was
used for the examination of X-ray films.
Baseline information regarding 12 dif-
ferent health and discomfort symp-
toms was sampled among 48 employ-
ees at a hospital radiology department
(37 females, 11 males). The informa-
tion was collected by means of the
same questionnaire used in Study 1
four times during September and Oc-
tober 1997.
In the middle of November 1997,
the indoor environment of the room
Fig. 1. In the office experiment in Study 1, three self-watering containers filled was changed as follows: 23 containers
with common interior plants were placed on the window bench during the with one or more commonly used
intervention with plants. In addition, a terracotta container with plants stood indoor foliage plants were placed into
in the back corner of the office (not shown in the photograph). the room and light sources in the
ceiling and in the film viewers were
Methods 1995 and 3 months in Spring 1996. changed to full-spectrum fluorescent
The questionnaire, modelled after light (True-Lite from Duro-Test) (Fig.
STUDY 1: EFFECTS OF INDOOR FOLI- Anderson et al. (1993), covered 12 2). The plants consisted of four ming
AGE PLANTS ON HEALTH AND DISCOMFORT different health symptoms. The scores aralia (Polyscias fruticosa (L.) Harms)
SYMPTOMS AMONG OFFICE WORKERS. A reflect problems or symptoms on the [175 cm (6 ft)], as well as the same
crossover study with randomized pe- exact day that the questionnaire is plant species that were used in the
riod order, with one period with plants filled in. Each symptom could be given office study (Study 1). Sampling of
in the office and one period without one of the following scores: 0 (no health and discomfort information, via
plants in the office, was conducted problems), 1 (minor problems), 2 the same questionnaire, continued five
among 51 office workers (27 males (moderate problems), or 3 (severe times during the period from Novem-
and 24 females). The plant interven-
tion consisted of 13 common foliage
plants that were placed in three self-
watering containers on a window bench
and in a terracotta container in the
back corner of the office (Fig. 1). The
planters contained golden evergreen
(Aglaonema commutatum Schott.),
striped dragonpalm (Dracaena
deremensis Engl.), golden pothos
(Epipremnum aureum (Lind. &
André) Bunting), and heartleaf philo-
dendron (Philodendron scandens K.
Koch and Sello var. oxycardium
(Schott) Bunting). The terracotta con-
tainer was filled with a 175 cm (6 ft)
corn plant [Dracaena fragrans (L.)
Ker-Gawl.] ‘Janet Craig’ and heartleaf
philodendron. All participants worked
in single office rooms that were iden-
tical, with a floor area of 10 m2 (108
ft2) and a window covering most of the
outer wall.
The participants completed a Fig. 2. The radiology department location (Study 2) during the intervention
questionnaire every second week dur- received 23 plant containers, both on top of the film viewers and on the floor.
ing two periods: 3 months in Spring Full spectrum lighting was also added.

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January–March 2000 10(1) • INTERNATIONAL HUMAN ISSUES IN HORTICULTURE 47
 Results
STUDY 1. It was found that the
mean score sum, as a mean of 12
symptoms, was 23% lower during the
period when the participants were ex-
posed to plants in their offices com-
pared to the period without plants.
The mean score sum was 7.1 during
the period without plants, while it was
5.6 during the period with plants (P =
0.002). Complaints regarding cough
and fatigue were reduced by 37% and
30%, respectively, if the offices con-
tained plants, while the self-reported
level of dry or hoarse throat and dry or
flushed facial skin each decreased about
23% after intervention (Table 1). If the
symptoms are grouped by the body’s
responses (Fjeld et al., 1998), a signifi-
cant reduction was obtained in neu-
Fig. 3. The biological classroom (Study 3) was created by adding foliage plants ropsychological symptoms (fatigue,
in a bioprocess system and by using full-spectrum lighting. feeling heavy-headed, headache, diz-
ziness, and concentration problems)
ber 1997 to February 1998. Demo- toms, as well as information regarding and in mucous membrane symptoms
graphics and information on how much how the pupils perceived their indoor (itching or irritation of the eyes; irri-
of the workday each employee spent in environment (semantic information), tated, running, or stuffy nose; dry or
the room were also gathered. All to- was sampled among the pupils using hoarse throat; and cough), while skin
gether 51 air samples were collected the three biological classrooms (n = symptoms (dry or flushed facial skin;
before and after intervention, in order 61). A control group was established scaling or itching scalp or ears; and
to analyze possible changes in content of pupils from three classes using ordi- hands with dry, itching, or red skin)
of fungi in the air. Air samples were nary classrooms (n = 59). Ages of the seemed to be unaffected by the plant
analyzed by the Norwegian Institute pupils were 14 to 16 years. intervention.
for General Health, Oslo. STATISTICAL ANALYSES. Since most The responses from the participants
STUDY 3: EFFECTS OF INDOOR FOLI- of the subjects in Study 1 and 2 did not also indicate that green plants in the office
AGE PLANTS AND FULL-SPECTRUM FLUO- fill in the questionnaire at all sampling were regarded as a positive element for
RESCENT LIGHT ON HEALTH AND DISCOM- dates (due to traveling, illness etc.), a feelings of well-being, with 82% of the
FORT SYMPTOMS AMONG PUPILS IN A JUN- mean score was calculated for each participants agreeing to the statement “I
IOR HIGH SCHOOL. Significant problems person for every symptom in each of feel more comfortable if I have plants in my
with the indoor air quality in the class- the two periods (Spring 1995 and office” and 82% agreeing to the statement
rooms were the background for estab- 1996 for Study 1 and before and after “I would like to have plants in my office in
lishing this study in a junior high school intervention for Study 2). The statisti- the future” (Table 2).
15 km (9.3 miles) southwest of Oslo, cal analysis is based on these mean STUDY 2. A 25% decrease in com-
Norway. In February 1997, three class- scores, together with the mean sum plaints was observed after changing
rooms were planted with tropical, in- score (summarized for all 12 symp- the interior environment of a hospital
door plants in a bioprocess system toms). radiology department by adding plants
(indoor air flows through the soil/ A two-sided Wilcoxon signed- and full-spectrum lights. The mean
root-zone), the light sources were rank test was used to decide if a mean score sum of 12 complaints was 9.0
changed to full-spectrum fluorescent difference between the periods or lo- before intervention and 6.7 after inter-
lamps (True-Lite from Duro-Test), cations with and without plants was vention (P = 0.0001). Highly signifi-
and the irradiance level was increased statistically significant. In the cross- cant effects were found in the follow-
to 700 to 800 lux. These were referred over study, analysis was conducted to ing specific symptoms: fatigue; feeling
to as biological classrooms (Fig. 3). check carry-over effects that might heavy-headed; headache; dry or hoarse
The following plants were used: golden destroy the crossover design. No carry- throat; and hands with dry, itching, or
evergreen, striped dragonpalm, corn over effects were seen in any of the red skin (Table 3). When subjects were
plant, golden pothos, heartleaf philo- symptom scores. In the radiology de- grouped according to how much daily
dendron, and javan grape (Tetrastigma partment study and the school study, work took place in the study location,
Planch.). parallel-group analysis was conducted a 34% decrease in complaints was found
In February 1998, a pilot survey by using a two-sided Wilcoxon rank among those who spent most of their
was conducted among pupils and teach- sum test to check single symptoms. day in the room, compared to 21%
ers, by means of four different ques- For the semantic information (Study among those working about half of
tionnaires. Information regarding well- 3), simple means of the characteristics each day there and 17% among those
being and health and discomfort symp- were calculated. working less than half of the day in the

48 ●
January–March 2000 10(1)
Table 1. Effects of plant intervention on mean scores of 12 self-reported health and discomfort symptoms among office
workers (n = 51). Scores indicate symptoms present on the day the questionnaire was filled out.

Scorez Scorez Reduction if

without with plants are
Symptoms plants plants present (%) P
Neuropsychological symptoms
Fatigue 0.82 0.58 30 0.001
Feeling heavy-headed 0.71 0.58 18 0.055
Headache 0.33 0.27 18 0.25
Dizziness/nausea 0.27 0.22 18 0.34
Concentration problems 0.50 0.42 16 0.22
Mucus membrane symptoms
Itching or irritation of the eyes 0.70 0.59 16 0.14
Irritated, running, or stuffy nose 0.60 0.43 28 0.081
Dry or hoarse throat 0.83 0.62 24 0.022
Cough 0.38 0.24 37 0.020
Skin symptoms
Dry or flushed facial skin 0.88 0.68 23 0.044
Scaling or itching scalp or ears 0.56 0.51 9 0.38
Hands with dry, itching, or red skin 0.52 0.50 4 0.76
zBased on a scale of 0 = no symptoms, 1 = minor symptoms, 2 = moderate symptoms, 3 = severe symptoms.

Table 2. Distribution of answers obtained from 51 office workers in response to the question “To what extent do you
agree with the following statements?”

Answers (distribution in %)
I agree I agree I am I disagree I disagree
Statement strongly somewhat indifferent somewhat strongly
I feel more comfortable with than without plants in my office 51 31 7 7 4
I feel that the air improves when there are plants in my office 22 24 40 9 4
I would like to have plants in my office in the future 66 16 13 2 2
The plants used in the project occupied too much of the
workspace around my desk 27 29 18 20 6

Table 3. Effects of plant intervention on mean scores of 12 self-reported health and discomfort symptoms among workers
in a hospital radiology department (n = 48). Scores indicate symptoms present on the day the questionnaire was filled
out.

Scorez Scorez Reduction if

before after plants are
Symptom plants plants present (%) P
Neuropsychological symptoms
Fatigue 1.24 0.84 32 0.001
Feeling heavy-headed 1.16 0.78 33 0.004
Headache 0.72 0.40 45 0.009
Dizziness 0.20 0.15 25 0.297
Concentration problems 0.40 0.41 –2.5 0.778
Mucus membrane symptoms
Itching or irritation of the eyes 0.66 0.56 15 0.298
Irritated, running, or stuffy nose 0.81 0.72 11 0.589
Dry or hoarse throat 0.97 0.67 31 0.0009
Cough 0.34 0.21 38 0.84
Skin symptoms
Dry or flushed facial skin 0.79 0.70 11 0.146
Scaling or itching scalp or ears 0.37 0.30 19 0.256
Hands with dry, itching, or red skin 1.23 0.97 21 0.0025
zBased on a scale of 0 = no symptoms, 1 = minor symptoms, 2 = moderate symptoms, 3 = severe symptoms.

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January–March 2000 10(1) • INTERNATIONAL HUMAN ISSUES IN HORTICULTURE 49
Table 4. Mean scores of 10 discomfort symptoms reported by pupils in biologi- health complaints was 21% lower
cal classrooms (n = 61) and traditional classrooms (n = 59) in response to the among pupils in biological classrooms
following question: “Have you been bothered by any of the following symp- compared to those in the control class-
toms during the last week? rooms (Table 4). Complaints regard-
ing headache and dry or hoarse throat
Scorez in Scorez in Reduction
biological traditional in biological
were found to be 37% and 36% lower,
Symptom classroom classroom classroom (%) respectively, among pupils in biologi-
cal classrooms compared to the con-
Neuropsychological symptoms trol (Table 4). No significant differ-
Fatigue 2.2 2.4 9 ences between pupils in the two types
Feeling heavy-headed 1.6 1.9 15 of classrooms were observed regard-
Headache 0.9 1.7 37* ing symptoms of flu or colds: both
Concentration problems 1.4 1.7 16 groups of pupils seemed to be affected
Mucus membrane symptoms at the same range. In spite of this,
Dry, itching eyes 1.7 1.0 30* complaints regarding respiratory symp-
Dry or hoarse throat 1.0 1.6 36* toms (dry, itching eyes and dry or
Cough 2.5 1.8 17 hoarse throat) and headache were sig-
I have had/have a cold/the flu 1.9 2.0 4 nificantly lower in the biological class-
Skin symptoms rooms, indicating less strain induced
Dry or flushed facial skin 1.1 1.5 25 by the indoor environment.
Hands with dry, itching, or red skin 1.0 1.3 20 The results indicated significant
Sum of symptom scores 13.3 16.8 21* changes in the perception of the class-
zBased on a scale of 0 = no symptoms, 1 = minor symptoms, 2 = moderate symptoms, 3 = severe symptoms. rooms due to the intervention: the se-
*Significant at P < 0.05. mantic survey showed that pupils in
biological classrooms gave a more posi-
room (data not shown). All together fungi in the air. No changes in content tive evaluation of their classrooms, in-
51 air samples were collected before of fungi or fungi spores were observed cluding rating the room as more beau-
and after intervention, in order to ana- after intervention. tiful, brighter, and more comfortable,
lyze possible changes in content of STUDY 3. The sum of symptoms or compared to the control group (Fig. 4).

Fig. 4. Distribution of answers on seven different characteristics of the interior classroom environment, presented as
semantic pairs. Data given is the mean of 61 pupils using biological classrooms (open circles) and 59 pupils using tradi-
tional classrooms (closed squares). Scale ranges from 1 (very similar to the positive characteristic) through 5 (very similar
to the negative characteristic).

50 ●
January–March 2000 10(1)
Table 5. Comparison of effects of plant intervention on mean scoresz of all therefore, be one explanation of our
health and discomfort symptoms in three different studies. results.
The decrease in health complaints
Score Score Reduction if during the period with plants may also
Study without with plants are be explained by an improvement in
subjects plantsz plantsz present (%)
well-being. According to Ulrich and
Office personnel 0.59 0.47 21 Parsons (1992), it seems clear that the
Radiology department employees 0.75 0.56 25 benefit of viewing vegetation goes far
School children 1.68 1.33 21 beyond aesthetics and includes not
zBased on a scale of 0=no symptoms, 1=minor symptoms, 2=moderate symptoms, 3=severe symptoms. Scores
only psychological effects, but also mea-
indicate the self-experienced health and discomfort on the day the questionnaire was filled out. surable physiological effects (Ulrich,
1981). Relief from stress may be ac-
The self-experienced indoor air qual- findings may have several main expla- complished faster and more completely
ity was also reported as better among nations: 1) an improvement of air qual- if the setting is dominated by vegeta-
pupils in the biological classrooms. ity by the plants, 2) an increase in tion than if it is an urban one with little
Although the plants in fact occupied general well-being due to the percep- or no vegetation (Ulrich et al., 1991).
some floor and wall space, neither tion of foliage plants, 3) an appreciable It has also been reported that the re-
pupils (Fig. 4) nor teachers (data not influence from establishing a more covery of patients from surgery may be
shown) seemed to think that the plant nature-like indoor light environment, influenced by the view the patient has
system occupied too much space in the and 4) an effect of increased attention through the window, resulting in
classroom. towards the employees. shorter postoperative stays and fewer
Pupils using biological classrooms Earlier studies have shown that postsurgical complications if patients
seemed satisfied with the intervention: commonly used species of indoor foli- looked out on trees compared to pa-
69% evaluated their well-being as bet- age plants may reduce the content of tients who looked out on a brick wall
ter in a biological classroom as com- air contaminants. Plants exposed to (Ulrich, 1984). A more recent study
pared to an ordinary classroom, and high levels of chemicals in sealed indicated that living plants might ap-
82% of the pupils hoped to use biologi- Plexiglas chambers markedly reduced preciably affect systolic blood pressure
cal classrooms in the future (data not the concentration of air contaminants and even reaction time on a computer-
shown). in those chambers (Wolverton et al., based productivity task among students
SIMPLE COMPARISON BETWEEN THE 1989). These results, however, do not (Lohr et al., 1996). This means that it is
THREE STUDIES. The three presented necessarily apply to the office condi- likely that indoor vegetation may change
studies were conducted at different tion, since the removal rate of pollut- the indoor environment in such a way
locations, at different times, and with ants by plants is much slower than that that it will correspond better with our
different subjects, yet the results were of an optimal-functioning ventilation psychological or biological capacity, and
in the same range when it came to the system (Levin, 1992). A minor change hence may influence the measurable
level of reduction of health and dis- in the content of air contaminants stress level in the body. When people
comfort symptoms due to the inter- might, on the other hand, have a posi- intuitively express a positive preference
ventions (Table 5). In addition, a quite tive influence on the employees’ expe- towards plants, indoor or outdoor, and
similar trend was found regarding rience of comfort (Forsberg et al., thereby tell that their feeling of well-
which specific symptoms or symptom 1997), and thereby result in a lower being is good or that the environment is
groups were affected: neuropsycho- score on the self-reported health and nice or more relaxing, they are probably
logical symptoms, such as fatigue and discomfort symptoms. The symptoms reflecting the interaction between the
headache, and mucous membrane irri- chosen for this study are known to be psychological effect and the physiologi-
tations and irritations of respiratory affected by indoor air quality. cal response. The second explanation
organs seemed to be affected more The plants might also increase the for our findings, hence, may be an
than skin symptoms. air humidity (Lohr, 1992a, 1992b). In increase in general well-being due to
In the office study and the radiol- buildings with a modern, well-func- the plants.
ogy department study, analyses were tioning ventilation system, the humid- A change in the light environ-
conducted regarding demographics. ity supplied by the plants would tend ment might influence both visual and
No significant differences in any of the to be distributed throughout the build- nonvisual effects. Studies on seasonal
two studies were found regarding age, ing. It is, however, likely that the mi- affective disorder (winter depression)
gender or smoking habits among the croclimate around the plants will have give reason to believe that both the
subjects (data not shown). a somewhat higher level of humidity. light level and the spectral constitu-
Particulate matter accumulation has tion of light might influence health
Discussion also been found to be lower when and well-being—especially symptoms
The present studies strongly sug- plants were present compared to the regarding neuropsychological effects
gest that foliage plants and foliage absence of plants in a room (Lohr and (Küller and Lindsten, 1992; Maas et
plants in combination with full-spec- Pearson-Mims, 1996). Hence, the sub- al., 1974; Rosenthal et al., 1984). Ef-
trum fluorescent light may appreciably jects’ perception of the air quality might fects obtained in Study 2 and Study 3,
influence health and discomfort symp- be affected, especially since most of the therefore, might be an interaction of
toms. People reported fewer com- plants were placed close to the sub- plant effects and light effects.
plaints under the treatment conditions jects. The effect of plants on the per- Another explanation of our find-
than under control conditions. Our ception of the local air quality may, ings may be an effect from increased

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January–March 2000 10(1) • INTERNATIONAL HUMAN ISSUES IN HORTICULTURE 51
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