Environmental Intolerance

Abstract: The editor discusses usage of the terms "iidiopathic environmental intolerance," "multiple chemical sensitivity," and "environmental illness." Also addressed are prevalence, theories of etiology, evaluation and treatment, and social and political implications.

Abstract: People frequently attribute adverse symptoms to particular buildings when exposure to pollutants is low, within nonhazardous levels. Our aim was to characterize building-related intolerance (BRI) i ...

Abstract: Adverse reactions to ambient odorous and pungent substances in daily activities among pregnant women who are half-way through pregnancy, and changes in odor perception at predominantly an early stage of pregnancy motivated the present study of odor intolerance at an early pregnancy stage. Ninety-five women averaging gestational week 11 and 102 non-pregnant women were compared with the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR). General environmental intolerance was assessed with items from the Noise Sensitivity Scale that are analogous to the CSS-SHR (“NSS-SHR”). Pregnant women were found to have higher scores on the CSS-SHR, but not on the “NSS-SHR”. This suggests an odor intolerance that affects pregnant women's daily activities, which appears not to be due to a general environmental intolerance. The effect size of pregnancy on CSS-SHR score is larger in the present study of early pregnancy than in the previous study of women half-way through pregnancy.

Abstract: Background Chronic nonspecific symptoms attributed to indoor nonindustrial work environments are common and may cause disability, but the medical nature of this disability is unclear. The aim was to medically characterize the disability manifested by chronic, recurrent symptoms and restrictions to work participation attributed to low-level indoor pollutants at workplace and whether the condition shares features with idiopathic environmental intolerance. Methods We investigated 12 patients with indoor air–related work disability. The examinations included somatic, psychological, and psychiatric evaluations as well as investigations of the autonomic nervous system, cortisol measurements, lung function, and allergy tests. We evaluated well-being, health, disability, insomnia, pain, anxiety, depression, and burnout via questionnaires. Results The mean symptom history was 10.5 years; for disabling symptoms, 2.7 years. Eleven patients reported reactions triggered mainly by indoor molds, one by fragrances only. Ten reported sensitivity to odorous chemicals, and three, electric devices. Nearly all had co-occurrent somatic and psychiatric diagnoses and signs of pain, insomnia, burnout, and/or elevated sympathetic responses. Avoiding certain environments had led to restrictions in several life areas. On self-assessment scales, disability showed higher severity and anxiety showed lower severity than in physician assessments. Conclusion No medical cause was found to explain the disability. Findings support that the condition is a form of idiopathic environmental intolerance and belongs to functional somatic syndromes. Instead of endless avoidance, rehabilitation approaches of functional somatic syndromes are applicable.