Does the Environment Make You Ill? Take the Quick Environmental Exposure and Assessment Inventory

Negative health effects are reported by an increasing number of people as a result of ingredients in common air fresheners, fragrances, cleansers, and other chemical products.

Sharing the airspace with an air freshener or being near someone wearing fragrance affects the nervous, cardiovascular, immune, respiratory, reproductive, gastrointestinal, and musculoskeletal systems as well as the skin, eyes, ears, nose, and throat.

Headaches, fatigue, poor memory recall, tremor, loss of coordination, disorientation, dizziness, irregular heart beat, unsteady gait, migraines, vertigo, speech impairment, comprehension problems, personality changes, numbness/tingling, abnormal reflexes, and seizure are the most common nervous system effects. These effects occur during and shortly after an exposure, yet are mitigated in exposure free conditions.

Symptoms may occur in other body systems and include chest pain, irregular heart beat, auto immune disorders, allergies, impotence, nausea, vomiting, diarrhea, constipation, gas, Candida, malabsorption of nutrients, asthma, coughing, airway disease, shortness of breath, joint and muscle pain, muscle spasms, skin disorders, infections, ringing in the ears, rhinitis, sinusitis, sneezing, and sensitivity to light and noise.

People who are chronically exposed to fragrances, air fresheners, solvents, or petrochemicals may find themselves diagnosed with numerous disorders, including irritable bowel syndrome, migraines, asthma, lung disease, cancer, fibromyalgia, chronic fatigue syndrome, and restless leg syndrome

Multiple chemical sensitivity (MCS) often results from a single acute or chronic long-term exposure. MCS is an acquired and progressive neurological disease induced by exposure to pervasive chemical and fragrance products found in homes, schools, workplaces, and the environment.

Diagnosing MCS early is important because people with MCS may suffer progressive and cumulative harm, cognitive impairment, brain changes, and end organ damage with exposure to even small amounts of seemingly innocuous chemical and fragrance substances.

The Quick Environment Exposure Sensitivity Inventory (QEESI) is a standardized questionnaire developed by Dr. Claudia Miller that assists researchers and clinicians when evaluating patients for chemical sensitivity. It measures exposure levels and symptom severity and estimates the life impact of a chemical injury.

The QEESI also uncovers "masking", which can best be described as a hidden cause. Masking occurs when patients don´t realize their symptoms are related due to routine and regular exposure to a substance. For example, a patient who suffers from constant itchy skin may not realize that chemicals in the scented fabric softener she uses are related because the itchy skin always seems to be present… along with the clothes she wears, sheets she sleeps in, and towels she uses which have all been washed with the fabric softener. Removing the scented fabric softener may prove to eliminate her seemingly mysterious symptoms.

Miller lists potential uses for the QEESI. She includes:

1. Research - to characterize and compare study populations, and to select subjects and controls.

2. Clinical evaluations - to obtain a profile of patients´ self-reported symptoms and intolerances.

3. Clinical evaluations – to administer at intervals to follow symptoms over time or to document responses to treatment or exposure avoidance.

4. Workplace or community investigations - to identify and assist those who may be more chemically susceptible or who report new intolerances.

Studies have shown that the QEESI can be used for surveys as well as diagnostic assessment of patients with MCS.

Manabe and colleagues, researchers at the University of Miyazaki, Japan, recently investigated the incidence of multiple chemical sensitivity (MCS) and effectiveness of the QEESI on Japanese workers and concluded otherwise.

Over 35% of the surveyed respondents from specific buildings had been diagnosed with allergies and their QEESI scores tended to be higher. Yet only a half percent met the criteria for MCS. This led Manabe and colleagues to conclude that the QEESI score tends to be high in individuals with allergy and that careful consideration is required when using the QEESI for screening MCS patients.

Two methodological flaws occur in the survey Manabe and colleagues performed. First, they failed to consider was whether the respondents who claimed they had allergies were misdiagnosed and, instead, actually had MCS. MCS is often misinterpreted as allergy by busy practitioners who may make a diagnosis based on symptoms and subjective patient reporting without doing detailed allergy testing.

Second, they failed to consider the high co-morbidity rate between allergies and MCS. People with MCS are more likely to have allergies than people without MCS. People with allergies are also more likely to have MCS than people without allergies. So there is a great potential for truth in the higher QEESI scores exhibited by allergy sufferers.

Thus, the QEESI appears to be beneficial for the uses outlined by Miller.

For copies of the QEESI, call 210-567-7407 or email millercs@uthscsa.edu.

Reference

Manabe R, Kunugita N, Katoh T, Kuroda Y, Akiyama Y, Yamano Y, Uchiyama I, Arashidani K. Questionnaire survey of workers in specific buildings regarding multiple chemical sensitivity. Nippon Eiseigaku Zasshi. 2008 Jul;63(4):717-23.

This article originally appeared in the MCS America News, November 2008 Issue. http://mcs-america.org/november2008.pdf. For more articles on this topic, see: MCSA News.

Copyrighted 2008 Lourdes Salvador & MCS America