Fragrance Sensitivity and Everyday Life

This 10-minute video on fragrance sensitivity and chemical intolerance featuring Dr. Anne Steinemann brings attention to a growing problem— one that many people dismiss, until it happens to them. More than even political differences, fragrance sensitivity divides co-workers, families, and friends.

Many physicians, particularly in allergy, psychiatry, and environmental and occupational and environmental medicine, turn a blind eye to a problem that literally is under their noses— one that adversely affects their patients, staff, family members, and even themselves.

When health care professionals use fragrances on themselves or in their medical offices, they and their staff may experience concentration or memory problems, fatigue more easily, and make more mistakes. At the same time, use of fragrances deters sensitive patients in need of their services. Hospitals, medical offices, patient areas, imaging facilities, and therapy rooms, all need to be fragrance-free.

In our book Chemical Exposures: Low Levels and High Stakes, Nicholas Ashford, PhD, JD, of MIT and I described Toxicant-Induced Loss of Tolerance or TILT. Chicago allergist Theron Randolph first noted these intolerances just after World War II. His patients reported symptoms triggered by fragrances, train exhaust, and various synthetic organic chemicals, their derivatives, and combustion products. He called it “the Petrochemical Problem” or “chemical susceptibility.” Whether one uses one of these names, or “multiple chemical sensitivity” (MCS), the pattern remains the same. Industry representatives attending a WHO workshop in Berlin, attempted to relabel this problem as “Idiopathic Environmental Intolerance” (IEI). As opposed to the name TILT, which encourages us to identify the initiating exposure events that can lead to intolerances, IEI is cited in courtrooms and disability hearings to imply a lack of knowledge or evidence. Idiopathic in most of medicine means “of unknown cause or etiology.” However, there is ample evidence that exposures underlie this illness.

Diagnosing TILT is simply a matter of doctors’ acknowledging this new two-step illness pattern, currently observed worldwide: (1) Initiation by an exposure event (or repeated low level exposures) followed by (2) Triggering of multi-system symptoms by everyday exposures that never bothered the person before and don’t bother most people.

TILT can happen to anyone with sufficient exposure, and result in lifelong, disabling illness. Diverse chemicals, pesticides, solvents, diesel exhaust, and myriad indoor air contaminants outgassing from new construction or remodeling materials can initiate TILT. Although some people and families are more susceptible, overall the numbers appear to have grown in industrialized nations.

Preventing initiation, early recognition, and rapid intervention are paramount. Prevention starts with educating health professionals and eliminating exposures in hospitals and medical facilities.

We have developed a questionnaire called the Quick Environmental Exposure and Sensitivity Inventory, or QEESI, to aid practitioners in taking an exposure history. This tool is designed to help epidemiologists, patients, and health providers determine who is at increased risk, or having worsening chemical, food and drug reactions.

-Dr. Claudia Miller