Many children experience headaches, fatigue, mood changes, muscle aches, or other health problems that are difficult to explain by routine clinical evaluation alone.
In some cases, these symptoms may vary in relation to environmental exposures, including foods, medications, fragrances, pesticides, cleaning products, mold, combustion products, or other triggers.
The PediQEESI™ (the Pediatric Quick Environmental Exposure and Sensitivity Inventory) is a new structured screening and documentation tool to help parents and clinicians recognize patterns among a child’s symptoms, exposures, and daily functioning.
The PediQEESI™ was developed by the TILT Research Program for Chemical Intolerance at UT Health San Antonio as a pediatric adaptation of the Quick Environmental Exposure and Sensitivity Inventory (QEESI®), an internationally validated questionnaire used globally in research and clinical settings to assess chemical intolerance in adults.
“Parents might see their child having a severe adverse reaction to fragrances or foods. The PediQEESI™ can help the parent determine if their child has chemical intolerance, give that information to their doctor, and help avoid future exposure,” said Dr. Claudia S. Miller, allergist/immunologist, professor emeritus, and leader of the TILT Research Program at UT Health San Antonio.
What is Chemical Intolerance?
Chemical intolerance can impact children and adults, Miller said.
The condition stems from Toxicant-Induced Loss of Tolerance (TILT). TILT is a two-stage disease process characterized by an initial exposure event, which can be acute, repeated, or chronic. Once a toxic exposure has altered and sensitized an individual’s mast cells – the body’s first line of defense against foreign substances – it triggers TILT.
After that, exposure to small amounts of structurally unrelated substances can trigger multisystem health symptoms.
TILT initiating exposures may include mold, pesticides, solvents, combustion products, fires, oil spills, fracking chemicals, indoor air contaminants, implants, or other toxicants. Later triggers may include fragrances, cleaning products, traffic exhaust, new furnishings, fabrics, foods, caffeine, medications, and other common exposures.
Learn more in this TILT Tutorial.
How Does the PediQEESI™ Connect a Child’s Symptoms to Chemical Intolerance?
Miller said it is important to document a careful environmental exposure history when evaluating children with chronic, fluctuating, or unexplained symptoms.
The PediQEESI™ can help in three steps:
- Complete the PediQEESI™ symptom and exposure questionnaire.
- Use the QEESI Symptoms Star to score and visualize symptom severity.
- Complete the brief exposure history to help identify possible environmental contributors.
Repeated use of the PediQEESI™ over time can help families and clinicians track whether symptoms improve or worsen in relation to changes in exposures, environments, diet, medications, or daily activities.
The QEESI Symptoms Star helps quickly visualize symptom patterns over time.
“The PediQEESI™ is a new pediatric innovation that provides a structured method for capturing and documenting symptom patterns and exposure relationships.” Miller said. “It allows families and clinicians to also evaluate potential contributors to Autism and ADHD symptoms.”
Elizabeth O’Nan, mother of a child disabled by pesticides and leader of the Protect All Children’s Environment (PACE) environmental nonprofit organization, helped Miller adapt the QEESI questionnaire to accommodate children.
“The PediQEESI™ may be especially useful for families.” O’Nan said. “Children who have persistent or unexplained symptoms, or health changes following a known exposure event, often face a lack understanding from their doctors and others.”
Miller said she hopes parents will bring their PediQEESI™ results to their doctor to help parents explain the issue to the provider.
“For each child, we encourage you to print and complete this PediQEESI™, share it with each of your child’s doctors, and ask that it be placed in their medical records,” Miller said. “This is an important exposure history to take.”
The PediQEESI™ is available free of charge to individual patients and practitioners at https://bit.ly/pediqeesi.
Those interested in research use or any profit-making undertakings must contact and receive written permission from the TILT Research Program for Chemical Intolerance at UT Health San Antonio.