perfume fume

Sniff and scratch?

Environmental or chemical intolerance may be the culprit

A headache after smelling strong perfume. Queasiness after sitting in a new car, surrounded by the aromas of fresh leather and carpet glue. Confusion after walking through vehicle exhaust fumes.

These could be signs of chemical or environmental intolerance, which affects about 20 percent of chronically ill patients, said Claudia S. Miller, M.D., M.S., an occupational and environmental health expert with UT Medicine San Antonio.

Everyday chemicals in the home, workplace or outdoors can trigger this intolerance, called Toxicant-Induced Loss of Tolerance. As common as the intolerances are, though, they rarely are diagnosed by physicians, Dr. Miller said.

In answer, she launched an online questionnaire called the Quick Environmental Exposure and Sensitivity Inventory, the only one of its kind validated in several countries and offered in multiple languages that comprehensively assesses symptom severity, severity of intolerances and life impact. Accessible for free on desktop computers and handheld devices at, it generates a summary of the users’ responses that can be shared with their doctors to determine if they suffer from chemical and environmental intolerance and identify which substances are to blame.

“Patients who otherwise would suffer in silence can now measure whether chemical exposures contribute to their illnesses,” Dr. Miller said.

The test screens for multiple chemical intolerances on four scales: symptom severity, chemical intolerances, other intolerances and life impact. Each scale contains 10 items, scored from zero to 10, to rank severity. There’s also a “masking index,” which gauges ongoing exposures and overlapping symptoms that hide responses, blocking one’s awareness of their intolerances, and the intensity of their responses to exposures.

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