Application of Quick Environment Exposure Sensitivity Inventory (QEESI©) for Japanese population: study of reliability and validity of the questionnaire

Abstract

A standardized questionnaire has not been established for screening or diagnostic assessment of patients with multiple chemical sensitivity (MCS) in Japan. In the US, Miller and Prihoda (1999a,b) developed a questionnaire that could be used internationally, the Quick Environment Exposure Sensitivity Inventory (QEESI), to assist researchers and clinicians in evaluating patients and populations for chemical sensitivity. The Japanese version of QEESI was subsequently translated by Ishikawa and Miyata (1999). The present study was performed to investigate the reliability and validity of QEESI (Japanese version) for research purposes and for evaluation of patients with MCS in Japan. A total of 498 subjects were recruited from the general population of Miyagi prefecture, Japan. The factor structure in QEESI was analyzed with 40 items on four subscales except for the items in 'Masking' using principal components analysis with Promax rotation. The results showed that 30 items on three subscales, 'Chemical Inhalant Intolerances,' 'Symptom Severity,' and 'Life Impact' except for 'Other Intolerances' were consistent with those reported for the US population by Miller and Prihoda (1999a). Cronbach's alpha reliability coefficient ranged between 0.87 and 0.94 indicating high internal consistency in the 30 items on three subscales. Next, we compared the mean scores on three subscales of QEESI in two groups: 131 self-reported MCS group who were new outpatients at the Environmental Medical Center in Kitasato Institute Hospital, and 131 members of the general population (controls) who were matched for both gender and age with the self-reported MCS group. Mean scores on each subscale for the self-reported MCS group were significantly greater than those for controls (P <0.001). Mean scores on all of the 30 items on three subscales for the self-reported MCS group were also significantly greater than for the controls (P <0.001). These findings indicated that the 30 items on three subscales in QEESI can be used for surveys and for diagnostic assessment of patients with MCS as well as for comparative studies between patients in Japan and in other countries.

Evaluation of subjective symptoms of Japanese patients with multiple chemical sensitivity using QEESI©

“…We determined unique Japanese cutoff values for the Chemical Intolerance subscale (40), Symptom Severity subscale (20), and Life Impact subscale (10). The subjects whose scores met or exceeded the cutoff values in any two of the three subscales accounted for 88.4% of the patient group but only 14.5% of the control group.…”

“…Each item includes a 0-10 rating scale, the ratings being tallied to obtain a total scale score of 0-100. Miller and Prihoda [16] defined the criteria for three levels of symptom score as low (0-19), medium (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), and high (40-100).…”

“…However, Other Intolerance, the fourth QEESI Ó subscale, showed small factor loading with random scattering. Therefore, we concluded that this subscale is not useful in Japan and that revision of this subscale is thus required for more accurate assessment of Japanese patients [20].…”

“…The Japanese version of QEESI Ó was translated by Ishikawa and Miyata [19]. We [20] surveyed the reliability and validity of the QEESI Ó (Japanese version) in the Japanese population and concluded that 30 questions of three subscales in the QEESI Ó (Chemical Intolerance, Symptom Severity, and Life Impact) showed high reliability and validity that allowed comparison between MCS patients in Japan and those in other countries. However, Other Intolerance, the fourth QEESI Ó subscale, showed small factor loading with random scattering.…”

Classification of Patients Complaining of Sick House Syndrome and/or Multiple Chemical Sensitivity

“…In order to assess the relation between the SHS classification and MCS, the Japanese version of the Quick Environment Exposure Sensitivity Inventory (QEESI) was used to evaluate the possibility of MCS (Ishikawa and Miyata 1999;Hojo 2002;Hojo et al 2003Hojo et al , 2004Hojo et al , 2005. Using a simplified screening method introduced by Miller and Prihoda (1999), symptom severity and chemical intolerance, out of five subscales, were translated into scaled scores.…”