Carpet/4-Phenylcyclohexene Toxicity: The EPA Headquarters Case

Hirzy, J. William; Morison, Rufus

doi:10.1007/978-1-4899-2370-7_6

Cited by 7 publications

(5 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The substance most implicated in these illnesses was 4-phenylcyclohexene (4-PCH), an undesirable byproduct with an odor of new carpet from the manufacture of styrene-butadiene rubber (SBR) latex-an adhesive used to attach carpets to their backing. A description of this event and related indoor air testing can be found elsewhere [2,4,51,84].…”

Section: Evidence and Implications Of Initiating Exposuresmentioning

confidence: 99%

What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults

Miller,

Palmer,

Kattari

et al. 2023

Environ Sci Eur

View full text Add to dashboard Cite

Background Worldwide observations point to a two-stage theory of disease called Toxicant-Induced Loss of Tolerance (TILT): Stage I, Initiation by an acute high-level or repeated lower-level chemical exposures, followed by Stage II, Triggering of multisystem symptoms by previously tolerated, structurally diverse chemical inhalants, foods/food additives and drugs. Until recently, there was no known biological mechanism that could explain these observations. In 2021, we published a plausible and researchable two-stage biomechanism for TILT involving mast cells: Stage I, Initiation via mast cell sensitization; Stage II, Triggering of mast cell degranulation by previously tolerated exposures, resulting in the release of thousands of mediators, including histamine and a host of inflammatory molecules. The objective of this study was to identify common TILT initiators. Methods A randomized, population-based sample of 10,981 U.S. adults responded to a survey which included items concerning medical diagnoses, personal exposures, antibiotic use, and several possible initiators of Chemical Intolerance (CI). CI was assessed using the internationally validated Quick Environmental Exposure and Sensitivity Inventory (QEESI). Participants identified as chemically intolerant were asked to recall when their intolerances began and what they felt had initiated their condition. Results Twenty percent met QEESI criteria for TILT, approximately half of whom identified one or more initiating exposures. Initiators in order of frequency were mold (15.6%), pesticides (11.5%), remodeling/new construction (10.7%), medical/surgical procedures (11.3%), fires/combustion products (6.4%), and implants (1.6%). Protracted antibiotic use for infections involving the prostate, skin, tonsils, gastrointestinal tract, and sinuses were strongly associated with TILT/CI (OR > 2). Discussion Participants identified two broad classes of TILT initiators: 1) fossil fuel-derived toxicants (i.e., from coal, oil, natural gas), their combustion products, and/or synthetic organic chemical derivatives, e.g., pesticides, implants, drugs/antibiotics, volatile organic compounds (VOCs); and 2) biogenic toxicants, e.g., particles and VOCs from mold or algal blooms. One in four primary care patients suffers from Medically Unexplained Symptoms (MUS). Doctors in primary care, neurology, psychiatry, psychology, occupational medicine, and allergy/immunology would be well-advised to include TILT in their differential diagnosis of patients with so-called MUS. Because 20% of U.S. adults meet QEESI criteria for CI, the role of contemporary exposures in initiating and exacerbating these conditions via mast cells needs our immediate attention. There is a concomitant need for policies and practices that reduce initiating exposures as well as ubiquitous and often unavoidable triggers such as fragranced personal care, cleaning, and laundry products in multi-occupant housing, workplaces, medical settings, schools, places of worship, and all public buildings—literally anywhere air is shared. Fossil fuels are assaulting humans and other animal species both from within via mast cell sensitization, and from without via climate change.

show abstract

Section: Evidence and Implications Of Initiating Exposuresmentioning

confidence: 99%

What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults

Miller,

Palmer,

Kattari

et al. 2023

Environ Sci Eur

View full text Add to dashboard Cite

show abstract

“…latex-an adhesive used to attach carpets to their backing. A description of this event and related indoor air testing can be found elsewhere (Nick Hirzy & Morison, 1991;National Federation of Federal Employees, 1989).…”

Section: Evidence and Implications Of Initiating Exposuresmentioning

confidence: 99%

What Initiates Chemical Intolerance? Findings from a Large Population-Based Survey of U.S. Adults

Miller¹,

Palmer²,

Kattari³

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Worldwide observations point to a two-stage theory of disease called Toxicant-Induced Loss of Tolerance (TILT): Stage I, Initiation by an acute high-level or repeated lower-level chemical exposures, followed by Stage II, Triggering of multisystem symptoms by previously tolerated, structurally diverse chemical inhalants, foods/food additives and drugs. Until recently, there was no known biological mechanism that could explain these observations. In 2021 we published a plausible and researchable two-stage biomechanism for TILT involving mast cells: Stage I, Initiation via mast cell sensitization; Stage II, Triggering of mast cell degranulation by previously tolerated exposures, resulting in the release of thousands of mediators, including histamine and a host of inflammatory molecules. The objective of this study was to identify common TILT initiators. Methods A randomized, population-based sample of 10,981 U.S. adults responded to a survey which included items concerning medical diagnoses, personal exposures, antibiotic use, and several possible initiators of Chemical Intolerance (CI). CI was assessed using the internationally validated Quick Environmental Exposure and Sensitivity Inventory (QEESI). Participants identified as chemically intolerant were asked to recall when their intolerances began and what they felt had initiated their condition. Results Twenty percent met QEESI criteria for TILT, approximately half of whom identified one or more initiating exposures. Initiators in order of frequency were mold (15.6%), pesticides (11.5%), remodeling/new construction (10.7%), medical/surgical procedures (11.3%), fires/combustion products (6.4%), and implants (1.6%). Protracted antibiotic use for infections involving the prostate, skin, tonsils, gastrointestinal tract, and sinuses were strongly associated with TILT/CI (OR > 2). Discussion Participants identified two broad classes of TILT initiators: 1) fossil fuel-derived toxicants (i.e., from coal, oil, natural gas), their combustion products, and/or synthetic organic chemical derivatives, e.g., pesticides, implants, drugs/antibiotics, volatile organic compounds (VOCs), and 2) biogenic toxicants, e.g., particles and VOCs from mold or algal blooms. One in four primary care patients suffers from Medically Unexplained Symptoms (MUS). Doctors in primary care, neurology, psychiatry, psychology, occupational medicine, and allergy/immunology would be well-advised to include TILT in their differential diagnosis of patients with so-called MUS. Because 20% of U.S. adults meet QEESI criteria for CI, the role of contemporary exposures in initiating and exacerbating these conditions via mast cells needs our immediate attention. There is a concomitant need for policies and practices that reduce initiating exposures as well as ubiquitous and often unavoidable triggers such as fragranced personal care, cleaning, and laundry products in multi-occupant housing, workplaces, medical settings, schools, places of worship, and all public buildings—literally anywhere air is shared. Fossil fuels are assaulting humans and other animal species both from withinvia mast cell sensitization, and from without via climate change.

show abstract

“…To date, researchers have described this phenomenon-groups of individuals developing multisystem symptoms and new-onset intolerances following an initial chemical exposure event-in more than a dozen industrialized countries, including the United States, Canada, Australia, New Zealand, and nine European nations. 10,26 These groups include the following: radiology workers from New Zealand and elsewhere exposed to X-ray developer solution containing glutaraldehyde and other solvents; 27 federal employees in the EPA headquarters building in Washington, D.C., exposed to volatile organic chemicals outgassing from new carpet and construction materials; 28,29 German home owners exposed to pentachlorophenol wood preservative used in log homes; 30 sheep dippers in Great Britain exposed to organophosphate pesticides; 10,31,32 hospital workers in Nova Scotia exposed to building air contaminants; 10 and casino card dealers in Lake Tahoe, Nevada, exposed to solvents and pesticides, 33 among others.…”

Section: A Compelling Anomalymentioning

confidence: 99%

The Compelling Anomaly of Chemical Intolerance

Miller

2001

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

In science, anomalies expose the limitations of existing paradigms and drive the search for new ones. In the late 1800s, physicians observed that certain illnesses spread from sick, feverish individuals to those contacting them, paving the way for the germ theory of disease. The germ theory served as a crude, but elegant formulation that explained dozens of seemingly unrelated illnesses affecting literally every organ system. Today, we are witnessing another medical anomaly—a unique pattern of illness involving chemically exposed groups in more than a dozen countries, who subsequently report multisystem symptoms and new‐onset chemical, food, and drug intolerances. These intolerances may be the hallmark for a new disease process or paradigm, just as fever is a hallmark for infection. The fact that diverse demographic groups, sharing little in common except some initial chemical exposure event, develop these intolerances is a compelling anomaly pointing to a possible new theory of disease, one that has been referred to as “Toxicant‐Induced Loss of Tolerance” (“TILT”). TILT has the potential to explain certain cases of asthma, migraine headaches, and depression, as well as chronic fatigue, fibromyalgia, and “Gulf War syndrome”. It appears to evolve in two stages: (1) initiation, characterized by a profound breakdown in prior, natural tolerance resulting from either acute or chronic exposure to chemicals (pesticides, solvents, indoor air contaminants, etc.), followed by (2) triggering of symptoms by small quantities of previously tolerated chemicals (traffic exhaust, fragrances, gasoline), foods, drugs, and food/drug combinations (alcohol, caffeine). While the underlying dynamic remains an enigma, observations indicating that affected individuals respond to structurally unrelated drugs and experience cravings and withdrawal‐like symptoms, paralleling drug addiction, suggest that multiple neurotransmitter pathways may be involved.

show abstract

Carpet/4-Phenylcyclohexene Toxicity: The EPA Headquarters Case

Cited by 7 publications

References 3 publications

What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults

What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults

What Initiates Chemical Intolerance? Findings from a Large Population-Based Survey of U.S. Adults

The Compelling Anomaly of Chemical Intolerance

Contact Info

Product

Resources

About