Does improving indoor air quality lessen symptoms associated with chemical intolerance?

Abstract

Aim: To determine whether environmental house calls that improved indoor air quality (IAQ) is effective in reducing symptoms of chemical intolerance (CI). Background: Prevalence of CI is increasing worldwide. Those affected typically report symptoms such as headaches, fatigue, ‘brain fog’, and gastrointestinal problems – common primary care complaints. Substantial evidence suggests that improving IAQ may be helpful in reducing symptoms associated with CI. Methods: Primary care clinic patients were invited to participate in a series of structured environmental house calls (EHCs). To qualify, participants were assessed for CI with the Quick Environmental Exposure and Sensitivity Inventory. Those with CI volunteered to allow the EHC team to visit their homes to collect air samples for volatile organic compounds (VOCs). Initial and post-intervention IAQ sampling was analyzed by an independent lab to determine VOC levels (ng/L). The team discussed indoor air exposures, their health effects, and provided guidance for reducing exposures. Findings: Homes where recommendations were followed showed the greatest improvements in IAQ. The improvements were based upon decreased airborne VOCs associated with reduced use of cleaning chemicals, personal care products, and fragrances, and reduction in the index patients’ symptoms. Symptom improvement generally was not reported among those whose homes showed no VOC improvement. Conclusion: Improvements in both IAQ and patients’ symptoms occur when families implement an action plan developed and shared with them by a trained EHC team. Indoor air problems simply are not part of most doctors’ differential diagnoses, despite relatively high prevalence rates of CI in primary care clinics. Our three-question screening questionnaire – the BREESI – can help physicians identify which patients should complete the QEESI. After identifying patients with CI, the practitioner can help by counseling them regarding their home exposures to VOCs. The future of clinical medicine could include environmental house calls as standard of practice for susceptible patients.

Environmental House Calls Can Reduce Symptoms of Chemical Intolerance: A Demonstration of Personalized Exposure Medicine

“…This study is an extension of our previous data analysis published as Does improving indoor air quality lessen symptoms associated with chemical intolerance? (Perales et al, 2022). The ve VOC measurement categories identi ed in that paper were: total volatile organic compounds (TVOC), light solvents, odorants & fragrances, personal care products, and a composite terpene variable representing the averaged indoor air concentrations of limonene, linalool, α-pinene, and β-pinene.…”

“…In order to evaluate symptom changes, participants completed the Symptom Scale at baseline prior to the EHC, and at an 8-12month follow-up visit (Perales et al 2022).…”

Clinical assessment and patient education of chemical intolerance

“…The CI team has had prior success in reducing symptoms of CI through patient education consisting of identifying triggers in the home and/or the workplace, and teaching individuals with CI how to avoid these exposures. 24 These education sessions typically take between 5-7 sessions.…”

Workplace Health Promotion Embedded in Medical Surveillance: The Italian Way to Total Worker Health Program

“…Consequently, headache disorders (one of the main causes of years lived with disability globally) [ 18 ], musculoskeletal disorders [ 19 ], and syncope (responsible for a significant increase in the risk of occupational accidents and termination of employment) [ 20 ] have been investigated. Symptoms associated with air quality [ 21 , 22 , 23 ] and with the low quality of work organization [ 24 ] have also been studied due to their high prevalence. In other cases, the search for strategies to increase work engagement and reduce burnout and occupational stress [ 25 , 26 ] has been the main objective.…”