Symptomatic Responses to Low‐Level Occupational and Environmental Exposures

Abstract

There are individuals who experience symptoms in response to exposures at levels below those generally considered toxic. Symptoms are real and can range from mild to disabling. Several diagnostic terms have been used to describe this condition, including chemical intolerance, multiple chemical sensitivity, and idiopathic environmental intolerance. Common triggering exposures include gasoline fumes, construction, cleaning, and perfumed products, adhesives, and new carpeting. The pathogenesis of these symptomatic responses to low‐level exposures remains poorly defined but is likely multifactorial, involving neurosensory, olfactory, behavioral, and psychological pathways. Workers with symptomatic responses to low‐level exposures in the workplace should undergo medical evaluation to clarify the diagnosis and identify modifiable triggering exposures. Treatment includes acknowledging the patient's condition and its impact on work and other activities, reduction of triggering exposures, work accommodations as feasible, and management of symptoms.