Subjective symptoms, onset/trigger factors, allergic diseases, & exposures in Japanese patients with multiple chemical sensitivity

Abstract

Subjective symptoms, onset/trigger factors, allergic diseases, & exposures in Japanese patients with multiple chemical sensitivity Hojo S, Mizukoshi A, Azuma K, Okumura J, Ishikawa S, Miyata M, Mizuki M, Ogura H, Sakabe K. Survey on changes in subjective symptoms, onset/trigger factors, allergic diseases, and chemical exposures in the past decade of Japanese patients with multiple chemical sensitivity. Int J Hyg Environ Health. 2018 Aug 13. pii: S1438- 4639(18)30271-2. doi: 10.1016/j.ijheh.2018.08.001. Abstract BACKGROUND: Recently, with rapid changes in the Japanese lifestyle, the clinical condition of patients with multiple chemical sensitivity (MCS) may also have undergone change. Thus, we conducted a new survey for subjective symptoms, ongoing chemical exposures, the prevalence of allergic diseases, and presumed onset/trigger factors in patients with MCS and compared results with those of an old survey from ten years ago. METHODS: The new survey was conducted from 2012 to 2015 and the old survey was independently conducted from 1999 to 2003, meaning it was not a follow-up study. Patients were initially diagnosed by physicians at five medical institutions with MCS specialty outpatient services, with 111 and 103 patients participating in the new and old surveys, respectively. The controls were a general population living in Japan, with 1313 and 2382 participants in the new and old surveys, respectively. Subjective symptoms and ongoing chemical exposure were evaluated using a quick environmental exposure sensitivity inventory. Additionally, from clinical findings recorded by an attending physician, the prevalence of allergic diseases and presumed onset/trigger factors were evaluated. Differences between new and old surveys were analyzed using logistic regression analyses and significance tests. RESULTS: Compared with ten years ago: (1) Regarding factors affecting patients with ongoing chemical exposures, the proportion of patients affected decreased significantly for two items only (insecticides and second-hand smoke). The proportion of controls showing ongoing exposure to 8 out of 10 items changed significantly. (2) In patients, scores for chemical intolerances, other intolerances, and life impacts increased significantly. (3) In terms of the prevalence of allergic diseases among patients with MCS, bronchial asthma (adjusted odds ratio [AOR]: 5.19), atopic dermatitis (AOR: 3.77), allergic rhinitis (AOR: 5.34), and food allergies (AOR: 2.63) increased significantly, while hay fever (AOR: 0.38) and drug allergies (AOR: 0.40) decreased significantly. (4) With regard to construction and renovation, which was the presumed predominant onset/trigger factor for MCS 10 years ago, this decreased from 68.9% to 35.1%; in contrast, electromagnetic fields (0.0%-26.1%), perfume (0.0%-20.7%), and medical treatment (1.9%-7.2%) increased significantly, confirming the diversification of onset/trigger factors. CONCLUSION: Compared to ten years ago, for patients with MCS, an increase in avoidance behavior toward chemical substance exposures, which were presumed to be aggravating factors for symptoms, was confirmed. It has been suggested that the ongoing chemical exposure of the general population in Japan has largely changed. In addition, for patients with MCS, chemical intolerances and life impacts have become severe, the prevalence of the main allergic diseases has increased, and onset/trigger factors have become diversified. ncbi.nlm.nih.gov

AI evidence extraction

Main findings

Two independent surveys (1999–2003 vs 2012–2015) found that among MCS patients, scores for chemical intolerances, other intolerances, and life impacts increased significantly. The presumed onset/trigger factor “electromagnetic fields” increased from 0.0% to 26.1% (construction/renovation decreased from 68.9% to 35.1%), alongside increases in perfume and medical treatment as triggers.

Outcomes measured

• Subjective symptoms (chemical intolerances, other intolerances, life impacts)
• Ongoing chemical exposures (Quick Environmental Exposure Sensitivity Inventory)
• Prevalence of allergic diseases (e.g., bronchial asthma, atopic dermatitis, allergic rhinitis, food allergies, hay fever, drug allergies)
• Presumed onset/trigger factors for MCS (including electromagnetic fields, perfume, medical treatment, construction/renovation)

Limitations

• Old and new surveys were independent (not a follow-up study).
• Exposure and symptoms were assessed by survey instrument and physician-recorded clinical findings; specific EMF characteristics (frequency, intensity, duration) were not reported in the abstract.

Suggested hubs

• who-icnirp (0.2)
  Mentions electromagnetic fields as a presumed onset/trigger factor, but no standards/policy content is described.

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