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Stanley M. Caress, PhD and Anne C. Steinemann, PhD

Stanley M. Caress is with the State University of West Georgia, Carrollton, Ga. Anne C. Steinemann is an associate professor at the Georgia Institute of Technology, Atlanta.

Correspondence: Requests for reprints should be sent to Stanley M. Caress, PhD, State University of West Georgia, Carrollton, GA 30118 (e-mail: scaress{at}westga.edu).

	ABSTRACT

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We examined the prevalence of multiple chemical sensitivities (MCS), a hypersensitivity to common chemical substances. We used a randomly selected sample of 1582 respondents from the Atlanta, Ga, standard metropolitan statistical area. We found that 12.6% of our sample reported the hypersensitivity and that, while the hypersensitivity is more common in women, it is experienced by both men and women of a variety of ages and educational levels. Our prevalence for MCS is similar to that (15.9%) found by the California Department of Health Services in California and suggests that the national prevalence may be similar.

	INTRODUCTION

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Uncertainty surrounds the prevalence of hypersensitivity to common chemicals in the US population. This hypersensitivity, frequently labeled multiple chemical sensitivity (MCS),¹ is also known as environmental illness or toxicant-induced loss of tolerance.² A report published by the National Academy of Sciences in 1981 said that 15% of the American population could have a heightened sensitivity to chemicals.³ Subsequent studies using anecdotal evidence,⁴ self-selected subjects,⁵ clinical environments,⁶ or limited areas⁷ disclosed a wide range of results. A more recent random population study by the California Department of Health Services (CDHS) indicated a hypersensitivity prevalence of 15.9% in Californians surveyed.⁸

	METHODS

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In this study we investigated the prevalence of hypersensitivity to common chemicals and the extent of the medical diagnosis of MCS in a geographic sample. We also explored this hypersensitivity’s etiology, effects, and potential linkages to asthma, age, gender, and educational level.

We used a randomly selected sample of 1582 residents of the Atlanta, Ga, metropolitan area (sampling error 3%, confidence level 97%). Metropolitan Atlanta has a population of 4 112 000 persons and is a mixture of urban, suburban, and rural areas.⁹ Respondents were surveyed in 3 cohorts to account for seasonal variations: summer 1999 (n = 496), fall 1999 (n = 322), and winter–spring 2000 (n = 764).

Our questionnaire was pretested on randomly selected individuals (n = 253) and subsequently shortened to ensure maximum subject cooperation. The final version asked if the respondent had ever been diagnosed with MCS or environmental illness. It then asked, "Compared with other people, do you consider yourself to be allergic or unusually sensitive to everyday chemicals like those in household cleaning products, paints, perfumes, detergents, insect spray, and things like that?" This wording is identical to that of the CDHS questionnaire. Respondents who answered "yes" or "not sure" were asked additional questions about reaction magnitude, behavior modifications, age of onset, and the hypersensitivity’s origin. All respondents were asked if they had asthma, and their replies were cross-tabulated with hypersensitivity. Questions on gender, age, and education level were asked of all respondents and also cross-tabulated with hypersensitivity.

	RESULTS

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In our study we found that 12.6% (n = 199) of the respondents reported a hypersensitivity to common chemicals (Table 1). The percentage of respondents who reported having been medically diagnosed as having MCS or environmental illness was 3.1% (n = 49). Respondents who reported a diagnosis of asthma made up 12.1% (n = 192) of the sample. A cross-tabulation of hypersensitivity to chemicals with asthma indicated that 30.2% (n = 60) of respondents with hypersensitivity also reported having asthma, while 69.3% (n = 138) said that they did not.

The percentage of respondents with hypersensitivity who received medical treatment was 45.1% (n = 106). Those who took precautions at home to avoid exposures to offending chemicals was 61.5% (n = 142), while 29.9% (n = 64) indicated that their hypersensitivity made it difficult to shop in stores. Moreover, 13.5% (n = 29) reported losing their jobs because of their hypersensitivity.

This hypersensitivity first emerged for 32.4% (n = 70) of respondents before they reached 20 years of age; for 35.2% (n = 76) between 20 and 35 years of age; and for 14.8% (n = 32) between 36 and 50 years of age. Only 7.9% (n = 17) of respondents reported that their hypersensitivity first emerged after age 50 years.

The sample was 60.7% female (n = 926) and 39.3% male (n = 600); totals on this question were less than the total number of cases because of unmarked answers or damaged questionnaires. The educational level of respondents was: high school degree or less, 34.8% (n = 526); some college, 25.7% (n = 389); and a college degree or higher, 39.4% (n = 579). Ages of those sampled were: 20 years, 5.8% (n = 89); 20–35 years, 24.3% (n = 373); 36–50 years, 32.2% (n = 510); and > 50 years, 34.5% (n = 530). Cross-tabulation indicated respondents with the hypersensitivity were 71.7% female and 28.3% male. Regarding education, 33.2% of the hypersensitive have a high school education or less, 29% have some college, and 37.8% have a college degree or higher. The ages of the hypersensitive were: < 20 years, 6.5% (n = 13); 20–35 years, 18.1% (n = 36); 36–50 years, 35.2% (n = 70); and > 50 years, 38.2% (n = 76).

The variations in the seasonal cohorts were not significant and the above data are aggregations.

	DISCUSSION

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The 12.6% hypersensitivity prevalence, though below the 15.9% found by the CDHS, is statistically similar. While the percentage of hypersensitive respondents is disproportionately female, the female bias in the sample exaggerates the gender differential. The higher education levels and ages of hypersensitive respondents are also less significant because of the sample’s bias. The data indicate, therefore, that hypersensitivity affects both genders as well as individuals of different ages and educational levels.

	Acknowledgments

 
This study was funded by the State University of West Georgia.

The authors thank J. Mantell, L. B. Caress, A. Immele, and C. Waddick.

Human Participant Protection
This study was approved by the institutional review boards of both the State University of West Georgia and the Georgia Institute of Technology.

	Footnotes

 
Contributors
S. Caress designed the study, conducted the survey, and wrote part of the text. A. C. Steinemann collaborated on the study and questionnaire construction and wrote part of the text.

Peer Reviewed

Accepted for publication November 23, 2001.

	References

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1. Cullen M., Pace P, Redlich C. The experience of the Yale Occupational and Environmental Medicine Clinics with multiple chemical sensitivities, 1986–1991. Toxicol Ind Health. 1992;8:15–19.[Web of Science][Medline]

2. Ashford NA, Miller CS. Chemical Exposures: Low Levels and High Stakes. 2nd ed. New York, NY: Van Nostrand Reinhold; 1998.

3. National Research Council, Committee on Indoor Pollutants, Board on Toxicology and Environmental Health Hazards, Assembly of Life Sciences. Indoor Pollutants. Washington, DC: National Academy Press; 1981.

4. Mooser SB. The epidemiology of multiple chemical sensitivities (MCS). Occup Med. 1987;2:663–668.

5. Bell IR, Schwartz GE, Peterson JM, Amend D, Stini WA. Self-reported illness from chemical odors in young adults without clinical syndromes or occupational exposures. Arch Environ Health. 1993;48:6–13.[Web of Science][Medline]

6. Kipen HM, Hallman W, Kelly-McNeil K, Fiedler N. Measuring chemical sensitivity prevalence: a questionnaire for population studies. Am J Public Health. 1995;85:575–577.

7. Meggs WJ, Dunn KA, Bloch RM, Goodman PE, Davidoff AL. Prevalence and nature of allergy and chemical sensitivity in a general population. Arch Environ Health. 1996;51:275–282.[Web of Science][Medline]

8. Kreutzer R, Neutra RR, Lashuay N. Prevalence of people reporting sensitivities to chemicals in a population-based survey. Am J Epidemiol. 1999;150:1–12.[Abstract/Free Full Text]

9. US Census Bureau. Statistical Abstract of the United States: 2002. Washington, DC: Bureau of the Census; 2002:122:32.

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This Article Abstract Full Text (PDF) Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Caress, S. M. Articles by Steinemann, A. C. Search for Related Content PubMed PubMed Citation Articles by Caress, S. M. Articles by Steinemann, A. C. Related Collections Geography Surveys Other Environment