Sick of smells : Empirical findings and a theoretical framework for chemical intolerance

Abstract: Chemical intolerance (CI) is a term that refers to the surprisingly common phenomenon of persons getting ill from everyday chemicals. Although seemingly similar to asthma and allergies, CI sufferers do not react to exposures with increased histamine release. CI neither conforms to toxicological dose-response relationships as sufferers react to very low concentrations of chemicals assumed to be harmless. In addition, no particular chemical can be tied to any particular set of symptoms as in the case of other kinds of toxic injuries. The two overreaching goals of this thesis were to empirically investigate important hypotheses regarding CI, and to develop a theoretical framework that integrates previous theories of CI into a coherent whole.There are four empirical studies in this thesis. Utilizing event-related potentials (ERPs), magnitude estimations of perceived intensity, detection tests and functional magnetic resonance imaging (fMRI), the studies provided support for the following hypotheses: (1) persons with self-reported CI sensitize to olfactory and chemosomatosensory stimuli, whereas non-intolerant individuals habituate; (2) sensitization in CI is similar in terms of brain activation patterns to both non-clinical sensitization and other unexplained illnesses such as fibromyalgia; (3) persons with CI have an attention bias to chemical exposures, reflected by problems with withdrawing attention from such stimuli; (4) measures of peripheral hyperreactivity are correlated with chemosensory ERP measures; but failed to corroborate (5) the reactions of women resemble those found in persons with CI to a greater degree than the case in men.Three major theories of CI are also discussed. The neural sensitization theory describes CI as pathological and non-immunological increases in neural responsiveness. The conditioning theory describes CI as the result of basic associative learning mechanisms. The neurogenic inflammation theory describes CI as proliferation of sensory c-fibers and inflammatory responses carried to several parts of the body through axon reflexes and release of inflammatory mediators. The main point of the theoretical synthesis is that the theories offer different and complementary perspectives on CI, rather than presenting conflicting ontologies. With an integrated perspective, infected debates whether CI is a psychological or organic illness can hopefully be avoided.Finally, the unexplained characteristics of CI, the empirical findings and the theoretical accounts are described within the theoretical framework of signal detection theory. Several features of CI, e.g. sensitization and peripheral hyperreactivity, are described in terms of applying a low criterion (ß).