[Chemical odor intolerance. 5 cases].

Presse Med

Service de Médecine du Travail et des Maladies Professionnelles, CHU de Clermont-Ferrand, Faculté de Médecine.

Published: October 1999

Background: Chemical odor intolerance is a benign, non-specific, generally subjective syndrome triggered by inhalation of non-toxic doses of chemical compounds or products which had been previously well tolerated. We report five characteristic cases and discuss current data.

Case Reports: Five patients (3 women, 2 men; age range 23-52 years) presented the basic criteria of chemical odor intolerance: acquired syndrome, non-specific signs (headache, nausea, vertigo ...) triggered by the odor of one or more chemical substances. Physical examination and exploratory tests were normal. In 3 cases, the course was favorable after evicting the causal substances. For the other 2 cases, intolerance spread to other compounds. Four of the patients changed their work situation because of the chemical odor intolerance.

Discussion: The diagnosis is clinical. Different pathogenic hypotheses have been put forward in the literature: immunological, toxic, neurobiological, psychological, and psychiatric mechanisms have been proposed. The mechanism is probably multifactorial but psychological factors appear to play an important role either as predisposing or triggering factors.

Conclusion: Due to the social and occupational consequences of chemical odor intolerance, better knowledge of its prevalence and mechanism would be most helpful in managing these patients.

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