Describing preparations for Hurricane Sandy, guest blogger Laura MacCleery gives a humorous example of the old adage about how “no good deed goes unpunished.” Laura is a lawyer, mother and self-described “squeaky wheel in search of a spoke.” She writes commentary at Laura’s Rules.

By Laura MacCleery

When I recently filled out a helpful questionnaire on chemical intolerance, the Quick Environmental Exposure and Sensitivity Inventory (QEESI), or “Queasy” as I like to call it among friends, a screw-shaped light bulb went off. (Compact fluorescent, of course.)

According to the results of this scientifically validated tool for measuring sensitivities to toxins in our environment, I am on the “high” end for both exposures and symptoms, meaning that I don’t tolerate smells like gasoline and off-gassing furniture well.

The survey powerfully showed why I obsess about such things, while other people may shrug them off. Seeing how I scored was important to me because it identified some common sources for the headaches and other discomfort I often experience following exposure to an unpleasant chemical-laden odor.

Most of the things on the list on the QEESI, which is a quick inventory, as the name implies, including bleach-based cleaning supplies or a “new car” smell, can make me feel a bit off, even in small doses. I still remember being newly pregnant in a Washington, D.C., wintertime and driving with the windows way down, the cold wind in my face, because freezing was far preferable to the vinyl smell emanating from my brand-new Nissan, especially given my bionic nose from the pregnancy!

But that sensitivity hasn’t gone away since I had my daughter, either. And I’m not the only one who’s bothered by the fragrances crowding our environment. A recent article in a UK newspaper notes that: “One leading expert suggests nearly a third of people suffer adverse health effects from being exposed to scents.”

The article explains:

“Allergies are on the increase, and the amount of perfumed products is also on the rise,” says Dr. Susannah Baron, consultant dermatologist at Kent & Canterbury hospital, and BMI Chaucer Hospital. “Fragrance allergy can show up as contact dermatitis in the site a perfumed product is applied, or as a flare-up of existing eczema. It can be a real problem.” … Often it may not be immediately obvious that you’ve developed a fragrance allergy, says Dr. Baron. “You don’t react immediately; the body notes that it does not like the chemical and develops ‘memory cells,’ which cause inflammation when the body is next exposed to this chemical. Gradually, as you are exposed more and more, the body ramps up its reaction, until it becomes more noticeable to you.”

As the designer of the QEESI tool, Dr. Claudia Miller, an immunologist/allergist, explains based on her many years of research, that biological response is to the chemicals being used to produce the fragrances. Her pioneering work shows that exposures to chemicals of all kinds – not just the smelly ones – can and do trigger a loss of tolerance in some people, causing ill health.

And the simplest things can lead to new exposures, such as our recent utterly ridiculous adventures with installing a generator for our home. We often lose power, and so the prospect of Hurricane Sandy barreling down on us caused a run to the store and triggered a panicky purchase of a generator to help see us through.

Turned out we didn’t need to use it, and instead bought ourselves a world of trouble. In fact, what I didn’t know about it can be counted on all my fingers and toes in the dark, including the substantial extra costs of having an electrician hook it up properly, and the excruciating task of filling tanks up with gasoline, poised over the wafting fumes to ensure that I didn’t overfill the tanks and spill it all on my shoes.

To complete the misadventure, a small amount of gasoline did spill inside my car, rendering it nastily smelly once more. To get the odor out, I tried everything – wiping it down with baby oil, auto cleaners, and baking soda. Repeatedly.

Then I finally took it to a detail shop, and paid them a small fortune to use completely toxic cleaning supplies on the floor and seats. The smell has diminished, but it’s not gone, and it’s mingling with all the cleaners for a soupier feel. I still drive with the windows open and leave them all cracked while parked, at least when there’s no rain coming.

Contrary to what most folks think when they imagine what we are doing to “the environment,” indoor air is far more polluted than that outdoors. Given the number of people whose symptoms have been identified by the QEESI, I don’t think I’m alone in thinking that something is very wrong when the places we build – to live in, no less – are not particularly safe or comfortable for at least some living things.

So if you are like me, and these kinds of odors bother you as you go about your day-to-day, you may want to take the QEESI and see how and why they may be impacting you. And to learn what may be “masking” their effects, so that you don’t know where the headaches are coming from.

Even more pointedly, suppose you go on vacation and get a break from these exposures and feel suddenly better, which happened to a friend of mine, then you may want to start clearing your house of odoriferous chemicals and plastics to see if it makes a difference. It certainly did for her.

On the other hand, if you’re one of the lucky ones who feels just fine in this man-made world of olfactory offenders, well, then, you can snicker at us anti-chemical folk if you’d like to. But you may also want to think about whether those of us with the higher QEESI scores – and the concomitant fascination with “greening” our homes – are actually canaries in a mineshaft.

Tweet, tweet, I say, a bit sadly.

And because I’m a modern bird: Retweet? Are you a canary too?

Is there a way to make “green” buildings as friendly to people as they are to the environment?

I had the opportunity to discuss indoor air quality and chemical susceptibility with some of the nation’s leading architects and building technologists at a recent conference about building standards. I was one of 13 guest speakers at the conference hosted by the School of Architecture at the University of Texas in Austin.

Indoor air has a profound effect on people’s health, and my goal was to persuade the group that poor quality air makes some people sick. My message was simple: If you protect the most vulnerable people, you will protect everyone.

I suggested adding a new level to the coveted LEED building certification. The new certification level would recognize buildings that assure excellent indoor air quality.

Certification under LEED, short for “Leadership in Energy and Environmental Design,” reflects a rating system for the design, construction and operation of green buildings. Developed by the U.S. Green Building Council, it is intended to provide building owners and operators with a framework for identifying and implementing practical and measurable green building design, construction, operations and maintenance solutions. Buildings receive LEED certification based on five categories of construction quality. I proposed a sixth: indoor air quality. A building can be LEED certified and yet have indoor air exposures that pose major health problems for a building’s most susceptible occupants, such as the chemically intolerant, those with asthma, pregnant women, etc.

Americans spend 90 percent of their day indoors so architects and builders bear a major responsibility for the quality of indoor air.

Who is most vulnerable? Children, pregnant women, and more susceptible adults (people with asthma, allergies, or chemical intolerance). At any given time, of 100 people, 3 are pregnant or will become pregnant within a year, 7 are children under the age of 5 (another 17 are still under the age of 18 and the brain continues to develop into the early 20s!), 7 have asthma, 20 have
allergies, and 15 are chemically intolerant.

LEED certification does not protect the most vulnerable building occupants from indoor air contaminants such as chemicals, particles, allergens, and microbes. Although indoor environmental quality requirements are part of LEED certification and builders and owners can earn points by taking additional measures that can improve indoor air quality, the levels of certification such as “silver,”"gold,” or “platinum” are insufficient to protect the most vulnerable building occupants. A new designation, perhaps “LEED Diamond,” should be introduced with mandatory criteria to ensure excellent indoor air and protect all building occupants.

My presentation is available in .pdf and PowerPoint.

Medical researchers are finding that children with autism and their parents suffer in some of the same ways when they encounter certain chemicals in everyday products.

Recently, at the invitation of the Autism Society of America, I presented a national webinar describing how children with autism and their parents often share certain intolerances, and may react in similar ways. Why? I think it’s a case where “Genetics loads the gun, and the environment pulls the trigger.”

We know, for example, that in adults certain acute or chronic chemical exposures sometimes can initiate a process that has come to be known as “Toxicant-induced Loss of Tolerance,” or TILT. TILT may develop after a workplace exposure or remodeling of a home or exposure to petrochemicals or combustion products from a fire. Thereafter, everyday exposures to common chemicals, foods, medications, and even caffeine, can trigger cognitive and mood difficulties, as well as a host of baffling symptoms that can affect the nervous system, digestive tract, airways, and skin.

Notably, many of the same environmental exposures, e.g., certain pesticides, that initiate TILT in adults can also interfere with neurodevelopment in a fetus, starting as early as the first month of pregnancy when the neural tube forms and before the mother even knows she is pregnant!

And, as for chemically intolerant adults, we should make every effort to prevent suspected initiating exposures as well as minimize exposures that can continue to trigger autistic behaviors and other symptoms throughout the lifespan. This also means that continued avoidance of even low-level exposure triggers may be important for treating children and adults with autism.

These differences in susceptibility to environmental chemical exposures, which may predispose to TILT in adults and autism in children, are the consequence of normal human genetic diversity — a good thing! My concern, as we learn more about the important relationships between autism, genes and exposures, is that differences in our genetic susceptibility not be viewed as a defects, but rather normal individual differences. These differences are not new. What is new are our exposures. Since World War II, the petrochemical era has ushered in myriad chemical exposures, exposures unprecedented in human history. There can be as much as a 10,000-fold difference, from person to person, in our ability to detoxify and eliminate substances from our bodies. Currently we are unable predict which exposures can cause TILT or autism in which persons.

Other shared features of autism and chemical intolerance include food cravings (mimicking addiction) and intolerances including gluten (wheat) and milk. From our own studies, mothers of children with autism, compared to mothers of “neurotypical children’” were much more likely to report that common chemical exposures make them sick. These included household cleaners, fragrances and pesticides. We used the validated “Quick Environmental Exposure and Sensitivity Inventory” or QEESI, questionnaire to gauge chemical, food and other environmental intolerances in the mothers. You too can use the QEESI questionnaire to gauge sensitivities.

The underlying causes for autism and the reasons why it now affects a staggering 1 in 110 babies born in the United States — a national epidemic according to the Centers for Disease Control and Prevention (CDC) — continue to elude the medical and scientific communities. There are many clues, and theories. The webinar I presented on behalf of the Autism Society of America, which is available to you free of charge, focuses on the striking and often overlooked parallels between autism and chemical intolerance. The increased use of petrochemically based household products and recent emphasis on greener, more energy efficient homes with little fresh air to dilute contaminants in the United States parallels the rise in autism over the past few decades. Globally, autism has been on the rise in every industrialized nation.

During medical school, my colleagues and I learned that children are not just little adults! There are obvious size and many metabolic differences between children and adults. At the same time, children with autism and chemically intolerant adults are strikingly similar in important ways: They share exposures to petrochemicals, indoor air pollutants and pesticides, and both experience chemical and food intolerances. A crucial difference in the case of autism is timing: Exposures that occur during pregnancy or early childhood have the potential to alter neurodevelopment. One tool that is urgently needed in medicine is an Environmental Medical Unit, or EMU, which would allow physicians and families to determine whether and to what extent autism might be reversible if chemical and food triggers could be avoided systematically for a few weeks. Here is a paper I wrote about EMUs.

Here is the webinar presentation to the Autism Society of America.

To follow the proceedings, you will need to install the Cisco Webex browser software. You will be prompted at the website. Adding the software only takes a few seconds.