Chemical odor intolerance: 5 cases

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 f ive characteristic cases and discuss current data. CASE REPORTS: Five patients (3 women, 2 men; age range 23 - 52 years) prese nted the basic criteria of chemical odor intolerance: acquired syndrome, no n-specific signs (headache, nausea, vertigo...) triggered by the odor of on e or more chemical substances. Physical examination and exploratory tests w ere normal. In 3 cases, the course was favorable after evicting the causal substances. For the other 2 cases, intolerance spread to other compounds, F our of the patients changed their work situation because of the chemical od or 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 mechanis m is probably multifactorial but psychological factors appear to play an im portant role either as predisposing or triggering factors. CONCLUSION: Due to the social and occupational consequences of chemical odo r intolerance, better knowledge of its prevalence and mechanism would be mo st helpful in managing these patients.