There’s a lot of things for survivors in Florida’s Big Bend to worry about as they clean up in the aftermath of Hurricane Idalia—access to safe water and food, emergency prescriptions, electrical hazards, and toxic mold. Since mold can develop only a day or two after flooding, it is always a concern after a tropical storm or hurricane, yet it can be easily overlooked since it’s not quite as obvious as a fallen power line.
But mold can cause disease, trigger allergic reactions and persist in the environment long after hurricane cleanup is complete. In fact, in a new survey of over 10,000 U.S. adults, participants cited “exposure to mold” as the initiating event behind the development of their chemical intolerance.
Chemical intolerance is a term used to describe a condition in which the sufferer experiences a complex array of recurrent unspecific symptoms ultimately attributed to low-level chemical exposure that may not affect other people. At this time, it is a controversial issue as to whether it is a clinical diagnosis or not. Many in the medical community lean toward these symptoms being physical manifestations of psychiatric illness rather than a primary medical illness. While others in the medical community, along with organizations, agree that severe chemical intolerance is a real negative physical reaction.
“Our search for the underlying causes of chemical intolerance represents a much-needed addition to the literature, whose principal focus has been on triggers that elicit symptoms from day-to-day with no attempt to determine what initiated [the intolerance],” said study author and physician-researcher Claudia Miller, MD, from The University of Texas Health Science Center at San Antonio.
To that end, Miller’s study furthers understanding about how a two-stage disease process called TILT—toxicant-induced loss of tolerance—begins. The survey asked 10,981 people to state their self-perceptions about the events that began the downward spiral through TILT and into chemical intolerance.
Participants completed an 80-question online survey called the Personal Exposure Inventory. It included items concerning individuals’ medical diagnoses and personal exposures. Chemical intolerance was assessed using the Quick Environmental Exposure and Sensitivity Inventory (QEESI) developed by Miller 25 years ago. It is a validated, self-administered questionnaire now used worldwide to differentiate individuals with chemical intolerance from the general population.
According to the survey results, published in Environmental Sciences Europe, 18% of survey respondents cited mold as the initiating event on the Personal Exposure Inventory—the most frequent answer. Mold was then followed by exposures to pesticides (14%), medical/surgical procedures (13%), remodeling/new construction (12%), fires/combustion products (7%) and breast implants (2%).
“With climate change contributing to more severe storms and more intense flooding worldwide, the danger posed by toxic mold is likely to increase dramatically in the near future,” Miller said. “As mold exposure is known to be a major initiator, the likelihood of more and more people with chemical intolerance is also unfortunately on the rise."
Additionally, prolonged use of antibiotics prescribed for infections categorized as skin, tonsil, gastrointestinal, prostate, sinus, wound and pneumonia were most strongly associated with chemical intolerance.
Miller and her team encourage practitioners who see patients with medically unexplained symptoms—currently 1 in 4 primary care patients—to consider administering the QEESI.
“‘TILTed’ individuals who report brain fog, memory, mood and concentration difficulties often receive referrals to psychiatrists, psychologists or social workers who explore their psychosocial environments but do not ask about changes in their actual—physical and chemical—environments,” Miller said. “If initiating exposures such as pesticides, toxic mold, implants and combustion products are not stopped, sensitivities can spiral out of control.”
The study estimates that chemical intolerance affects anywhere from 20 to 30% of Americans.
More resources:
Microbiome First Summit
"Toxicant-Induced Loss of Tolerance for Chemicals, Foods, and Drugs: A Global Phenomenon”
2022 National Forum Series from Beyond Pesticides
“Pesticides, TILT, and Mast Cells: A Growing Global Concern”
Masri, S., Miller, C.S., Palmer, R.F. et al. Toxicant-induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon. Environ Sci Eur 33, 65 (2021).
Miller, C.S., Palmer, R.F., Dempsey, T.T., Ashford, N. Mast cell activation may explain many cases of chemical intolerance. Environ Sci Eur 33, 129 (2021).
Palmer, R.F., Rincon, R., Perales, R.B., Walker, T.T., Jaen, C.R., Miller, C.S. The Brief Environmental Exposure and Sensitivity Survey (BREESI): an international validation study. Environ Sci Eur 34,32 (2022).
Miller C.S., Palmer, R.F., Kattari, D., Masri, S., Ashford, N.A., Rincon, R., Perales, R.B., Grimes, C., Sundblad, D.R. What initiates chemical intolerance? Findings from a large population-based survey of U.S. adults. Environ Sci Eur 35, 65 (2023).