Use of QEESI© questionnaire for a screening study in Japan

Abstract

QEESI # (Miller and Prihoda, 1999a: Toxicology and Industrial Health , 15, 370) was applied to 498 subjects, recruited from the general population of Miyagi prefecture, Japan, who had not been diagnosed previously as having multiple chemical sensitivity (MCS) or sick building syndrome.Seventeen (3.8%) of 440 subjects who returned valid completed questionnaires were classified as having symptoms 'very suggestive' of MCS using the four-classification system of Miller and Prihoda (1999a). We conducted detailed telephone interviews with these 17 individuals. All were visiting local hospitals on an outpatient basis with diagnoses other than MCS and had either current or previous presumed chemical exposure. Therefore, we recommended they undergo a medical check by MCS medical experts and indoor air quality assessment.Seven subjects participated in both the medical check and indoor air quality monitoring, six subjects participated in indoor air quality monitoring only and four subjects participated in neither. The seven subjects who participated in both the medical check and monitoring were diagnosed as having MCS by the above expert physicians. In nine houses of 13 subjects who participated in indoor environmental quality (IEQ) survey, acetaldehyde (9/9), formaldehyde (8/9), total volatile compounds (TVOCs) (6/9) and paradichlorobenzene (3/9) levels were above the respective guideline values for indoor air concentrations, outlined by the Ministry of Health, Labor and Welfare of Japan and were presumed to act as factors contributing to the subjects' hypersensitivity and onset or development of symptoms.These results suggested that there might still be a population of patients not properly diagnosed as having MCS by clinicians in Japan. Therefore, we verified the efficacy of QEESI (Japanese version) for screening of MCS patients.The results of indoor air quality analysis suggested the manifestation and deterioration of MCS in Japan might be precipitated by indoor air pollutants, such as formaldehyde, acetaldehyde, volatile compounds (VOCs) and paradichlorobenzene. Toxicology and Industrial Health 2005; 21: 113 Á/124.

Evaluation of subjective symptoms of Japanese patients with multiple chemical sensitivity using QEESI©

“…In accordance with our recommendation, 7 of the 17 subjects participated in a medical examination and were diagnosed as having MCS by expert physicians of the Environmental Medical Center, Kitasato Institute Hospital, suggesting the QEESI Ó (Japanese version) to be useful for screening MCS patients in Japan [21]. However, we [22] also compared QEESI Ó scores between Japanese MCS patients and the American MCS patients reported by Miller and Prihoda [17].…”

“…All 103 MCS patients underwent the three neuro-ophthalmologic examinations (smooth pursuit eye movement, contrast sensitivity function, and pupillary reaction to light) included in the Japanese MCS diagnostic criteria, as well as general neurological and electrocardiographic examinations described previously [21,23]. Each of these tests is used in the diagnosis of diseases other than MCS.…”

“…Each item includes a 0-10 rating scale, the ratings being tallied to obtain a total scale score of 0-100. Miller and Prihoda [16] defined the criteria for three levels of symptom score as low (0-19), medium (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), and high (40-100).…”

“…Each of these tests is used in the diagnosis of diseases other than MCS. The normal range was determined by evaluating data from a large number of healthy Japanese, and those whose results fell outside the normal range were diagnosed as abnormal [21,23].…”

“…Additionally, we [21] conducted a questionnaire survey using the QEESI Ó (Japanese version) in 498 Japanese subjects not previously diagnosed as having MCS, and 17 subjects were consequently identified as having clinical features consistent with ''very suggestive of MCS'' based on the criteria of Miller and Prihoda (Chemical Intolerance C40 and Symptom Severity C40) [17]. In accordance with our recommendation, 7 of the 17 subjects participated in a medical examination and were diagnosed as having MCS by expert physicians of the Environmental Medical Center, Kitasato Institute Hospital, suggesting the QEESI Ó (Japanese version) to be useful for screening MCS patients in Japan [21].…”