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Disease comorbidities associated with chemical intolerance

Background: Chemical intolerance (CI) is characterized by multisystem symptoms initiated by a one-time high-dose or a persistent low-dose exposure to environmental toxicants. Prior studies have investigated symptom clusters rather than defined comorbid disease clusters. We use a latent class modelin...

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Published in:Environmental disease 2021-10, Vol.6 (4), p.134-141
Main Authors: Palmer, Raymond, Walker, Tatjana, Perales, Roger, Rincon, Rodolfo, Jaén, Carlos, Miller, Claudia
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container_issue 4
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container_title Environmental disease
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creator Palmer, Raymond
Walker, Tatjana
Perales, Roger
Rincon, Rodolfo
Jaén, Carlos
Miller, Claudia
description Background: Chemical intolerance (CI) is characterized by multisystem symptoms initiated by a one-time high-dose or a persistent low-dose exposure to environmental toxicants. Prior studies have investigated symptom clusters rather than defined comorbid disease clusters. We use a latent class modeling approach to determine the number and type of comorbid disease clusters associated with CI. Methods: Two hundred respondents with and without CI were recruited to complete the Quick Environmental Exposure and Sensitivity Inventory (QEESI), and a 17-item comorbid disease checklist. A logistic regression model was used to predict the odds of comorbid disease conditions between groups. A latent class analysis was used to inspect the pattern of dichotomous item responses from the 17 comorbid diseases. Results: Those with the highest QEESI scores had significantly greater probability of each comorbid disease compared to the lowest scoring individuals (P < 0.0001). Three latent class disease clusters were found. Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms-therefore guide potential treatment efforts.
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Prior studies have investigated symptom clusters rather than defined comorbid disease clusters. We use a latent class modeling approach to determine the number and type of comorbid disease clusters associated with CI. Methods: Two hundred respondents with and without CI were recruited to complete the Quick Environmental Exposure and Sensitivity Inventory (QEESI), and a 17-item comorbid disease checklist. A logistic regression model was used to predict the odds of comorbid disease conditions between groups. A latent class analysis was used to inspect the pattern of dichotomous item responses from the 17 comorbid diseases. Results: Those with the highest QEESI scores had significantly greater probability of each comorbid disease compared to the lowest scoring individuals (P &lt; 0.0001). Three latent class disease clusters were found. Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms-therefore guide potential treatment efforts.</description><identifier>ISSN: 2468-5690</identifier><identifier>ISSN: 2468-5704</identifier><identifier>EISSN: 2468-5704</identifier><identifier>DOI: 10.4103/ed.ed_18_21</identifier><language>eng</language><publisher>Wolters Kluwer India Pvt. 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Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms-therefore guide potential treatment efforts.</description><subject>chemical intolerance</subject><subject>comorbid disease</subject><subject>idiopathic environmental intolerance</subject><subject>latent class</subject><subject>multiple chemical sensitivity</subject><subject>quick environmental exposure and sensitivity inventory</subject><issn>2468-5690</issn><issn>2468-5704</issn><issn>2468-5704</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNo10E1OwzAQhmELgURVuuICuUDLTOzYCTtUClSqxAbWln_G1DSpURwUcXsKbVfzaRbv4mHsFmEhEPgd-QV5jbUu8YJNSiHreaVAXJ63bOCazXKOFoSUKJUUE3b_GDOZTIVLXept9HGIlAuTc3LRDOSLMQ7bwm2pi860RdwPqaXe7B3dsKtg2kyz052y96fV2_Jlvnl9Xi8fNnPHBfq5cwoUApauUipgY2tbkwcfJHoAzkMFpWigceDJWCOwUsS5sw1HE2oOfMrWx65P5lN_9bEz_Y9OJur_R-o_tOmH6FrSVgQBAWWFZSMsojGVskGUjRKEtXWH1urYGlM7UJ937fdIve7I7_Zp1Aj6j1IfHM-UGrnQJyR9RuK_6MVvZQ</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Palmer, Raymond</creator><creator>Walker, Tatjana</creator><creator>Perales, Roger</creator><creator>Rincon, Rodolfo</creator><creator>Jaén, Carlos</creator><creator>Miller, Claudia</creator><general>Wolters Kluwer India Pvt. 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Class 1 (17% of the sample) was characterized by a cluster consisting of irritable bowel syndrome (IBS), arthritis, depression, anxiety, fibromyalgia, and chronic fatigue. The second class (53% of the sample) was characterized by a low probability of any of the co-morbid diseases. The third class (30% of the sample) was characterized only by allergy. Discussion: We have demonstrated that several salient comorbid diseases form a unique statistical cluster among a subset of individuals with CI. Understanding these disease clusters may help physicians and other health care workers to gain a better understanding of individuals with CI. As such, assessing their patients for CI may help identify the salient initiators and triggers of their CI symptoms-therefore guide potential treatment efforts.</abstract><pub>Wolters Kluwer India Pvt. Ltd</pub><doi>10.4103/ed.ed_18_21</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects chemical intolerance
comorbid disease
idiopathic environmental intolerance
latent class
multiple chemical sensitivity
quick environmental exposure and sensitivity inventory
title Disease comorbidities associated with chemical intolerance
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