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Idiopathic Environmental Intolerance

Part 1: A Causation Analysis Applying Bradford Hill’s Criteria to the Toxicogenic Theory

Toxicological Reviews volume 22, pages 235–246 (2003)Cite this article

Abstract

Idiopathic environmental intolerance (IEI) is a descriptor for a phenomenon that has many names including environmental illness, multiple chemical sensitivity and chemical intolerance. Toxicogenic and psychogenic theories have been proposed to explain IEI. This paper presents a causality analysis of the toxicogenic theory using Bradford Hill’s nine criteria (strength, consistency, specificity, temporality, biological gradient, biological plausibility, coherence, experimental intervention and analogy) and an additional criteria (reversibility) and reviews critically the scientific literature on the topic. The results of this analysis indicate that the toxicogenic theory fails all of these criteria. There is no convincing evidence to support the fundamental postulate that IEI has a toxic aetiology; the hypothesised biological processes and mechanisms are implausible.

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Acknowledgements

No funding was received to assist the preparation of this manuscript. The authors have no conflict of interest. We thank Su Dierbeck for secretarial assistance. We dedicate this work to the memory of our colleague, Neil L. Rosenberg, M.D.

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Authors and Affiliations

  1. Behavioral Medicine, Multi-Disciplinary Toxicology, Treatment and Research Center, 5800 E. Evans Ave, Suite 20B, Denver, Colorado, 80222, USA

    Herman Staudenmayer

  2. Division of Clinical Immunology and Allergy, University of Toronto, Toronto, Canada

    Karen E. Binkley & Arthur Leznoff

  3. Toxicology Associates, Multi-Disciplinary Toxicology, Treatment and Research Center, Denver, Colorado, USA

    Scott Phillips

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  1. Herman Staudenmayer
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  2. Karen E. Binkley
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  3. Arthur Leznoff
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  4. Scott Phillips
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Correspondence to Herman Staudenmayer.

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Staudenmayer, H., Binkley, K.E., Leznoff, A. et al. Idiopathic Environmental Intolerance. Toxicol Rev 22, 235–246 (2003). https://doi.org/10.2165/00139709-200322040-00005

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Keywords

  • Toxic Exposure
  • Multiple Chemical Sensitivity
  • Sick Building Syndrome
  • Idiopathic Environmental Intolerance
  • Chemical Intolerance