Exacerbation of chemical sensitivity: a case study.

We report exacerbation of symptoms and chemical intolerances in three of four self-described chemically sensitive women following relocation to a newly constructed office building. Levels of total volatile organic compounds (TVOCs) in this building prior to occupancy were approximately 200 micrograms/m3 (toluene equivalent units) with a myriad of individual components present. By day 50 after occupancy, the concentration of TVOCs in the building dropped to approximately 50 micrograms/m3. Nevertheless, three women reported significant worsening of their symptoms with spreading of their sensitivities to previously tolerated chemical exposures. One woman relocated to another building, while the other two managed their symptoms by reducing time spent in the building or by using a room air cleaner. By day 600 following occupancy, although TVOCs had increased significantly (perhaps due to cleaning agents), there were fewer individual VOCs present in the air, and some of the women were able to tolerate the air in the building. We conclude that complex mixtures of VOCs at very low levels tolerated by the majority of building occupants may pose problems for persons who report pre-existing chemical sensitivities. TVOC measurements may not correlate with symptoms in these individuals. Reasonable accommodations by an employer can reduce problem exposures, making it possible for some affected individuals to continue productive employment.