Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If You Use a Screen Reader

This content is available through Read Online (Free) program, which relies on page scans. Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.

Toxicant-Induced Loss of Tolerance: An Emerging Theory of Disease?

Claudia S. Miller
Environmental Health Perspectives
Vol. 105, Supplement 2: Chemical Sensitivity (Mar., 1997), pp. 445-453
DOI: 10.2307/3433351
Stable URL: http://www.jstor.org/stable/3433351
Page Count: 9
  • Read Online (Free)
  • Subscribe ($19.50)
  • Cite this Item
Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Toxicant-Induced Loss of Tolerance: An Emerging Theory of Disease?
Preview not available

Abstract

This paper attempts to clarify the nature of chemical sensitivity by proposing a theory of disease that unites the disparate clinical observations associated with the condition. Sensitivity to chemicals appears to be the consequence of a two-step process: loss of tolerance in susceptible persons following exposure to various toxicants, and subsequent triggering of symptoms by extremely small quantities of previously tolerated chemicals, drugs, foods, and food and drug combinations including caffeine and alcohol. Although chemical sensitivity may be the consequence of this process, a term that may more clearly describe the observed process is toxicant-induced loss of tolerance. Features of this yet-to-be-proven mechanism or theory of disease that affect the design of human exposure studies include the stimulatory and withdrawallike nature (resembling addiction) of symptoms reported by patients and masking. Masking, which may blunt or eliminate responses to chemical challenges, appears to have several components: apposition, which is the overlapping of the effects of closely timed exposures, acclimatization or habituation, and addiction. A number of human challenge studies in this area have concluded that there is no physiological basis for chemical sensitivity. However, these studies have failed to address the role of masking. To ensure reliable and reproducible responses to challenges, future studies in which subjects are evaluated in an environmental medical unit, a hospital-based facility in which background chemical exposures are reduced to the lowest levels practicable, may be necessary. A set of postulates is offered to determine whether there is a causal relationship between low-level chemical exposures and symptoms using an environmental medical unit.

Page Thumbnails

  • Thumbnail: Page 
445
    445
  • Thumbnail: Page 
446
    446
  • Thumbnail: Page 
447
    447
  • Thumbnail: Page 
448
    448
  • Thumbnail: Page 
449
    449
  • Thumbnail: Page 
450
    450
  • Thumbnail: Page 
451
    451
  • Thumbnail: Page 
452
    452
  • Thumbnail: Page 
453
    453