https://hdl.handle.net/1721.1/114982 2026-04-12T01:34:18Z 2026-04-12T01:34:18Z Masri, Shahir Miller, Claudia Palmer, Raymond Ashford, Nicholas A. https://hdl.handle.net/1721.1/131176 2025-07-23T23:50:03Z 2021-01-01T00:00:00Z

Toxicant‑induced loss of tolerance for chemicals, foods, and drugs: assessing patterns of exposure behind a global phenomenon Masri, Shahir; Miller, Claudia; Palmer, Raymond; Ashford, Nicholas A. Background: Despite 15–36% of the U.S. population reporting Chemical Intolerances (CI) or sensitivity, the condition has been overlooked in medicine and public health. CI is characterized by multisystem symptoms and new-onset intolerances that develop in a subset of individuals following a major chemical exposure event or repeated low-level exposures. While Toxicant-Induced Loss of Tolerance (TILT) is a two-stage disease mechanism proposed to explain CI, less is known about the exposures that initiate the disease, than about the intolerances that have been documented. Methods: We reviewed eight major exposure events that preceded onset of chemical intolerance in groups of individuals sharing the same exposure. Our goal was to identify the chemicals and/or groups of chemicals that were most pervasive during each exposure event as well as identify the concentrations of key chemicals involved in each exposure event and the proportions of exposed individuals who ultimately developed TILT following exposure. Case studies we selected for review included (1) workers at U.S. Environmental Protection Agency (EPA) headquarters during renovations; (2) Gulf War veterans; (3) pesticide exposure among casino workers; (4) exposure to aircraft oil fumes; (5) the World Trade Center tragedy; (6) surgical implants; (7) moldy environments; and (8) tunnel workers exposed to solvents. Results: Mixed volatile and semi-volatile organic compounds (VOCs and SVOCs), followed by pesticides and combustion products were most prevalent across TILT initiation events. As a broader category, synthetic organic chemicals and their combustion products were the primary exposures associated with chemical intolerance. Such chemicals included pesticides, peroxides, nerve agents, anti-nerve agent drugs, lubricants and additives, xylene, benzene, and acetone. Conclusion: A select group of exposures were predominant in several major initiating events, suggesting their potential role in TILT initiation. Such insights are useful to public health scientists, physicians, and policymakers seeking to minimize harmful exposures and prevent future disease.

2021-01-01T00:00:00Z Ashford, Nicholas A. Miller, Claudia S. https://hdl.handle.net/1721.1/130916 2021-06-08T03:01:44Z 1999-01-01T00:00:00Z

Social and Policy Implications of Low-Level Exposures to Chemicals Ashford, Nicholas A.; Miller, Claudia S.

1999-01-01T00:00:00Z Ashford, Nicholas A. https://hdl.handle.net/1721.1/130913 2021-06-08T03:31:57Z 1999-01-01T00:00:00Z

The Economic and Social Context of Special Populations Ashford, Nicholas A.

1999-01-01T00:00:00Z Ashford, Nicholas A. Miller, Claudia S. https://hdl.handle.net/1721.1/130889 2021-06-02T03:16:07Z 1996-01-01T00:00:00Z

Low-level chemical sensitivity: current perspectives Ashford, Nicholas A.; Miller, Claudia S.

1996-01-01T00:00:00Z Miller, Claudia S. Ashford, Nicholas A. https://hdl.handle.net/1721.1/130635 2021-05-22T03:31:17Z 2000-01-01T00:00:00Z

Multiple Chemical Intolerance and Indoor Air Quality Miller, Claudia S.; Ashford, Nicholas A.

2000-01-01T00:00:00Z Miller, C.S. Ashford, Nicholas A. https://hdl.handle.net/1721.1/116809 2019-04-12T17:09:30Z 1995-09-01T00:00:00Z

Chemical Sensitivity: Perspectives from North America and Europe Miller, C.S.; Ashford, Nicholas A. Chemical sensitivity is a controversial and perplexing illness that has been attributed to low-level chemical exposure in industrial workplaces, indoor environments, and contaminated communities, and to the use of consumer products and pharmaceuticals, first in North America and now in Europe. This paper explores the different types of sensitivity and the relationship of low-level chemical sensitivity to them. A synopsis of the largest North American study of the condition conducted to date is provided and its findings are contrasted with observations fro recent nine-county European study of chemical sensitivity. Between-country variations in construction and ventilation practices, choices of furnishings and floor coverings, chemical use (pesticides, fragrances, cleaners), cultural practices (e.g. time spent out-of-doors, window-opening practices), physician awareness/acceptance of the illness, health care systems, compensation practices, and environmental activism may influence the [reported] prevalence and/or recognition of chemical sensitivity.

1995-09-01T00:00:00Z Hattis, Dale R. Goble, Robert Ashford, Nicholas A. https://hdl.handle.net/1721.1/116794 2019-04-11T09:08:45Z 1982-01-01T00:00:00Z

Airborne Lead: A Clearcut Case of Differential Protection Hattis, Dale R.; Goble, Robert; Ashford, Nicholas A.

1982-01-01T00:00:00Z Ashford, Nicholas A. Miller, Claudia S. https://hdl.handle.net/1721.1/116792 2019-04-12T17:15:40Z 1994-09-01T00:00:00Z

Chemical Sensitivity: An Emerging Public Health and Environmental Problem Ashford, Nicholas A.; Miller, Claudia S.

1994-09-01T00:00:00Z Hattis, Dale Ashford, Nicholas A. Heaton, George, R. Katz, Judith I. https://hdl.handle.net/1721.1/116775 2019-04-10T12:40:39Z 1976-02-01T00:00:00Z

Some Consideration in Choosing an Occupational Noise Exposure Regulation Hattis, Dale; Ashford, Nicholas A.; Heaton, George, R.; Katz, Judith I.

1976-02-01T00:00:00Z Frenkel, R. Curtis Priest, W. Ashford, Nicholas A. https://hdl.handle.net/1721.1/116688 2019-04-12T16:26:34Z 1980-01-01T00:00:00Z

Occupational Safety and Health: A Report on Worker Perceptions Frenkel, R.; Curtis Priest, W.; Ashford, Nicholas A.

1980-01-01T00:00:00Z Ashford, Nicholas A. https://hdl.handle.net/1721.1/115917 2019-04-12T23:06:32Z 1987-01-01T00:00:00Z

New Scientific Evidence and Public Health Imperatives Ashford, Nicholas A.

1987-01-01T00:00:00Z Ashford, Nicholas A. https://hdl.handle.net/1721.1/115914 2019-04-12T23:06:32Z 1975-01-01T00:00:00Z

Worker health and safety: an area of conflicts Ashford, Nicholas A.

1975-01-01T00:00:00Z Miller, Claudia S. Ashford, Nicholas A. https://hdl.handle.net/1721.1/115899 2019-04-11T07:55:43Z 1995-01-01T00:00:00Z

Chemical Sensitivity: Perspectives from North America and Europe Miller, Claudia S.; Ashford, Nicholas A.

1995-01-01T00:00:00Z Ashford, Nicholas A. https://hdl.handle.net/1721.1/115867 2019-04-10T14:31:36Z 1999-01-01T00:00:00Z

Low-level chemical sensitivity: implications for research and social policy Ashford, Nicholas A.

1999-01-01T00:00:00Z Miller, Claudia S. Ashford, Nicholas A. https://hdl.handle.net/1721.1/115573 2019-04-12T23:04:01Z 1992-01-01T00:00:00Z

Possible Mechanisms for Multiple Chemical Sensitivity: The Limbic System and Others Miller, Claudia S.; Ashford, Nicholas A.

1992-01-01T00:00:00Z Miller, Claudia S. Ashford, Nicholas A. https://hdl.handle.net/1721.1/115572 2019-04-10T19:15:35Z 1992-01-01T00:00:00Z

Allergy and Multiple Chemical Sensitivities Distinguished Miller, Claudia S.; Ashford, Nicholas A.

1992-01-01T00:00:00Z Ashford, Nicholas A. Miller, Claudia S. https://hdl.handle.net/1721.1/115571 2019-04-12T23:02:40Z 1992-01-01T00:00:00Z

Case Definitions for Multiple Chemical Sensitivity Ashford, Nicholas A.; Miller, Claudia S.

1992-01-01T00:00:00Z Ashford, Nicholas A. Bauman, Patricia Brown, Halina, S. Clapp, Richard, W. Finkel, Adam, M. Gee, David Hattis, Dale, B. Martuzzi, Marco Sasco, Annie, J. Sass, Jennifer, B. https://hdl.handle.net/1721.1/115064 2019-04-12T22:23:35Z 2015-02-13T00:00:00Z

Cancer Risk: Role of environment Ashford, Nicholas A.; Bauman, Patricia; Brown, Halina, S.; Clapp, Richard, W.; Finkel, Adam, M.; Gee, David; Hattis, Dale, B.; Martuzzi, Marco; Sasco, Annie, J.; Sass, Jennifer, B.

2015-02-13T00:00:00Z