https://hdl.handle.net/1721.1/114982 Sat, 11 Apr 2026 09:23:55 GMT 2026-04-11T09:23:55Z https://hdl.handle.net/1721.1/131176 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. Fri, 01 Jan 2021 00:00:00 GMT https://hdl.handle.net/1721.1/131176 2021-01-01T00:00:00Z https://hdl.handle.net/1721.1/130916 Social and Policy Implications of Low-Level Exposures to Chemicals Ashford, Nicholas A.; Miller, Claudia S. Fri, 01 Jan 1999 00:00:00 GMT https://hdl.handle.net/1721.1/130916 1999-01-01T00:00:00Z https://hdl.handle.net/1721.1/130913 The Economic and Social Context of Special Populations Ashford, Nicholas A. Fri, 01 Jan 1999 00:00:00 GMT https://hdl.handle.net/1721.1/130913 1999-01-01T00:00:00Z https://hdl.handle.net/1721.1/130889 Low-level chemical sensitivity: current perspectives Ashford, Nicholas A.; Miller, Claudia S. Mon, 01 Jan 1996 00:00:00 GMT https://hdl.handle.net/1721.1/130889 1996-01-01T00:00:00Z https://hdl.handle.net/1721.1/130635 Multiple Chemical Intolerance and Indoor Air Quality Miller, Claudia S.; Ashford, Nicholas A. Sat, 01 Jan 2000 00:00:00 GMT https://hdl.handle.net/1721.1/130635 2000-01-01T00:00:00Z https://hdl.handle.net/1721.1/116809 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. Fri, 01 Sep 1995 00:00:00 GMT https://hdl.handle.net/1721.1/116809 1995-09-01T00:00:00Z https://hdl.handle.net/1721.1/116794 Airborne Lead: A Clearcut Case of Differential Protection Hattis, Dale R.; Goble, Robert; Ashford, Nicholas A. Fri, 01 Jan 1982 00:00:00 GMT https://hdl.handle.net/1721.1/116794 1982-01-01T00:00:00Z https://hdl.handle.net/1721.1/116792 Chemical Sensitivity: An Emerging Public Health and Environmental Problem Ashford, Nicholas A.; Miller, Claudia S. Thu, 01 Sep 1994 00:00:00 GMT https://hdl.handle.net/1721.1/116792 1994-09-01T00:00:00Z https://hdl.handle.net/1721.1/116775 Some Consideration in Choosing an Occupational Noise Exposure Regulation Hattis, Dale; Ashford, Nicholas A.; Heaton, George, R.; Katz, Judith I. Sun, 01 Feb 1976 00:00:00 GMT https://hdl.handle.net/1721.1/116775 1976-02-01T00:00:00Z https://hdl.handle.net/1721.1/116688 Occupational Safety and Health: A Report on Worker Perceptions Frenkel, R.; Curtis Priest, W.; Ashford, Nicholas A. Tue, 01 Jan 1980 00:00:00 GMT https://hdl.handle.net/1721.1/116688 1980-01-01T00:00:00Z https://hdl.handle.net/1721.1/115917 New Scientific Evidence and Public Health Imperatives Ashford, Nicholas A. Thu, 01 Jan 1987 00:00:00 GMT https://hdl.handle.net/1721.1/115917 1987-01-01T00:00:00Z https://hdl.handle.net/1721.1/115914 Worker health and safety: an area of conflicts Ashford, Nicholas A. Wed, 01 Jan 1975 00:00:00 GMT https://hdl.handle.net/1721.1/115914 1975-01-01T00:00:00Z https://hdl.handle.net/1721.1/115899 Chemical Sensitivity: Perspectives from North America and Europe Miller, Claudia S.; Ashford, Nicholas A. Sun, 01 Jan 1995 00:00:00 GMT https://hdl.handle.net/1721.1/115899 1995-01-01T00:00:00Z https://hdl.handle.net/1721.1/115867 Low-level chemical sensitivity: implications for research and social policy Ashford, Nicholas A. Fri, 01 Jan 1999 00:00:00 GMT https://hdl.handle.net/1721.1/115867 1999-01-01T00:00:00Z https://hdl.handle.net/1721.1/115573 Possible Mechanisms for Multiple Chemical Sensitivity: The Limbic System and Others Miller, Claudia S.; Ashford, Nicholas A. Wed, 01 Jan 1992 00:00:00 GMT https://hdl.handle.net/1721.1/115573 1992-01-01T00:00:00Z https://hdl.handle.net/1721.1/115572 Allergy and Multiple Chemical Sensitivities Distinguished Miller, Claudia S.; Ashford, Nicholas A. Wed, 01 Jan 1992 00:00:00 GMT https://hdl.handle.net/1721.1/115572 1992-01-01T00:00:00Z https://hdl.handle.net/1721.1/115571 Case Definitions for Multiple Chemical Sensitivity Ashford, Nicholas A.; Miller, Claudia S. Wed, 01 Jan 1992 00:00:00 GMT https://hdl.handle.net/1721.1/115571 1992-01-01T00:00:00Z https://hdl.handle.net/1721.1/115064 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. Fri, 13 Feb 2015 00:00:00 GMT https://hdl.handle.net/1721.1/115064 2015-02-13T00:00:00Z