What the Nose Knows - Avery Gilbert [54]
Twenty years after the Pleasure Faire, people in Marin County were once more channeling a Medieval mind-set, and this time it wasn’t fun and games. Like a pitchfork-wielding rabble demanding protection from plague-inducing vapors, antifragrance activists were out to ban perfume because they believed it was making them sick. They objected not just to perfume, but to the lingering scent of shampoo, body lotion, hair spray, deodorant, laundry detergent, and fabric softener. Protesting at a perfume industry meeting in San Francisco, activists wore respirators and carried a prop barrel labeled CALVIN KLEIN and TOXIC CHEMICALS. The “disability coordinator” for the San Francisco mayor’s office joined the fray. “Ten years from now it will be politically incorrect to wear perfumes in public,” he proclaimed. Even by the flamboyant standards of the Bay Area, this was great political theatre. But it raised an important question: Can a smell actually make us sick?
THE PROTESTERS were people who suffered from what they called Multiple Chemical Sensitivity, or MCS. They claimed to be so sensitive to chemicals in perfume that the slightest whiff would trigger symptoms. I spoke with several MCS patients at the time, and was struck by how unhappy and miserable they were. Their extreme efforts to avoid scented people and smelly places made them virtual shut-ins. One woman had moved her family to the Arizona desert in the hope that living in an isolated trailer custom-built with “nontoxic” metal and tile surfaces would solve her problem. It didn’t. It was clear to me that these folks were genuinely distressed and deserving of sympathy. What wasn’t clear to me was the nature of their illness.
Despite numerous investigations by medical experts and public health authorities, including the World Health Organization, there is no precise definition of MCS. According to a paper in Occupational and Environmental Medicine, it is “a poorly understood and controversial syndrome. Common symptoms include fatigue, difficulty concentrating, pounding heart, shortness of breath, anxiety, headache, and muscle tension. They occur ‘in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful effects. No single widely accepted test of physiological function can be shown to correlate with symptoms.’” The American Medical Association looked into MCS and decided in 1991 not to recognize it as an official diagnosis. In the meantime, MCS has been renamed Idiopathic Environmental Intolerance (or IEI) to reflect the fact that it has no known cause (i.e., it is idiopathic).
Amid all this confusion, IEI patients are consistent about one thing: they claim to be far more sensitive to odors than are other people. This is an easily testable proposition, and numerous studies have compared the olfactory sensitivity of IEI patients and healthy controls (matched for age and sex). The results consistently show no difference between the groups in odor-detection thresholds. In this strict sense, IEI sufferers are no more sensitive to odor than anyone else.
There are some differences in how IEI patients and healthy people respond to odor, however. For example, patients find the rosy scent of phenylethyl alcohol less pleasant than nonpatients, and they are more likely to report eye/nose/throat irritation in response to it. In another test, IEI patients and controls were confirmed to have similar levels of odor sensitivity. They were then exposed for ten minutes to unscented air or to air with a barely detectable level of 2-propanol (rubbing alcohol). Only 10 percent of normal volunteers reported physical symptoms in either condition. In contrast, 30 percent of the patients reported symptoms to both scented and unscented air. This exaggerated subjective response implies a difference