Haanes Jan Vilis, Nordin Steven, Hillert Lena, Witthöft Michael, van Kamp Irene, van Thriel Christoph, Van den Bergh Omer
Department of Occupational and Environmental Medicine, University Hospital of North Norway, NO-9038 Tromsø, Norway; Department of Community Medicine, University of Tromsø, NO-9037 Tromsø, Norway.
Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
J Psychosom Res. 2020 Feb 5;131:109955. doi: 10.1016/j.jpsychores.2020.109955.
Health conditions characterized by symptoms associated with chemical, physical and biological environmental factors unrelated to objectifiable pathophysiological mechanisms are often labelled by the general term "idiopathic environmental intolerances". More specific, exposure-related terms are also used, e.g. "multiple chemical sensitivities", "electromagnetic hypersensitivity" and "candidiasis hypersensitivity". The prevalence of the conditions varies from a few up to more than 50%, depending on definitions and populations. Based on evolving knowledge within this field, we provide arguments for a paradigm shift from terms focusing on exposure and intolerance/(hyper-)sensitivity towards a term more in line with the perceptual elements that seem to underlie these phenomena. Symptoms caused by established pathophysiologic mechanisms should not be included, e.g. allergic or toxicological conditions, lactose intolerance or infections. We discuss different alternatives for a new term/concept and end up proposing an open and descriptive term, "symptoms associated with environmental factors" (SAEF), including a definition. "Symptoms associated with environmental factors" both is in line with the current knowledge and acknowledge the experiences of the afflicted persons. Thus, the proposed concept is likely to facilitate therapy and communication between health professionals and afflicted persons, and to provide a base for better understanding of such phenomena in healthcare, society and science.
以与化学、物理和生物环境因素相关的症状为特征，但与可客观化的病理生理机制无关的健康状况，通常被统称为“特发性环境不耐受”。也会使用更具体的、与暴露相关的术语，例如“多重化学敏感性”、“电磁超敏反应”和“念珠菌超敏反应”。这些状况的患病率因定义和人群而异，从百分之几到超过50%不等。基于该领域不断发展的知识，我们提出理由支持从关注暴露和不耐受/（超）敏反应的术语向更符合这些现象背后感知因素的术语转变。由既定病理生理机制引起的症状不应包括在内，例如过敏或毒理学状况、乳糖不耐受或感染。我们讨论了新术语/概念的不同备选方案，最终提出了一个开放且具有描述性的术语“与环境因素相关的症状”（SAEF），并给出了定义。“与环境因素相关的症状”既符合当前知识，又认可患者的经历。因此，所提出的概念可能有助于医疗专业人员与患者之间的治疗和沟通，并为在医疗保健、社会和科学领域更好地理解此类现象提供基础。
