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We identified optimal cutoff scores for three questionnaire instruments that quantify environmental annoyance (affective reactions and behavioral disruptions) attributed to everyday environmental e ...

The objective was to develop, metrically evaluate and establish normative data for the Environmental Symptom-Attribution Scale (ESAS), which is a questionnaire-based instrument for quantifying degree to which health symptoms are attributed to specific environmental exposures and sources. Data were used from 3406 individuals who took part in the Vasterbotten Environmental Health Study in Sweden. The responders constitute a random sample, aged 18–79 years. They responded to the ESAS and to questions about physician-based diagnoses for evaluation of concurrent validity of the ESAS. Four dimensions of the ESAS were identified, constituting subscales: the Odorous/Pungent, Building-Related, Sound, and Electromagnetic Field Subscales. A Global Scale is available as well. In general, the distributions of the scores on the scales were positively skewed and leptokurtic in shape. The results demonstrate good reliability and concurrent validity of all five ESAS scales. Percentiles were obtained as normative data. Examples of use of the ESAS applied on individuals are provided. The favorable metric properties of the ESAS and its rapid administration suggest that it is useful for assessment in clinical and epidemiological settings.

Calibration with the master-scale procedure provides a defined unit of measurement for direct comparison between subjective reports from different individuals, obtained at different occasions, and in different contextual settings. A standard set of reference stimuli and the environmental target stimulus are rated on the same scale. The applicability of this procedure was demonstrated by applying it to odor annoyance from environmental pollution at three sites in communities with steel industry (Study 1) and bio-fuel processing (Study 2). Series of pyridine concentrations were used as reference stimuli that, together with the environmental target stimuli, were judged with magnitude estimation by participants with normal olfactory function. The results provide annoyance estimates for each of the six sites expressed in master-scale units and in pyridine equivalents that are directly comparable with each other and with those from other environmental studies using this procedure.

The Chemical Sensitivity Scale (CSS) is used to quantify affective reactions to and behavioral disruptions by odorous/pungent substances in the environment, and has good test–retest reliability, good internal consistency, satisfying predictive and concurrent validity, and two major dimensions. However, to enable identification of hypersensitive individuals, the objective of the present study was to collect normative data for reference, by means of a population-based study. From the sample of the Skovde, general population-based study, a sub-sample of 693 individuals was drawn, stratified in proportion to age and gender. In total, 596 individuals (86%), aged 20–88 years, agreed to participate by responding to the CSS. The results show that the CSS generates approximately normal distributions, irrespective of age group and gender. Furthermore, CSS scores were found to be higher in elderly than in young and middle-aged adults, and higher in women than in men. Obtained standard deviations and confidence intervals may be used for reference, such as for criteria for identifying individuals with environmental hypersensitivity to odorous/pungent substances.

A questionnaire-based tool for quantifying self-reported affective reactions to and behavioral disruptions by odorous/pungent substances, called the Chemical Sensitivity Scale (CSS), analogous to the Noise Sensitivity Scale (NSS), was evaluated regarding psychometric properties. Twenty-six members from the Swedish Asthma and Allergy Association and 124 control participants responded to the CSS, the NSS, and to additional questions for evaluation of the validity of the CSS and NSS. The results showed that the CSS generates approximately normal distributions, has good test–retest reliability ( r xy =0.87), good internal consistency ( r α =0.88), and satisfying predictive and concurrent validity. These metric properties of the CSS and NSS were in general very similar. The content validity of the CSS is discussed. Two major dimensions of the CSS appear to represent sensory/somatic and neurasthenic symptoms, respectively. The analogy of the CSS to the NSS implies that use of both scales in combination may enhance understanding for the issue of general environmental sensitivity versus specific sensitivity to chemicals. Correlation coefficients between CSS and NSS scores for the asthma and allergy members ( r xy =0.40) and controls ( r xy =0.42) imply a moderate correspondence between chemical and noise sensitivity.