William S. Cain

Evaluation of olfactory dysfunction in the connecticut chemosensory clinical research center

The olfactory test administered to patients at the Connecticut Chemosensory Clinical Research Center combines stability of outcome with sensitivity to variables known to affect olfaction (age, sex). The test, which pairs an odor threshold component with an odor identification component, readily resolves differences in function between patients and controls. It reveals differences in the distribution of functioning for various probable causes (nasal/sinus disease, postupper respiratory infection, and head trauma), proves sensitive to improvements in function caused by therapeutic intervention (ethmoidectomy, steroid administration for nasal/sinus disease), and correlates with objective signs of nasal/sinus disease (visual exam, x‐ray). The two components of the test agree well, though the odor identification component seems somewhat more sensitive than the threshold component as currently designed.

Ventilation rates and health: multidisciplinary review of the scientific literature

UNLABELLED The scientific literature through 2005 on the effects of ventilation rates on health in indoor environments has been reviewed by a multidisciplinary group. The group judged 27 papers published in peer-reviewed scientific journals as providing sufficient information on both ventilation rates and health effects to inform the relationship. Consistency was found across multiple investigations and different epidemiologic designs for different populations. Multiple health endpoints show similar relationships with ventilation rate. There is biological plausibility for an association of health outcomes with ventilation rates, although the literature does not provide clear evidence on particular agent(s) for the effects. Higher ventilation rates in offices, up to about 25 l/s per person, are associated with reduced prevalence of sick building syndrome (SBS) symptoms. The limited available data suggest that inflammation, respiratory infections, asthma symptoms and short-term sick leave increase with lower ventilation rates. Home ventilation rates above 0.5 air changes per hour (h(-1)) have been associated with a reduced risk of allergic manifestations among children in a Nordic climate. The need remains for more studies of the relationship between ventilation rates and health, especially in diverse climates, in locations with polluted outdoor air and in buildings other than offices. PRACTICAL IMPLICATIONS Ventilation with outdoor air plays an important role influencing human exposures to indoor pollutants. This review and assessment indicates that increasing ventilation rates above currently adopted standards and guidelines should result in reduced prevalence of negative health outcomes. Building operators and designers should avoid low ventilation rates unless alternative effective measures, such as source control or air cleaning, are employed to limit indoor pollutant levels.

Taste and olfaction: Independence vs interaction ☆

Abstract Twenty persons sipped and judged overall perceived magnitude, odor magnitude, and taste magnitude of various concentrations of the odorant citral, the tastants sodium chloride and sucrose, and odorant-tastant combinations. In a second experiment, the same twenty persons sniffed and judged perceived odor magnitude for the same set of stimuli. The investigation probed two primary questions: Does the apparent harmony of an olfactory-taste mixture dictate the degree of additivity in that mixture? Does harmony of the components influence the production of any taste-smell confusion? The data from both the harmonious mixture (citral and sucrose) and the dissonant mixture (citral and NaCl) imply absence of sensory inhibition or facilitation between taste and olfaction. Nevertheless, both types of mixtures led to substantial taste-smell confusion whereby olfactory stimulation evoked sensations of taste.

Odor recognition: familiarity, identifiability, and encoding consistency.

The investigation examined the association between the perceived identity of odorous stimuli and the ability to recognize the previous occurrence of them. The stimuli comprised 20 relatively familiar odorous objects such as chocolate, leather, popcorn, and soy sauce. Participants rated the familiarity of the odors and sought to identify them. At various intervals up to 7 days after initial inspection, the participants sought to recognize the odors among sets of distractor odors that included such items as soap, cloves, pipe tobacco, and so on. The recognition response entailed a confidence rating as to whether or not an item had appeared in the original set. At the time of testing, the participants also sought to identify the stimuli again. The results upheld previous findings of excellent initial recognition memory for environmentally relevant odors and slow forgetting. The results also uncovered, for the first time, a strong association between recognition memory and identifiability, rated familiarity, and the ability to use an odor label consistently at inspection and subsequent testing. Encodability seems to enhance rather than to permit recognizability. Even items identified incorrectly or inconsistently were recognized at levels above chance.

Clinical evaluation of olfaction

An odor identification test and an odor threshold test offered satisfactory quantitative information on olfactory function in patients with chemosensory complaints. The threshold test used various concentrations of butanol presented in an ascending sequence. On each trial, the participant had to choose between stimulus and blank (two-alternative forced-choice procedure). The identification test used common odorous items (e.g., baby powder and ground coffee) and pungent items (e.g., ammonia) to test trigeminal function. A list of odor names and use of corrective feedback during testing overcame word-finding difficulty in odor identification. Each test readily distinguished between patients and control subjects. At present, a score that reflects the combined outcome of the tests is used to indicate five categories of functioning: normal osmesis, mild hyposmia, moderate hyposmia, severe hyposmia, and anosmia.

Olfactory sensitivity: Reliability, generality, and association with aging.

Thirty-two Ss between 22 and 59 years of age yielded detection thresholds for 4 odorants over 4 sessions. The thresholds decreased and reliability increased over the course of testing. High intercorrelations between odorants and the stability of an Ss relative position within the threshold distributions showed that a general factor of sensitivity dominated the outcome. Age contributed strongly to intersubject variation. Even among these nonelderly individuals, it accounted for up to 2 orders of magnitude in threshold performance. Other important factors included superiority of the right nostril and a negative correlation between the mean and variance of threshold distributions. Scant attention to the correlation may have contributed to overestimation of the frequency and specificity of specific anosmia. A clinically relevant outcome was that measurement of threshold for diagnostic purposes can generally rely on just 1 odorant.

Thresholds for odor and nasal pungency.

Detection thresholds were measured repeatedly for 11 chemicals in normosmic and anosmic subjects. The stimuli comprised the first eight members of the series of n-aliphatic alcohols, phenyl ethyl alcohol, pyridine, and menthol. Results showed that anosmics could detect, via pungency, all but phenyl ethyl alcohol reliably. In the aliphatic series, both odor and pungency thresholds declined with chain length in a way that implied dependence of both in part on phase distribution in the mucosa. Odor thresholds, however, declined more rapidly than pungency thresholds: the ratio of anosmics threshold/normosmics threshold increased from 23 for methanol to 10,000 for 1-octanol. The outcome of a scaling experiment employing normosmic subjects indicated that, with the exception of methanol and ethanol, pungency arose when perceived intensity reached a narrowly tuned criterion level. When thresholds were expressed as percentages of saturated vapor, an index of thermodynamic activity, thereby accounting for differences in solubility and in phase distribution in the mucosa among the various stimuli, both odor and pungency thresholds depicted a striking constancy across stimuli.

Improving the Health of Workers in Indoor Environments: Priority Research Needs for a National Occupational Research Agenda

Indoor nonindustrial work environments were designated a priority research area through the nationwide stakeholder process that created the National Occupational Research Agenda. A multidisciplinary research team used member consensus and quantitative estimates, with extensive external review, to develop a specific research agenda. The team outlined the following priority research topics: building-influenced communicable respiratory infections, building-related asthma/allergic diseases, and nonspecific building-related symptoms; indoor environmental science; and methods for increasing implementation of healthful building practices. Available data suggest that improving building environments may result in health benefits for more than 15 million of the 89 million US indoor workers, with estimated economic benefits of

Nasal pungency and odor of homologous aldehydes and carboxylic acids

5 to

Scope and evaluation of odor counteraction and masking.

75 billion annually. Research on these topics, requiring new collaborations and resources, offers enormous potential health and economic returns.