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One or many environmental intolerance(s)? A cluster analysis over two representative samples.

Tara M Petzke1, Ralph C A Rippe2, Michael Witthöft3

  • 1Université Paris Cité, INSERM U1266, Institut de Psychiatrie et Neuroscience de Paris, 102-108 Rue de la Santé, F-75014 Paris, France; Université Paris Cité, VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), 1 Parvis Notre-Dame, F-75004 Paris, France; Clinical Psychology and Psychotherapy, Ruhr University Bochum, Massenbergstraße 9-13, 44787 Bochum, Germany.

International Journal of Hygiene and Environmental Health
|February 20, 2026
PubMed
Summary
This summary is machine-generated.

Symptoms associated with environmental factors (SAEFs) likely represent a single disorder, not distinct subtypes. Research suggests shared clinical features and potential biopsychosocial determinants across different SAEF presentations.

Keywords:
Electromagnetic hypersensitivityIdiopathic environmental intolerancesK-prototypes clusteringLumping vs. splittingMultiple chemical sensitivityPredictive processingSymptoms associated with environmental factors

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Area of Science:

  • Environmental Health
  • Psychosomatic Medicine
  • Clinical Epidemiology

Background:

  • Symptoms associated with environmental factors (SAEFs) are attributed to various environmental sources, leading to debate on whether these represent distinct disorders or unified conditions.
  • Understanding the underlying characteristics and potential for lumping versus splitting SAEFs is crucial for effective diagnosis and treatment.

Purpose of the Study:

  • To investigate whether different types of SAEFs represent distinct clinical entities or a single, unified disorder.
  • To identify specific characteristics that differentiate or unify individuals experiencing SAEFs.

Main Methods:

  • K-prototypes cluster analysis was performed on two large, population-based datasets from Sweden and Finland (N=1576 and N=1233, respectively).
  • Twenty-three clinically relevant variables were analyzed to identify distinct clusters within the SAEF population.
  • Cluster profiles were inspected to understand the differences and similarities between identified groups.

Main Results:

  • Cluster analysis distinguished individuals with SAEFs from those without, but did not support the existence of empirically distinct SAEF clusters.
  • Key differentiating factors included chemical, noise, and electromagnetic field sensitivity, as well as sleep quality.
  • Individuals within the SAEF cluster exhibited higher scores on psychopathology markers (anxiety, depression) and a higher proportion of women were identified.

Conclusions:

  • The findings support the 'lumping' hypothesis, suggesting that different SAEF subtypes share similar clinical features.
  • This implies that common biopsychosocial determinants may underlie symptom experience across various SAEF subtypes.
  • Individuals with different SAEFs may benefit from similar therapeutic interventions.