Do You Have Chemical Sensitivity? Answering Just Three Questions Can Tell You

If you think you may be suffering from chemical intolerance now there is a new quick and easy way for you and your healthcare team to determine whether that is the case.  To increase screening of chemical intolerance, researchers have developed and validated a three-question survey that can be incorporated into patient visits within a minute. The new brief inventory can help identify those at risk for anything from COVID-19 disinfectants (including the ones that some manufacturers have been spraying inside designer face masks–yuk!), to wildfire smoke containing toxic chemicals from sick buildings, to volatile organic compounds (VOCs) leaching from household building materials, to pesticides and molds, to chemical additives in your food and medicines–any chemicals that endanger chemically-susceptible individuals.


Prior research and clinical reports have demonstrated that intolerance to chemicals, foods and drugs impact anywhere from 8% to an alarming 33% of individuals–yet few people are screened for it at their doctors’ offices.

To address this problem and increase awareness of chemical intolerance, researchers at The University of Texas Health Science Center at San Antonio (UT Health San Antonio) developed and validated a three-question, yes-or-no survey that primary care providers, allergists, dermatologists and other specialists can incorporate into patient visits. The survey, called the Brief Environmental Exposure and Sensitivity Inventory, or BREESI, can also be used by researchers and patient groups, and for epidemiological studies in exposed populations.

About the BREESI Chemical Intolerance Short Test

The researchers measuring the accuracy of BREESI reported the short test accurately predicts scores on the more comprehensive 50-question survey called the Quick Environmental Exposure and Sensitivity Inventory (QEESI). The QEESI, which the UT Health San Antonio group introduced online back in 2014, is available at no charge to patients and clinicians. Researchers worldwide are using it, making it the new standard for measuring chemical intolerance.

Predictive value of the BREESI Short Test

The BREESI focuses on three different exposure categories: chemical inhalants, drugs/medications and foods/food additives. The research team enrolled 293 volunteers from a university-based primary care clinic and online to complete the BREESI and QEESI.

“The BREESI showed high sensitivity and specificity,” according to the authors.

  • Of respondents who said “yes” to all three BREESI questions, 90% had scores “very suggestive” of chemical intolerance.
  • Of those who said “no” to all three BREESI questions, 95% had scores “not suggestive” of chemical intolerance.

The Merits of the BREESI Test

Here at we have been using the comprehensive 50-question survey Quick Environmental Exposure and Sensitivity Inventory (QEESI) in our work consulting with clients and we will now also be incorporating the Brief Environmental Exposure and Sensitivity Inventory (BREESI) for quick assessments.  But there are also several other applications for which rapid screening using the quick BREESI test is perfect…

“Only a minute or two is required to administer the BREESI, making routine evaluation of chemical intolerance feasible for medical and surgical workups, epidemiological investigations, and before-and-after studies of environmental exposure events such as the Gulf War burn pits or 9/11.

-Claudia S. Miller, MD, MS, professor emeritus, Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health, San Antonio

Additionally, the researchers note that the quick screening test can be used to identify misuse of disinfectants to combat COVID-19 that may be endangering susceptible individuals, as well as combustion products from the wildfires currently affecting so many people in the western states. People who are pregnant or plan on becoming pregnant and their offspring can be better protected if they are identified as having chemical sensitivity during their regular healthcare visits.  Additionally, the test can quickly identify those people highly sensitive to outgassing of volatile organic chemicals (VOCs) from new construction, home remodeling and “sick” buildings–all of which are known to frequently trigger chemically intolerant individuals’ symptoms.

The BREESI Quick Screening Tool Should Have Broad Applications

“Quick screening questionnaires are used routinely in clinics today, e.g., for quality of life or substance abuse, or reactions to antibiotics or latex, and we believe chemical intolerance also needs to be assessed routinely, given its high prevalence.

-Ray Palmer, PhD, professor of family and community medicine, University of Texas Health, San Antonio

The Quick Environmental Exposure and Sensitivity Inventory (BREESI) Quick Assessment Test for Chemical Sensitivity

The Quick Environmental Exposure and Sensitivity Inventory (QEESI) 50-Question Test for Chemical Sensitivity

Journal Reference:  Raymond F. Palmer, Carlos R. Jaén, Roger B. Perales, Rodolfo Rincon, Jacqueline N. Forster, Claudia S. Miller. Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI). PLOS ONE, 2020; 15 (9): e0238296 DOI: 10.1371/journal.pone.0238296