ORIGINAL ARTICLE Normative data for the chemical sensitivity scale for sensory hyperreactivity: the Va ¨sterbotten environmental health study Steven Nordin • Eva Palmquist • Mats Bende • Eva Millqvist Received: 19 December 2011 / Accepted: 9 August 2012 Ó Springer-Verlag 2012 Abstract Objectives The chemical sensitivity scale for sensory hyperreactivity (CSS-SHR) is used to quantify affective reactions to and behavioral disruptions by odorous/pungent substances in the environment and has documented good metric properties. However, normative data have not been available. The main objective of the present study was therefore to establish normative data for reference by means of a large-scale population-based study. Materials and methods From a random sample of 8,520 reachable inhabitants in the county of Va ¨sterbotten in Sweden, aged 18–79 years, stratified for age and gender, 3,406 individuals agreed to participate. Results The results show fairly high internal consistency (Cronbach’s a = 0.78–0.83) of the CSS-SHR and that it generates scores with approximately normal distributions (skewness: 0.045–0.454; kurtosis: -0.314 to 0.230), irre- spective of age group and gender. Mean scores, standard deviations, confidence intervals, and proportions of indi- viduals who met the diagnostic cutoff score for the CSS- SHR were obtained for reference of normality. Conclusions CSS-SHR can be recommended for quanti- fication of affective reactions to and behavioral disruptions by odorous/pungent environmental substances, and with the advantage of comparing scores with normality. Keywords Multiple chemical sensitivity Á Normation Á Environmental hypersensitivity Á Population-based Á Reliability Introduction Intolerance to odorous and pungent substances includes the clinical diagnoses multiple chemical sensitivity (Multiple chemical sensitivity: a 1999 consensus 1999), idiopathic environmental intolerance attributed to chemicals (IPCS 1996), and sensory hyperreactivity (SHR; Millqvist 2008). Persons with these intolerances react to common volatile substances, such as perfume and cleaning agents that are tolerated by a majority of the general population. Apart from olfaction, the so-called ‘‘common chemical sense’’ plays an important role for these conditions by mediating pungent sensations of irritation, tickling, burning, warming, cooling, and stinging from, predominantly, the nasal cavity and cornea that are mediated by nociceptors and the tri- geminal nerve (Doty and Cometto-Muniz 2003). Moreover, it is possible that transient receptor potential (TRP) chan- nels, such as TRPA 1 and TRPV 1 , contribute to chemical hypersensitivity, as well as to chronic cough, airway inflammation in asthma, and chronic obstructive pulmon- ary disease (Bessac and Jordt 2008). The symptoms in intolerance to odorous and pungent substances cover a wide range, including airway, affective, cognitive, head-related, cardiac, neuromuscular, musculo- skeletal, and gastrointestinal symptoms (Andersson et al. 2009a). Airway symptoms are particularly common among patients with SHR when exposed to pungent substances. S. Nordin (&) Á E. Palmquist Department of Psychology, Umea ˚ University, 901 87 Umea ˚, Sweden e-mail: steven.nordin@psy.umu.se M. Bende Department of Otorhinolaryngology, Central Hospital, Sko ¨vde, Sweden E. Millqvist Asthma and Allergy Research Group, Sahlgrenska University Hospital, Go ¨teborg, Sweden 123 Int Arch Occup Environ Health DOI 10.1007/s00420-012-0812-2