Top

International Archives of Occupational and Environmental Health

Published in:

01-05-2006 | Review

Olfactory dysfunction and its measurement in the clinic and workplace

Author: Richard L. Doty

Published in: International Archives of Occupational and Environmental Health | Issue 4/2006

Abstract

Objectives: To provide an overview of practical means for quantitatively assessing the sense of smell in both the clinic and workplace. To address basic measurement issues, including those of test sensitivity, specificity, and reliability. To describe and discuss factors that influence olfactory function, including airborne toxins commonly found in industrial settings. Methods: Selective review and discussion. Results: A number of well-validated practical threshold and suprathreshold tests are available for assessing smell function. The reliability, sensitivity, and specificity of such techniques vary, being influenced by such factors as test length and type. Numerous subject factors, including age, sex, health, medications, and exposure to environmental toxins, particularly heavy metals, influence the ability to smell. Conclusions: Modern advances in technology, in conjunction with better occupational medicine practices, now make it possible to reliably monitor and limit occupational exposures to hazardous chemicals and their potential adverse influences on the sense of smell. Quantitative olfactory testing is critical to establish the presence or absence of such adverse influences, as well as to (a) detect malingering, (b) establish disability compensation, and (c) monitor function over time.

Adams RG, Crabtree N (1961) Anosmia in alkaline battery workers. Br J Ind Med 18:216–221PubMed

Ahlstrom R, Berglund B, Berglund U, Lindvall T, Wennberg A (1986) Impaired odor perception in tank cleaners. Scand J Work Environ Health 12:574–581PubMed

Amoore JE (1986) Effects of chemical exposure on olfaction in humans. In: Barrows CS (ed) Toxicology of the nasal passages. Hemisphere Publishing Corporation, Washington, pp 155–190

Amoore JE, Ollman BG (1983) Practical test kits for quantitatively evaluating the sense of smell. Rhinology 21:49–54PubMed

Anderson J, Maxwell L, Murphy C (1992) Odorant identification testing in the young child. Chem Senses 17:590

Bolla KI, Schwartz BS, Stewart W, Rignani J, Agnew J, Ford DP (1995) Comparison of neurobehavioral function in workers exposed to a mixture of organic and inorganic lead and in workers exposed to solvents. Am J Ind Med 27:231–246PubMedCrossRef

Cain WS, Gent J, Catalanotto FA, Goodspeed RB (1983) Clinical evaluation of olfaction. Am J Otolaryngol 4:252–256PubMedCrossRef

Cain WS, Gent JF (1991) Olfactory sensitivity: reliability, generality, and association with aging. J Exp Psychol Hum Percept Perform 17:382–391PubMedCrossRef

Chalke HD, Dewhurst JR, Ward CW (1958) Loss of smell in old people. Pub Health 72:223–230CrossRef

Choudhury ES, Moberg P, Doty RL (2003) Influences of age and sex on a microencapsulated odor memory test. Chem Senses 28:799–805PubMedCrossRef

Corwin J, Loury M, Gilbert AN (1995) Workplace, age, and sex as mediators of olfactory function: data from the National Geographic Smell Survey. J Gerontol Ser B Psychol Sci Soc Sci 50:179–186

Dalton P, Cowart B, Dilks D, Gould M, Lees PSJ, Stefaniak A, Emmett EA (2003) Olfactory function in workers exposed to styrene in the reinforced-plastics industry. Am J Ind Med 44:1–11PubMedCrossRef

Deems DA, Doty RL, Settle RG, Moore-Fillon V, Shaman P, Mester AF, Kimmelman CP, Brightman VJ, Snow JB Jr (1991) Smell and taste disorders: a study of 750 patients from the University of Pennsylvania Smell and Taste Center (1981–1986). Arch Otolaryngol Head Neck Surg 117: 519–528PubMed

Doty RL (1986) Gender and endocrine-related influences upon olfactory sensitivity. In: Meiselman HL, Rivlin RS (eds) Clinical measurement of taste and smell. MacMillan, New York, pp 377–413

Doty RL (1995) The Smell Identification Test^TM Administration Manual, 3rd edn. Sensonics, Inc., Haddon Hts

Doty RL (2000) Odor Threshold Test^TM, Administration Manual. Sensonics, Inc., Haddon Hts., NJ

Doty RL (2003a) Odor perception in neurodegenerative diseases. In: Doty RL (ed) Handbook of olfaction and gustation, 2nd edn. Marcel Dekker, New York, pp 479–502

Doty RL (2003b) Introduction and historical perspective. In: Doty RL (ed) Handbook of olfaction and gustation, 2nd edn. Marcel Dekker, New York, pp xv–xlv

Doty RL, Applebaum S, Zusho H, Settle RG (1985a) Sex differences in odor identification ability: a cross-cultural analysis. Neuropsychologia 23:667–672PubMedCrossRef

Doty RL, Bartoshuk LM, Snow JB Jr (1991) Causes of olfactory and gustatory disorders. In: Getchell TV, Doty RL, Bartoshuk LM, Snow JB Jr (eds) Smell and taste in health and disease. Raven Press, New York, pp 449–461

Doty RL, Bromley SM, Stern MB (1995a) Olfactory testing as an aid in the diagnosis of Parkinson’s disease: development of optimal discrimination criteria. Neurodegeneration 4:93–97PubMedCrossRef

Doty RL, Diez JM, Turnacioglu S, McKeown DA, Glendhill J, Armstrong K, Lee WW (2003) Influences of feedback and ascending and descending trial presentations on perithreshold odor detection performance. Chem Senses 28:523–526PubMedCrossRef

Doty RL, Frye RE, Agrawal U (1989) Internal consistency reliability of the fractionated and whole University of Pennsylvania Smell Identification Test. Percept Psychophys 45:381–384PubMed

Doty RL, Hastings L (2001) Neurotoxic exposure and olfactory impairment. Clin Occupat Environ Med 1:547–575

Doty RL, Laing DG (2003) Psychophysical measurement of olfactory function, including odorant mixture assessment. In: Doty RL (ed) Handbook of olfaction and gustation, 2nd edn. Marcel Dekker, New York, pp 203–228

Doty RL, Marcus A, Lee WW (1996) Development of the 12-item cross-cultural smell identification test (CC-SIT). Laryngoscope 106:353–356PubMedCrossRef

Doty RL, McKeown DA, Lee WW, Shaman P (1995b) A study of the test–retest reliability of ten olfactory tests. Chem Senses 20:645–656PubMedCrossRef

Doty RL, Newhouse MG, Azzalina JD (1985b) Internal consistency and short-term test–retest reliability of the University of Pennsylvania Smell Identification Test. Chem Senses 10:297–300CrossRef

Doty RL, Shaman P, Applebaum SL, Giberson R, Siksorski L, Rosenberg L. (1984a) Smell identification ability: changes with age. Science 226:1441–1443PubMedCrossRef

Doty RL, Shaman P, Dann M (1984b) Development of the University of Pennsylvania Smell Identification Test: a standardized microencapsulated test of olfactory function. Physiol Behav 32:489–502PubMedCrossRef

Doty RL, Smith R, McKeown DA, Raj J (1994) Tests of human olfactory function: principal components analysis suggests that most measure a common source of variance. Percept Psychophys 56:701–707PubMed

Double KL, Rowe DB, Hayes M, Chan DK, Blackie J, Corbett A, Joffe R, Fung VS, Morris J, Halliday GM (2003) Identifying the pattern of olfactory deficits in Parkinson disease using the brief smell identification test. Arch Neurol 60:545–549PubMedCrossRef

Duff K, McCaffrey RJ, Solomon GS (2002) The Pocket Smell Test: successfully discriminating probable Alzheimer’s dementia from vascular dementia and major depression. J Neuropsychiatr Clin Neurosci 14:197–201

Elsberg CA, Levy I (1935) The sense of smell: I. A new and simple method of quantitative olfactometry. Bull Neurol Inst NY 4:5–19

Fechner GT (1860) Elemente der Psychophysik. Breitkopf & Härtel, Leipzig

Feron F, Perry C, McGrath JJ, Mackay S (1998) New techniques for biopsy and culture of human olfactory epithelial neurons. Arch Otolaryngol Head Neck Surg 124:861–866PubMed

Friberg L (1950) Health hazards in the manufacture of akaline accumulators with special reference to chronic cadmium poisoning. Acta Med Scand 138:1–124

Frye RE, Schwartz BS, Doty RL (1990) Dose-related effects of cigarette smoking on olfactory function. JAMA 263:1233–1236PubMedCrossRef

Furuta S, Nishimoto K, Egawa M, Ohyama M, Moriyama H (1994) Olfactory dysfunction in patients with Minamata disease. Am J Rhinol 8:259–263CrossRef

Gibbons B (1986) The intimate sense of smell. Nat Geogr Mag 170:324–361

Green BG, Dalton P, Cowart B, Shaffer G, Rankin K, Higgins J (1996) Evaluating the ‘Labeled Magnitude Scale’ for measuring sensations of taste and smell. Chem Senses 21:323–334PubMedCrossRef

Guilford JP (1954) Psychometric methods. McGraw-Hill, New York

Harada N, Fujii M, Dodo H (1983) Olfactory disorders in chemical plant workers exposed to SO₂ and/or NH₃. J Sci Labour 59:17–23

Hashimoto Y, Fukazawa K, Fujii M, Takayasu S, Muto T, Saito S, Takashima Y, Sakagami M (2004) Usefulness of the odor stick identification test for Japanese patients with olfactory dysfunction. Chem Senses 29:565–571PubMedCrossRef

Hastings L, Miller ML (2003) Influence of environmental toxicants on olfactory function. In: Doty RL (ed) Handbook of olfaction and gustation, 2nd edn. Marcel Dekker, New York, pp 575–591

Heywood PG, Costanzo RM (1986) Identifying normosmics: a comparison of two populations. Am J Otolaryngol 7:194–199PubMedCrossRef

Hirsch AR, Zavala G (1999) Long-term effects on the olfactory system of exposure to hydrogen sulphide. Occupat Environ Med 56:284–287

Holstrom M, Wilhelmsson B (1988) Respiratory symptoms and pathophysiological effects of occupational exposure to formaldehyde and wood dust. Scand J Work Environ Health 14:306–311

Hudson R, Arriola A, Martinez-Gomez M, Distel H (2004) Effect of air pollution on olfactory function in residents of Mexico City. In: Association for chemoreception abstracts. Sarasota, p 100

Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) ‘Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22:39–52PubMedCrossRef

Jackman AH, Doty RL (2005) Utility of a 3-item smell identification test in detecting olfactory dysfunction. Laryngoscope 115:2209–2212PubMedCrossRef

Jones FN (1955) Olfactory absolute thresholds and their implications for the nature of the receptor process. J Psychol 40:223–227

Jones FN (1953) A test of the validity of the Elsberg method of olfactometry. Am J Psychol 66:401–409CrossRef

Katzenschlager R, Zijlmans J, Evans A, Watt H, Lees AJ (2004) Olfactory function distinguishes vascular parkinsonism from Parkinson’s disease. J Neurol Neurosurg Psychiat 75:1749–1752PubMedCrossRef

Kern RC (2000) Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa. Laryngoscope 110:1071–1077PubMedCrossRef

Kern RC, Conley DB, Haines GK III, Robinson AM (2004) Pathology of the olfactory mucosa: implications for the treatment of olfactory dysfunction. Laryngoscope 114:279–285PubMedCrossRef

Kilburn KH, Seidman BC, Warshaw R (1985) Neurobehavioral and respiratory symptoms of formaldehyde and xylene exposure in histology technicians. Arch Enviorn Health 40:229–233

Kobal G (2003) Electrophysiological measurement of olfactory function. In: Doty RL (eds) Handbook of olfaction and gustation, 2nd edn. Marcel Dekker, New York, pp 229–249

Kobal G, Hummel T, Sekinger B, Barz S, Roscher S, Wolf (1996) “Sniffin’ sticks”: screening of olfactory performance. Rhinology 34:222–226PubMed

Koelega HS (1979) Olfaction and sensory asymmetry. Chem Senses Flav 4:89–95CrossRef

Lawless HT, Malone GT (1986a) The discrimination efficiency of common scaling methods. J Sens Stud 1:85–98CrossRef

Lawless HT, Malone GT (1986b) A comparison of rating scales: sensitivity, replicates and relative measurement. J Sens Stud 1:155–174CrossRef

Lee SH, Lim HH, Lee HM, Park HJ, Choi JO (2000) Olfactory mucosal findings in patients with persistent anosmia after endoscopic sinus surgery. Ann Otol Rhinol Laryngol 109:720–725PubMed

Lehrner J, Deecke L (1999) Die Wiener Olfaktorische Testbatterie (WOTB). Akt Neurologie 26:1–8CrossRef

Linschoten MR, Harvey LO Jr, Eller PM, Jafek BW (2001) Fast and accurate measurement of taste and smell thresholds using a maximum-likelihood adaptive staircase procedure. Percept Psychophys 63:1330–1347PubMed

Liu HC, Wang SJ, Lin KP, Lin KN, Fuh JL, Teng EL (1995) Performance on a smell screening test (the MODSIT): a study of 510 predominantly illiterate Chinese subjects. Physiol Behav 58:1251–1255PubMedCrossRef

Lötsch J, Lange C, Hummel T (2004) A simple and reliable method for clinical assessment of odor thresholds. Chem Senses 29:311–317PubMedCrossRef

Mascagni P, Consonni D, Bregante G, Chiappino G, Toffoletto F (2003) Olfactory function in workers exposed to moderate airborne cadmium levels. Neurotoxicology 24:717–724PubMedCrossRef

Mergler D, Beauvais B (1992) Olfactory threshold shift following controlled 7-hour exposure to toluene and/or xylene. Neurotoxicology 13:211–215PubMed

Moberg PJ, Doty RL, Turetsky BI, Arnold SE, Mahr RN, Gur RC, Bilker W, Gur RE (1997) Olfactory identification deficits in schizophrenia: correlation with duration of illness. Am J Psychiat 154:1016–1018PubMed

Nordin S, Bramerson A, Liden E, Bende M (1999) The Scandinavian Odor-Identification Test: development, reliability, validity and normative data. Acta Otolaryngol 118:226–234

Nordin S, Bramerson A, Liden E, Bende M (1998) The Scandinavian Odor-Identification Test: development, reliability, validity and normative data. Acta Otolaryngol 118:226–234PubMedCrossRef

Potts CL (1965) Cadmium proteinuria—the health of battery workers exposed to cadmium oxide dust. Ann Occup Hygiene 8:55–61

Prah JD, Benignus VA (1979) Decrements in olfactory sensitivity due to ozone exposure. Percept Mot Skills 48:317–318PubMed

Punter PH (1983) Measurement of human olfactory thresholds for several groups of structurally related compounds. Chem Senses 7:215–235CrossRef

Rose CS, Heywood PG, Costanzo RM (1992) Olfactory impairment after chronic occupational cadmium exposure. J Occup Med 34:600–605PubMed

Rovee CK, Cohen RY, Shlapack W (1975) Life-span stability in olfactory sensitivity. Dev Psychol 11:311–318CrossRef

Rydzewski B, Sulkowski W, Miarzynska M (1998) Olfactory disorders induced by cadmium exposure: a clinical study. Internat J Occupat Med Environ Health 11:235–245

Sandmark B, Broms I, Lofgren L, Ohlson CG (1989) Olfactory function in painters exposed to organic solvents. Scand J Work Environ Health 15:60–63PubMed

Santos DV, Reiter ER, DiNardo LJ, Costanzo RM (2004) Hazardous events associated with impaired olfactory function. Arch Otolaryngol Head Neck Surg 130:317–319PubMedCrossRef

Schwartz BS, Bolla KI, Stewart W, Ford DP, Agnew J, Frumkin H (1993) Decrements in neurobehavioral performance associated with mixed exposure to organic and inorganic lead. Am J Epidemiol 137:1006–1021PubMed

Schwartz BS, Doty RL, Monroe C, Frye R, Barker S (1989) Olfactory function in chemical workers exposed to acrylate and methacrylate vapors. Am J Pub Health 79:613–618PubMed

Schwartz BS, Ford DP, Bolla KI, Agnew J, Rothman N, Bleecker ML (1990) Solvent-associated decrements in olfactory function in paint manufacturing workers. Am J Ind Med 18:697–706PubMedCrossRef

Segal NL, Brown KW, Topolski TD (1992) A twin study of odor identification and olfactory sensitivity. Acta Genet Med Gemellol 41:113–121PubMed

Segal NL, Topolski TD, Wilson SM, Brown KW, Araki L (1995) Twin analysis of odor identification and perception. Physiol Behav 57:605–609PubMedCrossRef

Ship JA, Weiffenbach JM (1993) Age, gender, medical treatment, and medication effects on smell identification. J Gerontol 48:M26–M32PubMed

Simmen D, Briner HR, Hess K (1999) Screening test des Geruchssinnes mit Riechdisketten. Laryngorhinootologie 78:125–130PubMed

Smith CG (1935) The change in volume of the olfactory and accessory olfactory bulbs of the albino rat during postnatal life. J Comp Neurol 61:477–508CrossRef

Stevens JC, Cain WS, Burke RJ (1988) Variability of olfactory thresholds. Chem Senses 13:643–653CrossRef

Stevens SS (1936) A scale for the measurement of psychological magnitude: loudness. Psychol Rev 43:405–416CrossRef

Sun TJ, Miller ML, Hastings L (1996) Effects of inhalation of cadmium on the rat olfactory system: behavior and morphology. Neurotoxicol Teratol 18:89–98PubMedCrossRef

Takagi SF (1989) Human olfaction. University of Tokyo Press, Tokyo

Thurstone LL (1927) A law of comparative judgment. Psychol Rev 34:273–286CrossRef

Turetsky BI, Moberg PJ, Yousem DM, Doty RL, Arnold SE, Gur RE (2000) Reduced olfactory bulb volume in patients with schizophrenia. Am J Psychiat 157:828–830PubMedCrossRef

Valentin G (1848) Lehrbuch der Physiologie des Menschen. Braunschweig

Watanabe S, Fukuchi Y (2000) Occupational impairment of the olfactory sense of chromate producing workers. Jpn J Ind Health 23:606–611

Weber EH (1834) De Pulsu, Resorptione, Auditu et Tactu: Annotationes Anatomicae et Physiologiae. Koehler, Leipzig

Yin-Zeng L, Jin-Xiang H, Cheng-Mo L, Bo-Hong X, Cui-Juan Z (1985) Effects of cadmium on cadmium smelter workers. Scand J Work Environ Health 11:29–32

Yoshida M (1984) Correlation analysis of detection threshold data for “standard test” odors. Bull Fac Sci Eng Cho Univ 27:343–353

Title: Olfactory dysfunction and its measurement in the clinic and workplace
Author: Richard L. Doty
Publication date: 01-05-2006
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 4/2006
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-005-0055-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Olfactory dysfunction and its measurement in the clinic and workplace

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2006

Olfactory toxicity: long-term effects of occupational exposures

Examination of the influence of personal traits and habituation on the reporting of complaints at experimental exposure to ammonia

The role of odor and irritation, as well as risk perception, in the setting of occupational exposure limits

Editorial: Evaluation of chemosensory effects due to occupational exposures

Setting occupational exposure limits in humans: contributions from the field of experimental psychology

From chemosensory thresholds to whole body exposures—experimental approaches evaluating chemosensory effects of chemicals