Development and evaluation of a questionnaire instrument for chemical intolerance, based on the International Classification of Functioning, Disability and Health

Figures & data

Figure 1. Development and evaluation of the APECI-ICF in three steps.

Table 1. Characteristics of the participants with chemical intolerance included in step 2 and 3.

	Step 2 n = 19	Step 3 n = 91
Age, mean (SD)	48.5 (8.20)	51.2 (11.6)
Women	16 (84%)	82 (90%)
University education	10 (53%)	57 (63%)
Living with partner	15 (83%)	55 (60%)
Living with children	10 (56%)	22 (24%)
Housing
Apartment	2 (11%)	38 (42%)
Apartment with private entrance	2 (11%)	10 (11%)
Semidetached house	1 (6%)	8 (9%)
Private house	13 (72%)	35 (38%)
Occupation
Working full time	5 (26%)	27 (30%)
Working part time	2 (11%)	7 (7%)
Studying full time	1 (5%)	1 (1%)
Unemployed	1 (5%)	6 (7%)
Sick-listed full time	3 (16%)	9 (10%)
Sick listed part time	1 (5%)	4 (4%)
Disability pension full time	4 (21%)	16 (17%)
Disability pension part time	0 (0%)	1 (1%)
Other*	2 (11%)	19 (21%)
Smoking	0 (0%)	1 (1%)
Self-reported health
Excellent/Very good	3 (18%)	9 (10%)
Good/Fairly good	9 (53%)	54 (59%)
Poor	5 (29%)	28 (31%)
Duration of having chemical intolerance, (years) mean (SD)	20.0 (11.2)	15.0 (11.3)
Self-reported conditions**	6 (33%)	19 (21%)
Multiple chemical sensitivity	12 (67%)	45 (52%)
Sensory hyperreactivity
Self reported diagnosis**	4 (24%)	22 (25%)
Asthma due to allergy	6 (35%)	28 (31%)
Asthma without known allergy	6 (35%)	38 (42%)
Allergic rhinitis
Symptoms from odorous/pungent chemicals
Symptoms each time being exposed	17 (94%)	88 (98%)
Symptoms disappearing when incitants are removed	16 (89%)	68 (77%)
Symptoms from at least two chemically unrelated incitants	18 (100%)	88 (99%)
Airway symptoms	18 (100%)	78 (87%)
Multiple organ system symptoms	18 (100%)	89 (99%)
CSS-SHR score, mean (SD)	50.5 (3.6)	48.5 (5.2)

*Other included: Retired, working occasionally with different assignments (not within an employment), self-employed but not having specified working full time or part time, waiting for disability pension or other allowance, and receiving activity grant.

**Reporting having had the condition verified by a physician.

Bold represents Housing and unbold represents apartment.

Table 2. Test-retest result, sorted by ICF chapter, for each item in the area Activities and participation: Kappa agreement, percent agreement, “>1 category disagreement”**, and interquartile range and range for the first and second measurement (when differing from the first).

Chapter Item	Weighted Kappa (quadratic)	Percent agreement (%)	>1 category disagreement ** (%)	Interquartile Range 1:a (2:a)	Range 1.a (2:a)
1. Learning and applying knowledge
Focusing attention (d160)*	0.59	80.2	0	0 (1)	2
Reading (d166)	0.68	75.8	2.2	1	3 (2)
Calculating (d172)	0.72	78.6	2.4	1	3
Solving problems (d175)	0.76	78.4	0	1	3
4. Mobility
Moving around within the home (d4600)	0.45	52.3	9.3	2	3
Moving around within buildings other than home (d4601)	0.65	82.4	1.1	1	2
Taking a taxi (d4701)	0.62	77.8	2.8	1	3
Using public transportation (d4702)	0.68	89.3	1.2	0	2
5. Self-care
Visiting public restrooms (d5308)	0.87	93.1	0	0	2
Visiting health care facilities (d5708)	0.68	71.5	0	1	2 (3)
6. Domestic life
Acquiring a place to live (d6108)	0.66	76.9	7.5	1	4 (3)
Living in an apartment building (d698)	0.79	87.0	0	1	2
Using common laundry room (d6408)	0.58	89.9	1.4	0	3 (2)
Acquisition of goods and services (d620)	0.72	75.6	0	1	2 (3)
7. Interpersonal interactions and relationships
Parent-child relationships (7600)	0.80	71.1	3.4	1	3
Child-parent relationships (7601)	0.60	54.4	1.8	1	3
Sibling relationships (7602)	0.77	67.1	1.4	1 (2)	3
Extended family relationships (7603)	0.56	67.9	1.3	1	2 (3)
Intimate relationships (770)	0.82	63.0	2.8	2	4 (3)
Interacting according to social roles (7203)	0.66	85.7	1.1	0	2 (3)
Relationships with friends (7500)	0.69	70.8	1.1	1	3
Relationships with neighbors (7501)	0.72	72.2	0	1	3
Relationships with acquaintances (7502)	0.66	77.2	2.2	1	2 (3)
8. Major life areas
School education (d820)	0.94	95.5	0	0	2
Higher education (d830)	0.72	80.0	0	0.5	2 (3)
Work-related education (839)	0.77	87.3	0	0	2
Seeking employment (d8450)	0.74	83.9	1.6	0 (1)	2
Full-time employment (d8502)	0.66	90.7	1.6	0	2
Part-time employment (d8501)	0.18 (0.57)¤	86.7	4.4	0	3 (2)
Accommodated work (d859)	0.48	48.4	16.1	2	3
Financial self-sufficiency (d8708)	0.70	66.6	7.1	1	3
9. Community social and civic life
Informal associations (d9100)	0.72	83.9	2.6	0 (1)	2 (3)
Ceremonies (d9102)	0.73	79.1	1.2	1	2 (3)
Sports (d9201)	0.47	76.1	2.8	0 (1)	2 (3)
Arts and culture (d9202)	0.56	79.6	2.2	0.5	2 (3)
Socializing (d9205)	0.74	78.0	0	1	2 (3)
Holiday traveling (d9208)	0.49	73.0	1.2	0	2

*Code/number within parenthesis stands for the ICF-code/number that each ICF item has in the ICF classification system. e.g. d160.

**>1 category disagreement = the percentage of participants who at the second occasion (test-retest) gave a response alternative that was more than one category different from their alternative at the first occasion.

¤Kappa agreement after the sensibility analysis.

Table 3. Test-retest result, sorted by ICF chapter, for each item in the area Environmental factors: Kappa agreement, percent agreement, “>1 category disagreement”**, and interquartile range and range for the first and second measurement (when differing from the first).

Chapter Item	Weighted Kappa (quadratic)	Percent agreement (%)	> 1 category disagreement** (%)	Interquartile Range 1:a (2:a)	Range 1.a (2:a)
1. Products and technology
Possible barriers:
General products and technology for personal use in daily life (e1150)*	0.76	93.4	0	0	2
Scent machines and air fresheners (e198)	0.54	93.3	0	0	1
Possible facilitators:
Supportive products for use in daily life (e1158)	0.51	83.4	3.3	0	3
General products and technology for communication (e1250)	0.60	71.2	5.6	0 (0.5)	3
Products and technique that enable distance studies (e1308)	0.78	84.9	3.0	0	3 (4)
Products and technique that enable distance work (e1358)	0.62	80.1	6.8	0	3 (4)
Good ventilation in buildings for public use (e1508)	0.58	85.2	2.3	0	3
Good ventilation in buildings for private use (e1558)	0.56	82.2	2.2	0	3
2. Natural environment and human made changes to the environment
Possible barriers:	0.79	83.1	3.3	1	3
Flowers with a strong scent (e2208)	0.52	91.2	0	0	2 (1)
Indoor air quality (e2600)	0.73	80.2	1.1	0.5 (1)	3
Outdoor air quality (e2601)
3. Support and relationships
Possible facilitators:
Support from colleagues (e325)	0.83	82.4	1.5	0	3
Support from persons in positions of authority (e330)	0.48	85.7	7.8	0	3
Support from health care professionals (e355)	0.34	79.1	7.7	0	3
4. Attitudes
Possible barriers:
Attitudes of colleagues (e425)	0.66	67.2	4.5	1	3
Attitudes of persons in positions of authority (e430)	0.63	64.0	3.9	1	3
Attitudes of health care professionals (e450)	0.68	68.2	5.6	1	4 (3)
Societal attitudes (e460)	0.62	65.4	3.9	1	3
5. Services. systems and policies
Possible facilitators:
Housing services (e5258)	0.34 (0.49)¤	84.4	3.2	0	3 (2)
Social security services (e570)	0.45	88.9	3.2	0	3

*Code/number within parenthesis stands for the ICF-code/number that each ICF item has in the ICF classification system. e.g. d160.

**>1 category disagreement = the percentage of participants who at the second occasion (test-retest) gave a response alternative that was more than one category different from their alternative at the first occasion.

¤Kappa agreement after the sensibility analysis.