Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Survey Method
2.3. Survey Content
- (1)
- Attributes (e.g., sex, school year), diagnosis of sick house syndrome (SHS), and diagnosis of MCS.
- (2)
- Allergies, including hay fever, atopic dermatitis, asthma, hives, and other allergies, assessing whether the respondent currently had symptoms or had symptoms in the past.
- (3)
- Living environment (i.e., whether the respondent lived in a new building or a building undergoing renovations) and details about the environment surrounding the home.
- (4)
- Lifestyle (including various aspects of daily habits and routine).
- (5)
- QEESI [19] sections, specifically QEESI Q1 (Chemical Intolerance), Q3 (Symptom Severity), and Q5 (Impact on Life). Each section comprised 10 questions, scored on a 0–10 scale, resulting in a total score range of 0 to 100 points for Q1, Q3, and Q5.
2.4. Statistical Analysis
2.5. Ethical Considerations
3. Results
3.1. Participant Characteristics
3.2. Sex, Diagnosis, and Symptoms
3.3. Number of Allergy-like Symptoms
3.4. Residential Environment
3.5. Lifestyle Habits
3.6. The Three QEESI Category Scores
3.7. Logistic Regression Analysis of Factors Related to the MCS High-Risk Group
4. Discussion
4.1. Prevalence of MCS-like Symptoms
4.2. Allergy-like Symptoms and MCS
4.3. Factors Related to the MCS High-Risk Group and Prospects for the Prevention of MCS Onset
4.4. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | p-Value 1 | |||
---|---|---|---|---|---|---|---|
N | (%) | n | (%) | n | (%) | ||
Sex | <0.001 | ||||||
Male | 2413 | (52.1) | 2238 | (53.1) | 175 | (42.2) | |
Female | 2217 | (47.9) | 1977 | (46.9) | 240 | (57.8) | |
Grade | 0.711 | ||||||
Sophomore | 2342 | (50.6) | 2129 | (50.5) | 213 | (51.3) | |
Junior | 1639 | (35.4) | 1499 | (35.6) | 140 | (33.7) | |
Senior | 649 | (14.0) | 587 | (13.9) | 62 | (14.9) | |
Course | 0.189 | ||||||
General | 3013 | (65.1) | 2734 | (64.9) | 279 | (67.2) | |
Commercial | 568 | (12.3) | 522 | (12.4) | 46 | (11.1) | |
Industrial | 628 | (13.6) | 574 | (13.6) | 54 | (13.0) | |
Another | 421 | (9.1) | 385 | (9.1) | 36 | (8.7) |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | Crude Odds Ratio (95% CI 3) | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
n | (%) | N | (%) | n | (%) | ||||
Sex | Male | 2413 | (52.1) | 2238 | (53.1) | 175 | (42.2) | 1.00 | <0.001 |
Female | 2217 | (47.9) | 1977 | (46.9) | 240 | (57.8) | 1.55 | ||
(1.27–1.90) | |||||||||
Health condition | |||||||||
SHS diagnosis | No | 4611 | (99.6) | 4201 | (99.7) | 410 | (98.8) | 1.00 | 0.023 |
Yes | 19 | (0.4) | 14 | (0.3) | 5 | (1.2) | 3.67 | ||
(1.31–10.21) | |||||||||
MCS diagnosis | No | 4606 | (99.5) | 4195 | (99.5) | 411 | (99.0) | 0.267 | |
Yes | 24 | (0.5) | 20 | (0.5) | 4 | (1.0) | |||
Allergies 2 | No | 1023 | (22.1) | 950 | (22.5) | 73 | (17.6) | 1.00 | 0.022 |
Yes | 3607 | (77.9) | 3265 | (77.5) | 342 | (82.4) | 1.36 | ||
(1.05–1.77) | |||||||||
Hay fever | No | 1799 | (38.9) | 1656 | (39.3) | 143 | (34.5) | 0.054 | |
Yes | 2831 | (61.1) | 2559 | (60.7) | 272 | (65.5) | |||
Atopic dermatitis | No | 3788 | (81.8) | 3468 | (82.3) | 320 | (77.1) | 1.00 | 0.009 |
Yes | 842 | (18.2) | 747 | (17.7) | 95 | (22.9) | 1.38 | ||
(1.08–1.76) | |||||||||
Asthma | No | 3852 | (83.2) | 3513 | (83.3) | 339 | (81.7) | 0.389 | |
Yes | 778 | (16.8) | 702 | (16.7) | 76 | (18.3) | |||
Mold/dust/mite | No | 3379 | (73.0) | 3100 | (73.5) | 279 | (67.2) | 1.00 | 0.006 |
allergies | Yes | 1251 | (27.0) | 1115 | (26.5) | 136 | (32.8) | 1.36 | |
(1.09–1.68) | |||||||||
Urticaria | No | 3198 | (69.1) | 2934 | (69.6) | 264 | (63.6) | 1.00 | 0.012 |
Yes | 1432 | (30.9) | 1281 | (30.4) | 151 | (36.4) | 1.31 | ||
(1.06–1.62) | |||||||||
Food allergies | No | 3991 | (86.2) | 3653 | (86.7) | 338 | (81.4) | 1.00 | 0.003 |
Yes | 639 | (13.8) | 562 | (13.3) | 77 | (18.6) | 1.48 | ||
(1.14–1.93) | |||||||||
Drug allergies | No | 4503 | (97.3) | 4108 | (97.5) | 395 | (95.2) | 1.00 | 0.007 |
Yes | 127 | (2.7) | 107 | (2.5) | 20 | (4.8) | 1.94 | ||
(1.19–3.17) | |||||||||
Metal allergies | No | 4513 | (97.5) | 4121 | (97.8) | 392 | (94.5) | 1.00 | <0.001 |
Yes | 117 | (2.5) | 94 | (2.2) | 23 | (5.5) | 2.57 | ||
(1.61–4.11) |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | p-Value | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | ||||||||
Count or allergy-like symptoms 1 | Median value 1.0 [1.0–3.0] | Median value 2.0 [1.0–3.0] | <0.001 2 | |||||||
1.7 ± 1.5 | 2.1 ± 1.6 | |||||||||
No allergies | 1023 | (22.1) | 950 | (22.5) | 73 | (17.6) | ||||
Has allergies | 3607 | (77.9) | 3265 | (77.5) | 342 | (82.4) | ||||
One allergy-like symptom | 1351 | (29.2) | 1242 | (29.5) | 109 | (26.3) | ||||
Two allergy-like symptoms | 1029 | (22.2) | 936 | (22.2) | 93 | (22.4) | ||||
Three allergy-like symptoms | 637 | (13.8) | 577 | (13.7) | 60 | (14.5) | <0.001 3 | |||
Four allergy-like symptoms | 349 | (7.5) | 305 | (7.2) | 44 | (10.6) | ||||
Five allergy-like symptoms | 165 | (3.6) | 144 | (3.4) | 21 | (5.1) | ||||
Six allergy-like symptoms | 60 | (1.3) | 49 | (1.2) | 11 | (2.7) | ||||
Seven allergy-like symptoms | 12 | (0.3) | 8 | (0.2) | 4 | (1.0) | ||||
Eight allergy-like symptoms | 4 | (0.1) | 4 | (0.1) | 0 | (0.0) |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | (95% CI 2) Crude Odds Ratio | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | ||||
Number of times the respondent has experienced moving into a new home | (1.01–1.53) | 0.036 | |||||||
Zero times | 2157 | (46.6) | 1984 | (47.1) | 173 | (41.7) | 1.00 | ||
One time or more | 2473 | (53.4) | 2231 | (52.9) | 242 | (58.3) | 1.24 | ||
Have you experienced home renovations, extensions, or redecorating? | (1.06–1.68) | 0.015 | |||||||
No | 3642 | (78.7) | 3335 | (79.1) | 307 | (74.0) | 1.00 | ||
Yes | 988 | (21.3) | 880 | (20.9) | 108 | (26.0) | 1.33 | ||
Indoor environment | |||||||||
Mold/condensation | 1906 | (41.2) | 1723 | (40.9) | 183 | (44.1) | 0.204 | ||
Tatami room | 4087 | (88.3) | 3713 | (88.1) | 374 | (90.1) | 0.220 | ||
Is there a freeway or national highway near your house? | (1.01–1.53) | 0.044 | |||||||
No | 3078 | (66.5) | 2821 | (66.9) | 257 | (61.9) | 1.00 | ||
Yes | 1552 | (33.5) | 1394 | (33.1) | 158 | (38.1) | 1.25 | ||
Are there high-voltage power lines near your house? | 0.839 | ||||||||
No | 3815 | (82.4) | 3475 | (82.4) | 340 | (81.9) | |||
Yes | 815 | (17.6) | 740 | (17.6) | 75 | (18.1) | |||
Is there an intersection near your house? | 0.196 | ||||||||
No | 2061 | (44.5) | 1889 | (44.8) | 172 | (41.4) | |||
Yes | 2569 | (55.5) | 2326 | (55.2) | 243 | (58.6) | |||
Is there a railway near your house? | 0.570 | ||||||||
No | 3661 | (79.1) | 3328 | (79.0) | 333 | (80.2) | |||
Yes | 969 | (20.9) | 887 | (21.0) | 82 | (19.8) | |||
Is there a factory near your house? | (1.01–1.05) | 0.045 | |||||||
No | 3544 | (76.5) | 3243 | (76.9) | 301 | (72.5) | 1.00 | ||
Yes | 1086 | (23.5) | 972 | (23.1) | 114 | (27.5) | 1.26 | ||
Is there a park near your house? | 0.135 | ||||||||
No | 2174 | (47.0) | 1994 | (47.3) | 180 | (43.4) | |||
Yes | 2456 | (53.0) | 2221 | (52.7) | 235 | (56.6) | |||
Is there a cropping field or orchard near your house? | 0.401 | ||||||||
No | 1853 | (40.0) | 1695 | (40.2) | 158 | (38.1) | |||
Yes | 2777 | (60.0) | 2520 | (59.8) | 257 | (61.9) | |||
Is there a golf course near your house? | 0.179 | ||||||||
No | 4272 | (92.3) | 3882 | (92.1) | 390 | (94.0) | |||
Yes | 358 | (7.7) | 333 | (7.9) | 25 | (6.0) | |||
Is there a gas station near your house? | 0.112 | ||||||||
No | 3444 | (74.4) | 3149 | (74.7) | 295 | (71.1) | |||
Yes | 1186 | (25.6) | 1066 | (25.3) | 120 | (28.9) | |||
Is there a rubbish dump near your house? | (1.08–2.10) | 0.017 | |||||||
No | 4270 | (92.2) | 3900 | (92.5) | 370 | (89.2) | 1.00 | ||
Yes | 360 | (7.8) | 315 | (7.5) | 45 | (10.8) | 1.51 | ||
Do you smell offensive odors near your house? | (1.54–2.37) | <0.001 | |||||||
No | 3594 | (77.6) | 3320 | (78.8) | 274 | (66.0) | 1.00 | ||
Yes | 1036 | (22.4) | 895 | (21.2) | 141 | (34.0) | 1.91 |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | Crude Odds Ratio (95% CI 2) | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | ||||
Use of ventilation, exhaust fans | 0.610 | ||||||||
Yes | 4081 | (88.1) | 3712 | (88.1) | 369 | (88.9) | |||
No | 549 | (11.9) | 503 | (11.9) | 46 | (11.1) | |||
Use of insect repellant | 0.335 | ||||||||
No | 2780 | (60.0) | 2540 | (60.3) | 240 | (57.8) | |||
Yes | 1850 | (40.0) | 1675 | (39.7) | 175 | (42.2) | |||
Use of air fresheners | 0.250 | ||||||||
No | 1088 | (23.5) | 981 | (23.3) | 107 | (25.8) | |||
Yes | 3542 | (76.5) | 3234 | (76.7) | 308 | (74.2) | |||
Use of insecticides, electric mosquito coil | 0.099 | ||||||||
No | 1928 | (41.6) | 1771 | (42.0) | 157 | (37.8) | |||
Yes | 2702 | (58.4) | 2444 | (58.0) | 258 | (62.2) | |||
Use of floor wax | 0.780 | ||||||||
No | 3030 | (65.4) | 2761 | (65.5) | 269 | (64.8) | |||
Yes | 1600 | (34.6) | 1454 | (34.5) | 146 | (35.2) | |||
Extermination of termites and mites | 0.176 | ||||||||
No | 3784 | (81.7) | 3455 | (82.0) | 329 | (79.3) | |||
Yes | 846 | (18.3) | 760 | (18.0) | 86 | (20.7) | |||
Use of agricultural chemicals, herbicides | 0.850 | ||||||||
No | 3564 | (77.0) | 3243 | (76.9) | 321 | (77.3) | |||
Yes | 1066 | (23.0) | 972 | (23.1) | 94 | (22.7) | |||
Use of a kerosene stove | 0.151 | ||||||||
No | 2242 | (48.4) | 2055 | (48.8) | 187 | (45.1) | |||
Yes | 2388 | (51.6) | 2160 | (51.2) | 228 | (54.9) | |||
Use of an air purifier | 0.708 | ||||||||
Yes | 1868 | (40.3) | 1697 | (40.3) | 171 | (41.2) | |||
No | 2762 | (59.7) | 2518 | (59.7) | 244 | (58.8) | |||
Has pets | 0.379 | ||||||||
No | 2538 | (54.8) | 2302 | (54.6) | 236 | (56.9) | |||
Yes | 2092 | (45.2) | 1913 | (45.4) | 179 | (43.1) |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | Crude Odds Ratio (95% CI 2) | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | ||||
Eats breakfast every day | 0.483 | ||||||||
Yes | 4184 | (90.4) | 3813 | (90.5) | 371 | (89.4) | |||
No | 446 | (9.6) | 402 | (9.5) | 44 | (10.6) | |||
Considers a balanced nutritional intake | 0.095 | ||||||||
Yes | 2412 | (52.1) | 2212 | (52.5) | 200 | (48.2) | |||
No | 2218 | (47.9) | 2003 | (47.5) | 215 | (51.8) | |||
Frequent consumption of instant foods | 0.882 | ||||||||
No | 2147 | (46.4) | 1956 | (46.4) | 191 | (46.0) | |||
Yes | 2483 | (53.6) | 2259 | (53.6) | 224 | (54.0) | |||
Meals are mainly Western cooking | 0.627 | ||||||||
No | 2896 | (62.5) | 2641 | (62.7) | 255 | (61.4) | |||
Yes | 1734 | (37.5) | 1574 | (37.3) | 160 | (38.6) | |||
Frequent consumption of fermented foods such as miso and pickles | 0.094 | ||||||||
Yes | 3294 | (71.1) | 2984 | (70.8) | 310 | (74.7) | |||
No | 1336 | (28.9) | 1231 | (29.2) | 105 | (25.3) | |||
Frequent consumption of vegetables | 0.300 | ||||||||
Yes | 3427 | (74.0) | 3111 | (73.8) | 316 | (76.1) | |||
No | 1203 | (26.0) | 1104 | (26.2) | 99 | (23.9) | |||
Drinking water is from a water purifier or is bought water | 0.147 | ||||||||
Yes | 1876 | (40.5) | 1694 | (40.2) | 182 | (43.9) | |||
No | 2754 | (59.5) | 2521 | (59.8) | 233 | (56.1) | |||
Frequent consumption of green tea from plastic bottles (made from polyethylene terephthalate) | 0.944 | ||||||||
No | 2105 | (45.5) | 1917 | (45.5) | 188 | (45.3) | |||
Yes | 2525 | (54.5) | 2298 | (54.5) | 227 | (54.7) | |||
Exercises more than once a week (outside of physical education class) | 0.006 | ||||||||
Yes | 2875 | (62.1) | 2643 | (62.7) | 232 | (55.9) | 1.00 | ||
No | 1755 | (37.9) | 1572 | (37.3) | 183 | (44.1) | 1.33 | ||
(1.08–1.63) | |||||||||
Soaks in the bathtub when bathing | 0.712 | ||||||||
Yes | 2817 | (60.8) | 2561 | (60.8) | 256 | (61.7) | |||
No | 1813 | (39.2) | 1654 | (39.2) | 159 | (38.3) | |||
Usage time of PC/smartphone | 0.181 | ||||||||
Less than 3 h | 2209 | (47.7) | 2024 | (48.0) | 185 | (44.6) | |||
3 h or more | 2421 | (52.3) | 2191 | (52.0) | 230 | (55.4) | |||
Television viewing time | 0.470 | ||||||||
Less than 2 h | 2220 | (47.9) | 2014 | (47.8) | 206 | (49.6) | |||
2 h or more | 2410 | (52.1) | 2201 | (52.2) | 209 | (50.4) |
Comparative Items | Total Number n = 4630 (100%) | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | Crude Odds Ratio (95% CI 2) | p-Value 1 | ||||
---|---|---|---|---|---|---|---|---|---|
n | (%) | N | (%) | n | (%) | ||||
Smoking habit 1 | 0.110 | ||||||||
Non-smoker | 4500 | (97.2) | 4097 | (97.2) | 403 | (97.1) | |||
Former smoker | 119 | (2.6) | 110 | (2.6) | 9 | (2.2) | |||
Smoker | 11 | (0.2) | 8 | (0.2) | 3 | (0.7) | |||
Smoking habit 2 | 0.069 | ||||||||
Non-smoker or former smoker | 4619 | (99.8) | 4207 | (99.8) | 412 | (99.3) | |||
Smoker | 11 | (0.2) | 8 | (0.2) | 3 | (0.7) | |||
Family member who smokes | 0.213 | ||||||||
No | 1726 | (37.3) | 1583 | (37.6) | 143 | (34.5) | |||
Yes | 2904 | (62.7) | 2632 | (62.4) | 272 | (65.5) | |||
Drinking habit | 0.176 | ||||||||
Does not drink alcohol | 4481 | (96.8) | 4084 | (96.9) | 397 | (95.7) | |||
Drinks alcohol sometimes or every day | 149 | (3.2) | 131 | (3.1) | 18 | (4.3) | |||
Cold hands and feet | <0.001 | ||||||||
No | 2910 | (62.9) | 2702 | (64.1) | 208 | (50.1) | 1.00 | ||
Yes | 1720 | (37.1) | 1513 | (35.9) | 207 | (49.9) | 1.78 | ||
(1.45–2.18) | |||||||||
Fatigue | <0.001 | ||||||||
No | 2250 | (48.6) | 2111 | (50.1) | 139 | (33.5) | 1.00 | ||
Yes | 2380 | (51.4) | 2104 | (49.9) | 276 | (66.5) | 1.99 | ||
(1.61–2.46) | |||||||||
Hours of sleep | 0.064 | ||||||||
7–8 h | 2298 | (49.6) | 2110 | (50.1) | 188 | (45.3) | |||
9 h or more or 6 h or less | 2332 | (50.4) | 2105 | (49.9) | 227 | (54.7) | |||
Bed time | 0.138 | ||||||||
Before 11 p.m. | 431 | (9.3) | 384 | (9.1) | 47 | (11.3) | |||
After 11 p.m. | 4199 | (90.7) | 3831 | (90.9) | 368 | (88.7) | |||
Normal temperature | 0.148 | ||||||||
34.5–35.9 °C | 1450 | (31.3) | 1307 | (31.0) | 143 | (34.5) | |||
36.0 °C or higher | 3180 | (68.7) | 2908 | (69.0) | 272 | (65.5) | |||
Subjective stress 1 | <0.001 | ||||||||
Slight | 1307 | (28.2) | 1247 | (29.6) | 60 | (14.5) | 1.00 | ||
Moderate–significant | 3323 | (71.8) | 2968 | (70.4) | 355 | (85.5) | 2.49 | ||
(1.88–3.29) | |||||||||
Subjective stress 2 | <0.001 | ||||||||
Slight–moderate | 3826 | (82.6) | 3528 | (83.7) | 298 | (71.8) | 1.00 | ||
Significant | 804 | (17.4) | 687 | (16.3) | 117 | (28.2) | 2.02 | ||
(1.60–2.54) |
QEESI 2 | Control Group n = 4215 (91.0%) | High-Risk Group n = 415 (9.0%) | Difference | p-Value 1 | |
---|---|---|---|---|---|
Q1 Chemical Intolerance | Mean ± standard deviation | 16.1 ± 16.0 | 51.7 ± 8.5 | 35.6 | |
Median (25–75% points) | 12 (2–26) | 50 (46–56) | 38.0 | <0.001 | |
Minimum to maximum | 0–100 | 40–100 | - | ||
Q3 Symptom Severity | Mean ± standard deviation | 18.6 ± 15.3 | 45.5 ± 13.6 | 26.9 | |
Median (25–75% points) | 15 (6–28) | 46 (35–54) | 31.0 | <0.001 | |
Minimum to maximum | 0–84 | 20–93 | - | ||
Q5 Life Impact | Mean ± standard deviation | 5.5 ± 7.3 | 25.9 ± 14.3 | 20.4 | |
Median (25–75% points) | 3 (0–8) | 22 (14–34) | 19.0 | <0.001 | |
Minimum to maximum | 0–63 | 10–100 | - |
Variables | Univariate Analysis | p-Value 1 | Multivariable Analysis | p-Value 1 | ||
---|---|---|---|---|---|---|
Crude Odds Ratio | 95% CI 3 | Adjusted Odds Ratio | 95% CI 3 | |||
Sex, female [male] 2 | 1.55 | 1.27–1.90 | <0.001 | 1.29 | 1.04–1.60 | 0.020 |
Atopic dermatitis [no] | 1.38 | 1.08–1.76 | 0.009 | 1.29 | 1.01–1.65 | 0.045 |
Metal allergies [no] | 2.57 | 1.61–4.11 | <0.001 | 1.79 | 1.11–2.91 | 0.018 |
Cold hands and feet [no] | 1.78 | 1.45–2.18 | <0.001 | 1.36 | 1.09–1.69 | 0.006 |
Number of times moving to a new home/one time or more [0 times] | 1.24 | 1.01–1.53 | 0.036 | 1.26 | 1.02–1.55 | 0.030 |
Offensive odor [no] | 1.91 | 1.54–2.37 | <0.001 | 1.69 | 1.35–2.10 | <0.001 |
Bedtime [after 11 p.m.] | 0.79 | 1.57–1.08 | 0.138 | 1.40 | 1.01–1.95 | 0.044 |
Subjective stress 1/moderate–significant [slight] | 2.49 | 1.88–3.29 | <0.001 | 2.02 | 1.51–2.71 | <0.001 |
Fatigue [no] | 1.99 | 1.61–2.46 | <0.001 | 1.45 | 1.15–1.82 | 0.002 |
The Hosmer–Lemeshow test resulted in p = 0.976 and the model’s discriminant accuracy was 91.0% |
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Suzuki, T.; Bai, Y.; Ohno, Y. Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students. Int. J. Environ. Res. Public Health 2024, 21, 934. https://doi.org/10.3390/ijerph21070934
Suzuki T, Bai Y, Ohno Y. Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students. International Journal of Environmental Research and Public Health. 2024; 21(7):934. https://doi.org/10.3390/ijerph21070934
Chicago/Turabian StyleSuzuki, Tamami, Yoshiko Bai, and Yuko Ohno. 2024. "Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students" International Journal of Environmental Research and Public Health 21, no. 7: 934. https://doi.org/10.3390/ijerph21070934