Olfactory dysfunction and its measurement in the clinic and workplace.
OBJECTIVE
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.
Doty
Richard L
RL
Smell and Taste Center, Department of Otorhinolaryngology: Head and Neck Surgery, University of Pennsylvania Medical Center, 5 Ravdin Building, Philadelphia, PA 19104, USA. doty@mail.med.upenn.edu
D000395:Air Pollutants, Occupational / Q000009:adverse effects; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis*; D016273:Occupational Exposure / Q000009:adverse effects; D000857:Olfaction Disorders / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D012903:Smell; D017132:Workplace
D000395:Air Pollutants, Occupational