Impaired sense of smell increases risk for certain hazards

CHICAGO – Patients with an impaired or absent sense of smell are at risk for experiencing certain hazards that may have been avoided with an intact sense of smell, according to an article in the March issue of The Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals.

Approximately 2.7 million adults in the United States have chronic olfactory dysfunction, according to background information in the article. Olfaction, or sense of smell, helps detect environmental cues that can warn of potentially life-threatening situations, like fires, spoiled food or gas leaks. Sense of smell can be impaired by head trauma, viral infection, nasal obstruction or septal deviation, neurologic disorders, medications, hormonal disturbances, and normal aging.

Daniel V. Santos, M.D., of Virginia Commonwealth University, Richmond, and colleagues assessed the risk of olfactory-related hazardous events in 445 patients who were evaluated in a university-based clinic for smell and taste disorders, and who underwent olfactory testing and were interviewed between 1983 and 2001.

Of these patients, the average age was 50 years, approximately half were men, and 18 percent were regular tobacco users. The researchers found that 76 percent of patients had some degree of olfactory impairment, and 30 percent had no sense of smell. Thirty-seven percent of patients with olfactory impairment, but only 19 percent of patients with a normal sense of smell experienced at least one olfactory-related potentially hazardous event. Cooking-related incidents were the most common, representing 45 percent of olfactory-related hazardous events, and ingestion of spoiled food (25 percent), inability to detect a gas leak (23 percent), and inability to detect a fire (7 percent) were reported less frequently.

"In summary, olfactory impairment exposes patients to an increased risk of cooking accidents, ingestion of toxic or spoiled substances, and inability to detect fires and gas leaks," the authors write. "These hazards are potentially life-threatening and collectively pose a significant public health risk. As patients with olfactory dysfunction will often seek evaluation by an otolaryngologist [physician who specializes in treatment of ear, nose and throat disorders], otolaryngologists must be capable not only of diagnosing and treating patients with olfactory disturbances, but also of counseling them regarding potential risks of their disorders."

(Arch Otolaryngol Head Neck Surg. 2004;130:317-319. Available post-embargo at archoto.com)

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .

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