Multiple chemical sensitivity - the role of environmental health professionals.* "Sometimes these bouts of fatigue come on so fast and are so absolute that I've actually fallen off chairs that didn't have arm rests and crumpled crum·ple
v. crum·pled, crum·pling, crum·ples
1. To crush together or press into wrinkles; rumple.
2. To cause to collapse.
1. to the floor where I stood."
* "I forgot commitments, I forgot things I had just read, I forgot where I'd parked my car, what people's phone numbers were, how to get to places where I was driving."
* "Not a day goes by that I don't miss the old life and the old me."
- Statements from Patients with Multiple Chemical Sensitivity multiple chemical sensitivity (MCS), adverse physical reaction to certain chemicals in susceptible persons. When exposed to the chemicals, people with MCS react with symptoms such as nausea, headache, dizziness, fatigue, impaired memory, rash, and respiratory
Multiple chemical sensitivity (MCS), also called environmentally triggered illness, twentieth-century disease, universal allergy, and chemical AIDS, was first described almost a half century ago when a Chicago allergist al·ler·gist
A physician specializing in the diagnosis and treatment of allergies.
allergist Immunology A physician, who is often trained in both internal medicine and clinical immunology and who manages Pts with began to see a pattern of patients who reported becoming iii after being exposed to a variety of petrochemicals. Since that time many more cases of MCS have been reported, yet we still have no case definition for the condition and no medical test that can diagnose it. Treatment that is effective is, at best, difficult to determine.
Developing MCS is believed to be a two-step process. A person becomes sensitized sensitized /sen·si·tized/ (sen´si-tizd) rendered sensitive.
see sensitization (2). after receiving a "major" exposure to an environmental chemical such as a pesticide, a solvent, or a combustion product. The sensitized person then begins to respond to low-level chemical exposures from ordinary substances such as perfumes and tobacco smoke. These low-level exposures are said to "trigger" a response. Over time, chemically unrelated substances may trigger symptoms. The symptoms reported by MCS patients vary a good deal but typically include chest pain, depression, difficulty remembering, dizziness, fatigue, headache, inability to concentrate, nausea, and aches and pains in muscles and joints.
Several populations have been identified as possibly being chemically sensitive, including Persian Gulf Persian Gulf, arm of the Arabian Sea, 90,000 sq mi (233,100 sq km), between the Arabian peninsula and Iran, extending c.600 mi (970 km) from the Shatt al Arab delta to the Strait of Hormuz, which links it with the Gulf of Oman. veterans, industrial workers, occupants of "sick buildings," and people who live near contaminated contaminated,
v 1. made radioactive by the addition of small quantities of radioactive material.
2. made contaminated by adding infective or radiographic materials.
3. an infective surface or object. sites. The racial, ethnic, and socioeconomic characteristics of these groups vary greatly enough to suggest that a real health problem is occurring.
Recently, a federal interagency work group was convened to discuss MCS. Cochaired by Dr. Barry Johnson, assistant surgeon general The U.S. Surgeon General is charged with the protection and advancement of health in the United States. Since the 1960s the surgeon general has become a highly visible federal public health official, speaking out against known health risks such as tobacco use, and promoting disease and assistant administrator of the Agency for Toxic Substances and Disease Registry The United States Agency for Toxic Substances and Disease Registry, (ATSDR) is an agency for the U.S. Department of Health and Human Services that is directed by a congressional mandate to perform specific functions concerning the effect on public health of hazardous , and Dr. Richard Jackson Richard Jackson may refer to the following people:
With an enrollment of approximately 167 students per class, USU School of Medicine is located in Bethesda, Maryland on the , the Department of Energy, the U.S. Environmental Protection Agency Environmental Protection Agency (EPA), independent agency of the U.S. government, with headquarters in Washington, D.C. It was established in 1970 to reduce and control air and water pollution, noise pollution, and radiation and to ensure the safe handling and , the National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health,
n.pr an institute of the Centers for Disease Control and Prevention that is responsible for assuring safe and healthful working conditions and for developing standards of safety and health. , and the Veterans Administration. After reviewing the scientific literature and the work of several expert panels, the work group developed recommendations on technical and policy issues surrounding MCS. Among the findings of the work group, as reported in the predecision draft-for-comment, are the following facts:
* Little information is available on the prevalence of MCS and its fiscal cost to society.
* Little information on MCS is available to health care providers.
The panel made the following recommendations:
* Develop a phased approach to MCS research and target the research at data gaps such as the question of mechanisms of action.
* Develop a limited information campaign, focused on clinician education and awareness.
* Determine an appropriate treatment protocol broad enough to address the variety of needs of MCS patients.
* Coordinate efforts across agencies.
* Develop a strategic plan for addressing MCS, including development of an improved scientific database on MCS.
An issue of concern with the report is that it does not recognize the role environmental health professionals play in the story of MCS. While a thorough case history is relevant to diagnosis and treatment, it is the environmental health professional who conducts the actual environmental sampling from which relevant dose-response scenarios are determined. It is the environmental health professional who assesses the daily environment of the patient and recommends ways of reducing and stopping exposure. And it is the environmental health professional who is frequently called upon to respond to public requests for information about multiple chemical sensitivity. I submit that we, as environmental health professionals, should be an integral part of the effort to address the work group's recommendations.
Addressing a condition that has no defined diagnosis or etiology is obviously problematic, but we cannot ignore the increased reports of functionally similar cases. Is the study of MCS merely an example of science chasing its own tail, as some would have us believe? The best way to address this perplexing per·plex
tr.v. per·plexed, per·plex·ing, per·plex·es
1. To confuse or trouble with uncertainty or doubt. See Synonyms at puzzle.
2. To make confusedly intricate; complicate. problem is to take a phased and well-planned approach, such as that proposed by the interagency work group. I applaud the efforts of the work group and look forward to seeing environmental health professionals included in the plans for addressing MCS.