The simple truth about MCS: low-tech solutions for real suffering.

Multiple chemical sensitivity (MCS), characterized by a hypersensitivity to common household chemicals such as cleaning agents and pesticides, is becoming an acknowledged medical disorder, although debate continues as to whether a psychological component underlies development of the illness. Because MCS is not well understood, no one is sure how best to treat it. This month, researchers led by Pamela Reed Gibson of the James Madison University School of Psychology present survey findings that shed light on what best helps MCS sufferers, as well as the lengths to which they will go for relief [EHP 111:1498-1504].

The investigators surveyed 917 people with self-reported MCS, whom they contacted through the Chemical Injury Information Network, a nonprofit support and advocacy organization. The survey included questions about demographics, the impact of having MCS on the respondent's finances, the number of practitioners seen, and efficacy ratings for any of 108 different treatments the respondent might have tried. The treatments fell into nine categories: environmental medicine and "oasis" techniques (e.g., creating environments with fewer chemical exposures), holistic therapies (e.g., aromatherapy), nutritional supplements (e.g., vitamin E), detoxification techniques (e.g., removal of mercury-containing fillings), Eastern-origin techniques (e.g., tai chi), body therapies (e.g., massage), so-called newer therapies (e.g., eye movement desensitization and reprocessing), prescription drugs (e.g., Prozac, Valium), and other remedies (e.g., prayer, psychotherapy).

The investigators found that, over the course of their illnesses, the respondents had consulted a mean of 12 health care providers and spent a mean total of $51,000 on MCS-related health care costs. The remedies the participants tried met with mixed success, but a full 95% of survey respondents rated reducing exposure to chemicals as somewhat or very helpful. Treatments that participants rated as least effective and most harmful given potential side effects were taking various types of antidepressants, antiseizure medications, and tranquilizers.

Evidence that the best strategies are also fairly noninvasive and low-risk may be welcome news to MCS sufferers (however, with respondents reporting spending an average of $57,000 to lessen chemical exposures in their homes, these strategies are still quite expensive). The survey results may also be used by those affected by MCS to help weed out fraudulent treatments that are often offered to desperate MCS sufferers.

Gibson's findings dovetail with those of another new study presented in this issue, in which Georgia researchers Stanley M. Caress and Anne C. Steinemann found both that MCS is a common and serious condition and that sufferers had little history of depression, anxiety, or other emotional problems before MCS was diagnosed [EHP 111:1490-1497]. The researchers found in a random sampling of 1,582 individuals from the Atlanta metropolitan area that 12.6% of respondents reported a hypersensitivity to common chemicals. Among 13.5% of these, the problem was so bad that they lost their jobs. Only 1.4% of respondents reporting MCS had a history of emotional problems before their physical symptoms occurred, but 37.7% reported developing such problems afterwards, suggesting that MCS has a physiologic and not a psychologic etiology.