Positive Health Online

The Symptoms of Multiple Chemical Sensitivity

Many people will have, or know someone who has, experienced an increasing trend of reacting to a growing number of everyday items, without it at first registering in their mind, or if they have noticed it, only to dismiss these small 'irritations' when they occur. These symptoms can range from congestion to sneezing to more severe reactions such as rashes, breathing problems, to such as weeping eyes, pains in the joints, etc., or even worse. In the early days these 'occurrences' may be intermittent. These reactions are often non-specific to natural allergens and include symptoms such as headache, sore eyes, sore throat, general weakness in muscles, a feeling of constant tiredness, etc. These symptoms, being non-specific, are often dismissed as 'all in the mind' or 'seeking sympathy' or 'looking for excuses'.

Low levels of many common household chemicals often trigger off such symptoms. Sufferers are said to be experiencing multiple chemical sensitivity (MCS), or what is often called 'environmental illness' or '20th-century disease'. In severe cases, victims have to isolate themselves from society, synthetic products, and any type of chemical product. Yet this illness or disease is not always viewed as a real illness and is often dismissed by the medical profession.

Research Findings and Reports

In the modern world, whether indoors or out, in the city or in the country, the mountains or the desert, we are all of us continually exposed to chemicals. Chemicals both natural and synthetic are a part of our lives.

A WHO publication[1] states that air pollution is a major environmental health problem affecting both developed and developing countries. However, despite ever-increasing knowledge of the harmful health effects of air pollution, preventive action is often slow to follow. Dr Michael Repacholi, WHO Coordinator, Occupational and Environmental Health states, "WHO would like to provide its 191 Member States with irrefutable evidence that air pollution causes a disproportionately heavy burden of disease. We would like to provide them with a proper strategy to eliminate avoidable air pollutants and thus reduce this disease burden in a cost-effective way."

In 1995, the European Commission produced a report on chemical sensitivity,[2] which was carried out by several authors including M Ashford, a leading expert on chemical sensitivity who also produced a report for the New Jersey State Department of Health.

There are other government official reports such as Chemical Sensitivities: a Global Problem,[3] which was prepared at the request of the US Interagency Taskforce on Multiple Chemical Sensitivities by C Wilson. On 24 August 1998, the interagency Workgroup on MCS published a comprehensive Predecisional Draft Report[4] on MCS to include background, government interest, public health issues in medical evaluation and care of MCS patients, organizational statements relating to MCS, federal actions, recommendations (overview and MCS as a public health priority). There is also a long list of references, annex of research suggested by expert reviewers and recommendations from selected meetings about MCS. Particularly in recent years, there have been numerous studies on MCS and reports covering areas such as the effects of housing on MCS sufferers.[5]

Despite the above authoritative reports on MSC, the UK medical establishment and the Government continually dismiss MSC as being 'all in the mind'. For example, the Department of Health's Committee on the Medical Effects of Air Pollutants (COMEAP) published a report on air pollution in January 1998,[6] which estimated that in 1997, 12,000-24,000 deaths of vulnerable people were brought forward by air pollution and 14,000-24,000 hospital admissions and re-admissions of vulnerable people were associated with air pollution in the UK. The Government's response has been the building of more incinerators (there are plans for at least 25 such plants) and relaxing of various ADI values.

This policy not to accept MSC, despite the increasingly large numbers of people suffering from it, is best illustrated by soldiers who suffer from Gulf War syndrome resulting in MCS, the victims from the aluminium sulphate poisoning at Camelford, and the many thousands of individuals suffering as a result of various incidents both recognized and unrecognized.

During March 2000, one sufferer from MCS spoke to BBC News Online and said, "I am very sensitive to domestic gas, detergents, perfumes and chemical cleaners. I was diagnosed three years ago. When I have a severe chemical exposure, I lose consciousness for a couple of hours. I can't go somewhere where there's a gas cooker on, though I can cope with a gas boiler so long as it's in a separate room, with the door shut."

What is becoming more common is that there is an increase in the numbers of people having an adverse physical reaction to low levels of many common chemicals, ranging from congestion to sneezing to more severe reactions such as rashes, breathing problems and worse; these reactions are often non-specific and hence dismissed.

Multiple Chemical Sensitivity (MCS) is the name given to the broad issue of reactions to specific or cumulative chemicals in the environment. In brief, chemicals damage the immune system and the liver, and suppress the cellular mediation that controls the way the body protects itself from foreign materials. MCS is, in fact, an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful effects. No single widely accepted test of physiologic function can be shown to correlate with the symptoms.

In 1991 Ashford and Miller stated, "The patient with multiple chemical sensitivities can recover by the removal of the suspected offending agents and by re-challenge, after an appropriate interval, under strictly controlled environmental conditions. Causality is inferred by the clearing of symptoms with removal from the offending environment and recurrence of symptoms with specific challenge."[7]

MCS was first brought to the attention of the US medical establishment when the late Theron Randolph, a physician trained in allergy and immunology, reported that a number of his patients reacted adversely to chemicals in their environment.[8] He compared the condition to Selye's stress-oriented general adaptation syndrome[9] and linked the adverse effects of this 'petrochemical problem' to contact with chemicals found in commonly encountered substances such as cosmetics, auto fuels, exhaust fumes and food additives. He also observed that many of his patients reacted to many industrial solvents found in small amounts in manufactured products such as construction materials, newspaper and other ink-related products, furniture and carpet.

It was not until 1963, in Kailin and Brook's study,[10] that for the first time patients were classified as suffering from multiple chemical sensitivities. It was also the first time that a double-blind study was used to remove any doubts that people did suffer from MCS.

Since then there have been numerous publications of scientific articles, editorials, books and reports on or directly related to MsCS disorders. Albert Donnay[11] has published a detailed chronology of MCS from 1945 through to September 1999, which is a very good source of background information.

A report has also been published to help people with MCS/environmental sensitivity prepare for surgery.[12] The first and most important point is to avoid a gas anaesthetic. The reason for this is that anaesthetic gases are neurotoxic and can cause serious problems especially for people with sensitivities.

It must be remembered that environmental-type illness is not something that only a few people suffer from. According to the National Academy of Sciences, 37 million Americans suffer from environmental illness. Its estimate further holds that as high as 15% of Americans can no longer live comfortably in this post-industrial world and by this it is meant in their own homes. These awful statistics are also supported by a WHO strategy meeting on Air Quality and Health held in Geneva in September 2000 where it stated, "As many as one billion people, mostly women and children, are regularly exposed to levels of indoor air pollution exceeding WHO guidelines by up to 100 times." According to the EU's own studies, a person is confronted by at least 300 chemicals on a daily basis. The true figure in UK is unknown. This is not because the UK population is immune to MCS, but because the Poison Unit at Guy's Hospital deals with most if not all MCS cases (including the Gulf War veterans, organophosphate victims, Camelford, etc). Referral of MCS patients to the Poison Unit at Guy's Hospital in London usually results in some well-known phrase of diagnosis, i.e. "all in the mind and in need of psychiatric treatment", often resulting in further damage to the victim's health.

The Dangers of the Wrong Diagnosis

In 1989, a family in Paignton, Devon, were exposed to cellulose paint spray emitted from an 'illegal factory' next door to their home and restaurant. The entire family were made seriously ill and were left with MCS, and the reason given by the Environmental Health Officer for not intervening was that to do so would have meant paying compensation to the paint sprayer!

The son who is now 25 years old is the most affected and applied for incapacity allowance for not being able to work in a 'normal environment' as low-level pollutants can trigger his MCS symptoms.

During the appeal hearing, the environment of the room had so adversely affected the young man that he experienced breathing difficulty. The doctor who was present at the hearing put a bag over the young man's mouth and nose (a mis-diagnosis of hyperventilation), resulting in it being impossible for him to breathe. If he had been too young and not had the presence of mind to push the bag away from his face, the result of the bag over his mouth and nose could have been devastating.

There clearly is a need to give MCS sufferers the recognition and help they need to regain their dignity, quality of life and a working life where possible.

In spite of well-documented knowledge of the effects on human health and the environment, product labels that warn of adverse reactions such as headaches, nausea, blurred vision, etc., and mounting animal research that links specific reactions to specific chemicals as well as the introduction of double-blind clinical studies with humans, subjective symptoms of those suffering from MCS still remain highly controversial and are very often dismissed. Double-blind studies are routinely discounted by critics because of subjective concerns such as there being no way to verify if a patient is nauseous. For conventional medical practitioners, humans are still not considered reliable indicators!

With time-dependent sensitization (TDS) and enzyme deficiencies, animal models are now available for the study of MCS; however, the lack of funding for basic research is still a major problem. Another problem encountered is that even to have basic research published in established medical journals is virtually impossible. For example, doctors employed by the Dow Chemical Company, Eastman-Kodak, General Motors and the ITT Corporation control the Journal for Occupational Medicine.

Dr Nino Kunzli of the University's Institute for Social and Preventive Medicine led a European study on traffic and outdoor related air pollution,[13] which cited "increasing evidence that air pollution may also influence mortality rates of newborn babies or infants." The author acknowledges, "As we did not quantify attributable number of deaths below age 30 years, we might have underestimated lifetime lost." The report also states that, in total, 6% of deaths in Austria, France and Switzerland – more than 40,000 people a year – are due to air pollution.

According to an analysis conducted by the Natural Resources Defence Council (NRDC),[14] every year some 64,000 may die prematurely from cardiopulmonary causes linked to particulate air pollution. In the most polluted cities, lives are shortened by an average of one to two years. Los Angeles tops the list, with an estimated 5,873 early deaths.

Global Chemical Production

The above findings, however, must be looked at in the context of the global production of chemicals, which has increased from 1 million tonnes in 1930 to 400 million tonnes today. We have about 100,000 different substances registered in the EU market alone, of which 10,000 are marketed in volumes of more than 10 tonnes, and a further 20,000 are marketed at 1-10 tonnes.

The world chemical production in 1998 was estimated at $1,244 billion, with 31% for the EU chemical industry, which generated a trade surplus of $41 billion. In 1998, it was the world's largest chemical industry, followed by that of the US with 28% of production value and a trade surplus of $12 billion. The chemical industry is also Europe's third largest manufacturing industry. It employs 1.7 million people directly and up to 3 million jobs are dependent on it. As well as several leading multinationals, it also comprises around 36,000 small-to-medium- sized enterprises (SMEs). These SMEs represent 96% of the total number of enterprises and account for 28% of chemical production.

The Future

Following its report in 1995,[15] on 13 February 2001, the EuropeanCommission further adopted a White Paper setting out the strategy for a future 'Community Policy for Chemicals'.[16] The main objective of the new chemical strategy is to ensure a high level of protection for human health and the environment, while ensuring the efficient functioning of the internal market and stimulating the innovation of competitiveness in the chemical industry.

With an ever-increasing number of adults, families and children continuing to become chemically sensitive, there is still no immediate and corrective medical advice available. What will the future hold for the next generation unless we can convince the mainstream medical profession and/or Government bodies of the increasing need to understand MCS or similar types of syndrome? Governments' medieval responses today means that, unless we the people take action, the legacy we will leave for the next generation will be a life on Prozac or even stronger, more addictive drugs.

References

1. World Health Organization. Danger in the Air. Press Release WHO/56. WHO. 14 September 2001. See website at www.who.int/inf-pr-2000/en/pr2000-56.html
2. Ashford M et al. Chemical Sensitivity in Selected European Countries: An Exploratory Study. European Commission. 1995. See website at http://www.health.gov/environment/mcs/toc.htm
3. Wilson C. Chemical Sensitivities: A Global Problem. 1998. A report prepared at the request of the US Interagency Taskforce on MCS
4. Interagency Workgroup on MCS. Predecisional Draft Report. Environmental Health Policy Committee, Department of Health, USA. 1998.
5. Haney D Jason L & Bangheart MA.. The effect of housing on individuals with multiple chemical sensitivities. J Ptrim Prev. 19: 31-42. 1998.
6. Committee on the Medical Effects of Air Pollutants (COMEAP). The Quantification of Effects of Air Pollution on Health in the United Kingdom. Department of Health. 1998.
7. Ashford N and Miller C. Chemical exposures: Low Level and high stakes. John Wiley & Sons inc. 1998. USA.
8. Randolph T. Sensitivity to petroleum including its derivatives and antecedents. J Lab Clin Med. 40: 931-32. 1952.
9. Kurt TL. Multiple chemical sensitivities – a syndrome of pseudotoxicity manifest as exposure perceived symptoms. J Toxical Clin Toxical. 33: 101-05. 1995.
10. Kailin E and Brook C. Systemic toxic reaction to soft plastic food containers. Med Ann. Washington DC. 32: 1-8. 1963.
11. Albert Donnay MHS, MCS Referral and Resources, 508 Wetgate Road, Baltimore, MD, 21229-2343. See website at http://www.mcsrr.org/factsheets/
12. Beck Susan. Tips for Anaesthetics and Hospitalization for People with MCS – A Report. 7 June 1999. See website at www.immuneweb.org
13. Kunzli N. Public Health Impact of Outdoor and Traffic Related Air Pollution: A European Assessment. Environment News Service. 10 September 2001. See website at http://ens.lycos.com
14. Natural Resources Defence Council. Breath-Taking: Premature Mortality Due to Particulate Air Pollution in 239 American Cities. NRDC. May 1996.
15. Ashford M et al. ibid.
16. European Commission. Commission Sets Out the Path towards Sustainable Use of Chemicals. White Paper IP/01/201. European Commission. Brussels. 2001. See website at http://europa.eu.int