Multiple chemical sensitivity (MCS), as defined by Spenser et al (2008), is 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. One proposed causation is a chemically induced injury of the liver, which may generate injury of the enzymatic detoxification systems, triggering a myriad of end organ responses.
In the 1950’s, Theron Randolph was the first to recognize the process that later became known as multiple chemical sensitivity. Victims suffer negative health effects, such as rapid heart rate, dizziness, difficulty breathing, fatigue, flushing, nausea, coughing, shortness of breath, and seizure activity when exposed to pesticides, fragrances, air fresheners, household cleaning products, cigarette smoke, paint fumes, and many other chemically unrelated compounds found in nearly every indoor environment, as well as many outdoor environments.
MCS results in significant morbidity and mortality, and economic, healthcare, and social burdens. As many as 13.5% of cases result in job loss and countless costs are incurred seeking out medical interventions, which also burdens the health care system.
In the 1950’s, Theron Randolph was the first to recognize the process that later became known as multiple chemical sensitivity. Victims suffer negative health effects, such as rapid heart rate, dizziness, difficulty breathing, fatigue, flushing, nausea, coughing, shortness of breath, and seizure activity when exposed to pesticides, fragrances, air fresheners, household cleaning products, cigarette smoke, paint fumes, and many other chemically unrelated compounds found in nearly every indoor environment, as well as many outdoor environments.
MCS results in significant morbidity and mortality, and economic, healthcare, and social burdens. As many as 13.5% of cases result in job loss and countless costs are incurred seeking out medical interventions, which also burdens the health care system.
Roughly 15% of the population report negative health effects upon exposure to chemicals, which presents the scientific, medical, legal, and political communities with many challenges.
The first challenge of MCS is the persistent difficulty in defining an underlying disease process. Industry, ready to protect its financial interests in the chemicals it produces, has supported a psychological causation. This has created a debate in the medical and political communities, which is complicated by the lack of an accepted diagnosis test, such as a blood test, to confirm the condition.
The second challenge of MCS is called masking, a process by which ongoing exposures hide the effects of a specific exposure, making identifying triggers and diagnosis difficult. In severe cases, the patient may be in a constant state of reaction, requiring a controlled setting devoid of triggers to unmask routine exposures over a period and then diagnose the specific effects of individual acute exposures.
The third challenge of MCS is that it is not consistent with current ideas in toxicology, which rely heavily on visible and lethal effects to label a substance as toxic. A new paradigm in toxicology is needed to establish toxic effects at lower, non-lethal doses. Then, the precautionary principle can be adopted to regulate potentially harmful chemicals when scientific evidence is convincing.
The fourth challenge of MCS is a lack of ongoing federally supported research. The EPA and CDC have been woefully deficient, and according to Spenser, “government funding and support impacts the legitimization of the experiences of millions of ill Americans, independent of whatever the etiology may be.”
The fifth challenge of MCS is that policy makers currently fail to regulate a chemical until it is later discovered to be harmful. Newly proposed regulations, such as the Kid Safe Chemical Act, would place the onus on industry to prove their products safe before they go to market.
The sixth challenge of MCS is that it falls within the realm of government regulation, since environmental triggers from air pollution and toxic waste are at fault. Some have recommended establishing a disease registry with MCS as a reportable condition, while increasing funds and programs and minimizing use of toxic chemicals.
The seventh challenge of MCS is that if it is proven scientifically valid, MCS would significantly impact public health. Spenser asserts, “MCS could fundamentally alter our understanding of pathophysiology, affecting disease research design and disease prevention measures. On a much broader level, the government, private sector, consumers, and general population would be engaged in a partnership that would benefit all of public health.”
Spenser concludes, “The question of whether MCS is a legitimate physiologic disease process is, to some degree, only incidental. Even if MCS does not prove to be the disease its proponents claim, this does not negate the need for appropriate treatment for the illness. The health care system and public health as a whole should respond appropriately. A public health community that is unable or unwilling at a minimum to contemplate paradigm-altering possibilities neglects its duty. With such significant implications, neglect would be insensitive.”
Indeed, many individuals with MCS suffer great neglect at the hands of the health care system. Often being denied care altogether, those that can find adequate care can rest assured most of it will not be covered by insurance. The stigma and financial burden of acquiring MCS assures most victims of societal rejection.
One has to consider that the nature of MCS, being defined by chemically induced injury by chemicals that are virtually unavoidable, means that you or your loved ones could suddenly become affected. What then?
We must fight now for funding for more research, EPA and CDC involvement, and tighter chemical regulations. We must assist and learn from our citizens who have been injured by chemicals. Our future depends on it!
Reference
Spencer TR, Schur PM. The challenge of multiple chemical sensitivity. J Environ Health. 2008 Jun;70(10):24-7.
Note: This article appeared in the MCS America News, July 2008, Volume 3, Issue 7 at http://mcs-america.org/July2008pg1011.pdf
Key Words: multiple chemical sensitivity, chemical sensitivity, chemical sensitivities, multiple chemical sensitivities, MCS, EI, environmental illness, sick building syndrome, idiopathic environmental intolerance, fibromyalgia, chronic fatiuge, FM, CFS, mold illness, clinical ecology, alternative medicine, environmental medicine, neuropathy, encephalopathy, toxic, chemical
