Saturday, September 29, 2007

Children's environmental health and the precautionary principle

Copyright © 2007 Elsevier GmbH All rights reserved.

Children's environmental health and the precautionary principle

Dorota Jarosinska, a and David Geea
aEuropean Environment Agency, Kongens Nytorv 6, 1050 Copenhagen, Denmark

Available online 21 September 2007.


The concept of precaution has a long history in medicine and public health. The modern precautionary principle (PP), originating from environmental debates in Germany in the 1970s, has been included in many international agreements, such as the Treaty on European Union. PP is a public policy tool that justifies actions, which protect human health and the environment in face of uncertain risks. The outcome of the application of PP depends on the level, nature, and distribution of acceptable risks and on the availability of alternatives, and can range from taking no action to banning of substances or the activities of concern.

Given the complex nature and uncertainty of environmental risks to children's health, a precautionary approach is warranted. Public health professionals and clinical practitioners could adopt such an approach within the wider context of considering the environment as a source of risks to children's health. Relevant knowledge and skills are needed to enable health care professionals to address these issues. New methodological and scientific approaches are necessary to make use of scattered, but potentially relevant clinical evidence in providing 'early warnings' of health hazards.

Keywords: Precautionary principle; Children's health; Environment

Abbreviations: APHA, American Public Health Association; BSE, bovine spongiform encephalopathy; CFCs, chlorofluorocarbons; DES, diethylstilboestrol; EC, European Commission; EEA, European Environment Agency; PCBs, polychlorinated biphenyls; TBT, tributyltin; WHO, World Health Organization

Friday, September 28, 2007

Laundry detergents: an overview.

J Oleo Sci. 2007;56(7):327-40.Click here to read

Laundry detergents: an overview.

Department of Oil and Paint Technology, Harcourt Butler Technological Institute.

Nowadays laundry detergents are becoming increasingly popular as they can be metered automatically into the washing machine, impart softness, antistaticness, resiliency to fabrics, mild to eyes and skins and shows good dispersibility in water. Because it is consumed when it is used, the sale of laundry detergent is a rather large business. There are many different kinds or brands of laundry detergent sold, many of them claiming some special qualities as selling points. A Laundry detergent composition is a formulated mixture of raw materials that can be classified into different types based on their properties and function in the final product. The different classes of raw materials are surfactants, builders, bleaching agents, enzymes, and minors which remove dirt, stain, and soil from surfaces or textiles gave them pleasant feel and odour. The physico-chemical properties of surfactants make them suitable for laundry purposes. Laundry detergent has traditionally been a powdered or granular solid, but the use of liquid laundry detergents has gradually increased over the years, and these days use of liquid detergent equals or even exceeds use of solid detergent. This review paper describes the history, composition, types, mechanism, consumption, environmental effects and consumption of laundry detergents.

PMID: 17898499 [PubMed - in process]

Free Ful Text is available, however I was unable to open the link. 

What is the short term effect of perfumes on olfactory thresholds?

J Laryngol Otol. 2007 Aug;121(8):755-8. Epub 2007 May 1. Links

What is the short term effect of perfumes on olfactory thresholds?

Department of Otorhinolaryngology, University Hospitals of Leicester NHS Trust, Norwich, UK.

OBJECTIVES: Body sprays and perfumes are commonly worn by patients attending ENT out-patients clinics. Their effect on performance in olfactory testing is unknown. The aim of this study was to determine whether olfactory thresholds are altered by the presence of such fragrances. MATERIALS AND METHODS: One hundred and sixty healthy volunteers, aged 18 to 65 years, underwent olfactory thresholds testing. Each was then exposed to one of four strong perfumes, applied in a facemask for two minutes, and the thresholds were retested. RESULTS AND ANALYSIS: All olfactory thresholds worsened after being exposed to the strong perfumes of Lynx and Impulse body sprays, with the strongest effect being on olfactory detection of phenylethyl alcohol (p<0.001). CONCLUSIONS: Strong perfumes can have a negative effect on olfactory thresholds. SIGNIFICANCE: Patients attending olfactory threshold testing need to be advised not to wear body sprays or perfumes.

PMID: 17470308 [PubMed - indexed for MEDLINE]

Sensitization, glutamate, and the link between migraine and fibromyalgia

Curr Pain Headache Rep. 2007 Oct;11(5):343-51. Links

Sensitization, glutamate, and the link between migraine and fibromyalgia.

Neurologic Clinic, Department of Medical and Surgical Specialties and Public Health, University of Perugia, Ospedale Santa Maria della Misericordia, Via Santa Andrea delle Fratte, San Sisto, 06158 Perugia, Italy.

Recent advances have shed insight on the pathophysiologic mechanisms of fibromyalgia and migraine, especially in the chronic form. A growing body of evidence supports the involvement of peripheral and central sensitization disturbances of pain-related processes underlying both disorders. They involve increased glutamate transmission through interaction with its ionotropic and metabotropic receptors. Few studies supporting the implication of this excitatory amino acid in chronic migraine and primary fibromyalgia demonstrated increased levels of glutamate in the cerebrospinal fluid of affected patients. These findings have implications for future therapies directed against glutamate receptors (in particular, N-methyl-D-aspartate receptors). Limited clinical experience in this regard, although promising, does not exclude additional mechanisms contributing to the maintenance of pain, which can be the target of therapeutic approaches in both disorders.

PMID: 17894924 [PubMed - in process]

Perceived annoyance and asthmatic symptoms in relation to vehicle exhaust levels outside home: a cross-sectional study

Perceived annoyance and asthmatic symptoms in relation to vehicle exhaust levels outside home: a cross-sectional study.

Lars Modig email and Bertil Forsberg email

Environmental Health 2007, 6:29doi:10.1186/1476-069X-6-29

Published: 28 September 2007

Abstract (provisional)


Exhaust emissions from vehicles is a well known problem with both epidemiological and experimental studies showing increasing adverse health effects with elevating levels. Many of the studies concerning vehicle exhausts and health are focused on health outcomes where the proportion attributed to exhaust is low, while there is less information on early and more frequent subjective indicators of adverse effects.


The primary aim of this study was to study perceived annoyance in relation to vehicle exhaust concentrations using modelled levels of nitrogen dioxide outside the home as an indicator with high spatial resolution. Almost 2800 persons in a random sample from three Swedish cities (Umea, Uppsala and Gothenburg) responded to our questionnaire. Questions were asked to determine the degree of annoyance related to vehicle exhausts and also the prevalence of irritating and asthmatic symptoms. Exposure was described for each participants home address by meteorological dispersion models with a 50 meter resolution.


We found a significant increase of peoples' self-assessed annoyance with rising levels of NO2. The odds of being very annoyed by vehicle exhausts increased by 14% per 1ug/m3 increase of the NO2 level (odds ratio (OR)= 1.14, 95% confidence interval (CI)= 1.11-1.18), and the odds of reporting the air as daily or almost daily irritating increased by 9% (OR= 1.09, 95% CI= 1.05-1.13). Also the odds of reporting asthmatic symptoms increased significantly with elevated NO2 levels (OR= 1.04, 95% CI= 1.01-1.07).


This study found the degree of annoyance related to vehicle exhaust and irritating and asthmatic symptoms to be significantly dependant on the levels of traffic related pollutants outside the home. The detailed exposure assessment lowers the degree of misclassification as compared to between-city analyses, which makes the results more accurate and applicable on the local scale.

Links for the Week Ending 9/28/2007

Dr. Michael Harbut
Center for Occupational and Environmental Medicine, PC
118 North Washington Avenue
Royal Oak, MI 48067
Tel: 248-547-9100
Fax: 248-547-9336

Organic Cotton T-shirts

News Links for the Week Ended September 28, 2007

October 8, 2007

The High Price of Beauty

Ground-breaking study links food additives to hyperactivity in children

Sens. Clinton, Hatch, and Speaker Pelosi Promote New Health Initiative to
Protect Americans from Environmental Health Hazards

September 26, 2007

Potential hazards spur Walgreens to pull air fresheners

Lunchbox supplier nixed lead warnings
If the bags had been labeled, officials say, state would have tossed them.

Formulating environmentally friendly flame retardants

September 25, 2007

Protecting Americans through Better Chemical Exposure Monitoring

Tyson foods drops antibiotics from its chicken meat products

How to Use Nutrition to Eliminate IBS and Treat Asthma, Allergies

EPA to Approve New Fumigant for Crops

September 24, 2007

How "Fresh" Is Air Freshener?,8599,1664954,00.html

Exposure to the invisible cloud of energy called electrosmog is rising

Smog vs. breath

September 23, 2007

Sick of it all

5 THINGS TO KNOW ... about mold,1,4406239.story?ctrack=1&cset=true\\

Why Stuff Stinks: Secret Sniffed Out

Cloud of worry gathers over wireless health risks

September 22, 2007

Potentially Harmful Chemical Found in Some Air Fresheners

Smells like teen spirit: TVHS looks to regulate student scents

September 21, 2007

Coercion as a Cure?

September 20, 2007

Oxygen Therapy Benefits Children With Autism

September 18, 2007

Hillary Proposes Universal Healthcare Plan

September 18, 2007

Restricting pesticides could greatly reduce suicide rates worldwide

September 17, 2007
Soldier faces threats from military after refusing anthrax vaccine

September 15, 2007
Study of epigenetics seeks to control genes' functions

August 29, 2007
DDT's resurrection

Lourdes "Sal" Salvador
MCS America:
MCS America Blog:
MCS America Logo Shop:
To subscribe to the monthly MCS America News:

Thursday, September 27, 2007

Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey

Association between respiratory tract diseases and secondhand smoke exposure among never smoking flight attendants: a cross-sectional survey

Jon O Ebbert email, Ivana T Croghan email, Darrell R Schroeder email, Judith Murawski email and Richard D Hurt email

Environmental Health 2007, 6:28doi:10.1186/1476-069X-6-28

Published: 26 September 2007

Abstract (provisional)


Little is known about long-term adverse health consequences experienced by flight attendants exposed to secondhand smoke (SHS) during the time smoking was allowed on airplanes. We undertook this study to evaluate the association between accumulated flight time in smoky airplane cabins and respiratory tract diseases in a cohort of never smoking flight attendants.


We conducted a mailed survey in a cohort of flight attendants. Of 15,000 mailed questionnaires, 2053 (14%) were completed and returned. We excluded respondents with a personal history of smoking (n = 748) and non smokers with a history of respiratory tract diseases before the age of 18 years (n = 298). The remaining 1007 respondents form the study sample.


The overall study sample was predominantly white (86%) and female (89%), with a mean age of 54 years. Overall, 69.7% of the respondents were diagnosed with at least one respiratory tract disease. Among these respondents, 43.4% reported a diagnosis of sinusitis, 40.3% allergies, 30.8% bronchitis, 23.2% middle ear infections, 13.6% asthma, 13.4% hay fever, 12.5% pneumonia, and 2.0% chronic obstructive pulmonary disease. More hours in a smoky cabin were observed to be significantly associated with sinusitis (OR = 1.21; p = 0.024), middle ear infections (OR = 1.30; p = 0.006), and asthma (OR = 1.26; p = 0.042).


We observed a significant association between hours of smoky cabin exposure and self-reported reported sinusitis, middle ear infections, and asthma. Our findings suggest a dose-response between duration of SHS exposure and diseases of the respiratory tract. Our findings add additional evidence to the growing body of knowledge supporting the need for widespread implementation of clean indoor air policies to decrease the risk of adverse health consequences experienced by never smokers exposed to SHS.

Wednesday, September 26, 2007

MCS America News - October 2007 Issue

MCS America News
Volume 2 Issue 10
October 2007

Full PDF:

Article Previews on the Web wtih Links to Individual Articles:

Position Statement on MCS Etiology
This paper will support the position that MCS is a disorder of organic biological origin induced by toxic environmental insults, and requires immediate recognition in the workplace, medical community, school system, and public places across America; and that it is crucial that environmental toxicants are identified and reduced or effectively regulated and enforced through legislation to prevent additional injury to citizens.

Community Spotlight:Martin L. Pall, PhD
PDF: How did you become interested in MCS and the tenth disease paradigm?

I became  interested in this group of illnesses, mainly because I came down with chronic fatigue syndrome after a viral infection a bit over ten years ago.  My  interest in CFS became broadened to this group of illnesses, as I became aware of their many similarities, their co-morbidity and the proposals from others that they may share a common etiology  (causal mechanism).

Activist's Corner
This months Activist's Corner is dedicated to a call to action on behalf of Dr. Rea.  Dr. Rea writes:
Dear Patients:
This letter is being sent to you so that we may provide information about a potential serious threat to your choice of medical care. To put it bluntly, there is currently an organized nation-wide effort to destroy the specialty of Environmental Medicine and to eliminate from practice physicians who diagnose and treat patients suffering from chemical sensitivities.

Studies:  Antibacterial Soap Harmful
Researchers at the University of Michigan say antibacterial soaps has no health benefits and may, in fact, be more harmful than regular soap.
Allison Aiello her colleagues found that washing hands with an antibacterial soap is no more effective in preventing infectious disease. In addition, antibacterial soaps do not remove any more bacteria during washing than regular soap.

Studies:  Green Tea as a Detoxifier
Green tea prevents cancer, according to researchers from the University of Arizona who state that green tea consumption has been associated with decreased risk of certain types of cancers in humans.  Chow et al set out to determine the biochemical mechanisms responsible for the cancer-preventive effect of green tea in a clinical study, and more specifically, to determine the effect of repeated green tea polyphenol administration on a major group of detoxification enzymes  known as glutathione S-transferases (GST).

World Trade Center Teaches a Lesson
September 11th is a day that will never be forgotten for various reasons.  While most of us remember the day as shocking and emotional,  those involved in rescue at the World Trade Center's twin tower's, remember the toxic cloud of air pollution, dust, and smoke with every breath.  According to scientists, occupational exposures at the World Trade Center disaster site have been associated with a disease profile in which ongoing respiratory symptoms predominate.

AMeriCanS with Disabilities
Multiple Chemical Sensitivity (MCS) is an invisible disability.   According to a presentation at the Association of Postdoctoral and Psychology Internship Centers Membership Conference, which was held April 12 – 14, 2007, an invisible disability is not readily apparent to others and, therefore, a person with MCS faces social and attitudinal, as well as chemical, barriers with the risk of misunderstandings of sincere communications, misinterpretations of behaviors, and reactions of doubt, blame, and trivialization regarding one's symptoms.

Artistic Endeavors:  Breezes
Breezes ebb and flow with varying force;
Pushing, then releasing the leaf - filled branches
of the small, but growing tree.

Searching for safety while flying solo,
a harrowing sparrow lites on a branch,
as it's lifted from gusts of wind.
Once settled, the sparrow rides the
jostling movements of the branch.

Sal's Place
MCS Can Be Deadly
Multiple Chemical Sensitivity (MCS) is a life changing illness.  As an invisible disability, often not apparent to others,  a person with MCS not only faces chemical barriers, but also social and attitudinal barriers, which researchers say carries the risk of misunderstandings, misinterpretations of behavior, reactions of doubt, victim blaming, and  worse, trivialization of symptoms.  These barriers exist as a result of others not being able to visibly see the disability of MCS, since symptoms are not often visible to others and instead manifest in fatigue, pain, respiratory problems, cognitive decline, and general health decline, none of which is apparent to the naked eye.

Inside MCSA
PDF: The following information is quoted from   at the request of Gordon McHendry, founder of MCS International.  Gillian is in the UK.  More information on Gillian, including video's may be found at the link above.
Dear Friends,
PLEASE - help us save Gillian McCarthy. Your help is urgently needed. 

Community News
PDF: Is Mystery Mold to Blame for Student Sickness?

UNSW has delivered a final blow to the theory that Chronic Fatigue Syndrome
(CFS) is driven by the body's immune system

Text:  N/A
I Can Breathe Masks

Featured Research Studies
Text:  N/A
Environmental Exposure Assessment, Pollution Sources, and Exposure Agents:
A Primer for Pediatric Nursing Professionals

Multiple Chemical Sensitivities America

Copyrighted © 2007  MCS America

Position Statement on Multiple Chemical Sensitivity (MCS) Etiology

Position Statement: Multiple Chemical Sensitivity


Multiple chemical sensitivity (MCS) is an environmental illness (EI) in which negative neurological, pulmonary, cardiac, and rheumatic health effects, among others, are experienced from exposure to common environmental chemicals including fragrances, cleaners, pesticides, and other petrochemicals at concentrations that are below regulatory toxicity thresholds and that are normally deemed as safe.1-2   In 1989, consensus criteria were established for the diagnoses and definition of MCS and later revised in 1999.3  The case criteria, currently under revision, define MCS for diagnostic purposes as meeting six criteria: 3


1. The condition is chronic.

2. Symptoms recur reproducibly with repeated chemical exposure.

3. Symptoms recur in response to lower levels of chemicals than previously tolerated.

4. Symptoms appear in response to multiple chemically unrelated substances.

5. Symptoms improve or resolve when chemical incitants are removed.

6. Multiple organ systems are affected.


This paper will support the position that MCS is a disorder of organic biological origin induced by toxic environmental insults, and requires immediate recognition in the workplace, medical community, school system, and public places across America; and that it is crucial that environmental toxicants are identified and reduced or effectively regulated and enforced through legislation to prevent additional injury to citizens.


Current Evidence of MCS


Nuclear medicine utilizes SPECT (Single Photon Emission Computerized Tomography) technology to perform brain scans which records brain functioning by measuring perfusion (blood flow).4  MCS patients commonly have a lower baseline flow of blood to the brain, and develop further decreases in brain perfusion upon exposure to perfumes and petrochemicals.5-7  Individuals with chronic symptoms show long-term reduced blood flow to the brain and reduced ability of the brain to take up the tracer substance in the early phase of injection, indicating a pattern of neurotoxic metabolic abnormality.7-11  Over 90% of MCS patients exhibit a pattern of neurotoxic metabolic abnormalities in the brain that is consistent with toxic encephalopathy, but that  is not consistent with the changes associated with psychiatric disease.10-11  SPECT brain scans on MCS patients with chronic symptoms following toxic exposure to various petrochemical, perfume, and related compounds have thus provided evidence to support an organic, biological basis to MCS when compared with healthy control subjects.6-11


Numerous studies have documented toxic encephalopathy and other adverse reactions resulting from low level chronic exposure to various chemicals.12-15  Researchers have identified numerous physiological abnormalities in MCS subjects, including cardiac abnormalities16-18, reactive upper airway disease155, vasculitis19, thrombophlebitis20, impaired Phase 1 and Phase II detoxification clearance16, glutathione depletion16,21, tinnitus22, thyroid and adrenal abnormalities23, gastrointestinal disturbances155, T-cell activation/impaired NK cell function/auto-immune disorders16,25-26, vitamin and mineral deficiencies16,27, nuerocognitive decline16,28-29, rhinitis30, sinusitis30, respiratory inflammation17, abnormal methacholine challenge17, somatosensory abnormality31, peripheral neuropathy16, sleep disturbance32, impaired balance16, and elevated levels of xenobiotics25 among others. 


Mast cell activation and disorders of porphyrin metabolism have also been linked to MCS.16,33  Those with mastocytosis can be exquisitely sensitive to even small amounts of chemicals.33  A group of MCS patients tested for mast cell disease showed some patients actually had mastocytosis and others were found to have a mast cell disorder.33   Porphyrin enzyme abnormalities have also been shown to manifest in blood enzyme deficiencies and chemical sensitivity in 86% of subjects.34


Research suggests substantial individual differences in chemical sensitivity, often spanning orders of magnitude.35  There are more than 40 studies on MCS published from the United States, Canada, Europe, Japan, and Australia which have shown that most cases of MCS are initiated after one or more exposures to organic solvents and three classes of pesticides.157,163  The pattern of causality by chemical exposure is well documented.157,163,165  Evidence now shows that genes controlling the activity of enzymes known to have roles in the metabolism of these organic solvents and pesticides, also have roles in determining increased susceptibility to MCS.163,165  The epidemiological evidence and genetic evidence of causality is further supported by the Hill criteria, which was developed to determine the likelihood of a causal role for environmental factors in disease.163-165


Genetic differences relating to detoxification processes are present more often in those with MCS than those without.67  Five genetic polymorphisms have a statistically significant role in determining MCS prevalence.67  People with a ''high'' expression of two specific genes (CYP2D6 and NAT2) were shown to be 18 times more likely to have MCS.67   Each of these genes encodes proteins that metabolize chemicals previously implicated in MCS, notably some organophosphorus pesticides (PON1 and PON2 genes) and the organic solvents (CYP2D, NAT1 and NAT2 genes). 67   Chemicals shown to initiate MCS must be in a specific chemical form to be active; therefore, individuals who metabolize them at different rates vary in their susceptibility to MCS.67   Genetic predisposition for MCS may involve altered biotransformation of environmental chemicals.66   Haley found similar, confirmatory results with the PON1 gene in studies of the Gulf War syndrome veterans65, findings that have been confirmed by Furlong, Hulla, and Thier.156-158   


Another study analyzed genetic variants of four genes: NAT2, GSTM1, GSTT1, and GSTP1.  The GST- genes code for enzymes in the glutathione system, the body's frontline defense against xenobiotics.37  Individuals who are NAT2 slow acetylators and those with homozygously deleted GSTM1 and GSTT1 genes are significantly more likely to develop chemical sensitivity.37  Glutathione S-transferases act to inactivate chemicals; people without these GSTM1 and GSTT1 genes are less able to metabolize environmental chemicals.37   Glutathione S-transferases play a crucial role in the process of detoxification of chemicals.37  The deletion of another gene, the GSTP1 gene, leaves individuals more susceptible to developing MCS, as lack of these genes means a loss of protection from oxidative stress.37 


MCS may also be caused by low molecular weight chemicals that bind to chemoreceptors on sensory nerve C-fibers leading to the release of inflammatory mediators.38   Brain inflammation, biochemistry, oxidative stress, excitotoxicity and other interrelated mechanisms are correlated with symptoms of MCS.39,163 An accumulating body of consistent and well-documented evidence implicates elevated nitric oxide (NO) and peroxynitrite (ONOO-) as the etiology of the central nervous system and peripheral tissue sensitivities seen in MCS and other multi-system illnesses, including fibromyalgia (FM), chronic fatigue syndrome (CFS), post-traumatic stress disorder (PTSD), and Gulf War syndrome.39  Peroxynitrite (ONOO-) is oxidized from nitric oxide.39-40  Excess peroxynitrite, implicated in MCS and related illnesses, depletes energy stores, which in turn causes extreme fatigue.39-40  Peroxynitrite also increases the permeability of the blood brain barrier; excess levels allow chemicals greater chemical access to the brain.40   Breakdown of the blood brain barrier has been shown in MCS patients by Kuklinski and in animal models of MCS by Abou-Donia.161-162   The key effect of nitric oxide (NO) in the body is inhibition of cytochrome P-450 activity and slowing degradation of hydrophobic organic chemicals.39-40  Excess nitric oxide levels, as found in MCS patients, slows down the body's natural detoxification processes leaving chemical toxicants in the body for a longer period of time.39-40  A reduced blood-brain barrier and increased time to naturally detoxify the body may render MCS patients subject to permanent and long-term brain and nervous system damage and toxic encephalopathy.  At least thirteen stressors are implicated as initiators that begin the NO/ONOO cycle of biochemistry in these multi-system illnesses through chronic low-level exposure or a sudden acute exposure to an inciting agent, including carbon monoxide exposure, organophosphate poisoning , and ionizing radiation exposures.39,41


Prior Paradigms


There have been various claims that MCS is caused by some ill-defined and unsupported psychogenic mechanisms.42-44,50  One such theory suggests that MCS may be a Pavlovian learned fear response.44  There is no supporting evidence for the claim of a Pavlovian learned response, as Pavlovian conditioning requires the formation of an association between a conditioned stimulus (CS) and an unconditioned stimulus (US) through repetition in order for learning to occur.45   The subject would have to know, understand, and connect the dangers of chemical ingredients of the same nature as incitants, despite these ingredients being generally regarded as safe and, in the case of fragrances and many cleaning chemicals, unlabeled on the product under HHS § 720.9 of the Food and Drug Administration.46  It is quite conceivable that MCS patients learn of the chemical content of common products used in the environment after they develop MCS, when they are thus forced to educate themselves in order to practice avoidance to improve and ultimately remain well.  Subjects reliably react to fragrances in provocation tests in which their nose was clamped, showing symptoms were not transmitted via the olfactory nerve, since the subjects could not smell the perfume.47-48,60-61  Much like those unaware of chemical exposure to virtually odorless products, such as carbonless copy paper or sick buildings, patients with MCS also react to chemicals which are odorless, giving no hint of impending exposure and invalidating the theory of MCS being a fear induced olfactory response or learned behavior.24,47-48,60


Psychological proponents have also purported that co-occurring depression and/or anxiety in a portion of subjects causes MCS.50-51  If this were true, then 100%, or at least a statistically significant proportion, of the subjects would have co-occurring mental illnesses, and that illness would likely have been present prior to MCS onset.  Since that is not the case and the rate of co-occurring mental illness in MCS patients is similar to that of other physiologically based chronically ill populaces, then depression and/or anxiety may be ruled out as an etiologic mechanism and instead considered reactionary.52-57    Further evidence against this theory is provided by statistics that show psychotherapy and psychoactive drugs intended to cure MCS have been shown to be more likely to harm patients than help them.58    A study shows 80% of MCS patients report no benefit from psychotherapy to cure MCS and 15% have reported further harm.58   Though 65% find psychotherapy helpful to cope with the dramatic life changes MCS bestows upon them, psychotherapy is obviously not a cure, as MCS is not a psychologically mediated disease.58  Further, psychiatric drugs such as Zoloft, Prozac, Elavil, and other antidepressants were reported to harm an average of 60% of those who tried them and had no effect on an additional 25%.58  Drugs such as Valium and Xanax proved to harm 45% and had no effect on an additional 30%.58   There is not a single empirical study that shows any significant remission rate in the symptoms of a cohort of environmental illness patients from counseling or psychiatric drug therapy. 


Proponents of a psychological etiology claim that MCS defies classification as a disease because it supposedly lacks evidence, and has no consistent characteristics or objective measurable features; however, all these proponents have shown is their own failure to read and cite the numerous studies in the peer-reviewed literature that report the physiological, biochemical, and genetic findings of MCS.17,30,38,58-62,76  Further, they have failed to provide any explanation for the factors distinguishing the chemicals involved in MCS from those that have no role; they have not shown how a psychological mechanism could stand behind an odorless chemical producing symptoms or a benign odiferous chemical failing to produce symptoms.63  They have also ignored the prospects for objective biomarker tests for MCS that have been published by Kimata, Millqvist, Bell and Fox and their respective colleagues, each of which is based on measurable physiological changes in response to low level chemical exposures in MCS patients.17,58-62  They have disregarded SPECT imaging results showing brain changes which are inconsistent with psychiatric disease and indicate a biological origin for MCS in neurotoxicity.7-11  More importantly, they have overlooked the genetic data of Schnakenberg, McKeown-Eyssen and her colleagues, and the earlier work of Haley and his colleagues showing that the chemicals initiating MCS act as toxicants, not as odors generating some strictly olfactory response.37,65.67  The proponents have given complete disregard to the genetic roles that meet Hill criteria and which are, by definition, causal, as subjects have no idea what forms of these genes they carry and consequently, their psychology cannot be influenced by the perception that they should be more susceptible.37,65.67,163-164  Genetic studies, coupled with known biochemical functions of the genes involved, are the recognized approach to determining the biological mechanism of MCS.66-67 These specific studies provide significant confirmation of the toxicogenic roles of chemicals previously implicated in MCS.66-67 


In the past, MCS patients have been labeled as being psychogenic, largely due to the outward symptoms of physiological neurotoxicity.28,58  Patients with MCS may develop hyperactivity in deep structures of the brain during chemical exposure, explaining the emotional liability some experience, on a physiological rather than psychological basis.68   Petrochemicals and organic solvents are known etiologic mechanisms with an organic basis that induce depression, anxiety, panic attacks, and other apparent mental disorders via known organic etiologic mechanisms; but these manifestations resolve when incitants are removed, thus distinguishing them from true psychiatric illnesses.69-71  The evidence is now abundant that MCS is a true organic, biological illness.17,61-63   Patients may be helped with detoxification protocols, biochemical stabilizing therapy, and/or exposure education, and should not be sent for useless, and often harmful, psychiatric treatment and medications to cure MCS.17,61-63  Patients with MCS desire qualified medical care and the opportunity to return to a full life and career.27,73-73  Many report that they had successful, professional careers prior to becoming ill and reported that they would happily resume their old lives if they found relief from their MCS.28,72-73  This relief includes the recognition and acceptance of MCS, access to proper medical treatment, and accommodations in the school system, workplace, and public community.28,72-73  




A surprising number of people report sensitivity to ordinary everyday chemicals.74-81  The figures range from an average of eleven to seventeen percent, with spikes as high as thirty percent of subjects who report reactions to multiple chemical incitants.74-81  The figures reveal that at least two percent, and as many as six percent, have been so bothered by chemical exposures that they sought medical care and received a doctor-diagnosis of multiple chemical sensitivity (MCS).79,81   Applying the case definition criteria3 to the average reported chemical sensitivity, it appears that 1.5 out of 10 people suffer from MCS.74-81


Health care utilization costs directly related to MCS have been estimated at approximately $1,581 annually per patient.82   The United States Population is estimated to be 302.8 million.83   Prevalence studies predict that approximately 15% of the United States population, now estimated at 302.8 million, suffers from MCS; therefore, direct health care utilization costs amount to a staggering $71.8 billion dollars per year.74-82  Estimated costs for MCS and other disorders linked to neurotoxicity amount to an additional $81.5 to $167 billion annually in lost productivity.84   Cumulative social and economic costs identified in four case studies of illnesses that are candidates for environmental causation totaled between $568 billion and $793 billion dollars per year.85




Prevalence of MCS


General Populace Reporting Symptoms of MCS

Bell, IR, Schwartz, GE, Peterson, JM and Amend, D. Self-reported illness from chemical odors in young adults without clinical syndromes or occupational exposures.  Arch Environ Health. 1993 48:6-13.


Bell, IR, Schwartz, GE, Peterson, JM, Amend, D and Stini, WA. Possible time-dependent sensitization to xenobiotics: self-reported illness from chemical odors, foods, and opiate drugs in an older adult population. Arch Environ Health. 1993 48: 315-27.


Meggs WJ, Dunn KA, Bloch RM, Goodman PE, & Davidoff AL. Prevalence and nature of allergy and chemical sensitivity in a general population. Arch Environ Health. 1996 Jul-Aug;51(4):275-82.


Voorhees, RE. Memo from Deputy State Epidemiologist Voorhees to Joe Thompson, Special Counsel, Office of the Governor. New Mexico Department of Health. 1998.


Bell, IR, Warg-Damiani, L, Baldwin, CM, Walsh, ME and Schwartz, GE. Self-reported chemical sensitivity and wartime chemical exposures in Gulf War veterans with and without decreased global health ratings. Mil Med. 1998 163:725-32.

30% (Gulf War Veterans)

Kreutzer R, Neutra RR, & Lashuay N. Prevalence of people reporting sensitivities to chemicals in a population-based survey. Am J Epidemiol. 1999 Jul 1;150(1):1-12.

15.9%          6.3% doctor diagnosed

Caress SM, & Steinemann AC. Prevalence of multiple chemical sensitivities: a population-based study in the southeastern United States. Am J Public Health. 2004 May;94(5):746-7.


Caress SM, & Steinemann AC. A national population study of the prevalence of multiple chemical sensitivity. Arch Environ Health. 2004 Jun;59(6):300-5.


Caress SM, & Steinemann AC. National prevalence of asthma and chemical hypersensitivity: an examination of potential overlap. J Occup Environ Med. 2005 May;47(5):518-22

11.2%           7.4% doctor diagnosed

All studies report most common in women and not specific to any particular socioeconomic status.



Evidence of the Toxicity of Everyday Chemicals


Various studies of product safety generating EPA safe limits have failed to consider the impact of combined exposures in day-to-day living, which add to the body burden of chemicals in humans and must be utilized, expelled, or stored.2,86-116  Many of the chemicals that act as MCS incitants, including fragrances, cleaning products, air fresheners, fabric softeners, disposable diapers, and pesticides, have been scientifically shown to elicit symptoms of toxicity in "normals" at levels of common, and often unavoidable, exposure in the environment. 117-128,130.134,136  At the time the Toxic Substances Control Act (TSCA) of 1976 was passed, the chemical industry effectively grandfathered substances already on the market and exempted them from testing.160  Europe has taken a more pro-actively protective stance than the United States through REACH (Registration, Evaluation, Authorization and Restriction of Chemical substances) legislation.159  The aim of REACH is to improve the protection of human health and the environment through the better and earlier identification of the intrinsic properties of chemical substances.159  Products used by United States consumers on a daily basis are continually and routinely recalled for toxic effects, as recent recalls of lead tainted toys, popcorn flavoring, and FEMA trailers, to name a few, demonstrate.138-140 


After inhalation, chemicals enter the limbic system, affecting the hypothalamus and pituitary; and through pituitary control, elicit some symptoms though affecting adrenal, thyroid and reproductive function.130-132    Tests have shown verifiable and chronic changes in brain function after petrochemical exposure and determined that exposure to chemicals through inhalation may aggravate the allergic lung inflammation.64,128,129,132, 135  Developing organisms are generally recognized as differentially sensitive to chemical exposure because of toxicokinetic and/or toxicodynamic factors.141   


Fragrances have been shown to cause sensory irritation, pulmonary irritation, decreases in expiratory airflow velocity, and alterations of the functional observational battery in mice, indicative of neurotoxicity after an hour of normal level exposure to common cologne.  The severity of the symptoms increased after mice were repeatedly exposed to the fragranced product.117  Subsequent analysis of the test atmosphere revealed the presence of chemicals with known irritant and neurotoxic properties, providing a toxicological basis to explain human complaints of adverse reactions to fragrances.117


The use of consumer cleaning agents and air freshener may yield high levels of volatile organic compounds (VOC's).133-134   Consumer cleaning products were shown to contain glycol ethers, which are regulated toxic air contaminants, as well as terpenes, which can react with ozone to form a variety of secondary pollutants such as formaldehyde and ultrafine particles.133  Known chemical toxicants are emitted during air-freshener use, including d-limonene, dihydromyrcenol, linalool, linalyl acetate, beta-citronellol, alpha-pinene, beta-pinene, 3-carene, camphene, benzyl propionate, benzyl alcohol, bornyl acetate, isobornyl acetate, and benzaldehyde.118,133-134  Maternal depression has been significantly associated with air freshener use in the home136  and one name brand air freshener, which contains short chain aliphatic hydrocarbons, was shown to induce fatal ventricular fibrillation.119  Air fresheners, at concentrations to which individuals are actually exposed, have been linked to increases in sensory and pulmonary irritation, decreases in airflow velocity, and abnormalities of behavior as measured by the functional observational battery score, providing a toxicological explanation for human complaints of adverse reactions to air fresheners.120


Laundry products, particularly fabric softener emissions, have been shown to induce sensory irritation, pulmonary irritation, mild inflammation of the lungs, and airflow limitation in mice.121   Dry laundry and linen, like that which consumers wear and sleep on, was shown to emit sufficient chemical residue to cause sensory irritation.121   Analysis of the emissions of a dryer sheet revealed concentrations of the respiratory irritants isopropylbenzene, styrene, trimethylbenzene, phenol, and thymol, and induced respiratory affects when left in a room overnight with mice.121   The results of this study provide a toxicological basis for human complaints of adverse reactions to fabric softener emissions.121


Pesticides are known endocrine disruptors and have been shown to delay sexual maturity and interfere with sex hormone synthesis, and have been linked to increased malaise, chronic illness, asthma, mortality, cancer, leukemia, lupus, Parkinson disease, diabetes, and decreased neuropsychologic functioning scores, neurobehavioral performance, cognitive function, psychomotor function, sensory/motor function, and nerve conduction.123-127,137


Disposable diapers have been demonstrated to emit mixtures of chemicals with documented respiratory toxicity, inducing sensory irritation, reduced mid-expiratory airflow velocity, increased respiratory rates, and increased tidal volume.122   


Advanced stages of multiple chemical sensitivity can lead to organ failure.144-145   Many observable and empirical, scientific facts accompany MCS including SPECT scan changes, vitamin deficiencies, mineral deficiencies, excess amino acid deficiency, and disturbed lipid and carbohydrate metabolism.2,7,9,146   While the germ theory of illness was the main threat to health, the zeal to kill germs with chemical toxicants has now created a health paradigm shift in which chemicals have become the main threats to health, as many diseases are now being linked to chemical and toxic origin.


Worldwide Recognition


The Centers for Disease Control (CDC) recently recognized chemical sensitivity as a symptom of Chronic Fatigue Syndrome (CFS).147    Studies have shown that removal of incitants and proper environmental control is the most efficacious treatment known to date.58,148-151  Ninety-five percent of patients report improvement upon practicing avoidance and 94% report improvement upon moving to a chemical free living space.58  Clearly educating patients to avoid chemical irritants and toxicants is most helpful.58,148-151 


MCS is already formally recognized by the national health care system in Germany.152   The Danish Environmental Protection Agency has already concluded that there is ample evidence that MCS is due to environmental contaminants and has taken initiative to minimize off-gassing materials in the indoor environment in efforts to prevent the development of new cases of MCS.152   The government of Sweden recognizes electrical sensitivity as a disability.152   Canada has also recognized MCS and has taken preventive measures by limiting the use of pesticides, fragrances, and other toxicants.152   Diagnostic criteria for MCS have been accepted internationally and are currently under review to consider new findings; the recognition of MCS at all levels of government is steadily increasing.152   We are now seeing public policy and regulations advance towards protecting people from tobacco smoke, pesticides, fragrances, vehicle exhaust, and other chemicals in public places.152   More than one half of the states in the US have already provided a proclamation deeming at least one day or month dedicated for MCS and/or Toxic Injury Awareness.153


Therefore, it is essential that MCS be immediately and fully recognized in America as an organic physiological disorder induced by toxic environmental insults.  Environmental toxicants and irritants from perfumes, smoke, pesticides, industry, and building materials must be reduced or effectively regulated through legislation and enforcement to prevent injury to all citizens.  Immediate accommodation with a safe environment for school, work, and housing should be granted to MCS victims who are still capable of working, while those permanently injured should receive disability benefits.  The Americans with Disabilities Act must be enforced, to provide the same rights to MCS patients as other disabilities, with protection from abuse, harassment, and discrimination.  As new information is published regarding MCS, it is crucial that it be communicated to the medical and public communities.  Accurate, objective information which is free from conflicts of interests, ties to the chemical industry, and connections to the pharmaceutical industry must be rigorously researched and widely disseminated.  Funding is immediately and direly needed for additional investigation into the etiology, treatment, and prevention of this costly, devastating, and disabling disorder.


The future of America is in our collective hands.  It is crucial that industrial financial gain must not be permitted to compromise the health and well being of all citizens.  There are alternatives to the toxic products and pollution man has created.  A shift to these safer alternatives will be market-driven as accurate information on risks becomes readily available; meanwhile informed and enlightened regulation is highly encouraged in order to prevent MCS in the future and allow current patients to engage fully in society as productive members without threat of further injury.  We must never forget that many MCS patients can and do function normally in exposure free conditions.  It is time to move past the view that science does not a grasp of MCS.154   Sufficient clear and present evidence is currently available to show that MCS is real and disabling, and to justify, indeed to demand, immediate action. 


On Behalf of MCS America,



Lourdes Salvador, President

October 1, 2007


To sign this position statement via petition, visit:


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