Multiple Chemical Sensitivity

Multiple Chemical Sensitivity (MCS) is a syndrome where multiple symptoms occur with low-level chemical exposure. Since 1989, many definitions of MCS have existed, which made diagnosis difficult. Since 1999, there is one consensus definition accepted by the American Medical Association, the American Lung Association, the U.S. Environmental Protection Agency, and the U.S. Consumer Product Safety Commission. Using this agreed-upon definition, a diagnosis of MCS can be made, if all six consensus criteria are met: (1) the patient's symptoms are reproducible with repeated chemical exposure; (2) the condition is chronic; (3) low levels of chemical exposure result in manifestations of the syndrome; (4) symptoms improve when the offending substance is removed; (5) responses occur to many different chemicals that are unrelated; (6) symptoms include multiple organ systems. Patients with MCS syndrome have various symptoms that significantly interfere with their everyday life and work. The typical symptoms occur in three categories: gastrointestinal, respiratory, and the nervous system. Because MCS cannot be totally eliminated, the goal of the physician is to manage the syndrome, which includes utilizing all the physical and psychological treatments available.

Defining MCS have been problematic since the Gulf War era when many veterans were coming back from the war with medical symptoms from multiple chemical exposures. Various labels were given to their symptoms. Research studies were conducted by the U.S. Department of Veteran Affairs concerning medical symptoms as a result of chemical exposure during the war. At the same time, in California, civilians with similar symptoms were being diagnosed as having environmental illness. Officials recognized a need to arrive at a common way to describe these civilians and veterans with similar symptoms. Thus, in 1989, multiple chemical sensitivity was defined as a medical syndrome.

The more specific symptoms of the patient with MCS is as follows: fatigue, difficulty concentrating, depression, dizziness, weakness, memory loss and headaches, heat intolerance, and athralgias. They report having no symptoms until after they had a significantly large exposure. Some of the large exposures these patients had were to aerosol deodorant, aerosol air freshener, marking pens, cigarette smoke, asphalt pavement, cigar smoke, diesel fuel, diesel exhaust, dry-cleaning fluid, floor cleaner, furniture polish, gasoline exhaust, hair spray, insect repellant, laundry detergent, nail polish, and formaldehyde. Afterward, [Page 1145]the patient reports having symptoms even in low-lev-el exposure. In addition, they feel certain their symptoms are caused by chemical exposure.

The goal of the physician treating patients with MCS, according to specialists in the field today, should focus on management of the syndrome. Many forms of treatment have been proposed. MCS syndrome includes both physical and somatic/psychological. Therefore, rehabilitation needs to address the physical symptoms as well as psychological support.

The Occupational Safety and Health Administration (OSHA) established policies that employers must abide by when providing a safe and healthy workplace environment. Some of these are as follows: a smoke-free workplace; air monitoring units, which force employers to monitor the air quality; no asbestos in the working areas; carpeting/or paneling that has not been treated with formaldehyde; proper ventilation; limitations on the type and use of air conditioning.

...