Multiple Chemical Sensitivity (MCS) -- A Disorder Triggered by Exposures to Chemicals in the Environment




What is Multiple Chemical Sensitivity?
What can cause MCS?
Treatments
The MCS controversy in the medical community
MCS is now recognized as a disability
Accomodating individuals with MCS in the workplace


Synthetic chemicals are all around us. They're in the products we use, in the clothes we wear, in the food we eat, in the air we breathe at work. Because chemicals are everywhere in the environment, it's not possible to escape exposure. No wonder, then, that many people have become sensitized to the chemicals around them. In fact, it is estimated that 15% of the population has become sensitized to common household and commercial products.

For some people, the sensitization is not too serious a problem. They may have what appears to be a minor allergy to one or more chemicals. Other people are much more seriously affected. They may feel tired all the time, and suffer from mental confusion, breathing problems, sore muscles, and a weakened immune system. Such people suffer from a condition known as Multiple Chemical Sensitivity (MCS).

What is Multiple Chemical Sensitivity?

MCS is a disorder triggered by exposures to chemicals in the environment. Individuals with MCS can have symptoms from chemical exposures at concentrations far below the levels tolerated by most people. Symptoms occur in more than one organ system in the body, such as the nervous system and the lungs. Exposure may be from the air, from food or water, or through skin contact. The symptoms may look like an allergy because they tend to go with exposures, though some people's reactions may be delayed. As MCS gets worse, reactions become more severe and increasingly chronic, often affecting more bodily functions. No single widely available medical test can explain symptoms.

In the early stages of MCS, repeat exposure to the substance or substances that caused the initial health effects provokes a reaction. After a time, it takes less and less exposure to this or related chemicals to cause symptoms. As the body breaks down, an ever increasing number of chemicals, including some unrelated to the initial exposure, are found to trigger a reaction.

MCS affects the overall health and feeling of well-being of those with the disorder. It typically impairs many bodily functions including the nervous system and digestion. Each individual affected by MCS has a unique set of health problems. A chemically sensitive person may also have other pre-existing health conditions. Many affected people experience a number of symptoms, in relation to their chemical exposures. Symptoms of MCS may include:

  • headaches
  • flu-like symptoms
  • asthma or other breathing problems
  • dizziness
  • increased sensitivity to odors
  • mental confusion
  • bloating or other intestinal problems
  • fatigue and depression
  • short- and long-term memory loss
  • chronic exhaustion
People with MCS report many other health conditions such as :
  • persistent skin rashes and sores
  • inflammation
  • muscle weakness and joint pains
  • food allergies
  • numbness and tingling
  • visual disturbance
  • ear, nose, and throat problems
  • autoimmune disorders
  • cardiovascular irregularities
  • seizure disorders
  • genitourinary problems
  • irritability
  • persistent infections, especially yeast
  • behavioral problems
  • learning disabilities in children
MCS may result from a single massive exposure to one or more toxic substances or repeated exposures to low doses. On one hand, some people may become chemically sensitive following a toxic chemical spill at work or in their community after being sprayed directly with pesticides. On the other, individuals may develop this condition from spending forty hours each week in a poorly ventilated building where they breathe a profusion of chemicals common to our modern way of life.

In many cases, MCS has been brought on by a wide array of chemicals found at home and work. Studies show that many of the people diagnosed with MCS were :

  • industrial workers
  • teachers, students, office, and health care workers in tight buildings
  • chemical accident victims
  • people living near toxic waste sites
  • people whose air or water is highly polluted
  • people exposed to various chemicals in consumer products, food, and pharmaceuticals
  • Gulf war veterans
Not all people with MCS fit any of these categories. For example, some may have experienced a toxic exposure from flea or roach sprays or from (urea formaldehyde) foam insulation in their home. Other people with MCS cannot identify any situations where they had unusual exposures to chemicals.

People with MCS may become partially or totally disabled for several years or for life. This physical condition affects every aspect of their life. They must make dramatic changes in lifestyle at home. Their marriages and other relationships may end from the stress off coping with this disabling condition. As members of the workforce, they may drag themselves to work only to return home sicker and more exhausted each day. Alternatively, they may be forced to leave their jobs and deal with the devastating loss of income and consequent poverty. However, even in the most severe cases, some people eventually recover, at least partially.

What can cause MCS?

No one knows for sure what causes MCS. However, in non-industrial workplaces, a number of common products and processes are often identified as contributing to the onset of MCS :
  • offgassing of new carpets
  • gas stoves
  • cleaning supplies
  • house paints
  • pesticides and wood preservatives
  • vehicle exhaust fumes
  • new building materials and furnishings
  • toxic chemicals used in art, photography, printing, etc.
  • formaldehyde in new clothes, books, and other products
  • carbonless paper, inks, copying machine, and laser printer toner
  • second-hand tobacco smoke
When our bodies are assaulted with levels of toxic chemicals that our systems cannot safely process, it is likely that at some point in our lifetimes, many of us will become ill. For some, the outcome could be cancer or reproductive damage. Others may become hypersensitive to these chemicals or develop other chronic disorders, while some people may not experience any noticeable health effects. Even where high levels of exposure occur, generally only a small percentage of people becomes chemically sensitive. The threshold for toxic injury is not the same for everyone because sensitivity varies greatly among individuals.

Most chemicals in consumer products remain untested for health effects, such as cancer, reproductive problems, and the impacts of long-term, low level exposure. How these substances affect women, children, and people with existing conditions is also little studied.

Once a person's defenses have been broken down and he or she has become hypersensitive, a wide variety of common chemical exposures can trigger a reaction. Just what products and other chemicals which cause problems varies greatly among affected individuals. These include the same chemicals which can bring about MCS in the first place, as well as the following :

  • perfumes and fragrances
  • dry cleaning solvents
  • detergents and other cleaners
  • anaesthesia
  • prescribed medications
  • artificial colors, flavors, and preservatives in foods, drinks, and drugs

Treatments

MCS is difficult for physicians to define and diagnose. There is no single set of symptoms which fit together as a syndrome, nor a single diagnostic test for MCS. Instead, physicians should take a complete patient history which includes environmental and occupational exposures, and act as detectives in diagnosing this problematic condition.

After the onset of MCS, a person's health generally continues to deteriorate. It may only begin to improve once the chemical sensitivity condition is uncovered. While a number of treatments may help improve the baseline health status for some patients, at thee present time, there is no single "cure" except avoidance.

Avoiding the chemicals which may trigger reactions is an essential part of treating MCS. Those with MCS who are able to strictly avoid exposures often experience dramatic improvement in their health over the period of a year or more. Yet the profusion of new and untested synthetic chemicals makes this extremely difficult.

Individuals affected by MCS often create a "sanctuary" relatively free from chemical emissions in their home, where they spend as much time as possible. Because of the serious impact of even an accidental unavoidable exposure, MCS sufferers often spend as much time at home as possible and often must choose not to participate in society. As a result, they may experience intense isolation, and loss of self-esteem and depression from not being able to have an active work or social life. Therefore, supportive counseling is often a very useful form of treatment.

The MCS controversy in the medical community

Many traditional allergists and other physicians discount the existence of an MCS diagnosis. They claim that there is not yet sufficient evidence that MCS exists. Research effort regarding the mechanisms that cause MCS have been inadequate and unfortunately are often financed and supported by the industries which benefit from chemical proliferation. Generally medical doctors have not been trained to understand or seriously investigate conditions such as MCS. In fact, the vast majority of physicians receive very little training (four hours or less) in occupational and environmental medicine or in toxicology and nutrition.

Therefore, it is not surprising that many affected individuals consult with a large number of specialists. People with MCS are often even diagnosed with serious degenerative diseases. Often baffled doctors tell their patients with MCS that their illness is entirely psychosomatic -- in their head. And many whose health is impaired by MCS have never heard of the condition. The lack of support and understanding from physicians and the stress created by having no explanation for symptoms tends to produce a high level of anxiety and distress in people with MCS.

At this time, conventional medicine offers very few medical treatments for MCS besides avoiding offending products. Unfortunately, medications and other conventional medical treatments offer little or no relief and may even prompt new sets of symptoms. Treatment with anti-depressants masks the underlying condition and can also cause other serious problems.

Physicians who clearly recognize the MCS phenomenon include some occupational and environmental health specialists and those MDs who specialize in the new field of clinical ecology. A wide range of new or "alternative" treatments have been utilized by MCS sufferers with varying success. Though some of these treatments are still experimental in nature, they seem to help some individuals with MCS. These treatments may include a combination of the following :

  • nutritional programs,
  • immunotherapy vaccines,
  • food-allergy testing,
  • detoxification regiments through exercise and sweating,
  • chelation for heavy metals,
  • any number of non-Western healing methods. Diagnosis may involve unconventional laboratory tests not customary to conventional medicine, including tests for thee presence of chemical contaminants, such as total body burden of accumulated pesticides.

    Many workers have shown improvement with these treatments, though others have not. Unfortunately, these treatments are not usually reimbursed by insurance plans, since few participating practioners support alternative approaches. Yet some disabled workers have won reimbursement for such treatments through successful Workers' Compensation claims.

    MCS is now recognized as a disability

    Both the US Department of Housing and Urban Development (HUD) and the Social SECURITY Administration (SSA) have recognized MCS as a disabling condition. people with MCS have won Workers' Compensation cases. A recent human rights lawsuit in Pennsylvania established the right of an affected person to safe living space in subsidized housing. Both the Maryland State Legislature and New Jersey State Department of Health have officially commissioned studies of MCS. The NJ study provides an excellent overview of medical and legal issues related to MCS.

    Just as physical barriers prevent wheelchair access, chemical use and emissions can prevent entry to those with MCS. a new federal law called the Americans with Disabilities Act (AD) will protect the disabled from many types of discrimination. This law provides for reasonable access to people with disabilities. Reasonable accommodations enable people with MCS to enjoy access to work, public facilities, and other necessary settings. Whether and individual developed MCS at work or was already sensitized prior to employment, the right to a safe workplace should be insured.

    For injured workers who have a right to Workers' Compensation or Disability, it is necessary to find a physician who can diagnose MCS and who will also support the patient's legitimate claims. Finding such a physician is very important in winning such a claim and for gaining reasonable accommodation at work or in rental housing.

    If you are affected and you think your employer is discriminating, then:

    • Get your condition diagnosed.
    • If you work in a unionized workplace, consult with your union about filing a grievance or taking legal action.
    • Seek legal counsel. (Your union may be able o provide an attorney or seek assistance through a legal clinic or make an appropriate referral.)
    • Join a support group.
    For further assistance, contact one of the worker health resource groups or support groups in your local area. These cases are difficult to win and can take a long time to resolve.

    Similarly, if you have been injured on the job, find an attorney experienced with chemical exposure cases in the Workers' Compensation system or personal injury claims. In such cases, you will not need to pay your attorney up front; instead your attorney receives a percentage from the settlement if you win. It costs you nothing if you lose your case.

    Accomodating individuals with MCS in the workplace

    These are some suggested ways to accommodate individuals with MCS at work. They will not be effective in all cases. These measures will also help to prevent other workers from becoming similarly disabled, and all reductions in toxic materials contribute to thee general health of the environment.

    Reasonable Accommodations

    • Windows that open
    • Well-ventilated space free of pollutants such as tobacco smoke, pesticides, toxic and fragrant-laden cleaning products, deodorizers, and exhaust fumes
    • Selection of least toxic/allergenic building furnishings and supplies
    • "Least toxic" integrated pest management (IPM) using no sprayed or volatile pesticides in and around buildings
    • Pre-notification prior to painting, pesticide application, and renovations with provisions for alternative work arrangements
    • Education of co-workers, management, and employers as to the nature of the disability to avert stigma and harassment
    • Schedule options so that affected people can work when fewer co-workers are present, when ventilation is working at its peak, or where surroundings are least problematic
    • Allow the option of working at home

    MCS may be a preventable disability

    People suffering from MCS have become a driving force for improved indoor air quality and for the adoption of less toxic housekeeping and building maintenance practices. Good indoor air quality and substitution of less toxic materials boost morale and productivity. A healthy workplace also lowers absenteeism and injuries.

    A safe working environment is always a worthwhile investment for employers. Therefore, complaints about indoor air problems must be taken seriously by employers, labor unions, regulatory agencies and health care providers.

  • NYCAP New York Coalition for
    Alternatives to Pesticides
    353 Hamilton Street, Albany, New York 12210-1709
    phone 518-426-8246, fax 518-426-3052, nycap@crisny.org
    http://www.crisny.org/not-for-profit/nycap/nycap.htm


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