Chemical
Sensitivity
From "Indoor
Air Pollution."
Co-sponsored by:
The American Lung Association
(ALA),
The Environmental Protection Agency (EPA),
The Consumer Product Safety Commission (CPSC), and
The American Medical Association (AMA)
The diagnostic label of multiple chemical sensitivity
(MCS) -- also referred to as "chemical hypersensitivity" or
"environmental illness" -- is being applied increasingly,
although definition of the phenomenon is elusive and its pathogenesis as a
distinct entity is not confirmed. Multiple chemical sensitivity has become
more widely known and increasingly controversial as more patients receive
the label63.
Persons with the diagnostic label of multiple chemical
sensitivity are said to suffer multi-system illness as a result of contact
with, or proximity to, a spectrum of substances, including airborne
agents. These may include both recognized pollutants discussed earlier
(such as tobacco smoke, formaldehyde, et al.) and other pollutants
ordinarily considered innocuous. Some who espouse the concept of MCS
believe that it may explain such chronic conditions as some forms of
arthritis and colitis, in addition to generally recognized types of
hypersensitivity reactions.
Some practitioners believe that the condition has a purely
psychological basis. One study63 reported a 65 percent
incidence of current or past clinical depression, anxiety disorders, or
somatoform disorders in subjects with this diagnosis compared with 28
percent in controls. Others, however, counter that the disorder itself may
cause such problems64, since those affected are no longer able
to lead a normal life, or that these conditions stem from effects on the
nervous system65.
The current consensus is that in cases of claimed or
suspected MCS, complaints should not be dismissed as psychogenic, and a
thorough workup is essential. Primary care givers should determine that
the individual does not have an underlying physiological problem and
should consider the value of consultation with allergists and other
specialists.
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