MULTIPLE CHEMICAL SENSITIVITY
A DISORDER TRIGGERED BY EXPOSURES TO
CHEMICALS IN THE ENVIRONMENT
written by Tracy First

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 come and 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 preexisting health conditions. Many affected people experience a number of symptoms, in relation to their chemical exposures:. . . . . . .

 

SYMPTOMS OF MCS

  • headaches
  • asthma or other breathing problems
  • increased sensitivity to odors
  • bloating or other intestinal problems
  • short- and long-term memory loss
  • flu-like symptoms
  • dizziness
  • mental confusion
  • fatigue and depression
  • chronic exhaustion
  • persistent skin rashes and sores
  • muscle weakness and joint pains

People with MCS report many other health conditions such as:.

  • numbness and tingling
  • ear, nose and throat problems
  • cardiovascular irregularities
  • genitourinary problems
  • persistent infections, esp. yeast
  • learning disabilities in children
  • food allergies
  • visual disturbance
  • autoimmune disorders
  • seizure disorders
  • irritability
  • behavioral problems
  • inflammation

MCS may result from a single massive exposure to one or more toxic substance 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 or area 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:_

PEOPLE DIAGNOSED WITH MCS

  • 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 of 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. Alternately 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:

SOME EXPOSURES LINKED TO MCS

  • offgassing of new carpets
  • cleaning supplies
  • pesticides and wood preservatives
  • 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
  • gas stoves house paints
  • vehicle exhaust fume.

These substances are the causes of indoor air pollution and are the contaminants in our air and water. Many of the chemicals which trigger MCS symptoms are known to be irritants or to be toxic to the nervous system. One especially harmful group of chemicals, known as "volatile organics", readily evaporates into the air at room temperature. Permitted airborne levels of such contaminants can still make ordinary people sick.

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 persons 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 products and chemicals which can bring about MCS in the first place, as well as the following:

OTHER PRODUCTS WHICH CAN CAUSE A TOXIC REACTION
perfumes and fragrances . detergents and other cleaners
prescribed medications
anesthesia
artificial colors, flavors, and preservatives in foods, drinks, and drugs
dry cleaning solvents

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 the 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 efforts 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 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 antidepressants 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 MD's 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, as well as any number of non-Western healing methods. Diagnosis may involve unconventional laboratory tests not customary in conventional medicine, including tests for the 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 practitioners 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 nights 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 caused the Americans with Disabilities Act (ADA) 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 an 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

• 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 to provide an attorney or 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 area as well as other organizations listed at the end of this fact sheet. These cases are very .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 upfront; instead your attorney receives a percentage from the settlement if you win. It costs you nothing if you lose your case.

To find an appropriate attorney for your case, consult your union or one of the organizations listed below to obtain referrals. Select your attorney carefully; remember, your attorney works for you and you should feel comfortable with him or her.

ACCOMMODATING 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 prevent other workers from becoming similarly disabled, and all reductions in toxic materials contribute to the general health of the environment.

REASONABLE ACCOMMODATIONS

MCS MAY BE: A PREVENTABLE DISABILITY

People suffering from MCS have become a driving force for improved indoor air quality and or 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.

 

FOR HELP AND MORE INFORMATION

National Center for Environrnental Health Strategies (NCEHS), 1100 Rural Avenue, Voorhees, NJ 08043. (609) 429-5358. Mary Lamielle, President. Provides information, referral} and advocacy. Tracks scientific, legislative, legal, medical, and policy issues. Newsletter "The Delicate Balance". Excellent information packets.

NY Coalition for Alternatives to Pesticides (NYCAP), PO Box 6005, Albany, NY 12206-0005. (518) 426-8246. Tracy Frisch, Coordinator. Focuses on pesticide hazards and safer alternatives. Provides information, referral, workshops, and advocacy. "NYCAP News" is its 40 page quarterly. Incident reporting project. Also hosts a MCS support group in the Albany area. (See below.)

MCS Referral & Resources
Albert Donnay, MHS
Exec. Director, MCS Referral & Resources, Inc.
508 Westgate Road, Baltimore MD 21229-2343410-362-6400, fax 362-6401, donnaya@rtk.net
Grace Zeim MD, DrPH
16926 Eyler's Valley Rd
Emmitsburg, MD 21727
Phone:301-241-4346
Fax: 301-241-4348

MCS Referral & Resources, . Albert Donnay, Executive Director. New educational organization initiated by Grace Ziem, MD, DPH, to assist people with MCS and MCS physicians, attorneys, and other professionals. Distributes relevant articles and other resources on prevention, diagnosis accommodations and treatment on MCS and is launching an 800 number referral service.

The Environmental Health Network, PO Box 1155, Larkspur, CA 94977. (415) 331-9804. Susan Molloy, editor. "The New Reactor" bimonthly newsletter. http://users.lanminds.com/~wilworks/ehnindex.htm e-mail <wilworks@LANMINDS.COM>

Chemical Injury Information Network, PO Box 301, White Sulphur Springs, MT 59645. (406) 547-3608. Cynthia Wilson. "Our Toxic Times" monthly newsletter.

The Labor Institute, 853 Broadway, Room 2014, New York, NY 10012. (212) 674-3322. Cydney Pullman. Produced "Multiple Chemical Sensitivity: An Emerging Occupational Hazard" (28 min. video), $15, and "Multiple Chemical Sensitivity at Work: A Training Workbook for Working People" (95 pages, $3 for shipping) Order form APEX Press, Publication Office, PO Box 337, Croton-on-Hudson, NY 109520. (914) 271-6500.

Center for Safety in the Arts, 5 Beekman Street, Suite 820, New York, NY 10038. (212) 227-6220. Michael McCann, Ph.D., CIH, Executive Director. Provides information, referral, workshops, and factsheets on on hazards and safer substitutes and practices.

SELF HELP/SUPPORT GROUPS

Human Ecology Action League (HEAL), PO Box 49126, Atlanta, GA 30359-1126. (404) 248-1898. Has local patient support group chapters in many parts of the U.S. Also publishes the "The Human Ecologist" quarterly  http://members.aol.com/HEALNatnl/

OCCUPATIONAL HEALTH CLINICS

For diagnosis and treatment of MCS, consider consulting with medical staff at one of the occupational health clinics overseen by the NYS Department of Health. The medical staff at these clinics vary in their expertise in this area; selected clinics are listed below. Each clinic is governed by a board of directors, which generally welcome patient feedback in the form of a letter on clinic services.

Self-help and support groups listed above may provide additional referrals to physicians. (The American Academy of Environmental Medicine AAEM, PO Box 16106, Denver, CO 80216, is a professional association of environmental physicians, also known as clinical ecologists. Provides regional listings of member doctors.)

Occupatinal and Environmental Medicine
Grace Zeim MD, DrPh, 16926 Eyler's Valley Rd, Emmitsburg, MD 21727
Phone:301-241-4346 - Fax: 301-241-4348
The following Clinics were choosen for Chemically injured in New York and surrounding areas. Eastern New York Occupational Health Program, 1201 Troy Schenectady Road, Latham, NY 12110. (S18) 783-1518 or (800) 638-0668 x4423. Eckhardt Johanning, MD, and Chris Grosse, Education Director.

Satellite clinics in Poughkeepsie and Glen Falls.

Central New York Occupational Clinical Center, 6712 Brooklawn Parkway, Suite 204, Syracuse, NY 13211-2195. (315) 432-8899. Michael B . Lax, MD, MPH, Medical Director, has a lot of experience with workers with chemical sensitivity. Satellite clinics in Utica and Binghamton.

Mount Sinai-Irving J. Selikoff Occupational Health Clinical Center, PO Box 1058, I Gustave L. Levy Place, NY, NY 10029. (2123 241-9738. Satellite clinic in Tarrytown (Westchester County).

Long Island Occupational and Environmental Medicine Clinic, 625 Belle Terre Road, Suite 207, Port Jefferson, NY 11777. (516) 476-2719.

GOVERNMENT AGENCIES

Contact the agencies appropriate to your situation.

NY City Department of Health, Susan Klitzman or Nancy Jeffery, Environmental Epidemiology Unit, 125 Worth Street, Box 34C, NY, NY l0013. (212) 788-4396. To report MCS cases in NY City in order to assess the extent of the problem in NY City.

NYS Department of Health Environmental and Occupational Health hotline, 1-800-458- 1158. Includes information about medical reporting for the pesticide poisoning and heavy metals registry.

NYS Division of Human Rights—Check in the blue pages of your phone book under NYS Government Offices. For general information, call (212) 870-8400.

Pennsylvania Human Rights Commission, Raymond Cartwright, 101 South 2nd Street, Room 303, Harrisburg, PA 17101. (717) 7B3-8274. Mr. Cartwright worked on the landmark Pennsylvania case which granted a chemically sensitive woman the right to reasonable accommodations in her rented apartment.

US Department of Housing and Urban Development (HUD), Office of Fair Housing and Equal Opportunity, NY City Regional Office, Stanley Seidenfeld, director (212) 264-1290; Buffalo Regional Office, Charles Martin, director, (716) 846-5785.

US Social Security Administration—Check in the blue pages of your phone book under US Government Offices, Health and Human Services. For general information, call 1-800-772-1213.

Americans With Disabilities Act -- hotline, 1-800-USA-ABLE.

FOR FURTHER READING

Multiple Chemical Sensitivities, Board on Environmental Studies and Toxicology, National Research Council. 1992. (195 pp.) National Academy Press. An addendum to Biological Markers in Immunotoxicology. $25 from NCEHS listed above (includes chapter 9 on MCS in Biological Markers book).

Chemical Exposures: Low Levels and High Stakes, Second Edition, Nicholas A. Ashford, Ph.D., JD, and Claudia S. Miller, MD. 1991. (449 pp. hardcover) Van Nostrand Reinhold, NY. Based on the Landmark New Jersey Department of Health study. Available $42 including shipping from:

American Environmental Health Foundation
 
$42.00 including shipping and handling
(214) 350-8942 Fax (214) 350-8942
MCS Referral & Resources, Inc.
$42.00 including shipping and handling
508 Westgate Road, Baltimore MD 21229-2343
410-362-6400, fax 362-6401,

Multiple Chemical Sensitivity, Bette Hylleman, Chemical and Engineering News, July 1991, vol. 69, no. 29. Excellent overview article. Available from NCEHS, 1100 Rural Avenue, Voorhees, NJ 08043. (See above.)

Workers with Multiple Chemical Sensitivities, Mark R. Cullen, MD, editor. Occupational Medicine, State of the Art Reviews, vol. 2, no. 4, 1987. Hanley and Belfus, Philadelphia

Bibliography and Resource List from "No Place to Hide: Air Pollution the Great Indoors" broadcast of KPFK FM (Pacifica Radio), 3729 Cahuenga Boulevard West, North Hollywood, CA 91604. (818) 985-2711. (Also available from NYCAP. See above.)

Canary News, from the Chicago-area EI/MCS Support Group, 1404 Judson Avenue, Evanston, IL 60201. Excellent monthly newsletter.

Staying Well in a Toxic World: Understanding Environmental Illness, Multiple Chemical Sensitivities, Chemical Injuries, and Sick Building Syndrome, by Lynn Lawson (editor of Canary News). 1993. The Noble Press, Chicago. $15.95.

This booklet was produced by the:

Multiple Chemical Sensitivity in the Workplace Task Force c/o NY Coalition for Alternatives to Pesticides 33 Central Avenue Albany NY 12210 (518)426-8246

Copies are available at $1.00 each or 10 or more copies at 50 cents each Contact NYCAP for more information. e-mail  <nycap@crisny.org>

It was written by Tracy First with the help of many task force members. This booklet was made possible in part by a grant from the NYS Department of Labor Occupational Safety and Health Training and Education Program. Reprinting with permission is encouraged.

Contact the above address.

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