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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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2
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Fares-Medina S, Díaz-Caro I, García-Montes R, Corral-Liria I, García-Gómez-Heras S. Multiple Chemical Sensitivity Syndrome: First Symptoms and Evolution of the Clinical Picture: Case-Control Study/Epidemiological Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15891. [PMID: 36497963 PMCID: PMC9737200 DOI: 10.3390/ijerph192315891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Multiple chemical sensitivity (MCS) is a chronic condition characterized by the appearance of symptoms caused by exposure to chemical compounds that are tolerable for the general population. It mainly affects middle-aged women. There are very few studies focusing on the most frequent symptoms of MCS considering age groups and gender. The main goal of this study was to find the most frequent symptoms both at the onset of the disease and at the present time describing them by age groups. The QEESI (Quick Environmental Exposure and Sensitivity Inventory) questionnaire, Scale 3 which assesses symptoms and their severity, was used as a diagnostic tool for the disease. A case-control study was conducted with the participation of 210 people. Of the cases, 94.3% were women. The symptoms that most often manifested first were airway and mucous membrane alterations (68.9%). In the development of the disease, we found cognitive alterations (OR = 31.25), heart or chest problems (OR = 22.49), neuromuscular problems (OR = 20.00) and head-related symptomatology (OR = 19.29). Identifying the most frequent pattern of symptoms by age group and sex will allow an early diagnosis of the disease to improve its prognosis and treatment.
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Affiliation(s)
- Sandra Fares-Medina
- Student International Doctoral School, Rey Juan Carlos University (URJC), 28922 Madrid, Spain
| | | | - Rebeca García-Montes
- Student International Doctoral School, Rey Juan Carlos University (URJC), 28922 Madrid, Spain
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3
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Driesen L, Patton R, John M. The impact of multiple chemical sensitivity on people's social and occupational functioning; a systematic review of qualitative research studies. J Psychosom Res 2020; 132:109964. [PMID: 32114179 DOI: 10.1016/j.jpsychores.2020.109964] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/03/2020] [Accepted: 02/11/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Social and occupational functioning are important for psychological health. However, quantitative research has suggested that these areas can be adversely affected by multiple chemical sensitivity (MCS). This systematic review therefore sought to explore what qualitative research has suggested about how people with MCS perceive it to affect their social and occupational functioning. METHOD Journal articles were included if they were 1) peer reviewed 2) qualitative or mixed methods 3) published in English 4) reported qualitative findings relevant to the review. Studies were excluded if they were 1) descriptive only 2) primarily concerned with environmental intolerances other than chemicals or 3) focussed on specific populations such as veterans. Quality was assessed using the National Institute for Health and Care Excellence (NICE, 2018) qualitative quality criteria. However, quality was not used to determine eligibility for inclusion. Six databases (CINAHL, Medline, PsychArticles, PsychInfo, Scopus and Web of Science) were searched between the 24th of February 2019 and 2nd of March 2019. RESULTS Having removed duplicates, database searches identified 388 potential articles. Thirteen of these articles were eligible for inclusion. Following review, no more articles were included from the reference lists of these studies. Meta-aggregation of the findings identified seven categories. These were synthesised into three themes; 'limited access', 'loss & anxiety' and 'seeking engagement'. CONCLUSIONS The findings suggested that MCS limits some people's social and occupational functioning. The results warrant further research, and, the development of prevention and intervention strategies. Studies predominantly recruited United States and Canadian females and had several limitations.
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Affiliation(s)
- Laura Driesen
- School of Psychology, The University of Surrey, United Kingdom.
| | - Robert Patton
- School of Psychology, The University of Surrey, United Kingdom
| | - Mary John
- School of Psychology, The University of Surrey, United Kingdom
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4
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Harter K, Hammel G, Fleming M, Traidl-Hoffmann C. Multiple chemical sensitivity (MCS) - a guide for dermatologists on how to manage affected individuals. J Dtsch Dermatol Ges 2020; 18:119-130. [PMID: 32026633 DOI: 10.1111/ddg.14027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/13/2020] [Indexed: 02/03/2023]
Abstract
Multiple chemical sensitivity (MCS) is a condition characterized by a subjectively perceived increase in sensitivity to environmental chemicals. Individuals affected report a wide variety of nonspecific complaints, and frequently attribute cutaneous and mucosal symptoms to chemical exposures. Dermatologists should therefore be familiar with this condition. MCS is a diagnosis of exclusion. Other causes for the patients' symptoms should be ruled out by routine laboratory tests, allergy tests and, if indicated, monitoring for toxic (environmental) substances. The primary job of dermatologists is to rule out skin diseases or hypersensitivities as possible causes of the complaints. Interdisciplinary patient management is essential, especially in severe cases in which those affected have problems coping with everyday life. Relevant specialties in this context include environmental medicine, psychosomatic medicine as well as occupational and social medicine. Cutaneous symptoms are usually addressed with symptomatic treatment using basic skin care products. There are currently no evidence-based treatment recommendations for MCS. It is crucial that MCS patients be protected from unnecessary treatments and thus from mental, social and financial strain. In addition to medical skills, managing MCS patients requires communicative and psychosocial competence in particular. Physicians involved in the treatment will benefit from training in psychotherapy. Irrespective of the mechanisms that lead to MCS, diagnosis and treatment of this condition require an actively supportive attitude towards these patients, a good doctor-patient relationship and interdisciplinary cooperation.
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Affiliation(s)
- Katharina Harter
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Gertrud Hammel
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Megan Fleming
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Outpatient Clinic for Environmental Medicine at Augsburg University Medical Center, Augsburg, Germany
| | - Claudia Traidl-Hoffmann
- Chair and Institute of Environmental Medicine, UNIKA-T, Medical Faculty of the Technical University Munich and Helmholtz Center Munich, Augsburg, Germany.,Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Outpatient Clinic for Environmental Medicine at Augsburg University Medical Center, Augsburg, Germany
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Harter K, Hammel G, Fleming M, Traidl-Hoffmann C. Multiple Chemikaliensensibilität (MCS) – Ein Leitfaden für die Dermatologie zum Umgang mit den Betroffenen. J Dtsch Dermatol Ges 2020; 18:119-131. [PMID: 32026641 DOI: 10.1111/ddg.14027_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 01/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Katharina Harter
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Professur für Soziologie mit Schwerpunkt Gesundheitsforschung, Philosophisch-Sozialwissenschaftliche Fakultät, Universität Augsburg, Augsburg, Deutschland
| | - Gertrud Hammel
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz
| | - Megan Fleming
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Hochschulambulanz für Umweltmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Claudia Traidl-Hoffmann
- Lehrstuhl und Institut für Umweltmedizin, UNIKA-T, Medizinische Fakultät der Technischen Universität München und Helmholtzzentrum München, Augsburg, Deutschland.,Christine-Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.,Hochschulambulanz für Umweltmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland
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6
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Gibson PR. Introduction to the Special Issue on Environmental Sensitivities: Living on the Margins with Access Denied. ECOPSYCHOLOGY 2017. [DOI: 10.1089/eco.2017.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, Virginia
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8
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, Virginia
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Gibson PR, Horan MC, Billy J. Women growing older with environmental sensitivities: A grounded theory model of meeting one's needs. Health Care Women Int 2016; 37:1289-1303. [DOI: 10.1080/07399332.2016.1191495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gibson PR, Lockaby SD, Bryant JM. Experiences of persons with multiple chemical sensitivity with mental health providers. J Multidiscip Healthc 2016; 9:163-72. [PMID: 27103817 PMCID: PMC4827900 DOI: 10.2147/jmdh.s100688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In this paper, we summarize the results of an online survey of persons in the United States with chemical intolerance/multiple chemical sensitivity who sought help from mental health providers, including counselors, psychologists, psychiatrists, and others. Respondents reported on their most recent contact with a provider, describing reasons for the contact, accommodations requested and received, and suggestions for how the experience could be more helpful. Overall, though clients were accommodated in small ways, some received no accommodation, and many felt that the providers needed to be more knowledgeable regarding chemical intolerance. Results are discussed in terms of the importance of providers becoming more aware of multiple chemical sensitivity and more willing to make their services accessible to these clients.
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
| | - Sharon D Lockaby
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
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12
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Mizukoshi A, Kumagai K, Yamamoto N, Noguchi M, Yoshiuchi K, Kumano H, Sakabe K, Yanagisawa Y. In-situ Real-Time Monitoring of Volatile Organic Compound Exposure and Heart Rate Variability for Patients with Multiple Chemical Sensitivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12446-65. [PMID: 26445055 PMCID: PMC4626978 DOI: 10.3390/ijerph121012446] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 11/23/2022]
Abstract
In-situ real-time monitoring of volatile organic compound (VOC) exposure and heart rate variability (HRV) were conducted for eight multiple chemical sensitivity (MCS) patients using a VOC monitor, a Holter monitor, and a time-activity questionnaire for 24 h to identify the relationship between VOC exposure, biological effects, and subjective symptoms in actual life. The results revealed no significantly different parameters for averaged values such as VOC concentration, HF (high frequency), and LF (low frequency) to HF ratio compared with previous data from healthy subjects (Int. J. Environ. Res. Public Health2010, 7, 4127–4138). Significant negative correlations for four subjects were observed between HF and amounts of VOC change. These results suggest that some patients show inhibition of parasympathetic activities along with VOC exposure as observed in healthy subjects. Comparing the parameters during subjective symptoms and normal condition, VOC concentration and/or VOC change were high except for one subject. HF values were low for five subjects during subjective symptoms. Examining the time-series data for VOC exposure and HF of each subject showed that the subjective symptoms, VOC exposure, and HF seemed well related in some symptoms. Based on these characteristics, prevention measures of symptoms for each subject may be proposed.
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Affiliation(s)
- Atsushi Mizukoshi
- Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine, 377-2, Ohno-higashi, Osakasayama, Osaka 589-8511, Japan.
- Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
| | - Kazukiyo Kumagai
- Environmental Health Laboratory, California Department of Public Health, 850 Marina Bay Pkwy, Richmond, CA 94804, USA.
| | - Naomichi Yamamoto
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea.
| | - Miyuki Noguchi
- Department of Materials and Life Science, Faculty of Science and Technology, Seikei University, 3-3-1 Kichijoji-kitamachi, Musashino, Tokyo 180-8633, Japan.
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Hiroaki Kumano
- Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
- Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama 359-1192, Japan.
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Yukio Yanagisawa
- The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8654, Japan.
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Gibson PR, Kovach S, Lupfer A. Unmet health care needs for persons with environmental sensitivity. J Multidiscip Healthc 2015; 8:59-66. [PMID: 25670904 PMCID: PMC4315542 DOI: 10.2147/jmdh.s61723] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Studies of unmet health care needs have shown that women, people with poor health, and people with lower socioeconomic status are more likely to report having unmet health care needs. In this study, we examined the types of and reasons for unmet health care needs in 465 people with environmental sensitivities. A second area of inquiry involved negative reactions to general anesthesia. Results showed that the most common barriers to receiving care were the inability to find a provider who understands environmental sensitivities and a lack of accessibility due to chemical and electromagnetic exposures in health care environments. Lower income and poorer health (longer illness, a worsening or fluctuating course of illness, and a higher level of disability) were significantly correlated with the total number of reported unmet health care needs. Some people with environmental sensitivities reported having negative reactions to anesthesia of long duration; most common were nausea and vomiting, fatigue, and reduced cognitive ability.
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
| | - Shannon Kovach
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
| | - Alexis Lupfer
- Department of Psychology, James Madison University, Harrisonburg, VA, USA
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14
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Akdag M, Bakir S, Alabalik U, Ozkurt FE, Topcu I. Does usage of a room air freshener affect the nasal mucosa? Am J Rhinol Allergy 2014; 28:202-8. [PMID: 25216996 DOI: 10.2500/ajra.2014.28.4105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Effects of chemicals emitted from the room air freshener sprays (RAFSs) on nasal mucosa are still unclear. The purpose of this study was to investigate effects of RAFSs on the nasal mucosa of rats for different time intervals. METHODS Twenty-eight rats were randomly divided into four experimental groups: group 1 (n = 7) was the control group and not exposed to RAFS or other chemicals, group 2 (n = 7) was exposed to RAFS for 1 month, group 3 (n = 7) was exposed to RAFS for 2 months, and group 4 (n = 7) was exposed to RAFS for 3 months. Samples from the nasal septum were stained using hematoxylin and eosin solution, examined by a pathologist using a light microscope, and analyzed with Fisher's exact test. RESULTS We observed that distinct histopathological differences in the nasal mucosa of exposed rats depends on different time intervals (p < 0.05). Increased congestion was found after the 1st month of exposure (group 2). Although edema and mild inflammatory cell infiltration, including some eosinophils, was seen after the 2nd month (group 3), squamous metaplasia, numerous eosinophils, and intense inflammatory cell infiltration began after 3 months of exposure (group 4). CONCLUSION Our results showed that continuous use of RAFS can cause inflammation and eosinophilic infiltration in rats, which begins after 2 months of exposure and may lead to metaplasia after 3 months. Because of differences in body size, geometry, and physiological responses of rats, the extrapolation of these results to humans is not straightforward. However, any such comparison should be made with caution. Finally, more performance is necessary to clarify this subject.
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Affiliation(s)
- Mehmet Akdag
- Department of Otolaryngology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
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Genuis SJ. Chemical sensitivity: pathophysiology or pathopsychology? Clin Ther 2013; 35:572-7. [PMID: 23642291 DOI: 10.1016/j.clinthera.2013.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 04/05/2013] [Accepted: 04/11/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Escalating numbers of people throughout the world are presenting to primary care physicians, allergists, and immunologists with myriad clinical symptoms after low-level exposure to assorted everyday chemicals such as smoke, perfumes, air fresheners, paints, glues, and other products. This clinical state is referred to by various diagnostic labels, including multiple chemical sensitivity disorder, environmental intolerance, chemical sensitivity (CS), and sensitivity-related illness, and has been the subject of much controversy within the health care community. OBJECTIVE The goal of this study was to provide a brief overview of the etiology, pathogenesis, clinical presentation, and management of CS. An evaluation of the medical community's response to this emerging diagnosis was also explored. METHODS This review was prepared by assessing available medical and scientific literature from MEDLINE, as well as by reviewing numerous books, toxicology journals, conference proceedings, government publications, and environmental health periodicals. A primary observation, however, is that there is limited scientific literature available on the issue of CS. The format of a traditional integrated review was chosen because such reviews play a pivotal role in scientific research and professional practice in medical issues with limited primary study and uncharted clinical territory. RESULTS The sensitization state of CS seems to be initiated by a significant toxic exposure, occurring as a 1-time event, or on surpassing a threshold of toxicity after toxicant accrual from repeated lower-level exposures. Once sensitized through a toxicant-induced loss of tolerance, individuals exposed to inciting triggers such as minute amounts of diverse everyday chemicals may experience various clinical and immune sequelae, sometimes involving lymphocyte, antibody, or cytokine responses. Precautionary avoidance of inciting triggers will prevent symptoms, and desensitization immunotherapy or immune suppression may improve symptoms in some cases. Sustained resolution of the CS state occurs after successful elimination of the accrued body burden of toxicants through natural mechanisms of toxicant bioelimination and/or interventions of clinical detoxification. Despite extensive clinical evidence to support the veracity of this clinical state, many members of the medical community are reluctant to accept this condition as a pathophysiologic disorder. CONCLUSIONS The emerging problem of ubiquitous adverse toxicant exposures in modern society has resulted in escalating numbers of individuals developing a CS disorder. As usual in medical history, iconoclastic ideas and emerging evidence regarding novel disease mechanisms, such as the pathogenesis of CS, have been met with controversy, resistance, and sluggish knowledge translation.
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Affiliation(s)
- Stephen J Genuis
- Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada.
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16
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Gibson PR, Lindberg A. Physicians' perceptions and practices regarding patient reports of multiple chemical sensitivity. ISRN NURSING 2011; 2011:838930. [PMID: 22007328 PMCID: PMC3168894 DOI: 10.5402/2011/838930] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Accepted: 07/07/2011] [Indexed: 11/23/2022]
Abstract
Ninety physicians practicing in the state of Virginia USA completed a mail survey regarding Multiple Chemical Sensitivity (MCS). Survey questions addressed demographics; familiarity with MCS; etiology; overlapping conditions; accommodations made for patients and practices regarding evaluation, treatment, and referral. A little over half of respondents were familiar with MCS. Under a third had received any medical training regarding chemical sensitivity, only 7% were "very satisfied" with their knowledge, and 6% had a treatment protocol for the condition. Participants cited a range of etiologies and overlapping conditions including asthma, Reactive Airway Dysfunction Syndrome (RADS), Sick Building Syndrome (SBS), Chronic Fatigues Syndrome (CFS), and Fibromyalgia. Physicians infrequently considered chemicals as a cause of illness when seeing new patients. Evaluation techniques included interviews, blood work, immune profiles, and allergy testing. Interventions recommended included chemical avoidance, alterations in the home environment, diet restrictions, the use of air filters, and referrals to outside specialists.
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, MSC 7704, Harrisonburg, VA 22807, USA
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Hayley S, Mangano E, Crowe G, Li N, Bowers WJ. An in vivo animal study assessing long-term changes in hypothalamic cytokines following perinatal exposure to a chemical mixture based on Arctic maternal body burden. Environ Health 2011; 10:65. [PMID: 21745392 PMCID: PMC3148548 DOI: 10.1186/1476-069x-10-65] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 07/11/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND The geographic distribution of environmental toxins is generally not uniform, with certain northern regions showing a particularly high concentration of pesticides, heavy metals and persistent organic pollutants. For instance, Northern Canadians are exposed to high levels of persistent organic pollutants like polychlorinated biphenyls (PCB), organochlorine pesticides (OCs) and methylmercury (MeHg), primarily through country foods. Previous studies have reported associations between neuronal pathology and exposure to such toxins. The present investigation assessed whether perinatal exposure (gestation and lactation) of rats to a chemical mixture (27 constituents comprised of PCBs, OCs and MeHg) based on Arctic maternal exposure profiles at concentrations near human exposure levels, would affect brain levels of several inflammatory cytokines METHODS Rats were dosed during gestation and lactation and cytokine levels were measured in the brains of offspring at five months of age. Hypothalamic cytokine protein levels were measured with a suspension-based array system and differences were determined using ANOVA and post hoc statistical tests. RESULTS The early life PCB treatment alone significantly elevated hypothalamic interleukin-6 (IL-6) levels in rats at five months of age to a degree comparable to that of the entire chemical mixture. Similarly, the full mixture (and to a lesser degree PCBs alone) elevated levels of the pro-inflammatory cytokine, IL-1b, as well as the anti-inflammatory cytokine, IL-10. The full mixture of chemicals also moderately increased (in an additive fashion) hypothalamic levels of the pro-inflammatory cytokines, IL-12 and tumor necrosis factor (TNF-α). Challenge with bacterial endotoxin at adulthood generally increased hypothalamic levels to such a degree that differences between the perinatally treated chemical groups were no longer detectable. CONCLUSIONS These data suggest that exposure at critical neurodevelopmental times to environmental chemicals at concentrations and combinations reflective of those observed in vulnerable population can have enduring consequences upon cytokines that are thought to contribute to a range of pathological states. In particular, such protracted alterations in the cytokine balance within the hypothalamus would be expected to favor marked changes in neuro-immune and hormonal communication that could have profound behavioral consequences.
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Affiliation(s)
- Shawn Hayley
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, Canada
| | - Emily Mangano
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, Canada
| | - Geoffrey Crowe
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, K1S 5B6, Canada
| | - Nanqin Li
- Environmental Health Science and Research Bureau, Health Canada, 50 Colombine Driveway, Ottawa, K1A OK9, Canada
| | - Wayne J Bowers
- Environmental Health Science and Research Bureau, Health Canada, 50 Colombine Driveway, Ottawa, K1A OK9, Canada
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Gibson PR, Sledd LG, McEnroe WH, Vos AP. Isolation and lack of access in multiple chemical sensitivity: A qualitative study. Nurs Health Sci 2011; 13:232-7. [PMID: 21595819 DOI: 10.1111/j.1442-2018.2011.00606.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This paper describes a qualitative interview study of 26 persons with multiple chemical sensitivity (MCS), also referred to as chemical intolerance. We used a phenomenological perspective and planned to focus on the impact of MCS on relationships, but found that difficulty with accessing safe spaces at times prevented relationships by limiting access to personal interactions. Thus, persons with MCS either lost or were unable to cultivate new relationships as a result of lack of spatial access. Others' lack of understanding and refusal to make accommodations at times denied spatial access to those with MCS. In this way, relationships (relationality) and spatial access (spatiality) interacted with one another to keep persons isolated. In this paper, we describe informants' detailed experience of living with chemical intolerance in a culture where chemical exposures are commonplace.
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Affiliation(s)
- Pamela Reed Gibson
- Department of Psychology, James Madison University, Harrisonburg, Virginia, USA.
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Genuis SJ. Sensitivity-related illness: the escalating pandemic of allergy, food intolerance and chemical sensitivity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:6047-6061. [PMID: 20920818 DOI: 10.1016/j.scitotenv.2010.08.047] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 08/21/2010] [Accepted: 08/26/2010] [Indexed: 05/29/2023]
Abstract
The prevalence of allergic-related diseases, food intolerance, and chemical sensitivities in both the pediatric and adult population has increased dramatically over the last two decades, with escalating rates of associated morbidity. Conditions of acquired allergy, food intolerance and chemical hypersensitivity are frequently the direct sequelae of a toxicant induced loss of tolerance (TILT) in response to a significant initiating toxic exposure. Following the primary toxicant insult, the individuals become sensitive to low levels of diverse and unrelated triggers in their environment such as commonly encountered chemical, inhalant or food antigens. Among sensitized individuals, exposure to assorted inciting stimuli may precipitate diverse clinical and/or immune sequelae as may be evidenced by clinical symptoms as well as varied lymphocyte, antibody, or cytokine responses in some cases. Recently recognized as a mechanism of disease development, TILT and resultant sensitivity-related illness (SRI) may involve various organ systems and evoke wide-ranging physical or neuropsychological manifestations. With escalating rates of toxicant exposure and bioaccumulation in the population-at-large, an increasing proportion of contemporary illness is the direct result of TILT and ensuing SRI. Avoidance of triggers will preclude symptoms, and desensitization immunotherapy or immune suppression may ameliorate symptomatology in some cases. Resolution of SRI generally occurs on a gradual basis following the elimination of bioaccumulated toxicity and avoidance of further initiating adverse environmental exposures. As has usually been the case throughout medical history whenever new evidence regarding disease mechanisms emerges, resistance to the translation of knowledge abounds.
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Affiliation(s)
- Stephen J Genuis
- Environmental Health Sciences, Faculty Of Medicine, University Of alberta, Canada.
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Of the world but not in it: barriers to community access and education for persons with environmental sensitivities. Health Care Women Int 2010; 31:3-16. [PMID: 20390633 DOI: 10.1080/07399330903042823] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this article I explore community access-primarily the lack thereof-for persons with disabling environmental sensitivities (ESs). Respondents with chemical and electrical sensitivities described their level of access to common community resources that most persons take for granted, including communities of worship, grocery stores, health food stores, community meetings, public libraries, the homes of extended family members and friends, offices of dentists and medical doctors, public parks, and classes at their local universities. Most had tentative access at best. In addition, participants listed the disability barriers that most restricted them from public participation. Results are described using both quantitative and qualitative data and the problem is analyzed within the context of industrial capitalism's influence upon institutions.
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Skovbjerg S, Zachariae R, Rasmussen A, Johansen JD, Elberling J. Attention to bodily sensations and symptom perception in individuals with idiopathic environmental intolerance. Environ Health Prev Med 2009; 15:141-50. [PMID: 19953345 DOI: 10.1007/s12199-009-0120-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 10/30/2009] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Idiopathic environmental intolerance (IEI) is characterized by non-specific symptoms attributed to exposure to environmental odours or chemicals at levels below those known to induce adverse health effects. A clarification of whether psychological processes involved in sensory perceptions are associated with IEI would add to our understanding of this complex disorder. PURPOSE To examine if measures of somato-sensory amplification, autonomic perception and absorption are associated with IEI. METHODS The study included individuals with self-reported or physician-diagnosed IEI. Participants (n = 732) completed questionnaires that included items on descriptive variables of IEI, the Somato-Sensory Amplification Scale (SSAS), the Autonomic Perception Questionnaire (APQ), the Tellegen Absorption Scale (TAS) and a Negative Affectivity Scale (NAS). RESULTS Multiple, hierarchical linear regression analyses revealed significant positive associations between SSAS, APQ, and IEI, while small and inverse associations were seen between TAS and IEI. CONCLUSIONS The association with SSAS and APQ suggests that perceptual personality characteristics are important in understanding this disorder.
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Affiliation(s)
- Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Ledreborg Alle 40, 2.th, 2820, Gentofte, Denmark.
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