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Suzuki T, Bai Y, Ohno Y. Prevalence and Factors Related to High Risk of Multiple Chemical Sensitivity among Japanese High School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:934. [PMID: 39063510 DOI: 10.3390/ijerph21070934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/04/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Multiple chemical sensitivity (MCS) onset in minors can greatly impact learning and future employment. This study investigated the prevalence of MCS and related factors in high school students to determine whether it was the same as in adults. A comprehensive survey was conducted on 80 high schools in Gunma Prefecture, Japan. The survey incorporated the Quick Environmental Exposure and Sensitivity Inventory, as well as items related to allergies, the living environment, and lifestyle. Of the 4630 students analyzed, according to Hojo's cut-off value, 9.0% were classified as high-risk for MCS and 77.9% reported some allergy-like symptoms. Significant factors associated with elevated MCS risk included female sex, having various allergic conditions, having experienced living in a new home or home renovations or extensions, proximity to environmental stressors (freeways, national highway, factories, rubbish dumps, or sources of offensive odors), insufficient physical activity (exercising less than once a week outside of physical education classes), having cold hands and feet, being fatigued, having a bedtime earlier than 11 p.m., and having moderate-frequent subjective stress. Overall, 9.0% of high school students in Japan are at high risk for MCS. Enhancing awareness of MCS-like symptoms and addressing allergies, living environments, and lifestyle habits may mitigate these symptoms.
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Affiliation(s)
- Tamami Suzuki
- Graduate School of Nursing, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan
| | - Yoshiko Bai
- Institutional Research Center, Dokkyo Medical University, 880 Kitakobayashi, Mibu 321-0293, Japan
| | - Yuko Ohno
- Graduate School of Engineering, Osaka University, 1-1 Yamadaoka, Suita 565-0871, Japan
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2
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Watai K, Suda W, Kurokawa R, Sekiya K, Hayashi H, Iwata M, Nagayama K, Nakamura Y, Hamada Y, Kamide Y, Fukutomi Y, Nakabayashi T, Tanaka K, Kamita M, Taniguchi M, Hattori M. Metagenomic gut microbiome analysis of Japanese patients with multiple chemical sensitivity/idiopathic environmental intolerance. BMC Microbiol 2024; 24:84. [PMID: 38468206 PMCID: PMC10926566 DOI: 10.1186/s12866-024-03239-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Although the pathology of multiple chemical sensitivity (MCS) is unknown, the central nervous system is reportedly involved. The gut microbiota is important in modifying central nervous system diseases. However, the relationship between the gut microbiota and MCS remains unclear. This study aimed to identify gut microbiota variations associated with MCS using shotgun metagenomic sequencing of fecal samples. METHODS We prospectively recruited 30 consecutive Japanese female patients with MCS and analyzed their gut microbiomes using shotgun metagenomic sequencing. The data were compared with metagenomic data obtained from 24 age- and sex-matched Japanese healthy controls (HC). RESULTS We observed no significant difference in alpha and beta diversity of the gut microbiota between the MCS patients and HC. Focusing on the important changes in the literatures, at the genus level, Streptococcus, Veillonella, and Akkermansia were significantly more abundant in MCS patients than in HC (p < 0.01, p < 0.01, p = 0.01, respectively, fold change = 4.03, 1.53, 2.86, respectively). At the species level, Akkermansia muciniphila was significantly more abundant (p = 0.02, fold change = 3.3) and Faecalibacterium prausnitzii significantly less abundant in MCS patients than in HC (p = 0.03, fold change = 0.53). Functional analysis revealed that xylene and dioxin degradation pathways were significantly enriched (p < 0.01, p = 0.01, respectively, fold change = 1.54, 1.46, respectively), whereas pathways involved in amino acid metabolism and synthesis were significantly depleted in MCS (p < 0.01, fold change = 0.96). Pathways related to antimicrobial resistance, including the two-component system and cationic antimicrobial peptide resistance, were also significantly enriched in MCS (p < 0.01, p < 0.01, respectively, fold change = 1.1, 1.2, respectively). CONCLUSIONS The gut microbiota of patients with MCS shows dysbiosis and alterations in bacterial functions related to exogenous chemicals and amino acid metabolism and synthesis. These findings may contribute to the further development of treatment for MCS. TRIAL REGISTRATION This study was registered with the University Hospital Medical Information Clinical Trials Registry as UMIN000031031. The date of first trial registration: 28/01/2018.
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Affiliation(s)
- Kentaro Watai
- Center for Immunology and Allergy, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa, 247-8533, Japan.
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
| | - Wataru Suda
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
| | - Rina Kurokawa
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
| | - Kiyoshi Sekiya
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Hiroaki Hayashi
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Maki Iwata
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Kisako Nagayama
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Yuto Nakamura
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Yuto Hamada
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Yosuke Kamide
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | | | - Kosei Tanaka
- H.U. Group Research Institute G.K., Akiruno, Tokyo, Japan
| | | | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Masahira Hattori
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
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3
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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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Abstract
Aim: To determine whether environmental house calls that improved indoor air quality (IAQ) is effective in reducing symptoms of chemical intolerance (CI). Background: Prevalence of CI is increasing worldwide. Those affected typically report symptoms such as headaches, fatigue, ‘brain fog’, and gastrointestinal problems – common primary care complaints. Substantial evidence suggests that improving IAQ may be helpful in reducing symptoms associated with CI. Methods: Primary care clinic patients were invited to participate in a series of structured environmental house calls (EHCs). To qualify, participants were assessed for CI with the Quick Environmental Exposure and Sensitivity Inventory. Those with CI volunteered to allow the EHC team to visit their homes to collect air samples for volatile organic compounds (VOCs). Initial and post-intervention IAQ sampling was analyzed by an independent lab to determine VOC levels (ng/L). The team discussed indoor air exposures, their health effects, and provided guidance for reducing exposures. Findings: Homes where recommendations were followed showed the greatest improvements in IAQ. The improvements were based upon decreased airborne VOCs associated with reduced use of cleaning chemicals, personal care products, and fragrances, and reduction in the index patients’ symptoms. Symptom improvement generally was not reported among those whose homes showed no VOC improvement. Conclusion: Improvements in both IAQ and patients’ symptoms occur when families implement an action plan developed and shared with them by a trained EHC team. Indoor air problems simply are not part of most doctors’ differential diagnoses, despite relatively high prevalence rates of CI in primary care clinics. Our three-question screening questionnaire – the BREESI – can help physicians identify which patients should complete the QEESI. After identifying patients with CI, the practitioner can help by counseling them regarding their home exposures to VOCs. The future of clinical medicine could include environmental house calls as standard of practice for susceptible patients.
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Zucco GM, Doty RL. Multiple Chemical Sensitivity. Brain Sci 2021; 12:46. [PMID: 35053790 PMCID: PMC8773480 DOI: 10.3390/brainsci12010046] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 01/09/2023] Open
Abstract
Multiple Chemical Sensitivity (MCS), a condition also known as Chemical Sensitivity (CS), Chemical Intolerance (CI), Idiopathic Environmental Illness (IEI) and Toxicant Induced Loss of Tolerance (TILT), is an acquired multifactorial syndrome characterized by a recurrent set of debilitating symptoms. The symptoms of this controversial disorder are reported to be induced by environmental chemicals at doses far below those usually harmful to most persons. They involve a large spectrum of organ systems and typically disappear when the environmental chemicals are removed. However, no clear link has emerged among self-reported MCS symptoms and widely accepted objective measures of physiological dysfunction, and no clear dose-response relationship between exposure and symptom reactions has been observed. In addition, the underlying etiology and pathogenic processes of the disorder remain unknown and disputed, although biologic and psychologic hypotheses abound. It is currently debated whether MCS should be considered a clinical entity at all. Nevertheless, in the last few decades MCS has received considerable scientific and governmental attention in light of the many persons reporting this illness. In this review, we provide a general overview of the history, definition, demographics, prevalence, and etiologic challenges in defining and understanding MCS.
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Affiliation(s)
- Gesualdo M Zucco
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, 35100 Padova, Italy
| | - Richard L Doty
- Smell and Taste Center, Department of Otorhinolaryngology, Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Multiple Chemical Sensitivity in Patients Exposed to Moisture Damage at Work and in General Working-Age Population-The SAMDAW Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312296. [PMID: 34886041 PMCID: PMC8657242 DOI: 10.3390/ijerph182312296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/18/2021] [Accepted: 11/21/2021] [Indexed: 11/17/2022]
Abstract
A considerable proportion of patients having respiratory tract or voice symptoms associated with workplace moisture damage (MD) could have multiple chemical sensitivity (MCS). MCS is characterized by symptoms of different organ systems in association with low-level chemical exposure. The objective of this study was to assess the prevalence of MCS among patients referred to secondary health care because of respiratory or voice symptoms associated with workplace MD compared to the general working-age population. Using three subscales of the QEESI© questionnaire, we assessed MCS in the study patients and 1500 controls in the same district randomly selected from the Finnish Population Information System. Study patients had significantly more often high scores in chemical intolerance (39% vs. 23%, p = 0.001), symptom severity (60% vs. 27%, p < 0.001), and life impact subscales (53% vs. 20%, p < 0.001). Asthma, chronic rhinosinusitis, laryngeal problems, and atopy were not associated with the presence of MCS. MCS is common among patients referred to secondary health care with respiratory tract and/or voice symptoms associated with workplace MD, and it considerably affects their everyday life. MCS should be considered as a possible explanatory factor for MD-associated symptoms.
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Suojalehto H, Ndika J, Lindström I, Airaksinen L, Karvala K, Kauppi P, Lauerma A, Toppila-Salmi S, Karisola P, Alenius H. Transcriptomic Profiling of Adult-Onset Asthma Related to Damp and Moldy Buildings and Idiopathic Environmental Intolerance. Int J Mol Sci 2021; 22:ijms221910679. [PMID: 34639020 PMCID: PMC8508786 DOI: 10.3390/ijms221910679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
A subset of adult-onset asthma patients attribute their symptoms to damp and moldy buildings. Symptoms of idiopathic environmental intolerance (IEI) may resemble asthma and these two entities overlap. We aimed to evaluate if a distinct clinical subtype of asthma related to damp and moldy buildings can be identified, to unravel its corresponding pathomechanistic gene signatures, and to investigate potential molecular similarities with IEI. Fifty female adult-onset asthma patients were categorized based on exposure to building dampness and molds during disease initiation. IEI patients (n = 17) and healthy subjects (n = 21) were also included yielding 88 study subjects. IEI was scored with the Quick Environmental Exposure and Sensitivity Inventory (QEESI) questionnaire. Inflammation was evaluated by blood cell type profiling and cytokine measurements. Disease mechanisms were investigated via gene set variation analysis of RNA from nasal biopsies and peripheral blood mononuclear cells. Nasal biopsy gene expression and plasma cytokine profiles suggested airway and systemic inflammation in asthma without exposure to dampness (AND). Similar evidence of inflammation was absent in patients with dampness-and-mold-related asthma (AAD). Gene expression signatures revealed a greater degree of similarity between IEI and dampness-related asthma than between IEI patients and asthma not associated to dampness and mold. Blood cell transcriptome of IEI subjects showed strong suppression of immune cell activation, migration, and movement. QEESI scores correlated to blood cell gene expression of all study subjects. Transcriptomic analysis revealed clear pathomechanisms for AND but not AAD patients. Furthermore, we found a distinct molecular pathological profile in nasal and blood immune cells of IEI subjects, including several differentially expressed genes that were also identified in AAD samples, suggesting IEI-type mechanisms.
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Affiliation(s)
- Hille Suojalehto
- Occupational Medicine, Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (H.S.); (I.L.); (L.A.); (K.K.)
| | - Joseph Ndika
- Human Microbiome (HUMI) Research Program, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (J.N.); (P.K.)
| | - Irmeli Lindström
- Occupational Medicine, Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (H.S.); (I.L.); (L.A.); (K.K.)
| | - Liisa Airaksinen
- Occupational Medicine, Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (H.S.); (I.L.); (L.A.); (K.K.)
| | - Kirsi Karvala
- Occupational Medicine, Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (H.S.); (I.L.); (L.A.); (K.K.)
- Varma, 00098 Helsinki, Finland
| | - Paula Kauppi
- Skin and Allergy Hospital, Helsinki University Hospital, 00250 Helsinki, Finland; (P.K.); (A.L.); (S.T.-S.)
| | - Antti Lauerma
- Skin and Allergy Hospital, Helsinki University Hospital, 00250 Helsinki, Finland; (P.K.); (A.L.); (S.T.-S.)
| | - Sanna Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital, 00250 Helsinki, Finland; (P.K.); (A.L.); (S.T.-S.)
| | - Piia Karisola
- Human Microbiome (HUMI) Research Program, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (J.N.); (P.K.)
| | - Harri Alenius
- Human Microbiome (HUMI) Research Program, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (J.N.); (P.K.)
- Institute of Environmental Medicine (IMM), Karolinska Institutet, 171 77 Stockholm, Sweden
- Correspondence: ; Tel.: +358-50-4489526
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Van den Bergh O, Bräscher AK, Witthöft M. Idiopathic Environmental Intolerance: A Treatment Model. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2020.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Storino V, Muñoz-Ortiz J, Villabona-Martinez V, Villamizar-Sanjuán JD, Rojas-Carabali W, de-la-Torre A. An Unusual Case of Multiple Food Allergies Comorbid with Multiple Chemical Sensitivity: A Case Report. J Asthma Allergy 2021; 14:317-323. [PMID: 33833533 PMCID: PMC8020051 DOI: 10.2147/jaa.s293248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 02/26/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose To report the case of a patient with multiple food allergies comorbid with multiple chemical sensitivity (MCS) who was misdiagnosed on various occasions, resulting in a negative impact on the patient's personal and social life. Case Report We present the case of a 43-year-old Colombian women with multiple food allergies concomitant with MCS. Symptoms started with a mild reaction to insecticides, car exhaust smoke, and perfumes and gradually evolved into a severe reaction to her environment. She also presented recurrent episodes of clinical reactivity to foods and persistent elevated IgE levels, as well as several life-threatening anaphylactic reactions. Alternative and allopathic therapies were applied, but her symptoms persisted. Various diagnoses were made before the definitive diagnosis. Conclusion MCS is an unusual entity of unknown pathophysiology that can, on rare occasions, coexist with food allergies. Early recognition and multidisciplinary treatment are required as these entities have a major impact on the patient's quality of life. We present the first Latin American case regarding the association of the two diseases.
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Affiliation(s)
| | - Juliana Muñoz-Ortiz
- Escuela Barraquer, Research Group, Escuela Superior de Oftalmología, Instituto Barraquer de América, Bogotá, Colombia
| | - Valeria Villabona-Martinez
- Neuroscience Research Group "NeURos", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Juan Diego Villamizar-Sanjuán
- Neuroscience Research Group "NeURos", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - William Rojas-Carabali
- Neuroscience Research Group "NeURos", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Alejandra de-la-Torre
- Neuroscience Research Group "NeURos", Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
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Palmer RF, Jaén CR, Perales RB, Rincon R, Forster JN, Miller CS. Three questions for identifying chemically intolerant individuals in clinical and epidemiological populations: The Brief Environmental Exposure and Sensitivity Inventory (BREESI). PLoS One 2020; 15:e0238296. [PMID: 32936802 PMCID: PMC7494077 DOI: 10.1371/journal.pone.0238296] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 08/14/2020] [Indexed: 12/12/2022] Open
Abstract
The Quick Environmental Exposure and Sensitivity Inventory (QEESI) is a validated questionnaire used worldwide to assess intolerances to chemicals, foods, and drugs, and has emerged as the gold standard for assessing chemical intolerance (CI). Despite a reported prevalence of 8–33%, epidemiological studies and routine primary care clinics rarely assess CI. To help address this gap, we developed the Brief Environmental Exposure and Sensitivity Inventory (BREESI)—a 3-item CI screening tool. We tested the BREESI’s potential to predict whether an individual is likely to be classified as chemically intolerant if administered the 50-item QEESI. We recruited 293 participants from a university-based primary care clinic and through online participation. The statistical sensitivity, specificity, and positive and negative predictive values of the BREESI were calculated against the validated QEESI. Ninety percent (90%) of participants answering “yes” to all three items on the BREESI fit the QEESI criteria for being very suggestive of CI based upon their chemical intolerance and symptom scores (positive predictive value = 90%). For participants endorsing two items, 93% were classified as either very suggestive (39%) or suggestive (54%) of CI (positive predictive value = 87%). Of those endorsing only one item, 13% were classified as very suggestive of CI, and 70% as suggestive. Of those answering “No” to all of the BREESI items, 95% were classified as not suggestive of CI (i.e., negative predictive value = 95%). The BREESI is a versatile screening tool for assessing potential CI useful for clinical and epidemiological applications, based upon individuals’ past adverse responses in a variety of settings. Just as health care professionals routinely inquire about latex allergy to prevent adverse reactions, the BREESI provides an essential screen for CI. Together, the BREESI and QEESI provide new diagnostic tools that may help predict and prevent future adverse reactions to chemicals, foods, and drugs.
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Affiliation(s)
- Raymond F. Palmer
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- * E-mail:
| | - Carlos R. Jaén
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Roger B. Perales
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Rodolfo Rincon
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Jacqueline N. Forster
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Claudia S. Miller
- Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Chemical intolerance: involvement of brain function and networks after exposure to extrinsic stimuli perceived as hazardous. Environ Health Prev Med 2019; 24:61. [PMID: 31640568 PMCID: PMC6806489 DOI: 10.1186/s12199-019-0816-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/23/2019] [Indexed: 01/09/2023] Open
Abstract
Background Chemical intolerance (CI) is a chronic condition characterized by recurring and severe symptoms triggered by exposure to low levels of odorous or pungent substances. The etiology of CI has been a controversial subject for a long time. The aim of this review is to summarize findings on the neurological processing of sensory information during and after exposure to low levels of odorous or pungent substances in individuals with CI, focusing on the brain function and networks. Methods Scientific studies on CI published between 2000 and 2019 in academic peer-reviewed journals were systematically searched using medical and scientific literature databases. Only peer-reviewed articles reporting original research from experimental human studies directly associated with CI, and involving related neurological responses or brain imaging after exposure to odorous or pungent substances (i.e., in chemical provocation tests), were considered. Results Forty-seven studies were found to be eligible for a full-text review. Twenty-three studies met the selection criteria and were included in this review. Evidence indicated that differences between subjects with CI and healthy controls were observed by brain imaging during and after exposure to odorous or pungent substances. Differences in brain imaging were also observed between initial exposure and after exposure to these substances. Neurological processing of sensory information after exposure to extrinsic stimuli in the limbic system and related cortices were altered in subjects with CI. A previous documentable exposure event was likely to be involved in this alteration. Conclusions This review documents consistent evidence for the altered neurological processing of sensory information in individuals with CI. Further neurophysiological research exploring the processing of extrinsic stimuli and cognition of sensation through the limbic system and related cortices in CI, and the appearance of symptoms in individuals with CI, are required.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, Osaka, 589-8511, Japan. .,Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan.,Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan
| | - Mari Tanigawa
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, 606-8225, Japan.,Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, 184-8501, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, 635-0832, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, 606-8225, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, 259-1193, Japan
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12
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Multiple Chemical Sensitivity: Review of the State of the Art in Epidemiology, Diagnosis, and Future Perspectives. J Occup Environ Med 2019; 60:138-146. [PMID: 29111991 PMCID: PMC5794238 DOI: 10.1097/jom.0000000000001215] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Systematic bibliography analysis of about the last 17 years on multiple chemical sensitivity (MCS) was carried out in order to detect new diagnostic and epidemiological evidence. The MCS is a complex syndrome that manifests as a result of exposure to a low level of various common contaminants. The etiology, diagnosis, and treatment are still debated among researchers. METHOD Querying PubMed, Web of Science, Scopus, Cochrane library, both using some specific MESH terms combined with MESH subheadings and through free search, even by Google. RESULTS The studies were analyzed by verifying 1) the typology of study design; 2) criteria for case definition; 3) presence of attendances in the emergency departments and hospital admissions, and 4) analysis of the risk factors. OUTLOOK With this review, we give some general considerations and hypothesis for possible future research.
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Hojo S, Mizukoshi A, Azuma K, Okumura J, Mizuki M, Miyata M. New criteria for multiple chemical sensitivity based on the Quick Environmental Exposure and Sensitivity Inventory developed in response to rapid changes in ongoing chemical exposures among Japanese. PLoS One 2019; 14:e0215144. [PMID: 31026284 PMCID: PMC6485617 DOI: 10.1371/journal.pone.0215144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/27/2019] [Indexed: 12/12/2022] Open
Abstract
Background & objectives The Quick Environmental Exposure and Sensitivity Inventory (QEESI) developed by Miller and Prihoda in the USA is used as a questionnaire for patients with multiple chemical sensitivity (MCS) in >10 countries. We developed a Japanese version of QEESI, assessed its reliability and validity, and defined original cut-off values for screening Japanese patients with MCS in 2003. Our recent study revealed that opportunities for exposure to various chemicals had increased for people in Japan, while subjective symptoms of MCS in patients had increased in severity. In this study, we considered new cut-off values that combined QEESI subscale scores based on the current situation in Japan. Methods The questionnaire used was a Japanese version of QEESI. The survey was conducted from 2012 to 2015. Participants were 111 patients with MCS (mean age: 46 ± 20, 81% female) initially diagnosed by physicians, and 444 age- and gender-matched controls not diagnosed with MCS by doctors. The discriminatory validity of QEESI scores of patients and controls were evaluated by logistic regression and receiver operating characteristic analyses when considering interactions of the Masking Index (ongoing chemical exposure). New combined cut-off values were then set. Results New combined cut-off values (meeting conditions of Chemical Intolerances ≥ 30, Symptom Severity ≥ 13, and Life Impacts ≥ 17) showed high sensitivity (82.0%) and specificity (94.4%). Using new criteria when considering ongoing chemical exposure, study participants were categorized as: Very suggestive, Somewhat suggestive, Problematic, and Not suggestive. Participants classified as Very suggestive included 25 (5.6%) controls. Conclusions We have set new criteria with combined cut-off values based on current Japanese conditions. Such new criteria can be used for screening and as a diagnostic aid for Japanese patients with MCS and suggest approximately 6% of the Japanese general population may be classified as “Very suggestive people with MCS”.
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Affiliation(s)
- Sachiko Hojo
- Institute of Applied Brain Sciences, Waseda University, Tokorozawa, Japan
- Shokei Gakuin University, Natori, Japan
- Tohoku University Graduate School of Dentistry, Sendai, Japan
- * E-mail:
| | - Atsushi Mizukoshi
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Jiro Okumura
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Masami Mizuki
- Department of Respiratory Medicine and Allergy, National Hospital Organization, Morioka National Hospital, Morioka, Japan
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Indoor Air Quality and Health in Newly Constructed Apartments in Developing Countries: A Case Study of Surabaya, Indonesia. ATMOSPHERE 2019. [DOI: 10.3390/atmos10040182] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In times of rapid urbanization, increasing usage of chemicals in buildings, and energy saving measures, the topic of indoor air quality (IAQ) demands reinforced attention. Nevertheless, especially in developing countries with urgent building construction needs, IAQ has hardly been examined. This study investigates the condition of IAQ and health of occupants in newly constructed high-rise apartments in contrast to traditional detached houses (Kampongs) in Surabaya, Indonesia. Information on building attributes, cleaning and ventilation behavior, interior sources, personal characteristics and health, especially multiple chemical sensitivity (MCS), was collected through 471 questionnaires. In addition, 76 measurements of TVOCs, formaldehyde and 30 measurements of mold risk were carried out. The results showed that the share of people in apartments with a very suggestive risk of MCS was twice as high as that in Kampongs (17.6% vs. 6.7%). Correlation analysis suggested that for both residential types, health problems, negative smell or perception of IAQ, and higher levels of stress determined higher degrees of MCS. For IAQ, high concentrations of formaldehyde and TVOCs were measured in apartments and corresponded to higher MCS risk, whereas severe mold issues were predicted in Kampongs. This study suggests major shortcomings in the indoor environment in newly constructed apartments for the physical and the mental health of occupants.
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Watai K, Fukutomi Y, Hayashi H, Kamide Y, Sekiya K, Taniguchi M. Epidemiological association between multiple chemical sensitivity and birth by caesarean section: a nationwide case-control study. Environ Health 2018; 17:89. [PMID: 30547814 PMCID: PMC6295056 DOI: 10.1186/s12940-018-0438-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Multiple chemical sensitivity (MCS) is characterized by recurrent nonspecific symptoms that are attributed to exposure to trace levels of environmental agents. Although the clinical symptoms of MCS have been described in several studies, the risk factors for this condition remain unclear. Our aim was to clarify the risk factors for MCS and the association between MCS and birth by caesarean section. METHODS We conducted a nationwide case-control study of Japanese individuals (aged 20-65 years) with physician-diagnosed MCS (183 cases) and without MCS (345 controls). The study participants were selected from among 150,000 people in a web-based research panel with approximately 1,000,000 registrants. They completed an online survey including questions on their sociodemographic characteristics, birth history (i.e., birth by caesarean section), and other potential risk factors for MCS. Multivariate logistic regression analysis was employed to determine the association between sociodemographic characteristics and the risk of MCS. RESULTS The proportions of case and control subjects who were born by caesarean section were 39.9 and 7.0%, respectively. The association between birth by caesarean section and MCS was significant even after adjusting for potential confounders (adjusted odds ratio: 6.15; 95% confidence interval: 3.13-12.1). A history of agricultural work, mouth breathing, ≥11 vaccinations in the past 10 years, and residing in a new home (< 1 year-old) ≥3 times were also significantly associated with MCS. CONCLUSION Our data indicate an epidemiological link between MCS and birth by caesarean section. Moreover, we show that factors other than chemical exposure may be associated with the development of MCS.
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Affiliation(s)
- Kentaro Watai
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan.
- Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Yuma Fukutomi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
- Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroaki Hayashi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
| | - Yosuke Kamide
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
| | - Kiyoshi Sekiya
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
| | - Masami Taniguchi
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan
- Course of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Azuma K, Ohyama M, Azuma E, Nakajima T. Background factors of chemical intolerance and parent-child relationships. Environ Health Prev Med 2018; 23:52. [PMID: 30355299 PMCID: PMC6201541 DOI: 10.1186/s12199-018-0743-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/08/2018] [Indexed: 12/13/2022] Open
Abstract
Background Chemical intolerance is a widespread public health problem characterized by symptoms that reportedly result from low-level exposure to chemicals. Although several studies have reported factors related to chemical intolerance in adults, the impact of family members has not been reported. In the present study, we investigated the background factors related to chemical intolerance in family members and parent–child relationships. Methods We distributed a self-reported questionnaire to 4325 mothers who were invited to visit the Kishiwada Health Center in Kishiwada City, Osaka, between January 2006 and December 2007 for the regular health checkup of their three-and-a-half-year-old children. Results The prevalence of chemical intolerance in the 3-year-old children was almost one eighteenth of that reported by their mothers. Multiple logistic regression analyses revealed that cold sensitivity [odds ratio (OR), 1.89; 95% confidence interval (CI), 1.04–3.44], past bronchial asthma (OR, 2.84; 95% CI, 1.46–5.53), and any past allergies (OR, 2.21; 95% CI, 1.36–3.60) were significantly associated with chemical intolerance in the mother. The presence of indoor cat during childhood (OR, 1.99; 95% CI, 1.08–3.69) was significantly associated with chemical intolerance in the mother; however, the association was weak compared with cold sensitivity and past asthma and allergies. The current chemical intolerance of the mother was significantly associated with allergic rhinitis (OR, 2.32; 95% CI, 1.19–4.53), bronchial asthma (OR, 3.66; 95% CI, 2.00–6.69), and chronic bronchitis (OR, 3.69; 95% CI, 1.04–13.03) in her 3-year-old child. Conclusions The results suggest that inherent physical constitution and childhood housing environment are associated with a risk of acquiring chemical intolerance. Children of mothers with chemical intolerance have a possible risk of respiratory hypersensitivity or inflammation. Further investigation is recommended to determine the inherent physical constitution and background environmental factors associated with the risk of acquiring chemical intolerance. The impact of having mothers with chemical intolerance on the health of children also requires further study. Electronic supplementary material The online version of this article (10.1186/s12199-018-0743-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, 377-2 Ohnohigashi, Osakasayama, 589-8511, Japan.
| | - Masayuki Ohyama
- Department of Environmental Health, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Emiko Azuma
- Department of Food Chemistry, Osaka Institute of Public Health, Osaka, 537-0025, Japan
| | - Takae Nakajima
- Department of Environmental Health, Osaka Institute of Public Health, Osaka, 537-0025, Japan
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Hojo S, Mizukoshi A, Azuma K, Okumura J, Ishikawa S, Miyata M, Mizuki M, Ogura H, Sakabe K. Survey on changes in subjective symptoms, onset/trigger factors, allergic diseases, and chemical exposures in the past decade of Japanese patients with multiple chemical sensitivity. Int J Hyg Environ Health 2018; 221:1085-1096. [PMID: 30115513 DOI: 10.1016/j.ijheh.2018.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 07/19/2018] [Accepted: 08/02/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Recently, with rapid changes in the Japanese lifestyle, the clinical condition of patients with multiple chemical sensitivity (MCS) may also have undergone change. Thus, we conducted a new survey for subjective symptoms, ongoing chemical exposures, the prevalence of allergic diseases, and presumed onset/trigger factors in patients with MCS and compared results with those of an old survey from ten years ago. METHODS The new survey was conducted from 2012 to 2015 and the old survey was independently conducted from 1999 to 2003, meaning it was not a follow-up study. Patients were initially diagnosed by physicians at five medical institutions with MCS specialty outpatient services, with 111 and 103 patients participating in the new and old surveys, respectively. The controls were a general population living in Japan, with 1313 and 2382 participants in the new and old surveys, respectively. Subjective symptoms and ongoing chemical exposure were evaluated using a quick environmental exposure sensitivity inventory. Additionally, from clinical findings recorded by an attending physician, the prevalence of allergic diseases and presumed onset/trigger factors were evaluated. Differences between new and old surveys were analyzed using logistic regression analyses and significance tests. RESULTS Compared with ten years ago: (1) Regarding factors affecting patients with ongoing chemical exposures, the proportion of patients affected decreased significantly for two items only (insecticides and second-hand smoke). The proportion of controls showing ongoing exposure to 8 out of 10 items changed significantly. (2) In patients, scores for chemical intolerances, other intolerances, and life impacts increased significantly. (3) In terms of the prevalence of allergic diseases among patients with MCS, bronchial asthma (adjusted odds ratio [AOR]: 5.19), atopic dermatitis (AOR: 3.77), allergic rhinitis (AOR: 5.34), and food allergies (AOR: 2.63) increased significantly, while hay fever (AOR: 0.38) and drug allergies (AOR: 0.40) decreased significantly. (4) With regard to construction and renovation, which was the presumed predominant onset/trigger factor for MCS 10 years ago, this decreased from 68.9% to 35.1%; in contrast, electromagnetic fields (0.0%-26.1%), perfume (0.0%-20.7%), and medical treatment (1.9%-7.2%) increased significantly, confirming the diversification of onset/trigger factors. CONCLUSION Compared to ten years ago, for patients with MCS, an increase in avoidance behavior toward chemical substance exposures, which were presumed to be aggravating factors for symptoms, was confirmed. It has been suggested that the ongoing chemical exposure of the general population in Japan has largely changed. In addition, for patients with MCS, chemical intolerances and life impacts have become severe, the prevalence of the main allergic diseases has increased, and onset/trigger factors have become diversified.
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Affiliation(s)
- Sachiko Hojo
- Institute of Applied Brain Sciences, Waseda University, Tokorozawa, Japan; Shokei Gakuin University, Natori, Japan; Graduate School of Dentistry, Tohoku University, Sendai, Japan.
| | - Atsushi Mizukoshi
- Institute of Applied Brain Sciences, Waseda University, Tokorozawa, Japan; Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Jiro Okumura
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Satoshi Ishikawa
- Environmental Medical Center, Kitasato Institute Hospital, Tokyo, Japan
| | | | - Masami Mizuki
- Department of Respiratory Medicine and Allergy, Morioka National Hospital, Morioka, Japan
| | - Hideo Ogura
- Department of Clinical Research and Allergy, Kochi National Hospital, Kochi, Japan
| | - Kou Sakabe
- Environmental Medical Center, Kitasato Institute Hospital, Tokyo, Japan; Department of Human Structure and Function, Tokai University School of Medicine, Isehara, Japan
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Steinemann A. Prevalence and effects of multiple chemical sensitivities in Australia. Prev Med Rep 2018; 10:191-194. [PMID: 29868366 PMCID: PMC5984225 DOI: 10.1016/j.pmedr.2018.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 12/19/2022] Open
Abstract
Multiple chemical sensitivities (MCS) is a medical condition associated with exposure to common chemical pollutants. The aims of this study are to assess the prevalence of MCS, its overlaps with asthma and fragrance sensitivity, and its health and societal effects in Australia. Data were collected in June 2016 using an on-line survey with a representative national sample (N = 1098) of adults (ages 18–65) in Australia. Results found that, across the country, 6.5% report medically diagnosed MCS, 18.9% report chemical sensitivity (being unusually sensitive to everyday chemicals and chemically formulated products), and 19.9% either or both. Among people with MCS, 74.6% also have diagnosed asthma or an asthma-like condition, and 91.5% have fragrance sensitivity, reporting health problems (such as migraine headaches) when exposed to fragranced consumer products (such as air fresheners and cleaning supplies). In addition, among people with MCS, 77.5% are prevented from access to places because of fragranced products, 52.1% lost workdays or a job in the past year due to fragranced product exposure in the workplace, and 55.4% report health effects considered potentially disabling. Results indicate that MCS is a widespread disease, affecting an estimated 1 million adult Australians, with chemical sensitivity affecting another 2 million. Reducing chemical exposure to problematic sources, such as fragranced consumer products, is critical to reduce adverse effects.
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Affiliation(s)
- Anne Steinemann
- Department of Infrastructure Engineering, Melbourne School of Engineering, The University of Melbourne, Melbourne, Victoria 3010, Australia.,College of Science, Technology and Engineering, James Cook University, Townsville, Queensland 4811, Australia.,Climate, Atmospheric Sciences, and Physical Oceanography, Scripps Institution of Oceanography, University of California, La Jolla, San Diego, CA 92093, USA
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A randomised, placebo-controlled trial of transcranial pulsed electromagnetic fields in patients with multiple chemical sensitivity. Acta Neuropsychiatr 2017; 29:267-277. [PMID: 27919300 DOI: 10.1017/neu.2016.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To evaluate the efficacy of transcranially applied pulsed electromagnetic fields (PEMF) on functional impairments and symptom severity in multiple chemical sensitivity (MCS) patients. METHODS The study was conducted as a nationwide trial in Denmark using a randomised, parallel-group, double-blind and placebo-controlled design. Sample size was estimated at 40 participants. Eligibility criteria were age 18-75 years and fulfilment of the MCS case criteria. Participants received either PEMF or placebo PEMF (no stimulation) applied transcranially for 6 weeks. The primary outcome was the Life Impact Scale (LIS) of the Quick Environmental Exposure and Sensitivity Inventory (QEESI). Secondary outcomes were the Symptom Severity Scale (SSS) and the Chemical Intolerance Scale of QEESI. RESULTS A total of 39 participants were randomised to PEMF or placebo treatment. No significant difference was observed on QEESI LIS between groups with a mean change score of -5.9 in the PEMF group compared with -1.5 in the placebo group (p=0.35, effect size=-0.31). However, a significant decrease was detected on QEESI SSS within and between groups with a mean change score of -11.3 in the PEMF group compared with -3.2 in the placebo group (p=0.03, effect size=-0.60). CONCLUSION PEMF treatment of 6 weeks showed no effect on functional impairments in MCS. However, a significant decrease in symptom severity was observed.
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Heo Y, Kim SH, Lee SK, Kim HA. Factors Contributing to the Self-Reported Prevalence of Multiple Chemical Sensitivity in Public Facility Workers and the General Population of Korea. J UOEH 2017; 39:249-258. [PMID: 29249738 DOI: 10.7888/juoeh.39.249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Multiple chemical sensitivity (MCS), an acquired disorder with multiple recurrent symptoms, has been studied for its association with diverse environmental factors. The present study investigated the factors associated with the self-reported prevalence of MCS in public facility workers and the general population in Korea. The Quick Environmental Exposure Sensitivity Inventory (QEESI) questionnaire was obtained from public facility workers (N=530) and the general population (N=500) to determine the prevalence of MCS and the degree of its risk. Information about demographic characteristics, subjective perceptions of sick building syndrome or sick house syndrome or allergy (SBS/SHS/Allergy), and certain home- or workplace-related events were also obtained. There was not a statistical difference between the public facility workers and the general population in the QEESI scores. The overall prevalence of MCS was 14.4% and there was no statistical difference between the two groups. Regarding the overall degree of risk of MCS, 21.8% of the study subjects were categorized as "very suggestive", and there was no significant difference between the two groups. Gender and the subjective perception of SBS/SHS/Allergy significantly affected the prevalence of MCS and the MCS risk criteria. Considering the absence of diagnostic criteria and/or treatment methods for MCS in Korea, these results can be utilized in establishing future strategies to manage MCS.
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Affiliation(s)
- Yong Heo
- Department of Occupational Health, Daegu Catholic University, Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Seoul Eulji Hospital, Korea
| | - Seok-Ki Lee
- Department of Applied Chemistry, Woosuk University, Korea
| | - Hyoung-Ah Kim
- Department of Preventive Medicine, The Catholic University of Korea, Korea
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Azuma K, Uchiyama I, Tanigawa M, Bamba I, Azuma M, Takano H, Yoshikawa T, Sakabe K. Association of Odor Thresholds and Responses in Cerebral Blood Flow of the Prefrontal Area during Olfactory Stimulation in Patients with Multiple Chemical Sensitivity. PLoS One 2016; 11:e0168006. [PMID: 27936122 PMCID: PMC5148047 DOI: 10.1371/journal.pone.0168006] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/24/2016] [Indexed: 12/31/2022] Open
Abstract
Multiple chemical sensitivity (MCS) is a disorder characterized by nonspecific and recurrent symptoms from various organ systems associated with exposure to low levels of chemicals. Patients with MCS process odors differently than controls do. Previously, we suggested that this odor processing was associated with increased regional cerebral blood flow (rCBF) in the prefrontal area during olfactory stimulation using near-infrared spectroscopic (NIRS) imaging. The aim of this study was to investigate the association of odor thresholds and changes in rCBF during olfactory stimulation at odor threshold levels in patients with MCS. We investigated changes in the prefrontal area using NIRS imaging and a T&T olfactometer during olfactory stimulation with two different odorants (sweet and fecal) at three concentrations (zero, odor recognition threshold, and normal perceived odor level) in 10 patients with MCS and six controls. The T&T olfactometer threshold test and subjective assessment of irritating and hedonic odors were also performed. The results indicated that the scores for both unpleasant and pungent odors were significantly higher for those for sweet odors at the normal perceived level in patients with MCS than in controls. The brain responses at the recognition threshold (fecal odor) and normal perceived levels (sweet and fecal odors) were stronger in patients with MCS than in controls. However, significant differences in the odor detection and recognition thresholds and odor intensity score between the two groups were not observed. These brain responses may involve cognitive and memory processing systems during past exposure to chemicals. Further research regarding the cognitive features of sensory perception and memory due to past exposure to chemicals and their associations with MCS symptoms is needed.
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Affiliation(s)
- Kenichi Azuma
- Department of Environmental Medicine and Behavioral Science, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- * E-mail:
| | - Iwao Uchiyama
- Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Outpatient Department of Sick-house Syndrome, Hyakumanben Clinic, Kyoto, Japan
| | - Mari Tanigawa
- Clinical Immune Function Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research, Kyoto, Japan
- Division of Internal Medicine, Hyakumanben Clinic, Kyoto, Japan
| | - Ikuko Bamba
- Faculty of Education, Home Economics, Tokyo Gakugei University, Koganei, Tokyo, Japan
| | - Michiyo Azuma
- Department of Human Environmental Design, Faculty of Health Science, Kio University, Kitakatsuragi-gun, Nara, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Toshikazu Yoshikawa
- Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kou Sakabe
- Department of Anatomy and Cellular Biology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
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Mindfulness-based cognitive therapy (MBCT) for multiple chemical sensitivity (MCS): Results from a randomized controlled trial with 1 year follow-up. J Psychosom Res 2015; 79:628-34. [PMID: 26311155 DOI: 10.1016/j.jpsychores.2015.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by symptoms from multiple organ systems following the perception of common odorants. The condition can cause severe functional impairment for afflicted individuals. The aim of this study was to assess the effects of mindfulness-based cognitive therapy (MBCT) for individuals with MCS. METHODS The intention-to-treat sample (ITT) included 69 individuals who had been randomized to either MBCT or treatment as usual (TAU). The primary outcome measure was the Quick Environmental Exposure and Sensitivity Inventory (QEESI), which measures the following aspects of MCS impact of MCS on daily life, symptoms, and reactions following chemical exposures. Secondary outcome measures included the Brief Illness Perception Questionnaire (BIPQ) and the anxiety and depression subscales of the symptom checklist 92 (SCL-92). Participants were assessed at baseline and post treatment, and at follow-up periods of 6- and 12-months. RESULTS We found no effect of MBCT on the primary outcome, nor did we find an effect on levels of depression or anxiety. We did, however, find positive changes in illness perceptions, which were sustained at 12-month follow-up. Dropout rates were low, suggesting MBCT was well received and regarded as an acceptable intervention by individuals with MCS. CONCLUSIONS Overall, these results suggest that MBCT does not change overall illness status in individuals with MCS, but that MBCT positively changes emotional and cognitive representations. Possible explanations for these results are discussed.
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Azuma K, Uchiyama I, Katoh T, Ogata H, Arashidani K, Kunugita N. Prevalence and Characteristics of Chemical Intolerance: A Japanese Population-Based Study. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2015; 70:341-353. [PMID: 25137616 DOI: 10.1080/19338244.2014.926855] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Population-based cross-sectional study was performed to estimate the prevalence of chemical intolerance and to examine the characteristics of the sample. A Web-based survey was conducted that included 7,245 adults in Japan. The criteria for chemical intolerance proposed by Skovbjerg yielded a prevalence of 7.5% that was approximately consistent with that reported from a Danish population-based survey. Female gender, older age, and renovation in the house during the past 7 years were positively associated with chemical intolerance. Improvements in the condition were observed with daily ventilation habits. Medical history of atopic dermatitis, allergic rhinitis, food allergy, multiple chemical sensitivity, and depression were associated with chemical intolerance. Fatigue, depressed mood, and somatic symptoms were also positively correlated with chemical intolerance. Better elucidation of the causes, comorbidities, concomitants, and consequences of chemical intolerance has the potential to provide effective solutions for its prevention and treatment.
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Affiliation(s)
- Kenichi Azuma
- a Department of Environmental Medicine and Behavioral Science, Kinki University Faculty of Medicine , Osaka , Japan
- b Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Iwao Uchiyama
- b Sick-house Medical Science Laboratory, Division of Basic Research, Louis Pasteur Center for Medical Research , Kyoto , Japan
| | - Takahiko Katoh
- c Department of Public Health, Graduate School of Life Sciences, Kumamoto University, Kumamoto , Japan
| | - Hiromitsu Ogata
- d Center for Public Health Informatics, National Institute of Public Health , Saitama , Japan
| | | | - Naoki Kunugita
- f Department of Environmental Health, National Institute of Public Health , Saitama , Japan
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Tran MTD, Skovbjerg S, Arendt-Nielsen L, Bech P, Lunde M, Elberling J. Two of three patients with multiple chemical sensitivity had less symptoms and secondary hyperalgesia after transcranially applied pulsed electromagnetic fields. Scand J Pain 2014; 5:104-109. [PMID: 29913674 DOI: 10.1016/j.sjpain.2013.11.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 11/16/2013] [Indexed: 10/25/2022]
Abstract
Background Multiple chemical sensitivity (MCS) is a chronic, disabling condition characterized by recurrent multisystem symptoms triggered by common airborne chemicals. Evidence points towards abnormal sensory processing in the central nervous system (CNS) as a likely pathophysiological mechanism. No effective treatment has yet been reported, but clinical observations suggest that as pulsed electromagnetic fields (PEMF) is a treatment for some CNS disorders (depression and chronic pain), it may also be a treatment modality for MCS. Methods In an open case study, the effects of PEMF were assessed in three MCS patients. All cases received 30 min daily treatment 5 days a week for 8 consecutive weeks. Symptoms and functional impairments related to MCS, depressive symptoms, and capsaicin-induced secondary punctate hyperalgesia were assessed at baseline and weekly until an 18-week follow-up. Results Two of the three cases showed considerable improvement on all measures of symptoms and functional impairments related to MCS in response to PEMF therapy. One case showed no improvement and during the treatment period was unexpectedly diagnosed with depression. Conclusion Our findings indicate potential benefits of PEMF therapy in MCS. Implication The therapeutic effect of PEMF in MCS needs to be investigated by a randomized placebo-controlled trial.
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
| | - Sine Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
| | - Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Frederik Bajers Vej 7 D3, DK-9220 Aalborg, Denmark
| | - Per Bech
- Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - Marianne Lunde
- Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hillerød, Denmark
| | - Jesper Elberling
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2. th., DK-2820 Gentofte, Denmark
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Alobid I, Nogué S, Izquierdo-Dominguez A, Centellas S, Bernal-Sprekelsen M, Mullol J. Multiple chemical sensitivity worsens quality of life and cognitive and sensorial features of sense of smell. Eur Arch Otorhinolaryngol 2014; 271:3203-8. [PMID: 24687801 DOI: 10.1007/s00405-014-3015-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 03/17/2014] [Indexed: 11/25/2022]
Abstract
Multiple chemical sensitivity (MCS) is characterized by a loss of tolerance to a variety of environmental chemicals. Multiple chemical sensitivity is frequently triggered by exposure to chemical agents, especially insecticides. The aim of the study was to measure the sense of smell and quality of life in patients with MCS compared to the control group. We studied the sense of smell, both sensitive and sensorial characteristics, in female patients with MCS (n = 58, mean 50.5 ± 8.5 years) and healthy female volunteers without rhinosinusal pathologies (n = 60, mean age 46 ± 10.2 years). Olfactometry (Barcelona Smell Test 24/BAST-24), sinonasal symptoms (visual analogue scale/VAS 0-100 mm), and quality of life (Quick Environmental Exposure and Sensitivity Inventory/QEESI) were assessed. Multiple chemical sensitivity patients showed a significant impairment in smell identification (19 ± 12 %; p > 0.05) and forced choice (62 ± 18 %; p > 0.05), but not in smell detection (96 ± 4 %) compared to the control group. Multiple chemical sensitivity patients reported more odours as being intense and irritating and less fresh and pleasant when compared with the control group. Patients scored a high level (40-100) on QEESI questionnaire (symptom severity, chemical intolerances, other intolerances, life impact). In MCS patients, total symptom intensity (VAS/0-700 mm) score was 202 ± 135, while disease severity score was 80 ± 23. The most frequent symptoms were itching and posterior rhinorrhea. Multiple chemical sensitivity patients have an impairment in smell cognitive abilities (odour identification and forced choice, but not for detection) with increased smell hypersensitivity and poor quality of life.
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Affiliation(s)
- Isam Alobid
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Hospital Clinic, Universitat de Barcelona, c/Villarroel, 170, Barcelona, 08036, Spain,
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Dantoft TM, Elberling J, Brix S, Szecsi PB, Vesterhauge S, Skovbjerg S. An elevated pro-inflammatory cytokine profile in multiple chemical sensitivity. Psychoneuroendocrinology 2014; 40:140-50. [PMID: 24485486 DOI: 10.1016/j.psyneuen.2013.11.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 11/15/2013] [Accepted: 11/15/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Multiple chemical sensitivity (MCS) is a medically unexplained condition characterized by reports of recurrent unspecific symptoms attributed to exposure to low levels of common volatile chemicals. The etiology of MCS is poorly understood, but dysregulation of the immune system has been proposed as part of the pathophysiology. OBJECTIVE To compare plasma levels of cytokines in Danish MCS individuals with a healthy, sex- and age-matched control group. METHOD Blood samples were obtained from 150 un-exposed MCS individuals and from 148 age- and sex-matched healthy controls. Plasma concentrations of 14 cytokines, chemokines and growth and allergen-specific IgE were measured. All participants completed a questionnaire including questions on MCS, psychological distress, morbidities and medication use at the time of the study. RESULTS Plasma levels of interleukin-1β, -2, -4, and -6 were significantly (P<0.001) increased in the MCS group compared with controls, tumor necrosis factor-α was borderline significantly (P=0.05) increased and interleukin-13 was significantly decreased (P<0.001). CONCLUSION MCS individuals displayed a distinct systemic immune mediator profile with increased levels of pro-inflammatory cytokines and interleukin-2 and inverse regulation of Th2 associated cytokines interleukin-4 and interleukin-13 suggestive of low-grade systemic inflammation, along with a deviating Th2-associated cytokine response not involving IgE-mediated mechanisms.
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Affiliation(s)
- T M Dantoft
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Gentofte, Denmark.
| | - J Elberling
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Gentofte, Denmark
| | - S Brix
- Center for Biological Sequence Analysis, Department of Systems Biology, Technical University of Denmark, Lyngby, Denmark
| | - P B Szecsi
- Department of Clinical Biochemistry, Copenhagen University Hospital Gentofte, Gentofte, Denmark
| | - S Vesterhauge
- Aleris-Hamlet, Private Hospital, Copenhagen, Denmark
| | - S Skovbjerg
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Gentofte, Denmark
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Yun MJ, Kang DM, Lee KH, Kim YK, Kim JE. Multiple chemical sensitivity caused by exposure to ignition coal fumes: a case report. Ann Occup Environ Med 2013; 25:32. [PMID: 24472417 PMCID: PMC3923363 DOI: 10.1186/2052-4374-25-32] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 08/27/2013] [Indexed: 11/17/2022] Open
Abstract
Background Although multiple chemical sensitivity (MCS) is a well-known disorder caused by environmental exposures, MCS caused by occupational exposure has been reported in Korea. Therefore, we report a MCS case caused by environmental exposure to ignition coal after a differential diagnosis to exclude other diseases. Case report Since 2011, a 55-year-old woman had experienced edema, myalgia, and other symptoms when she smelled ignition coal near her workplace. She had been diagnosed with fibromyalgia syndrome(FMS) and was treated, with no improvement of symptoms. Since then, she showed the same symptoms after exposure to city gas, the smell of burning, and exhaust gas. To avoid triggering substances, she moved to a new house and used an air purifier. She quit her job in November 2012. After visiting our hospital, she underwent a differential diagnosis for FMS, chronic fatigue syndrome, and somatization disorder. She was diagnosed with MCS by the Korean version of the Quick Environment Exposure Sensitivity Inventory (QEESI). She was educated about the disease and to avoid triggering substances. She received ongoing treatment for her symptoms. Conclusion This case showed that symptoms began after smelling ignition coal. After that, her triggers was increased such as the smell of city gas, burning, and exhaust gas. This case is the first reported in Korea of MCS due to environmental exposure after ruling out other diseases.
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Affiliation(s)
| | - Dong-Mug Kang
- Department of Preventive and Occupational Medicine, School of Medicine, Pusan National University, Pusan, South Korea.
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Tran MTD, Skovbjerg S, Arendt-Nielsen L, Christensen KB, Elberling J. Transcranial pulsed electromagnetic fields for multiple chemical sensitivity: study protocol for a randomized, double-blind, placebo-controlled trial. Trials 2013; 14:256. [PMID: 23947742 PMCID: PMC3765111 DOI: 10.1186/1745-6215-14-256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 08/05/2013] [Indexed: 12/17/2022] Open
Abstract
Background Multiple chemical sensitivity (MCS) is a chronic condition of unknown etiology. MCS is characterized by recurrent nonspecific symptoms from multiple organ systems in response to chemical exposures in concentrations that are normally tolerated by the majority of the population. The symptoms may have severe impact on patients’ lives, but an evidence-based treatment for the condition is nonexisting. The pathophysiology is unclarified, but several indicators point towards abnormal processing of sensory signals in the central nervous system. Pulsed electromagnetic fields (PEMF) offer a promising new treatment for refractory depression and can be targeted at the brain, thereby activating biochemical cell processes. Methods/Design In a parallel, randomized, double-blind, placebo-controlled trial conducted at the Danish Research Centre for Chemical Sensitivities, the effects of PEMF in MCS patients will be assessed using the Re5 Independent System. Based on sample size estimation, 40 participants will be randomized to either PEMF therapy or placebo. The allocation sequence will be generated by computer. All involved parties (that is, participants, investigators, the research nurse, and the statistician) will be blinded to group allocation. The participants will receive PEMF therapy or placebo applied transcranially 30 minutes twice a day for 7 days a week over 6 consecutive weeks. Outcomes will be measured at baseline, once weekly during treatment, post treatment, and at 2.5-month and 4.5-month follow-up according to a predefined timetable. The primary outcome will be a measurement of the impact of MCS on everyday life. The secondary outcomes will be measurements of MCS symptoms, psychological distress (stress, anxiety or depressive symptoms), capsaicin-induced secondary punctate hyperalgesia, immunological markers in serum, and quality of life. Discussion This trial will assess the effects of PEMF therapy for MCS. Currently, there is no treatment with a documented effect on MCS, and in terms of healthcare there is very little to offer these patients. There is thus a great need for well-conducted randomized trials aimed at assessing possible treatment effects. A positive outcome will pave the way for improved healthcare and understanding of this very disabling and overlooked condition. Trial registration ClinicalTrials.gov, NCT01834781
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Affiliation(s)
- Marie Thi Dao Tran
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Allé 40, 2, th,, DK-2820 Gentofte, Denmark.
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Multiple chemical sensitivity and the workplace: current position and need for an occupational health surveillance protocol. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2013; 2013:351457. [PMID: 23844274 PMCID: PMC3697784 DOI: 10.1155/2013/351457] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 05/28/2013] [Indexed: 12/03/2022]
Abstract
Multiple chemical sensitivity, commonly known as environmental illness, is a chronic disease in which exposure to low levels of chemicals causes correlated symptoms of varying intensity. With the continuous introduction of new substances, people with MCS suffer significant limitations to their living environment and frequently to their workplace. This paper describes the current situation as regards MCS and the critical points in its case definition, which is still not generally agreed upon; this makes it difficult to recognize with certainty, especially, its precise relationship with work. Other problems arise in relation to the occupational physician's role in diagnosing and managing the worker with the disorder, the question of low levels of exposure to chemicals, and the best measures possible to prevent it. A diagnostic “route” is proposed, useful as a reference for the occupational physician who is often called in first to identify cases suspected of having this disease and to manage MCS workers. Work-related problems for people with MCS depend not only on occupational exposure but also on the incompatibility between their illness and their work. More occupational physicians need to be “sensitive” to MCS, so that these workers are recognized promptly, the work is adapted as necessary, and preventive measures are promoted in the workplace.
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Hauge CR, Bonde PJE, Rasmussen A, Skovbjerg S. Mindfulness-based cognitive therapy for multiple chemical sensitivity: a study protocol for a randomized controlled trial. Trials 2012; 13:179. [PMID: 23016822 PMCID: PMC3560121 DOI: 10.1186/1745-6215-13-179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 09/13/2012] [Indexed: 11/18/2022] Open
Abstract
Background Multiple chemical sensitivity (MCS) is a condition characterized by recurrent, self-reported symptoms from multiple organ systems, attributable to exposure to a wide range of chemically unrelated substances at low levels. The pathophysiology is unknown, and affected individuals generally favor avoidance of the symptom triggering substances as a coping strategy. The impact of MCS on daily life may thus be severe. An intervention that may effectively reduce the impact of MCS, alleviate the symptoms and the psychological distress associated with the condition is therefore highly needed. In this study we will assess the effects of a mindfulness-based cognitive (MBCT) program on MCS. Methods/Design Using a randomized controlled design (RCT), we will compare MBCT with treatment as usual (TAU). The MBCT intervention will include 8 weekly 2.5 hour sessions, and 45 minutes of mindfulness home practice 6 days each week. Participants will be asked to complete questionnaires at baseline, post-treatment, and at 6 and 12 months’ follow-up. Based on sample size estimation, 82 participants will be randomized to either the MBCT intervention or to TAU. The primary outcome will be a measure of the impact of MCS on the participants’ lives. The secondary outcome measures are physical symptoms of psychological distress, perceived stress, illness perceptions, QOL, and work ability. Lastly, we will assess whether any effect of MBCT on the primary effect measure is mediated by level of mindfulness, self-compassion, perceived stress, and rumination. Discussion This trial will provide important information on the effects of MBCT on MCS. Trials registration Clinical trials identifier NCT01240395
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Affiliation(s)
- Christian Riise Hauge
- The Danish Research Centre for Chemical Sensitivities, Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, Ledreborg Alle 40, 2th, Gentofte 2820, Copenhagen, Denmark.
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