A Brief Overview of MCS 
Multiple Chemical Sensitivity

• MCS People - The Dispossessed

Cynthia Wilson Executive Director Chemical Injury Information Network P.O.Box 301 White Sulfur Springs MT 59645 404-547-2255

Back when doctors believed their patients and before psychosomatic illness and stress became a catch-all for illnesses doctors couldn't diagnose, there is evidence to suggest that doctors were diagnosing chemical sensitivities as vapors. Vapors was described as an exhalation of bodily organs held to affect the physical and/or mental condition or as a depressed or hysterical nervous condition. Then in the late 1940s to early 1950s, Theron Randolph, M.D., recognized that people were getting sick from their environment, hence the name Environmental Illness.

In the 1960s, it finally became evident to the government that pollution was causing adverse health affects. Dr. Randolph attended that first conference. He was the only one to question the effects of indoor air pollution, and his concerns where ignored and/or ridiculed by the medical profession as well as the government. In 1992, EPA conservatively estimated that poor indoor air quality costs the U.S. $1 billion annually in lost productivity. That same year, the National Academy of Sciences estimated indoor air pollution contributes $15 to $100 billion annually to health care costs.

The energy crisis of the 1970s exacerbated the problem of chemical sensitivities but did nothing to add to the understanding of the illness itself To conserve energy, the government encouraged weatherization and energy efficient construction that included reducing the ventilation requirements of bringing outdoor air into new buildings. It is this reduction together with the increase in volatile chemicals in new materials and products since World War 11 that is being blamed for the ever increasing number of people who are slowly being poisoned.

Then in 1981, in response to the poisoning of thousands of people by urea formaldehyde foam insulation, the National Research Council commissioned a study called Formaldehyde And Other Aldehydes. The report estimated that 10 to 20% of the population was at risk from low level exposure to aldehydes. Though the report's major focus was the cancer risk, it did recommend an extensive study be done on chemical sensitivities. Nothing was done.

Here the medical understanding of the illness starts to break down because of a lack of knowledge created by a lack of basic research. There are several theories as to how these low level exposures are poisoning people, however, these theories are better discussed in detail by the professionals. The one principal that is emerging is that chemical sensitivity is probably not an immune system dysfunction but is most probably central nervous system damage with secondary endocrine and immune system involvement and more often than not is characterized by real, verifiable damage to the body though the health implications of these anomalies are poorly understood and need additional investigation.

Clinical Ecology, now called Environmental Medicine, has been involved in helping the chemically sensitive since the very beginning. The discipline has taken a beating from the American Medical Association and other medical professional organizations because it was willing to believe patients were ill without having the scientific/biological research to prove it. However, the clinical ecologists were also quite lax in documenting MCS according to established scientific procedures, a fact which has helped to keep it controversial. The experimental nature of many of the treatment practices of clinical ecologists also helps keep this discipline controversial and has allowed several medical disciplines to use clinical ecology as a way of discrediting MCS by association.

Unfortunately, until recently, clinical ecologists were the only ones who believed we were sick. The rest of the scientific and medical communities didn't believe there was anything to study and had simply written MCS off. Thankfully, that is changing.

The government has been woefully slow to respond with research money, not only for chemical sensitivities, but to study any of the adverse (non-cancer) health affects being associated with toxic chemicals in general. The chemical companies have a vested interest in promoting the belief that MCS is more psychiatric in nature than, a response to being poisoned by their products. It is the Chemical Manufacturer's Association that' stated in it's 1991 briefing paper, "The primary impact on society would be the huge cost associated with legitimization of environmental illness. "

Two other factors help complicate the process of unraveling chemical poisoning. They are masking (adaptation) and spreading. A very simplistic explanation of the very complicated process of masking is that the body forms an allergy/addiction to a chemical so that if a person doesn't get a regular dose of the chemical, the body will go into withdrawal much like that associated with drug or alcohol addiction. While overt symptoms are being controlled by the masking, internal damage continues unchecked. Spreading turns chemical sensitivity into a progressive disease. Once a person is sensitized to one chemical, the sensitivity can spread to include other chemicals. Once that happens, repeat exposures reduce the body's tolerance level by an as yet unknown mechanism so the body becomes more easily reactive to more and more chemicals at lower and lower levels until it finally reaches the point where the person is sick all the time. If this illness reaches that point, the person can kiss a life of casual convenience good-bye.

Tests are now being developed that link chronic low level exposure to immune system problems; brain damage; liver, kidney, and heart conditions; neurological disorders; autoimmunity; birth defects; and numerous other health complaints. The working hypothesis behind these tests is that low level chemical exposures cause such minor damage that the body doesn't register that it's in danger until the injuries have reached a critical point. Often the body doesn't start responding with overt symptoms to these chemical assaults until after irreversible damage has been done.

Blood tests have been developed to track chemicals in the body as well as to track the damage these chemicals have caused. In the Antibody Assay Laboratory (AAL) series of tests for antibodies to formaldehyde, trimellitic anhydride, diisocyanates, and others, it is theorized that IgM antibodies show recent exposure, IgG antibodies show chronic or long term exposure, and IgE antibodies show classic allergy responses, For these tests, a score of 0-4 is negative, 8 is positive, 16 is very positive, and 32 is as high as these tests currently go. AAL also has two other tests that establish immune activation and/or suppression of the white blood cells and the creation of autoimmune antibodies. The primary target organs of these autoimmune antibodies are the thyroid, heart, liver, kidneys, small intestines, and stomach. In addition, they frequently attack the central nervous system. New research suggests a direct link between the severity of symptoms and the level of antibody formation. However, the AAL tests are still fairly controversial, in part, because it does not have an established track record on split sample testing.

Most patients experience immediate reactions to chemicals. With the exception of a histamine response and some IgE-mediated responses such as anaphylactic shock, the immune system is not generally capable of reacting that fast. This has led some researchers to look at the central nervous system because it can and does have the capacity to respond within the time-frame most patients experience. For example, if your immediate reaction upon exposure or the cessation of the exposure is nausea or vomiting, these reactions are most probably being neurologically mediated. Neurologic testing is finally proving subtle nervous system dysfunction and damage. While it may be years before the full implications of these tests are understood, at least they are available to objectively show abnormalities. Through MRI scans, qEEG evoked potentials, SPECT scans, and PET scans, great strides are being made in documenting the effects of chemicals on the nervous system. However, the lack of controlled blind studies on MCS central nervous system effects is problematic.

Time-dependent sensitization, a neurological phenomenon which has been primarily studied in animals for the last 20 years, has an amazing similarity to MCS and may not only help explain how the brain becomes sensitized to low level chemical exposures in the first place, but the role that stress plays in adverse chemical reactions.

In addition, recent findings are showing that approximately 50% of MCS patients have developed porphyria, a rare metabolic disorder involving the production of heme (a component of blood) and liver and/or bone marrow damage and has many symptoms in common with MCS. Porphyria may also explain how a single exposure may leave a patient ill for days, weeks, or even months.

Our subjective symptoms still remain highly controversial in spite of medical advances; product warning labels that advise of adverse reactions such as headaches, nausea, blurred vision, etc.; mounting animal research that links specific reactions to specific chemicals; and numerous double-blind clinical studies with humans that demonstrate a direct connection between exposure and symptoms. Double-blind studies are routinely discounted by critics because there is no way to verify if a patient is nauseous. In science, humans are still not considered reliable indicators. In recent years, two animal models have been found for MCS, however, lack of funding for basic research is still a major problem and getting what research is available into an established medical journal is even more difficult. For example, the Journal for Occupational Medicine is controlled by doctors employed by Dow Chemical Company, Eastman-Kodak, General Motors, and ITT Corporation.

While things are changing, chemical injuries resulting in chemical sensitivities are still controversial. So given the controversial nature of this illness, the best advice I can offer you is the same advice I got from one of my doctors. He told me I had to become the expert on me. And you need to become the expert on you. With the aid of a daily diary, a digital blood pressure meter and the time-table for reactions contained in Maximum Immunity, , I was able to track specific reactions to their chemical source. It's a complicated process, but it has enabled me to do my own risk assessment and take charge of my life again. If your symptoms are primarily in the respiratory track, you may want to use a peck-flow monitor.

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