37-Year-Old Mechanic with Multiple Chemical Sensitivities  

Environmental Health Perspectives Volume 108, Number 4, Apr00

Howard M. Kipen and Nancy Fiedler

Environmental and Occupational Health Sciences Institute and UMDNJ-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA

Abstract
A 37-year-old heating, ventilation, and air-conditioning mechanic developed respiratory, musculoskeletal, and central nervous system symptoms associated with a variety of odorous environmental chemicals. Organic disease was not evident, but the patient was distressed by these symptoms and was at risk for becoming disabled by them. His symptoms fit broadly into the condition recognized as multiple chemical sensitivity. Multiple chemical sensitivity is a diagnostic term for a group of symptoms without demonstrated organic basis. The symptoms are characteristic of dysfunction in multiple organ systems, they increase and decrease according to exposure to low levels of chemical agents in the patient's environment, and they sometimes occur after a distinct environmental change or insult such as an industrial accident or remodeling. Although traditional medical organizations have not agreed on a definition for this syndrome, it is being increasingly recognized and makes up an increasing percentage of the caseload at occupational and environmental medicine clinics. Although there is often dispute about whether the symptoms have a functional or organic basis, an informed approach to evaluation, diagnosis, and management and a careful assessment of impairment, disability, and work relatedness are necessary. Careful exclusion of organic causes is critical, and this should be followed by a judicious approach to coping with symptoms. Key words: chemical exposure, multiple chemical sensitivity, psychology. Environ Health Perspect 108:377-381 (2000). [Online 9 March 2000]

http://ehpnet1.niehs.nih.gov/docs/2000/108p377-381kipen/abstract.html

Address correspondence to H.M. Kipen, EOHSI, 170 Frelinghuysen Road, Piscataway, NJ 08854 USA. Telephone: (732) 445-0123 x629. Fax: (732) 445-3644. E-mail: kipen@eohsi.rutgers.edu

Received 13 September 1998; accepted 1 February 2000.

Last Updated: March 9, 2000