. "Case Definitions for Multiple Chemical Sensitivity." Multiple Chemical Sensitivities: Addendum to Biologic Markers in Immunotoxicology. Washington, DC: The National Academies Press, 1992.
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This ease definition, intended for epidemiological use, is intentionally narrow. Cullen excludes persons who react to substances no one else in aware of on the basis that such individuals may be delusional and excludes persons who have bronchospasm, vasospasm, seizures, or 'any other reversible lesion" that can be identified and specifically treated. Clinical ecologists, however, would argue that persons with bronchospasm, vasospasm, seizures, and other illnesses excluded by Cullen may well have the chemical sensitivity problem. Each issue of the clinical ecologists' journal, Clinical Ecology, contains the following definition:
Ecologic illness is a chronic multi-system disorder, usually polysymptomatic, caused by adverse reactions to environmental incitants, modified by individual susceptibility and specific adaptation. The incitants are present in air, water, food, drugs and our habitat.
Although the patients the clinical ecologists and Cullen see are demographically divergent, the definitions of their illnesses are remarkably alike. Both describe the chemically sensitive patient in similar terms. [See Miner and Ashford, "Allergy and Multiple Chemical Sensitivity (MCS) Distinguished" in this report for a discussion of sensitive populations.]