Multiple Chemical Sensitivities Addendum to Biologic Markers in Immunotoxicology (1992) / Chapter Skim
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Allergy and Multiple Chemical Sensitivities (MCS) Distinguished
Allergy and Multiple Chemical Sensitivities (MCS) Distinguished
Pages 47-64
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From page 47... ...
Although what he observed In his patients appeared to be some kind of hypersensitivity, it was not allergy. Subsequently, Randolph and other physicians known as clinical ecologists published clinical descriptions of patients with polysomatic complaints, frequently including mood and cognition difficulties, triggered by a wide variety of chemical exposures, but especially petrochemical exposures, and often with concomitant food and drug intolerances.
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From page 48... ...
symptoms such as di~cul~ concentrating or Stability are common, and physical examinations are frequently Unremarkable for individuals In each category. TABLE 1 Chemically Sensitive Groups Group Nature of Exposure Demographics Industrial workers Acute and chronic exposure Primarily males: blue to industrial chemicals collar; 20 to 65 years old Tight-building occupants Contaminated communities Off-gassing from construction materials, office equipment or supplies; tobacco smoke; inadequate ventilation ~ To~nc waste sites; aerial pesticide spraying; ground water conatmmation; air contamination by nearby industry and other community exposures Females more than males; white collar office workers and professionals; 20 to 65 years old; schoolchildren All ages, male and female; Mildred or infants may be affected first or most; pregnant women with possible effects on fetuses; middle to lower class Individuals Heterogeneous; indoor air 70-80% females; 30 to 50 (domestic)
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From page 49... ...
Based upon the increasing number of outbreaks of sick building syndrome, increased reporting of symptoms ~ contaminated communities to state health departments, increased recognition of problems In the industrial workplace, and the Increasing numbers of physician treating chemically related sensitivities, the easing evidence does suggest that chemical sensitivity is on the rise and could become a large problem with significant economic consequences related to the disablement of productive members of society. The fact that the demographically diverse groups listed in Table 1 share similar patterns of illness (that is, onset after a major chemical exposure; subsequent hyperreactiv~ty to tow levels of a variety of chemicals commonly encountered in the environment such as cigarette smoke, perfume, and traffic exhaust; and multLystem compacts with frequent mood' memory and concentration difficulties)
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From page 50... ...
Cube B is a sensitivitr diser~ution of Topic or allergic individuals in the population who are sensitive to an allergen, e.g., ragweed or bee venom. Curve C ~ a se~dvitr distribution for individuals with multiple chemical Unties who, bemuse they are already senadzed, subsequently respond to particular incitants, e.g., formaldehyde or phenol.
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From page 51... ...
Curve B is a cumulative dose response curve for atopic or allergic individuals in the population who are sensitive to an allergen, e.g., ragweed or bee venom. Cune C is a cumulative dose response curve for individuals wad multiple chemical sensitivities who, bemuse they are already sensitized subsequently respond to particular incitants, e.g., formaldehyde or phenol.
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From page 52... ...
Levels of indoor air contaminants were often many times higher than outdoor levels, and sometimes orders of magnitude higher than outdoor levels. Breath levels for most chemicals measured were 30 40 percent of indoor air levels, but measured up to 90 percent of indoor air levels ~ some cases - tetrachioroethylene, for example.
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From page 53... ...
Randolph, who had been hospit~i~ng patients and testing them for their food sensitivities, found a critical element in many of his patients' recoveries was avoidance of environmental chemical exposures In their jobs and homes while In the hospital. He developed Comprehensive environmental controls, a diagnostic approach in which patients avoid exposure to synthetic chemicals In order to facilitate diagnosis of chemical sensitivity.
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From page 54... ...
. Features of Environmental Unix Characteristics/Practices Allergists' Unitb Clinical Ecologists' Units' Construction using materials that Yes do not off-gas (prtnarLb glass, stem Cedric; cotton bedding and clothing)
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From page 55... ...
By b~ ~ poems Tom ~b Bug _~en~ Ed ~= IO -- OS~ ~ lo ^ ~ ~ ~ ~ I'm=_ ~s~d~ acme scam ~ bomb rag ~ ~ pawn removes to ma =~= s~sl==s ~ ~, ~ or awed. ^~t^n ~ ~ ~ over =~1~ ~ "acd~o~ or "a^^~", "~^~o~, "dawn Toledo" ad ~n "adage.
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From page 56... ...
The point is that the human body appears able to adapt to an endless array of substances. By isolating MCS patients Tom their usual environments and then re-expos~g them to venous foods and che~al~ one by one, physicians have observed that many common substances patients eat, drink or inhale seem to provoke symptoms.
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From page 57... ...
Under normal living coerce stances, the stimulatory and Withdrawal levels for foods and chimp s overlap each other (Figure 3) so that In real life - outside an environmental unit - at any gnen moment what the orgasm may be feeling Is a summation of all effects, whether stimulatory or depressive, of all substances recently inhaled, contacted, or ingested.
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From page 58... ...
desenbed ~ MCS patients, solvents are among the chemicals most Frequently implicated by chemically sensitive patients who attribute the onset of their illness to a particular exposure (Terr, 1989; Cone et al., 1987) and adaptation to solvents has also been documented Vapors from various solvents are the most prevalent of indoor air contaminants (Molhave, 19823.
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From page 59... ...
7~. Through comprehensive environmental control (that is, an environmental unity, one may be able to overcome the masking effect of adaptation and back up or reverse the exposure to allow mowtonog of toxoid ~ progress.
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From page 60... ...
Comprehensive environmental control, that is, use of an environmental unit, can overcome the masking effect of adaptation and the problems of overlapping exposures that result In overlapped responses to multiple agents. The environmental unit can back up or reverse the experience of adaptation and allow the investigator to monitor tornado In progress.
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From page 61... ...
Comprehensive environmental control, that is, use of an environmental unit, can Overcome Else masking effect of adaptation and the problems of overlapped exposures that result in overlapping responses to multiple agents. The environmeIltal Unit can baclc up or reverse the e~enence of adaptation and allow the investigator to monitor to=nty In progress.
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From page 62... ...
1987. Patients With multiple chemical sensitivities: clinical diagnostic subsets among an occupational health clinic population.
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From page 63... ...
1965. Ecologic onentation in medicine: comprehensive environmental control in diagnosis and therapy.
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