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Chemical Sensitivity Awareness Month
By Jeff Stier, Esq.
As we begin June, are you more aware of asthma and allergies? Better sleep? Hepatitis? High blood pressure? Well, May was awareness month for these important health issues as well as others -- it was National Physical Fitness and Sports Month, too, and the public is reportedly better informed about all twenty-three of the issues brought to their attention last month.
But "awareness" of an imaginary, phantom illness does not do us any good. So a thumbs-down to Louisiana governor Kathleen Blanco (D) who made May 2004 the first "Chemical Sensitivity Awareness Month," at least in Louisiana.
Those who claim they have multiple chemical sensitivity (MCS) do indeed suffer greatly. As recently as the 16th day of MCS awareness month, former Boston University football coach Dan Allen, 48, died, according to the Boston Globe, "of complications from multiple chemical sensitivity." Despite years of searching, though, there is still no scientific evidence to support this diagnosis.
Those promoting the legitimacy of such a disease are mainly professed "victims," not medical professionals.
As a matter of fact, no mainstream medical institutions recognize this diagnosis. The strongest support for the theory that MCS exists will be found among the plaintiff's bar. A Google search for "multiple chemical sensitivty" yielded a paid advertisement in the upper right-hand corner for a law firm that may not rid you of your disease, but will at least try to make it financially rewarding for you (and them).
To compensate for heightened MCS awareness in May, perhaps June should be "junk science awareness month."
Jeff Stier is an associate director of the American Council on Science and Health. For earlier ACSH reports on MCS, please see:
MCS: Mis-Concern Serious
MCS: Multiple Chemical Sensitivity
RESPONSES:
June 3, 2004
That our present scientific methodology cannot detect something (for example, MCS) certainly does not mean that it doesn't exist. We are cavalier to vehemently claim that MCS doesn't exist, especially when we look back at the history of substances such as lead and mercury. For the record, I am not a proclaimed MCS sufferer.
—Sharon Drozdowsky
Stier replies:
Sharon,
Thank you for your comment. Please see further discussion on the topic at http://www.acsh.org/healthissues/newsID.650/healthissue_detail.asp .
At the risk of sounding cavalier, is it safe to assume, given your lead and mercury analogy, that you do not use a cell phone because of the brain tumor risks?
I know that present scientific methodology cannot detect the brain tumor-cell phone relationship, but that doesn't mean it doesn't exist, especially when we look back at the history of cigarettes, which it turns out, do cause cancer, heart disease, etc. (see: http://www.acsh.org/publications/pubID.188/pub_detail.asp ).
Thanks.
June 3, 2004
Exactly, I could have used your analogy as well...My point is that we all need to be open-minded and realize that we don't have all the answers.
Regards,
—Sharon
Stier replies:
Sharon,
I can't argue with that. But if we assume that these diseases exist, in the face
of no evidence that this one does, we are paralyzed, which has its own consequences.
June 3, 2004
I don't think I was saying that we should assume that the diseases exist, just be open to the possibility. These issues are very difficult, and I know that as an attorney you are involved in a field where decisions need to be made. Your point about being paralyzed is very true. Toxicology and epidemiology are fascinating to me but frustrating as well because of the difficulty of proving causality.
Thanks for the dialogue.
—Sharon Drozdowsky
Roger Mostad (July 12, 2004)
his may be a bit off topic but there exists a 1995 movie "Safe" (or possibly "(Safe)") by director Todd Haynes. Here is a link to the IMDB page for it:
http://www.imdb.com/title/tt0114323/
This is probably one of the best films of the 1990s. The cinematography takes the idea of 'environmental illness' to heart. It is beautifully written and directed by Todd Haynes and the acting of Julianne Moore is simply astounding.
One thing to note if you are looking for 'movie', look elsewhere. Not trying to be snobby but this is not an action packed film but a carefully crafted film that asks the question, "What is wrong with this woman?"
I would suggest to anyone who might be interested in the film to have a look at some to the comments on the IMDB site. These comments will give you a good idea about whether this film is for you. It will be years, if ever, before I forget the final scene of this movie.
L Smith (December 29, 2004)
Compassion is an admirable quality, as well as a quote from long ago: "There but for the grace of God, go I."
My belief about MCS is that it will be shown to be a genetic illness. I agree with the posters above who say that in time we will find out what it is.
I also believe that there are far too many chemicals around in use. The opinions in the editoral above strike me as fairly ignorant. Isn't it unscientific to poo-poo something, when there is not enough facts, really? I think it is very unscientific.
Marti Wolfe (April 5, 2005)
The MCS info on this site is woefully out of date. See:
Pall, M. L. 2003. Elevated nitric oxide/peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-D-aspartate receptors in the sensitivity mechanism. Environ Health Perspect 111: 1461-4.
Pall, M. L. 2002. NMDA sensitization and stimulation by peroxynitrite, nitric oxide, and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity. Faseb J 16: 1407-17.
Also, check out his website:
http://molecular.biosciences.wsu.edu/faculty/pall/pall_mcs.htm
McKeown-Eyssen, G., C. Baines, D. E. Cole, N. Riley, R. F. Tyndale, L. Marshall and V. Jazmaji. 2004. Case-control study of genotypes in multiple chemical sensitivity: CYP2D6, NAT1, NAT2, PON1, PON2 and MTHFR. Int J Epidemiol 33: 971-8.
Baines, C. J., G. E. McKeown-Eyssen, N. Riley, D. E. Cole, L. Marshall, B. Loescher and V. Jazmaji. 2004. Case-control study of multiple chemical sensitivity, comparing haematology, biochemistry, vitamins and serum volatile organic compound measures. Occup Med (Lond) 54: 408-18.
cheers
marti
Ohio_Valley Native (April 16, 2005)
Mainstream Medical Science has long since recognized as physiological and valid the phenomenon of Hypersensitivity to Chemicals.
It has also recognized the phenomenon of Sensitization.
Therefore, Mainstream Medical Science already recognizes that chemicals and chemical-bearing agents do cause adverse physiological reactions in susceptible persons, whenever they are inhaled, ingested, "photo-contacted", or absorbed by such persons, at even low-to-moderate levels. And of course, it depends on the individual and the individual's specific vulnerabilities.
Moreover, the AMA, the AAAAI, and the American Lung Association all recognize without reservation Chemical Sensitivity (Environmental Illness) as it applies to ASTHMA and to DERMATITIS. Each mainstream organization even advocates the practice of AVOIDANCE. And regarding the necessity of AVOIDANCE for all allergen sensitive, irritant sensitive, and chemically sensitive Asthmatics, see:
Table No.5 of Report 4 of the Council on Scientific Affairs (A-98), found at:
http://www.ama-assn.org/ama/pub/category/13603.html
and see
Managing Your Asthma; Asthma Trigger Control Plan; AMA Physician Select Reference Library, found at:
http://dbapps.ama-assn.org/aps/asthma/manage.htm
Continuing onward, Mainstream Medical Science also recognizes the phenomenon of Cross-Reactivity (Cross-Sensitization, aka Co-sensitization.)
This means that, if a person is adversely reactive to one member of a chemical family, then that same person is adversely reactive to every other member of the same family. It is known elsewhere in mainstream America as "Concomitant positive reactions to allergens." However, chemical triggers are usually regarded as "irritants", as opposed to allergens.
Salicylates are a suitable example of this Cross-Sensitization phenomenon, being that it is a chemical family that ranges from aspirin and other NSAIDs to sun screen lotions, oil of wintergreen, certain foods, and the asthma-triggering whistle fuel of fireworks, known as Sodium Salicylate.
The formaldehyde/quaternium-15/imidazolidinyl urea family, in its many appearances throughout commonly encountered products, makes for another suitable example. After all, it spans from shampoo products and medicines to certain fabrics and various building materials, such as plywood and drywall.
All in all, the medical doctrine of Cross-Reactivity (Cross-Sensitization) indicates that it is expected to find chemically sensitive persons intolerant of a multiplicity of chemical-bearing agents/products; and not merely one, two, or three.
Chemical Sensitivity has already been recognized without controversy throughout the venues of Mainstream Medicine in "CASE-SPECIFIC FORM." Such case-specific forms include:
1a] Occupational Asthma due to low molecular weight agents.
1b] Irritant-induced Asthma.
2a] Hypersensitivity Pneumonitis (aka Extrinsic Allergic Alveolitis) due to chemical or irritant gas sensitization.
2b] Chemical Worker's Lung.
03] Reactive Airways Dysfunction Syndrome.
04] Reactive Upper-Airways Dysfunction Syndrome, aka Irritant-induced Rhinitis.
05] Phthalic Anhydride Hypersensitivity (which was found to be "specific IgE mediated" as far back as 1975.)
6a] Irritant-induced Contact Dermatitis.
6b] Occupational Contact Dermatitis.
6c] Irritant-induced Diaper Dermatitis.
6d] Chronic Actinic Dermatitis.
07] Occupational Contact Urticaria.
08] Acute Generalized Exanthematous Pustulosi.
09] Drug-induced Systemic Lupus Erythematosus.
10] Stevens-Johnson Syndrome.
11] Aspirin Sensitivity.
12] Acetaminophen/Paracetamol Intolerance.
13] Peripheral Neuropathy due to isoniazid.
14] NSAID Hypersensitivity.
15] Aplastic Anemia due to chloramphenical.
16] Aplastic Anemia due to low-levels of inhaled benzene.
17] Nitrate Anaphylaxis.
18] Halothane-induced Hepatitis.
19] Sulfite Intolerance.
20] Irritant-associated Vocal Cord Dysfunction.
21] Red Cedar Allergy (plicatic acid).
22] Pine Resin Allergy (albietic acid).
23] Peruvian Lily Allergy (tuliposide A).
24] Balsam of Peru Allergy (myroxylon perirau resin).
25] and even the Merck Manual recognizes by name:
Sick Building Syndrome.
In fact, the same "AAAAI position statement", often used to assert that mainstream medicine does not recognize Chemical Sensitivity and/or Environmental Illness, fully recognizes "TRUE ENVIRONMENTALLY CAUSED DISEASES", by name. It is simply that the diagnostic title "Multiple Chemical Sensitivity" is too vague, too non-predictive, and too non-case-specific to assign to it its own medical code number. So too is this the case with the equally vague phrase, "Idiopathic Environmental Intolerance". None-the-less, the AAAAI does admit, in its exact same position statement, that:
"...allergens, toxins, and irritants are responsible for diseases that are clinically well characterized..."
Moreover, within that same AAAAI paragraph is the recognition of the Environmental Illness / Chemical Sensitivity titles: BUILDING-RELATED ILLNESS, SICK BUILDING SYNDROME, HYPERSENSITIVITIY PNEUMONITIS, and REACTIVE AIRWAYS DYSFUNCTION SYNDROME. (And it is a relatively short position statement which doesn't afford much more room for the addressing of other diagnostic titles of what is referred to as "True Environmentally Caused Diseases".
Now, being that it has long since been concluded that Chemical Sensitivity and "True Environmentally Caused Diseases" are physiological and NOT psychiatric, there have been objective physiological medical findings in chemically sensitive persons. And anyone who states that there are no such objective physiological medical findings in such patients is a liar. In as much, such findings in the chemically sensitive, depending on each individual's condition, have thus far included:
01] Medically Determinable "Textbook" Asthma (as in failing the Arterial Blood Gases Test).
02] Significant declines in FEV1 during challenge testing, as well as other bronchial hyperreactivity scenarios.
03] Interstitial Inflammation (alveolitis).
04] Desquamation of the Epithelium and Permeability of Epithelial Cell Junctions.
05] Glandular Hyperplasia.
06] Dermatitis/Urticaria/Angioedema scenarios.
07] Turbinate Hypertrophy and other upper respiratory inflammation scenarios, as well as "a cobblestone appearance of the posterior pharynx and base of tongue", along with other definitive findings in fiberoptic rhinolaryngoscopic examinations.
08] The simultaneous Release of Leukotriene B4 and Interleukin-8.
09] Specific and nonspecific IgE Mediation, as well as visible and measurable wheals in intradermal skin testing, involving the testing of formaldehyde, ethanol, phenol, etc.
10] Type IV IgA, IgG & IgM mediated Allergic Reactivity.
11] Internal Erythema.
12] Chemically-induced Aplastic Anemia even at low levels of inhalant exposure (apparently extremely rare, but documented nonetheless, as in the case of a petrochemical factory worker.)
13] Elevated ALT count.
14] Systemic Lupus Erythematosus, as was previously mentioned.
15] Acute Generalized Exanthematous Pustulosi, as was previously mentioned.
16] The production of the toxic hepatic metabolite N-Acetyl-Benzoquinoneimine in excess of the Mercapturate that neutralizes it, as in Acetaminophen Hypersensitivity and Hypersensitivty to all other similar P450 Cytochrome Inducers.
17] and even ANAPHYLAXIS.
Let it be repeated: Low-to-moderate levels of chemical-bearing agents (and the chemicals themselves) have not only caused asthma and regional inflammation, but it has also resulted in even ANAPHYLAXIS; one of the ultimate forms of Chemical Sensitivity and/or Allergic Reactivity. And of course, it depends on the vulnerability of each individual. None-the-less, chemical-bearing anaphylactic triggers have thus far included:
1] Sulfites, 2] Perfume, 3] Hair Bleaching Agent, 4] Nitrates, 5] Formaldehyde-bearing Root Canal Sealant, 6] Benzoic Acid, & 6] Aspirin/NSAIDs. See:
-Occupational acute anaphylactic reaction to assault by perfume spray in the face. [concerning three and only three sprays of perfume.] (J Am Board Fam Pract. 2001 Sep-Oct;14(5):400-1.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11314921
-Adverse reactions to sulfites. (CMAJ. 1985 Nov 1;133(9):865-7, 880.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=4052897
-Allergic reaction to sulfiting agents. (Ann Emerg Med. 1986 Jan;15(1):77-9.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=3942360
-Anaphylactic reaction following hair bleaching. (Hautarzt. 2005 Feb 2;)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15688222
-Anaphylaxis due to formaldehyde released from root-canal disinfectant. (Contact Dermatitis. 2002 Oct;47(4):215-8.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12492520
-Anaphylactic shock during endodontic treatment due to allergy to formaldehyde in a root canal sealant. (J Endod. 2000 Sep;26(9):529-31.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11199795
-IgE allergy due to formaldehyde paste during endodontic treatment. Apropos of 4 cases: 2 with anaphylactic shock and 2 with generalized Urticaria. (Rev Stomatol Chir Maxillofac. 2000 Oct;101(4):169-74.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11103423
-Nitrate anaphylaxis. (Ann Allergy Asthma Immunol. 2000 Jul;85(1):74-6.)
http://www.ncbi.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10923609
-Excessive allergy due to benzoic acid followed by anaphylactic shock. (Derm Beruf Umwelt. 1981;29(5):123-30.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7297428&dopt=Abstract
-A Report of a Teacher in England who Suffered Anaphylaxis due to fragrances in class room.
http://www.royalcityrecord.com/issues04/022104/news/022104nn3.html
All in all, intolerance of perfumes is not psychiatric. Perfume reactivity has been so well founded that it resulted in the hypo-allergenic product line of soaps, detergents, and cosmetics. In fact, there is:
-Chloroatranol, an extremely potent allergen hidden in perfumes: a dose-response elicitation study. (Contact Dermatitis. 2003 Oct;49(4):180-4.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14996064
-Inhalation challenge effects of perfume scent strips in patients with asthma. (Ann Allergy Asthma Immunol. 1995 Nov;75(5):429-33.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7583865&dopt=Abstract
-Concomitant positive reactions to allergens in a patch testing standard series from 1988-1997. (Am J Contact Dermat. 1999 Dec;10(4):219-23.)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10594298
There is much more medical documentation of the board-certified, licensed, and accredited professionals of mainstream to cite, in order to illustrate that low-to-moderate levels of chemical exposure/ingestion/absorption adversely effects susceptible persons, physiologically.
Now, there has been a two-part observation repeatedly cited, in order to convince readers into concluding that the Multiple Chemical Sensitivity Diagnostic title is malpractice. And that is this:
1]Multiple Chemical Sensitivity involves impairment to multiple body systems, instead of merely one.
2] MCS has attributed to it a large range of multiple symptoms, instead of a narrowly select few.
Firstly, no chemically sensitive patient has every symptom in any MCS symptom roster. Each person only has a minority subset thereof.
Secondly, it is easy to falsely exaggerate the number of symptoms attributed to MCS, via the redundancy technique. This redundancy occurs when four ways to describe the same one symptom are counted as four symptoms instead of one. And this numerical exaggeration also occurs when an objective medical finding is counted as a symptom. (And of course, symptoms involve pain, whereas medical findings involve professional observation and measurement.)
Anyway:
Carbon Monoxide Poisoning also impairs multiple body systems, while having attributed to it a very large number of symptoms, also. So too is this the case with Salicylate Intolerance. Thus, to declare Multiple Chemical Sensitivity invalid on account of its mulitplicity factor is to automatically declare that Carbon Monoxide Poisoning doesn't exist, either.
None-the-less, the great tragedy of the Chemical Sensitivity debate was the mistaken presumption that only the product lines of the chemical and pharmaceutical industries triggered illness. This, of course, is false, being that chemical sensitivity triggers are also found in unprocessed nature, as is the case with Ramin Wood, Red Cedar, Honey, Peruvian Lily, and Pine.
Moreover, not every pharmaceutical product is injurious to the chemically sensitive, even though the majority might be. After all, there is the relatively new product line of the Leukotriene Inhibitor Class, and that class might be able to provide an element of needed relief to a chemically sensitive patient, if and only if that patient is not hypersensitive to Leukotriene Inhibitors, as is the case with those person susceptible to Churg Strauss Syndrome. Atrovent, as well, might help a chemically sensitive asthmatic, unless, of course, he/she be hypersensitive to it.
For quite some time, the Chemical Sensitivity debate was a very unnecessary and vicious fight which left the chemically sensitive to suffer tremendously. Yet, there really shouldn't have been a debate, being that the phenomenon of Sensitization was already well-founded, and it extended beyond the realm of chemical exposure scenarios. It spanned into the realms of organic dusts (as in Byssinossis), metal dusts (as in Chronic Berylliosis), workplace enzyme exposure (as in Baker's Asthma), and mold exposure scenarios (as in Mushroom Worker's Lung.)
Of course, there are newer findings, in this 21st Century. And much much more can be included. In fact, a new paper was recently released via Washington State University. And at this point, of all the findings on Chemical Sensitivity, the ones that seem to be the most pivotal are the ones concerning the desquamation of the epithelium and the permeability of epithelial cel junctions. Yet, whatever be the case, there is reality attached to the chemical sensitivity (environmental illness) phenomenon. And there has been a lot of pain -- physical pain, as well as ill treatment and defamation by those who obviously have no idea what it is to suffer from the more severe forms of this condition.
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