OK – Here we go….
In response to questions and comments about MCS, (multiple chemical sensitivity syndrome, AKA MCSS) posted by some NACHI members….
To try and present all the information that would support my earlier post, would be difficult simply due to the sheer overwhelming volume of peer reviewed medical and scientific literature regarding the psychological nature of MCS and its non-diagnosis as a true physiological illness. Indeed, it is not so much a question of “Is the literature out there?” but rather, “Could anyone interested in MCS possibly read any reliable literature and avoid running into it around every corner?” So, asking for references about the non-existence of MCS it’s rather like asking if any one knows of any historical references to World War II… where do I begin?
Furthermore, I am aware of only one otherwise legitimate governmental paper which was just very recently released and alluded to the EMF/MCS issue as possibly real. This inclusion, which occurred just immediately before the publication came out and occurred without the approval, or knowledge of the contributing authors. The inclusion of the single sentence in the introduction to the paper, immediately relegated what would have been an important scholastic paper in the depths of junk science, and made it virtually a discredited paper upon publication. The contributing authors with whom I have spoken were furious with the inclusion of the non-scientific and unfounded editorial, and have attempted to now distance themselves from the recent paper.
Since this is a Home Inspectors board, and not the “Psychiatric Disorders” discussion group, let me lay a little ground work for those who may be unfamiliar with MCS. Firstly, that sensitivities to multiple chemicals occur is absolutely beyond dispute. However, sensitivities to multiple chemicals is a very different beast than “multiple chemical sensitivity syndrome” (MCS). They simply are not the same thing. Many people who may be sensitive to multiple chemicals DO NOT have MCS – it is completely different. The importance of this statement cannot be overemphasized.
It is primarily because of this important distinction that MCS is frequently referred to in professional circles as Idiopathic Environmental Intolerance (IEI) to ensure that MCS sufferers are not confused with people who exhibit real, actual, clinical hypersensitivities to multiple chemicals. Failure to make that distinction will result in a lot of people getting hopelessly confused in this discussion and will absolutely lead one down a muddy road. I won’t engage in discussions for those who don’t graps the distinction - since it makes go a little crazy ](*,) :freaked-:
So, to re-emphasize - actual sensitivities to multiple chemicals is NOT, NOT, NOT “Multiple Chemical Sensitivity Syndrome.”
Also, that that distinction is not very clear in the minds of most people claiming to have MCS results in the information in many good articles on actual chemical sensitivities being taken out of context by those people who exhibit the characteristic psychological profile of an MCS sufferer. That is, they point to those studies and erroneously think that the studies support their beliefs (not true).
To help make the distinction here, I point to some work by a colleague of mine, a toxicologist and a leading authority on chemical and biological sensitivities who performed trial challenges wherein MCS subjects were placed in environmental challenge booths. During those trials, the researchers were able to induce hives, syncope, respiratory distress and an host of other very real physiological responses by simply allowing the MCS subject to believe they had just been exposed to a chemical insult, when in reality, the conditions in the chamber had not changed at all and no exposures occurred. Similarly, in those trials, when the MCS subjects were surreptitiously exposed to chemicals they claimed induced their symptoms, the subjects did not exhibit symptoms because they did not know they had been exposed and therefore did not believe they were being exposed.
In the MCS sufferer, symptoms characteristic of dysfunction in multiple organ systems do not correlate to actual exposures. Instead, researchers have found that if an MCSer merely believes they are being exposed, they will get sick, even if no exposure has occurred, and they will **not **get sick even if they have been exposed, if they do not believe they have been exposed. (Whew!)
By contrast, similar challenges using subjects who suffer from true chemical sensitivities to multiple chemicals (but who do not claim to have MCS) results in clinical symptomology when they are exposed to those chemicals and no symptomology when there was no exposure regardless of whether they believed they were being exposed or not. That is, if you put gunk in their environment, they got sick even if they didn’t know it was there (unlike the MCSers), and didn’t get sick when the gunk wasn’t there, even if they thought it was. (Gunk is a scientific term ).
Therefore, the single most important part of the MCSer’s symptomology is their belief, not any actual exposure; and the most important aspect of those who suffer from actual sensitivities to multiple chemicals is their exposure; not their beliefs. (See for example, Staudenmayer H, Selner JC, Buhr MP, Double-blind provocation chamber challenges in 20 patients presenting with “multiple chemical sensitivity” Regulatory Toxicology and Pharmacology. 1993 Aug;18(1):44-53.)
Across the world, over many, many years, scientific and medical organizations have issued position papers on the unscientific basis of the claims of MCS as a clinical psychological manifestation, the psychological component of MCS and the unreliability and misuse of the diagnostic procedures upon which a diagnosis of MCS as a physiological illness was based, and the lack of scientific support for clinical evidence of the claimed effects from environmental chemicals in MCS patients.
Some of the first included the American Academy of Allergy and Clinical Immunology Executive Committee in 1986 (Position statement: Clinical ecology. J Allergy Clin Immunol 1986;78:269-71); in Britain, the Royal College of Physicians and Royal College of Pathologists (National Health Service. Clin Exp Allergy 1995;25:586-95); The American College of Physicians (Clinical ecology. Ann Intern Med 1989;111:168-178 ) by the way, that was the position that was later adopted by the American College of Occupational and Environmental Medicine.
Dr. Steven Barrett with The American Council on Science and Health published their position in 1994 and whose position was reflected by Dr. Ron Gotts (a wonderfully insightful author who is famous for cracking the notorious Washington Airport IAQ “Banana incident;” a “must-read” for anyone interested in indoor air quality issues.) After reviewing over 100 cases of MCS, Dr. Gots concluded that MCS was:
*"…a label given to people who do not feel well for a variety of reasons and who share the common belief that chemical sensitivities are to blame… It defies classification as a disease. It has no consistent characteristics, no uniform cause, no objective or measurable features. It exists because a patient believes it does and a doctor validates that belief." *Found in “Multiple Chemical sensitivities: What is it?” (North Bethesda, MD: Risk Communication International, Inc., March 31, 1993).
As pointed out by NACHI member Brian Kelly in an earlier post, studies have consistently shown that people who report characteristics of MCS Syndrome achieve higher clinical scores in psychasthenia, schizophrenia, hypochondriasis, hysteria, depression, and psychopathic deviance. Kipen and Fiedler with the Robert Wood Johnson Medical School, stated:
*To date, psychiatric, personality, cognitive/neurologic, immunologic, and olfactory studies have been conducted comparing subjects with primary chemical sensitivity to various control groups. Thus far, the most consistent finding is that chemically sensitive patients have a higher rate of psychiatric disorders across studies and relative to diverse comparison groups." *(Environ Health Perspect 105 (Suppl 2):409-415 (1997))
In my discussions on radon, I have addressed metastudies; some metastudies, mostly produced by those rascally, mostly discredited, back-peddling “clinical ecologists” who recognize the psychological link but oppose the causation speculate that MCS causes the psychotic disorders and not the other way around! However these “studies” very carefully avoid the clinical exposure evidence and rely on questionnaires, self-reporting, self-evaluation and an host of subjective and, occasionally, hokey analyses (little wonder “clinical ecology” is not a recognized medical specialty).
Dr. Black with the University of Iowa doesn’t like these rascals either and stated: (in Regulatory Toxicology and Pharmacology Volume 18, Issue 1 , August 1993, Pages 23-31, Environmental Illness and Misdiagnosis - A Growing Problem)
A fringe group of medical practitioners called clinical ecologists believes that hypersensitivity to common foods, chemicals, and organisms can disrupt the immune system and lead to diverse medical or psychiatric problems. They believe this condition, frequently referred to as environmental illness (EI), can be diagnosed on the basis of a patient’s history of exposure, and the results of provocation testing and elimination diets. They advise treating the condition with avoidance of the offending agent(s), special diets, and symptom neutralization. Other treatments are often recommended. Clinical ecology beliefs and practices have been criticized by mainstream medical practitioners who have urged that EI not be recognized as a clinical syndrome. Research has shown that individuals receiving a diagnosis of EI frequently have common psychiatric or medical disorders, which are usually unrecognized and untreated. Thus, the clinical ecologists are misinterpreting common signs and symptoms of illness and failing to prescribe appropriate and proven therapies. The advice and recommendations of a clinical ecologist can lead to iatrogenic social and occupational disability.
It is interesting to note that one of the psychological characteristics of the MCS suffer is a psychiatric element which is manifests as vehement vindictiveness towards anyone who does not support their belief that MSC is a physiological diagnosis and doesn’t buy into their belief system. In trial studies, physicians have had to be warned that their patients may become extremely abusive upon release of the results of the trial tests. I personally know of one researcher who had to close down the research due to the violent nature of some MCSers, when they were shown the results of their tests (i.e., when they found out they responded when no exposure occurred, and the failed to respond when they were exposed).
I personally have participated in exposure trials and have seen the results for myself and have been the recipient of death threats by MCSers who didn’t like what I had to say. In my trials, I was able to make an MCSer sick, by merely lying, and I told them that I had accidentally just released a chemical into their environment (when I had done no such thing), the person become very ill. Although the person’s physiological response to my lie was a very real physiological response, it was due entirely to an imaginary exposure.
It’s fascinating stuff and you’ll believe it if the list moderator allows all the responses this post will likely provoke from anger MCSers! (Not to mention the hate mail that will fill my email box for a week following the appearance of this post! I will have to read the correspondence with sun-glasses for protection!)
That should get the ball rolling…. (I’m already beginning to doubt the wisdom of embarking on this topic yet again…)
Caoimhín P. Connell
Forensic Industrial Hygienist
(The opinions expressed here are exclusively my personal opinions and do not necessarily reflect my professional opinion, opinion of my employer, peers, or professional affiliates. The above post is for information only and does not reflect professional advice and is not intended to supercede the professional advice of others.)
(I edited this message on 4/20/07 at 11:05 MST by changing the word “my” to “by” in the third to the last paragraph.