Re: Posters who post here


"Mark Probert" <markprobert@xxxxxxxxxxxxxxxx> wrote in message
news:Pm0Ti.1681$hG2.1672@xxxxxxxxxxx
edgger wrote:
Isn't it interesting how those that say MCS isn't real, keep ignoring
all the studies and doctors that have proven otherwise?

Incorrect. No one claims that MCS is not real. It is a REAL psychosomatic
disorder.

See how MARK LIES.............

http://news.yahoo.com/news?tmpl=story&cid=534&e=2&u=/ap/20050715/ap_on_he_me/contaminated_newborns

[My, my how surprising it disappeared].

Study: Fetuses Exposed to Toxic Chemicals

By TERENCE CHEA, Associated Press Writer
3 minutes ago



SAN FRANCISCO - A new study released Thursday questions the long-held
belief that fetuses in the womb are largely protected from dangerous
chemicals pregnant women are exposed to.



Laboratory tests of the umbilical cord blood of 10 newborns found that
the samples contained an average of 200 chemicals that can cause
cancer, brain damage, birth defects and other health ailments,
according to the study sponsored by the Environmental Working Group.

"This is conclusive evidence that babies are being exposed to hundreds
of industrial chemicals throughout pregnancy," said Sonya Lunder, an
EWG scientist in Oakland who is five months pregnant. "The placenta
isn't a magic shield."

Lunder and other health advocates spoke Thursday at a news conference
in San Francisco, where they called on California lawmakers to pass
legislation that would require the state to collect data on chemicals
found in people's blood.

The American Chemistry Council, which represents major U.S. chemical
companies, argued that chemicals are often found in people's blood or
urine in amounts that do not cause or increase risks for disease.

"The measurements by themselves are not an indication of a risk to
health and should not be cause for alarm," the council said in a
statement. "Scientists long have understood that our bodies can absorb
substances present in our environment."

Health advocates countered that even minute amounts of chemicals such
as mercury, pesticides and PCBs can disrupt fetal development, and
that scientists still don't know what are safe doses for many of the
chemicals detected.

For the study, the Environmental Working Group commissioned
independent lab tests on ten random samples, provided by the
American Red Cross, of umbilical cord blood from babies born in U.S.
hospitals in August and September last year.

The lab tests tested for 413 chemicals and detected 287 in the 10
blood samples, with each containing between 159 and 234 chemicals. Of
the contaminants detected, 180 can cause cancer in humans and animals,
217 are known to be dangerous to the nervous system and brain, and 208
can cause birth defects in animals, according the EWG study, which was
peer-reviewed by eight physicians and a toxicologist.

Health advocates said the study underscored the need to pass
legislation that would create the country's first statewide
"biomonitoring" program to measure chemical contaminants in people.
Backers say the program will generate data to help state officials
better protect people from toxic chemicals.

"What this study illustrates is that we know very little about what
our bodies are carrying," said Sen. Deborah Ortiz, D-Sacramento,
chairman of the Senate Health Committee and one of the bill's
sponsors.

___

On the Net:

Environmental Working Group: http://www.ewg.org/

(thanks to Tim C)

http://www.theglobeandmail.com/servlet/ArticleNews/TPPrint/LAC/20050305/TOXIC05/TPHealth/


I am polluted
You are exposed to hundreds of chemicals every day, so it's not surprising
that they get inside you. MARK STEVENSON has himself tested in the name of
the emerging and unsettling science of body burden
By MARK STEVENSON
Saturday, March 5, 2005 Updated at 6:28 PM EST
BOSTON -- My nose is clamped and I'm trying not to choke on a tube a
scientist at Harvard University has stuffed in my mouth. I am blowing into a
clear plastic bag, which is sealed and later studied for what it contains.
Sure, everyone suffers occasionally from a little bad breath. But what they
found in mine was enough to keep my wife away for a week.
Besides my breath, researchers at Harvard's School of Public Health examined
my blood, hair, urine, toenails and bones. It's all in the name of the
emerging science of body burden, a concept referring to the amount of
chemicals that accumulate in the human body.
As it turns out, I am polluted. Everyone is to some degree. But as the list
of toxic chemicals identified in people continues to grow, scientists are
trying to figure out what the implications are for human health.
"It is alarming," Professor John Spengler says. "This is not meant to be
settling information. I think if more people wake up to this fact, the
better we are going to be . . . and the more demanding we're going to be of
our governments and our industries."
An estimated 35,000 chemicals are in commercial use in Canada and more than
twice as many in the United States. The national American government
registers an average of 2,000 newly synthesized chemicals each year.
Cosmetics have at least 5,000 chemicals; more than 3,200 are added to food.
As many as 1,010 chemicals are used in the production of 11,700 consumer
products, and about 500 chemicals are used as active ingredients in
pesticides, according to Environmental Protection Agency data cited by the
Environmental Working Group, based in Washington, D.C.
Many chemicals end up in the environment, even thousands of kilometres from
industry.
Despite being banned years ago, PCBs are still found in Arctic wildlife.
Biologists are also finding rising levels of polybrominated diphenyl ethers
(PBDEs), flame retardants used in foam, textiles and plastics, as well as
chlorinated paraffins, chemicals used in paints, sealants and
rubber-processing.
Scotchgard, which is part of a family of chemicals used to make clothes,
carpets and furniture stain-resistant, has been found in polar bears in
Alaska and bald eagles around the Great Lakes.
If chemicals are showing up in wildlife and the environment, it's no
surprise that many are being discovered in people.
"Pretty much from the minute you wake up to the moment you go to bed, you're
exposed to hundreds and hundreds of chemicals," says Jane Houlihan,
vice-president of research for the Environmental Working Group. ". . . In
most cases, they're in minuscule quantities. But that fact is it's hundreds
[of chemicals] and they're adding up."
What's disturbing, Prof. Spengler says, is how the majority of the chemicals
have been approved for use without any research being done on their
potential impact on human health, except mainly for those that end up in
drugs or food.
What's more, little is known about what our chemical body burden truly is.
"So measurements like we're doing on you, and myself, and our research
subjects are really part of a new frontier because it's really trying to
understand . . . what effects these might have on disruption of human
function," Prof. Spengler says.
No extensive study has considered the chemical body burden of Canadians,
although separate studies have reported the presence of individual
compounds -- for example, research documenting a dramatic rise of PBDEs in
breast milk.
More wide-ranging studies have been done in the United States.
In one, researchers found at an average of 91 "industrial compounds,
pollutants and chemicals" in the blood and urine of nine volunteers and a
total of 167 chemicals in the group. According to the research, conducted by
Mount Sinai School of Medicine in New York with the Environmental Working
Group, "76 cause cancer in humans or animals, 94 are toxic to the brain or
nervous system, and 79 cause birth defects or abnormal development." None of
the people tested worked with chemicals or lived near an industrial
facility.
"I expected to find many different chemicals," Ms. Houlihan says. "But to
actually see the numbers roll out that show that one person has 100
chemicals in their blood at one time. It's pretty powerful."
The most comprehensive research on body burden to date was conducted by the
U.S. Centers for Disease Control and Prevention and released in 2003. As
part of the $6.5-million (U.S.) report, the agency tested the blood and
urine of 2,500 volunteers for 116 compounds, including PCBs, pesticides,
dioxins, furans and metals.
It found many of the contaminants in at least half of the people they
tested. As well, researchers discovered elevated levels of lead in the blood
of children and the ubiquitous presence of phthalates, chemicals widely used
in plastics that are linked to cancer and reproductive problems in studies
on rats.
Meanwhile, they also discovered that chemicals such as DDT and PCBs, which
are banned or restricted, appear to be going down.
"Just because they can [detect it] doesn't mean it's at a dangerous level or
a level that causes health effects. It mostly reflects the fact that we've
improved our ability to measure," says Jim Pirkle, deputy director of
science for the CDC, referring to new technology that allows scientists to
identify compounds in amounts that would have gone unnoticed a decade
earlier.
Dr. Pirkle notes that most of the chemicals being found are in
infinitesimally small amounts of parts per million and parts per billion,
equivalent to a grain of rice in an Olympic-sized swimming pool.
"There are going to be small levels of many things in people. That's because
they're dispersed in low levels all over the environment. What you really
have to do is stop and look at them one by one and go through them and say,
'Is that a level that's likely to cause disease? Is that a level that's so
trivially small, we have good instruments that can measure it, but it's so
small it's not of any concern?' You have to do that one chemical at a time."
All this brings us back to Harvard and my own results.
After bombarding my knee for half an hour with a small amount of radiation,
the technician in the bone lab gives me the news: My skeleton is
contaminated with lead.
Lead is an acute toxin. It's poisonous at higher levels. But even at low
concentrations, research has linked it to an increased risk of hypertension,
kidney disease, impaired neurological development in children, even
cataracts.
The good news is my lead levels place me well within the average range for
someone my age with no appreciable health risk, says Howard Hu, a professor
of occupational and health medicine at Harvard's School of Public Health.
Others are less fortunate. Dr. Hu has measured lead amounts five to 10 times
higher in many women, posing potential harm to their unborn babies.
"There's so many different exposure routes that just living and breathing
can provide exposures today," he says. "Lead is in many different consumer
products. It was in gasoline. . . . It was in food cans, pipes and solder. .
.. . It was in toys and plastics."
In another lab across the street, scientists have clipped a lock of my hair
and are analyzing it. It will tell them how much mercury my body contains.
Although it occurs naturally in the environment, mercury is also a byproduct
of coal-fired power plants and waste incinerators. When it enters the water
and reacts with bacteria, it is transformed into methyl mercury and it
accumulates in fish, and people when they eat it.
It's a neurotoxin and the human fetus is particularly vulnerable. At low
doses, it can cause subtle changes to the developing brain; at larger doses,
it can cause blindness and other birth defects. At high levels, it can kill
nerve cells, causing blurred vision, lack of co-ordination and slurred
speech.
Fortunately, my mercury level is .411 parts per million, about half the EPA
guideline of 1 ppm.
Next came my blood results. As it turns out, my blood contains PCBs and
pesticides, including DDT, an insecticide banned in North America decades
ago. But for many people my age, my results are considered well within the
low-to-average range.
Unfortunately, as Russ Hauser of Harvard's School of Public Health points
out, his research is finding that men exposed to similar doses have problems
with semen quality, which is associated with infertility.
"PCBs and DDT were banned decades ago, but they're still present in the
environment," Dr. Hauser says. "You're exposed primarily through intake of
food because they accumulate as we move up the food chain. . . . So
consuming fish, dairy products, meats, that's primarily how you're exposed."
Although the Harvard scientists were looking for arsenic, a highly poisonous
metal, in my toenails, they found virtually none. Prof. Spengler wasn't
surprised, saying it's something they typically find in people who drink
water from a well and mine comes from a lake.
But he was amazed by something in my breath, the content of which is an
indicator of relatively recent exposure to chemicals in the air. It wasn't
the list of solvents, such as benzene, that are often associated with
vehicle exhaust. It was MTBE, a fuel additive that is not supposed to be
widely used in Canada (less than 2 per cent of gas in this country contains
it, according to Environment Canada). Prof. Spengler speculates I breathed
in MTBE on the way to Harvard in a taxi.
In total, the scientists found 76 chemicals in my body, including PCBs,
pesticides, solvents and metals. Even though my body contains extremely
small amounts of them, I can't help but ask Prof. Spengler whether I should
be worried.
"I would say you're not very toxic compared to people we've measured all
over the world, even compared to me," he says.
He points out that his own DDT levels place him in the top fifth of
Americans. I'm in the bottom fifth.
"On the one hand, you might say, 'Well, I'm normal. I might be a little high
on one thing and low on another.' But that's not the way we should look at
it."
Prof. Spengler says the issue is not whether one has an average amount of
chemicals in his body. Rather, it's why the average person is carrying
around so many chemicals in the first place.
There has been little scientific inquiry into the net effect of being
exposed to many chemicals at the same time, the so-called "toxic soup
effect."
Complicating the toxicology is the counterintuitive concept of hormesis, a
phenomenon in which a small dose of an otherwise toxic substance can be
helpful. Studies on plants and animals have documented it in alcohol,
antibiotics, hydrocarbons and pesticides.
Nevertheless, Prof. Spengler and many other scientists believe that exposure
to a range of chemicals in the environment may be behind a host of emerging
health problems in addition to those already well documented. "We're
concerned about the growing rates of cancer in our society, the growing
rates of autism," he says. "In most developed countries, asthma has grown
substantially over the past 20 years, particularly in children"
As for myself, Prof. Spengler says there's very little I can do to reduce
the contamination that is already in my body. Aside from eating different
types of fish to lower my mercury level, the PCBs and pesticides are there
for the long haul while the solvents will continue to show up in my breath
as long as I'm exposed to cars and trucks, which are kind of difficult to
avoid.
Prof. Spengler says the solution is targeting chemicals we don't want in our
bodies in the first place. He points to PBDEs, which has been referred to as
the "PCBs of the 21st century."
Research commissioned by The Globe and Mail and CTV News found that many
everyday foods consumed by Canadians -- such as salmon, ground beef, cheese
and butter -- are laced with PBDEs.
In Sweden, the flame retardants were banned after rising levels were noticed
in the breast milk of women. "They said to the industry, 'We don't want them
in our plastics. We don't what them in our materials' -- and they started to
see the levels come down," Prof. Spengler says.
"Now, you see the similar data out of North American women. . . . The levels
are already 50 times higher in our populations and nobody is saying, 'Ban
that product.' . . . So I think this really has to do with how we've come to
judge what is beneficial to the population," he says. "[But] at what point
do we invoke some precaution?"
Mark Stevenson is an independent producer and a regular contributor to the
Discovery Channel's Daily Planet. A version of this feature has aired on the
show.
MARK'S BODY
Test results show low levels of 76 chemicals.
Metals in blood*
metalNormal levels (ppb):Mark's levels (ppb):
Lead<10019.13
Manganese4.2-16.5969
Cadmium<50.06

Mercury in hair
EPA reference level: 1.0 ppm
Mark's level: 0.411 ppm
Arsenic in toenails
Normal level: below 0.2 ppm
Mark's level: 0.032 ppm
Solvents in breath (nanogram/litre)
solventMark
MTBE6.22**
Hexane2.71
Benzene4.23
Toluene4.05
Xylene1.38
Pinene4.30
Limonene108.42***

Pesticides in blood
Mark has 0.879 ppb of DDT (low to average)
PCBs in blood
Mark has 0.82 ppb (low to average)
Lead content in bone
Mark has 4.67 ppm (average)
*Lead, cadmium and mercury are not considered "natural" elements in the
body. Manganese, on the other hand, is an essential element at very trace
amounts.
**MTBE, a fuel additive to improve emissions, could have been inhaled in the
United States where it is much more common than in Canada.
***The high limonene level could be attributed to orange juice or air
freshener.

http://www.environmentalhealth.ca/w03mcs99.html

Multiple Chemical Sensitivity: A 1999 Consensus

ABSTRACT. Consensus criteria for the definition of multiple chemical
sensitivity (MCS) were first identified in a 1989 multidisciplinary
survey of 89 clinicians and researchers with extensive experience in,
but widely differing views of, MCS. A decade later, their top 5
consensus criteria (i.e., defining MCS as [1] a chronic condition [2]
with symptoms that recur reproducibly [3] in response to low levels of
exposure [4] to multiple unrelated chemicals and [5] improve or resolve
when incitants are removed) are still unrefuted in published
literature. Along with a 6th criterion that we now propose adding
(i.e., requiring that symptoms occur in multiple organ systems), these
criteria are all commonly encompassed by research definitions of MCS.
Nonetheless, their standardized use in clinical settings is still
lacking, long overdue, and greatly needed-especially in light of
government studies in the United States, United Kingdom, and Canada
that revealed 2-4 times as many cases of chemical sensitivity among
Gulf War veterans than undeployed controls. In addition, state health
department surveys of civilians in New Mexico and California showed
that 2-6%, respectively, already had been diagnosed with MCS and that
16% of the civilians reported an "unusual sensitivity" to common
everyday chemicals. Given this high prevalence, as well as the 1994
consensus of the American Lung Association, American Medical
Association, U.S. Environmental Protection Agency, and the U.S.
Consumer Product Safety Commission that "complaints [of MCS] should
not be dismissed as psychogenic, and a thorough workup is essential,"
we recommend that MCS be formally diagnosed-in addition to any other
disorders that may be present-in all cases in which the 6
aforementioned consensus criteria are met and no single other organic
disorder (e.g., mastocytosis) can account for all the signs and
symptoms associated with chemical exposure. The millions of civilians
and tens of thousands of Gulf War veterans who suffer from chemical
sensitivity should not be kept waiting any longer for a standardized
diagnosis while medical research continues to investigate the etiology
of their signs and symptoms.


AS RESEARCHERS AND CLINICIANS with experience in the study, evaluation,
diagnosis, and/or care of adults and children with chemical sensitivity
disorders, we support the stated goal of the National Institutes of
Health 1999 Atlanta Conference on the Health Impact of Chemical
Exposures During the Gulf War "to fully characterize the nature of
multiple chemical exposures within the Gulf War veteran population and
to relate this characterization to what is known about Multiple
Chemical Sensitivity (MCS) and related conditions and disorders within
civilian populations."(1) Based on research conducted by state and
federal government agencies, we already know that MCS is one of the
most commonly diagnosed chronic disorders in civilians and the most
common-but still largely undiagnosed-disorder of any kind in Gulf
War veterans of the United States.

In statewide telephone surveys of randomly selected adults, conducted
by health departments in California in 1995 and 1996 and New Mexico in
1997, investigators found that 6% of adults in California(2) and 2% of
adults in New Mexico(3) indicated that they had already been diagnosed
with MCS or Environmental Illness, whereas 16% in both states said they
were "unusually sensitive to everyday chemicals." When randomly
selected adults in other states were asked if they were "especially
sensitive" (instead of "unusually" sensitive), one-third
consistently maintained that they were.(4-6)

Among Gulf War era veterans, data from the largest random survey
presented by the U.S. Department of Veterans' Affairs (VA) in 1998
(based on questionnaires completed by 11 216 deployed to the Gulf and 9
761 nondeployed) show that 5% reported chemical sensitivity among the
nondeployed personnel and 15% reported the same among the deployed.(7)
Other VA researchers report much higher rates-but the same 3-fold
difference-in a smaller random sample of VA hospital outpatients: 86%
of ill veterans deployed to the Gulf complained of chemical
sensitivity, compared with 30% of undeployed ill veterans.(8) In the
only study in which MCS was specifically assessed among veterans
selected randomly from the VA Registry, investigators found 36% of 1
004 met common research criteria for MCS.(9) Among randomly selected
Department of Defense (DOD) personnel who remain on active duty, two
larger studies by the Centers for Disease Control found slightly
lower-but still significant-2.1- and 2.5-fold increases in the
prevalence of self-reported chemical sensitivity among those deployed
to the Gulf, compared with those who were not deployed. In the
"Iowa" study, in which the prevalence rates for deployed and
nondeployed individuals were 5.4% and 2.6%, respectively, investigators
used a detailed questionnaire to assess "probable MCS."(10) In the
"Pennsylvania" study,(11) in which prevalence rates were 5% versus
2%, respectively, only one "yes/no" question was asked about
chemical sensitivity. Canadian Gulf War veterans reported only
approximately one-half the prevalence of MCS (2.4%), but nevertheless
this was 4 times more than their controls.(12) Even in the United
Kingdom where MCS is little known, Gulf War veterans report being
diagnosed with MCS at 2.5 times the rate of military controls.(13)

Clearly, there is a significant need for a standardized clinical
definition of MCS and a comprehensive clinical protocol that VA, DOD,
and other physicians can use to evaluate it. We recommend to our
colleagues and the sponsors of the Atlanta Conference-the Department
of Health and Human Services' Office of Public Health and Science,
the Centers for Disease Control and Prevention, the National Institutes
of Health, and the Agency for Toxic Substances and Disease
Registry-that MCS be formally defined for clinical purposes by the
top 5 "consensus criteria" identified in a 1989 survey of 89
clinicians and researchers who had extensive experience in MCS but who
also held widely divergent views about its etiology.(14) Included were
36 specialists in allergy, 23 in occupational medicine, 20 in
"clinical ecology," and 10 in internal medicine and otolaryngology.
We would add only that symptoms associated with chemical exposures must
involve multiple organ systems, thus distinguishing MCS from specific
single-organ system disorders (e.g., asthma, migraine) that also may
meet the first 5 criteria.

Consensus Criteria for MCS
The following consensus criteria for the diagnosis of MCS were gleaned
from the study by Nethercott et al.(14) (funded in part by grants from
US NIOSH and US NIEHS):

1. "The symptoms are reproducible with [repeated chemical]
exposure."

2. "The condition is chronic."

3. "Low levels of exposure [lower than previously or commonly
tolerated] result in manifestations of the syndrome."

4. "The symptoms improve or resolve when the incitants are
removed."

5. "Responses occur to multiple chemically unrelated
substances."

6. [Added in 1999]: Symptoms involve multiple organ systems.

Given the only other explicit consensus ever published on MCS-the
1994 statement of the American Lung Association, American Medical
Association, U.S. Environmental Protection Agency, and U.S. Consumer
Product Safety Commission, that "complaints [of MCS] should not be
dismissed as psychogenic, and a thorough workup is essential" (ALA
1994)-we recommend that MCS be diagnosed whenever all 6 of the
consensus criteria are met, along with any other disorders that also
may be present, such as asthma, allergy, migraine, chronic fatigue
syndrome (CFS), and fibromyalgia (FM). MCS should be excluded only if a
single other multi-organ disorder can account for both the entire
spectrum of signs and symptoms and their association with chemical
exposures, such as mastocytosis or porphyria, but not CFS or FM, which
are not so associated.

To assist physicians who are unfamiliar with the evaluation of MCS, we
recommend that clinical protocols include validated questionnaires for
screening and characterizing chemical sensitivity,(15,16) a list of
overlapping disorders to consider in the differential diagnosis of MCS,
and a list of signs and test abnormalities associated with MCS in the
peer-reviewed literature (summarized by Ashford and Miller(17) and
Donnay(18)). Although no single test is yet considered diagnostic of
MCS, those suggested by signs, symptoms, or history may be helpful in
treating and tracking the disorder.

The presentation of MCS may vary greatly among cases and over time.
Some individuals are totally disabled by severe symptoms suffered on a
daily basis, for example, whereas others are disabled only minimally by
mild symptoms suffered occasionally. We, therefore, recommend that any
clinical diagnosis of MCS be characterized and followed over time using
quantitative and/or qualitative indices of life impact or disability
(e.g., minimal, partial, total); symptom severity (e.g., mild,
moderate, severe); symptom frequency (e.g., daily, weekly, monthly);
and sensory involvement (identification of which sensory
pathways-olfactory, trigeminal, gustatory, auditory, visual and/or
touch, including perception of vibration, pain and heat or cold-show
altered (+/-) sensitivity and/or tolerance for normal levels of
stimuli, either chronically or in response to particular chemical
exposures).

For research purposes that require greater homogeneity, we encourage
investigators to refine the consensus criteria for MCS with whatever
additional inclusion or exclusion criteria they believe are needed to
test their hypotheses. The indices and domains that are used to
characterize and select both cases and controls in MCS research should
be fully reported so that results from different studies can be
compared and their broader applicability assessed.

Given the significant overlap in clinic populations of MCS with both
CFS and FM, as well as the need to better understand the relationships
between these disorders,(19-21) we recommend that all
"solicitations" and "requests for applications" issued by
federal agencies for human research into any one of CFS, FM, or MCS
direct investigators to screen for all three (regardless of their
selection criteria, which need not be affected) and to report their
results in these terms. There is a precedent for this: the National
Institute of Arthritis and Musculoskeletal Disorders routinely requires
that in studies of fibromyalgia investigators must screen for and
report any overlap with temporo-mandibular joint disorder. CFS, FM, and
MCS research could all benefit from greater collaboration, and so we
welcome the Congressional initiative of Senator Tom Harkin to earmark
$3 million of the DOD's 1999 Gulf War illnesses research budget for
multidisciplinary studies of CFS, FM, and MCS together (solicitation
074&&&-9902-0005 issued 2/12/99) to better understand both their
overlaps and differences. We recommend that such three-way studies be
solicited by all federal agencies funding CFS, FM or MCS research.

References

1. Eisenberg J. Report to Congress on Research on Multiple Chemical
Exposures and Veterans with Gulf War Illnesses. Washington DC: US
Department of Health and Human Services, Office of Public Health and
Science. 15 January 1998.

2. Kreutzer R, Neutra R, Lashuay N. The prevalence of people
reporting sensitivities to chemicals in a population-based survey. Am J
Epidemiol (in press).

3. Voorhees RE. Memorandum from New Mexico Deputy State
Epidemiologist to Joe Thompson, Special Counsel, Office of the
Governor; 13 March 1998.

4. Bell IR, Schwartz GE, Amend D, et al. Psychological
characteristics and subjective intolerance for xenobiotic agents of
normal young adults with trait shyness and defensiveness. A
parkinsonian-like personality type? J Nerv Ment Dis 1998; 182:367-74.


5. Bell IR, Miller CS, Schwartz GE, et al. Neuropsychiatric and
somatic characteristics of young adults with and without self-reported
chemical odor intolerance and chemical sensitivity. Arch Environ Health
1996; 51:9-21.

6. Meggs WJ, Dunn KA, Bloch RM, et al. Prevalence and nature of
allergy and chemical sensitivity in a general population. Arch Environ
Health 1996; 51(4):275-82.

7. Kang HK, Mahan CM, Lee KY, et al. Prevalence of chronic fatigue
syndrome among US Gulf War veterans. Boston, MA: Fourth International
AACFS Conference on CFIDS, 10 October 1998 (abstract and presentation).


8. Bell IR., Warg-Damiani L, Baldwin CM, et al. Self-reported
chemical sensitivity and wartime chemical exposures in Gulf War
veterans with and without decreased global health ratings. Mil Med
1998; 163:725-32.

9. Fiedler N, Kipen H, Natelson B. Civilian and veteran studies of
multiple chemical sensitivity. Boston, MA: 216th Annual Meeting of
American Chemical Society, Symposium on Multiple Chemical Sensitivity:
Problems for Scientists and Society, 26 August 1998 (abstract and
presentation).

10. Black DW, Doebbing BN, Voelker MD, et al. Multiple Chemical
Sensitivity Syndrome: Symptom Prevalence and Risk Factors in a Military
Population. Atlanta, GA: The Health Impact of Chemical Exposures During
the Gulf War-A Research Planning Conference. 28 February 1999
(presentation, manuscript submitted).

11. Fukuda K, Nisenbaum R, et al. 1998. Chronic multisymptom illness
affecting Air Force veterans of the Gulf War. JAMA 1998; 280:981-88.

12. Canadian Department of National Defense (CDND). Health Study of
Canadian Forces Personnel Involved in the 1991 Conflict in the Persian
Gulf. Ottawa, Canada: Goss Gilroy; 20 April 1998. [Online at:
http://www.DND.ca/menu/press/Reports/Health/health_study_e_vol1_TOC.htm]


13. Unwin C, Blatchley N, Coker W, et al. Health of UK servicemen who
served in the Persian Gulf War. Lancet 1999; 353:169-78.

14. Nethercott JR, Davidoff LL, Curbow B, et al. Multiple chemical
sensitivities syndrome: toward a working case definition. Arch Environ
Health 1993; 48:19-26.

15. Szarek MJ, Bell IR, Schwartz GE. Validation of a brief screening
measure of environmental chemical sensitivity: the chemical odor
intolerance index. J Environ Psychol 1997; 17:345-51.

16. Miller CS, Prihoda TJ. The Environmental Exposure and Sensitivity
Inventory (EESI): a standardized approach for quantifying symptoms and
intolerances for research and clinical applications. Toxicol Ind Health
(in press).

17. Ashford NA, Miller CS. Chemical Exposures: Low Levels and High
Stakes (2nd ed). New York: John Wiley, 1998.

18. Donnay A. A Resource Manual for Screening and Evaluating Multiple
Chemical Sensitivity. Baltimore MD: MCS Referral and Resources, 1999.

19. Buchwald D, Garrity D. Comparison of patients with chronic
fatigue syndrome, fibromyalgia, and multiple chemical sensitivities.
Arch Int Med 1994; 154:2049-53.

20. Slotkoff AT, Radulovic DA, Clauw DJ. The relationship between
fibromyalgia and the multiple chemical sensitivity syndrome. Scand J
Rheumatol 1997; 26:364-67.

21. Donnay A, Ziem G. Prevalence and overlap of chronic fatigue
syndrome and fibromyalgia syndrome among 100 new patients with multiple
chemical sensitivity syndrome. J Chron Fatigue Syndrome 5(2):(in
press).

Signatories to the 1999 Consensus on Multiple Chemical Sensitivity

Liliane Bartha, M.D.
William Baumzweiger, M.D.
David S. Buscher, M.D.
Thomas Callender, M.D., M.P.H.
Kristina A. Dahl, M.D.
Ann Davidoff, Ph.D.
Albert Donnay, M.H.S.
Stephen B. Edelson, M.D., F.A.A.F.P., F.A.A.E.M.
Barry D. Elson, M.D.
Erica Elliott, M.D.
Donna P. Flayhan, Ph.D.
Gunnar Heuser, M.D., Ph.D., F.A.C.P.
Penelope M. Keyl, M.Sc., Ph.D.
Kaye H. Kilburn, M.D.
Pamela Gibson, Ph.D.
Leonard A. Jason, Ph.D.
Jozef Krop, M.D.
Roger D. Mazlen, M.D.
Ruth G. McGill, M.D.
James McTamney, Ph.D.
William J. Meggs, M.D., Ph.D., F.A.C.E.P.
William Morton, M.D., Dr.P.H.
Meryl Nass, M.D.
L. Christine Oliver, M.D., M.P.H., F.A.C.P.M.
Dilkhush D. Panjwani, M.D., D.P.M., F.R.C.P.C.
Lawrence A. Plumlee, M.D.
Doris Rapp, M.D., F.A.A.A., F.A.A.P., F.A.A.E.M.
Myra B. Shayevitz, M.D., F.C.C.P., F.A.C.P.
Janette Sherman, M.D.
Raymond M. Singer, Ph.D., A.B.P.N.
Anne Solomon, Ph.D., M.A.
Aristo Vodjani, Ph.D.
Joyce M. Woods, Ph.D., R.N.
Grace Ziem, M.D., Dr.P.H., M.P.H.
This article was published in the May/June 1999 issue of Archives of
Environmental Health, Vol. 54, No. 3, pp. 147-149. Heldref
Publications, Helen Dwight Reid Educational Foundation
http://www.heldref.org. The publisher grants permission for the free
reprinting and distribution of this statement.
http://www.environmentalhealth.ca/w03mcs99.html

Multiple Chemical Sensitivity: A 1999 Consensus

ABSTRACT. Consensus criteria for the definition of multiple chemical
sensitivity (MCS) were first identified in a 1989 multidisciplinary
survey of 89 clinicians and researchers with extensive experience in,
but widely differing views of, MCS. A decade later, their top 5
consensus criteria (i.e., defining MCS as [1] a chronic condition [2]
with symptoms that recur reproducibly [3] in response to low levels of
exposure [4] to multiple unrelated chemicals and [5] improve or resolve
when incitants are removed) are still unrefuted in published
literature. Along with a 6th criterion that we now propose adding
(i.e., requiring that symptoms occur in multiple organ systems), these
criteria are all commonly encompassed by research definitions of MCS.
Nonetheless, their standardized use in clinical settings is still
lacking, long overdue, and greatly needed-especially in light of
government studies in the United States, United Kingdom, and Canada
that revealed 2-4 times as many cases of chemical sensitivity among
Gulf War veterans than undeployed controls. In addition, state health
department surveys of civilians in New Mexico and California showed
that 2-6%, respectively, already had been diagnosed with MCS and that
16% of the civilians reported an "unusual sensitivity" to common
everyday chemicals. Given this high prevalence, as well as the 1994
consensus of the American Lung Association, American Medical
Association, U.S. Environmental Protection Agency, and the U.S.
Consumer Product Safety Commission that "complaints [of MCS] should
not be dismissed as psychogenic, and a thorough workup is essential,"
we recommend that MCS be formally diagnosed-in addition to any other
disorders that may be present-in all cases in which the 6
aforementioned consensus criteria are met and no single other organic
disorder (e.g., mastocytosis) can account for all the signs and
symptoms associated with chemical exposure. The millions of civilians
and tens of thousands of Gulf War veterans who suffer from chemical
sensitivity should not be kept waiting any longer for a standardized
diagnosis while medical research continues to investigate the etiology
of their signs and symptoms.


AS RESEARCHERS AND CLINICIANS with experience in the study, evaluation,
diagnosis, and/or care of adults and children with chemical sensitivity
disorders, we support the stated goal of the National Institutes of
Health 1999 Atlanta Conference on the Health Impact of Chemical
Exposures During the Gulf War "to fully characterize the nature of
multiple chemical exposures within the Gulf War veteran population and
to relate this characterization to what is known about Multiple
Chemical Sensitivity (MCS) and related conditions and disorders within
civilian populations."(1) Based on research conducted by state and
federal government agencies, we already know that MCS is one of the
most commonly diagnosed chronic disorders in civilians and the most
common-but still largely undiagnosed-disorder of any kind in Gulf
War veterans of the United States.

In statewide telephone surveys of randomly selected adults, conducted
by health departments in California in 1995 and 1996 and New Mexico in
1997, investigators found that 6% of adults in California(2) and 2% of
adults in New Mexico(3) indicated that they had already been diagnosed
with MCS or Environmental Illness, whereas 16% in both states said they
were "unusually sensitive to everyday chemicals." When randomly
selected adults in other states were asked if they were "especially
sensitive" (instead of "unusually" sensitive), one-third
consistently maintained that they were.(4-6)

Among Gulf War era veterans, data from the largest random survey
presented by the U.S. Department of Veterans' Affairs (VA) in 1998
(based on questionnaires completed by 11 216 deployed to the Gulf and 9
761 nondeployed) show that 5% reported chemical sensitivity among the
nondeployed personnel and 15% reported the same among the deployed.(7)
Other VA researchers report much higher rates-but the same 3-fold
difference-in a smaller random sample of VA hospital outpatients: 86%
of ill veterans deployed to the Gulf complained of chemical
sensitivity, compared with 30% of undeployed ill veterans.(8) In the
only study in which MCS was specifically assessed among veterans
selected randomly from the VA Registry, investigators found 36% of 1
004 met common research criteria for MCS.(9) Among randomly selected
Department of Defense (DOD) personnel who remain on active duty, two
larger studies by the Centers for Disease Control found slightly
lower-but still significant-2.1- and 2.5-fold increases in the
prevalence of self-reported chemical sensitivity among those deployed
to the Gulf, compared with those who were not deployed. In the
"Iowa" study, in which the prevalence rates for deployed and
nondeployed individuals were 5.4% and 2.6%, respectively, investigators
used a detailed questionnaire to assess "probable MCS."(10) In the
"Pennsylvania" study,(11) in which prevalence rates were 5% versus
2%, respectively, only one "yes/no" question was asked about
chemical sensitivity. Canadian Gulf War veterans reported only
approximately one-half the prevalence of MCS (2.4%), but nevertheless
this was 4 times more than their controls.(12) Even in the United
Kingdom where MCS is little known, Gulf War veterans report being
diagnosed with MCS at 2.5 times the rate of military controls.(13)

Clearly, there is a significant need for a standardized clinical
definition of MCS and a comprehensive clinical protocol that VA, DOD,
and other physicians can use to evaluate it. We recommend to our
colleagues and the sponsors of the Atlanta Conference-the Department
of Health and Human Services' Office of Public Health and Science,
the Centers for Disease Control and Prevention, the National Institutes
of Health, and the Agency for Toxic Substances and Disease
Registry-that MCS be formally defined for clinical purposes by the
top 5 "consensus criteria" identified in a 1989 survey of 89
clinicians and researchers who had extensive experience in MCS but who
also held widely divergent views about its etiology.(14) Included were
36 specialists in allergy, 23 in occupational medicine, 20 in
"clinical ecology," and 10 in internal medicine and otolaryngology.
We would add only that symptoms associated with chemical exposures must
involve multiple organ systems, thus distinguishing MCS from specific
single-organ system disorders (e.g., asthma, migraine) that also may
meet the first 5 criteria.

Consensus Criteria for MCS
The following consensus criteria for the diagnosis of MCS were gleaned
from the study by Nethercott et al.(14) (funded in part by grants from
US NIOSH and US NIEHS):

1. "The symptoms are reproducible with [repeated chemical]
exposure."

2. "The condition is chronic."

3. "Low levels of exposure [lower than previously or commonly
tolerated] result in manifestations of the syndrome."

4. "The symptoms improve or resolve when the incitants are
removed."

5. "Responses occur to multiple chemically unrelated
substances."

6. [Added in 1999]: Symptoms involve multiple organ systems.

Given the only other explicit consensus ever published on MCS-the
1994 statement of the American Lung Association, American Medical
Association, U.S. Environmental Protection Agency, and U.S. Consumer
Product Safety Commission, that "complaints [of MCS] should not be
dismissed as psychogenic, and a thorough workup is essential" (ALA
1994)-we recommend that MCS be diagnosed whenever all 6 of the
consensus criteria are met, along with any other disorders that also
may be present, such as asthma, allergy, migraine, chronic fatigue
syndrome (CFS), and fibromyalgia (FM). MCS should be excluded only if a
single other multi-organ disorder can account for both the entire
spectrum of signs and symptoms and their association with chemical
exposures, such as mastocytosis or porphyria, but not CFS or FM, which
are not so associated.

To assist physicians who are unfamiliar with the evaluation of MCS, we
recommend that clinical protocols include validated questionnaires for
screening and characterizing chemical sensitivity,(15,16) a list of
overlapping disorders to consider in the differential diagnosis of MCS,
and a list of signs and test abnormalities associated with MCS in the
peer-reviewed literature (summarized by Ashford and Miller(17) and
Donnay(18)). Although no single test is yet considered diagnostic of
MCS, those suggested by signs, symptoms, or history may be helpful in
treating and tracking the disorder.

The presentation of MCS may vary greatly among cases and over time.
Some individuals are totally disabled by severe symptoms suffered on a
daily basis, for example, whereas others are disabled only minimally by
mild symptoms suffered occasionally. We, therefore, recommend that any
clinical diagnosis of MCS be characterized and followed over time using
quantitative and/or qualitative indices of life impact or disability
(e.g., minimal, partial, total); symptom severity (e.g., mild,
moderate, severe); symptom frequency (e.g., daily, weekly, monthly);
and sensory involvement (identification of which sensory
pathways-olfactory, trigeminal, gustatory, auditory, visual and/or
touch, including perception of vibration, pain and heat or cold-show
altered (+/-) sensitivity and/or tolerance for normal levels of
stimuli, either chronically or in response to particular chemical
exposures).

For research purposes that require greater homogeneity, we encourage
investigators to refine the consensus criteria for MCS with whatever
additional inclusion or exclusion criteria they believe are needed to
test their hypotheses. The indices and domains that are used to
characterize and select both cases and controls in MCS research should
be fully reported so that results from different studies can be
compared and their broader applicability assessed.

Given the significant overlap in clinic populations of MCS with both
CFS and FM, as well as the need to better understand the relationships
between these disorders,(19-21) we recommend that all
"solicitations" and "requests for applications" issued by
federal agencies for human research into any one of CFS, FM, or MCS
direct investigators to screen for all three (regardless of their
selection criteria, which need not be affected) and to report their
results in these terms. There is a precedent for this: the National
Institute of Arthritis and Musculoskeletal Disorders routinely requires
that in studies of fibromyalgia investigators must screen for and
report any overlap with temporo-mandibular joint disorder. CFS, FM, and
MCS research could all benefit from greater collaboration, and so we
welcome the Congressional initiative of Senator Tom Harkin to earmark
$3 million of the DOD's 1999 Gulf War illnesses research budget for
multidisciplinary studies of CFS, FM, and MCS together (solicitation
074&&&-9902-0005 issued 2/12/99) to better understand both their
overlaps and differences. We recommend that such three-way studies be
solicited by all federal agencies funding CFS, FM or MCS research.

References

1. Eisenberg J. Report to Congress on Research on Multiple Chemical
Exposures and Veterans with Gulf War Illnesses. Washington DC: US
Department of Health and Human Services, Office of Public Health and
Science. 15 January 1998.

2. Kreutzer R, Neutra R, Lashuay N. The prevalence of people
reporting sensitivities to chemicals in a population-based survey. Am J
Epidemiol (in press).

3. Voorhees RE. Memorandum from New Mexico Deputy State
Epidemiologist to Joe Thompson, Special Counsel, Office of the
Governor; 13 March 1998.

4. Bell IR, Schwartz GE, Amend D, et al. Psychological
characteristics and subjective intolerance for xenobiotic agents of
normal young adults with trait shyness and defensiveness. A
parkinsonian-like personality type? J Nerv Ment Dis 1998; 182:367-74.


5. Bell IR, Miller CS, Schwartz GE, et al. Neuropsychiatric and
somatic characteristics of young adults with and without self-reported
chemical odor intolerance and chemical sensitivity. Arch Environ Health
1996; 51:9-21.

6. Meggs WJ, Dunn KA, Bloch RM, et al. Prevalence and nature of
allergy and chemical sensitivity in a general population. Arch Environ
Health 1996; 51(4):275-82.

7. Kang HK, Mahan CM, Lee KY, et al. Prevalence of chronic fatigue
syndrome among US Gulf War veterans. Boston, MA: Fourth International
AACFS Conference on CFIDS, 10 October 1998 (abstract and presentation).


8. Bell IR., Warg-Damiani L, Baldwin CM, et al. Self-reported
chemical sensitivity and wartime chemical exposures in Gulf War
veterans with and without decreased global health ratings. Mil Med
1998; 163:725-32.

9. Fiedler N, Kipen H, Natelson B. Civilian and veteran studies of
multiple chemical sensitivity. Boston, MA: 216th Annual Meeting of
American Chemical Society, Symposium on Multiple Chemical Sensitivity:
Problems for Scientists and Society, 26 August 1998 (abstract and
presentation).

10. Black DW, Doebbing BN, Voelker MD, et al. Multiple Chemical
Sensitivity Syndrome: Symptom Prevalence and Risk Factors in a Military
Population. Atlanta, GA: The Health Impact of Chemical Exposures During
the Gulf War-A Research Planning Conference. 28 February 1999
(presentation, manuscript submitted).

11. Fukuda K, Nisenbaum R, et al. 1998. Chronic multisymptom illness
affecting Air Force veterans of the Gulf War. JAMA 1998; 280:981-88.

12. Canadian Department of National Defense (CDND). Health Study of
Canadian Forces Personnel Involved in the 1991 Conflict in the Persian
Gulf. Ottawa, Canada: Goss Gilroy; 20 April 1998. [Online at:
http://www.DND.ca/menu/press/Reports/Health/health_study_e_vol1_TOC.htm]


13. Unwin C, Blatchley N, Coker W, et al. Health of UK servicemen who
served in the Persian Gulf War. Lancet 1999; 353:169-78.

14. Nethercott JR, Davidoff LL, Curbow B, et al. Multiple chemical
sensitivities syndrome: toward a working case definition. Arch Environ
Health 1993; 48:19-26.

15. Szarek MJ, Bell IR, Schwartz GE. Validation of a brief screening
measure of environmental chemical sensitivity: the chemical odor
intolerance index. J Environ Psychol 1997; 17:345-51.

16. Miller CS, Prihoda TJ. The Environmental Exposure and Sensitivity
Inventory (EESI): a standardized approach for quantifying symptoms and
intolerances for research and clinical applications. Toxicol Ind Health
(in press).

17. Ashford NA, Miller CS. Chemical Exposures: Low Levels and High
Stakes (2nd ed). New York: John Wiley, 1998.

18. Donnay A. A Resource Manual for Screening and Evaluating Multiple
Chemical Sensitivity. Baltimore MD: MCS Referral and Resources, 1999.

19. Buchwald D, Garrity D. Comparison of patients with chronic
fatigue syndrome, fibromyalgia, and multiple chemical sensitivities.
Arch Int Med 1994; 154:2049-53.

20. Slotkoff AT, Radulovic DA, Clauw DJ. The relationship between
fibromyalgia and the multiple chemical sensitivity syndrome. Scand J
Rheumatol 1997; 26:364-67.

21. Donnay A, Ziem G. Prevalence and overlap of chronic fatigue
syndrome and fibromyalgia syndrome among 100 new patients with multiple
chemical sensitivity syndrome. J Chron Fatigue Syndrome 5(2):(in
press).

Signatories to the 1999 Consensus on Multiple Chemical Sensitivity

Liliane Bartha, M.D.
William Baumzweiger, M.D.
David S. Buscher, M.D.
Thomas Callender, M.D., M.P.H.
Kristina A. Dahl, M.D.
Ann Davidoff, Ph.D.
Albert Donnay, M.H.S.
Stephen B. Edelson, M.D., F.A.A.F.P., F.A.A.E.M.
Barry D. Elson, M.D.
Erica Elliott, M.D.
Donna P. Flayhan, Ph.D.
Gunnar Heuser, M.D., Ph.D., F.A.C.P.
Penelope M. Keyl, M.Sc., Ph.D.
Kaye H. Kilburn, M.D.
Pamela Gibson, Ph.D.
Leonard A. Jason, Ph.D.
Jozef Krop, M.D.
Roger D. Mazlen, M.D.
Ruth G. McGill, M.D.
James McTamney, Ph.D.
William J. Meggs, M.D., Ph.D., F.A.C.E.P.
William Morton, M.D., Dr.P.H.
Meryl Nass, M.D.
L. Christine Oliver, M.D., M.P.H., F.A.C.P.M.
Dilkhush D. Panjwani, M.D., D.P.M., F.R.C.P.C.
Lawrence A. Plumlee, M.D.
Doris Rapp, M.D., F.A.A.A., F.A.A.P., F.A.A.E.M.
Myra B. Shayevitz, M.D., F.C.C.P., F.A.C.P.
Janette Sherman, M.D.
Raymond M. Singer, Ph.D., A.B.P.N.
Anne Solomon, Ph.D., M.A.
Aristo Vodjani, Ph.D.
Joyce M. Woods, Ph.D., R.N.
Grace Ziem, M.D., Dr.P.H., M.P.H.
This article was published in the May/June 1999 issue of Archives of
Environmental Health, Vol. 54, No. 3, pp. 147-149. Heldref
Publications, Helen Dwight Reid Educational Foundation
http://www.heldref.org. The publisher grants permission for the free
reprinting and distribution of this statement.

Todd Hymas is Grist's editorial assistant. He's had Multiple Chemical
Sensitivities since 1998.


~~~~

Note from Ilena Rosenthal:
The most rabid and deceitful Chemical Industry hack, Stephen Barrett,
has led campaigns for years against fine scientists and doctors
looking to help the many like Todd who suffer from MCS.

This unlicensed for over a decade, so called 'psychiatrist' never was
able to pass the psychiatric board certification ... and has written
many deceitful articles on MCS for ACSH.org ... long funded by the
chemical industry.

Thousands of women with breast implants are affected by MCS ... and
many of their physicians have been ravaged by this maniac.

This is just one:

www.BreastImplantAwareness.org/sinaiko.htm

Thankfully ... after years and years .. Dr. Sinaiko prevailed at huge
cost and loss of years of helping patients.

~~~~~~~~~~~~~~~~~~~

http://toxtown.nlm.nih.gov/


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