Expert advice about Environmental Illnesses and types of help available.

Multiple Chemical Sensitivity (MCS) ‘- is it all in the mind?’
Dr Kartar Badsha MSc CChem MRSC MAE

Many people will have, or know someone who has, experienced an increasing trend of reacting to an increasing number of everyday items, without it at first registering in their mind, or if they have noticed it, only to dismiss these small “irritations” when they occur. These symptoms can range from congestion to sneezing to more severe reactions such as rashes, breathing problems, to such as “weeping eyes, pains in the joints etc” or even worse. In the early days these “occurrences” may be intermittent. These reactions are often non-specific to natural allergens and include symptoms such as headache, sore eyes, sore throat, general weakness in muscles, a feeling of constant tiredness etc. These symptoms being non-specific are often dismissed as “all in the mind” or “seeking sympathy” or “looking for excuses”.

Low levels of many common household chemicals often trigger off such symptoms. Sufferers are said to be suffering from Multiple Chemical Sensitivity (MCS), or what is often called Environmental Illness or 20th Century Disease. In severe cases, victims have to isolate themselves from society, synthetic products, and any type of chemical product. Yet this illness or disease is not always viewed as a real illness and often dismissed by the medical profession.

In the modern world, whether indoors or out, in the city or in the country, the mountains or the desert, we are all of us continually exposed to chemicals. Chemicals both natural and synthetic are a part of our lives.

A WHO publication states air pollution to be a major environmental health problem affecting both developed and developing countries. Despite ever increasing knowledge of the harmful health effects of air pollution preventive action is often slow to follow.

Dr Michael Repacholi, WHO Coordinator, Occupational and Environmental Health states “WHO would like to provide its 191 Member States with irrefutable evidence that air pollution causes a disproportionately heavy burden of disease. We would like to provide them with a proper strategy to eliminate avoidable air pollutants and thus reduce this disease burden in a cost-effective way.”

In 1995, the European Commission produced a report “Chemical Sensitivity in Selected European Countries: An Exploratory Study” which was carried out by several authors including M Ashford, a leading expert on Chemical Sensitivity who also produced a report for the New Jersey State Department of Health.

There are other government official reports such as “Chemical sensitivities: a global problem”, which was prepared at the request of the US Interagency Taskforce on Multiple Chemical Sensitivities by C Wilson. On the 24 August 1998, the interagency Workgroup on MCS published a comprehensive “Predecisional Draft” report on MCS to include Background, Government interest, Public Health issues in Medical Evaluation and Care of MCS Patients, Organisational Statements Relating to MCS, Federal Actions, Recommendations (Overview and MCS as a Public Health Priority). There is also a long list of references, Annex of Research suggested by Expert Reviewers and recommendations from Selected Meetings about MCS. Particularly in recent years there have been numerous studies on MCS and reports such as “The effect of housing on individuals with multiple chemical sensitivities” (J. Ptrim. Prev. 19:31-42, 1998).

Despite the above authoritative reports on MCS, the UK medical establishment and the Government continuously dismiss MCS as being “all in the mind”. For example the Department of Health’s Committee on the Medical Effects of Air Pollutants (COMEAP) published a report: The Quantification of Effects of Air Pollution on Health in the United Kingdom in January 1998. The report estimated that in 1997, 12,000-24,000 deaths of vulnerable people were brought forward by air pollution and 14,000-24,000 hospital admissions and readmissions of vulnerable people were associated with air pollution in the UK. The Government’s response has been the building of more incinerators (there are plans for at least 25 such plants) and relaxing of various ADI values.

This policy not to accept MCS, despite increasing number of people suffering in large numbers is best illustrated by soldiers who suffer from Gulf War syndrome resulting in MCS, the victims from the aluminium sulphate poisoning at Camelford, and the many of thousands of individuals suffering as a result of various incidents both recognised and unrecognised.

During March 2000, one sufferer from MCS spoke to BBC News Online and said “I am very sensitive to domestic gas, detergents, perfumes and chemical cleaners. I was diagnosed three years ago. When I have a severe chemical exposure, I lose consciousness for a couple of hours. I can’t go somewhere where there’s a gas cooker on, though I can cope with a gas boiler so long as it’s in a separate room, with the door shut”.

What is becoming more common is that there is an increase in the numbers of people having an adverse physical reaction to low levels of many common chemicals, ranging from congestion to sneezing to more severe reactions such as rashes, breathing problems and worse, these reactions are often non-specific and hence dismissed.

Multiple Chemical Sensitivity is the name given to the broad issue of reactions to specific or cumulative chemicals in the environment. In brief chemicals damage the immune system, the liver, and suppress the cellular mediation that controls the way the body protects itself from foreign materials. Multiple chemical sensitivity is in fact an acquired disorder characterized by recurrent symptoms, referable to multiple organ systems, occurring in response to demonstrable exposure to many chemically unrelated compounds at doses far below those established in the general population to cause harmful effects. No single widely accepted test of physiologic function can be shown to correlate with the symptoms.

In 1991 Ashford and Miller stated, “The patient with multiple chemical sensitivities can recover by the removal of the suspected offending agents and by re-challenge, after an appropriate interval, under strictly controlled environmental conditions. Causality is inferred by the clearing of symptoms with removal from the offending environment and recurrence of symptoms with specific challenge.”

Multiple Chemical Sensitivity was first brought to the attention of the U.S. medical establishment when the late Theron Randolph, a physician trained in allergy and immunology, reported that a number of his patients reacted adversely to chemicals in their environment (Randolph, 1952, “Sensitivity to petroleum including its derivatives and antecedents”. J.Lab.Clin.Med 40:931-932). He compared the condition to Selye's stress oriented general adaptation syndrome (Kurt, “Multiple chemical sensitivities-a syndrome of pseudotoxicity manifest as exposure perceived symptoms”. J.Toxical.Clin.Toxical 33:101-105, 1995) and linked the adverse effects of this "petrochemical problem" to contact with chemicals found in commonly encountered substances such as cosmetics, auto fuels, exhaust fumes, and food additives. He also observed that many of his patients reacted to many industrial solvents found in small amounts in manufactured products such as construction materials, newspaper and other ink related products, furniture, and carpet.

It was not until 1963 Kailin and Brook in their study called the “Systemic toxic reaction to soft plastic food containers” that for the first time patients were classified as suffering from multiple chemical sensitivities. It was also the first time that a double-blind study was used to remove any doubts that people did suffer from MCS (Med. Ann Washington DC 32:1-8 1963).

Since then there have been numerous publications (Bibliography) of scientific articles, editorials, books, reports on / or directly related to multiple chemical sensitivity disorders. Albert Donnay MHS of MCS Referral & Resources, 508 Wetgate Road, Baltimore MD 21229-2343, has published a detailed chronology of MCS from 1945 through to September 1999, which is a very good source of background information.

There are also Tips for Anaesthetics and Hospitalisation for People with MCS - A report to help people with MCS/environmental sensitivity prepare for surgery, the first and most important point is to avoid a gas anaesthetic. The reason or this is that anaesthetic gasses are neurotoxic and can cause serious problems especially for people with sensitivities. (Source: www.immuneweb.org by Susan Beck – 7 June 1999).

It must be remembered that environmental type Illness is not something that only a few people suffer from. According to the National Academy of Sciences, 37 million Americans suffer from Environmental Illness. Their estimate further holds that as high as 15% of Americans can no longer live comfortably in this post-industrial world and by this it in meant in their own homes. These awful statistics are also supported by a WHO strategy meeting on Air Quality and Health held in Geneva in September 2000 where it stated that “As many as one billion people, mostly women and children, are regularly exposed to levels of indoor air pollution exceeding WHO guidelines by up to 100 times.” According to EU’s own studies, a person is confronted by at least 300 chemicals on a daily basis. The true figure in UK is unknown. This is not because the UK population is immune to MCS, but because the Poison Unit at Guys Hospital deals with most if not all MCS cases, (these cases include the Gulf War veterans, organophosphate victims, Camelford etc). Referral of MCS patients to the Poison Unit at Guy’s Hospital in London, usually results in same well known phrase of diagnosis i.e. “all in the mind and in need of psychiatric treatment” often resulting in further damage to the victim’s health.

The dangers of the wrong diagnosis: In 1989, a family in Paignton, Devon were exposed to cellulose paint spraying emitted from an “illegal factory” next door to their home and restaurant. The entire family were made seriously ill and were left with MCS and the reason given by Environment Health Officer was that to intervene would meant paying compensation to the paint sprayer!

The son who is now 25 years old is the most affected and applied for incapacity allowance for not been able to work in a “normal environment” as low-level pollutants can trigger his MCS symptoms.

During the appeal hearing, the environment of the room had so adversely affected the young man that he experienced breathing difficulty. The doctor who was present at the hearing put a bag over the young man’s mouth and nose (a mis-diagnosis of hyperventilation) resulting in it being impossible for him to breath. If he had been too young and not had the presence of mind to push the bag away from his face the result of the bag over his mouth and nose could have had a devastating effect.

There clearly is a need to give MCS sufferer’s recognition and the help they need to regain the dignity, quality and a working life where possible.

In spite of well documented knowledge of the affects on human health and environment along with product labels that warn of adverse reactions such as headaches, nausea, blurred vision, etc and in spite of mounting animal research that links specific reaction to specific chemicals as well as the introduction of double-blind clinical studies with humans, subjective symptoms of those suffering from MCS still remain highly controversial and very often dismissed. Double-blind studies are routinely discounted by critics because of subjective concerns such as there being no way to verify if a patient is nauseous. For conventional medical practitioners, humans are still not considered reliable indicators!

With time-dependent sensitisation (TDS) and enzyme deficiencies, animal models are now available for the study of MCS; however, the lack of funding for basic research is still a major problem. Another problem encountered is that even to have basic research published in established medical journals is virtually impossible. For example, doctors employed by Dow Chemical Company, Eastman-Kodak, General Motors, and ITT Corporation controls the Journal for Occupational Medicine.

Dr Nino Kunzli of the University’s Institute for Social and Preventive Medicine led a study entitled “Public Health impact of outdoor and traffic related air pollution: a European Assessment” which cited “increasing evidence that air pollution may also influence mortality rates of newborn babies or infants. The author acknowledges “As we did not quantify attributable number of deaths below age 30 years, we might have underestimated lifetime lost” (Source: http://ens.lycos.com – Environment News Service dated 10 September 2001). The report also states in total, six percent of deaths in Austria, France and Switzerland - more than 40,000 people a year - are due to air pollution.

According to an analysis conducted by the Natural Resources Defence Council (NRDC), every year, some 64,000 may die prematurely from cardiopulmonary causes linked to particulate air pollution. In the most polluted cities, lives are shortened by an average of one to two years. Los Angeles tops the list, with an estimated 5,873 early deaths (Based on Breath-Taking: Premature Mortality Due to Particulate Air Pollution in 239 American Cities, May 1996 report by NRDC).

The above, however, must be looked in the context of global production of chemicals, which has increased from 1 million tonnes in 1930 to 400 million tonnes today. We have about 100,000 different substances registered in the EU market alone of which 10,000 are marketed in volumes of more than 10 tonnes, and a further 20,000 are marketed at 1-10 tonnes.

The world chemical production in 1998 was estimated at $1,244 billion, with 31% for the EU chemical industry, which generated a trade surplus of $41 billion. In 1998, it was the world’s largest chemical industry, followed by that of the US with 28% of production value and a trade surplus of $12 billion. The chemical industry is also Europe’s third largest manufacturing industry. It employs 1.7 million people directly and up to 3 million jobs are dependent on it. As well as several leading multinationals, it also comprises around 36,000 SMEs. These SMEs represent 96% of the total number of enterprises and account for 28% of chemical production.

In 1995 the European Commission commissioned a report, “Chemical sensitivity in Selected European Countries: An exploratory Study.” On the 13 February 2001, The European Commission further adopted a White Paper setting out the strategy for a future ‘Community Policy for Chemicals’. The main objective of the new Chemical Strategy is to ensure a high level of protection for human health and the environment, while ensuring the efficient functioning of the internal market and stimulating innovation of competitiveness in the chemical industry.

With an ever-increasing number of adults, families and children continuing to be become chemically sensitive, there is still no immediate and corrective medical advice available. What will the future hold for the next generation unless we can convince mainstream medical profession and (or) government bodies of the increasing need to understand MCS or similar types of syndrome? Today’s Government’s medieval response means that the legacy, unless we the people take action, will leave for the next generation a life on “Prozac” or even more stronger, addictive drugs.

Many who suspect their health has been damaged by pollution find it difficult to obtain informed, objective medical advice. The average GP is neither trained nor has the time to deal with these kinds on complex problems, and will almost certainly refer you to a consultant practising in your local area. Sometimes this may not be the best person, especially if a correct diagnosis has not been established, or with rare complaints where there may only be one or two experts in the country.
It is however most important to keep your GP on your side. The GP is the first point of contact, and is in a position to organise NHS referrals, write reports on your state of health before and after exposure to pollutants and so on. In fact, keeping accurate records of dates, times, places, symptoms, medication etc. is essential. Not only is this legal evidence - an accurate and detailed medical history is a vital tool for effective treatment.

If you are not confident that your doctors have the right experience and expertise, you are entitled to a second opinion, even if this means seeing someone in a different Health Authority. A frequent problem is that you might be shunted around a variety of specialists, none of whom are looking at the whole picture. Always make sure that a complete set of your medical notes, tests, X-rays and so on are made available to each person you see.

Beware! Under these circumstances it is easy to become labelled as a hysterical nuisance. Be calm, keep your own record of events, but above all inform yourself. If you consider your treatment is unsatisfactory, and your current advisors have run out of ideas, you must now find your own expert. Your aim is to locate one with appropriate experience and up-to-date, comprehensive knowledge of the causes and treatment of your condition. It is all too tempting when desperate to fall into the hands of quacks. This is not to say that all alternative therapies are to be discounted, bit extreme caution should be exercised, especially where significant amounts of money are involved. And never stop conventional treatments without consulting your doctor, it can be extremely dangerous.

The following checklist may help you locate appropriately qualified experts:

Contact relevant charities, help-lines and self-help groups

Read/watch/listen to items in the media, but be discriminating. The quality press is usually fairly accurate, but all tend to focus on the bizarre and the extreme. Surf the internet. Don't believe everything you are told, and don't clutch at straws.

Compile a list of possible experts. Look up Health Which. CHECK THEM OUT IN THE MEDICAL DIRECTORY. (This will detail qualifications, previous jobs, experience etc. If they are not in, proceed with extreme caution or not at all.) Identify the most promising one.

Go back to your current medical advisors. Give reasons why you want to be referred. You may or may not be able to wangle it on the NHS if you are not covered by private insurance. If a referral is refused, you can make a direct approach to your chosen expert. Be prepared to argue your case. Making sure your complete medical notes are made available is even more important if you have referred yourself.

Check out your chosen expert before committing yourself. Interview them for the job of looking after you. Find out what they know, what their results are like. If they are going to be any help they must be willing to listen to your story.

And in conclusion, once you feel you might at last be in safe hands, try to trust your physicians. Give them the time and co-operation they need to get results. Follow their advice meticulously. Resist the temptation to try to sort out all sorts of remedies at once, or to abandon treatments impatiently when immediate improvements are not forthcoming.

The Natural Tool, Homoeopathy top
Peter Smith LCH MHMA

Homoeopathy is a Natural tool for dealing with ill-health brought on by amongst other triggers chemical exposure. In the following article, Registered Homoeopath Peter Smith begins to explore an area of concern to many people - dealing Naturally with some of the environmentally-triggered health problems experienced by increasing numbers of the population.

What’s the Problem? There are probably at least 50,000 + different chemicals in our environment that didn’t exist 75 years ago. They pollute our air, water, food - and we (the polluting species) ourselves. Multiple Chemical Sensitivity (MCS) lies at one extreme, where people are forced to survive in isolated, chemical-free environments; M.E. is yet another less extreme but horrendously debilitating example; allergies, food-sensitivity, asthma and eczema could be described as the precursor of more serious problems in the making. Nobody mentions Chernobyl any more, yet it, too, is adding to the toxic load that we are all struggling to cope with and to survive.

In many ways, ‘Silent Spring’ is coming very rapidly. Much that we were warned of by visionaries such as Rachel Carson is coming true and worse. The ‘good’ scientists (upon whom we all rely to sort out the messes caused by their colleagues and by the Society which permits the pollution etc to continue) face a monumental task. In Medicine, iatrogenic disease (illness caused by pharmaceutical drugging) is another massive source of dis-ease on the planet.

In less than 100 years we have managed to throw out the baby with the bathwater, so to speak, by ignoring all the wisdom and knowledge gleaned over many centuries by what can loosely be termed ‘Natural Medicine’. What do we do while we wait for the Magic Bullets to arrive ? Until/if ever Science can sort out the mess and develop new interventions, one suggestion is to use what works, and has done so since time immemorial, Natural Medicines such as Acupuncture, Herbalism, Naturopathy and Homoeopathy.

What’s the Difference between Orthodox Medicine (allopathy) and Homoeopathy ? I hope that not many people will argue with this brief definition of the two different approaches, but space is limited. Homoeopathy is based on two Greek words: homoeios (similar) and pathos (suffering).

The homoeopath is involved in the prescribing of scientifically-prepared, diluted, tried-and-tested medicines (remedies) based on the similarity of symptoms of the patient with the ability of the remedy to cause those symptoms in a healthy person. In other words, homoeopaths fight fire with something that is like fire (but isn’t!). Allopathy: is a word coined to express the difference between Orthodox Medicine and Homoeopathy. Again, based on two Greek words allo (other) and pathos, it conveys other/opposite suffering. In other words, it involves using (relatively) large material doses of ‘drugs’ to overcome disease. Homoeopaths prefer to use the word ‘suppress’ when talking about such drugs as hydrocortisone and the like, which are very powerful but which, when stopped, allow the disease to resurface, for eventual (proper) cure.

Helping the Body to Heal Homoeopathy and other therapies can do a tremendous amount to enable the body to regain many (if not all) of its function. It is useless at microsurgery etc. - but can help to avoid the need for other surgery etc, given enough time. In other words, please do not for one minute think that Homoeopathy is so arrogant to think that it can do it all, but it can do a tremendous amount. In future Newsletters I will address some of the capabilities of Natural medicine to help the body to detoxify, rebuild damaged organs and systems, raise energy levels and relieve the malaise so often experienced by the majority of the population. We will explore some basic but priceless self-help techniques as well as showing some of the different applications of Homoeopathy.

Peter Smith, LCH, MHMA has been in practice in Cornwall since 1984. He continues to be involved in the Camelford Water Pollution Incident of 1988 and has helped to treat some 200 of those affected.

Multiple chemical sensitivity top
Dr H Morrow-Brown MD FRCP

During the last century countless completely new chemicals have been introduced to the environment, and if not obviously harmful it may be many years before it is recognised that a specific chemical can cause illness. MSC has vague symptoms similar to Gulf War syndrome, or to ME, and although all these illnesses have been declared as to be "all in the mind" there is now increasing evidence to the contrary, and there is a great deal of controversy.
An example is when gross exposure to a toxic chemical, as when a pipe bursts, produces acute symptoms which subside, but is followed by reacting to mere traces of the chemical, and also gradual acquisition of multiple sensitivity to the many other chemicals encountered in everyday life, such as scent, alcohol, formaldehyde, artificial fragrances and insecticides etc.
More commonly there is no acute exposure episode, but long term exposure at work, or in the home to very toxic chemicals sued to eradicate dry rot. People find that they begin gradually with wheezing or other symptoms to many household chemicals, so that avoidance becomes a great problem, and in extreme cases where the patient seems to be "allergic to everything" attract press publicity. There are no laboratory tests which will give a reliable diagnosis, the symptoms are all subjective, and the patients are often dismissed as either malingerers or neurotics, often leading to resentment and emotional upset as a result of being disbelieved. This is a condition waiting for a test to establish it as a definite entity, as it is only in case of industrial exposure to the isocyantes and phthalates the specific IgE can be demonstrated in the blood.
It is obvious that deliberate exposure to the suspected chemicals in tiny amounts in a closed chamber, given precisely and using a double blind protocol to reproduce the symptoms, might convince the medical profession that this is a real illness. Unfortunately there are many difficulties in carrying out such investigations, which could make the patient quite ill, and the technology has not been properly developed.
To start with the suspected chemical would be introduced into the chamber in a concentration well below the level which might cause harm, then given in increasing amounts until the patient reacts, or it is evident that no reaction is going to take place. As patients may be sensitised to many chemicals, they might need to be challenged with several on different days, or perhaps the subject might need to be challenged with several on different days, or perhaps the subject might react only when they are all present the subject might react only when they are present, as they might be having an additive effect.
Before this type of test could be carried out it would be preferable if prior to the tests the sufferer was isolated in a special hospital where all the usual chemicals and pollution are rigidly excluded. Unfortunately there is only one unit in this country offering such isolation facilities, there are none on the NHS, and very few specialists with an interest in environmental illness.
At this time treatment depends on mainly identifying and avoiding chemicals which cause symptoms, which is not always easy or practical. In cases where compensation is sought for industrial or accidental exposure the lack of reliable laboratory tests for chemicals puts the plaintiff at a serious disadvantage.

top