Multiple Chemical Sensitivity Syndrome: A Clinical Perspective. I. Case Definition, Theories of Pathogenesis, and Research Needs

Details

• Personal Author:
  Altman LC ; Black DW ; Daniell W ; Kipen HM ; Simon GE ; Sparks, Patricia J. ; Terr AI
• Description:
  Multiple chemical sensitivity syndrome (MCS) does not appear to fit established principles of toxicology. Yet social, political, and economic forces are demanding that MCS be defined medically, even though to date scientific studies have not identified pathogenic mechanisms for the condition or any objective diagnostic criteria. Consequently, a working definition of MCS can rely only on an individual's subjective symptoms of distress and attribution to environmental exposures rather than currently measurable objective evidence of disease. Nevertheless, patients labeled with MCS are clearly distressed and many are functionally disabled. In this review, four theories of causation are explored: (I) MCS is a purely biologic/physical or psychophysiologic reaction to low-level chemical exposures. (2) MCS symptoms may be elicited by low-level environmental chemical exposures, but the sensitivity is initiated by psychologic stress. (3) MCS is a misdiagnosis and chemical exposure is not the cause. The symptoms may be due to misdiagnosed physical or psychologic illness. (4) MCS is an illness belief system manifest by culturally shaped illness behavior. Areas for further research regarding the etiologies of MCS are suggested. Recognizing that the cause of the syndrome may be multifactorial, strategies are proposed for clinical evaluation and management in Part II of this manuscript using a biopsychosocial model of illness. [Description provided by NIOSH]
• Subjects:
  Mining Occupational Health Risk Assessment Safety
• Keywords:
  Clinical Diagnosis Clinical Tests Environmental Exposure Etiology MCS Multiple Chemical Sensitivity Psychological Factors Psychophysiology
• ISSN:
  0096-1736
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Iowa ; New Jersey ; New York ; OSHA Region 10 ; OSHA Region 2 ; OSHA Region 7 ; OSHA Region 9 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  36
• Issue:
  7
• NIOSHTIC Number:
  nn:20059935
• Citation:
  J Occup Med 1994 Jul; 36(7):718-730
• Contact Point Address:
  Patricia J. Sparks, MD, MPH, Medical Director, Business Health Services, Providence Medical Center, 1600 E. Jefferson, Suite 201, Seattle, WA 98122
• Federal Fiscal Year:
  1994
• Performing Organization:
  Mount Sinai School of Medicine, New York
• Peer Reviewed:
  True
• Start Date:
  19920701
• Source Full Name:
  Journal of Occupational Medicine
• End Date:
  19970630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0b73e88c52a79e3f4f0a57a5540302703e83422b827d7f4c25d9a6bdf250f1a3468bffd00a1e520e41e93f911787d46d6c067414c878665b3ae77f8c08b8188d
• Download URL:
  https://stacks.cdc.gov/view/cdc/223988/cdc_223988_DS1.pdf
• File Type:
  [PDF - 1.56 MB ]