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
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
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.
Finding the Right Medical Expert
Dr H Morrow-Brown MD FRCP
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
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
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
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
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
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
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.