The Multiple Chemical Sensitivity Syndrome (also referred to as Idiopathic Environmental Intolerance) is a controversial disorder in which the patient develops symptoms following exposure to levels of two or more substances in the environment significantly below the toxic level.
Criteria for the Multiple Chemical Sensitivity Syndrome:
(1) The respondent feels ill when exposed to routine or normal levels of exposure to chemical agents or substances.
(2) Sensitivity or illness after exposure is reported in 2 or more substances (listed below)
(3) Symptoms reported include 2 or more of categories (listed below)
(4) The symptoms lead to one or more behavioral responses (listed below)
Substances associated with reactions:
(1) smog or air pollution
(2) cigarette smoke
(3) vehicle exhaust or fumes
(4) copiers, printers and office machines
(5) newsprint
(6) pesticides, herbicides, and fertilizers
(7) new buildings
(8) carpeting and drapery
(9) organic chemicals, solvents, glues, paints, fuel
(10) cosmetics, perfumes, hair spray, deodorants, and nail polish
(11) other
Symptom categories reported:
(1) constitutional (fever, night sweats, fatigue, weight loss, weight gain)
(2) rheumatologic (joint pain, muscle aches)
(3) neurologic (headaches, sensory loss, tingling, paralysis)
(4) cardiovascular (palpitations)
(5) gastroenteric (gas, bloating, abdominal pain)
(6) dermatologic (rashes, blisters)
(7) pulmonary (shortness of breath, cough, wheezing)
(8) cognitive (confusion, difficulty concentrating, memory loss)
Behavioral responses to symptoms:
(1) wearing mask, gloves, or special clothes
(2) changing one's lifestyle to minimize chemical exposure
(3) move to a new home or location
(4) use of special vitamins, supplements or diets
(5) use of oxygen, antifungal agents, neutralizing injections, neutralizing drops
Differential diagnosis includes:
(1) an allergy to one or more of the implicated compounds
(2) an allergy to a routine environmental allergen (pollen, grass, etc.)
(3) a toxic exposure, either to an unrecognized agent or from a higher than realized dose
(4) psychological distress
Evaluation requires:
(1) a careful history to determine all exposures and the relationship between exposures and symptom onset
(2) careful allergy evaluation
(3) psychiatric evaluation
(4) toxicologic assays as indicated
