17
May
Multiple Chemical Sensitivity Recognized by State of Massachusetts
(Beyond Pesticides, May 17, 2024) Massachusetts Governor Maura Healey (D) proclaimed May 12 -18, 2024 as Multiple Chemical Sensitivity Awareness Week, first established in 1998 in numerous states across the U.S. Multiple Chemical Sensitivity (MCS)—also called chemical intolerance or Toxicant-Induced Loss of Tolerance (TILT), is characterized by disorders in one or more body systems, including respiratory, gastrointestinal, musculoskeletal, and neurological processes. It is thought to be caused by adverse reactions to environmental chemicals and/or biological substances such as mold. Affected individuals suffer fatigue, rashes, muscle and joint pains, memory loss, and other symptoms.
The Massachusetts proclamation encourages “residents of the commonwealth to take cognizance†of the event and recognize the distress of their fellow citizens who suffer from MCS. May 12 is also known as International May 12th Awareness Day, an observance started in 2006 in the United Kingdom to educate the public about many diseases associated with sensitivity to chemicals, including MCS, fibromyalgia, and Gulf War Syndrome.
While some scientists have considered MCS a psychological or psychosomatic problem, there is increasing support for the reality of MCS as a physical disease distinct from mental or emotional disorders. Yet there are no medical tests that can reliably confirm a diagnosis, so health care providers must rely on self-reporting such as the TILT questionnaire. This leaves the medical profession with one option for patients: to try to alleviate the symptoms by avoiding triggering exposures. Often this entails changes in exercise and diet and reduced use of personal care products, cleaning products, and pesticides at home. The Centers for Disease Control and Prevention (CDC) recommends clinical treatment approaches here. The Massachusetts Association for the Chemically Injured offers numerous resources for coping with the symptoms of MCS and navigating medical and governmental assistance, along with links to many other groups working on MCS issues.
As noted in the Massachusetts proclamation, MCS is recognized by the Americans with Disabilities Act, the U.S. Environmental Protection Agency, Social Security Administration, Department of Housing and Urban Development, and other federal and state agencies. Yet MCS sufferers often experience a cascade of consequences to their well-being, ranging from unemployment to homelessness. It is difficult to find a place to live or work where chemical exposures do not occur.
Workplaces can be a significant source of trouble; workers typically spend about a fourth of their week inside office buildings. Even in these non-agricultural environments, pesticides and other industrial chemicals may be present, impregnated in building materials and décor such as furniture, carpets, and wood, or used against pests like cockroaches and ants.
Anne Steinemann, PhD, an honorary professor of civil engineering at the University of Melbourne, Australia, has done extensive research on consumer product emissions such as fragrances and indoor air quality. In 2018, Dr. Steinemann published a study finding that 25 percent of Americans develop symptoms in response to common chemicals in paint, petrochemical fumes, and fragrances.
A 2021 study gathered data on workplace exposures in offices in the U.S. the United Kingdom, India and China. The workers wore silicone wristbands, which absorb chemicals in the environment. Out of the 99 chemicals the study targeted, all but five were detected in at least one wristband. For some pesticides, such as malathion and chlorpyrifos, exposures were highest in India and China, but permethrin was most frequent in the U.S. and U.K., probably because permethrin is used to prevent insect infestations and against mosquitoes in urban areas in addition to its agricultural applications. Importantly, several chemicals that have been banned showed up on the wristbands, including chlordane, the DDT breakdown product DDE, PCBs, and PBDE flame retardants (mostly banned in the European Union but not entirely in the U.S.). This demonstrates that these persistent chemicals linger far past their original application dates, potentially exposing generations of people at work and at home.
The wristband study notes that hand-washing reduced exposures significantly, so people with MCS may be able to adjust somewhat to chemical triggers by washing their hands frequently.
Treatment for MCS remains imprecise. In a video on the Massachusetts Association for the Chemically Injured website, L. Christine Oliver, MD, MPH, associate professor of clinical medicine at Harvard Medical School, notes that, “There are no miraculous cures out there.†Further, she says, physicians are not trained to recognize MCS and thus tend to either treat it as an emotional problem or to focus on one or more symptoms by testing for allergies, metabolic and cardiovascular disease, or digestive disorders. But despite the frustrating lack of specific physical disease mechanisms, Oliver stresses, “This is not a psychogenic disease.â€
The problem MCS patients confront, she adds, is similar to the controversy over banning smoking in workplaces and public spaces. There was strong resistance to banning smoking, but since smoke-free policies were implemented, we have learned a great deal about the health effects of secondhand smoke. Something very similar is likely to happen with victims of MCS, Dr. Oliver says. As a policy step to cope with MCS, she says the CDC’s internal policy for its own workplaces is “what we should be doing in every workplace in the country.†For example, workers should use no personal fragrances, and offices should warn sensitive individuals ahead of time when remodeling or redecorating is to occur so those individuals can avoid exposures to the related chemicals.
An additional complication is that, like many diseases associated with environmental chemicals, MCS may be caused not by exposure to one chemical or environmental toxicant, but by combinations of exposures, and not by single events, but by numerous events over time. Science, and in particular regulatory toxicology, has focused on single acute events and disregarded long-term, lower-dose events.
Chemical sensitivity has been raised as a medical condition for almost as long as the post-World War II burst of industrial development released a flood of new stressors. In a 2010 status report for Women’s College Hospital in Toronto, Canada, Lynn Marshall, MD and co-authors reviewed the history of scientific attention to MCS. The authors observed that more than 80,000 chemicals have been introduced since World War II and that already by the 1950s and 1960s patients began reporting symptoms related to intermittent exposures. In a 1962 book, Human Ecology and Susceptibility to the Chemical Environment, Theron G. Randolph, M.D. tried to make the connection, but the book was reviewed scathingly in the British Journal of Industrial Medicine. Then, about a decade after building construction became more airtight to save energy in the 1970s, “Sick Building Syndrome†emerged as an initiator of chemical sensitivities, according to Dr. Marshall, et al. Many other triggers, including electrical currents and microwave radiation, have since been added to the list of possible suspects. Â
But little progress has been made on determining whether, say, small doses of perfume combined with bathroom air fresheners and pesticides in building materials could set in motion the multiplicitous symptoms of MCS and their subsequent catastrophic effects on lives. More evidence is emerging of chemicals’ effects on cellular processes that affect many body systems (see Beyond Pesticides’ May 3 Daily News Blog on Parkinson’s disease). There may well be genetic factors that predispose some people to react negatively to exposures that have no effect on others. The molecular biology and genetic approaches used in neurodegenerative disease research could be a fruitful area of research for MCS.
But two things would really move the science forward for MCS patients: reliable objective diagnostics, including genetic profiling and biomonitoring, and effective, targeted treatments. Currently, the lack of these crucial tools leaves MCS patients open to assertions that MCS is entirely psychological and therefore not society’s problem.
Ultimately, it would probably be easier to reduce the number and toxicity of all industrial chemicals in the environment and peoples’ bodies than to undergo the painstaking and politically manipulable process of studying each chemical separately and each disease individually and then trying to parse the devilishly complex interactions among not only those 80,000 anthropogenic chemicals, but also the 30,000 genes, at least 200,000 proteins, and many other molecules required for human life to function.
All unattributed positions and opinions in this piece are those of Beyond Pesticides.
Sources:
The Commonwealth of Massachusetts
A Proclamation
Multiple Chemical Sensitivity Awareness Week
https://html.scribdassets.com/7nky11uhkwcfjcde/images/1-5135531184.jpg
Massachusetts Association for the Chemically Injured
https://www.maci-mcs.org/
Hormone receptor activities of complex mixtures of known and suspect chemicals in personal silicone wristband samplers worn in office buildings
Anna S. Young, et al.
Chemosphere
Volume 315, February 2023, 137705
https://www.sciencedirect.com/science/article/abs/pii/S0045653522041984?via%3Dihub
Care Now Ontario
https://carenowontario.org/action/
timeline of MCS as a diagnosis in Canada
Clinical Care of Patients with ME/CFS
Centers for Disease Control and Prevention
https://www.cdc.gov/me-cfs/healthcare-providers/clinical-care-patients-mecfs/index.html
Indoor carbon dioxide concentrations, VOCs, environmental sensitivity association with mucous membrane and lower respiratory sick building syndrome symptoms in the base study: analyses of the 100 building dataset
M.G. Apte and C.A. Erdmann
Lawrence Berkeley National Laboratory, 2002
https://escholarship.org/uc/item/3vj5m6wj
This is fabulous news! great article. I have sensitivities to chemicals/MCS. So lucky to have a good doctor that recognized that my methylation cycle wasn’t functioning properly – injured from a moldy government building in which i worked. I will share this on social media and friends.
May 17th, 2024 at 11:09 pm