Multiple Chemical Sensitivity Research Articles

Combined Neurological Syndrome in Electrohypersensitivity and Multiple Chemical Sensitivity: A Clinical Study of 2018 Cases

From a cohort of 2018 evaluable consecutive cases issued from the European Clinical Trial Database, we describe the complete clinical symptomatic presentation of electrohypersensitivity (EHS) and multiple chemical sensitivity (MCS) and their association in the framework of a unique, sensitivity-related environmental neurologic syndrome. Eligibility criteria are those of the Atlanta consensus meeting for MCS, and those of WHO for EHS. There were 1428 EHS, 85 MCS and 505 EHS/MCS evaluable cases, so EHS was associated with MCS in 25%. Women appeared to be much more susceptible to EHS and/or to MCS than men, with no statistical significance between the EHS and MCS groups (p = 0.07), but the combined group revealed a more significant female sex ratio of 80.4% (p < 0.0001). All symptoms except emotional behavior were significantly more frequent in EHS patients than in healthy controls (p < 0.0001). We found no pathognomonic symptoms to establish the diagnosis of both disorders or to distinguish EHS from MCS. The three groups of patients were found to share identical symptoms, while several symptoms were found to be more significantly frequent in EHS/MCS than in EHS (p < 0.0001). From these data, we suggest that EHS and MCS are new brain disorders, generated via a common etiopathogenic mechanism.

Functional Somatic Syndromes Are Associated With Varied Postoperative Outcomes and Increased Opioid Use After Spine Surgery: A Systematic Review.

Systematic Review. To perform a systematic review assessing the relationship between functional somatic syndromes (FSSs) and clinical outcomes after spine surgery. A systematic review of online databases (PubMed and Web of Science) through December 2021 was conducted via PRISMA guidelines to identify all studies investigating the impact of at least one FSS (fibromyalgia, irritable bowel syndrome (IBS), chronic headaches/migraines, interstitial cystitis, chronic fatigue syndrome, multiple chemical sensitivity) on outcomes after spine surgery. Outcomes of interest included patient reported outcome measures (PROMs), postoperative opioid use, cost of care, complications, and readmission rates. A total of 207 records were identified. Seven studies (n = 40,011 patients) met inclusion criteria with a mean MINORS score of 16.6 out of 24. Four studies (n = 21,086) reported postoperative opioid use; fibromyalgia was a strong risk factor for long-term opioid use after surgery whereas the association with chronic migraines remains unclear. Two studies (n = 233) reported postoperative patient reported outcome measures (PROMs) with mixed results suggesting a possible association between fibromyalgia and less favorable PROMs. One study (n = 18,692) reported higher postoperative complications in patients with fibromyalgia. Patients with fibromyalgia and possibly migraines are at higher risk for prolonged postoperative opioid use and less favorable PROMs after spine surgery. There is limited research on the relationship between other Functional somatic syndromes (FSSs) and outcomes following spine surgery. Growing evidence suggests the variation in outcomes after spine procedures may be attributed to non-identifiable organic patient factors such as FSSs.

Are Sexual Assaults Related to Functional Somatic Disorders? A Cross-Sectional Study.

An increasing number of sexual assaults (SAs) are being reported. This study investigated associations between SA and FSD, conceptualized as bodily distress syndrome (BDS), and five functional somatic syndromes (FSSs): chronic widespread pain (CWP), irritable bowel (IB), chronic fatigue (CF), multiple chemical sensitivity (MCS), and whiplash-associated disorder (WAD). Participants (n = 7493) from the population-based cohort Danish Study of Functional Disorders (DanFunD) completed questionnaires on FSD, emotional distress, SA, and sociodemographics. Risk ratios (RRs) for each FSD and emotional distress were calculated in nine models with SA as the primary exposure using generalized linear models with binomial family and log link and were adjusted for other potential risk factors. The results showed that SA was associated with single-organ FSD (RR = 1.51; 95% CI = 1.22-1.87), multi-organ FSD (RR = 3.51; 95% CI = 1.89-6.49), CWP (RR = 1.28; 95% CI = 0.83-1.98), IB (RR = 2.00; 95% CI = 1.30-3.07), CF (RR = 1.81; 95% CI = 1.42-2.32), WAD (RR = 2.62; 95% CI = 1.37-5.03), MCS (RR = 3.04; 95% CI = 1.79-5.17), emotional distress (RR = 1.75; 95% CI = 1.21-2.54), and health anxiety (RR = 1.65; 95% CI = 1.10-2.46). Overall, SA victims experienced significantly more somatic symptoms than individuals not exposed to SA. Adjusting for physical and emotional abuse did not change the observed associations. Our results suggest a large impact of SA on the overall somatic and mental health of SA victims. Due to the cross-sectional study design, further studies are required.

National representative prevalence survey on idiopathic environmental intolerance attributed to electromagnetic fields in Taiwan

National representative prevalence survey on idiopathic environmental intolerance attributed to electromagnetic fields in Taiwan

Prospective study on health status of patients with idiopathic environmental intolerance attributed to electromagnetic fields after a provocation test

Prospective study on health status of patients with idiopathic environmental intolerance attributed to electromagnetic fields after a provocation test

Multiple Chemical Sensitivity/Idiopathic Environmental Intolerance: A Practical Approach to Diagnosis and Management

Patients with multiple chemical sensitivity, now called idiopathic environmental intolerance, frequently present to clinical immunologists and allergists for diagnosis and treatment. Patients report a plethora of respiratory and multisystem problems attributed to a wide variety of unrelated, otherwise non-noxious, triggers. They may go to extreme, often seemingly bizarre lengths to avoid contact with everyday exposures and may become housebound, unable to work or function socially. Often beginning with exposure to odors, triggers can multiply to involve foods, clothing, medications, and even electromagnetic radiation. The condition cannot be explained by IgE-mediated or other immune processes, and clinical immunologists and allergists may feel unprepared to care for such patients. In this article, a paradigm to understand the probable mechanisms underlying this condition and a practical approach to diagnosis and management will be presented.

Multiple chemical sensitivity scoping review protocol: overview of research and MCS construct

IntroductionMultiple chemical sensitivity (MCS) has been characterised by reported adverse responses to environmental exposures of common chemical agents (eg, perfumes, paint, cleaning products and other inhaled or ingested agents) in...

Sick building syndrome and its impacts on health, well-being and productivity: A systematic literature review

People’s well-being, health and productivity in indoor environments are crucial areas of investigation, particularly concerning sick building syndrome (SBS). Sick building syndrome encompasses symptoms resulting from exposure to harmful factors associated with building use. Headaches, fatigue, malaise and nausea are amongst the complaints associated with SBS. A literature review was conducted, examining studies from Scopus and Web of Science to identify the major impacts of SBS on health, well-being and productivity. Out of 3601 initially identified articles, 134 were analyzed after applying predefined criteria. Three research questions (RQs) were formulated, leading to the following findings: (i) most studies focused on offices (35.48%), highlighting common respiratory symptoms that range from mild to severe based on individual sensitivity, indoor conditions and predictive factors; (ii) indoor air quality (IAQ) emerged as the primary factor influencing SBS, especially within the post-pandemic context. Increasing air circulation and ventilation are viable alternatives to enhance IAQ. (iii) Understanding SBS proves complex, with indications of potentially higher symptom frequencies in women due to historical factors, social roles, lower cold tolerance, limited understanding of female physiology and multiple chemical sensitivity.

Prevalence and correlation of multiple chemical sensitivity and electromagnetic hypersensitivity with age, sex, and depression in the Japanese population: a retrospective study

BackgroundIn Japan, there are currently no definitive conclusions regarding the characteristics of multiple chemical sensitivity (MCS) and electromagnetic hypersensitivity (EHS). This study aimed to determine the prevalence and correlation of MCS and EHS with age, sex, and depression in the Japanese population.MethodsAn anonymous self-report questionnaire was distributed to 2,007 participants. Variables such as MCS, EHS, depression score, and demographic characteristics were individually evaluated using the U-test, chi-squared test, and correlation analyses. Moreover, we performed a covariance structure analysis to build a structural equation model.ResultsOlder individuals and women were more likely to exhibit MCS and EHS symptoms. Moreover, depression was correlated with MCS and EHS.ConclusionsAlthough MCS and EHS are strongly correlated, they exhibit distinct characteristics and symptoms, indicating that they can be regarded as separate conditions.

Factors affecting multiple chemical sensitivity (MCS) in newly constructed apartments of Indonesia

In Indonesia, sick building syndrome (SBS) and related health problems possibly caused by chemicals are suspected among residents in newly constructed urban houses, in which modern building materials are used without sufficient material standards and the minimum ventilation rates. This paper analyzes the causal relationships of factors affecting multiple chemical sensitivity (MCS) in urban houses in Indonesia. The measured IAQ data from three major cities of Indonesia (n = 207) were calibrated, and a structural equation modeling (SEM) was performed to identify the factors affecting MCS from a questionnaire survey in apartments and Kampong (n = 896). The results showed that the respondents living in a higher concentration of either formaldehyde or TVOC tended to have higher MCS risk, especially in the apartments. Overall, the apartments exhibited poor air quality rates, with the average maximum values of 0.172 ppm formaldehyde and 1.64 mg/m3 TVOC, potentially resulting in allergic problems and MCS risk among residents. In Kampongs, the building age was observed to increase the dampness, thereafter possibly causing allergies and MCS among residents. The results of this study implied that higher MCS in the apartments was majorly affected not only by their allergic conditions but also by additional factors concerning building attributes and occupant behavior.

Imbalanced brain connectome: A possible link behind functional somatic disorders, multiple chemical sensitivity, and long COVID patients

Imbalanced brain connectome: A possible link behind functional somatic disorders, multiple chemical sensitivity, and long COVID patients

Comparison of environmental intolerances and symptoms between patients with multiple chemical sensitivity, subjects with self-reported electromagnetic hypersensitivity, patients with bronchial asthma, and the general population

BackgroundEnvironmental hypersensitivity/intolerance is considered closely related to allergic diseases. To understand these conditions, the environmental intolerances and symptoms of patients with multiple chemical sensitivity (MCS), subjects with self-reported electromagnetic hypersensitivity (EHS), patients with bronchial asthma (BA), and the general population were compared using universal questionnaires.MethodsA survey was conducted from 2012 to 2015. The subjects were categorized in four groups: 111 patients with physician-diagnosed MCS, 119 subjects with self-reported EHS, patients with 98 physician-diagnosed BA, and 619 controls from general population. The Quick Environmental Exposure and Sensitivity Inventory and EHS questionnaire were used. The differences between the questionnaire scores among the four groups were tested using logistic regression analyses adjusted for age and gender as covariates.ResultsThe MCS and EHS groups had significantly high scores of intolerances to multiple environmental factors, life impact, and multiple symptoms than the BA and control groups. Although the differences between most of these scores of the MCS and EHS groups were not significant, the electromagnetic hypersensitivity reaction was significantly higher in the EHS group than in the MCS group. In addition, the scores for intolerances to chemicals and other compounds, life impact, and several symptoms of the BA group were significantly higher than those of the control group.ConclusionsThis study clarified the similarities and differences of the environmental intolerances and symptoms between the four groups.

Laboratory Test Results in Patients with Workplace Moisture Damage Associated Symptoms—The SAMDAW Study

The mechanisms of health effects of moisture damage (MD) are unclear, but inflammatory responses have been suspected. The usefulness of laboratory and allergy tests among patients in secondary healthcare with symptoms associated with workplace MD were examined. Full blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), total serum immunoglobulin E (IgE), fractional exhaled nitric oxide (FeNO), and skin prick testing were assessed and analyzed in relation to multiple chemical sensitivity (MCS) and perceived stress in 99 patients and 48 controls. In analysis, t-tests, Mann-Whitney tests, and chi-squared tests were used. Minor clinically insignificant differences in blood counts were seen in patients and controls, but among patients with asthma an elevated neutrophil count was found in 19% with and only in 2% of patients without asthma (p = 0.003). CRP levels and ESR were low, and the study patients' FeNO, total IgE, or allergic sensitization were not increased compared to controls. The level of stress was high among 26% of patients and 6% of controls (p = 0.005), and MCS was more common among patients (39% vs. 10%, p < 0.001). Stress or MCS were not significantly associated with laboratory test results. In conclusion, no basic laboratory or allergy test results were characteristic of this patient group, and neither inflammatory processes nor allergic sensitization were found to explain the symptoms among these patients. While the value of basic laboratory tests should not be ignored, the use of allergy tests does not seem necessary when symptoms are indicated to be workplace-related.

Social economic factors and the risk of multiple chemical sensitivity in a Danish population-based cross-sectional study: Danish Study of Functional Disorders (DanFunD)

ObjectivesMultiple chemical sensitivity (MCS) is a rare multisystem and poly-symptomatic disease characterised by a report of various somatic symptoms attributed to inhalation of volatile chemicals in usually harmless doses. The...

Anesthesia in patients with multiple chemical sensitivity: current understanding

Multiple Chemical Sensitivity (MCS) is a pathological condition that we do not yet have a clear understanding of from an etiological and clinical point of view. The underlying mechanisms of the disorder are still being investigated and the most frequently reported symptoms by patients are malaise, fatigue, headache, arthralgia, insomnia and dermatitis. Although this condition may entail a real risk of the occurrence of adverse reactions following exposure to many substances, often inhaled, or the taking of drugs, medical/scientific literature provides only a little information regarding the safest course of action to be taken when patients affected by MCS need to undergo anesthesia. It is for this reason that an electronic search of existing literature has been made, using PubMed and Scopus as a primary source, in order to find articles about patients affected by MCS and who have undergone anesthesia. The time frame considered was January 2000–December 2022. The research showed only 13 articles that dealt with anesthesia in patients with multiple chemical sensitivity in the years in question. Only 6 works, all case reports, describe the drugs used to perform anesthesia. Five cases were for general anesthesia and one was a case of subarachnoid block. No major complications related to anesthesiological practice were reported in any of the cases. The limited data does not enable the identification of anesthesiological practice and anesthetic drugs that can be used more safely in MCS patients, but the absence of serious adverse reactions in the case reports described, and in the literature in general, is reasonably reassuring about the possibility of anesthesia in MCS patients without causing serious complications by implementing easily achievable measures.

Systemic Management Using Intravenous Sedation in a Patient with Multiple Chemical Sensitivities and Dentophobia

Systemic Management Using Intravenous Sedation in a Patient with Multiple Chemical Sensitivities and Dentophobia

Multiple Chemical Sensitivity Syndrome: First Symptoms and Evolution of the Clinical Picture: Case-Control Study/Epidemiological Case-Control Study

Multiple chemical sensitivity (MCS) is a chronic condition characterized by the appearance of symptoms caused by exposure to chemical compounds that are tolerable for the general population. It mainly affects middle-aged women. There are very few studies focusing on the most frequent symptoms of MCS considering age groups and gender. The main goal of this study was to find the most frequent symptoms both at the onset of the disease and at the present time describing them by age groups. The QEESI (Quick Environmental Exposure and Sensitivity Inventory) questionnaire, Scale 3 which assesses symptoms and their severity, was used as a diagnostic tool for the disease. A case-control study was conducted with the participation of 210 people. Of the cases, 94.3% were women. The symptoms that most often manifested first were airway and mucous membrane alterations (68.9%). In the development of the disease, we found cognitive alterations (OR = 31.25), heart or chest problems (OR = 22.49), neuromuscular problems (OR = 20.00) and head-related symptomatology (OR = 19.29). Identifying the most frequent pattern of symptoms by age group and sex will allow an early diagnosis of the disease to improve its prognosis and treatment.

Undertreatment with Osimertinib in patient with multiple chemical sensitivity. A case report.

Multiple chemical sensitivity (MCS), is a syndrome characterised by increased sensitivity to the exposure of environmental chemicals (1). There are considerable difficulties in reaching a good estimate of the prevalence of disease and the main pathogenetic hypotheses take into account both the organic and psychiatric/psychological factors. Treatment with epidermal growth factor tyrosine kinase receptor inhibitors (tkis), like Osimertinib, results in improved progression-free survival (PFS) compared to chemotherapy, in Non-small-cell lung carcinoma (NSCLC) with epidermal growth factor receptor (EGFR) mutation (2). We describe the case of a 74 year old woman with history of MCS and fibromyalgia in treatment with Osimertinib for EGFR-mutated NSCLC. Patient initially refused any form of active therapy for lung cancer, but thanks to teamwork and the important support of the psychologist, the patient decided to start treatment with Osimertinib at a reduced dose, not 80 mg but 40 mg. Subsequently, after few days , of his own free will and without informing the staff physicians, the patient changed the treatment schedule by taking one quarter of the dose of the medicine every other day, justifying this choice in therapeutic modification because of her fear and intolerance to any type of medicine and/ or chemical substance, being influenced by MCS. Despite the changes in the treatment plan, a PET scan performed after two months showed a sigificative lung response and the stability of bone metastases. Discussion. Our case describes a significative response with Osimertinib despite the change in dosage and schedule in a patient with MCS. Our experience deserves to be considered in the light of its particularity and uniqueness as it shows an excellent response to treatment with Osimertinib despite the change made to the dosage and schedule, in a patient presenting in her medical history this rare pathological condition: MCS syndrome.

Association between infections and functional somatic disorders: a cross-sectional population-based cohort study

ObjectivesIt has been suggested that infections can trigger functional somatic disorders (FSD). However, current evidence is limited by inconsistent findings in smaller studies conducted in clinical settings within selected populations...

Measurement of benzene, toluene, xylene in small biological samples by syringe equilibrium / headspace gas chromatography

Background: Benzene, toluene, and xylene (BTX) are ubiquitous in the community environment. However, workers who handle them are concerned about adverse effects such as neurotoxicity and carcinogenicity. On the other hand, recently, in a general indoor environment, low-concentration BTX exposure due to release from a house has attracted attention as a cause of sick building syndrome and multiple chemical sensitivity. In order to understand the exposure status of BTX, it is effective to measure the unchanged BTX in biological samples such as blood and urine. However, the burden on the subject when collecting samples cannot be ignored. Method: To generalize BTX measurement of biological samples in the field, the author has developed a syringe equilibrium / headspace gas chromatography using a small amount of biological sample and Portable GC and analytical accuracy was tested. Also, considering the case of bringing small samples back to the laboratory for analysis, ways to store biological samples containing BTX for extended periods of time was determined. And BTX contamination survey of newly built condominiums was conducted to verify the practicality. Result: The reproducibility of syringe equilibrium / headspace gas chromatography with standard -added blood. In all BTX, the relative standard deviation was found to be within 10%, and according to the internal standard method, the relative standard deviation was found to be within 5%. BTX contamination survey of newly built condominiums completed successfully. Benzene and toluene were detected in the urine of the resident, but only toluene was detected indoors. Conclusion: This method and the use of a portable GC with a photoionization detector enable assessment from microexposure in the living environment to occupational exposure levels with 50 μl microblood, reducing the burden on the subject. In addition, a long-term storage method of biological samples containing BTX, was developed to consider the case of bringing small samples back to the laboratory for analysis.