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State of the Art: Multiple Chemical Sensitivity

  • Michael Lacour
  • Klaus Schmidtke
  • Peter Vaith
  • Carl Scheidt
Part of the Allergy Frontiers book series (ALLERGY, volume 4)

The ‘multiple chemical sensitivity syndrome’ (MCS) is defined descriptively as a (1) chronic condition (2) with symptoms that recur reproducibly (3) in multiple organ systems (4) in response to low levels of exposures (5) to multiple unrelated chemicals and which (6) improve or are resolved when incitants are removed. Patients' symptom profiles indicate that two different symptom clusters exist with predominant ‘central’, to the central nervous system (CNS)-related, and ‘peripheral’, mucosa-associated chemical sensitivities. The latter is identical with occupational rhinitis and asthma. Thus, an MCS diagnosis should only be made in cases with predominant exposure-related, non-specific complaints of the CNS. Our understanding of the aetiology and pathogenesis of MCS is still incomplete. There is sufficient evidence that psychological, but not neurophysiologic or biological factors contribute to the induction and perpetuation of MCS. There are no specific laboratory tests to establish an MCS diagnosis. Differential diagnostic procedures encompass a clarification analogous to chronic fatigue syndrome (CFS) standards, evaluation of additional symptoms and a psychiatric evaluation. At present, no evidence-based treatment options exist.

Keywords

Chronic Fatigue Syndrome Chemical Sensitivity Vanilloid Receptor Multiple Chemical Sensitivity Occupational Rhinitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Randolph T (1954) Allergic-type reactions to industrial solvents and liquid fuels; mosquito abatement fogs and mists; motor exhaust; indoor utility gas and oil fumes; chemical additives of food and drugs; and synthetic drugs and cosmetics. J Lab Clin Med 44:910–922Google Scholar
  2. 2.
    Rea WJ, Bell IR, Suits CW, Smiley RE (1978) Food and chemical susceptibility after environmental chemical overexposure: case histories. Ann Allergy 41:101–109PubMedGoogle Scholar
  3. 3.
    Cullen MR (1987a) The worker with multiple chemical sensitivities: an overview. Occup Med 2:655–661Google Scholar
  4. 4.
    Cullen MR (1987b) Multiple chemical sensitivities summary and directions for future investigators. Occup Med 2:801–804Google Scholar
  5. 5.
    American Academy of Allergy, Asthma and Immunology (AAAAI) Board of Directors (1999) Idiopathic environmental intolerances. J Allergy Clin Immunol 103:36–40CrossRefGoogle Scholar
  6. 6.
    American College of Occupational and Environmental Medicine (ACOEM) Position Statement (1999) Multiple chemical sensitivities: idiopathic environmental intolerance. College of Occupational and Environmental Medicine. J Occup Environ Med 41:940–942CrossRefGoogle Scholar
  7. 7.
    Bolt H, Kiesswetter E (2002) Is multiple chemical sensitivity a clinically defined entity? Toxicol Lett 128:99–106PubMedCrossRefGoogle Scholar
  8. 8.
    Staudenmayer H (2001) Idiopathic environmental intolerance (IEI): myth and reality. Toxicol Lett 120:333–342PubMedCrossRefGoogle Scholar
  9. 9.
    Caress SM, Steinemann AC (2004) A national population study of the prevalence of multiple chemical sensitivity. Arch Environ Health 59:300–305PubMedGoogle Scholar
  10. 10.
    Caress SM, Steinemann AC (2004) Prevalence of multiple chemical sensitivities: a population-based study in the southeastern United States. Am J Public Health 94:746–747PubMedCrossRefGoogle Scholar
  11. 11.
    Kreutzer R, Neutra RR, Lashuay N (1999) Prevalence of people reporting sensitivities to chemicals in a population-based survey. Am J Epidemiol 150:1–12PubMedGoogle Scholar
  12. 12.
    Meggs WJ, Dunn KA, Bloch RM, Goodman PE, Davidoff AL (1996) Prevalence and nature of allergy and chemical sensitivity in a general population. Arch Environ Health 51:275–282PubMedGoogle Scholar
  13. 13.
    Thomas HV, Stimpson NJ, Weightman AL, Dunstan F, Lewis G (2006) Systematic review of multi-symptom conditions in Gulf War veterans. Psychol Med 36:735–747PubMedCrossRefGoogle Scholar
  14. 14.
    Black DW, Doebbeling BN, Voelker MD, Clarke WR, Woolson RF, Barrett DH, Schwartz DA (2000) Multiple chemical sensitivity syndrome: symptom prevalence and risk factors in a military population. Arch Intern Med 160:1169–1176PubMedCrossRefGoogle Scholar
  15. 15.
    Gray GC, Reed RJ, Kaiser KS, Smith TC, Gastanaga VM (2002) Self-reported symptoms and medical conditions among 11,868 Gulf War-era veterans. The Seabee Health Study. Am J Epidemiol 155:1033–1044CrossRefGoogle Scholar
  16. 16.
    Hausteiner C, Bornschein S, Hansen J, Zilker T, Forstl H (2005) Self-reported chemical sensitivity in Germany: a population-based survey. Int J Hyg Environ Health 208:271–278PubMedCrossRefGoogle Scholar
  17. 17.
    Ziem GE (1999) Profile of patients with chemical injury and sensitivity, part II. Int J Toxicol 18:401–409CrossRefGoogle Scholar
  18. 18.
    Caress SM, Steinemann A, Waddick C (2002) Symptomatology and etiology of multiple chemical sensitivities in the southeastern United States. Arch Environ Health 57:429–436PubMedGoogle Scholar
  19. 19.
    Davidoff AL, Keyl PM (1996) Symptoms and health status in individuals with multiple chemical sensitivities syndrome from four reported sensitizing exposures and a general population comparison group. Arch Environ Health 51:201–213PubMedGoogle Scholar
  20. 20.
    Miller CS, Gammage RB, Jankovic JT (1999) Exacerbation of chemical sensitivity: a case study. Toxicol Ind Health 15:398–402PubMedGoogle Scholar
  21. 21.
    Ray DE (2000) Pesticide neurotoxicity in Europe: real risks and perceived risks. Neurotoxicology 21:219–221PubMedGoogle Scholar
  22. 22.
    Redlick CA, Sparer J, Cullen MR (1997) Building syndrome. Lancet 349:1013–1016CrossRefGoogle Scholar
  23. 23.
    Saito M, Kumano H, Yoshiuchi K, Kokubo N, Ohashi K, Yamamoto Y, Shinohara N, Yanagisawa Y, Sakabe K, Miyata M, Ishikawa S, Kuboki T (2005) Symptom profile of multiple chemical sensitivity in actual life. Psychosom Med 67:318–325PubMedCrossRefGoogle Scholar
  24. 24.
    Caress SM, Steinemann AC (2003) A review of two-phase population study of multiple chemical sensitivities. Environ Health Perspect 111:1490–1497PubMedGoogle Scholar
  25. 25.
    Gronseth GS (2005) Gulf war syndrome: a toxic exposure? A systematic review. Neurol Clin 23:523–540PubMedCrossRefGoogle Scholar
  26. 26.
    Horn O, Hull L, Jones M, Murphy D, Browne T, Fear NT, Hotopf M, Rona RJ, Wessely S (2006) Is there an Iraq war syndrome? Comparison of the health of UK service personnel after Gulf an Iraq wars. Lancet 367:1742–1746PubMedCrossRefGoogle Scholar
  27. 27.
    Barnes JG (2001) ‘Sensitivity syndromes’ related to radiation exposures. Med Hypotheses 57:453–458PubMedCrossRefGoogle Scholar
  28. 28.
    Bell IR, Hardin EE, Baldwin CM, Schwartz GE (1995) Increased limbic system symptomatology and sensitizability of young adults with chemical and noise sensitivities. Environ Res 70:84–97PubMedCrossRefGoogle Scholar
  29. 29.
    Levallois P (2002) Hypersensitivity of human subjects to environmental electric and magnetic field exposure: a review of the literature. Environ Health Perspect 110 (Suppl. 4):613–618PubMedGoogle Scholar
  30. 30.
    International Programme on Chemical Safety/World Health Organization (IPCS/WHO) (1996) Conclusions and recommendations of a workshop on multiple chemical sensitivities (MCS). Regul Toxicol Pharmacol 24:S188–S189CrossRefGoogle Scholar
  31. 31.
    Dalton P, Hummel T (2000) Chemosensory function and response in idiopathic environmental intolerance. Occup Med 15:539–556PubMedGoogle Scholar
  32. 32.
    Joffres MR, Williams T, Sabo B, Fox RA (2001) Environmental sensitivities: prevalence of major symptoms in a referral center: the Nova Scotia Environmental Sensitivities Research Center Study. Environ Health Perspect 109:161–165PubMedCrossRefGoogle Scholar
  33. 33.
    Lacour M, Zunder T, Schmidtke K, Vaith P, Scheidt C (2005) Multiple Chemical Sensitivity Syndrome (MCS) – suggestion for an extension of the US MCS-case definition. Int J Hyg Environ Health 208:141–151PubMedCrossRefGoogle Scholar
  34. 34.
    Black DW, Rathe A, Goldstein RB (1990) Environmental illness. A controlled study of 26 subjects with ‘20th century disease’. JAMA 264:3166–3170PubMedCrossRefGoogle Scholar
  35. 35.
    Black DW, Okiishi C, Schlosser S (2000) A nine-year follow-up of people diagnosed with multiple chemical sensitivities. Psychosomatics 41:253–261PubMedCrossRefGoogle Scholar
  36. 36.
    Buchwald D, Garrity D (1994) Comparison of patients with chronic fatigue syndrome, fibro-myalgia, and multiple chemical sensitivities. Arch Intern Med 154:2049–2053PubMedCrossRefGoogle Scholar
  37. 37.
    Lax MB, Henneberger PK (1995) Patients with multiple chemical sensitivities in an occupational health clinic: presentation and follow-up. Arch Environ Health 50:425–431PubMedGoogle Scholar
  38. 38.
    Lohmann K, Prohl A, Schwarz E (1996) Multiple chemical sensitivity disorder in patients with neurotoxic illnesses [German]. Gesundheitswesen 58:322–331PubMedGoogle Scholar
  39. 39.
    Maschewsky W, Oppl N (2000) Psychic disturbed or occupational-related sick? Multiple Chemical Sensitivity (MCS), Solvent-Syndrome and Bk 1317. Impressum, Düsseldorf (Germany)Google Scholar
  40. 40.
    McKeown-Eyssen GE, Sokoloff ER, Jazmaji V, Marshall LM, Baines CJ (2000) Reproduci-bility of the University of Toronto self-administered questionnaire used to assess environmental sensitivity. Am J Epidemiol 151:1216–1222PubMedGoogle Scholar
  41. 41.
    Miller CS, Mitzel HC (1995) Chemical sensitivity attributed to pesticide exposure versus remodeling. Arch Environ Health 50:119–129PubMedGoogle Scholar
  42. 42.
    Miller CS, Prihoda TJ (2000) A controlled comparison of symptoms and chemical intolerances reported by Gulf War veterans, implant recipients and persons with multiple chemical sensitivity [German]. Umwelt Medizin Gesellschaft 13:119–133Google Scholar
  43. 43.
    Ziem G, McTamney J (1997) Profile of patients with chemical injury and sensitivity. Environ Health Perspect 105 (Suppl. 2):417–436PubMedCrossRefGoogle Scholar
  44. 44.
    Labarge AS, McCaffrey RJ (2000) Multiple chemical sensitivity: a review of theoretical and research literature. Neuropsychol Rev 10:183–211PubMedCrossRefGoogle Scholar
  45. 45.
    Lenzoff A, Binkley KE (2000) Idiopathic environmental intolerance: results of challenge studies. Occup Med 15:529–537Google Scholar
  46. 46.
    Osterberg K, Orbaek P, Karlson B (2002) Neuropsychological test performance of Swedish multiple chemical sensitivity patients—an exploratory study. Appl Neuropsychol 9:139–147PubMedCrossRefGoogle Scholar
  47. 47.
    Salamon R, Verret C, Jutand MA, Begassat M, Laoudj F, Conso F, Brochard P (2006) Health consequences of the first Persian Gulf War on French troops. Int J Epidemiol 35:479–487PubMedCrossRefGoogle Scholar
  48. 48.
    Simmons R, Maconochie N, Doyl P (2004) Self-reported ill health in male UK Gulf War veterans: a retrospective cohort study. BMC Public Health 4:27PubMedCrossRefGoogle Scholar
  49. 49.
    Haley RW, Kurt TM, Hom J (1997) Is there a Gulf War syndrome? Searching for syndromes by factor analysis of symptoms. JAMA 277:215–222PubMedCrossRefGoogle Scholar
  50. 50.
    Kang HK, Mahan CM, Lee KY, Murphy FM, Simmens SJ, Young HA, Levine PH (2002) Evidence for a deployment-related Gulf War syndrome by factor analysis. Arch Environ Health 57:61–68PubMedGoogle Scholar
  51. 51.
    Everitt B, Ismail K, David AS, Wessely S (2002) Searching for a Gulf War syndrome using cluster analysis. Psychol Med 32:1371–1378PubMedCrossRefGoogle Scholar
  52. 52.
    Shapiro SE, Lasarev MR, McCauley L (2002) Factor analysis of Gulf War illness: what does it add to our understanding of possible health effects of deployment? Am J Epidemiol 156:578–585PubMedCrossRefGoogle Scholar
  53. 53.
    Aaron LA, Buchwald D (2001) A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med 134:868–881PubMedGoogle Scholar
  54. 54.
    Jason LA, Taylor RR, Kennedy CL (2000) Chronic fatigue syndrome, fibromyalgia, and multiple chemical sensitivities in a community-based sample of persons with chronic fatigue syndrome-like symptoms. Psychosom Med 62:655–663PubMedGoogle Scholar
  55. 55.
    Fukuda K, Nisenbaum R, Stewart G, Thompson WW, Robin L, Washko RM, Noah DL, Barett DH, Randall B, Herwaldt BL, Mawle AC, Reeves WC (1999) Chronic multisymptom illness affecting Air Force veterans of the Gulf War. JAMA 280:981–988CrossRefGoogle Scholar
  56. 56.
    Joffres MR, Sampalli T, Fox RA (2005) Physiologic and symptomatic responses to low-level substances in individuals with and without chemical sensitivities: a randomized controlled blinded pilot booth study. Environ Health Perspect 113:1178–1183PubMedGoogle Scholar
  57. 57.
    Caress SM, Steinemann AC (2005) National prevalence of asthma and chemical hypersensi-tivity: an examination of potential overlap. J Occup Environ Med 47:518–522PubMedCrossRefGoogle Scholar
  58. 58.
    Eberlein-Konig B, Przybilla B, Kuhnl P, Golling G, Gebefugi I, Ring J (2002) Multiple chemical sensitivity (MCS) and others: allergological, environmental and psychological investigations in individual with indoor air related complaints. Int J Hyg Environ Health 205:213–220PubMedCrossRefGoogle Scholar
  59. 59.
    Black DW, Doebbeling BN, Voelker MD, Clarke WR, Woolson RF, Barrett DH, Schwartz DA (1999) Quality of life and health-services utilization in a population-based sample of military personnel reporting multiple chemical sensitivities. J Occup Environ Med 41:928–933PubMedCrossRefGoogle Scholar
  60. 60.
    Hotopf M, David A, Hull L, Nikkalaou V, Unwin V, Wessely S (2004) Risk factors for continued illness among Gulf War veterans: a cohort study. Psychol Med 34:747–754PubMedCrossRefGoogle Scholar
  61. 61.
    American Medical Association (AMA) (1992) Council on Scientific Affaires Report: clinical ecology. JAMA 268:3465–3467CrossRefGoogle Scholar
  62. 62.
    Fiedler N, Kipen H (1997) Chemical sensitivity: the scientific literature. Environ Health Perspect 105 (Suppl. 2):409–415PubMedCrossRefGoogle Scholar
  63. 63.
    Graveling RA, Pilkington A, George JP, Tannahill SN (1999) A review of multiple chemical sensitivity. J Occup Environ Med 56:73–85CrossRefGoogle Scholar
  64. 64.
    Black DW (2000) The relationship of mental disorders and idiopathic environmental intolerance. Occup Med 15:557–570PubMedGoogle Scholar
  65. 65.
    Kamel F, Hoppin JA (2004) Association of pesticide exposure with neurologic dysfunction and disease. Environ Health Perspect 112:950–958PubMedGoogle Scholar
  66. 66.
    Bascom R, Meggs WJ (1997) Neurogenic inflammation: with additional discussion of central and perceptual integration of nonneurogenic inflammation. Environ Health Perspect 105 (Suppl. 2):531–537PubMedCrossRefGoogle Scholar
  67. 67.
    Meggs WJ (1999) Mechanisms of allergy and chemical sensitivity. Toxicol Ind Health 15:331–338PubMedGoogle Scholar
  68. 68.
    Bachert C (2004) Persistent rhinitis — allergic or nonallergic? Allergy 59 (Suppl. 76):11–15PubMedCrossRefGoogle Scholar
  69. 69.
    Slavin RG (2003) Occupational rhinitis. Ann Allergy Asthma Immunol 90:2–6PubMedGoogle Scholar
  70. 70.
    Abou-Donia MB (2003) Organophosphorus ester-induced chronic neurotoxicity. Arch Environ Health 58:484–497PubMedCrossRefGoogle Scholar
  71. 71.
    Ismail K, Lewis G (2006) Multi-symptom illnesses, unexplained illness and Gulf War Syndrome. Philos Trans R Soc Lond B Biol Sci 361:543–551PubMedCrossRefGoogle Scholar
  72. 72.
    Haley RW, Gordon LD, Frederick P (2001) Use of structural equation modeling to test the construct of a case definition of Gulf War syndrome: Invariance over developmental and validation samples, service branches and publicity. Psychiatr Res 102:175–200CrossRefGoogle Scholar
  73. 73.
    Agency for Toxic Substances and Disease Registry (ATSDR) (2001) A quick guide to evaluating environmental exposures. Centers for Disease Control and Prevention. ATSDR, AtlantaGoogle Scholar
  74. 74.
    Staudenmayer H, Binkley KE, Leznoff A, Philips S (2003) Idiopathic Environmental Intolerance. Part 1: a causation analysis applying Bradford Hill's criteria to the toxicogenic theory. Toxicol Rev 22:235–246PubMedCrossRefGoogle Scholar
  75. 75.
    Gonzalez FJ (1998) The study of xenobiotic-metabolizing enzymes and their role in toxicity in vivo using targeted gene disruption. Toxicol Lett 102–103:161–166PubMedCrossRefGoogle Scholar
  76. 76.
    West WL, Knight EM, Paradhan S, Hinds TS (1997) Interpatient variability: genetic predisposition and other genetic factors. J Clin Pharmacol 37:635–648PubMedGoogle Scholar
  77. 77.
    McKeown-Eyssen G, Baines C, Cole DE, Riley N, Tyndale RF, Marshall L, Jazmaji V (2004) Case-control study of genotypes in multiple chemical sensitivity: CYP2D6, NAT1, NAT2, PON1, PON2 and MTHFR. Int J Epidemiol 33:971–978PubMedCrossRefGoogle Scholar
  78. 78.
    Pall ML (2003) Elevated nitric oxide/peroxynitrite theory of multiple chemical sensitivity: central role of N-methyl-D-aspartate receptors in the sensitivity mechanism. Environ Health Perspect 111:1461–1464PubMedGoogle Scholar
  79. 79.
    Schnakenberg E, Fabig K-R, Stanulla M, Strobl N, Lustig M, Fabig N, Schloot W (2007) A cross-sectional study of self-reported chemical-related sensitivity is associated with gene variants of drug-metabolizing enzymes. Environ Health 6:6PubMedCrossRefGoogle Scholar
  80. 80.
    Rea WJ (1988) Chemical hypersensitivity and the allergic response. Ear Nose Throat J 67:50–56PubMedGoogle Scholar
  81. 81.
    Polosa R, Salvi S, Di Maria GU (2002) Allergic susceptibility associated with diesel exhaust particle exposure: clear as mud. Arch Environ Health 57:188–193PubMedGoogle Scholar
  82. 82.
    Shusterman D, Taru A, Murphy MA, Morris J (2005) Seasonal allergic rhinitis and normal subjects respond differentially to nasal provocation with acetic vapor. Inhal Toxicol 17:147–152PubMedCrossRefGoogle Scholar
  83. 83.
    Gautrin D, Desrosiers M, Castano R (2006) Occupational rhinitis. Curr Opin Allergy Clin Immunol 6:77–84PubMedGoogle Scholar
  84. 84.
    Arts JHE, Mommers C, de Heer C (2006) Dose-response relationships and threshold levels in skin and respiratory allergy. Crit Rev Toxicol 36:219–251PubMedCrossRefGoogle Scholar
  85. 85.
    Pall ML, Anderson JH (2004) The vanilloid receptor as a putative target of diverse chemicals in multiple chemical sensitivity. Arch Environ Health 59:363–375PubMedCrossRefGoogle Scholar
  86. 86.
    Bell IR, Patarca R, Baldwin CM, Klimas NG, Schwartz GE, Hardin EE (1998) Serum neopterin and somatization in women with chemical intolerance, depressives, and normals. Neuropsychobiology 38:13–18PubMedCrossRefGoogle Scholar
  87. 87.
    Kimata H (2004) Effect of exposure to volatile organic compounds on plasma levels of neuropeptides, nerve growth factor and histamine in patients with self-reported multiple chemical sensitivity. Int J Hyg Environ Health 207:159–163PubMedCrossRefGoogle Scholar
  88. 88.
    Pall ML (2001) Common etiology of posttraumatic stress disorder, fibromyalgia, chronic fatigue syndrome and multiple chemical sensitivity via elevated nitric oxide/peroxynitrite. Med Hypotheses 57:139–145PubMedCrossRefGoogle Scholar
  89. 89.
    Johansson A, Millqvist E, Nordin S, Bende M (2006) Relationship between self-reported odor intolerance and sensitivity to inhaled capsaicin: proposed definition of airway sensory hyper-reactivity and estimation of its prevalence. Chest 129:1623–1628PubMedCrossRefGoogle Scholar
  90. 90.
    Ternesten-Hasseus E, Bende M, Millqvist E (2002) Increased capsaicin cough sensitivity in patients with multiple chemical sensitivity. J Occup Environ Med 44:1012–1017PubMedCrossRefGoogle Scholar
  91. 91.
    Wiesmuller GA, Van Thriel C, Steup A, Bachert C, Clinic EN, Blaszkewicz M, Golka K, Kiesswetter E, Seeber A (2002) Nasal function in self-reported chemically intolerant individuals. Arch Environ Health 57:247–254PubMedGoogle Scholar
  92. 92.
    Mitchell CS, Donnay A, Hoover DR, Margolick JB (2000) Immunologic parameters of multiple chemical sensitivity. Occup Med 15:647–665PubMedGoogle Scholar
  93. 93.
    Baines CJ, McKeown-Eyssen GE, Riley N, Cole DEC, Marshall L, Loescher B, Jazmaji V (2004) Case-control study of multiple chemical sensitivity, comparing haematology, biochemistry, vitamins and serum volatile organic compounds measures. Occup Med 54:408–418CrossRefGoogle Scholar
  94. 94.
    Vojdani A, Thrasher JD (2004) Cellular and humoral immune abnormalities in Gulf War veterans. Environ Health Perspect 112:840–846PubMedGoogle Scholar
  95. 95.
    Staines D (2005) Do vasoactive neuropeptide autoimmune disorders explain pyridostigmine's association with Gulf War syndrome? Med Hypotheses 65:591–594PubMedCrossRefGoogle Scholar
  96. 96.
    Hoover DR, Donnay A, Mitchell CS, Ziem G, Rose NR, Sabath DE, Yurkow EJ, Nakamura R, Vogt RF, Waxdal M, Margolick JB (2003) Reproducibility of immunologi-cal tests used to assess multiple chemical sensitivity syndrome. Clin Diagn Lab Immunol 10:1029–1036.PubMedGoogle Scholar
  97. 97.
    Friedmann EM, Lawrence DA (2002) Environmental stress mediates changes in neuro-immunological interactions. Toxicol Sci 67:4–10Google Scholar
  98. 98.
    Ferguson E, Cassaday HJ (2001) Theoretical accounts of Gulf War Syndrome: from environmental toxins to psychoneuroimmunology and neurodegeneration. Behav Neurol 13:133–147PubMedGoogle Scholar
  99. 99.
    Carlsson F, Persson R, Osterberg B, Hansen K, Hansen AM, Garde AH, Orbaek P (2004) Salivary cortisol and self-reported stress among persons with environmental annoyance. Scand J Work Environ Health 32:109–120Google Scholar
  100. 100.
    Bell IR, Baldwin CM, Fernandez M, Schwartz GE (1999) Neural sensitization model for multiple chemical sensitivity: overview of theory and empirical evidence. Toxicol Ind Health 15:295–304PubMedGoogle Scholar
  101. 101.
    Brown-DeGagne AM, McGlone J (1999) Multiple chemical sensitivity: a test of the olfac-tory-limbic model. J Occup Environ Med 41:366–377PubMedCrossRefGoogle Scholar
  102. 102.
    Devriese S, Winters W, Stegen K, Van Diest I, Veulemans H, Nemery B, Eelen P, Van den Bergh O (2000) Generalization of acquired somatic symptoms in response to odors: a pav-lovian perspective on multiple chemical sensitivity. Psychosom Med 62:751–759PubMedGoogle Scholar
  103. 103.
    Giardino ND, Lehrer PM (2000) Behavioral conditioning and idiopathic environmental intolerance. Occup Med 15:519–528PubMedGoogle Scholar
  104. 104.
    Gralewicz S (1999) Organic solvents and time-dependent sensitisation. Int J Occup Med Environ Health 12:371–381PubMedGoogle Scholar
  105. 105.
    Siegel S (1999) Multiple chemical sensitivity as a conditional response. Toxicol Ind Health 15:323–330PubMedGoogle Scholar
  106. 106.
    Sorg BA (1999) Multiple chemical sensitivity: potential role for neural sensitisation. Crit Rev Neurobiol 13:283–316PubMedGoogle Scholar
  107. 107.
    Ursin H, Erikson HR (2001) Sensitization, subjective health complaints, and sustained arousal. Ann NY Acad Sci 933:119–129PubMedGoogle Scholar
  108. 108.
    Van den Bergh O, Stegen K, Van Diest I, Raes C, Stulens P, Eelen P, Veulemans H, Van de Woestijne KP, Nemery B (1999) Acquisition and extinction of somatic symptoms in response to odors: a pavlovian paradigm relevant to multiple chemical sensitivity. J Occup Environ Med 56:295–301CrossRefGoogle Scholar
  109. 109.
    Huang SM, Bisogno T, Trevisani M, Al-Hayani A, De Petrocellis L, Fezza F, Tognettor M, Petros TJ, Krey JF, Chu CJ, Miller JD, Davies SN, Gepetti P, Walker JM, Di Marzo V (2002) An endogenous capsaicin-like substance with high potency at recombinant and native vanil-loid VR1 receptors. Proc Natl Acad Sci USA 99:8400–8405PubMedCrossRefGoogle Scholar
  110. 110.
    Szallasi A (2002) Vanilloid (capsaicin) receptors in health and disease. Am J Clin Pathol 118:110–112PubMedCrossRefGoogle Scholar
  111. 111.
    Mezey E, Toth ZE, Cortright DN, Arzubi MK, Krause JE, Elde R, Guo A, Blumberg PM, Szallasi A (2000) Distribution of mRNA for vanilloid receptor subtype 1, and VR1-like immunoreactivity in the central nervous system of the rat and human. Proc Natl Acad Sci USA 97:3655–3660PubMedCrossRefGoogle Scholar
  112. 112.
    Szabo T, Biro T, Gonzalez AF, Palkovits M, Blumberg PM (2002) Pharmacological characterization of vanilloid receptor located in the brain. Brain Res Mol Brain Res 98:51–57PubMedCrossRefGoogle Scholar
  113. 113.
    Pall ML (2002) NMDA sensitization and stimulation by peroxynitrite, nitric oxide, and organic solvents as the mechanism of chemical sensitivity in multiple chemical sensitivity. FASEB J 16:1407–1417PubMedCrossRefGoogle Scholar
  114. 114.
    Haley RW, Marshall WW, McDonald GG, Daugherty MA, Petty F, Fleckenstein JL (2000) Brain abnormalities in Gulf War Syndrome: Evaluation with 1H MR spectroscopy. Neuroradiology 215:807–817Google Scholar
  115. 115.
    Burtscher IM, Stahlberg F, Holtas S (1997) MR spectroscopy for routine diagnostic evaluation of brain lesions. Acta Radiol 38:953–960PubMedGoogle Scholar
  116. 116.
    Haley RW, Fleckenstein JL, Marshall WW, McDonald GG, Kramer GL, Petty F (2000) Effect of basal ganglia injury on central dopamine activity in Gulf War syndrome. Arch Neurol 57:1280–1285PubMedCrossRefGoogle Scholar
  117. 117.
    Menon PM, Nasrallah HA, Reeves RR, Ali JA (2004) Hippocampal dysfunction in Gulf War Syndrome. A proton MR spectroscopy study. Brain Res 1009:189–194Google Scholar
  118. 118.
    Moorhead JF, Suruda AJ (2000) Occipital lobe meningioma in a patient with multiple chemical sensitivities. Am J Ind Med 37:443–446PubMedCrossRefGoogle Scholar
  119. 119.
    Bell IR, Bootzin RR, Ritenbaugh C, Wyatt JK, DeGiovanni G, Kulniovich T, Anthony JL, Kuo TF, Rider SP, Peterson JM, Schwartz GE, Johnson KA (1996) A polysomnographic study of sleep disturbance in community elderly with self-reported environmental chemical odor intolerance. Biol Psychiatr 40:123–133CrossRefGoogle Scholar
  120. 120.
    Daniell WE, Stockbridge HL, Labbe RF, Woods JS, Anderson KE, Bissell DM, Bloomer JR, Ellefson RD, Moore MR, Pierach CA, Schreiber WE, Tefferi A, Franklin GM (1997) Environmental chemical exposures and disturbances of heme synthesis. Environ Health Perspect 105 (Suppl. 1):37–53PubMedCrossRefGoogle Scholar
  121. 121.
    Greene GJ, Kipen HM (2002) The vomeronasal organ and chemical sensitivity: a hypothesis. Environ Health Perspect 110 (Suppl. 4):655–661PubMedGoogle Scholar
  122. 122.
    Hahn M, Bonkovsky H (1997) Multiple chemical sensitivity syndrome and porphyria. A note of caution and concern. Arch Intern Med 157:281–285Google Scholar
  123. 123.
    Haley RW, Vongpatanasin W, Wolfe GI, Bryan WW, Armitage R, Hoffmann RF, Petty F, Callahan TS, Charuvastra E, Shell WE, Marshall WW, Victor RG (2004) Blunted circadian variation in autonomic regulation of sinus node function in veterans with Gulf War syndrome. Am J Med 117:469–478PubMedCrossRefGoogle Scholar
  124. 124.
    Ross PM (2000) Chemical sensitivity and fatigue syndrome from hypoxia/hypercapnia. Med Hypotheses 54:734–738PubMedCrossRefGoogle Scholar
  125. 125.
    Bolla KI (2000) Use of neuropsychological testing in idiopathic environmental intolerance. Occup Med 15:617–625PubMedGoogle Scholar
  126. 126.
    Davidoff AL, Fogarty L, Keyl PM (2000) Psychiatric inferences from data on psychlogic/ psychiatric symptoms in multiple chemical sensitivities syndrome. Arch Environ Health 55:165–175PubMedGoogle Scholar
  127. 127.
    Papo D, Eberlein-Konig B, Berresheim HW, Huss-Marp J, Grimm V, Ring J, Behrendt H, Winneke G (2006) Chemosensory function and psychological profile in patients with multiple chemical sensitivity: comparison with odor-sensitive and asymptomatic controls. J Psychosom Res 60:199–209PubMedCrossRefGoogle Scholar
  128. 128.
    Hummel T, Roscher S, Jaumann MP, Kobal G (1996) Intranasal chemoreception in patients with Multiple Chemical Sensitivities: a double-blind investigation. Regul Toxicol Pharmacol 24:S79–S86PubMedCrossRefGoogle Scholar
  129. 129.
    Witthoft M, Gerlach AL, Bailer J (2006) Selective attention, memory bias, and symptom perception in idiopathic environmental intolerance and somatoform disorder. J Abnorm Psychol 115:397–407PubMedCrossRefGoogle Scholar
  130. 130.
    Bornschein S, Forstl H, Zilker T (2001) Idiopathic environmental intolerances (formerly multiple chemical sensitivity) psychiatric perspectives. J Intern Med 250:309–321PubMedCrossRefGoogle Scholar
  131. 131.
    Bornschein S, Hausteiner C, Zilker T, Forstl H (2002) Psychiatric and somatic disorders and multiple chemical sensitivity. Psychol Med 32:1387–1394PubMedCrossRefGoogle Scholar
  132. 132.
    Hausteiner C, Mergeay A, Borschein S, Zilker T, Forstl H (2006) New aspects of psychiatric morbidity in idiopathic environmental intolerances. J Occup Environ Med 48:76–82PubMedCrossRefGoogle Scholar
  133. 133.
    Reid S, Hotopf M, Hull L, Ismail K, Unwin C, Wessely S (2001) Multiple chemical sensitivity and chronic fatigue syndrome in British Gulf War veterans. Am J Epidemiol 15:604–609CrossRefGoogle Scholar
  134. 134.
    Staudenmayer H, Binkley KE, Leznoff A, Phillips S (2003) Idiopathic Environmental Intolerance. Part 2: a causation analysis applying Bradford Hill's criteria to the psychogenic theory. Toxicol Rev 22:247–261PubMedCrossRefGoogle Scholar
  135. 135.
    Bailer J, Witthoft M, Paul C, Bayerl C, Rist F (2005) Evidence for overlap between idiopathic environmental intolerance and somatoform disorders. Psychosom Med 67:921–929PubMedCrossRefGoogle Scholar
  136. 136.
    Bale AJ, Lee HA (2005) An observational study on diagnoses of 3,233 Gulf Veterans (Op Granby 1990–91) who attended the Ministry of Defence's Medical Assessment Programme 1993–2004. J R Nav Med Serv 91:99–111PubMedGoogle Scholar
  137. 137.
    Nawab SS, Miller CS, Dale JK, Greenberg BD, Freidman TC, Chrousos GP, Strauss SE, Rosenthal NE (2000) Self-reported sensitivity to chemical exposures in five clinical populations and health controls. Psychiatr Res 95:67–74CrossRefGoogle Scholar
  138. 138.
    Henningsson M, Sundbom E (2000) Conversion disorder and multiple chemical sensitivity: a comparative study of psychological defense strategies. Percept Motor Skills 91:803–818PubMedCrossRefGoogle Scholar
  139. 139.
    Poonai N, Antony MM, Binkley KE, Stenn P, Swinson RP, Corey P, Silverman FS, Tarlo SM (2000) Carbon dioxide inhalation challenges in idiopathic environmental intolerance. J Allergy Clin Immunol 105:358–363PubMedCrossRefGoogle Scholar
  140. 140.
    Tarlo SM, Poonai N, Binkley KE, Antony MM, Swinson RP (2002) Responses to panic induction procedures in subjects with multiple chemical sensitivity/idiopathic environmental intolerance: understanding the relationship with panic disorders. Environ Health Perspect 110 (Suppl. 4):669–671PubMedGoogle Scholar
  141. 141.
    Binkley KE, King N, Poonai N, Seeman P, Ulpian C, Kennedy J (2001) Idiopathic environmental intolerance: increased prevalence of panic disorder-associated cholecystokinin B receptor allele 7. J Allergy Clin Immunol 107:887–890PubMedCrossRefGoogle Scholar
  142. 142.
    Black DW, Okiishi C, Gabel J, Schlosser S (1999) Psychiatric illness in the first-degree relatives of persons reporting multiple chemical sensitivities. Toxicol Ind Health 15:410–414PubMedGoogle Scholar
  143. 143.
    Bell IR, Peterson JM, Schwartz GE (1995) Medical histories and psychological profiles of middle-aged women with and without self-reported illness from environmental chemicals. J Clin Psychiatr 56:151–160Google Scholar
  144. 144.
    Bell IR, Baldwin CM, Schwartz GER (2000) Sensitization studies in chemically intolerant individuals: implications for individual difference research. Ann NY Acad Sci 38–47Google Scholar
  145. 145.
    Bell IR, Miller CS, Schwartz GE, Peterson JM, Amend D (1996) Neuropsychiatric and somatic characteristics of young adults with and without self-reported chemical odor intolerance and chemical sensitivity. Arch Environ Health 51:9–21PubMedGoogle Scholar
  146. 146.
    Bell IR, Baldwin CM, Russek LG, Schwartz GE, Hardin EE (1998) Early life stress, negative paternal relationships, and chemical intolerance in middle-aged women: support for a neural sensitization model. J Womens Health 7:1135–1147PubMedCrossRefGoogle Scholar
  147. 147.
    Staudenmayer H, Selner ME, Selner JC (1993) Adult sequelae of childhood abuse presenting as environmental illness. Ann Allergy 71:538–546PubMedGoogle Scholar
  148. 148.
    Hojo S, Kumano H, Yoshino H, Kakuta K, Ishikawa S (2003) Application of Quick Environment Exposure Sensitivity Inventory (QEESI) for Japanese population: study of reliability and validity of the questionnaire. Toxicol Ind Health 19:41–49PubMedCrossRefGoogle Scholar
  149. 149.
    Kreutzer R (2000) Idiopathic environmental intolerance: case definition issues. Occup Med 15:511–517PubMedGoogle Scholar
  150. 150.
    Consensus Conference (1999) Multiple chemical sensitivity: a 1999 consensus. Arch Environ Health 54:147–149Google Scholar
  151. 151.
    McKeown-Eyssen GE, Baines CJ, Marshall LM, Jazmaji V, Sokoloff ER (2001) Multiple chemical sensitivity: discriminant validity of case definitions. Arch Environ Health 56:406–412PubMedCrossRefGoogle Scholar
  152. 152.
    Baines CJ, McKeown-Eyssen GE, Riley N, Marshall L, Jazmaji V (2006) University of Toronto case-control study of multiple chemical sensitivity-3: intra-erythrocytic mineral levels. Occup Med 57:137–140CrossRefGoogle Scholar
  153. 153.
    Gordon BR (2003) Approaches to testing for food and chemical sensitivities. Otolaryng Clin NAM 36:917–940CrossRefGoogle Scholar
  154. 154.
    Beyer K, Teuber SS (2005) Food allergy diagnostics: scientific and unproven procedures. Curr Opin Allergy Clin Immunol 5:261–266PubMedCrossRefGoogle Scholar
  155. 155.
    Hamilton RG, Peterson EL, Ownby DR (2002) Clinical and laboratory-based methods in the diagnosis of natural rubber latex allergy. J Allergy Clin Immunol 110:S47–S56PubMedCrossRefGoogle Scholar
  156. 156.
    Nettis E, Colanardi MC, Ferrannini A, Tursi A (2002) Latex hypersensitivity: personal data and review of the literature. Immunopharm Immunot 24:315–334CrossRefGoogle Scholar
  157. 157.
    Ahmed SM, Aw TC, Adisesh A (2004) Toxicological and immunological aspects of occupational latex allergy. Toxicol Rev 23:123–134PubMedCrossRefGoogle Scholar
  158. 158.
    Nedorost ST, Cooper KD (2001) The role of patch testing for chemical and protein allergens in atopic dermatitis. Curr Allergy Asthma Rep 1:323–328PubMedCrossRefGoogle Scholar
  159. 159.
    Fox RA, Sabo BM, Williams TP, Joffres MR (1999) Intradermal testing for food and chemical sensitivities: a double-blind controlled study. J Allergy Clin Immunol 103:907–911PubMedCrossRefGoogle Scholar
  160. 160.
    Rea W, Didriksen N, Simon TR, Pan Y, Fenyves EJ, Griffiths B (2003) Effects of toxic exposure to molds and mycotoxins in building-related illnesses. Arch Environ Health 58:399–405PubMedGoogle Scholar
  161. 161.
    Caccappolo E, Kipen H, Kelly-McNeil K, Knasko S, Hamer RM, Natelson B, Fiedler N (2000) Odor perception: multiple chemical sensitivities, chronic fatigue, and asthma. J Occup Environ Med 42:629–638PubMedCrossRefGoogle Scholar
  162. 162.
    Fiedler N, Kipen HM (2001) Controlled exposures to volatile organic compounds in sensitive groups. Ann NY Acad Sci 933:24–37PubMedCrossRefGoogle Scholar
  163. 163.
    Georgellis A, Lindelof B, Lundin A, Arnetz B, Hillert L (2003) Multiple chemical sensitivity in male painters; a controlled provocation study. Int J Hyg Environ Health 206:531–538PubMedCrossRefGoogle Scholar
  164. 164.
    Osterberg K, Orbaek P, Karlson B, Akesson B, Bergendorf U (2003) Annoyance and performance during the experimental chemical challenge of subjects with multiple chemical sensitivity. Scand J Work Environ Health 29:40–50PubMedGoogle Scholar
  165. 165.
    Van Thriel C, Haumann K, Kiesswetter E, Blaszkewicz M, Seeber A (2002) Time course of sensory irritations due to 2-butanone and ethyl benzene exposure: influences of self-reported multiple chemical sensitivity (MCS). Int J Hyg Environ Health 204:367–369PubMedCrossRefGoogle Scholar
  166. 166.
    Bornschein S, Hausteiner C, Drzezga A, Bartenstein P, Schwaiger M, Forstl H, Zilker T (2002) PET in patients with clear-cut multiple chemical sensitivity (MCS). Nucl Med 41:233–239Google Scholar
  167. 167.
    Heuser G, Wu JC (2001) Deep subcortical (including limbic) hypermetabolism in patients with chemical intolerance: human PET studies. Ann NY Acad Sci 933:319–322PubMedCrossRefGoogle Scholar
  168. 168.
    Nordin S, Martinkauppi M, Olofsson J, Hummel T, Millqvist E, Bende M (2005) Chemosensory perception and event-related potentials in self-reported chemical hypersensi-tivity. Int J Psychophysiol 55:243–255PubMedCrossRefGoogle Scholar
  169. 169.
    Ross GH, Rea WJ, Johnson AR, Kickey DC, Simon TR (1999) Neurotoxicity in single photon emission computed tomography brain scans of patients reporting chemical sensitivities. Toxicol Ind Health 15:415–420PubMedGoogle Scholar
  170. 170.
    Hillert L, Musabasic V, Berglund H, Ciumas C, Savic I (2007) Odor processing in multiple chemical sensitivity. Human Brain Mapp 28:172–182CrossRefGoogle Scholar
  171. 171.
    Fukuda K, Strauss SE, Hickie J, Sharpe MC, Dobbins JG, Komaroff A (1994) The chronic fatigue syndrome – a comprehensive approach to its definition and study. Ann Intern Med 121:953–959PubMedGoogle Scholar
  172. 172.
    Wiener G, Pedrosa GF, Nowak D (2005) Multiple chemical sensitivity (MCS) – a case series [German]. Deut Med Wochenschr 130:329–332CrossRefGoogle Scholar
  173. 173.
    Lipson JG (2001) We are the canaries self-care in multiple chemical sensitivity sufferers. Qual Health Res 11:103–116PubMedCrossRefGoogle Scholar
  174. 174.
    Gibson PR, Elms AN, Ruding LA (2004) Perceived treatment efficacy for conventional and alternative therapies reported by person with multiple chemical sensitivity. Environ Health Perspect 111:1498–1504Google Scholar
  175. 175.
    Engel CC, Adkins JA, Cowan DN (2002) Caring for medically unexplained physical symptoms after toxic environmental exposures: effects of contested causation. Environ Health Perspect 110 (Suppl. 4):641–647PubMedGoogle Scholar
  176. 176.
    Gupta K, Horne R (2001) The influence of health beliefs on the presentation and consultation outcome in patients with chemical sensitivities. J Psychosom Res 50:131–137PubMedCrossRefGoogle Scholar
  177. 177.
    Andine P, Ronnback L, Jarvholm B (1997) Successful use of a selective serotonin reuptake inhibitor in a patient with multiple chemical sensitivities. Acta Psychiatr Scand 96:82–83PubMedCrossRefGoogle Scholar
  178. 178.
    Lacour M, Zunder T, Dettenkofer M, Schönbeck S, Lüdtke R, Scheid C (2002) An interdisciplinary therapeutic approach for dealing wit patients attributing chronic fatigue and functional memory disorders to environmental poisoning — a pilot study. Int J Hyg Environ Health 204:339–346PubMedCrossRefGoogle Scholar
  179. 179.
    Rea WJ, Pan Y, Johnson AR (1996) Reduction of chemical sensitivity by means of heat depuration, physical therapy and nutritional supplementation in a controlled environment. J Occup Environ Med 6:141–148Google Scholar
  180. 180.
    Staudenmayer H (2000) Psychological treatment of psychogenic idiopathic environmental intolerance. Occup Med 15:627–646PubMedGoogle Scholar
  181. 181.
    Teuber SS, Porch-Curren C (2003) Unproved diagnostic and therapeutic approaches to food allergy and intolerance. Curr Opin Allergy Clin Immunol 3:217–221PubMedCrossRefGoogle Scholar
  182. 182.
    Lacour M, Zunder T, Restle A, Schwarzer G (2004) No evidence for an impact of selenium supplementation on environment associated health disorders — a systematic review. Int J Hyg Environ Health 2007:1–13CrossRefGoogle Scholar

Copyright information

© Springer 2009

Authors and Affiliations

  • Michael Lacour
    • 1
  • Klaus Schmidtke
    • 2
  • Peter Vaith
    • 3
  • Carl Scheidt
    • 1
  1. 1.Department of Psychotherapy and Psychosomatic MedicineFreiburg University HospitalFreiburgGermany
  2. 2.Center for Geriatric Medicine and GerontologyFreiburg University HospitalFreiburgGermany
  3. 3.Department of Rheumatology and Clinical ImmunologyFreiburg University HospitalFreiburgGermany

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