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Multiple Chemical Sensitivity, MCS
Annex B
Recommendations from three working groups under the NRC Workshop 1991 (Interagency report, 1998)
Clinical Evaluation working group:
- Prospective longitudinal studies of exposure-based events are very important and should be performed.
- A research priority should be the study of the adaptation - de-adaptation hypothesis, and the study should be pursued using an ECU. In addition, a second approach should evaluate individuals, over
time, in their usual environment.
- Selection of research subjects should be based on the specific hypothesis to be tested (e.g., symptom-based, exposure-based, and population-based).
- Development of a database of chemicals, foods, drugs, and signs and symptoms reported to be associated with MCS is important.
Exposures and Mechanisms working group:
- Studies should include a comprehensive history, including exposures, physical examination, and appropriate laboratory testing. Endpoints for response should include immunological, neurological,
endocrinological, psychological, social, and other markers or measures.
- Dose-response relationships should be examined.
- Animal models should be developed that mimic the human syndrome.
- Tissues obtained by biopsy and necropsy from patients, animals, and their controls should be evaluated for signs of pathologic change.
Epidemiology working group:
- The magnitude of the problem caused by MCS in the general population should be determined.
- Multi-centre, clinical case-comparison studies in occupational/environmental medicine clinics should be an early priority.
- A broad set of symptom prevalences should be utilized that will allow flexible construction of a variety of case definitions.
- Population-based methods, including construction of survey instruments, should be used to determine the basic descriptive epidemiology of certain multi-organ disorders that have been linked to MCS
(e.g., systemic lupus erythematosus, scleroderma, multiple sclerosis, and somatization disorder).
- Prompt studies of defined populations subjected to discrete and sudden chemical exposures should be enacted to assess the initiation and natural history of sensitivity syndromes involving
environmental chemicals.
- Normal ranges for new test modalities, including the sensitivity and specificity of screening techniques and biomarkers, should be determined.
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Version 1.0 March 2005, © Danish Environmental Protection Agency
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