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Multiple Chemical Sensitivity, MCS

Contents

List of scientific terms and abbreviations

Preface

Summary and conclusions

1 Introduction

• 1.1 About the report
• 1.2 Sources of information

2 History, definition, name, and delimitation in relation to other syndromes

• 2.1 MCS, development history
  • 2.1.1 Sensitivity in a toxicological context
  • 2.1.2 Disease, illness, syndrome
• 2.2 Description of MCS
  • 2.2.1 MCS symptoms
  • 2.2.2 MCS definition
  • 2.2.3 MCS, course
  • 2.2.4 MCS synonyms
• 2.3 Delimitation in relation to other syndromes and illnesses
• 2.4 Comments

3 Conferences, workshops, and reports on MCS

• 3.1 Activities in the US
  • 3.1.1 Conferences, workshops, and expert reports
  • 3.1.2 The US - The intersectorial government committee: Interagency working group
  • 3.1.3 The attitudes of professional medical organisations to MCS problems
  • 3.1.4 Comments
• 3.2 Activities in Canada
• 3.3 Activities in Europe
  • 3.3.1 Report from the Environmental Directorate of the EU, 1996
  • 3.3.2 Report to the British Health and Safety Executive (HSE)
  • 3.3.3 Report from the British Society for Allergy, Environmental and Nutritional Medicine (BSAENM)
• 3.4 Activities under the UN / WHO
• 3.5 Conclusions

4 Examples of MCS

• 4.1 MCS after exposure to organic solvents
  • 4.1.1 MCS in workers after acute exposure to gasoline fumes during tunnel construction work
  • 4.1.2 MCS after exposure to plastics
• 4.2 MCS after exposure to pesticides
  • 4.2.1 The situation in Denmark
• 4.3 Wood preservatives - pentachlorophenol (PCP) in Germany
  • 4.3.1 MCS after exposure to Rentolin in Denmark
• 4.4 MCS in relation to indoor climate
• 4.5 The Gulf War Syndrome (GWS)
• 4.6 Comments
• 4.7 Chemicals which can cause MCS
  • 4.7.1 Chemicals and initial exposure in connection with MCS
  • 4.7.2 Chemicals which cause multiple reactions (trigger substances)

5 Frequency

• 5.1 Prevalence
  • 5.1.1 Prevalence of MCS in occupational medicine materials
• 5.2 Incidence
• 5.3 Prevalence according to environmental physicians and patient associations
  • 5.3.1 Frequency of MCS in Denmark according to patient associations
• 5.4 Comments

6 Possible causes and mechanisms of illness

• 6.1 Immunological mechanisms
• 6.2 Mechanisms in the mucous membrane of the nose
• 6.3 Neurological mechanisms
  • 6.3.1 The olfactory-limbic system
  • 6.3.2 Other mechanisms related to the neurogenic mechanism
  • 6.3.3 Changes in the functioning of the brain
• 6.4 Psychological mechanisms
  • 6.4.1 Conditioned reflexes (Pavlov's reflex)
  • 6.4.2 Psychogenic factors
  • 6.4.3 Environmental somatization syndrome
• 6.5 Toxic-induced loss of tolerance (TILT)
• 6.6 Illness model based on clinical ecology
• 6.7 Discussion
• 6.8 Conclusion

7 Methods of examination and diagnosis

• 7.1 Methods of examination
• 7.2 Diagnosing MCS
• 7.3 Comments and conclusion

8 How MCS is dealt with by the authorities

• 8.1 The US and Canada
  • 8.1.1 Regulation and recognition
  • 8.1.2 Conclusion
• 8.2 Europe
  • 8.2.1 Regulation and recognition
  • 8.2.2 Other activities
  • 8.2.3 Conclusion
• 8.3 Conditions in Denmark
  • 8.3.1 Authorities
  • 8.3.2 Examination of persons with MCS
  • 8.3.3 The Danish MCS Organisation
  • 8.3.4 Conclusion and recommendations

9 Summary, conclusions and recommendations

• 9.1 Summary
  • 9.1.1 Aim
  • 9.1.2 Description and definition of MCS
  • 9.1.3 International activities and research
  • 9.1.4 Examples of MCS
  • 9.1.5 Prevalence
  • 9.1.6 Possible mechanisms
  • 9.1.7 Methods of examination and diagnosis
  • 9.1.8 The handling of MCS by the authorities in the US and Europe
  • 9.1.9 Conditions in Denmark
• 9.2 Conclusions
• 9.3 Recommendations

10 References

Annex A

Annex B

Annex C

Annex D

Annex E

Annex F

Annex G

Annex H

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Version 1.0 March 2005, © Danish Environmental Protection Agency