Special Concerns for Women
Multiple Chemical Sensitivities
As the environments in which we live and work have become more polluted, increasing numbers of people report developing a condition referred to as multiple chemical sensitivity or multiple chemical sensitivities (MCS); other terms for MCS include environmental illness and chemical intolerance. MCS is almost always expressed as symptoms that wax and wane--depending on current environmental exposure--typically affecting multiple organ systems (for example, respiratory, neurological, cardiovascular, musculoskeletal, immune, and digestive), either simultaneously or sequentially, in a particular person. Health care practitioners are beginning to recognize that MCS is a real physiological problem, although much remains to be learned about its various causes and treatments.
There has been insufficient scientifically sound research on this perplexing condition. Nevertheless, evidence from around the globe suggests that a wide variety of chemical exposures, including indoor and outdoor air pollutants, as well as a severe viral illness, can make those of us who are susceptible feel sick. Subsequently, we find that we can no longer tolerate everyday substances--those that don’t bother most people and never bothered us before. Over time, our sensitivities seem to spread to common cleaning and remodeling products, foods, medications, alcoholic beverages, and caffeine, a process that has been called toxicant-induced loss of tolerance, or TILT.33 Most of us suffer from long-term disabilities and lead restricted lives.
Once the condition develops, symptoms may be triggered by a wide variety of everyday exposures, including: pesticides, mothballs, and air fresheners; new construction and renovation materials, such as carpeting, plastics, fresh paint, particleboard, formaldehyde, and adhesives; release of chemicals from office equipment and supplies such as correction fluid, felt-tip markers, new computers, printers, and photocopy toners; incomplete combustion products from fuels such as gasoline, oil, and wood; scented cleaning and laundry products; fabric softeners; cosmetics containing fragrances; and hair spray, nail polish, and nail polish remover. These toxicants are ubiquitous, present in most indoor environments, where 90 percent of Americans spend 90 percent of each day. Different individuals describe being affected in different ways and to a different degree, depending upon genetic makeup and the extent to which we have been exposed to harmful substances in the past.
It appears that MCS is not simply an allergic response. Common symptoms include irritated eyes, nose, and throat; respiratory difficulties; fast or irregular heartbeat; digestive disturbances and adverse food reactions; joint pain; incapacitating exhaustion; drowsiness; headaches; dizziness; disorientation; impaired concentration and memory; and seizures. Hormonal differences may explain why more women than men report suffering from MCS, although both sexes are affected. Also, women and children may be more vulnerable to toxic exposures because of lower body weight or a higher proportion of body fat (certain toxic chemicals accumulate in fat).
Most health care providers know little about MCS and may not yet recognize it as a legitimate physical illness. Hence, troubling multi-organ symptoms may go undiagnosed, and patients may be referred to psychiatrists as a last resort. It is important for health care providers to remain open-minded and respectful of a patient’s ability to cope, and to offer healthier alternatives. Just because a woman reports so-called psychological symptoms--such as fatigue, depression, irritability, anxiety, or cognitive difficulties--does not mean that these symptoms are caused by her mind and emotions.
At the present time, no laboratory test is available for clearly diagnosing MCS, and there is no generally agreed-upon case definition used by doctors or researchers. However, those of us who suffer from MCS feel far different than we did before the toxic exposure--usually hyper-reactive to substances we might ingest, breathe, or touch, often with the following response pattern: cognitive changes (sometimes experienced as “brain fog,” brain fatigue, or a feeling of being drunk or spacey); heightened senses of taste and smell that trigger adverse reactions; irritation or burning of the mucous membranes of the eyes, nose, and throat; swelling or inflammation of tissue; and being hypersensitive to physical agents, such as light, sound, and touch.
Avoiding chemicals that trigger adverse reactions is the first line of defense for chemically sensitive individuals. Lifestyle changes (for example, moving to a different home or job, changing heating systems, or removing carpeting) can reduce exposure and lead to improved health and regaining of tolerance. On the other hand, these interventions can be costly and may not always have the desired effect. MCS can be draining physically, emotionally, and financially for all of us who experience it or are close to someone who has it. Both professional and self-help groups may serve as good sources of support and information (see "Resources").
Studies worldwide suggest that the number of people who report chemical intolerances is large--about 15 percent in the United States34--making this potentially one of the most prevalent environmentally induced illnesses. The problem appears to have grown rapidly since World War II, as exposures to synthetic chemicals have increased. New construction practices since the mid-1970s have led to tightly enclosed, energy-efficient homes, schools, and other buildings containing new materials that off-gas low levels of chemicals without sufficient dilution from outside (fresh) air. Reducing our exposures to toxic chemicals may well be the best way to reverse the rise of MCS. This will require widespread education of health care providers and the public; major political and grassroots efforts; and enormous shifts in personal, community, and industry practices regarding chemical use--changes that involve every sphere of our lives.
Excerpted from the 2005 edition of Our Bodies, Ourselves, © 2005, Boston Women's Health Book Collective.
33. For more information, see Nicholas Ashford and Claudia Miller, Chemical Exposures: Low Levels and High Stakes (New York: John Wiley and Sons, 1998).
34. National Research Council, Multiple Chemical Sensitivities: Addendum to Biologic Markers in Immunotoxicology (Washington, DC: National Academy Press, 1992).
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